HEALTH LINEBRIEFS

Benefits seen forhigh-risk women inovary removal

CHICAGO (AP) — Newresearch suggests surgery toremove healthy ovaries givesa triple benefit to somewomen at high risk for can-cer. It lowers their threat ofbreast and ovarian cancer,and boosts their chances ofliving longer.

The women in the studyhad BRCA gene mutations.They got counseling to helpthem decide between preven-tive surgery or more screen-ing to watch for signs of can-cer. The study is the largestto date to find advantagesfrom surgery for these high-risk women.

The study appears inWednesday's Journal of theAmerican MedicalAssociation.

Most common'moderate' activityin US? – Preparing a mealOnly a tiny fraction ofAmericans heed the advice totake part in moderate or vig-orous activity to keep weightdown and stay healthy, andwhen they do, they're likely todo something a little self-defeating: prepare food.

Those are two key findingsof a study publishedWednesday in the AmericanJournal of PreventiveMedicine.

Only 5.07 percent ofAmericans reported doing anyvigorous-intensity activitylike running, while at theother end of the scale, morethan 95 percent said they hadengaged in the highly seden-tary activity of eating anddrinking.

The next most commonactivity was another sedentaryone -- watching television ora movie, which eight in 10Americans did.

The "most frequently report-ed moderate activities werefood and drink preparation(25.7 percent), followed bylawn, garden, and houseplantcare (10.6 percent)," the studysaid.

Lead author of the studyCatrine Tudor-Locke saidknowing what kind of activi-ties Americans do "can informintervention strategies aimedat improving energy balance,"or the balance of calories con-sumed by eating and drinkingcompared to calories burnedthrough physical activity.

September 2010

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LAURAN NEERGAARD,AP Medical Writer

WASHINGTON (AP) — It'sflu-shot season already, andfor the first time healthauthorities are urging nearlyeveryone to get vaccinated.There is even a new high-dose version for people 65 orolder.

What a difference a year

makes: Crowds lined up forhours for scarce shots duringlast fall's swine flu pandemic,when infections peaked wellbefore enough vaccine couldbe produced. This year, arecord vaccine supply isexpected — an all-in-oneinoculation that now promis-es protection against thatswine flu strain plus twoother kinds of influenza.

Shipments began so earlythat drugstores are offering

vaccinations amid their back-to-school sales.

But without last year's scarefactor, the question is howmany people will heed thenew policy for near-universalvaccination. No more stop-ping to check if you're on ahigh-risk list: A yearly doseis recommended for virtuallyeveryone except babiesyounger than 6 months — the

shot isn't approved for totsthat young — and peoplewith severe allergies to theeggs used to brew it.

"Influenza is serious, andanyone, including healthypeople, can get the flu andspread the flu," said Dr. AnneSchuchat of the Centers forDisease Control andPrevention. "Flu vaccines arethe best way to protect your-self and those around you."continued on page 6

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MIKE STOBBE,AP Medical Writer

ATLANTA (AP) — An apple a day?Apparently not in the United States.

Most Americans still don't eat vegetablesoften enough, and fruit consumption is actu-ally dropping a little, according to a newgovernment report released Thursday.

The Centers for Disease Control andPrevention found that last year about one-third of U.S. adults consumed fruit or fruitjuice at least twice a day. That's down slight-ly from more than 34 percent in 2000.

Only about 26 percent ate vegetables threeor more times a day, the same as in 2000.The statistics come from a national tele-

phone survey of hundreds of thousands ofAmericans.

No state met federal goals of three-quartersof Americans eating enough fruit, and halfeating enough vegetables. California ate themost fruit and Tennessee was best with veg-etables. Oklahoma was at the bottom forfruit and South Dakota had the lowest veg-etable consumption.

The report did not ask people which fruitsand vegetables they ate the most. But a CDCstudy published last year concluded thatorange juice is the top source of fruit amongU.S. adults and adolescents, and potatoes arethe favorite vegetable.

Health officials have been trying to promote

fruits and vegetables — especially leafygreens — as healthy alternatives to salty,fatty and sugary foods. The goal is to curbthe nation's obesity problem and reduce dia-betes, heart disease and other maladies tiedto bad diets.

The 2009 data are discouraging, said Dr.Jennifer Foltz, one of the study's authors.

"We aren't making progress, that's for sure,"said Foltz, a CDC epidemiologist.

However, the study was done before a newwave of government efforts to promotehome and community gardens and to expandthe sale of fruits and vegetables at stores. Asurvey planned for 2011 hopefully will showan improvement, she said.

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8 HealthShortcuts ThatWork page 4

Information on the flu vaccine sits on a desk, Friday, Aug. 27,2010, in Rockville, Md. It's flu-shot season again, and for thefirst time health authorities are urging nearly everyone to getvaccinated _ and people 65 or older even can choose to try anew high-dose version. (AP Photo/Evan Vucci)

By LEE BOWMANScripps Howard News Service

When you're sick or hurt,you go to the doctor -- but notnecessarily your personal doc-tor.A new study published in the

journal Health Affairs showsthat only 45 percent of morethan 350 million U.S. patientvisits for a newly arisinghealth complaint such as acough, fever or stomach paintake place with a primary-carephysician each year.

The rest take place at a hos-pital emergency room (28 per-cent), medical specialist'soffice (20 percent) or outpa-tient clinic (7 percent).

The report, based on govern-ment surveys of outpatientvisits made between 2001 and2004, found that patients with-out health insurance receivedmore than half of their acutecare in emergency depart-ments.But other recent research has

found that even many insuredfamilies either don't have aregular doctor or have difficul-ty securing a timely appoint-ment if they do.A 2006 study estimated thatmore than 60 millionAmericans lack any relation-ship with a family doctor, anumber that's likely swelledduring the recession.continued on page 6

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(HealthDay News) — Repeatimpaired-driving offendershave subtle deficits in theirdecision-making abilities thatmay not be detected throughconventional tests, says a newstudy.

