THE GO O D L IV IN G MAG AZ IN E f rom SOU TH ERN I LL I NOI S H EALTH C ARE AUGUST 2012f rom

how painkillers

differ

TOP CANCER CARE CLOSE TO HOME

SOOTHING SEDONA

BREATHE EASYDESPITE ASTHMA

MYSTERY MALADY, REVEALED

BE SAFE FROM lyme

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C2_SILL_SUMMER12.indd 2 7/19/12 4:35 PM

CONTENTS

AUGUST 2012

24269

FEATURES

LIFESTYLES / IS A LIVING WILL RIGHT FOR YOU?With it you can make your own choices for end-of-life care.

CLINICAL UPDATE / ‘I’M BACK’An outdoorsman beats prostate cancer thanks to robotic surgery.

HEALTHY LIVING / PAINKILLER RISKS: WHAT TO DO NOW Finding a safe strategy for relief

ESCAPES / SOOTHING SEDONAThere’s balm for the spirit in this stunning Southwest setting.

CLINICAL UPDATE / HEPATITIS: THE QUIET KILLERThis silent time bomb is ticking away at the lives of hundreds of southern Illinoisans.

BETTER CARE / THE MYSTERY DISEASEDon’t suffer in silence with the pain of fibromyalgia.

DEPARTMENTS

WELCOME LETTER

TAKING CHARGE / BREATHE EASYWe have your solution to asthma.

FOUNDATION FOCUS / HOPE IS HOMEVisit our facility for the latest technology in cancer treatment.

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FLASH / AUXILIARY DAY The community of Herrin honored the hospital’s Auxiliary by declaring a day in its honor.

TAKING CHARGE / LIFE GOES ON WITH CONGESTIVE HEART FAILURE Today’s treatments mean this condition needn’t be as limiting as it sounds.

PREVENTION / WHY WOMEN’S ‘ACHILLES HEEL’ IS IN THE KNEE The torn anterior cruciate ligament is the bane of the active woman—but you can reduce your risk.

STAYING WELL / THE ABC’S OFDIGESTIVE DISEASE Knowledge is power when it comes to tummy trouble.

YOUR BODY / COUNTING CALORIES A roundup of activities that do your body good

GLORIOUS FOOD / IMMORTAL OIL The fruit of the ancient olive tree yields one of nature’s most sublime creations.

SEASONAL HEALTH / LYME DISEASE Beware the disease spread by tick bites. It can be more than a nuisance if it’s not caught early.

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Welcome letter

Welcome to the august edition of Southern IllInoIS

health and life magazine.

in this issue, you will read about an initiative dear to the hearts of

many of our families, friends and neighbors—a comprehensive, free-

standing cancer center in our own backyard. for far too long, we have

watched our loved ones embark on the journey for treatment to places

far away from home. this takes an emotional, physical and financial

toll on the thousands of cancer patients who endure travel back and

forth each year; for many, that can mean 100 appointments in the

first 12 months alone. We want to change that and we need your help.

i hope the story of our hope is home campaign touches you. We

cannot do it alone.

in addition, we share innovative advances in da Vinci robotic surgery.

You will meet dr. srinivas Rajamahanty and an avid herrin angler

who bounced back from prostate surgery in time to hit our region’s

beautiful lakes last spring. dr. erica Kaufman shares her optimism

regarding fresh treatments for patients coping with hepatitis c. You will

hear from one woman who handles her adult asthma with inspiration

and ease with the help of her pulmonologist.

in each issue of Southern Illinois health and life magazine, we strive

to share relevant advances in modern medicine while highlighting the

physicians, specialists, nurses and other healthcare providers who dedi-

cate their lives to making us well. We couple this with a blend of healthy

lifestyle news and getaways that are good for body, mind and soul.

if you have any questions or input on something you would like to see

in our magazine, please let me know. i am always happy to hear from you.

sincerely,

here’s to

Rex P. BuddePResident andchief executiVe officeRsoutheRn illinois healthcaRe caRbondale, illinois

SIH STAFF

PResident and chief executiVe officeR Rex P. Budde

coRPoRate diRectoR ofmaRKeting and communication cHeRyl Benn

communications cooRdinatoR

RoSSlInd RIce

SouTHeRn IllInoIS HeAlTHcARe1239 East MainCarbondale, IL 62901(618) 457-5200

SIH cAll cenTeRPhysician referrals, information on classes and hospital services: Monday–Friday, 8 a.m. to 4:30 p.m. 1-866-SIH-2468 (1-866-744-2468)

WAInScoT STAFF

editoR in chiefRITA guARnA

aRt diRectoRSTePHen vITARBo

aRt assistantmegHAn BASHAW contRibuting editoR

TImoTHy kelley

Southern Illinois health & life is published by Wainscot media, 110 summit avenue, montvale, nJ 07645, in association with southern illinois healthcare. this is Volume 4, issue 1. © 2012 by southern illinois healthcare. all rights reserved.

material contained herein is intended for informational purposes only. if you have medical concerns, seek the guidance of a healthcare professional.

memorial hospital of carbondalest. Joseph memorial hospitalherrin hospitalcenter for medical artsminers memorial health centersih cancer institutelogan Primary care

the good living magazine from southern illinois healthcare you!

