healthwatch october 27, 2013

Health Watch1A

GAINESVILLE HEART AND VASCULAR GROUP

PAGE 12

FEATURING

IN THIS ISSUE• Go to bed!Children’s behavior tied to their bedtime... page 17

• Male breast cancerThousands of men each yearare diagnosed with breast cancer... page 2

THE FIGHT AGAINST CANCER

IS GAINING GROUND

North Georgia’s Health & Prevention Magazine

OCTOBER 2013

By Meredith [email protected]

Everyone is seeing pink as breast cancer awareness month continues this October. This and the large focus on women draws people away from the idea that there are men battling breast can-cer as well.

While uncommon, men some-times are diagnosed with breast cancer, a disease they are not usu-ally expecting to affect them.

Dr. Padma Nadella, a physician with Northeast Georgia Diagnostic Clinic’s oncology and hematology division, said the prevalence is low, but the risk should not be taken any less seriously by men.

“It can happen,” Nadella said, speaking about the chances for male breast cancer.

“Many men don’t know that, but men can have breast cancer.”

While the threat for breast can-cer is possible in men, many will not consider it because only about 1 percent of breast cancer patients are male. Compared to the almost 200,000 women diagnosed with the disease each year, only around 2,000 men are diagnosed.

“You’ll see 100 women with breast cancer before you’ll see male breast cancer,” Nadella said.

Out of the many risk factors associated with the cancer, the BRCA2 genetic mutation is the most common. This hereditary fac-tor can also cause pancreatic or prostate cancers. The family his-tory of cancer is important when considering the risks of breast cancer in any patient, Nadella said.

“Men need to be more vigilant in those situations where they have family members with pros-tate, pancreatic and many female breast cancer patients.”

Other risk factors are obesity, advancing age and the use of hormone therapies, such as those

used for prostate cancer.Dr. Charles Nash, a physician

with The Longstreet Clinic and director of the Cancer Center of Northeast Georgia, also mentions that treatment options are similar and the probability of success is high when the disease is detected early.

“Basically it’s treated, in many regards, just like female breast cancer,” Nash said.

Lump removal surgeries, more likely to be mastectomy surgery in men, are successful treatments for men, just like they are for women. Chemotherapy and radiation are also common treatments for all

cancer patients.Nash said that even though the

1 percent statistic may lead men to believe breast cancer will never affect them, the disease is still widespread and happens often.

“The common things are com-mon, and even though it’s less common in men, it’s something that men should not ignore,” Nash said. He also mentioned that if a breast lump is not detected, the chances of recovery are low.

“Generally, until it gets very advanced, there are no other symptoms,” he said. “That’s the problem. That’s why men need to pay attention to their breasts.”

Advanced breast cancer shows itself in ulceration and discharge from the breasts. By then, both the disease and treatments become more aggressive, and surgeries are less likely to succeed.

The best way, Nash said, to pre-vent this cancer from becoming too aggressive is to be mindful that the risk for breast cancer is applicable to patients of all gen-ders, and visit a physician when symptoms occur.

“It’s not something that men frequently will pay attention to, and it can catch them off guard,” he said. “Get in as soon as possible. Get in early.”

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2 Sunday, October 27, 2013 The Times, Gainesville, Georgia | gainesvilletimes com

Men should be aware of possibility of breast cancer

Meredith Pruitt | The TimesPadma Nadella, a doctor with the Northeast Georgia Diagnostic Clinic’s oncology department, goes over the stages of breast cancer

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Sunday, October 27, 2013 3gainesvilletimes comThe Times, Gainesville, Georgia |

By Andrew [email protected]

Home health care products make up a large industry, and it’s an industry with very personal connections to customers.

Durable medical equipment, as it is officially called, such as motorized wheelchairs, con-tinuous positive airway pressure devices, handicapped-accessible recliners and others are some-times prescribed by doctors, though the finance and home delivery process can be difficult to navigate.

Gainesville’s Care Medical office strives to make the pro-cess as streamlined, timely and easy as possible.

“We don’t go out and market to patients; we speak with the referral source and tell them how we do things,” said Care Medical Vice President Andy Latta. “We make sure we’re get-ting the order from the physi-cian and then we work with the patient to make sure that they get what they need and not something that is going to sit and collect dust.”

Care Medical is the preferred provider for Northeast Georgia Health System and a contract supplier for Medicare. Their main products consist of oxygen devices and related equipment, CPAP and sleep apnea equip-ment, mobility devices and medi-cal supplies such as diabetic or orthopedic equipment.

The process starts with patient referrals. From there, Care Medical works with the patient’s

physician to identify the product that fits the patient’s needs and to complete the proper paper-work.

“We get the paperwork from the physician or referral source,” Latta said. “That is not something that we put on the patient to do.”

Most home health care prod-ucts are either completely or par-tially covered by insurance; most items are covered by Medicare.

Every patient is fitted specifi-cally for their needs. Wheelchairs are adjusted properly, needed accessories are installed and, if necessary, home delivery and installation is provided.

“Everyone who gets a power chair from us, sees a physical therapist,” Latta said. “We do an evaluation to make sure we can see what the patient needs.

“We want to provide what they need, not just something out of a box.”

Items that are needed when a patient is discharged from the hospital are brought to the patient within an hour of the order receipt. Patients who visit the office can try out a wide variety of products to find the one that is best suited to their needs.

Care Medical is also active with several area charities and has, in the past, worked with Challenged Child and Friends and the Wounded Warrior Project as well as donating equipment to uninsured patients in need.

“We are not only a community provider; we are a community resource,” said Kyle Killinger, the company’s regional manager for the area.

Home medical equipment usually covered

by Medicare, insurance

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By Andrew [email protected]

Every year, about 5,000 patients with heart problems perform car-diac stress tests at the Northeast Georgia Heart Center. Often, patients who have never had the procedure wonder what the test will entail and if they will be able to properly perform it.

Considering that traditional stress tests involve the patient running on a treadmill while strapped with electrocardiogram leads, it is like-ly reasonable for someone facing the prospect to feel intimidated. However, not all tests are the same and there are sometimes alterna-tives to physical exercise.