Researchers assessed 34male, second-time DUI (driv-ing under the influence)offenders enrolled in a reha-bilitation program and a con-trol group of 31 healthy, non-offenders matched for age,education, and alcohol use.All the participants under-

went psychiatric assessmentsad conventional neuropsycho-logical testing, including thethe Iowa Gambling Task(IGT), to help assess person-ality patterns.

The IGT, Kasar explained, isused in many studies investi-gating alcohol problemsbecause it simulates real-lifedecision-making.

“We found that second-timeDUI offenders have a poorerperformance on the IGT testthan their matched counter-parts,” Muzaffer Kasar, a res-ident in psychiatry at theBakirkoy Research andTraining Hospital in Istanbul,

Turkey, said in a journal newsrelease.

In contrast, he and colleagueDavid J. Nutt, a professor ofpsychiatry at ImperialCollege London in the U.K.,found no differences betweenthe repeat DUI offenders andthe control group on conven-tional neuropsychologicaltesting and temperament andcharacter testing (TCI) scores.

“These findings suggest thatsecond-time DUI offendersdo not suffer from motorimpulsiveness — that is, alack of impulse control in‘here and now’ situations,”Nutt said. Instead, heexplained, “they suffer fromcognitive impulsiveness,which depends on associating

negative experiences withpossible negative conse-quences.”

In other words, “there arebrain reasons for why peoplemake poor choices regardingDUI,” he added.

The researchers urged thatsuch testing be expanded forpeople convicted of DUI,which they noted accountedfor 40 percent of the fatalmotor vehicle crashes in theUnited States. In addition,they said, 33 percent of theDUI drivers were recidivists,or repeat offenders.

The study appears onlineand in the December printissue of the journalAlcoholism: Clinical &Experimental Research.

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By Kendall Atkins LivickStaff Writer

Blue is the color for themonth of September, which isprostate cancer awarenessmonth; but “blue” would bethe last adjective used todescribe Hal Blake Amos, ofPikeville, who considers him-self a prostate cancer survivor.

"It sure made it easier toknow that people love youeven though you're old anddying," he said, laughing. “Ido have a sense of humor.Sometimes I'm told that it'sreally weird. You joke throughthis treatment. If you werereally serious all the time, itwould be a lot harder."

Aside from his sense ofhumor, Amos said his strongfaith in God, as well as thelove surrounding him from hisfamily and PikevilleMethodist Church family, iswhat saved him from this dis-ease.

"That love medicine is bet-ter than any of it, I tell you,”he said.

Amos said the love andconfidence from his devoutlyreligious wife and number onesupporter, Jane Amos, specifi-cally, was the glue that heldhim together during this time.

Jane said she never doubt-ed for a single moment, thathe would survive.

"I didn't want anybody tospeak anything negativearound him,” she said.

She even forbade anyonearound him from praying neg-atively, suggesting or enter-taining the idea that anythingother than healing, couldcome out of this battle.

“I'm very intuitive to theHoly Spirit," she said. “God isnot the author of sickness or

disease. He is the God ofhealing.”

This was the assurance thatAmos said kept him going,but that’s not to say he wasn’tafraid.

"The big C always scareseveryone,” Amos said. "Italways happens to someoneelse, but when it happens toyou, it is very frightening."continued on page 2

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Prostate cancer survivor, Hal Blake Amos, of Pikeville,said he is thankful to the Lord to be alive and well, andthrilled at the chance to spend afternoons such as thiswith his “little angel” of a granddaughter, Sidney Ratliff.

Page 2 • September 2010 • HEALTHLINE

HEALTHY LIVING

One in six men today will bediagnosed with prostate can-cer, now the most commontype of cancer next to skincancer. But is there anythingmen can do to lower their riskof getting prostate cancer?The answer is "yes" and "no."

There are some factors mencan control and others theycannot control. More alarm-ing is that there are some sup-plements being marketed tomen that are completelyunproven in lowering risk andcould be potentially harmful.Beyond control

Age: The risk of prostate can-cer increases with age. It ismost common in men overage 65. Eighty percent of menwho reach age 80 haveprostate cancer.

Race: African-American menare 60 percent more likely todevelop prostate cancer whencompared to Caucasian men.Japanese and African malesliving in their native countrieshave a low incidence ofprostate cancer. However,rates sharply increase forthese men when they immi-grate to the U.S.

Family history: A man witha father or brother who hadprostate cancer is twice aslikely to develop the disease.The risk is further increasedif the cancer is diagnosed infamily members before age55 or it affected three or morefamily members.

Where men live: Some stud-ies have suggested that menwho live in northern statesmay have a higher risk ofdying from prostate cancer.The lack of sunlight duringwinter months may have anegative effect on prostatehealth and can be addressedwith vitamin D supplementa-tion.

Within control

Diet: Some research suggeststhat prostate cancer may berelated to a high-fat diet. Thebest diet for prostate health isalso the heart-healthy dietrecommended by theAmerican Heart Association.A diet high in the antioxidantlycopene as found in somefruits and vegetables such astomatoes, pink grapefruit andwatermelon may also lowerprostate cancer risk.

Obesity: Obese men aremore often diagnosed withaggressive prostate cancer soit's important to lose weightand keep body mass indexdown.

Exercise: A healthy lifestyle,including exercise, helps tokeep obesity and a high-fatdiet in check, both risk fac-tors for prostate cancer.

Smoking: Smokers are moreoften diagnosed with aggres-sive prostate cancer so menare advised to stop smokingfor better risk control.

High calcium intake: Somestudies believe that high cal-cium intake may also be arisk factor for developing thedisease.

