healthsource virtual edition january 2011

January 2011 I FREE

The Continuum of Breast Health ServicesMayo‘s Breast Clinic offers a full spectrum of breast

health services — from screening and genetic counseling

to the latest drug therapies and innovative clinical trials

to survivorship support. We can help you at any point in

your care.

Mayo‘s Breast Clinic is highly focused on supporting our

patients before, during and after treatment to help them

live a normal life. Among our programs:

Cancer Resource Room Breast Health Forums Pink Sisters and Friends

Breast Cancer Survivor Program Cancer Support Group Psychological Counseling

4500 San Pablo Road, Jacksonville, Florida 32224(904) 953-2272 I www.mayoclinic.org

hether you’ve just been diagnosed

with breast cancer or need a second

opinion, Mayo’s Breast Clinic in Jacksonville, Fla.,

can help. Our team approach to care means you

have a compassionate group of specialists – all in

one location – working together for you.

The team at Mayo’s Breast Clinic includes internists,

oncologists, radiation oncologists, radiologists,

surgeons, plastic surgeons and a physician assistant.

Additionally there are two breast cancer program

coordinators, a nurse educator, advanced registered

nurse practitioner, dietitian, psychologist, social

worker, physical therapist, genetic counselor and

clinical research coordinators.

At Mayo Clinic, we are driven by the belief first

adopted by our founders more than a century ago

– “the needs of patient come first.” This statement

guides our practice and is the cornerstone for our

collaborative approach to patient care.

W

BREAST HEALTH SERVICES

Diagnostic services including

state-of-the-art breast imaging

(mammography, ultrasound, MRI,

image guided breast biopsy)

Individual diagnostic consultation

Coordination of multidisciplinary

teams for comprehensive care

Management of menopause symptoms

Breast health education & resource library

Lifestyle counseling

Women’s health promotion

Nutrition counseling

BREAST CANCER SERVICES

High risk assessment and familial

genetic counseling

Breast cancer prevention counseling

Consultation and second opinions

Breast medical oncology

Breast radiation oncology

Chemotherapy, hormone therapy,

biological therapy

Breast surgery

Oncoplastic breast reconstructive surgery

Breast cancer survivors program

Peer mentorship program

Clinical trials

Physical therapy

Psychological counseling

Mayo Clinic is a National Cancer Institute Comprehensive Cancer Center

InfoMayo‘s Breast Clinic

(904) 953-0707

www.mayoclinic.org

Becoming a Mayo Clinic PatientTo schedule an appointment with Mayo‘s Breast Clinic,

or for more information about specific services

or becoming a patient, call (904) 953-0707, or visit

www.mayoclinic.org/breastcancerprogram-jax/.

InsuranceMayo Clinic has agreements with nearly 100 insurance

carriers, third-party administrators and employers. For a

complete listing, visit www.mayoclinic.org/jacksonville,

and click on “Insurance Plan Contracts.”

Clinical TrialsFor more information on participating in clinical trials for

breast cancer, visit http://clinicaltrials.mayo.edu or call the

Breast Clinic at (904) 953-0707.

3990 San Jose Park Drive, Jacksonville, FL 32217 904.731.1324 www.drgaryperlman.com

Gary D. Perlman, D.D.S., offers the latest, most effective, patient-friendly treatment available for your gum disease. No scalpels, no stitches, greater

comfort and faster healing are all possible by using proven laser technology. Laser Assisted New Attachment Procedure (LANAP) eliminates gum disease

and helps restore your entire mouth to health.

The caring and compassionate physicians and staff at The Borland-Groover Clinic provide early diagnosis and prevention through the use of the most advanced medical technology available, giving you your best chance at a healthy life.

Contact the physicians at the Borland-Groover Clinic to schedule your consultationtoday – and get back to life!

In the Jacksonville region 904.398.7205 Including: Fernandina Beach, St. Augustine, Macclenny

In Port Orange (386) 788-1242 I In Ormond Beach (386) 677-0531 I In Delray Beach (561) 245-4550 www.borland-groover.com

...thanks to the physicians at the Borland-Groover Clinic, highly trainedexperts in research and education in the field of digestive health.

Vanessa E. [email protected]

6—HEALTHSOURCE January 2011

Letter from the EDITOR

PUBLISHERA.J. Beson

BUSINESS DEVELOPMENT DIRECTORMichael E. Hicks

EDITORVanessa Wells

ART DIRECTORChristine Tarantino

OPERATIONS MANAGERStacey Cotner

MARKETING CONSULTANTSStephanie AutryLori Robinson

MEDIA RELATIONS MANAGERMichelle Jacobs

MEDIA RELATIONS SPECIALISTKatie Whiteman

GRAPHIC DESIGNERSummer R. Morris

EDITORIAL ASSISTANTBradley Saad

SENIOR WRITERVirginia J. Pillsbury

CONTRIBUTING WRITERSLaura CapitanoLaNeta CrightonPriscilla Goudreau-SantosCynthia NelsonLauren TaylorJon Vredenburg

PHOTOGRAPHERRenee Parenteau

COVER HAIR AND MAKE-UPRenee Parenteau

If you’re interested in advertising call 904-992-9945

HealthSource is published by Beson4 Media Group, 13500 Sutton Park Drive South, Suite 105, Jacksonville, FL 32224, 904.992.9945. Content of the contributing advertisers do not reflect the opinions of Beson4 Media Group. Advertisers have proofed respective articles and content is assumed true and correct. HealthSource is not responsible for the care given by its advertisers. HealthSource is for informational purposes only and is not meant as medical advice. HealthSource believes that choosing a medical professional is a serious decision and should not be based solely on an advertisement. © 2011 HealthSource, Inc. All rights reserved. The contents of this publication includ-ing articles, may not be reproduced in any form without the written permission from the publisher.

www.HealthSourceMag.com

Send story ideas to [email protected] or call 904-992-9945.

You can now follow HealthSource magazine on:

www.twitter.com/healthsourcemag www.facebook.com/healthsourcemagazine

I’ve been the editor of Beson4 Media Group for the past year and it’s been the best year of my life. I love my job and truly enjoy the incredible stories from doctors, patients and others in the community. I am incredibly lucky to go to work everyday and find inspiration waiting for me. That being said, things sometimes get hectic, we’re always up against deadline and sometimes it takes a little perspective to realize how blessed we really are.

It seems there are less and less hours in the day and while the New Year is the perfect time to pause and reflect on the year that’s passed, sometimes it feels like there is hardly a moment to catch our breath.

That’s how I felt this past week as I was rushing off to a photo shoot. Everything was going according to plan and I was right on schedule. Traffic on the interstate, however, was not coop-erating and I was frustrated and won-dered what was holding everything up. Then I saw a woman in a broken down car in the middle lane. When you come upon something like that, time stops, frustration subsides and you realize appointments can wait.

I pulled my car in front of her vehicle and walked to her driver’s side door. She was on the phone with 911. I flagged down another car and we were able to stop traffic and get her vehicle to the side of the road. The entire process took less than 15 minutes; the woman was grateful (and safer), and as for my photo shoot…I was the first one to arrive. (Everyone else was tied up in traffic too).

This month instead of AJ’s letter from the publisher, we’ll have a guest

letter from the editor. Stay tuned for AJ’s regular letter next month.

That experience got me thinking about how incredibly easy it is to help someone everyday. Whether it’s helping someone with a broken down vehicle, or buying someone a cup of coffee or stopping to ask an elderly or disabled person if they need some assistance, paying it forward is an easy investment to make.

This year, let’s take a minute to sweat the small stuff so others don’t have to. And helping them reminds us how small our own frustrations are when we gain a little perspective and take a moment to focus on someone else.

Until next month…

January 2011 WWW.HEALTHSOURCEMAG.COM—7

If you suffer from migraines, facial or jaw pain, poor posture, or neck or upper spine pain, it may be time to see a dentist.

Most people don’t think of the dentist when they’re dealing with headaches or neck or back pain, but according to Keith Blankenship, DDS, a dentist who specializes in neuromuscular dentistry techniques, most of the upper body and head pain people experience is caused by a poor relationship between their jaw joints, the muscles in their neck, head and face, and their bite.

“While dentistry focuses on the teeth and overall health of the mouth, neuromuscular dentistry also takes into consideration your nerves, muscles and the proper position of your jaw,” says Dr. Blankenship, who has two offices – one in Ponte Vedra and one in the Oakleaf Town Center. “Neuromuscular dentistry recognizes that your

teeth, mouth, jaw joints, muscles and nerves all work together to properly align your jaw. If any of these elements are out of alignment, the result will be a misaligned or ‘bad bite,’ which can often leads to pain.”

Unfortunately, many people who suffer from migraines or facial or neck pain rely on pain medications to alleviate their symptoms simply because the real cause of the pain has not been determined yet. “When we treat patients, our goal is to put everything back in alignment in a relaxed physiologic balance– a relaxed position that helps keep the relationships between the nerves, muscles and joints in good form so it takes all pressure off the nerves and cramping of the muscles,” explains Dr. Blankenship. “The good news is that this type of treatment works on just about everyone.”

In addition to neuromuscular dentistry, Dr. Blankenship also offers comprehensive dentistry covering all aspects, including cosmetic, general, and implant dentistry. He has received extensive training from many of the “elite” educators of today, such as the Las Vegas Institute (LVI) for Neuromuscular and Cosmetic Dentistry, Nash Institute of Cosmetic Dentistry, The Pankey Institute, and the prestigious Misch International Implant Institute. He has also earned fellowships from the LVI and International Congress of Oral Implantologists.