The basic goal of a stress test is to observe how a patient’s heart func-tions under physical stress to deter-mine if there is a complication, such as coronary heart disease, that is preventing proper blood flow.

According to Dr. Heather Westmoreland, a physician at the heart center, cardiac stress tests commonly come in three varieties: the standard exercise stress test, the positron emission tomography test and the stress echocardiogram test.

Each test offers its own advantag-es, disadvantages and level of accu-racy, and doctors determine which test to use based on the needs of the patient. Many of these tests may involve exercise, though sometimes this can be simulated with drugs.

A PET test, along with the more commonly used but less accurate SPECT test, are nuclear tests, which means they use a radiopharmaceu-tical drug that allows a camera to take images of the patient’s heart. The drug is mildly radioactive but is considered a safe amount by

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What to expect when you take a cardiac stress test

Nat Gurley | The TimesGainesville resident Bill Griffith takes a cardiac stress test - an echocardiogram - at Northeast Georgia Heart Center as paramedic Lisa Miller watches the monitor, waiting for Griffith’s heart rate to hit 127 beats per minutePlease see Stress page 10

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www.ngheartcenter.com

By Meredith [email protected]

Most people are carving pumpkins, heading to corn mazes and looking for-ward to the colorful foliage that comes along with the fall season.

However, there are many that are expecting a much different and less exciting event — fall allergies.

Every year, the fifth-leading chronic disease strikes during autumn for a large portion of allergy sufferers. The first step to overcoming them is discov-ering their origin.

The knowledge of what causes sea-sonal allergies is what guides physi-cians to better, more effective treatment options.

“Allergies are sort of a manifesta-tion of an overactive immune system responding to environmental stimu-li that should be harmless,” said Dr. Amy Boyd, an allergist at the Allergy &

Asthma Clinic of Northeast Georgia.Common symptoms linked to fall

allergies are runny nose, redness or swelling of the eyes, nasal congestion, itchy and watery eyes and sneezing. Sometimes, cough can accompany these regular symptoms.

People who experience this often are most concerned with one question, “What actually works?” Boyd said that widely depends on the severity of the symptoms and the unique needs of the patient.

“Certainly, over-the-counter antihis-tamines are helpful, as are over-the-counter allergy eye drops, but the single most effective treatment for allergies is a nasal steroid spray,” she said.

“Patients who are very allergic to both perennial and seasonal allergens can benefit from allergy shots, which try to change the immune system’s response to the things in their environ-ment that they’re allergic to.”

Out of the many different perpetra-tors of allergies, including grass and ragweed, Boyd said pollen is most wide-spread this time of year among her patients.

“My pollen allergy patients are par-ticularly bothered during the spring and fall,” she said. “It’s helpful for people with pollen allergies to keep their win-dows rolled up, both in their car and in their home, during pollen season.”

She also said with youth, it is better to select the strongest treatment options possible so they are not forced to avoid the pleasant fall weather.

“We want children to be able to play outside, even during pollen season, and that’s why we try to control their aller-gic symptoms with allergy medicines and/or allergy shots, so that they can have a normal lifestyle and play outside as much as they want to,” she said. “We usually try (prescription) allergy medi-cines first.”

Although the respiratory system can be a main concern, many who experi-ence optical discomfort with fall aller-gies may confuse it with an infection of the eyes.

Dr. Lori Lebow, an ophthalmologist with Gainesville Eye Associates, said there are key signs to look for when determining the difference between the two, one being discharge from the eyes.

“If it’s a watery or slightly mucoid dis-charge, then it’s more likely an allergy,” Lebow said. “A green or yellow (dis-charge) would be more indicative of a bacterial infection.”

Factors in eliminating the possibility of infection, from the ophthalmologist’s perspective, are history of recent illness, signs of sinus or ear infection or swol-len lymph nodes in front of the ears.

Other smaller, less recognizable signs,

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• Board Certified Oncologists• Diagnosis and Treatment of all Types of Cancer

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Left to right: Padma Nadella, MD; Andre Kallab, MD; Christina Saurel, MD; Mark Clark, FNP-C; Saloni Tanna, MD

Autumn allergies affect many

Please see Allergies page 8

www.ngdc.com

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Gastroenterology Associates of Gainesville is the largestgastroenterology practice in Northeast Georgia.

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including a follicular or papillary reac-tion, require much closer focus from a physician, Lebow said.

“Under microscopic examination, there are certain types of inflammatory signs that we look for,” she said. “The patients couldn’t really see that them-selves without coming to see an eye care professional.”

Like Boyd, Lebow agrees that there are over-the-counter eye drops which provide relief. Two especially effective ingredients, ketotifen fumarate and nap-hazoline, are available in drops without a prescription.

Still, she said there are some that might make the condition worse.

“Some of them work pretty well,” she said. “That’s a very reasonable place to start. You want to avoid the drops that say ‘get the red out’ because those

actually constrict the blood vessels and sometimes prolong the period of inflammation.”

Prescriptions are most often a bet-ter option due to their multiple active ingredients, as opposed to one in over-the-counter medications.

A cold compress is another poten-

tially effective home remedy Lebow suggests. However, if nothing works at home, she said it is best to contact an eye specialist immediately.

To avoid the search for treatment, she said there are some prevention meth-ods that can eliminate allergies from occurring.

“If you know you have allergies, it might be reasonable to use an antihista-mine drop before you’re going to have an exposure,” she said.

“Say, if you’re going to go mow the lawn and you know you have a grass allergy, it might be more effective to use a drop before you go and do that.”

AllergiesContinued from page 6

Nat Gurley | The TimesAllergist Amy Boyd talks with mother Yoshia Maxwell about 9-year-old Ikira Patterson’s allergies at Allergy and Asthma Clinic of Northeast Georgia recently. A common skin prick test showed Ikira was allergic to hickory, oak and pecan pollen

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Call 770-297-2200 to schedule an appointment or visit longstreetclinic.com/women.Offices in Gainesville, Braselton, Dahlonega and Baldwin.