Medications: Aspirin andcholesterol-lowering drugs(statins) also may reduce therisk of the disease.

Myths and non-risksThe most common risk mis-perception is that other non-cancerous conditions of theprostate will cause prostatecancer. Some prostate condi-tions can cause similar symp-toms to prostate cancer andshould be evaluated but theydo not increase the risk ofprostate cancer.

Benign Prostatic Hyperplasia(BPH): This enlargementdoes not cause prostate can-cer.

Prostatitis: This is an infec-tion in the prostate and alsodoes not cause prostate can-cer.

Sexual activity: Studies showno correlation between sexualactivity and a higher rate ofprostate cancer. Similarly,having a vasectomy does notincrease a man's risk for thedisease.

Alcohol: There is no linkbetween alcohol and prostatecancer risk.

Supplements: Beware of"doctor-proven" supplementsthat are heavily marketedwith a promise of improvingprostate health. There is nobenefit proven to these med-ications and in fact one med-ication, PC-SPES, provedfatal for men 10 years ago bycausing blood clots and wasbanned by the Food and Drug

Administration. Men mustrealize that prostate health isa big business now andapproach all supplementswith caution, realizing somecan cause toxic and otherserious side effects.

Most prostate cancer is dis-covered through routinescreening. Most medicalorganizations recommend thatmen begin prostate cancerscreening in their 50s orsooner for men who have riskfactors for prostate cancer.Screenings are the essentialtool in reducing risk factorsfor aggressive prostate cancer.Men should take full advan-tage of screenings and otherways of reducing their risk ofthis disease.

Brian J. Moran, M.D., is aradiation oncologist from theChicago area who treatspatients at Adventist HinsdaleHospital and Adventist LaGrange Memorial Hospital

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Amos said he wasable to fight offthe cancer and thefear, with theencouragement

of not onlyhis fami-

ly, butwiththephysi-

cians, radiologists,nurses and assis-tants at Pikeville

Medical Center—people he now considers fam-ily, as well.

When Amos, then 71,went in for his annual, rou-tine checkup in February of2008, he wasn’t even havingsymptoms related to hisprostate. For all he knew, hewas healthy; but his PSA(prostate-specific antigen)screening told a differentstory.

“Usually, it's a cancer thatisn't associated with anysigns or symptoms, becausethe PSA picks it up veryearly in most cases,” Dr. JohnR. Simmons, PikevilleMedical Center radiationoncologist said.

Simmons said catchingthis cancer early, is usually alifesaver, because in the earlystages, the treatment optionsare abundant. These optionsusually include, radiation,surgery, hormone therapy,and in some cases, dependingon the stage, severity and ageof the patient, a simple watchand wait policy.

"The early patients usuallydo really well with 90 per-cent overall survival, so alltreatment options are prettyequal,” Simmons said.

When Amos was firstdiagnosed, he faced threeoptions. The first, was in thewords of Amos, a “surgicallyinvasive” removal of hisprostate gland. Anotheroption, was to have seeds ofradium implanted into hisprostate, which would remainthere forever, constantlyemitting radiation. The lastwas the standard 42 treat-ments of radiation. He chosethe ladder.

“The Lord helped me

through it, along with theseradiation people who werewonderful and encouragingevery day," he said.

Amos, wanting to givecredit where he felt creditwas due, said the people sur-rounding him made his treat-ments, not only bearable, butpain free. He never missed aday of work at ChrismanInsurance and said this treat-ment option was not as timeconsuming as one mightassume.

Now at the age of 74,Amos has been feeling hisenergy come back to him andsaid though he is older nowthan he was when he firstfound out he had cancer, heis feeling like his old self.

Since Amos’s treatment,which took place a couple ofyears ago, Pikeville MedicalCenter has acquired a newmachine for treating patients.Simmons said this new, “stateof the art” machine, called thetrilogy linear accelerator, cangive the patients their radia-tion in only two minutes,because it localizes the radia-tion directly to the prostategland.

“It's made a whole worldof difference in their ability toget back to work and do thethings that they need to do,”Simmons said.

Physicians agreed thisquick treatment is extremelyconvenient and helpful, espe-cially considering thatprostate cancer is the leadingcause of cancer in men.

In addition to the trilogylinear accelerator, anotherrelief effort by the hospital tohelp men dealing with thisproblem, is a support group.Simmons, along with Dr.Bharat Jenigiri, PikevilleMedical Center oncologist,started up the group, whichmeets in the cancer centerlobby every other month todiscuss anything and every-thing related to prostate can-cer. The men bring theirspouses, children and anyother supporter who wants tocome.

The doctors said they aimto create a safe space for mento talk about their problems

pertaining to the illness andtreatment, such as moodchanges and sexual perform-ance—topics that would ordi-narily be considered taboo formen to talk about. Their nextmeeting will take place onMonday, Oct. 19, at 6 p.m.

When it comes to prostatecancer, the main tip doctorsrecommend, is for men tohave regular screenings.

"I want people to continuedoing the screening,” said Dr.Rafael Rangel, of the PikeCounty Health Department’sMale Clinic. “I think thescreening is very important."

And those who don’t thinkthey can afford the screen-ings, should not be discour-aged. There are plenty of freescreening events sponsoredby various health organiza-tions around town, throughoutthe year.

Amos said he is certainlyglad he was able to catch hisprostate cancer early and nipit in the bud when he did.Now he said he relishes inspending time with his fami-ly—especially his 6-year-oldgranddaughter, Sidney BlakeRatliff, whom he sees nearlyevery day and refers to as his“little angel.”

"You know, we're dyingevery day,” he said. “Withevery heartbeat you get closerto death. Of course you neverthink about things like thatuntil you get sick. It sure doesgive you a different outlookon life."

The experience of prostatecancer gave Amos a chanceto reflect on life and death,and he said he knows exactlywhere he is going when hislife is over.