CEO_SIH_12.V3.REV1.indd 4 7/19/12 3:24 PM

1Do a little homework. End-of-life care is more complex than you may sus-pect. For example, “heroic measures” can mean dif-ferent things to different people. “If you have termi-nal cancer and don’t want aggressive treatment, does that mean doctors mustn’t insert a breathing tube for acute pneumonia?” asks Abby Woods, palliative care coordinator for South-ern Illinois Healthcare. Read up on end-of-life care (see box at right) and re-flect. Do you want all pain relieved even if doing so may hasten death? Per-haps you’d like all possible medical steps taken—a living will can say that too. And it can express wishes about hospice care, organ donation and the funeral.

2Discuss your wishes. Consult with the people who are closest to you—especially your intended proxy—and with your doc-tor and clergyperson.

3obtain a basic form. Southern Illinois Healthcare has a living will document it makes available to pa-tients. Sample documents that follow Illinois law may also be downloaded from the Illinois Department of Public Health website (www.idph.state.il.us/pub-lic/books/Livin.PDF) and www.illinoislegalaid.org.

4retain a lawyer if you choose. It isn’t required, but you may wish to have an at-torney complete your living will. His or her time will cost you from $100 to $500, says attorney Martin Shenkman, but you’ll save if you’ve used the forms to marshal ideas in advance.

5save your Document. In Illinois, two adults over the age of 18 must wit-ness living wills. These witnesses can’t be some-one responsible for your medical care or someone who will inherit from you. Keep one signed original at home where it’s close at hand (not in a bank’s safe deposit box). Give others to your doctor, your lawyer and your healthcare proxy.

with it you can make your own choices for end-of-life careif you could do something today that might save your loved

ones distress years from now, you’d do it, right?

You can, with modest cost and effort, but there’s a catch. It means thinking

about what may be uncomfortable to consider: your final days.

What you can do—even if you’re young and healthy—is create a living will.

It’s a legal document that records your wishes for medical care in case you

become terminally ill and unable to communicate. Often, medical technology

can extend life beyond the point where there is consciousness or the hope of

its return. But it can be heart-wrenching for a relative to have to decide that a

treatment should be withheld.

“Living wills can take a huge burden off the shoulders of family members

in making those terrible decisions,” says attorney Martin Shenkman, co-author

with his wife Patti Klein, M.D., of the book Living Wills and Healthcare Proxies. A

living will is one part of what’s called an advance directive; another part, equally

important, is a healthcare proxy directive, which names a trusted person to

make decisions in your stead.

is a living will right for you?

is it worth facing scary thoughts to create this tool? that’s up to you. however, consider this

haunting question: “what happens in the hospital when it’s 3 a.m. and someone has to decide?”

To FInD ouT MoREcheck amazon.com or another online book service for those volumes on living wills:

Living Wills and Healthcare Proxies, by martin shenkman and patti klein, m.d. law made easy press, 2004. How to Write Your Own Living Will, by edward a. haman. sphinx publishing, 2000. Planning for Uncertainty: A Guide to Living Wills and Other Advance Directives for Health Care, by

david John doukas, m.d., and william reichel, m.d. Johns hopkins university press, 1993.

LIfeStYLeS

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an outdoorsman beats prostate cancer thanks to robotic surgery

clinical update

Dave Duncan of herrin haD a feeling that the Day would come, although he tried not to dwell on it. “i knew

the possibility was there, but i tried not to think about it,” he

says. “i believe there is no sense in getting worked up about

something you really can’t control. i’m sort of laid-back and

care-free, and i wanted to stay that way.”

even though he tried not to fret, “it” was still there: the

likelihood that he someday would be facing prostate cancer.

after all, his father had suffered from the disease and his

own primary care physician had him on a “watch list” for the

disease for almost 10 years. With a family history of the

disease and knowing that nearly a quarter million new cases of

‘I’m back’

prostate cancer will be diagnosed in the u.S. this year, duncan

had cause for concern.

He underwent a prostate exam twice a year. a test last

summer indicated a higher-than-normal pSa score, a measure

of prostate-specific antigen, which can indicate cancer. a

referral to a urologist for a biopsy led to the unwelcome but

not unexpected news: prostate cancer.

duncan was given several options for treatment.

“i could have undergone chemotherapy or radiation, had

stents put in or had it removed,” he recalls. “i know that those

people who have the treatments are not always sure that the

cancer is 100 percent gone. i knew if the prostate was taken out

it would be gone, so i decided that at age 60, i didn’t need it

anymore.”

He turned to urological surgeon Srinivas Rajamahanty, M.d.,

at the center for Medical arts in carbondale for the proce-

dure. even then, duncan had two choices for removal of his

prostate: traditional open surgery or an operation utilizing the

Dave Duncan, avid fisherman, at Crab Orchard Lake

for more informationto find out if da Vinci robotic surgery is for you, contact the sih call center at 866-744-2468 or Visit www.daVincisurgery.com

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Prostate_FF12.V3.REV1.indd 1 7/19/12 3:33 PM

an outdoorsman beats prostate cancer thanks to robotic surgery

da Vinci® surgical robot. Dr. Rajamahanty is the only physician

in southern Illinois using the da Vinci for urological surgeries

including prostatectomy. After consultation with the surgeon,

Duncan chose the robotic procedure.