Dr. Blankenship is a dentist who is completely focused on giving his patients the best results. As League says, “Dr. Blankenship is an incredible dentist who cares deeply about his patients and their outcomes. In my opinion, he’s the best there is.”

Find out what professional athletes and a growing number of sports enthusiasts already know – the Makkar PPM works, and it works instantly!

At its most efficient, the human body is properly aligned from top down. Unfortunately for most of us, jaw align-ment and head posture is sub-optimal, resulting in “short-circuits” that impede performance. The PPM works by

bringing your jaw into an alignment position optimized for performance.

The PPM is a custom-fitted mouth piece appliance offered only through a network of PPM certified dentists.

GAME-CHANGING BENEFITS INCLUDE:Explosive Speed & Strength I Improved Range of Motion I Greater Balance & Flexibility

HOW DOES IT WORK?

Terrell Owens, Scott McCarron, Steve Elkington, Suzann Pettersen, Shaquille O’Neal, Evander-Holyfield, Tim TebowPPM PROFESSIONAL & COLLEGIATE ATHLETES INCLUDE:


Our mission is to help residents like you make knowledgeable health decisions. Inside you

will find a number of practitioners located in your neighborhood. Overall, the purpose of

HealthSource is to help you become more familiar with the caregivers in your area. Remember, this community service is for you, so tell us what you

want to read. Please take a moment to communicate your thoughts; we want to hear from you.

The Marathon of Breast CancerDiagnosis, treatment and recovery in the race for your life

Breast Cancer EducationA top priority for local hospitals, oncology practices and support groups

When FCAT Crosses Your PathHow to maximize your student’s performance at exam time

HealthSource Fit & Healthy ContestEden Kendall and Mark Avens are the winners of our inaugural HealthSource Fit & Healthy Contest

Dynamic DuoCalcium and vitamin D go hand in hand

Healthy MinuteA round-up of healthy info, tidbits and happenings.

11

January 2011

Welcometo HealthSource, the most informative

health magazine in North Florida.

PROFILESJanuary

Crossing the Finish Line pg 18Participants in the 26.2 with Donna run for a myriad of

reasons, from honoring loved ones to celebrating their own

triumph against the disease.

BREAST CANCER

The Marathon of Breast Cancer pg 11Our 2011 cover girls are Jennie and Mollie Case. In the marathon of breast

cancer, theirs is a story of sisterly love and support. Read about them and

others enduring the fight in our special feature that details the marathon of

breast cancer from start to finish.

22

30

Reaching the finish line in the race of your life.

26

Healthy Recipe pg 39Lentil “meat” loaf

PLUS:

You can now follow HealthSource magazine on: http://healthsourcemag.com/blog/

35

41

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program claims a 100% success rate for weight loss, and 85% of our patients maintain their weight after the program. Patient education is the driving force behind our success and is key to the continuation of a healthier lifestyle. Each patient receives a comprehensive medical weight loss plan designed specifically for them, and there are no hidden fees. We believe everyone deserves a permanent weight loss solution. That’s why at Blissful Wellness…weight loss is our only business.

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certified Internist with 16 years of experience, she offers patients, who are tired of struggling with their weight, a way to get healthy and change their lives forever.

Dr. Blissenbach founded Blissful Wellness, a medical weight loss center with a proven track record of helping patients lose weight and keep it off. Based on extensive research, the low-carbohydrate plan is designed to protect muscle mass and boost metabolism, which ensures the pounds being lost are truly fat. Patients can also avoid the plateaus that are so discouraging in

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Millie Tannen, DDS, MAGD

Dr. Millie Tannen received her Doctor

of Dental Surgery degree from Virginia

Commonwealth University Medical

College of Virginia and has been serving

the Jacksonville community since 1982.

In 2008, she received the Mastership

award from the Academy of General

Dentistry, an honor which is only earned

by about 1% of U.S. dentists. In her pur-

suit of excellence, she has studied at the

Las Vegas Institute for Advanced Dental

Studies and the Misch International

Implant Institute. She is also a Fellow

of the International Congress of Oral

Implantologists and a member of

the American Academy of Cosmetic

Dentistry.

“I am so grateful that I can smile now. I have more confidence and I feel so much better about my outward

is contagious because now when I smile, others smile back.”

“It was a life-changing

worth every penny.”

“When I first came to see

dental problems and even worse dental phobia. Thanks

wonderful staff. I no longer fear going to the dentist. But most importantly I have a fantastic smile.”

Over six million people experience some degree of anxiety when they visit the dentist. Two million dental patients are just plain scared, so scared they suffer shaking, confusion, heart palpita-tions and changes in speech and blood pressure just thinking about dental treatment.

Thanks to many dedicated research-ers, we’ve learned a lot about what causes fear. And we have the antidotes.

the same as it used to be.Our practice is pleased to offer Relax-

ation Dentistry, which is, just that: While you are slightly sedated we perform difficult or extensive procedures in a

the run, Relaxation Dentistry affords the care you need in a single session.

After an initial consultation where the entire process is explained in detail, we’ll schedule you for medication

before your visit. It’s good to come with a friend to help you get there safely and not concern yourself with transportation.

At your appointment, you’ll be drowsy, but thoroughly responsive. Our Relaxation Dentistry team moni-tors your every move throughout the procedure. Another big plus: Most patients don’t feel a thing, and we can work uninterrupted.

Best of all, with your dentistry done, your appointment will be over and you will feel relaxed and comfortable when you return home.

Please contact our office if Relax-ation Dentistry interests you, or would work for a loved one who’s put off dentistry far too long. We’ll be happy to sit down and talk.

The bad thing about dental phobia is that is prevents people from

seeking the care they need—when they need it. The good thing is,

today, we can treat fear as successfully as we treat tooth decay or

crooked teeth.

here is no training for breast cancer and there is not just one route. Each person has a different race to run. But as you prepare for the event,

take a few minutes to stop and make a plan. The key to battling breast cancer successfully, survivors say, is to not be hasty in your journey. Take a day or two, even a week, and do your research. Ask questions. Make a plan. Then push forward, taking each triumph and trial in stride. Surround yourself with cheerleaders and remember, when there are times of discouragement, keep your focus on the finish line. You’ll make it.

From start to finish, facing the diagnosis of breast cancer can be an

overwhelming and trying experience. The emotional hurdles that come from

this initial shock of hearing the diagnosis and adjusting to life as a survivor,

coupled with the physical challenges of enduring treatment, make breast

cancer a marathon in and of itself.

t



t’s the moment of impact – and it hits as hard, and as unexpectedly, as a head-on car crash. Numbing and

deafening at the same time. There is no right or wrong way to receive the diagnosis that

you have breast cancer.

her blackberry, the next moment she was hit with the words, “You have breast cancer.” She says the blackberry went by the wayside and with those words; the doctor got her full attention.

remembers. “I thought that there is no way humanly possible that they could be talking to me.”

Ever since that moment, she says she has journeyed through her cancer experience one breath at a time.

“The day I was diagnosed was a beautiful, sunny day,” remem-

when she left, after being told to return the next morning, she was the only one left in the office.

When she went to the parking lot, the beautiful sunny day had turned to a rainy one. “The walk to my car was the longest walk of my life,” she says. “I kept asking, ‘God, is this real?’”

As she pulled her car into the street, she knew that the rain was God’s communication with her. “I felt like my healing began

-

Starting Line — The Moment of Diagnosis

Me? You’re talking to me? You mean me? Heart stops, mind explodes, surrealism descends – maybe in that order; maybe not. Possibly it is an entirely different response.

ence has stayed with her throughout.

When Nancy Harrison, age 54, was diagnosed in September of 2010, the real-ization didn’t hit with the moment of diagnosis. “I some-how had the expectation that I would have some surgery, and some short-term follow-up treatment,” recalls Harrison who has always been fit and healthy, with no history of breast cancer in her family.

A few days later, while meeting with the team of oncologists, the impact of diag-nosis hit her out of left field. “I realized the seriousness of this problem – this was some-thing that would affect me for the next year and for the rest of my life,” she says. “As I lis-tened to the doctors, it just felt surreal and I kept thinking that maybe they had misdiagnosed me. It was very hard to get my arms around the fact that I was someone with cancer.”

Not looking at the big pic-ture has helped her. “I deal with it in stages because the whole process is overwhelm-ing,” she says. She spent a lot of time educating herself with material from her physicians and other resources that they recommended. “I also learned to back away from some of the reading and focus on how certain specific side effects of the chemotherapy were affect-ing me.”

had a small lump in her breast

since she was a teenager, her doctors were aware of it and assured her that it was benign. The lump disappeared when she was pregnant, but returned afterwards.

When she had a mammo-

that she had a fifty-fifty chance of having cancer. “I didn’t understand my reaction,” remembers Lewis. “I always thought that I would fall apart.” Instead, her thoughts went to her mother and how she would receive the news.

Lewis was scheduled for a biopsy on Monday.

“Once I got to my car, after the mammogram, I did fall apart. I don’t remember the ride home,” she says. She had the biopsy on Monday and the doctor called on Tuesday with the news of cancer. “Again I fell apart,” she says. She found the ten day whirlwind of doc-tor visits, MRIs and other steps towards surgery devastating.