"I think I'm going to be inthe arms of God,” he said.“That makes it easier also. Asa Christian would you ratherbe here on Earth or wouldyou want to be in the arms ofGod?"

Amos said his wife, chil-dren and grandchildren offera powerful persuasion thathas kept him fighting to stayhere on Earth; but one day, hewants to be in the arms of theLord—one day, and not amoment too soon.

Prostate Cancer Survivor continued from page 1

By Kendall Atkins LivickStaff Writer

Get ready EasternKentucky! Breast cancerawareness month is upon us,and some spirited ladies arepreparing topaint thetown pink!

56-year-old breastcancer sur-vivor, LindaRatliff ofPike County,said she can’twait to participate in some ofthe upcoming events inOctober.

“I’m glad I’m here to doit,” she said. “Well I’m notglad. I’m blessed I’m here todo it, is actually the rightphrase.”Shirley Coleman, PikevilleMedical cancer center pro-gram coordinator, said thereis one big event for Octoberthat is set in stone. That is theHot Pink and Cool BluesBash, which will take placeMonday, Oct. 4, at Mark V,Landmark Inn, in Pikeville.This event will include musicby “Jaguars,’” heavy horsd’oeuvres, a live silent auc-tion, a surprise display, anddancing. Hot Pink and CoolBlues Bash, is sponsored byABC (After Breast Cancer)support group at PikevilleMedical Center. Single tick-ets are $25, and a corporatetable for 10, s $250. Themoney goes to help providefree mammograms for thosewho are uninsured, and tohelp collect needed items forcancer patients going throughtreatment.

Aside from this, Colemansaid the ABC support group,will set up various informa-tional booths to heightenbreast cancer awareness atseveral businesses. Themembers will work thesebooths at their convenience.

"When you look at thebreast Cancer rates in theUnited States, one in eight

women will develop breastcancer,” Dr. John R.Simmons, Pikeville MedicalCenter radiation oncologistsaid. “Most of those will besurvivors, and the peoplewho are survivors really real-

ize whatanguish andstress theywent through,and their fami-ly wentthrough, andthey reallywant to reachout to help

those as they deal with theirdiagnosis and treatment.”

Ratliff said this is exactlywhat she is excited to do thisOctober.

“It makes me proud to talkto the women who are juststarting and tell them there isa light at the end of the tun-nel,” she said.

Simmons said part of thejoy of being a doctor, is see-ing his patients out and thriv-ing within the community.

“They've taken what couldhave been a great adversity,and turned it into a greatstrength in their lives,” hesaid. “It's a wonderful placeto be, to see those people thatyou've treated doing so welland back to their normal lifeand happy."

Physicians agree this actof coming together in cele-bration, is an integral part ofthe healing process.

"I think any time youcome together as a group andhave that social support, itabsolutely helps you getthrough that process,” VickyMorgan, Pikeville MedicalCenter oncology physiciansaid.

Breast cancer awareness isfor everyone, so whether youare a survivor, are currentlygoing through treatment, area woman, or know one, comeout and sport the pink ribbon.

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HEALTHLINE • September 2010 • Page 3

Page 4 • September 2010 • HEALTHLINE

The fibro-food connectionFibromyalgia is notoriously difficult to treat.Medication tends to reduce muscle pain,fatigue, and other symptoms of the chroniccondition by just 30% to 50%. As a result,many patients turn to diet and lifestyle changesfor added relief.

Learning which foods to avoid is a good placeto start, since fibro patients often have foodsensitivities that may not show up in food aller-gy tests. In one survey, 42% reported that cer-tain foods made their pain and stiffness worse.

How does food affect pain?Experts believe that oversensitive nerve cells inthe spinal cord and brain may be involved inthe way fibro patients process pain. Certainfoods may trigger the release of neurotransmit-ters that heighten this sensitivity, says DanielArkfeld, MD, a rheumatologist at theUniversity of Southern California's KeckSchool of Medicine.

Although the research on diet and fibromyalgiais limited, experts suggest that the following 10healthy eating rules can’t hurt, and may helppeople dealing with chronic pain.

Eat more fresh foodsRoughly half of fibro patients also suffer fromirritable bowel syndrome (IBS). Eating a diet offresh foods, devoid of preservatives and addi-tives, may ease fibro symptoms associated withIBS, says Dr. Arkfeld. "Foods that irritate yourbowel will trigger the body to send a messageto the brain that signals fibromyalgia symp-toms," he explains.

Whenever possible, it’s also a good idea to buyorganic food. “Some patients do better avoidingpesticides and chemicals,” says Dr. Arkfeld.

Don't OD on caffeineFibromyalgia is believed to be linked to animbalance of brain chemicals that controlmood, and it is often accompanied by unrestfulsleep and fatigue. Fibro patients may try to easefatigue with stimulants like caffeine, but theymay end up doing more harm than good in thelong run.

“Caffeine is a loan shark for energy. We recom-mend not using a lot,” says Kent Holtorf, MD,founding medical director of the Fibromyalgiaand Fatigue Centers, which are located acrossthe country.

Steer clear of some veggies"For joint pains, a lot of people say avoid

nightshade vegetables," says Dr. Arkfeld.Normally, veggies are low-cal, healthy options,but the nightshade variety—including tomatoes,potatoes, and eggplants—are believed to aggra-vate arthritis and pain in some people.

"The thought is that they have components thatare neurotoxins," says Dr. Holtorf. "For a smallpercentage of patients, cutting them out makesa dramatic difference."

Get plenty of omega-3sOmega-3 fatty acids, found in salmon and avariety of fish, have been touted as a heart-healthy food, and they may help with pain aswell. "The fatty acids are great," says Dr.Holtorf. "They reduce the inflammation andhelp brain function."