“Dr. Rajamahanty and I talked one-on-one for an hour,”

he says. “He went through everything and really took his time

explaining things to me.”

The explanation included the benefits of robotic surgery

as well as the actual procedure itself.

“We compare everything to open surgery, but open surgery

for prostate removal means an incision from the belly button

to the pubic bone—about six inches—and long hospital stays and

recovery time,” Dr. Rajamahanty explains. “The da Vinci offers

a lot of advantages over that. It is a minimally invasive option, a

sort of laparoscopic surgery.”

“I knew the possIbIlIty was there, but I trIed not

to thInk about It.”He says with the procedure, the long incision is replaced

by several small incisions for a tiny camera as well as for

the instruments which are attached to arms of the robot. The

much smaller incisions mean much less blood loss for the

patient.

“The average blood loss in traditional open surgery is 500

milliliters or more, usually requiring a transfusion,” the

doctor says. “With the robot, blood loss is under 200 milliliters.”

Additionally, he says, post-operative recovery time is

minimal.

“We usually send patients home the next day and they

sometimes can return to work in just a few days.”

Dr. Rajamahanty says that in da Vinci surgery, the physi-

cian in many ways mimics a traditional open surgery, but he is

able to do more and do it more precisely.

“We don’t cut corners; we do the same steps, but it is

minimally invasive and the robot gives us degrees of freedom

that we as surgeons don’t have,” he adds. “The human hand

and wrist are limited in movement; the robot can do things

we just cannot do.”

He says another advantage of the da Vinci is that it offers

a better visual perspective on the surgery.

“There’s a ten-fold magnification of the surgery,” he says.

“It means you can be more precise.”

During surgery, Dr. Rajamahanty manipulates the robotic

arms and instruments via a three-dimensional console in the

operating room, much like operating an elaborate video

game system. Through the use of hand controls and pedals, he

is able to precisely manipulate the robotic arms and instru-

ments. He can even view the readings of instruments and

see ultrasounds and other medical images without moving

his head.

“The robot is more of an extension of the surgeon during

the procedure. It presents a stronger magnification of the

surgery field and offers better dexterity because it can rotate

in more ways than the human hand,” he explains. “Plus, it filters

your natural hand tremor to make movement more precise.”

All in all, with a skilled urological surgeon, the da Vinci

improves all aspects of the surgical experience.

“The robot does not replace your intuition as a surgeon or

your knowledge,” Dr. Rajamahanty continues. “It just helps

you and you can use it to your advantage for your patients.”

The advantages of da Vinci-assisted prostatectomy are

not limited to the short-term benefits of less pain and quicker

recovery. Many men are concerned about a return to intimacy,

which is not a problem, the doctor assures.

There are also pluses over the long run, Dr. Rajamahanty

says.“Because I am able to see so much closer, I can do a better

job of rejoining the bladder and urethra after the prostate

is removed. That means the patient has less chance of urinary

problems like incontinence later in his life,” he adds.

“Technology is becoming so much more advanced that

robotic prostate surgery is quickly becoming the standard of

care,” Dr. Rajamahanty says. “In my mind, there is no doubt

that the results of robotic surgery are better for the patient.”

Duncan says the surgery was definitely better for him.

“No surgery is easy, but this was the easiest choice,” he

says, adding it wasn’t long after his operation that he, an avid

outdoorsman, was back to hunting and fishing. In fact, just

a few weeks after surgery he was catching fish on the lakes and

rivers of Alabama.

“I would recommend this surgery,” he adds. “I’m back to

just like before.”

Srinivas Rajamahanty, M.D.

s o u t h e r n I l l I n o I s h e a lt h & l I F e / 5

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Despite the confusing news reports, your Doctor can help you

plan a safe strategy for relief

healthy living

painkiller risks: what to do now

Must easing toDay’s pain Mean taking chances with

tomorrow’s health? no, the experts say—despite all that you’ve read

about risks. But if you suffer chronic discomfort from arthritis or

other ills, it may be time for a fresh conversation with your physician

about what pain-relief products are best for you.

Because of what we know about cardiac risk, says Scott Wright,

M.D., a cardiologist at the Mayo Clinic in Rochester, Minnesota,

“people should now think carefully about how to best manage their

long-term arthritic pain.”

Worries came to a head in September 2004, when the popular

prescription painkiller rofecoxib (brand name vioxx) was withdrawn

by its manufacturer because studies suggested that taking it for a

long time increased one’s risk of heart attack and stroke. Shortly

thereafter, the Food and Drug administration asked that a sister

medicine called valdecoxib (Bextra) be taken off the market because

of possible cardiovascular risk and the danger of potentially life-

threatening skin complications.

vioxx and Bextra are COX-2 inhibitors, a class of medications

that tend to constrict blood vessels, raise blood pressure and make

the platelets in the blood stickier. “Research data show that in

some situations patients’ risk of a cardiac event is 10 to 25 percent

higher if they’re on COX-2s long-term,” says Dr. Wright. the FDa

didn’t originally intend these medicines to be used indefinitely, he

adds, but “they’ve worked well for a large number of people—in-

cluding my own mother—and it’s human nature to want to stay

on them.” the FDa decided to require new “black box” label warn-

ing messages—its toughest kind—about cardiovascular risk for all

prescription nonsteroidal anti-inflammation drugs, or nSaiDs, a

larger category of medicines of which COX-2s are a subgroup.

and even for most non-prescription nSaiDs—familiar over-the-

counter products like ibuprofen (advil, Motrin), naproxen (aleve)

and ketoprofen (Orudis)—the agency requested that product

labeling include reminders about limiting dose and

duration and also provide more information about both cardio-

vascular and gastrointestinal risks.