Still she says that after the initial shock, once she and her husband started telling people, the support was amazing. Along with friends, family and her church providing prayers, meals for 18 weeks and childcare for her two young daughters, one friend even cut her hair and kept it short until Lewis had hair again.

When her doctor told her that she was going to be okay, Lewis says that was the first moment of real peace.

i

January 2011 WWW.HEALTHSOURCEMAG.COM

Hearing those words – “breast cancer” – can be a heart-stopping, gut-wrenching moment. The next, your mind is swirling with a million thoughts and questions. But where to start?

Sarah McLaughlin, M.D., a breast sur-geon at Mayo Clinic, recommends women who are newly diagnosed or concerned with breast cancer ask the following questions when it comes to their care.

“Within the first week of my diagnosis I decided that this would not defeat me,” says Lewis. “I want to encourage other newly diag-nosed women that it is scary but you can become stronger because of it,” she says.

When Lydia Russo had a mammogram that looked odd, and a subsequent biopsy, it never occurred to her that it would actually be cancer. Her mother had the identical experience the week before; all was well with her mom so Russo expected the same outcome.

remembers well the date and time that she received the call and news. A career counselor at a local law school, Russo was with a student at the time. “The doctor said that the results of the biopsy were not good. When he used the term ‘aggressive grade tumor,’ I thought that I was going to die,” she remembers. “I went from crying to laugh-ing and back throughout that day,” says Russo. “I have the memory of my husband and me sitting in front of the TV without any sound for more than an hour, we were so lost in our thoughts.”

The emotion seemed to compound and she recalls some defining moments. “During the first weeks my husband and I would just wake up in the middle of the night and start crying,” she

remembers. Prior to begin-ning chemotherapy, they also rushed to do in vitro fertil-ization in order to preserve Russo’s fertility.

The experience has taught her that she is very strong and that when going through the cancer process it is best to have no expectations and roll with the process. “All of the things that used to seem so important just totally changed – my life was instantly repri-oritized,” she says.

“The moment that you are diagnosed is always a fright-ening one – it’s your absolute introduction to the fact that you are mortal,” says Donna Deegan. “I think that there is nothing more that teaches us how to live than that moment that we realize that we are not forever.”

After that first sock in the gut, comes decision time, Deegan believes. “Today is the day that you decide whether you are going to start living or start dying,” she says and that “can rock your world beyond your first diagnosis.”

“No one wants to go through something like this, but it can be a game changer in such a positive way – we all have only so many breaths on this earth,” she says. “I haven’t lived a happier or more fulfilled life than I do now – if you allow it, you can decide that this moment is your life and live it to the hilt.”

1. “What are the specifics of my tumor?”

Breast cancer is breast cancer is breast cancer. No, says Dr. McLaughlin. Not all cancer tumors are alike, which is why there are various treatments out there. She advises you ask your doctor about the size, location and histological features of the tumor. Also, have your doctor explain the tumor’s hormone receptor status. This refers to the tumor’s sensitivity to estrogen or progesterone. And finally, ask if the tumor carries the HER2 protein. All of these fac-tors will influence your treatment options and the information can guide you in making decisions with your care team.

2. “Is my physician a mem-ber of multidisciplinary, integrated, specialized breast care team?”

A breast cancer diagnosis can come from an OB/GYN, a primary care physician or an oncologist. Regardless of where the journey begins, the skills and care of many

For more information on questions to ask about breast cancer, visit www.mayoclinic.org or watch on YouTube at http://bit.ly/askbreastcancerdoc

Preparing for the Race — 3 Questions to Ask

the marathon of breast cancer

professionals will be required. Dr. McLaughlin says an integrated care team is critical to success. To ensure each patient has the best treatment plan, Dr. McLaughlin believes it’s important that all parties – from the oncologist and radiation oncologist to the surgeon, plastic surgeon and even nutritionist – are in communi-cation before, during and after treatment.

3. “What is the best opera-tion for me?”

While lumpectomy and mastec-tomy may show equivalent survival rates long-term, one option may be better for you than another, says Dr. McLaughlin. Which surgery you choose – a lumpectomy or mastectomy – should be based on the size and location of the tumor, the shape of your breast, family history and personal preference. Dr. McLaughlin also suggests talking to your care team about all the factors upfront – including reconstruction options. This can help determine the best procedure and treatment plan for you.

“I’ve been diagnosed with breast cancer. Now what?”


hen Loving, a wife and mother of three, went in for her first mammogram the last thing she thought

she would hear is, “You have cancer.” Her surgeon ordered a mastectomy, but told her that chemo wouldn’t be necessary. She would be rid of the cancer and back to normal, or so she thought. After surgery, Loving was told to see an oncologist.

“I was devastated,” says Loving. “I felt misled.” Loving’s oncologist appointment did not go as she had expect-

ed, either.“The doctor said ‘Oh, you need to go out and buy a wig.

You need to have chemo,’” recalls Loving. “It just wasn’t how I expected a doctor to talk to me.” A friend suggested she seek a second opinion at Mayo’s Breast Clinic.

Her first appointment was with Alvaro Moreno Aspitia, M.D., who spent an hour and a half with Loving and went through her options. He explained she could walk away and be fine, but because of her age and type of cancer, chemo was his recommendation.

“He treated me like a friend of the family and I wasn’t; I had never met him before,” says Loving. “And he empowered me to be involved in my own healthcare decisions.

Loving opted to have the chemo at Mayo, which, she says despite the hair loss and side effects, was a positive experience. She was able to choose her own schedule, have a private treat-ment room, and she was encouraged by the staff to bring her friends and family for support.

Looking back, Loving says she wishes she could go back and change everything about her journey.

our goal is to get to the finish line as fast as you can with the best results. But most survivors will

tell you that support is crucial to fighting breast cancer and you’ll go farther if you having a cheering section urging you on to the finish line.

When Jennie Case went for a routine gynecology checkup in July, she was surprised when her doc-tor found a mass under her arm. Suddenly she was being referred for additional tests

the Jacksonville school teach-er suddenly found herself fac-ing a life-changing diagnosis.

Immediately, her family

Preparing for Success — No Points for Second Best

In competitions, there’s a saying that there are no points for second best. But when it comes to breast cancer, there is value in a second, maybe even a third opinion. So says Kim Loving, a survivor from St. Augustine.

“When you’re going through it, you’re distressed,” explains Loving. “You feel lost and overwhelmed by decisions that have to be made. You’re rushing to try to get the cancer out and you aren’t thinking of all the things you realize later may have changed your experi-ence.”

Loving doesn’t hesitate to tell others she wishes she had gotten a second opinion early on. “I wish I would have started at Mayo’s Breast Clinic. I think my experience with breast cancer could have been better if I had the whole team in one place,” she says.

As she approaches the second anniversary of her diagnosis date, Loving says she’s in a good place. “Throughout my treatment, everyone at Mayo reminded me that life would be normal again. And it is.”

w

Support AA Sister’s

The race begins as soon as yo

y

Kim Loving and Jill

rallied around her. Whether it was getting groceries for her, a trip to her favorite restaurant or company at one of her doctor’s appointment, her parents and sister were always right there.

Younger sister Mollie in particular rallied to bring awareness and support for Case. “She had a ‘pink party’ for me, ordered ‘Think Pink’ bracelets and organized two walks to support me. She even had ‘Jogging for Jennie’ t-shirts made.”

Case also received support from friends and strangers.

I had never even met were calling and emailing me with their advice,” she says. “While

it’s sad that so many have been on this journey before, they gave me so much advice and were so reassur-ing.”

Her colleagues, as well as her students and their parents have been wonderfully sup-portive, too. Case says some of her students even had shirts made in her honor for a local breast cancer walk.

To help update all the people who were inquir-ing about her, Case set up a Caring Bridge website. “There were 49 emails in one day,” she recalls. “After the initial shock of my diagnosis, the times I cried the most were when I read the guestbook entries, cards I received in the mail and emails. I was, and still am, blown away at how supportive everyone is.”

While she has not sought out a formal support group yet Case believes that it’s important to surround yourself with positive, caring people and to seek out opinions of those who have been through breast cancer.

Although the future is uncertain, Case isn’t fazed. “People ask me how I stay so upbeat and positive through all of this, but it really is because of my friends and family who love and support me. And, by me taking it day-by-day.”

After completing 6 weeks of radiation therapy, Case underwent surgery at Mayo on December 14. She’ll have reconstruction surgery later this year.

Along the Way —Bondou hear the words “breast cancer.”

Recovery Mode — After the Crisis

You think you’re done, but you’re not.

After diagnosis and treatment, which could include surgery, che-motherapy and radiation, it may seem that the breast cancer crisis is over.

While the immediate medical crisis may be over, the survivor pro-cess is just beginning. That recovery stage can have a physical, mental, emotional and financial impact.

“That is when it really hit me that I had breast cancer,” says one survivor of the post treatment period. “And most people around me had returned to their own lives and assumed that I was fine and had reentered my life too.”

The breast clinic at Mayo saw a need for its patients and opened a survivorship clinic in 2008. Medical communities across the country are now urged to treat the survival stage as an important stage of cancer care.

“We found that there was a gap after treatment,” says Amber Isley, M.D., family medicine physician and a member of Mayo’s Breast Clinic. “After the active phase of breast cancer ends, patients go into survi-vorship. Some oncologists continue to follow patients, some don’t and some patients simply think that they no longer need medical care,” she explains. “We’re trying to maintain a more consistent follow-up and start seeing them as soon as they are released from their oncologist – some are released after radiation and some are released after years because they have an advanced breast can-cer,” she adds.