A 2006 survey of arthritis patients found thatdaily fish oil supplements reduced pain symp-toms in 60% of the patients. Omega-3s havenot, however, been tested on fibromyalgiapatients specifically.

Easy on the yeastYeast, along with its partner in crime, gluten,can be found in a variety of baked goods.Consuming yeast may contribute to the growthof yeast fungus in the body, which can add topain, says Dr. Holtorf.

Fibromyalgia patients may also be more proneto gluten sensitivities. "Celiac disease is seen ina subset of patients. Avoiding [yeast and gluten]can help some patients improve," says Dr.Arkfeld.

Don't eat too much dairySome degree of lactose intolerance affectsabout 70% of adults worldwide, so it's not sur-prising that many fibromyalgia patients havetrouble digesting dairy products.

In a 1998 study, researchers tested whetherblood samples taken from 40 fibromyalgiapatients reacted to substances found in variousfoods; the blood of 25% of the subjects demon-strated an immune response to cow dairy prod-ucts.

Fibro patients on vegan diets have also seentheir symptoms improve.

Cut back on carbs"If I had to choose one particular diet forfibromyalgia patients, I would choose a low-carb, low-sugar diet," says Dr. Holtorf.

"About 90% of fibromyalgia patients have lowadrenal functioning," he adds, which affects the

metabolism of carbohydrates and may lead tohypoglycemia. These people crave sugar, butthey also experience the crash that follows theinitial energy high. "If you're hypoglycemic,you want to keep that sugar level as stable aspossible. Try carbs with a mix of protein andfat," says Dr. Arkfeld.

Ease up on aspartame"Getting off [aspartame] can make some painpatients feel much better," says Dr. Holtorf. Theartificial sweetener found in diet sodas andmany sugar-free sweets is part of a chemicalgroup called excitotoxins, which activate neu-rons that can increase sensitivity to pain.Though aspartame isn’t dangerous to healthypeople when consumed in moderation, it mayheighten fibro patients' sensitivity to pain.

Some artificial sweeteners, most notably sor-bitol and xylitol, can trigger IBS as well.

Avoid additivesFood additives such as monosodium glutamate(MSG) often cause trouble for pain patients.MSG—a high-sodium flavor enhancer oftenadded to fast food, Chinese food, and processedpackaged foods—is a an excitatory neurotrans-

mitter that may stimulate pain receptors; gluta-mate levels in spinal fluid have been shown tocorrelate with pain levels in fibromyalgiapatients.

A 1995 report commissioned by the U.S. Foodand Drug Administration stated that MSG maycause short-term reactions such as headaches,and a 2007 animal study in the journal Painsuggested that increases in glutamate in mus-cles may contribute to pain sensitivity.

Say no to junk foodThe National Fibromyalgia ResearchAssociation recommends limiting or eliminat-ing refined sugar, caffeine, fried foods, andhighly processed foods—in other words, mostfast food, candy, and vending-machine prod-ucts. In addition to contributing to weight gain,these foods may irritate muscles, disrupt sleep,and compromise the immune system.

Experimenting with an elimination diet andcutting the foods in this slideshow out com-pletely for several weeks—either one at a timeor all at once—may help you decide whetherthey affect your fibromyalgia symptoms.

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HEALTHLINE • September 2010 • Page 5

Page 6 • September 2010 • HEALTHLINE

PREVENTION

HEALTHLINEA Special Supplement

to the Appalachian News-Express

PUBLISHERJeff Vanderbeck

AVERTISING DIRECTORMike Davis

SECTION CONTENTAND DESIGN:

Tracie VanderbeckAndrew Littleton

The CDC was moving towardthat policy even before lastyear's pandemic brought homean inescapable fact: The fluvirus doesn't just kill grand-parents and babies and peoplewith weak lungs or hearts,although they're particularlyvulnerable. It also can killhealthy pregnant women and30-somethings. And 5-year-olds.

"We were discussing how wewere going to go get his StarWars Halloween costume afterhe got out of the hospital ...and all of a sudden his eyeslost their focus," said SereseMarotta of Dayton, Ohio,describing for reporters howher son Joseph, 5, died ofswine flu last October beforevaccine was available in hercommunity. She urged fami-lies to make vaccination a pri-ority.

Here are some questions andanswers about flu:

Q: I got vaccinated againstboth seasonal and that so-called H1N1 flu last year, sowhy do I need vaccine thisyear?A: It protects against a differ-ent strain of the H3N2influenza family that hascropped up, as well as lastyear's swine flu, part of theH1N1 family, and a Type Bstrain. Every year a differentflu vaccine is brewed to matchthe constantly changing flustrains that circle the globe.

Q: Why is there a new high-dose version for seniors?A: Your immune systemweakens with age, so it doesn'trespond as actively to a flushot. Sanofi Pasteur's FluzoneHigh-Dose quadruples thestandard dose for people 65and older. This winter, scien-tists will track if that translatesinto less illness. Until thatproof's in, the CDC says it'sOK to choose either option.

Sanofi is finalizing how muchto make, and availability mayvary with location. For exam-ple, Dr. Marvin Bittner of theVeterans Affairs MedicalCenter in Omaha estimates thenew shot might benefit one infour seniors and said his cen-ter has ordered enough for thatpopulation, while other VAclinics aren't ordering asmuch.

Q: Will I need just one shot?A: Most people will, but anychildren under 9 getting theirfirst-ever flu vaccine will needtwo, a month apart, to primetheir immune systems.

Q: What if my child's first-ever vaccine was last year andshe got one dose of seasonaland one dose of swine flu vac-cine?A: She wasn't primed enoughand needs her two doses thisyear, said Dr. Michael Bradyof Nationwide Children'sHospital, who co-authored theAmerican Academy ofPediatrics flu vaccinationguidelines out Monday.