So what’s a pain sufferer to do?

Consult your doctor, says John Chaney, a registered pharmacist

and pharmacy manager at herrin hospital. “a good rule of thumb

for any medication is to use the lowest prescribed dose in the

proper time frame for the shortest duration that gets the job done.

and remember that all medications—including over-the-counter

and herbal products—have potential risks.” Follow your physi-

cian’s advice if you’re going to be taking anything regularly for a

long period—including over-the-counter products, says Chaney.

Finally, it’s only fair to note that pain is subjective and not all

medications are perceived as equally effective. Some people

who have given up COX-2 inhibitors report that they’re not getting

quite the same level of pain relief from the medications they’re

now taking instead.

“remember that all medications—including

over-the-counter products—have risks.”

—pharMacist john chaney

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Don’t rule out gooD olD aspirin. this 19th-century miracle drug does pose a risk of gastrointestinal bleeding, but it’s also the one nsaiD for which the FDa is not request-ing new label information on cardiac risk—because it’s known to protect the heart. some people have levels of pain higher than the safe daily maximum of aspirin can han-dle, but for many the familiar tablet does double duty. “We recommend that most people take an aspirin every day to guard against heart disease,” says Dr. Wright. “it turns out aspirin may be much safer and better than we realized.”

4 Ways To sTay Safe

talk to your Doctor about your risk. your physician knows your medical history, and risks differ greatly from one individual to the next. “if you’re a 20-year-old with a knee injury who will be taking a pain reliever for a few weeks, the increased cardiac risk of a coX-2 inhibitor may not be worth worrying about,” says cardiologist scott Wright, M.D., of the Mayo clinic. “but if you’re a 60-year-old with diabetes, hypertension or a history of smoking or heart disease and you’ll need pain relief indefinitely, that’s dif-ferent.” if you take a blood-thinning medication such as warfarin (coumadin), you’ll likely be told to avoid aspirin, ibuprofen and naproxen.

consiDer a coMbination. if you rely on either celebrex or one of the older nsaiDs on an ongoing basis, says Dr. Wright, you may wish to guard against their gastro-intestinal risks by also taking a stomach-protecting medi-cine, perhaps a proton pump inhibitor such as omprazole (prilosec), lansoprazole (prevacid), esomeprazole (nexium), rabeprazole (aciphex) or pantoprazole (protonix).

iF inFlaMMation isn’t a concern, try acetamino-phen (tylenol). it’s gentle on the stomach and often works well against pain, but unlike nsaiDs does nothing against inflammation. it can be a good first line of defense if you have osteoarthritis, the kind that comes from thinning cartilage, but not if you have rheuma-toid arthritis, an inflammatory condition. in a study of people with osteoarthritis of the knee, 40 percent reported good-to-excellent relief with tylenol versus 60 percent with the riskier nsaiDs.

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For years doctors have known that traditional, inflammation-

fighting NSAIDs such as aspirin, naproxen and ibuprofen can

sometimes trigger peptic ulcers and bleeding in the stomach

lining. That’s because these medicines target a group of

enzymes called cyclooxygenase, or COX. COX enzymes pro-

duce the hormone prostaglandin, which stimulates inflammation.

But these enzymes also tend to protect the stomach lining,

and when their action is inhibited, so is that protection.

In 1990, scientists thought they’d found a better answer.

They discovered a new category of COX enzymes called

COX-2, which appear in cells only during the inflammatory

response. By targeting only the COX-2 enzymes, it was hoped,

a medication could achieve the welcome anti-inflammatory

effects without danger to the stomach lining.

Thus, in the late 1990s, COX-2 inhibitors were introduced.

Besides Vioxx and Bextra, they included celecoxib (Celebrex),

which is still available but now carries a new, FDA-mandated

warning about cardiovascular risk.

PAIN RELIEF MEDICATIONS: WHAT YOU NEED TO KNOWNO MEDICATION IS PERFECT, AND DIFFERENT ONES WILL BE RIGHT FOR DIFFERENT PEOPLE. HERE’S THE RUNDOWN ON FIVE COMMON PAIN RELIEVERS WITH THEIR ADVANTAGES AND DISADVANTAGES:

MEDICAL NAME TRADE NAME AVAILABLE OVER THE COUNTER?