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Technology adds new dimension to eyeglassesBy Andrea Chang

Los Angeles Times

Google Glass has been hogging the spotlight when it comes to eyewear, but get ready to see new technology designed for those stuck with old-fashioned prescription eyeglasses.

About 64 percent of Americans wear glasses to improve vision. Many can’t stand them, complain-ing that glasses are cumbersome, headache-inducing or don’t work in all situations. Meanwhile, the growing amount of time people spend in front of computers and mobile devices has also raised concern about the potential dam-aging effects on eyesight.

That’s spurring innovation among eye specialists, who say the glasses industry has been largely stagnant since bifocals

were invented by Benjamin Franklin in the 18th century.

“It’s a marketplace with slow technology adoption. There hasn’t been new technology in eyeglasses in forever,” said Stephen Kurtin, chairman of Superfocus, which makes adjust-able-focus glasses that enable wearers to choose the best focus for every distance.

Now companies are designing a host of solutions to aid glass-es wearers, including futuristic lenses and even an iPhone appli-cation that developers say can help people wean themselves off glasses.

One area of focus has been on reducing eyestrain for peo-ple who spend several hours a day staring at computers, tablets and smartphones. Many optom-etrists believe the light emitted

from such devices could damage a viewer’s eyesight over time, although that hasn’t been con-clusively proven.

Still, lens companies are rolling out a slew of new lenses that they say will help ward off those potentially harmful effects.

“Why would you take the risk? Let the science unfold and let us protect ourselves as it’s unfold-ing,” said Don Oakley, president of VSP Optics Group, which this year introduced its Unity with BluTech lenses at 30,000 eye doctor offices in the U.S.

BluTech lenses are infused with melanin, a natural pigment found in the iris of the eye, to help filter out high-energy blue light and UVA/UVB radiation while allow-ing what Oakley called “innocu-ous” light to pass through.

The melanin gives BluTech

lenses a yellowish hue, and is available for any prescription. Other companies produce lenses with blue-light filtering coatings.

Oakley said BluTech lenses reduce eyestrain and fatigue from long hours spent in front of the computer. Adding BluTech lenses to a pair of glasses is typically less than $100; they can be worn indoors and outdoors and can also be added to nonprescription glasses.

He cautioned that BluTech “doesn’t prevent anything per se but it protects.”

Although many eye doctors think all that time staring at your smartphone is bad for your eyes, one firm is encouraging people to use mobile devices to improve their vision.

Please see Tech specs page 11

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the National Council on Radiation Protection and Measurements.

“With nuclear testing, we actu-ally image the blood flow through the heart,” said Andy Alexander, a nuclear medicine technologist for Gainesville Heart and Vascular Group. “Generally speaking, it is more sensitive and accurate for detecting major blockage or coro-nary artery disease.

“When you’re getting into older patients or higher risk patients, the doctor makes the call to pick the most appropriate test.”

The PET test involves the patient lying on a scanning table under a machine similar to an MRI machine, though it is often smaller and won’t cover your face. PET tests use a drug named Lexiscan that increases

the blood flow through the arteries of the heart.

“There is no exercise involved in the PET test,” Westmoreland said. “The Lexiscan is mimicking what the body does during exercise.”

A stress echocardiogram is gener-ally for patients with fewer heart disease risk factors than those of PET test patients, Westmoreland said. It involves taking ultrasound pictures of the patient’s heart while at rest and after physical stress. It is similar to the ultrasound tests doc-tors perform on pregnant women.

The standard exercise stress test is the traditional test that most people think. It usually involves running on a treadmill while con-nected to an EKG. The level of stress is increased periodically by adjusting the slope and speed of the treadmill. The test administrator monitors and records the results. This is the most basic test and it is usually for low-risk patients, Westmoreland said.

StressContinued from page 4

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GlassesOff Inc. is gearing up to launch an iPhone app this year that it claims can enhance near-vision sharpness. The New York company contends that human vision is based on two main fac-tors: the quality of an image cap-tured by the eyes and the image-processing capabilities of the brain as it interprets the image.

By spending 12 to 15 minutes a day, three times a week for three months completing a game-like program, GlassesOff says, a user can improve the image-process-ing function by teaching the brain to better interpret blurred images.

The app is tailored for each individual and adapts according to his or her progress; the goal is to wean a viewer off reading glasses altogether.

“It’s relevant to practically any person that I know,” said Nimrod Madar, chief executive of GlassesOff. “We can empow-er people to self-improve their vision condition, so you’re no longer depending on external intermediates.”

The notion that people can improve their eyesight through eye exercises has drawn skep-ticism from some optometrists and ophthalmologists.

But in a paper published in the journal Scientific Reports, the scientists behind GlassesOff said participants in a study at the University of California-Berkeley showed a nearly 10-year improve-ment in eye age. That enabled them to be able to see more than two lines further down an eye chart and achieve normal or near-normal visual performance.

That was the case for Sharon Hayat, 46, who had depended on low-strength reading glass-es to see small text. She was

approached by GlassesOff to be a participant in an early trial this summer, an offer she accepted despite being “very skeptical, very dubious.”

“It’s kind of like a video game that you play,” the homemaker from Skokie, Ill., said. “There are these little dots that flash and these little stripes and I was like, ‘This is not going to do anything.’ “But by the end of the program, she said, she had no trouble read-ing newspapers and menus with-out her reading glasses. She was even able to reduce the text size on her Kindle e-reader.

“Just this week, I had my son’s cough medicine and I didn’t need anything to read the label,” Hayat said. “I hate to sound like a com-mercial, but it really did work.”

In the past few years, one of the new lens technologies that has gained the most traction is adjustable-focus eyeglasses.

The glasses are intended for people afflicted by presbyopia, an aging condition that affects the eye’s ability to focus on close objects, and are made by a hand-ful of companies, including Van Nuys, Calif., company Superfocus and Britain’s Adlens.

Superfocus’ adjustable-focus glasses feature fluid-filled lenses and a slider on the nose bridge. Users can manually adjust their lenses by moving the slider to the desired position, which changes the focus of the lens and eliminates the need to switch between multiple pairs of glasses or the use of bifocals or progres-sives.