Q: Will there be enough vac-cine?A: Manufacturers project 170million doses. Obviously thatwon't cover the entire popula-tion, but the CDC knows itsnear-universal vaccination pol-icy won't spark a stampede forshots. Before last year, fluvaccine was recommended for85 percent of Americans butonly about a third got vacci-nated. Last year nearly all 114million doses of seasonal vac-cine were used, but as theswine flu outbreak slowed,just 90 million doses of thespecial vaccine were used outof nearly 162 million eventu-ally produced for the generalpublic.

Q: Who's at high risk fromflu?A: Young children, anyone 50or older, anyone with chronic

medical conditions such asasthma or heart disease, preg-nant women. Also, healthworkers and caregivers ofinfants can infect the vulnera-ble unless vaccinated.

Q: Who can use the nasalspray vaccine?A: FluMist is for healthy peo-ple 2 to 49, no pregnancy orunderlying health conditions.

Q: When should vaccinationstart?A: Chain pharmacies alreadyhave started vaccinating; pro-tection will last all winter. Ittakes about two weeks to kickin, and flu typically starts cir-culating around November.

Q: How do I know it's safe?A: Unprecedented safety mon-itoring last year turned up norare side effects from the spe-cial swine flu-only vaccinesold in the United States."We're hoping a lot of themyths people had about theinfluenza vaccine may be a lit-tle bit less of a concern," saidpediatrics specialist Brady.

Abroad, a few reports of nar-colepsy after a Europeanswine flu vaccine are beingprobed; that vaccine didn't sellhere. An Australian seasonalvaccine dosed for young chil-dren won't be sold here afterbeing linked to some fever-related seizures in that coun-try.

Q: Why should I bother sincefewer people than usual diedlast year?A: Last year's U.S. toll: about12,000 deaths, 60 million ill-nesses and 265,000 hospital-izations. New CDC statisticslast week suggest flu strainmortality varies widely, from3,000 in an exceptionally mildyear to 49,000 in a recent real-ly bad one — and it's impossi-ble to predict how bad eachyear will be.Source:AP

MMoorree EEvviiddeennccee TThhaatt VVaacccciinneessDDoonn’’tt CCaauussee AAuuttiissmmBy Jenifer GoodwinHealthDay Reporter

MONDAY, Sept. 13 (HealthDay News) —Infants exposed to the highest levels ofthimerosal, a mercury-laden preservative thatused to be found in many vaccines, were nomore likely to develop autism than infantsexposed to only a little thimerosal, newresearch finds.

The study offers morereassurance to parentswho worry that vaccina-tion raises their children’srisk for autism, theresearchers said.

“Prenatal and early lifeexposure to ethylmercuryfrom thimerosal in vac-cines or immunoglobulinproducts does not increase a child’s risk ofdeveloping autism,” concluded senior studyauthor Dr. Frank DeStefano, director of theimmunization safety office at the U.S. Centersfor Disease Control and Prevention.

The study was released online Sept. 13 inadvance of publication in the October printissue of Pediatrics.

Thimerosal has been used as a preservative invaccines since the 1930s, according to back-ground information in the article.

Concerns about the chemical began to crop upin 1999, when the U.S. Food and DrugAdministration said that because of theincreased number of thimerosal-containing vac-cines added to the infant vaccination schedule,infants may be exposed to too much mercury.During the ensuing years, the FDA workedwith manufacturers to eliminate thimerosalfrom vaccines, according to the agency’s Web

site. Today, thimerosal has been removed orreduced to trace amounts in all vaccines rou-tinely recommended for children 6 years of ageand younger, with the exception of inactivatedseasonal flu vaccine, according to the FDA.Parents who are concerned about thimerosalcan ask for a preservative-free version,DeStefano said.

In February of 2009, a U.S. federal courtruled that there was no scientificevidence linking vaccines toautism.

In the new study, researchersexamined medical records andconducted interviews with themothers of 256 children with anautism spectrum disorder and752 children matched by birthyear who did not have autism.The children were all members

of three health care management organizationsin California and Massachusetts.

Children in the highest 10 percent ofthimerosal exposure, either prenatally orbetween infancy and 20 months, were no morelikely to have autism, an autism spectrum dis-order or autism spectrum disorder with regres-sion than children in the lowest 10 percent ofexposure.

“This study adds to a large body of evidenceindicating that early thimerosal exposurethrough vaccination does not cause autism,”said Geraldine Dawson, chief science officerfor a leading advocacy group, Autism Speaks.Dawson was not involved with the research.

She urged parents to have their children vacci-nated.

“We encourage parents to have their childrenvaccinated and to establish a trusting relation-ship with their child’s pediatrician so they candiscuss any concerns they have,” Dawson said.

TTiimmee ttoo ggeett yyoouurr fflluu sshhoott continued from page 1

By Kendall Atkins Livick Staff Writer

Flu shots. To inject or not to inject? Manydon’t question the need to get the flu shot. Thedoc. recommends it, so patients get it, and mostbite the bullet without a second thought.

"The CDC now recommends anyone to getit,” Director of the Pike County HealthDepartment Paul Hopkins said.

Despite nudging from authority figuresthough, many Pike Countians are passing it up,and it’s not becausethey have a fear ofneedles.

“For one thing, Ihave recurring sinusinfections, and I justreally don’t want torisk introducing theflu into my system,”Doug Woody, ofHarold, said.

Doug and his wifeDebbie, age 59, said they are of the strong opin-ion that the flu shot does not prevent the flu.Opinions such as these are not unusual; butwhat is unusual, is the fact that Woody himself,worked at a pharmacy.

For 10 years, he worked as a MedicalTechnician at C & C Apothecary inPrestonsburg, and he said he has his own theo-ries as to why the medical industry pushes theflu vaccine.