NSAID? SAFE DAILY ADULT DOSAGE LIMIT

THE GOOD NEWS THE BAD NEWS

CELECOXIB Celebrex No Yes 200 milligrams It’s the one COX-2 inhibitor left, and many people have found this class ef-fective; probably little risk of stomach bleeding in short term

May increase risk of heart attack and stroke; evidence now shows there is risk to stomach in long-term use

ACETAMINOPHEN Tylenol Yes No 4,000 milligrams (8 Extra Strength Tylenol capsules or 6 Tylenol Arthritis Formula capsules)

A good fi rst choice. Safe for the stomach; poses fewer risks than most pain relievers

Does not act against infl ammation, the cause of some pain; large amounts can promote liver damage, especially if users consume alcohol

ASPIRIN Yes Yes 4,000 milligrams Inexpensive; has addi-tional benefi t of protect-ing the heart

My cause bleeding in stomach lining; must not be used for children with viral illness

IBUPROFEN Advil, Motrin, etc. Yes Yes 1,200 milligrams (over the counter) 2,400-3,200 milligrams (perscription)

Very effective for many individuals

May cause bleeding in stomach lining, kidney or liver problems, high blood pressure or congestive heart failure

NAXPROXEN Yes Yes 660 milligrams or 440 milligrams for seniors (over the counter) 1,000 milligrams (prescription)

Effective; less frequent dosing

My cause bleeding in stomach lining, kidney or liver problems, high blood pressure; may increase risk of cardio-vascular event

Aleve, Naprosyn, etc.

Today, however, even COX-2 inhibitors’ easy-on-the-

stomach reputation has come into question—at least for long-

term use. “Research data have shown that after a year these

medicines have a risk of GI bleeding that may be comparable

to other agents,” says cardiologist Scott Wright,

M.D., of the Mayo Clinic. Still, many people

insist that the COX-2 inhibitors provide

the best pain relief they’ve

found yet.

THE RISE AND FALL OF COX-2 INHIBITORS

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Take a deep breaTh. breaThe in, filling your lungs

with air. Now exhale. It is a very simple process, and the ability

to breathe without thought or effort is something we take it

for granted. Well, most of us take it for granted. All across southern

Illinois are thousands of people for whom taking a deep breath

is very difficult—if not impossible—because of asthma.

“In layman’s terms, asthma is an inflammatory disease of the

airways that you can develop at any age,” explains pulmonologist

Raymund Pineda, M.D. “The main symptoms are wheezing, short-

ness of breath and coughing.” The disease is most common in

young people, many of whom outgrow it. Asthma, however, also

can first appear later in life.

Dr. Pineda says the root cause of the disease is unknown, but

certain factors such as allergies, weather changes, exercise

and environmental components such as pollen, dust and smoke

can incite flare-ups and airway spasms, making breathing difficult

for sufferers.

Valerie Funk of Elkville knows what it’s like. “Before treat-

ment, if I was having an attack, it would be a really bad thing,” she

recalls. “I couldn’t catch my breath, and it felt like the walls were

closing in and I couldn’t escape. Even with deep breaths it was like

I couldn’t get any air.”

Funk, 35, has had asthma since she was a child.

“I feel it has prevented me from doing some things,” she says.

“My worry was always that I’d push too much. I stayed away from

sports just because of the asthma.”

Diagnosing asthma requires some detective work on the part of

physicians, says Fadi Adra, M.D.

“Typically, you see episodes of coughing, wheezing, tightness

in the chest and occasionally a family history of asthma,” he

says. “Sometimes it is difficult because people come in with just a

cough and no other symptoms. It can be challenging.”

Breathing tests are used by the physicians to confirm asthma.

Then they try to address the roots of the illness as well as the

symptoms.

“First we try to eliminate the causes of the asthma,” Dr. Adra

says, explaining that things such as smoking, pets and exposure

to certain chemicals may be partially to blame. “But most of the

time it is very difficult to eradicate the causes.”

Attention then turns to treatment.

“Treatment depends on the frequency of the attacks and their

severity,” Dr. Pineda explains. “We always start with a simple

inhaler, which is used as needed, and we see how that goes.”

He says the treatment of asthma is a “step-up” and “step-down”

approach, with medications including inhaled corticosteroids.

More serious asthma cases such as Funk’s are treated with Immu-

noglobulin E receptor antibodies—a weekly or bi-weekly injection.

“It has worked wonders for many patients,” he says.

“It has pretty much prevented all of the attacks,” adds Funk,

who has been receiving the injections for two years. “I am really

able to do more now.”

Before the shots, even after puffs from an inhaler, Funk some-

times needed emergency treatment for especially severe attacks.

Today, those are a memory. She’s even taken up a nationally

known intense workout regimen.

“Before treatment I wouldn’t have been able to push myself like

that,” she says. “It definitely has made a positive impact on the

quality of my life.”

Dr. Pineda says people with asthma can live perfect normal

lives by controlling the disease, and gaining control of asthma

is relatively simple. That’s something to help all of us breathe a

little easier.

breathe easyWe have your soluTion To asThma

TAkINg cHARgE

Need help coNtrolliNg your asthma?

Call the SIH Call Centerat 866-744-2468 for a list of pulmonologists serving southern illinois.

Raymund Pineda, M.D.

Valerie Funk

Fadi Adra, M.D.

s o u T h e r n i l l i n o i s h e a lT h & l i f e / 9

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Soothing

Sedona

there’s balm for the spirit in this stunning southwest setting

Without a doubt, the best travel experiences are transformative,

healing mind, body and spirit alike. We come home not merely

refreshed and recharged, but somehoW rejuvenated and changed for the better.