Now patients come to one place and get answers and care. “We give

them direct access for anything that they might be worried about,” says Dr. Isley. “We want to calm their minds.”

The survivorship clinic is offered to every patient at Mayo diagnosed with breast cancer and in need of surgery. “The American Cancer Society and National Cancer Institute com-piled guidelines for breast cancer survivors,” says Dr. Isley. They include looking for recurrence through breast exams, MRIs, mammograms and blood tests. The clinic also involves nutrition guidelines, care with a psycholo-gist if needed, active studies for survivors and high risk studies regarding the function of success after their active cancer care. “We also monitor such things as mood and self image issues. And we have financial advisers who can offer assistance,” says Dr. Isley.

“It is just part of the plan now,” Dr. Isley adds. “At Mayo, the survivorship clinic is received as part of the standard of care. A health professional is examining them routinely and paying close attention to them.”

Make-up and hair by Renee Parenteau


For more information on Mayo’s Breast Clinic or to make an appoint-ment, please call (904) 953-0707 or visit www.mayoclinic.org.


s we prepare for the fourth annual 26.2 with Donna, many people want to know what’s happening on the

research front. Are we any closer to a cure? Part of the mission of the 26.2 with Donna is to fund research

cancer survivor Donna Deegan, it is the only mara-thon that donates the majority of its proceeds to breast cancer research to find a cure for the disease.

Over the past three years, more than a mil-lion dollars has been donated to Mayo Clinic, which hosts the marathon. Led by oncologist Edith Perez, M.D., a member of Mayo’s Breast Clinic and Deegan’s physician, researchers at Mayo Clinic have used the funds to staff and operate a new Breast Cancer Translational Genomics Center, which aims to identify specific genes responsible for breast can-cer so new therapies can be developed.

One of the key initiatives of the center is to identify every gene and protein related to breast cancer. That information has the potential to change all aspects of breast cancer care — from diagnosis to treatment to prognosis, says Dr. Perez.

“We need to make cancer care more effective and science is the way to reach that goal,” says Dr. Perez. “Identifying the genes and proteins causing breast cancer in each patient will help us to individualize treatment and develop new therapies.”

New DiscoveriesTo help achieve their goal, researchers at the center are lever-

aging a “next generation sequencer,” a machine that can scan

which are the building blocks for every cell in our bodies — in about three days. As recently as two years ago, compiling such a mountain of genetic data would have taken months.

It will take many years to achieve the goals that Dr. Perez and her colleagues have for the future of breast cancer care. But they already are discovering exciting leads about the genetic factors

identified several fusion gene products — when two previously separate genes become one and sometimes cause cancer — that have never been seen before in breast cancer tumors.

“We’re making progress,” says Dr. Perez. “Without the support of the 26.2 with -thon, we wouldn’t be anywhere near where we are. We have a long way to go but we’re making great strides.”

Family Dynamics and RiskIt was January 2008 when Debbie Williams was told she had

breast cancer. Pregnant with her third child, she was devastated.

Breast cancer didn’t run in her family – or so she thought.

“About 70 percent of all breast cancers occur in patients who have no known family history. But issues can come from either the mother or the father’s side of the family so it’s important to ask questions” says Stephanie L. Hines, M.D., a member of Mayo’s Breast Clinic.

Eventually Williams learned that several family members had had cancer. Doctors sug-gested she undergo testing to see if she had a rare genetic mutation that could have increased her risk of breast cancer. Her results came back positive.

Of the estimated 250,000 new cases of breast cancer diagnosed among women in the United States this year, only about five to 10 percent will be due to a genetic muta-tion, says Dr. Hines, who is

Cancer Program, which offers services to patients at increased risk of cancer due to hereditary factors.

“Every person has two cop-ies of the BRCA-1 and BRCA-2 gene. Studies have shown that a mutation to either gene can increase the risk for breast cancer as well as other cancers including prostate cancer for men and ovarian cancer for women,” she says.

Hearing that news, Williams urged other family members to be tested. Her sister, Mary Holm was one of them. “I did not want to be tested. I didn’t want to know,” says Holm,

Fighting for the Future — A World without Breast Cancer

Where are we in the battle against breast cancer?

a

Mayo’s certified genetics counselor, Maegan Roberts, discusses the alter-

natives and process for genetic testing for breast and ovarian cancers.

http://bit.ly/MayoGenetics1

http://bit.ly/MayoGenetics2

also of Jacksonville. “I didn’t know what I would do with the information.”

Holm was adamant about not being tested but even-tually, at the urging of an aunt, she acquiesced. Holm was positive for the genetic mutation, too – significantly increasing her risk of breast cancer.

The hardest part, Holm says, was not being told she was positive, but being advised to make decisions about her breasts and health-care that Holm didn’t feel prepared for. “Doctors advised increased surveillance but also talked to her about hav-ing a preventive mastectomy or taking tamoxifen, a drug shown to reduce occurrence of breast cancer, for five years. “I said no to both. I wanted to explore complimentary or alternative options to surgery or medication,” says Holm, at the time the mother of a young son (Christopher, now

to pursue thermography as opposed to traditional mam-mography, MRIs or other radiation-based surveillance methods.

Although Holm was well aware of the battle her sister was fighting, worrying about her risk of breast cancer was

not her number one prior-ity. “We don’t have control over this life. The only one who does is God. So for me, it’s not worth bothering to worry about something I can’t control.”

Unfortunately, her sister had no more control either. Despite a valiant effort, Debbie passed away on

gave birth to a daughter named in her honor a few days later.

Looking back, Holm says she’s glad she opted for the testing “because now I have a plan of action to address my risk.”

Since testing may not be for everyone, Holm advises others to find out their options and make decisions accordingly. “Talk to your doctor, do your research and decide what’s right for you.”

Holm says she’ll take the same approach with her chil-dren - who have a 50 percent chance of being positive for the genetic mutation also. “When they are old enough, it will be their choice as to what to do. I will give all the information and let them decide,” she says.

At press time, Holm was pregnant with her third child, due in July.



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Holm and

Williams in early 2009.


When asked if she ever imagined that the 26.2 with Donna would be such a huge event, Donna Deegan says, “Yes!” That’s because this national marathon dedicated to finish breast cancer was born out of a vision. “It came into my head and I saw the whole thing from the starting line to the finish line,” says Deegan. “It was defi-nitely more of a vision than an idea.”

Crossing the Finish Line

The marathon of breast cancer is a long and daunting journey, a journey made easier when friends and friends rally in the fight.

t takes a community to fight breast cancer, a

collective determination to finish this disease once and for all. The best example of a community fighting to finish breast cancer can be

Coast. While the participants in the 26.2 with Donna

Breast Cancer, run for differ-ent reasons, whether it is in honor of a loved one who has lost the fight, to support a family member or friend

who has undergone their own journey or to celebrate their own survivorship, the common goal is to raise breast cancer awareness, education and research and hopefully one day finish breast cancer.

The runners you are about to meet are among the thou-sands who will be running proudly and with purpose

It’s not too late to be a part, www.breastcancermarathon.com.

Originally when Deegan started the Donna Foundation to help women with breast cancer, she raised money by having a team run at the Gate River Run. Then running coach guru and former Olympian, Jeff Galloway approached her about training people for the Jacksonville Bank Marathon, again with the goal being to raise money for the Donna Foundation. “We raised almost 100,000 dollars that year,” Deegan remembers. The success of that experience led to the vision for a classic breast cancer marathon.

That vision quickly grew legs and ran as Deegan, Mayo Clinic’s Dr. Edith Perez, and Galloway put their collective goals and energies together and the 26.2 with Donna was born, with all of the money raised going to breast cancer research and women with breast cancer locally.

“The first year we had almost 7,000 people and this year we have close to 10,000,” says Deegan. “72 percent of

i

those runners are women,” she adds and she would love to see the male percentage increase. “Every time a woman is affected by breast cancer, so is a man – it is a man’s issue as well.”

Race day is a combination of exhaustion and euphoria for Deegan. “It is a really busy, high energy week that is capped off by that wonderful march through our beautiful beaches community,” she describes. “The amazing atmosphere is a combina-tion of love, joy and support – it’s a love fest out there and the best part of running.”

While there are competitive runners at the Donna, and two women made it to the Olympic trials as a result of last year’s race, most are there for the joy of the day. “For most of the women and men, it’s about being out there with each other and being in union with each other for a very important cause – everyone connects and you can feel it,” says Deegan.

Donna Deegan

Tim and

Mary Binkley says that her breast cancer is not about what she has lost. “It’s not about losing my bosoms,” says Binkley. “It’s about my life, and breast cancer was God’s way of getting my attention and changing my mindset.”

When Aretha Rodgers found out that African American women tend to get more aggressive breast cancers and also have later diagnoses she became deter-mined to help raise awareness. “Our health has to come first,” Rodgers, a three year survivor, says.


At age 37, Rodgers was training for the first 26.2 with Donna breast cancer marathon when she found a lump that never showed up on a mammogram. At first she ignored it, but she says that at night she felt like God was telling her to “go to the doctor or you will die.”

So she went to the doctor and when she got the news of an aggressive but early stage cancer, it hit her like a ton of bricks. “I just fell into my husband’s arms,” she remembers. Subsequently she had a lumpectomy, chemotherapy and radiation; she continued her job as a pharmacy technologist throughout. “I did all that I could and relied on God to take care of the rest,” she says.