Since being introduced to the commercial market four years ago, Superfocus has sold several thousand pairs nationwide, said Kurtin, the company’s chairman.

The lenses took years to devel-op because it was “technologi-cally so difficult,” he said. “You want to make a lens that has all the commercial attributes, yet change shape, yet be optically perfect.”

Tech specsContinued from page 9

Health Watch12A


705 Jesse Jewel Parkway, SE, Suite 200, Gainesvil le • Phone 770.534.9014 • www.ghvg.net


SERVICES OFFERED

WELCOMING NEW PHYSICIAN

Dr. Cesar Cruz Aguilar

WELCOMES NEW

PHYSICIANDr. Cesar Cruz Aguilar



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At Gainesville Heart & Vascular Group,we believe that the patient is the center of

our practice. We are committed to providing the best possible care through diligent clinical evaluation and appropriate use

of state-of-the-art technology. Guided by compassion for each individual, we strive to provide convenience and peace of mind to our patients by providing most services

under one roof. Our ultimate goal – help our patients achieve a better quality of life.

705 Jesse Jewel Parkway, SE, Suite 200, Gainesville • Phone 770.534.9014 • www.ghvg.net

Cardiovascular disease affects over 80 million people

in the United states.


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SERVICES OFFERED



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Dr. Cruz completed his Internal Dr. Cruz completed his Internal Dr. Cruz completed his Internal Dr. Cruz completed his Internal Dr. Cruz completed his Internal medicine residency, Cardiovascular medicine residency, Cardiovascular medicine residency, Cardiovascular medicine residency, Cardiovascular medicine residency, Cardiovascular disease and Clinical Cardiac disease and Clinical Cardiac disease and Clinical Cardiac disease and Clinical Cardiac disease and Clinical Cardiac disease and Clinical Cardiac disease and Clinical Cardiac Electrophysiology fellowships at Emory Electrophysiology fellowships at Emory Electrophysiology fellowships at Emory University in Atlanta, Georgia. Dr. University in Atlanta, Georgia. Dr. University in Atlanta, Georgia. Dr. University in Atlanta, Georgia. Dr. University in Atlanta, Georgia. Dr. University in Atlanta, Georgia. Dr. University in Atlanta, Georgia. Dr. Cruz is board certifi ed in Internal Cruz is board certifi ed in Internal Cruz is board certifi ed in Internal Cruz is board certifi ed in Internal Cruz is board certifi ed in Internal Medicine, Cardiovascular Disease, Medicine, Cardiovascular Disease, Medicine, Cardiovascular Disease, Medicine, Cardiovascular Disease, Medicine, Cardiovascular Disease, Nuclear Cardiology and Adult Cardiac Nuclear Cardiology and Adult Cardiac Nuclear Cardiology and Adult Cardiac Nuclear Cardiology and Adult Cardiac Nuclear Cardiology and Adult Cardiac Nuclear Cardiology and Adult Cardiac Nuclear Cardiology and Adult Cardiac Echocardiography. He is a member Echocardiography. He is a member Echocardiography. He is a member of the Heart Rhythm Society. He has of the Heart Rhythm Society. He has of the Heart Rhythm Society. He has of the Heart Rhythm Society. He has of the Heart Rhythm Society. He has of the Heart Rhythm Society. He has of the Heart Rhythm Society. He has published in key cardiac journals, published in key cardiac journals, published in key cardiac journals, published in key cardiac journals, published in key cardiac journals, presented in local and international presented in local and international presented in local and international presented in local and international presented in local and international presented in local and international presented in local and international meetings, and has coauthored a book meetings, and has coauthored a book meetings, and has coauthored a book chapter. He has a particular interest in chapter. He has a particular interest in chapter. He has a particular interest in cardiac arrhythmia ablation, including cardiac arrhythmia ablation, including cardiac arrhythmia ablation, including cardiac arrhythmia ablation, including cardiac arrhythmia ablation, including cardiac arrhythmia ablation, including cardiac arrhythmia ablation, including atrial fi brillation ablation and pacemake atrial fi brillation ablation and pacemake atrial fi brillation ablation and pacemake atrial fi brillation ablation and pacemake atrial fi brillation ablation and pacemake and defi brillator implantation.and defi brillator implantation.and defi brillator implantation.and defi brillator implantation.and defi brillator implantation.and defi brillator implantation.and defi brillator implantation.Accepting new patients.Accepting new patients.Accepting new patients.Accepting new patients.Accepting new patients.Accepting new patients.Accepting new patients.Accepting new patients.

705 Jesse Jewell Parkway SE Suite 200705 Jesse Jewell Parkway SE Suite 200705 Jesse Jewell Parkway SE Suite 200705 Jesse Jewell Parkway SE Suite 200705 Jesse Jewell Parkway SE Suite 200705 Jesse Jewell Parkway SE Suite 200705 Jesse Jewell Parkway SE Suite 200705 Jesse Jewell Parkway SE Suite 200705 Jesse Jewell Parkway SE Suite 200705 Jesse Jewell Parkway SE Suite 200705 Jesse Jewell Parkway SE Suite 200Gainesville, Ga. 30501Gainesville, Ga. 30501Gainesville, Ga. 30501Gainesville, Ga. 30501Gainesville, Ga. 30501

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705 Jesse Jewel Parkway, SE, Suite 200, Gainesville • Phone 770.534.9014 • www.ghvg.net

Cardiovascular disease affects over 80 million people

in the United states.


www.ghvg.net

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By Justine McDanielMcClatchy Washington Bureau

When U.S. Surgeon General Luther Terry released a groundbreaking report in 1964 linking smoking to can-cer, the disease was a whispered word — and a likely death sentence.

In the decades since, researchers and doctors have worked to stamp out the many diseases known as cancer. And today, the fight against cancer stands at a place of unprecedented progress, with research yielding new drugs, more knowledge about cancer-causing genes, better prevention and improved public awareness.

Dr. Otis W. Brawley, chief medical offi-cer for the American Cancer Society, estimates that more than 1 million American cancer deaths have been averted over the last 20 years.