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The gorgeous red hue of Sedona rocks comes from iron that has accumulated in sandstone over the millennia.

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If ever a destination dealt in transformation, it’s Sedona, Arizona. You

needn’t believe what they say about the spiritual energy of the place

to see that there’s something powerful about Sedona. Nor do you have

to visit an alternative healer, take a walk with a “coyote talker” or experi-

ence the sublime at one of Sedona’s spas (though you can do all these

things). The setting alone—with its soaring red rock buttes, sculpted

spires and stunning cliffs—is enough to work magic. Even down-to-

earth, grounded-in-reality types say they feel a special energy in Sedona.

Reports one recent visitor: “Something there really spoke to me.”

Over the past few decades, this once sleepy town and longtime

magnet for artists has evolved into a first-class resort community.

Besides fine lodging, dining and shopping, Sedona offers activities

and attractions that promise to soothe the souls not only of spiritual

seekers and nature lovers, but also of art and culture buffs, history and

archaeology fans, active adventurers and anyone else in need of renewal.

You can reach Sedona by flying into Phoenix, renting a car and

driving about two hours north. When you arrive, you’ll be in a bowl-

shaped valley that sits about 4,500 feet above sea level. First-time

visitors expecting a sandy desert landscape are surprised by the broad

swaths of pine forest surrounding Sedona. The green trees create

a striking contrast to red sandstone monoliths with names such as

Cathedral Rock, Bell Rock, Two Nuns and Elephant Rock.

If you’ve been to the Grand Canyon, Sedona’s red rock formations

will feel familiar. That’s because the rock layers of Sedona’s half-mile-

high cliffs are nearly identical to those found in the upper half of the

Grand Canyon. There is one key difference: In Sedona, rather than

looking down on the striated sandstone cliffs and monoliths, you’re

surrounded by them. That’s part of the power of the place.

Most days, the backdrop for this beauty is a vast, intensely blue sky

and a bright desert sun whose long rays cast a fiery orange glow on

the cliffs at sunrise and sunset. (Desert sun notwithstanding, Sedona’s

climate is comfortable year-round; it’s only in July and August that the

mercury regularly soars into the 90s, and even then nights are cool.)

Depending on where you stay in Sedona, you can step outside your

door, keep on walking and within 15 minutes find yourself high up on

one of those magnificent cliffs. But the best news is that you don’t have

to be especially fit to hit the hills, since there’s a wide choice of hiking

trails, from easy to difficult.

Even avid hikers will want to put aside their hiking gear for a jeep

tour of Sedona’s backcountry. These off-road tours bounce along

through rugged territory, exploring area canyons, following old

stagecoach routes, visiting ancient ruins and climbing to the top of the

2,000-foot-high Mogollon Rim.

The great outdoors in Sedona is so alluring that you may feel you

can never get enough. Fortunately, there are plenty of options for

exploring it, including guided horseback excursions, mountain biking

and sightseeing aloft by hot air balloon, helicopter or plane.

Or just hop in a car and drive. Among nearby sights worth a

visit are Chapel of the Holy Cross, an inspiring modern shrine built

right into the red rocks, scenic Boynton Canyon and Red Rock

Crossing, whose views of Oak Creek and Cathedral Rock have been

photographed so often they’ll seem familiar.

In Sedona, rather than lookIng down on the StrIated SandStone clIffS and monolIthS, you’re

Surrounded by them. that’S part of the power of the place.

Continued...

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DIST.travel.V2.REV2.rg.indd 28 7/19/12 3:26 PM

Opposite, Cathedral Rock, whose spires stand 1,000 feet over the road below, is known as a vortex center and a place for blissful meditation. This page, the Chapel at Tlaquepaque evokes the feel of a quaint Mexican village with its Spanish tiled roof, hand-carved leather pews and stunning mural over the altar. It’s located in an arts and crafts village with unique galleries, shops and restaurants.

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DIST.travel.V2.REV2.rg.indd 29 7/19/12 3:26 PM

Hiking in Sedona is an exhilarating experience, with trails for every fitness level. Visitors can hire a spiritual guide to lead them to vortex areas. Opposite, low-slung adobe casitas sit amid cottonwood trees at the Enchantment Resort; pan-seared veal chop with Morel sauce from the menu of the resort’s Yavapai restaurant.

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DIST.travel.V2.REV2.rg.indd 30 7/19/12 3:27 PM

You can even drive or take a tour from Sedona to the South Rim

of the Grand Canyon, just two and a half hours away. Or stay closer

to home and visit the former hillside mining town of Jerome.

One drive not to miss is Highway 89A as it winds up

16-mile-long Oak Creek Canyon. With sheer walls and unusual rock

formations, this stretch of road has been named one of the nation’s

most scenic drives. In summer, the creek is stocked with trout and

swimming holes beckon. Between late September and mid-October,

you’ll be treated to blazing autumn foliage. And no

matter when you visit, you can stop along the way

for a hike or a creek-side picnic.

Leave time to drive all the way to Oak Creek Vista

for a dramatic bird’s-eye view of the area. While there,

you can pick up locally crafted wares on sale by Native

American artisans. If you’re traveling with children—

or you’re kid-minded yourself—you’ll want to stop

at Slide Rock State Park, don your bathing suit and

splash your way down a natural water slide.