Her husband, Ronald, assured her that he was with her for the long run, cancer or no cancer. “He also said that we have cried enough and it was time to pray and fight,” she remembers. She says that their faith in God has carried them through. “We prayed and I played a lot of spiritual and gospel music to keep me positive,” she says.

She also committed herself to edu-cating others. Aretha, who found out

that several cousins have had breast cancer, had her mother and other rela-tives feel her lump. “It felt like a butter bean,” she says.

Her daughters, now ages 12 and 14, have learned to do their own self breast exams. They also know they’ll need their first mammograms at age 27 which is ten years younger than their mom’s age at diagnosis.

“Education has opened my eyes. We need to lose the fear and take control. I am a witness and I want to do all that I can while I am here,” says Rodgers.

Aretha has run in two Donna half marathons – this year she, her husband and daughters will volunteer. “The breast cancer marathon gives a sense of hope – we are one step closer to a cure.”

Binkley, age 54, had her annual mammogram in 2004. She says that 21 films that revealed clusters and a core surgical biopsy later, she was diag-nosed with pre-cancer, DCIS or ductal carcinoma in situ. “This is the beauty of mammography,” her physician Dr. Jefferson Edwards told her of its ability to reveal such an early form of cancer.

Still, when exploring her options, Binkley chose a double mastectomy which she had in January of 2005, followed by reconstruction that May. Three years earlier, her older sister Ann Lester, had stage 1 breast cancer. Her other sister, Betty remains cancer free. The sisters are being tested for the BRCA cancer gene.

But with sisters, two young daugh-ters, Ruth and Ann, and many nieces, Binkley was compelled to participate in the inaugural 26.2 with Donna. “They are my reason for running,” says Binkley, who has always been a run-ner and recently ran with other Donna marathoners at the Chicago Marathon.

On Saturdays Binkley attends the Galloway training sessions. And she stays till the end to cheer on those who finish last. She is grateful to her husband of almost 20 years, David, for his support and encouragement in all aspects of her life, but especially as she trains. This year she is in train-ing for the fourth annual 26.2 with Donna. “I pray with and for people when I run,” she says.

Prayer has been important throughout her life and her cancer. “My cancer is about faith, family and friends,” she says. “On my journey with Christ I knew that I would have all kinds of adventures and He always puts people in my life who lift me up and support me.”

When she runs on February 13, Binkley says that she will be joyful as she joins her Galloway training friends. “There are no ages on the road togeth-er,” she says of their like-mindedness. “When we run together we share our-selves and the road,” she says.

Aretha Rodgers

Mary Binkley


ARETHA WAS ONE OF OUR 2009 COVER GIRLSVisit http://www.facebook.com/healthsourcemagazine for an

girls.


Doug MacLean, one of three runners in the 26.2 with Donna who is part of this year’s new CEO Challenge, runs for health and happiness.

“I don’t ever want to get complacent about breast cancer,” says Jeanie Leapley, a Ponte Vedra real estate agent whose identical twin sister, Susie, was diagnosed with stage 2A breast cancer and had her left breast removed.

Doug MacLean


Jeanie Leapley

At age 58, MacLean, Chief Executive Officer of Pharmavite, is on his way to completing one hundred marathons. This is his second time to run in the 26.2 with Donna; he ran it two years ago with his son. “Donna and Tim are fantastic friends and I am very com-mitted to cancer research and finding a cure for this disease,” says MacLean. Breast cancer is also part of his wife Maureen’s family history; her mother and two aunts died of breast cancer at young ages. Two of Maureen’s close friends are breast cancer survivors.

“Every man is touched in someway by this dreaded disease, whether a fam-ily member or friend. For that reason, we (men) should all be “moved” to get behind the challenge to find a per-manent cure for breast cancer. There simply isn’t a more universal cause to run in support of,” he explains.

“I have run since high school when I ran cross country. Two miles was considered ‘long’ back then,” says MacLean who has been running fairly competitively for the last 20 years. “I

compete regularly at weekend races and have raced in well over 1000 races,” he says. Those races also include 97 mara-thons and two ultra marathons.

“There is nothing more satisfying and exhilarating than getting up on a weekend and heading out to the mountains with my dogs to run for one to two hours through forested trails,” says MacLean, who runs three to four times during the week. “I run at 5 a.m. to give my dogs some exercise and also to just start the day refreshed,” he says.

This year’s new marathon division for C-level Executives is through a partnership with CEO Challenges®. The exclusive division is open to CEOs, COOs, CFOs, Presidents or Owners, of companies with more than $1 million in annual gross revenue. Registration for this is limited to 20 CEOs, and awards will be given to the top male and female finishers. For more infor-mation go to www.breastcancermarathon.com/run/corporate-teams/.

Always a runner, but never a dis-tance runner, Leapley, age 45, is now training for the 26.2 with Donna. “I read Donna’s book and when I read that she did this race during chemo, I knew that I could do it,” says Leapley. At first she planned on the half mara-thon, but when she announced her intention to her sister, Susie said “you can do the whole thing.”

The sisters are very close and the whole family, including two other sisters and two brothers, has all offered support. “We are Catholic and have a very strong faith and that helps us too,” says Leapley who says that Susie’s breast cancer has given new meaning to her own life.

Now she donates a portion of each of her commissions to the Donna Foundation and has even incorporated the pink ribbon theme to her “going the distance” business cards. Her Christmas cards, “I’m dreaming of a

pink Christmas,” asked for donations to breast cancer instead of gifts.

On February 13, race day, the Leapleys will host a Pink Party – part-ly to celebrate the race. “We will also celebrate the completion of Susie’s marathon with breast cancer,” says her twin.

“When Susie asked her doctor why they had to do chemo after the mas-tectomy, the doctor explained that he wanted to step on the cancer with both feet,” says Leapley, who plans to give her twin a t-shirt for her last day of treatment that says “Stepped on it, with both feet.”

While Leapley also admits that it is a bit scary to know that she and her sister have identical DNA, she also realizes how lucky she is to know to stay vigi-lant in her own breast care.

“I believe that we will finish breast cancer,” says Leapley. “I plan to run the marathon until we do.” HS


Representing about 20 percent of all cancers in our community,

breast cancer is losing its stigma for patients and becoming an

important topic for healthcare providers and support groups.

ecause of the prevalence of breast cancer diagnosis (about 1.4 million women are diagnosed worldwide each year), there’s been a big push to

help patients become better educated about the disease and treatments options. Healthcare providers are quick to point out that every person and every cancer is different and treatment recommendations are tailored to the individual patient.

“Knowing all the facts and getting fully educated allows the patient to make the proper decisions,” said Scot Ackerman, M.D., Medical Director of and radiation

alone because friends and family can be advocates and having an advocate or advo-cates enhances survival.”

Dr. Ackerman and his team of two social workers and three oncology certified nurses provide education for patients and their families about treatment options and

Oncology also hosts a support group called “Celebration for Survival.” “We’ll discuss whatever issues the patients are facing, even social issues like dis-

crimination in the workplace,” he said.

Breast Cancer Education ResourcesOther resources for breast cancer education include the American Cancer Society

that Dr. Ackerman describes as the “single best unbiased source in the community” and most of the local hospitals offer resource centers and breast care coordinators to guide and support cancer patients and survivors through all the treatment stages of the disease.

21st Century Oncology radiation oncologist Joanne Dragun, M.D., and medical oncologist, Carlos Castillo, M.D., agree that the American Cancer Society is a tre-mendous resource for patients as are Bosom Buddies, an educational, support and

advocacy program for women with breast cancer through the Women’s Center of Jacksonville, and In the Pink, a not-for-profit specialty boutique for cancer patients and survivors operated by a two-time cancer survivor.

“We work closely with these organizations as well as with the local chapter of the Susan G. Komen for the Cure foun-dation,” said Dr. Dragun. “We also offer many publications for our patients and we’re a resource for those who’d like a second opinion including meeting with our breast cancer sur-geons to assure the best cosmetic outcome.”

“It’s absolutely essential that the patient meets with the three-member team and they then become the fourth mem-

ber,” said Dr. Castillo speaking about the 21st Century Oncology practice team of radiation, medical and surgical oncology specialists in breast cancer.

He continued, “There are three million breast cancer survivors in the U.S. and that’s what’s bringing higher specialization because patients are involved in treatment decisions. Once they’re part of the team, we help them manage that process so that they’re confident that the best treatment for their cancer and well-being has been met.”

Drs. Castillo and Dragun emphasize that breast cancer is not just a physical disease – it’s also an emotional and psychological disease and is treated through a holistic process that involves the entire family and mental health professionals if needed.

HealthSource

b“Knowing all the facts and getting fully educated allows the patient to make the proper decisions.”

— Scot Ackerman, M.D.

“There are three million breast cancer survivors in the U.S. and that’s what’s bringing higher specializa-tion because pa-tients are involved in treatment deci-sions.”

— Carlos Castillo, M.D.


Left: Background is breast cancer cells


“We encourage our patients to share their experiences with new cancer patients especially with someone look-ing ahead who may be a little afraid,” said 21st Century Oncology surgical

also work with the hospitals and breast imaging centers as well as with the dif-ferent boutiques that make breast pros-thetics for patients. We’re a resource to connect patients with other resources and in the future, we hope to offer more onsite programs at our cancer center.”

cancer treatment is often a very per-sonal approach. In a way, it’s good that there’s information out there [on the internet] but too much information can be difficult for patients and it’s up to their doctor to guide them through this information overload and through the process. Because breast cancer can be very different for each patient and every patient receives individualized treatment, we give our patients a treatment outline to let them know what’s coming up.”