“I think it’s just a money making thing fromthe pharmaceutical companies,” he said. “It’s allabout the money.”

Doug, who is 61-years-old, is a member ofthe high-risk flu category, to which health pro-fessionals recommend the vaccine the verymost. He has suffered from a slew of healthproblems over the last several years, includingbut not limited to, Chronic Bronchitis, Asthma,Bronchiectasis, collapsed arteries, a heart attack,and two bouts of digestive heart failure.He now has only 64 percent of total lung func-tion, and relies on a pace maker and defibrilla-tor. Doctors would consider someone with thesesymptoms to be the epitome of a flu shot posterchild; but Woody refuses, saying he is anti-flushot.

“I guess people who are pro think I’m nuts,but I’m not going to take the chance of gettingmore sick than I already am,” he said.

“My momma and daddy used to get the flushot and always got the flu afterwards,” Debbiesaid.

Debbie’s mother, who now lives in a nursinghome, has the options, along with the other resi-dents, of getting a yearly flu shot. Doug andDebbie have consistently made the decision notto vaccinate her. They said it’s no coincidencethat in the past few years, she has not had theflu.

Many like Doug and his wife, who haveopted not to get a flu shot, are of the belief thatthe vaccine, not only does nothing to preventthe flu, but that it can actually be the culprit ofthe virus.

"We hear that a lot, and really there is no cor-relation between getting a flu shot and gettingthe flu,” Hopkins said. “It's an inactivatedvirus."

Still, skeptics wonder, if the vaccine is sohighly recommended, then why do some recipi-ents still get the flu?

According to the CDC (Centers for DiseaseControl and Prevention), it can take up to twoweeks for the body to build up immunity to theflu. If the virus was already present in the bodybefore the vaccine or during that two week peri-od, the flu can take hold.

"Some people have developed a little bit of atemperature or soreness, aches and pains aftergetting the flu shot, but they've never reallydeveloped the flu from that,” Hopkins said.

Nay sayers aside, some swear by the flu shot."It's been found that those employers who

collect flu shots have less employees withmissed work days due to flu," Hopkins said.

Kanay Ogden, mother of 7-year-old ShelbyOgden, said she gets her daughter vaccinatedevery year.

“I just decided to because she was born sick,”Ogden said.

Shelby, who was born with pneumonia andspent her first four or five days in the ICU, alsospent time in the hospital with E.Coli when shewas six months old. In addition, she has severeallergies and has to take allergy shots on aweekly basis. Because she has had more deal-ings with severe illness than most children herage, her mother sees the flu shot as a necessaryprevention technique.

“She doesn’t like them, but she gets themanyway,” Ogden laughed. “She’s never had theflu.”

Many wonder whatconstitutes as “the flu.”There are many differentstrains, and those who aresuspicious often wonderhow one shot can preventagainst all the variousforms.

As is determined by theCDC, different flu vac-cines are made for differ-ent geographical locations,

with the design to fight against the three mostcommon strains in those respective areas.

"The CDC makes recommendations toHealth Departments based on what flu is goingaround what hemisphere," Hopkins said.

Of course, there is always the risk of peoplecarrying different strains of the virus from over-seas.

"With so much international travel that wehave, it's easy for someone to introduce a strainin the area that is not covered by the vaccine,"Hopkins said.

Though much of the flu shot debate is overits effectiveness, some question the vaccine forfear of negative side effects.

“With any vaccine that anyone takes, there'salways the risk of some kind of reaction,"Hopkins said.

It’s hard to ignore the horror stories and scarytales in the media, which end up circulatingaround YouTube. However rare these sideeffects may be, for one or two for every million,the aftermath of a flu shot is life changing.

For example, those who have ever hadGuillain-Barre Syndrome, which is a paralyticillness, should not get the shot. Doctors havesaid it is possible for the vaccine to trigger otherrare neurological disorders, as well. Also, peo-ple with severe allergies, specifically egg aller-gies, should steer clear, because the vaccinevirus is grown in eggs.

For everyone else, though, Hopkins said get-ting vaccinated for the flu is a personal decision.It is available for everyone, but no one can beforced to take it.

"It's everyone's individual choice if they wantto take the risk and not get the vaccine or beprepared and take it," Hopkins said. "We just tryto educate people about the flu, and what the fluis, and health problems that can be caused bythe flu and that it can lead to death."

Hopkins said those who do make the decisionto be vaccinated, will have the choice of twodifferent types. The most common, is the inacti-vated vaccine, which consists of dead flu virusthat is injected into the recipient’s muscle. Thesecond type is a live, attenuated vaccine, whichis weakened, but still living flu virus that issprayed into the recipient’s nostrils.

"If you've never had the flu, you don't knowhow serious it could get," Hopkins said. "I havea respiratory problem, so I've gotten it eversince it became available."

But Doug Woody, who has made no bonesabout his respiratory problems, will not be get-ting the shot this year or in any other year tocome.

“I guess I see everything just about as a con-spiracy theory,” Doug said, laughing. “I would-n’t feel any more protected with it than withoutit.”

Wherever your opinion lies in the flu shotdebate, health care professionals and medicalexperts always advise patients to make informeddecisions. If you are on the fence about thisdecision, it doesn’t hurt to address your healthcare provider and do your own research. Formore information about the flu shot, or vaccina-tions in general, visit the Centers for DiseaseControl and Prevention website atwww.cdc.gov.

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HEALTHLINE • September 2010 • Page 7

WELLNESS

PPllaayy HHeeaaddss--UUpp FFoooottbbaallll ttooAAvvooiidd GGeettttiinngg HHuurrtt

"More and morepatients regard theemergency depart-ment as an accept-able or even theproper place to gowhen they get sick,and the reality is thatthe ER is frequentlythe only option,'' saidDr. Stephen Pitts,lead author of thestudy in HealthAffairs and an asso-ciate professor ofemergency medicineat Emory Universityin Atlanta.