Nature is not Sedona’s only attraction. The region’s

human history is just as compelling. Numerous ruins

and rock art sites tell of ancient peoples who were

skilled in pottery, weaving and agriculture and who

traded with peoples throughout the Americas long

before Europeans came.

The most impressive of the sites is Montezuma Castle, about

25 miles south of Sedona. Constructed in the 12th century by the

Sinaguan people, this five-story, 20-room dwelling is built into the

sides of a high cliff. A few miles away is Montezuma Well, a huge

sinkhole that’s fed by underground springs that support a verdant

oasis. You can take tours of these and other sites that focus on the

archaeological, cultural and geological history.

Artistic types have long found that Sedona’s beauty fuels the

muse. In the 1920s, Hollywood discovered that red rock country

makes a dramatic film set, and numerous Westerns have been filmed

here since. The first well-known visual artist to “discover” Sedona

was surrealist painter and sculptor Max Ernst, who lived here in the

1950s, initiating an influx of artists that continues today.

Today, Sedona has a thriving art scene. Art lovers can spend

days perusing collections of Native American, Southwestern and

Western arts and crafts in more than 40 galleries, and the Sedona

Arts Center offers a full calendar of exhibitions,

plays and workshops. At Sedona Cultural Park,

concerts are held in an outdoor amphitheater.

As if nature didn’t provide enough in the way of

spectacular settings, visitors can also book a stay at

the luxurious Mii Amo spa, which takes its name

from the Native American word for journey. A world-

class destination in itself, it’s set within the grounds

of the luxurious 70-acre Enchantment Resort in

secluded Boynton Canyon. Lodgings here have

unmatched views of undulating red rock walls and

formations, contrasting with the deep green of trees.

For some, however, what makes Sedona most

compelling are not the visual delights, but a

handful of energy fields called vortexes that are

said to elicit profound healing and spiritual experiences. Never

scientifically proven, the vortexes are nonetheless the reason so

many seekers, mystics and healers find their way to this spot.

Perhaps they’re also why this area has long been considered sacred

by native peoples.

Find out for yourself by taking a vortex tour, or strike out on your

own for the vortex sites, many of which are located at Sedona’s most

dramatic rock formations. One way or the other, you’re bound to find

it a powerful—perhaps even transformative—experience.

Art lovers cAn spend

dAys perusing collections of nAtive AmericAn, southwestern And western

Arts And crAfts in more thAn 40 gAlleries.

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DIST.travel.V2.REV2.rg.indd 31 7/19/12 3:27 PM

foundation focus

ImagIne a place where IndIvIduals battlIng cancer

can go to receive the very latest in treatment. a place where

their physicians—regardless of specialty—are steps away from

each other, making consultations and collaboration easy. a place

where related services and support staff work together with

compassion and care to meet the needs of patients and their

families. a place that is comfortable, cheerful and, perhaps best of

all, close to home.

for decades such a place has been a wish for southern illinois

cancer patients and their medical providers, but the realization

of that dream is about to come true.

Planning and fundraising are under way for the southern illinois

Healthcare cancer center, a single comprehensive facility that will

provide state-of-the-art cancer care and treatment close to home.

“When we see an unmet need, we respond to it,” siH Presi-

dent/cEo Rex Budde explains. “that is the driving force behind

our latest and most aggressive undertaking: the creation of a new,

comprehensive cancer center for southern illinois. for too long,

cancer patients in our area have had the perception that they need

to travel long distances to get the care they required. this has

placed a burden on them, both financially and emotionally.”

the goal of the planned facility is to serve the entire region

from a convenient, easy-to-get-to location along the Route 13

corridor, keeping patients close to home, work, family and friends

and to the life they are accustomed to living. it will also improve

patient care by placing all of their providers and services under

one roof, says Jennifer Badiu, administrative director of the siH

cancer institute.

“We currently don’t have a central location to bring all of these

programs, services, physicians, teams and technology together,”

hope is home

Without support and gifts from the people of southern illinois, the Cancer Center will remain a

dream. But led by a volunteer committee that under- stands the needs and benefits of this project, the “hope

is home” Campaign is striving to raise $10 million for the new center. pledges can be fulfilled over a five-year

span and the facility will present a number of naming opportunities for donor recognition and for enduring

legacies. financial pledges or gifts of any size are welcome for hope is home, as are gifts of stocks, life

insurance, real estate or bequests. representatives of the campaign and the sih foundation are happy to

present ideas and options for giving.to become part of this exciting facility that will save

lives in southern illinois, call gene honn (gene.honn@sih.net) at the sih foundation,

(618) 457-5200, extension 67843. You may also donate online by visiting www.sih.net/hopeishome.

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CancerCenter_SIL12_V6.REV1.indd 16 7/19/12 3:23 PM

she adds. “Bringing all of those services to the patient in a

centrally located facility decreases their anxiety, improves

communication among the physicians and really speeds up the

care that is appropriate at the community level.”

Equally important will be the convenience for patients and

their loved ones.