Pink Ribbon SymposiumCynthia Anderson, M.D., a radia-

the Pink Ribbon Symposium with Linda Sylvester, M.D. The symposium is a day-long conference held every year in October to provide educa-tion about breast cancer and health issues for women. The symposium began in Orange Park but quickly grew to include healthcare providers and patients throughout the city.

“Breast cancer is unique in that there’s really no other cancer that garners so much national attention, and because

of that, we know so much more about it than we do other cancers,” she said. “Our strides now are to get a lot of the information that we’ve learned out to all women and especially to minori-ties because with almost any cancer, a minority individual does less well than others in every part of the process.”

Not only are patient education chan-nels better through healthcare providers and community support groups, but Dr. Anderson says that almost every hospi-tal now offers a multidisciplinary team approach to treatment and also a nurse navigator to guide patients as they’re going through the process. There’s also more knowledge about women and how they do better medically by sharing the experience with others.

“We’re trying to do more outreach now with the Latin population and also trying to get more of a minority out-reach in general,” she said. “We have someone who works with us to trans-late some of our materials into Spanish and we’ll be going out to Latin events in town to provide information. Even our best screening efforts won’t over-come the patient’s anxiety or even deni-al about what they’re feeling in their body. When patients wait to come in, it makes the breast cancer harder to treat than if it were discovered early.”

A New Center Helps with EducationBaptist Health began planning its new

Margaret and Robert Hill Breast Center that opened in October five years ago when providers realized that patients had to wait too long for services. The hospital also wanted to create a central-ized, all-in-one diagnostics center.

“Our new cancer center is three times the size of the first facility and we’re

located right next to the Baptist Cancer Institute,” said Linda Allen, director of women’s imaging. Allen is responsible for all breast imaging and diagnostics for the entire Baptist Health System and oversees the coordinated breast care delivery system that involves all the physicians.

“We started planning the actual nuts and bolts of the Margaret and Robert Hill Breast Center back in 2005 and now we have the opportunity to do more formal collaboration with repre-sentatives from medical oncology, surgi-cal oncology, breast imaging, pathology, radiation oncology and social services,” she said. “Baptist Health may also have been the first hospital in the city to have nurse coordinators and now it’s happening throughout the country.’

Each week at each of the Baptist campuses, all team members meet for a “breast conference” to discuss any new cases diagnosed the previous week so that they can all work together for the patient. Breast care coordinators then meet with newly diagnosed patients and provide them with a binder that offers complete information about breast cancer treatment options. Next, nurses facilitate all the recommended appoint-ments. Patients can then request addi-tional information or visit the Baptist Health Library on its downtown campus that offers an entire section relating to breast cancer.

“We try to direct them to the informa-tion that’s relevant for them,” said Allen. “Nurse coordinators are really vital for helping patients through the process and determining their needs. We also have a psychologist who specializes in all cancers who can meet with the patient and there’s a nurse practitioner who specializes in genetics (determin-ing predisposition to breast cancer) who will meet with the patient for testing, discuss test results and finally, what options are available.”

According to Allen, because breast

Cynthia Anderson, Linda Allen

“Breast cancer is unique in that there’s really no other cancer that garners so much national attention, and because of that, we know so much more about it than we do other cancers.”

— Cynthia Anderson, M.D.


At the Center For Health & Sports Medicine, Ross Osborn M.D., Board Certified in Family Medicine and Sports Medicine, provides comprehensive care for the entire family in the Mandarin and Julington Creek areas.

With the importance of an active lifestyle becoming more of a priority to families, Dr. Osborn’s commitment to health and exercise medicine, as well as his focus on the care of the entire family make it easier than ever to live better.

(904) 240.0442115 Bartram Oaks Walk, Suite 104St. Johns, Florida 32259(located in the Batram Walk Shopping Center)

Call for more information about our next Optifast session

cancer is being detected earlier and due to proactive screening, education and new research that’s being done to find cures and treatments, the survival rate has increased dramatically.

Kids Together Against Cancer The importance of talking about

breast cancer with all the co-survivors including family, friends and co-workers is underlined by a fairly new support group for children of can-cer patients known as Kids Together Against Cancer (KTAC). Administered through St. Vincent’s HealthCare and

week program that uses art to discuss difficult feelings.

“We collaborated with the Cummer Museum of Art & Gardens to develop the program that helps children normal-ize the cancer journey,” said Jennifer Maggiore, LCSW. “We started KTAC a year and a half ago to provide resources for children and a lot of it was in response to the fact that cancer has such a stigma. We really wanted to encourage dialogue so that children can express their feelings. Kids make a ‘strong’ box and write on the box all the things that make them feel strong and good. And, on the inside, they write all their fears.”

Elementary, middle and high school students – and their parents -- can all participate. “Parents do the same art projects as the children and it’s thera-peutic for them,” she said.

KTAC offers the six-week pro-grams four times a year at Riverside Presbyterian Day School in Riverside and parents can repeat sessions. All the programs are free for patients who are treated anywhere, not just St. Vincent’s. The next session starts this month and for those who can’t meet with the group, KTAC also meets monthly at the

about KTAC, visit www.ktacjax.com. HS

“Nurse coordinators are really vital for helping patients through the process and determining their needs.”

— Linda Allen


Perfection is not the goal. If you do nothing else to prepare your child for exam time, instill the idea that no one is expecting perfection. This alone does a great deal to reduce the stress level associ-ated with standardized testing.

“We just ask the students to do their best and be pre-pared,” offered Kathleen Maida, Media Specialist at J. Allen Axson Montessori Elementary School for the past 14 years. “It’s such a high stakes test environment, so it’s critical kids be prepared in every way possible.”

And, according to Robert Cywes, M.D., medical direc-tor and pediatrician at the Jacksonville Weight Loss Center, “Good enough is bet-ter than perfect. Kids try to study everything and trying to be perfect often destroys good enough.”

Eat Smart to Work SmartWhile teachers field the

bulk of academic preparation, Maida suggested that, “Parents are the most important teach-ers. What parents do in the home really gets the ball roll-ing.” She feels parents’ and students’ efforts toward getting adequate sleep and well-rounded nutrition on an ongo-ing basis are paramount to a

test-ready mind. And, sup-portive parents reflect in their students. After asking one of her students what he did to prepare for test day, he told her, “I eat a good breakfast. Brain food! Protein!” Maida said it was clear this was a student who had parents instilling positive preparation habits at home.

A strategy with potential home application that Maida said has worked well at Axson for getting students to embrace the healthful food choices they typically wouldn’t is to have classroom tastings. Students are given a list of vegetables they either don’t like or have never tried. Next, they research recipes, choosing one to take home and prepare. “The culminating event is a feast in the class-room. We’ve had students learn to like artichokes and spinach,” Maida explained. The lesson is that by taking interest in and ownership of new foods, kids can learn to overcome preconceived notions about what they do and do not like to eat.

Other stress-battling tech-niques employed at Axson include teachers leading a

-ings, and again at the end of the test day. And, Principal Paula Renfro said at Axson,

the only no-sugar school in Duval County, snack breaks include a whole grain, a dairy and a fruit or vegetable. Renfro urges parents to see that students eat the right amount of proteins and com-plex carbohydrates to give them the sustained energy they need throughout the day.

Don’t Ignore Emotional Needs

While rest and nutrition are key preparation focus areas, Dr. Cywes suggested parents also support the emotional needs of their students. “When

of the most fearful and stress-ful times for students,” Dr. Cywes said. “We have endor-phins in our brains that get released throughout the day to help us deal with our emo-tional needs or deal with emo-tional or stressful times,” Dr. Cywes explained. “That is a system the body uses whether we direct it or not.”

To better direct the body’s response to stress, Dr. Cywes recommended recognizing the students’ tension increase and need to blow off emotional steam, and scheduling time for them to do so. “Students should take a study break and do some physical activ-ity that allows their minds to empty for a little while. Not

With more than 200,000

students per grade

preparing to take the

Florida Comprehensive

Assessment Test (FCAT)

in February and March,

it is clear that this

examination is one of

the pivotal academic

experiences in the school

year. In the high stakes

test-taking environment,

ensure you’re doing all

you can to manage the

stress associated with

FCAT through time

management, nutrition-

al and emotional sup-

port strategies for your

student.

t

HealthSource

By Laura Capitano

HS

exercise. Exercise is strenuous. Walk the dog, dance around to a song on the iPod. Jump into the pool. It doesn’t have to be physically strenuous to stimulate the endorphin mechanism,” Dr. Cywes said.

-ical will allow the mind to be more absorptive when you return to work.” To this end, Dr. Cywes recommended a five-minute break for physical activity for every 20 – 40 min-utes of study time. “You will be far more effective if you build conscious breaks into your study time,” he offered.

Dr. Cywes also warned about some ineffective stress breaks, particularly the car-bohydrate breaks, when students stop and consume chips, cookies, soda or pop-corn. “Eating in response to emotional needs doesn’t give you the stress break you really want,” Dr. Cywes said. He also suggested students steer clear of caffeine. “Caffeine is one of the worst ways to deal with emotional stress. It doesn’t help with the mind’s absorptive capacity, and you crash and burn afterwards,” Dr. Cywes explained.