In “1991 ... a lot of things that we learned about cancer actually started kicking in,” Brawley said. “It takes a long time to apply them, and then once you start applying them, you finally, finally ... get to a point where things start getting better.”

This year, the society is celebrating its 100th anniversary. It was founded in 1913 by a team of New York busi-nessmen and doctors and has since become the largest non-governmental source of cancer research funding. It also provides patient support and focuses on public awareness.

Researchers and physicians such as Brawley have watched in recent years as care has become increasingly per-sonalized and highly targeted. Today, the risk of death from cancer is 20 percent lower than it was 20 years ago, according to society figures.

Certain cancers have seen even greater declines in death rates: There has been a 39 percent decline in colorectal cancer death rates, a 34 percent decline for breast cancer and a 20 percent decline for lung cancer,

Brawley said.Progress has occurred on all fronts,

including disease prevention, detec-tion strategies, surgery, radiation ther-apy and systemic treatments, accord-ing to Dr. William Nelson, director of the Baltimore-based Sidney Kimmel Comprehensive Cancer Center at Johns Hopkins.

For progress to continue, innovation like this cannot be stifled by policy change, said Andy Hill, a Republican state senator in Washington’s 45th District, just east of Seattle, who was diagnosed with lung cancer in 2009 at age 46.

“My hope is that when my kids are 50, 60, 70, and they’re diagnosed with cancer, they do a test and take a pill to vanquish it,” he said.

Given recent advances, Hill’s vision seems increasingly possible.

According to researchers, new knowledge about what goes wrong in cells and the study of specific genes is creating more pinpointed treatments. Further, the development of anti-can-cer drugs has taken off and become more cost effective, making it easier to get new drugs approved, Nelson said.

“As we have defined the processes that are involved in a cell becoming cancerous, we’ve actually started rede-fining cancer,” Brawley said. “We’ve gone from a 19th-century definition of cancer to a 21st-century” one.

“That will help us fine-tune our treat-ments even further,” he added.

Under this new definition, a patient’s specific type of cancer will be less important than which gene causes it. Doctors can identify the genes that are “acting up” and use targeted drugs to block their activity, Brawley said. Some

such drugs are already being success-fully used.

Chronic myeloid leukemia, breast cancer and prostate cancer are among the diseases that have responded well to these gene-targeting treatments, said Dr. Ruben A. Mesa, deputy director of the Mayo Clinic Cancer Center and chair of the division of hematology and medical oncology at the Mayo Clinic Arizona in suburban Phoenix.

“Really, it is a tremendous era of try-ing to individualize cancer care,” Mesa said. “We’re at the beginning of the new wave.”

Hill, the Washington state senator, was among the first patients to ride that wave. After his cancer spread to both lungs and his lymph nodes, Hill found a trial drug called crizotinib that

Cancer Society, researchers look back on decades’ worth of progress in fight against cancer

Please see Fight page 16

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could target his specific gene muta-tion.

“It was really miraculous. Within a week most of my symptoms had disap-peared and within three weeks I was jogging again,” he said.

Hill is an example of an increasingly common new breed of cancer survi-vor: one who may not be cured but can live with the disease.

“I’m not able to say that we’re going to have a cure,” Brawley said. “My vision of cancer in the future is that many of these diseases are going to become much more like diabetes: They will be chronic diseases.”

Other doctors are optimistic that some cancers can still be eradicated completely.

“We are curing cancers, even in a very advanced stage, ever more

often than we were,” Nelson said. “There’s a huge amount of hope that we finally understand enough about how the immune system works that we’re going to be able to use it to con-trol and eradicate these cancers more effectively.”

The progress has been aided by increased public awareness and bet-ter prevention. As facts about cancer become common knowledge, people are becoming more proactive about health. For example, self-detection is now the second most common way breast cancer is found, Brawley said.

Public figures frequently speak out about their diagnoses, following a trend started by first lady Betty Ford, who made waves in 1974 when she openly discussed her breast can-cer. Advocacy groups provide every-thing from brochures to educational retreats. Large-scale fundraising events like Relay for Life and the Susan G. Komen Race for the Cure loudly and proudly bring cancer to the public eye.

On the other side of awareness,

however, is stigma.Many taboos about cancer have

fallen away as American society has advanced along with medicine. But misperceptions remain, particularly with diseases whose potential causes lend a stigma to the diagnosis. That includes cancers of the lung, cervix, and head and neck.

“There is definitely a stigma of lung cancer that makes it harder to get funding,” said Hill, who never smoked. “Part of it is getting more survivors like myself so I can talk about it and advocate for it.”

Funding is arguably the most vital link in the chain of continuing prog-ress.

“One of the problems of talking about this today is that the federal research program is being impacted right now by the government shut-down. It’s a juxtaposition of the most promising signs (of progress) ever and some very unfortunate political decisions leading to an unnecessary slowing of research,” said Dr. Clifford A. Hudis, chief of breast cancer medicine

service at Memorial Sloan-Kettering Cancer Center in New York and president of the American Society of Clinical Oncology, referring to federal budget cuts and the current govern-ment shutdown.

In spite of such challenges, experts agree that the fight against cancer is at a better place than ever.

At the American Cancer Society’s anniversary celebration in May, CEO Dr. John R. Seffrin said he is ready to put the society out of business.

“We’re determined to make this can-cer’s last century,” he said.

“If you were to take someone from 1973 to 2013 in terms of the transfor-mation of the diagnosis, the treatment and the recovery from cancer, it’s truly unbelievable,” the Mayo Clinic’s Mesa said. “There are many cancers that are now curable that were incurable, and there are many cancers where ... people will live for many years where before they would’ve been catastroph-ic. It has been an unbelievable era of change, and I think these next 10 years may even put all of that in the past.”

FightContinued from page 14

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By Deborah NetburnLos Angeles Times

Struggling with a difficult kid? You might want to take a hard, honest look at how often he or she actually gets to bed on time.

Researchers have found a clear link between the lack of a regular bedtime and behavioral difficulties in children, and it is just what moms and dads know intuitively: Irregular bedtimes often lead to bad behavior in kids.

In a study published in the journal Pediatrics, the researchers also found that, on average, children’s behavior got worse as the number of nights they did not get to bed on time increased.