"Primary-care doc-tors have packedschedules and theiroffices are typicallyclosed in theevenings and onweekends,'' Pittsadded. "Too often,patients can't get thecare they need, whenthey need it, fromtheir family doctor,'' so theyturn to an ER. Yet, Pitts said,"Too often, emergency care isdisconnected from patients'ongoing health-care needs."

Health-policy analysts havespent decades debatingwhether emergency depart-ments are needlessly -- andexpensively -- clogged withpatients who are not in need ofurgent care. Some studies haveclaimed that up to 80 percentof ER patients aren't true emer-gencies.

But emergency physicians,who make up about 5 percentof the nation's doctors, counterthat most ER patients are therebecause they need to be, andpoint to a report issued by thefederal Centers for DiseaseControl and Prevention inAugust as proof. Also based onsurvey data, it found that only7.9 percent of patients whocame to emergency depart-ments in 2007 could be consid-ered "non-urgent."

Dr. Angela Gardner, presidentof the American College ofEmergency Physicians, notedthe study showed that nearlytwo-thirds of the ER patientscame in between 5 p.m. and 8a.m. during the week or on

weekends. "When you are theone who has a sick child, thelast thing you want is a 'closed'sign or after-hours message."Yet that's often what patients

hear when they call their fami-ly physician, despite efforts bymany general practitioners tobetter organize their officeswith more nimble scheduling,time blocks set aside for the"same day" sick and a host ofexperiments to become"patient-centered medicalhomes."Although the federal health

reform package includes anumber of provisions aimed atincreasing the supply andavailability of primary care inthe long run, many expertsdoubt those steps can reverse adecades-long trend of fewernew doctors taking up primarycare and of veteran family doc-tors fleeing the field or cuttingback on hours years ahead of

normal retirement age.Of course, patients, and par-

ticularly parents and care-givers, may see emergencieswhere doctors -- and insurancecompanies -- do not. And thereis a lot of uncertainty inwhether a fever or a cough orsprain or cut represents anurgent health problem or some-thing to gut out until you canget an appointment.Another study in the same

issue of Health Affairs, by ana-lysts at Rand Corp., found that,in the United States, 27 percentof the patients going to emer-gency departments could betreated at a retail clinic (typi-cally staffed by a nurse-practi-tioner) or an urgent-care center(such facilities usually have adoctor), based on the level ofcare provided in the ER.

However, that share droppedto about 17 percent when theresearchers took into accountthe hours that those ER alter-natives are typically open.Industry estimates show thereare 10,000 to 20,000 urgent-care and retail clinics, but thestudy did not attempt to meas-ure whether the facilities havethe capacity to take on millionsof additional patients.

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LLeessss rreelliiaannccee oonn ffaammiillyy ddooccttoorrss continued from page 1

(HealthDay News) — AsAmerican boys celebrate thereturn of their favorite profes-sional and college footballteams, many will also playthe sport themselves. But thegame doesn’t come withoutthe risk of potential injury.

With that in mind, a coalitionof national health-care organ-izations has decided to tacklethe issue of sports injuries inchildren with the launch ofthe “STOP Sports InjuriesCampaign.”

“Traumatic injuries to theknee and shoulder, as well asconcussions, are the mostcommon types of [football]injuries we see on both theprofessional and youth lev-els,” orthopaedic surgeon Dr.Matthew Matava, a teamphysician for the NationalFootball League’s St. LouisRams and spokesman for theAmerican Academy ofOrthopaedic Surgeons, said inan academy news release.

“Overuse injuries, especiallyin the beginning of the sea-son, are another big issuewith kids pushing themselvestoo far and too fast withoutproper conditioning.”

The campaign noted thatfootball injuries involvingyoungsters is a “growing epi-demic” that last year alonecost nearly $3 billion to treat.

Because many of theseinjuries are preventable, thecampaign is setting out toeducate both the athletes andtheir parents and coaches onways to minimize risk.

First, young athletes shouldundergo a preseason physicalto assess their ability to play.Also, pre-play, low-impactwarm-ups to increase theheart rate are encouraged, asare post-play cool-downs.Strength-training and stretch-ing (at 10 seconds to 12 sec-

onds per stretch to the pointof resistance) are alsoadvised.

Players should drink enoughfluids to prevent crampingand other health problems,and should be outfitted withwell-sized protective gearsuch as helmets, pads, shoes,and mouth guards.

Football players are advisedto tackle their opponents withtheir head up, rather thanleading with their helmet.

Finally, the campaign cau-tions young players not toplay “through the pain.”

If an injury occurs, quickaction is essential, particu-larly in the case of a concus-sion. Coaches, parents andathletes should know thesymptoms of a concussion,Matava said.

Symptoms include problemswith balance, vision, concen-tration, and communication;dizziness; sleepiness;fatigue; headache; and irri-tability.

Any young player with signsof a concussion should be

evaluated by a medical pro-fessional before returning toplay, according to theAmerican Academy ofPediatrics, which is part ofthe “STOP Sports InjuriesCampaign.”

Other organizations in thecampaign include theAmerican OrthopaedicSociety for Sports Medicine,the American Academy ofOrthopaedic Surgeons, theNational Athletic Trainers’Association, the NationalStrength and ConditioningAssociation, the AmericanMedical Society for SportsMedicine, the SportsPhysical Therapy Section,the Pediatric OrthopaedicSociety of North Americaand SAFE Kids USA.

More information

To learn more about prevent-ing sports injuries, visit theAmerican OrthopaedicSociety for Sports Medicinecoalition.

SOURCE: Pediatrics,September 2010; AmericanOrthopaedic Society forSports Medicine, newsrelease.

Page 8 • September 2010 • HEALTHLINE