The quality, in addition to quantity, of sleep a student gets is also a factor in dealing with the emotional distress of the test time. According to Dr. Cywes, “If you plan ahead, you can find peri-ods of time when you can effectively sleep. If you try to sleep when your mind is buzzing with information, you don’t get a restful sleep.” Dr. Cywes suggested that the bet-ter method is for students to study, be physically active and then sleep because then their minds have had breaks and are ready to be quieted.

Principal Renfro said her school works hard to reduce the stress associated with the importance of the test. She has found much of the pres-

sure students feel comes from the time constraints of the testing environment. “Students think, ‘I have 60 minutes to complete this, and there are five long stories to read; I’d better hurry,’” Renfro explained.

To help your students feel more comfortable with the time constraints, Renfro said it is important to have them practice sustained reading. “Children need the stamina to read multiple reading pas-

need to practice reading in a sustained fashion for 20 min-utes,” Renfro said.

Know Your ResourcesOf the online and communi-

ty resources available for par-ents and students to prepare

Renfro said the best resource

training tool is free and offers reading passages and interac-tive sample test items for all

-derful online piece to practice, but it needs to be a team effort to get the full benefit,” Renfro said. Her concern is that when left to practice unsupervised, the more unmo-tivated students catch on to the answer schema, which allows users to just keep click-ing answers until they get the right one.

Renfro also encouraged parents wanting to help their

-cess to contact their local schools about parent-teacher support seminars. Typically

these meetings give parents an idea of the types of questions given, sample tests and an understanding of the work the children are doing to prepare for the test in their academic environment.



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This past fall we held our inaugural HealthSource Fit&Healthy Contest. Since

Jacksonville boasts its fair share of health-minded citizens from yogis to cyclists to

marathoners, we asked our readers to submit stories about First Coast citizens who

make healthy living a number one priority. With plenty of entries sent via social

media, email and snail mail, we reviewed all of the submissions and a decision

was made…well two decisions were made. We selected two winners (a male and a

female) for our first ever HealthSource Fit&Healthy Contest.

And the winners are…

Eden Kendall & Mark Avens

HEALTHSOURCE January 2011

HealthSource

HS: Was there a turning point when you became more inter-ested in health and fitness?

EK: My first workout at Timed Exercise was in March 2010 and that first one did not go well. My stamina wasn’t there, and my energy wasn’t there and I couldn’t complete the thirty minute workout. While it is not unusual for people to struggle during that first workout, it was unacceptable to me. I thought, ‘What do you mean,

there were supportive people [at Timed Exercise] who said, “In a few weeks, you will be able to complete this. In four weeks, you will see results.” And it was true for me. If you can commit to doing this regularly, you will see results. The running came later; part of it was on my own and part was running with Paul (McRae) on a regular basis. It’s amazing how far I’ve come since that first workout.

HS: Why is fitness such a passion?

EK: It started off as a challenge and turned into a passion. I work out six days a week and run at least four days a week. It just started to snowball as I realized I could do more and more. This has become a lifestyle I know I will live for the rest of my life. Before, when people asked me what my hobby was, I would say

a nap in before the kids came home from school. Now I don’t nap at all during the day. I have so much energy.

HS: How do you stay motivated?

EK: Results, accountability and goal-setting help me stay motivat-ed. My family also keeps me motivated. “Eden’s mental toughness is what’s been so great to watch. Two weeks before the Jackson-ville Bank Half Marathon her father became ill and passed away. Between that, and sciatic nerve pain, she fell behind on her training

Gator Country’s morning show, Eden’s early morning schedule required an afternoon nap to make it through the day. Eden says one workout changed everything.

-sonal Running Solutions. During the course of that event, Brett invited her for a workout that changed everything.

schedule. She was determined to get caught up and still run even though nobody could have blamed her if she sat this one out. [On race day], when she came across that finish line, I had tears in my eyes,” said Eden’s husband, Steve Thomas.

HS: What are some of your fitness goals?

EK: My goals have evolved considerably in a short amount of time. My first goal was to be able to finish the thirty minute work-out. Then it was about slimming down, toning up and just feeling better. Now my goals are different. I want to win races in my age division. I have already won now in my age group for 5Ks. The next goal is to do even better. I also want to run a half marathon by the end of 2010 (Eden completed this goal at press time). And I would like to be able to complete an unassisted pull-up. I con-stantly reassess my goals. People I surround myself with help me set realistic goals. Brett and Paul, in particular, are good at judging what people are capable of.

HS: What would you say to inspire others to get started?

EK: It doesn’t matter where you are in your life; the best time to get started is now. When you set your goals, write them down. Also, try a few things until you find something you love doing. You may not know that you would love tennis. I have a friend who just picked up tennis and now she plays regularly. Don’t be afraid or intimidated. Get rid of the fear. This is an intense workout but it’s for all fitness levels. It’s possible for anyone so don’t be afraid. Also, I am a big proponent of coaches and trainers. It may not be in your budget, but if you really feel like you need that extra push, you can never overestimate the value of it – just to have someone in your corner. You would also be amazed at how willing people are to share their knowledge and experience with you. There is a sense of community. It really becomes all about encouraging other people – the more, the merrier.

Eden’s Story:

Eden Kendall with her trainer, Brett



HS: Why is fitness such a passion?

MA: I’ve been athletic my entire life. Growing up, I was always involved in sports. As I grew older, I maintained that active lifestyle and fitness eventually became a career. My pas-sion centers on seeing kids today with less access to fitness. As parents become busier and have less time for kids, I think it impacts the fitness level of the whole family. Part of my moti-vation is to get parents involved and get them healthy so they can pass that along to their kids as my wife, Nicole and I do.

HS: How do you stay motivated?

MA: I have the best job. It’s a challenging job but I love it. I think fitness is the best investment people can make in them-selves. The number one investment you can make in yourself is your health. If you put the effort into it, your return on investment is so much greater. My passion is being active and healthy. When I left New York, where there is plenty of acces-sibility to fitness, I thought, with such beautiful outdoors and the beach, Jacksonville has as much, if not more, accessibility to fitness. I wondered why Jacksonville wasn’t known as a fit city. I want to be a part of that change.

HS: Was there a turning point when you became more interested in health and fitness?

MA: Back in New York, I had two great job offers at the same time - one with a top orthopedic hospital and the other with

used his background in physical therapy and fitness to help golfers improve their swing. As he worked with them, he found that just teaching golfers basic healthy eating habits and proper exercise directly impacted mobility and flexibility

about golf, his main passion was helping moms and dads. He opened Atlantic Beach Performance as a way to help parents get fit.

a top fitness facility. I could work for the hospital and use my degree [in physical therapy] or take the fitness job which offered about 25% more money. I opted for the hospital. It was interesting because the turning point came after working for them for six years. Seeing so many people coming in for knee and hip replacements who were overweight; I saw that the weight was a strain on their joints and would make their recovery even more difficult. It really drove my passion after working in orthopedics and geriatrics – seeing older people who never exercised and seeing how much harder their lives were compared to people who were fit. I thought there has to be a better way to reach people beforehand. When I got into the fitness, it was a no brainer.

HS: What are some of your fitness goals?

MA: Before it was more about competing in a triathlon or rid-ing in a 100 mile bike ride. Now it’s all about my kids, Mason and Julia, and being a positive role model. One thing I tell parents is, “We need to be able to survive parenthood.”

HS: What would you say to inspire others to get started?

MA: Get started. Telling people about a goal is huge. Sign up for something like the Gate River Run. It gets you motivated and locks you into a goal where there is accountability. Sign up, commit and train.

Mark’s Story:

-ing in his studio.

HS


The HealthSource blog is going strong

with nearly 2,000 unique visitors per

month. We have some of our best writers

blogging on a weekly basis, like Virginia

-

Never Let a Slip Become a Slide

The year has come to a close and you

are sitting at your dinner table with family

and friends reflecting on the year’s events.

As you emerge from your seat at the table,

you notice you are casting a slightly larger

shadow than you were one year ago. It

seems that those food-centered activities

during the holidays have led to a sudden

urge to rest on the couch, loosen your belt,

and watch some more television.

Perhaps the path to post-holiday weight

After all, you managed to keep all of the

resolutions you made last year, right?

I didn’t think so.

Survey results indicate that one of the

to ‘Lose Weight’. It also happens to be the

most difficult to attain. Believe it or not, the

average holiday weight gain for most adults

during the holidays is only about two pounds.

Unfortunately, this is weight that typically

stays with you. Over time, you begin to realize

the toll it takes on your well-being. To read

more, visit http://healthsourcemag.com/

blog/

HealthSource:

BEST of theBLOG

HS


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any of us aren’t taking in enough calcium, and, even

when we do, if vitamin D levels are low-the benefit may be lost. Studies have shown that without vitamin D, only about 10-15% of dietary calcium is absorbed, forcing the body to find another source. Calcium that’s been stored in the bones is broken down and used, leaving them weakened and fragile.

Putting It to the TestOver the last decade there’s been extensive

research and debate over the benefits of vitamin D and calcium, and what levels are needed to keep the body healthy. One study conducted by researchers at Albert Einstein College of Medicine found that seven out of ten children in the United States had low vitamin D levels.

As awareness increases, testing for vitamin D levels has become much more common.

Ever notice that some things are just better in pairs? When it comes to bone strength, calcium and vitamin

D are two nutrients that go hand-in-hand. Calcium helps build strong bones and teeth, transmit nerve

impulses, regulate heartbeat and assist in blood clotting and cell balance. It also aids the immune system

in fighting bacteria, viruses and disease. But alone, calcium isn’t enough. We need vitamin D to help

absorb the calcium that’s consumed.