The research team from University College in London analyzed data from 10,230 7-year-olds from the UK Millennium Cohort Study, with

bedtime information collected from interviews with mothers when the children were 3, 5 and 7. The moth-ers also described their children’s behavior.

It will surprise nobody that they found the children most likely to have irregular bedtimes, or very late bedtimes, were also more likely to be from the poorest homes. Those chil-dren were also more likely to skip breakfast, have a television in their room, and have a mom in poor men-tal health than their regular-bedtime-having peers.

However, the good news in the study is that the effects of not hav-ing a regular bedtime appear to be reversible.

“For children who changed from not having to having regular bed-times, there were improvements in behavioral scores,” the researchers write.

The team, led by Yvonne Kelly, sug-gests that health care professionals screen for irregular bedtime sched-ules in young children, and encour-age parents to do their best to keep their kids on a regular nighttime schedule.

But they also understand how

tough that can be.“Family routines can be difficult

to maintain when parents are work-ing long hours and potentially unso-ciable hours,” they write. “So policy development is needed to better sup-port families to provide conditions in which young children can flourish.”

Study shows bedtimes impact kids’ behavior

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Every fall, high school students return to classes.

With the start of the school year, sports also begin. Some students will partake in extracurricular activities such as football, cross country and basketball.

In all these sports, injuries can occur at any time.

According to Dr. John Vachtsevanos at the Specialty Clinics of Georgia, the most common sports injuries during the fall occur in football, but the risk is in all sports.

The main injuries are knee sprains, fractured collar bones and separated or dislocated shoulders, he said.

However, one injury that doesn’t affect a ligament, muscle or bone, and can sideline a player for the same or longer amount of time, is a

concussion.“A concussion diagnosis is mainly

clinical, medical history and con-cussion history, ” Vachtsevanos said. “There is not one test that says ‘yes or no’ to a concussion.”

Vachtsevanos said the clinic uses Immediate Post-Concussion Assessment and Cognitive Testing to assess athletes suffering from concussion-like symptoms. Concussions affect the brain, he said.

The doctors administer the test to all athletes of every sports team before the season starts. Vachtsevanos said the test gives doctors a baseline for an athlete’s cognitive process without any con-cussion symptoms.

Then, if the athlete is diagnosed with a concussion, their concussion symptoms will be tested against their original baseline.

“The athlete will have to be

examined by a trainer and phy-sician before getting cleared,” Vachtsevanos said. “Then, we ease them back into (playing).”

The clinic follows the same con-cussion protocol as the NFL, he

Fall sports mean injuries to athletes

Please see Fall injuries pg19

Joshua Jones | The TimesBrenau volleyball player Marcella Toups meets with Christopher Kinsey at the Specialty Clinics of Georgia to be fitted for a protective knee brace.

19


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said.Vachtsevanos said sending an ath-

lete back into a sport before they’re cleared of a concussion is very risky. He said a second concussion is normally a lot worse than the first concussion the athlete suf-fered.

“Prevention comes from coaches, proper-tackling techniques, helmet technology,” he explained. “With the NFL doing what they’re doing, the lower-levels are taking (concus-sions) more serious.”

Symptoms of concussions include being dazed, disoriented, sensitive to bright lights and loud noise and experiencing memory loss and headaches, Vachtsevanos said.

“Post-concussion syndrome is monitored and it’s day-to-day,” he explained of the recovery process. “These things (concussions) can linger on for weeks and months.”

From someone being hit hard on the football field to a basketball player taking a fall on the court, or a baseball/softball player getting hit in the head with a ball, concussions are relevant in all sports, he said.

“That’s why we test all the kids with the imPACT Test,” he said.

With injuries that affect muscles, ligaments and bones, Vachtsevanos said most high school teams will have one or two players have an injury that requires surgery. He also said sometimes half a team can have injuries that don’t require sur-gery, just healing.

Physical therapy and rehabilita-tion are part of the healing process if there’s no surgery, he said.

Vachtsevanos said proper stretch-ing and warming up before an activity can help a person prevent injury.

“If stretching and warming up

weren’t a necessity, then the NFL wouldn’t bother,” he said. “At high school levels, you see the teams doing it (stretching and warm ups). It’s not going to prevent every inju-ry, but if it prevents one (injury), it’s

worth it.”During the football season, Vachts-

evanos said the clinic is open on Saturday mornings to treat any high school athlete who was injured throughout the week.

FallinjuriesContinued from page 18

Joshua Jones | The TimesNorth Hall football player Cole Strickland and his father John Strickland view an MRI of Cole’s MCL injury while waiting for Dr. John Vachtsevanos at the Specialty Clinics of Georgia.

20


By Nancy ChurninThe Dallas Morning News

At 60, Marty Wichter of Arlington, Texas, found himself in constant digestive distress and at a loss for what to do.

Then he tried a probiotic capsule packed with live bacteria. Within 48 hours, his problems went away. Wichter is now 67, and the problems haven’t returned except for the hand-ful of occasions when he’s taken less than five a week, he says.

Introducing bacteria into the body is part of a bold new way of thinking about health, says biologist Rob Dunn, author of the best-selling”The Wild Life of Our Bodies: Predators, Parasites, and Partners That Shape Who We Are Today”(HarperCollins, $26.99).

Like an increasing number of experts, Dunn, a biology professor at North Carolina State University, believes our bodies are ecosystems that require a good balance of healthy bacteria to help digest food and fend off certain diseases. He sees a correla-tion between our war against bacteria in the form of an overuse of antibiot-ics and antibacterial wipes, and the rise in a host of chronic conditions from Crohn’s to inflammatory bowel disease, rheumatoid arthritis, lupus, diabetes, multiple sclerosis, schizo-phrenia and autism.

“I don’t mean to discredit antibiot-ics,” he says. “The use of antibiotics to control pathogens has saved billions of lives. But we’re starting to learn that in addition to warding off bad bacteria, we need to start gardening good ones. There are thousands of species in our bodies and we don’t know which ones are important yet, but we do know that having a good community is important.”

Wichter takes probiotics with the support of Dr. Jay Yepuri, his gastro-

enterologist with Digestive Health Associates of Texas and on the medical staff at Texas Health HEB in Bedford.

Yepuri says that while much remains to be learned about probiotics and recommended amounts, research and his personal experience with patients have shown him that “we don’t know how much good it does, but it’s not going to hurt you.”

The same principle applies to fecal transplants. That procedure injects bacteria in the body by transferring stool from a healthy person into the intestines of those infected with Clostridium difficile, a bacterium that can lead to diarrhea and colitis and affects up to 3 million people in the United States.

A January report in the New England Journal of Medicine declared that in one study in the Netherlands, fecal transplants cured 94 percent of the patients and was such a success that the study was stopped and the treat-ment offered to the control group.

The Food and Drug Administration restricted its use earlier this year, with doctors required to submit an extensive application and wait up to 30 days for a response. After an outcry, the FDA lifted the restrictions June 17 and allowed the procedure for infections that aren’t responsive to standard therapies.

Another procedure showing prom-ise is the transplanting of earwax from an ear with healthy bacteria to one with chronic infections.

Dr. Lora Hooper, an associate pro-fessor of immunology and of micro-biology at the University of Texas Southwestern Medical Center, says that before she began her research in 1996, she had thought all bacteria were bad and it would be good to eliminate as many as she could.

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Doctors say some bacteria is good for you

Please see Bacteria page 21

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extent of bacterial species within the body, she was impressed with their beauty and complexity, she says. “I found out we’re actually more bacte-rial than we are human. We’ve got 100 trillion bacteria in our gut. That’s 10 to 100 times more bacteria than cells in your body. It’s almost as if we have another organ inside us with a mind of its own.”

That’s a good thing, says Hooper, who also serves as a Howard Hughes Medical Institute investiga-tor at UT Southwestern’s Cancer Immunobiology Center and its Center for the Genetics of Host Defense. “There’s no question that the compo-sition of our microbial communities determines our health.”

The National Institutes of Health

is studying that composition as part of the Human Microbiome Project, which it launched in 2008 to inves-tigate how changes in the human microbiome affect health or disease.

Dunn says it’s an exciting time, with scientists finding that the more we know, the more we realize we don’t know. The inside of our bodies is like a wilderness and the more we explore, the more questions we have, he says.

He wonders: Is it possible there is a connection between particular bacteria in our body and regulation of our stress levels? Could certain bac-teria and their interaction with the hormones that regulate appetite help determine whether we are heavy or lean? Babies born by natural child-birth tend to have fewer allergies or cases of asthma than those born by Caesarian section —could that be because they pick up healthy bacteria through the mother’s birth canal?

Is it time to take a more critical look at the frequency of antibiotics

prescriptions in the doctor’s office, and also at the antibiotics routinely pumped into the animals that we consume?

As consensus grows for the impor-tant role that healthy bacteria play in the gut, Dunn hopes a new mind-set will emerge.

Instead of humans seeing them-selves at war with the natural world, he would like to see a friendlier view of the living things within us and the vegetation, other species and humans with whom we exchange salutary microbes.

That’s why he encourages his own two boys to play in the dirt and to wash their hands with simple soap and water. And he’s considering get-ting a dog.

Studies have shown that families with dogs tend to be healthier, pos-sibly because the dogs bring nature outside us into our homes, he says.

Wichter also believes that probiot-ics are just one step in his ongoing journey. He avoids over-the-counter

medications that kill bacteria, he con-sumes whole grains and fibers that promote healthy bacterial growth, and he walks outside regularly.

“You have to know your body if you want to live and stay healthy,” he says.

21


BacteriaContinued from page 20

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Dr. Barrett is now accepting new patients. To schedule an appointment,please call 770-536-9864. Dr. Scott Barrett

MICROBE HEALTHWhat may help your microbes (and cer-

tainly won’t hurt), according to Rob Dunn, author of”The Wild Life of Our Bodies”:

Take probiotics in the form of unsweet-ened yogurt or capsules.

Stick to a healthy, balanced diet that is high in fibers, low in sugar and processed foods, and as free as possible of antibiotics and pesticides.

Spend time outdoors among trees, plants and animals.

Use plain soap and water for sanitizing, not antibacterial soap or wipes.

Discuss with your doctor limiting use of antibiotics and over-the-counter medica-tions to when they are absolutely neces-sary.

Consider getting a dog.

22


By John KeilmanChicago Tribune

On a chilly April morning, retired construction worker Philip Smith was driving down a Lake County, Ill., road when police say he sailed through a red light, smashing his Jeep into the side of a school bus.

Most of the 35 children aboard went to the hospital with minor injuries; Smith died at the scene. Authorities tested his blood and determined that the crash had been the result of Smith “having impaired judgment by having multiple drugs in his system.”

What were those drugs? A seda-tive and a narcotic painkiller — both medications prescribed by Smith’s doctors.

Experts say millions get behind the wheel every day under the influence of powerful medications that, while perfectly legal, can have dangerous consequences on the road.

Narcotic painkillers such as codeine and oxycodone can cause fatigue and mental clouding, while sedatives can slow reflexes. A National Highway Traffic Safety Administration study named a range of other drugs, from antide-pressants to beta blockers to allergy pills, as “potentially driver-impairing medications.”

That puts many patients in a difficult dilemma. They’re allowed to drive with these meds in their systems, but there’s no easy way to know the dosage or drug inter-actions that could make driving unsafe. If they’re pulled over or involved in a crash, a doctor’s order may not save them from being charged with DUI.

Much of the research on prescrip-tion drugs and driving has centered on narcotic medications. Scientists have long believed that patients on stable, long-term regimens of

opioids — opiumlike painkillers — develop a tolerance that allows them to drive safely, but recent studies have complicated that pic-ture.

One found that high doses of painkillers render a driver more likely to be involved in a crash, a conclusion that prompted a medi-cal journal to editorialize that doc-tors should “weigh the risk of road trauma into our decisions about the benefits and harms of opioids.”

Another study found that motor-ists taking the medications are more likely to perform “unsafe driv-ing actions” that make them respon-sible for roughly 150 fatal crashes in the U.S. each year.