The problem, says Matthew Benson, M.D.,

right now, there is no standard for testing. Dr. Benson, who is the director of a current study correlating decreased urine calcium levels in children to low vitamin D levels, says 9 to 12 % of infants and toddlers have low calcium levels. He hopes the low-cost urine screening test will make testing more affordable and lead to better diagnosis and treatment of deficiencies.

In November 2010, the Institutes of Medicine released new guidelines increasing the daily recommended amount for both nutrients.

What’s the harm? Infants and children who aren’t getting

enough vitamin D are at risk for rickets, a deficiency disease that prevents bones from

HealthSource

m

By LaNeta Crighton

mineralizing, making them soft and prone to deformity. “Nutritional rickets are an increasing problem, even in the U.S.,” says Dr. Benson, “and the problem is most common during the first seven years of life.” Dr. Benson describes the first year of life as the fastest growth period, followed by a slightly lower rate between ages one and two.

Rickets are most common in children who are breastfed. Although an advocate of breastfeeding, Dr. Benson believes it’s absolutely essential that infants who are exclusively breastfed receive vitamin D supplements. “About half of the moms in the South are deficient in vitamin D, and there’s an increased risk in kids whose mothers are deficient,” he says.

In adults, the lack of vitamin D and calcium can lead to osteoporosis, a condition that weakens bones. Osteoporosis occurs in both sexes, but is more common in women, particularly after menopause when estrogen levels decrease. Shelly Edens, RD, LD/N, a clinical dietitian at Memorial Hospital in Jacksonville, says she sees the condition frequently among elderly patients. “As you age, you absorb calcium less easily, and bones become soft,” says Edens. “Also, nursing home residents who don’t get in the sun much or those who have low calcium and vitamin D intake are at risk.”

What to DoEdens admits it can be

difficult to get the recommended amount of vitamin D from diet. “Dietary sources of vitamin D

are limited, but include fatty fishes like salmon, tuna and mackerel,” she says. Some foods like milk and cereals have added vitamin D. Reading labels and purchasing products fortified with vitamin D is an easy way to boost intake.“Sun is also an excellent source,” says Edens.

The sun does help the body produce vitamin D, but no one’s advising you ditch the sunscreen or bask at the beach. The risk of skin cancer means it’s wise to use caution when it comes to soaking up the rays. And, according to Dr. Benson, not all sun exposure is helpful. “In areas south of Atlanta, UV light has to be at a certain angle, which is only between the hours of 10 and 2,” he says. Because 10,000 to 20,000 IU of vitamin D are produced by one hour of sunlight, Dr. Benson says his own children spend between

in the sun without protection, followed by sunscreen for the rest of the day.

To boost vitamin D levels in infants, Dr. Benson recommends Poly-Vi-Sol drops until age two, when toddlers can begin taking a multi-vitamin. A multi-vitamin provides sufficient vitamin D for most adults, too, including pregnant and lactating women. Since some diseases and medications can affect absorption, it’s wise to consult your physician before adding supplements.

Edens says there are two kinds of calcium supplements. Calcium carbonate, which is found in Tums or Rolaids,

should be taken with food. Calcium Citrate is a more expensive option, but can be taken without food. Since the body can’t absorb large amounts of calcium at one time, Edens suggests dividing it into morning and evening doses.

exercise. Bone is made up of living tissue that is constantly renewed. As old bone is broken down, new bone takes its place. As we age bone loss accelerates and replacement slows, increasing the risk of fracture. “Exercise is one of the most effective things a person can do to strengthen bones,” says Eric Redding, a certified personal trainer and Head Trainer at

Mandarin location. Weight bearing exercises stimulate the growth of new bone cells, and, when combined with adequate calcium and vitamin D intake, can help keep bones strong. Redding has seen patients with even severe osteoarthritis benefit from the right kind of exercise. “Big compound movements that use both muscles and joints are best,” he says. But, he cautions, it’s wise to enlist the help of a trainer. “You wouldn’t just teach yourself ballet or karate. It’s the same with weight-bearing exercises,” says Redding. “It’s common for this type of exercise to be done wrong, and that can lead to serious bone issues, especially in patients with osteoporosis.”

Recommended

of Calcium and

The new guidelines for the recommended daily intake of calcium and vitamin D, released in November 2010 by the Institute of Medicine of the National Academies, are as follows:

CALCIUMIntake was determined by age and sex:

Adults: All adults between 19 and 50 years of age – 1000mgMen from 50 to 71 – 1000mgWomen starting at age 51 and men age 71 and up – 1200mg

Children:Ages 1 through 3 years – 700mg4 years through 8 years – 1000mg9 years through 18 years – 1300mg

VITAMIN DInfants under one year – 400IUAges 1 through 70 – 600IU 71 years and over – 800IU(The recommendations were based on minimal sun exposure).

High Risk ChildrenDr. Benson suggests children in high risk groups should be monitored for vitamin D deficiency. These include:

exclusively breastfed for at least one month

(melanin absorbs the UV rays so this group may not experience the same benefits from sun exposure)

unable to build adequate stores of calcium before birth

(below the 10th percentile)

underdeveloped countries

bow-legged than normal

FAAP

HS


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treatment of women’s pelvic health. As a sub-specialty of gynecology, urogynecologists offer the most extensive knowledge and expertise in the treatment of women’s pelvic health. This weekend, I can’t wait to see the look on John’s face when I beat him at his own game.

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3 QUESTIONS WITH JEFF GALLOWAY HS: Can you speak a little about your RUN-WALK-RUN™ method?

The Run-Walk-Run method gives you a strategy to erase fa-tigue, with the energy after workouts to do the other things needed for family after a long run. Walk breaks allow you to focus on one running segment at a time – instead of the total distance of the run. Using this technique, sedentary people of all ages have made the journey from the couch to the finish line – even the marathon –

HS: What advice do you have for someone training for a race? -

ods. They tell me the most significant aspects of the program are: Build the distance of a long run up to (or slightly farther than) race distance.Run long runs at least two minutes slower than your current 2. pace for a fast marathon. Have a reality check on pace, such as the “magic mile” used in our Galloway training programs, to monitor progress and assure a slow enough long run.Do two short runs a week (with walk breaks if desired). Insert walk breaks as noted in my Galloway Training Programs book on long runs. When in doubt, slow down and walk more, especially if the

HS: What is the most memorable race you’ve ever run?

running of this great race, and not because it was the greatest gathering of the running world to that point. This was special

his last marathon and I will remember so many details of it for the

www.healthsourcemag.com/blog.

WWW.HEALTHSOURCEMAG.COM—41

Shannon Miller Lifestyle (SML) launches a new initiative

tracking and rewards program that is designed to help people achieve a healthy and balanced lifestyle.

Over the past year, SML asked thousands of people about their health and fitness goals and challenges. Time and again people said getting started was a problem. That’s why SML created

“I’m competitive so I love counting steps. I can compete with myself everyday to see how many steps I can log. Wearing my pedometer has increased the amount of walking I do signifi-cantly. I no longer drive around for 5 minutes looking for the parking spot 10 feet closer to the door. Now, I make a point to park farther away just so I can gain steps,” says Shannon Miller.

www.shannonmillerlifestyle.com and start earning rewardshttp://healthsourcemag.com/blog/

Q: I get my blood pressure checked fairly fre-quently, whenever I go to the doctor or when my company has a health fair. Typically, they tell me its good but what does good mean? — Kim

Hi Kim,Great question! According to Mayo Clinic, blood pressure is determined by the amount of blood your heart pumps and the amount of resistance to blood flow in your arteries. When your heart contracts, or beats, it sends a surge of blood through the vessels, increasing blood pressure. This is called systolic pressure (the top number). When your heart relaxes between heart beats, your blood pressure decreases. This is called diastolic pressure (the lower number). According to the American Heart Association, a healthy blood pressure is below 120 systolic and below

80 diastolic. To see what blood pressure is, check out www.mayoclinic.com/health/what-is-blood-pressure/MM00783Health Designs provides questions and answers for Ask a Health Coach

HEALTHY EVENTS - JANUARY 2011

Do you know about an upcoming health event? Email [email protected]. Also, check out www.facebook.com/health-sourcemagazine for the latest on local health events.

Jeff Galloway

FREE ICE SKATING CLINIC

Apply strip lashes over eyeliner so the lashes appear fuller with a dark eye line. (Select lashes that aren’t too full and have a natural look). As the glue dries on the lid, gently push the lashes up to keep the upswept look. Lashes and DUO brand lash adhesive can be purchased at drugstores or beauty supply stores. To remove lashes, simply pull from the outer corner across your lid. If you don’t apply mascara, the lashes may be reused.

Waterproof gel eyeliner applied with an 2. angle brush is a great way to enhance your eyes and easily creates the look of full lashes with or without strip lashes.

Draw in an eyebrow with a brow pencil or matte brow powder applied with angular brush. Draw in tiny little hairs and create an arch that lines up above the iris. Use a clean mascara wand brush to blend.

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loose powder sparingly with a large fluffy brush.

Creme or sheertone (slightly frosty) blush applied with a fluffy blush brush brings soft color to the cheeks.

Renee Parenteau, who did the photos, make-up and hair for this month’s cover shoot, provides make-up tips for breast cancer patients.

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healthsource virtual edition january 2011

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