That might not sound like many, considering that more than 200 million opioid painkiller prescrip-tions are written each year, but research statistician Sacha Dubois said his calculations were conserva-tive: They didn’t include crashes in which people were maimed rather than killed, for instance, or those in which painkillers had been mixed with alcohol.

“This is like a plane crash a year,” he said. “If any company had a plane crash where everybody died, we’d be concerned about it.”

Philip Smith, 62, of Beach Park, had worked in construction until chronic back and neck pain forced him to retire, according to an inter-view his wife gave to investigators. A few weeks before the fatal crash he slipped and fractured a vertebra, an injury that put him in a back brace.

Smith had been on “multiple pain management medications for many years” under the care of a specialist, his wife said, and was taking daily doses of morphine and diazepam, the generic version of Valium.

Dr. Jerrold Leikin, director of medical toxicology at NorthShore

Prescription drugs can impair driving ability

Please see Drug driving page 23

University HealthSystem, reviewed Smith’s toxicology report at the Chicago Tribune’s request and said the results were “compatible with impairment.”

“These are all central nervous system depressants ... that can slow down reaction time, impair your judgment, (create) issues with mul-titasking, with coordination and perception, primarily visual percep-tion,” he said. “All those things can be affected by drugs of this type.”

Smith’s wife declined interview requests from the Tribune. She has filed a lawsuit against the bus

company, Durham School Services, claiming it was actually the bus driver who ran the red light.

James Zacny, a University of Chicago anesthesiology professor who has studied the effects of opioid painkillers on driving, said those drugs, when used alone at an appropriate dose, can actually improve motorists’ performance by allowing them to focus on the road instead of their pain.

The problem comes when opi-oids are combined with other drugs, such as sedatives, he said. The interaction’s effect on driving has not been well-researched, but Zacny said it would likely cause problems.

“It’s a synergistic effect, like one plus one equals three,” he said. “It’s a stronger effect than if you dou-

bled the dose of the opioid.”Some doctors are cautious even

when drug interactions are not an issue. Lynn Webster, a Salt Lake City physician who is president of the American Academy of Pain Medicine, said he advises patients taking narcotic painkillers to stay off the road unless they can prove they’re not impaired with a session in a driving simulator.

He acknowledged, though, that it’s just a recommendation — patients do not need their doctor’s permission to drive.

“It’s often a trade-off for patients,” he said. “They have to assume the risk of driving, but I think most physicians would advise them not to.”

There are no firm criteria to guide physicians and patients

about when it’s safe to drive with painkillers or other medications, and some experts say the subject — rife with tough decisions about potentially sacrificing one’s inde-pendence — is rarely discussed in doctors’ offices.

Dr. Brian Wilhelmi, a Phoenix phy-sician who has researched opioid-related DUIs, said that as America grows older and more obese — two populations particularly reli-ant on prescription drugs — the problem will demand more atten-tion from doctors, policymakers and law enforcement professionals.

“I think this is an issue that will reach a tipping point with these kinds of accidents, and we’ll decide to get serious,” he said. “I definitely sense that it’s coming down the road.”

23


Drug drivingContinued from page 22

By Erica TechoUGA Extension Service

With sports practice, after-school activities and errands, families often struggle to find time for home-cooked meals. But being on the go doesn’t have to mean fast food is on the menu.

To plan healthy, well-balanced meals and snacks on a tight sched-ule, Connie Crawley, a University of Georgia Extension nutrition and health specialist, says use MyPlate, the nutrition guide published by the United States Department of Agriculture, as a guide. Meal plan-ning and health tips can be found online at ChooseMyPlate.gov.

With a little forethought, food on a busy day can be a lot healthier than the fare offered at the local drive-thru.

“Most snacks can be stored in a cooler or bought away from home if carefully planned … If you plan to eat out, go online to find the better choices before you leave

home,” Crawley said. When parents make the choice

to purchase fast food, it is impor-tant to look up options that are lower in fat and calories.

About 17 percent of fast food menu items can be considered “healthy choices,” according to fastfoodmarketing.org. On kid’s menus, approximately 12 of the 3,039 possible meal combinations meet nutritional criteria for pre-schoolers, and 15 combinations meet the criteria for older chil-dren.

To combat occasional unhealthy eating, Crawley recommends bal-ancing everything out with health-ier at-home meals.

Snacks should be kept healthy too. When it’s time for baseball practice or dance lessons, children should have water before and after, and snacks should be kept light. “Nothing too elaborate or heavy,” Crawley said.

These options can include fruit, nuts, whole grain cereal and other

healthy foods. “If the child or teen is really

doing a heavy workout for over an hour with a lot of sweat, this is the one time a sports drink may be useful,” Crawley said.

If a child is not going to be this active, sports drinks should be avoided, and, as a general rule, energy drinks should be avoided all together.

To help on-the-go families, UGA Extension provides a few tips for healthy snacks and meals.

Simple snacksSimple snacks can include fruit

(plain, dried or paired with sorbet or cottage cheese), yogurt, whole grain cereal, 100 percent frozen fruit bars, nuts for older chil-dren, trail mix made with whole grain cereal, nuts and dried fruit, homemade fruit breads and muf-fins (such as banana bread or car-rot muffins), low-fat cheese with wholegrain bread or hummus and whole grain pita.

Planned snacksA few snacks that can be made

at home, then stored in a cooler or otherwise retained away from home include peanut butter sandwiches, salads with light dressing, milk in small boxes, hard-boiled eggs, single servings of cottage cheese, cut-up vegetables with light dip made with plain yogurt and homemade soups in thermos bottles.

Before and after practice snacksCut-up fruit and/or vegetables,

yogurt, milk, half a sandwich made with real turkey (not lunch meat) or low-fat cheese or whole-grain crackers and low-fat cheese make good snacks for active kids.

For more information on health related topics, contact your local UGA Extension office at 1-800-ASK-UGA1.

(Erica Techo, a communica-tions intern with UGA Extension, is studying English and Political Science at the University of Georgia.)

Help kids snack smart to stay healthy

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