“This center will not just offer technological expertise and

high-quality physicians and support staff,” says Carbondale-based

surgeon Marsha Ryan, M.D. “It also will be a place that is serene

and comforting and that allows patients not to have to travel, which

will be beneficial to them both emotionally and physically.”

Studies have shown that cancer patients make an average of

100 trips to medical facilities for treatment, tests and services in

the first year after a diagnosis. Often, for people in southern

Illinois, the distances can be great. Research has shown the treat-

ment of cancer is more likely to be successful when patients are

able to remain close to home, family and their normal routines.

Keeping life as normal as possible is a primary goal in all cancer

treatment, and the new Cancer Center will play a major role in

maintaining normalcy, said Mary Rosenow, M.D., medical director

of the SIH Cancer Institute.

“When a cancer diagnosis is made, there is a sudden and drastic

change in a person’s life,” she explained. “Priorities get rearranged,

there’s great concern about the future and then there is aggres-

sive treatment, all while the person is not feeling well and still

dealing with all of the issues related to family, jobs and financial

situations. It’s really difficult.”

The function of the Cancer Center will be patterned after SIH’s

own Breast Center, which treats hundreds of cases of breast

cancer each year in a team-based approach of diagnosis, treatment

and follow-up care.

“We want to take the highly successful model of centralized

care and expand it over other cancer diagnoses, and that will

require a real, live cancer center—with building, staff and provid-

ers,” says Dr. Ryan.

She adds that the center also will ensure that cancer treatment

remains on the cutting edge.

“I know that the new center will change the way that cancer

services are delivered in southern Illinois,” Dr. Ryan says. “And it

will do even more. The quality of each and every one of its

parts also will benefit patients with non-malignant illnesses, since

we will rally and recruit the best and brightest providers and staff.

Build it and almost everything else gets better as well.”

Officials estimate that the new center could treat up to 1,400

cancer patients annually. A specific location for the new center has

not yet been announced. It is estimated that total land acquisition,

site development and construction costs for the project will

approach $20 million. Southern Illinois Healthcare has committed

to about one-half of the total; fundraising for the balance is

underway through the SIH Foundation’s “Hope is Home” campaign.

To date, more than $2.4 million has been pledged by area com-

panies, organizations and individuals, including nearly $450,000

in pledges over the next five years from SIH employees, for the

46,000-square-foot facility and accompanying manicured grounds

and peaceful healing garden.

“The Cancer Center will not just promote high-quality care,”

says Dr. Ryan. “It will be a very visible legacy. It’s good for us, for

the community and all of our children.”

LEFT: Sujatha Rao, M.D., oncologist; Alberto Cuartas, M.D., oncologist; Marsha Ryan, M.D., surgeon and co-founder of the Breast Center; George Kao, M.D., radiation oncologist; BELOW: Dr. Ryan shares plans for the new Cancer Center during an unveiling dinner at the SIU Student Center ballrooms.

S O U T H E R N I L L I N O I S H E A LT H & L I F E / 17

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Herrin Hospital auxiliary Day

Celebrating a milestone

AuxiliAry DAy The community of Herrin honored

the hospital’s Auxiliary by declaring a day in its honor

on May 2, 2012, for its members’ outstanding service. The city proclamation coincided with

the Auxiliary’s $100,000 donation to the hospital’s new chest

pain unit—its third such donation in the past four years.

1 The proclamation 2 Auxiliary check presentation 3 Herrin

Mayor Vic ritter enjoys a laugh with the ladies while perched

on Auxiliary President Shirlene Carnaghi’s lap 4 Herrin Civic

Center billboard, one of several in the community, on Auxiliary Day

Flash_SIL12_v2.rg.REV1.indd 2 7/20/12 10:30 AM

Men’s HealtH ConferenCe7 SIH Marketing’s

Tracy Herron alongside NFL Hall

of Famer Jackie Smith, the keynote

speaker of this year’s Men’s Health

Conference at John A. Logan College

MHC HeALTHGrAdeS HealthGrades recognized Memorial Hospital of Carbondale with a 2012 Outstanding Patient experience award, which ranked Memorial in the top 10% nationally for patient satisfaction. 5 Pictured is SIH Service excellent Coordina-tor Jason Pigg with members of the emergency department staff. 6 Trophies from 2011 and 2012

obesity awareness walk 8 New Life Weight Loss Center’s Naresh Ahuja, M.d., bariatric surgeon, leads the walk around Bruce Park in energy. 9 Bariatric program coordinator Heather ruhe and SIH Manager of Community Benefits Amy Wright

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Flash_SIL12_v2.rg.REV1.indd 3 7/20/12 10:30 AM

taking charge

Today’s TreaTmenTs mean This condiTion needn’T be as limiTing as iT sounds“congesTive hearT failure”—The

phrase has a scary ring, and indeed it’s a

serious diagnosis. But today it’s possible to

live comfortably for many years with this

condition.

“Patients with heart failure are living

longer these days, living better and living

with less stress,” says nabil al-Sharif, M.D.,

a cardiologist at Prairie cardiovascular in

carbondale. “they go fishing, they go walk-

ing—in many cases they have a very good

lifestyle. But they and their doctors share a

big responsibility to stay in touch and pre-

vent trouble before it happens.”

congestive heart failure occurs when the

heart muscle weakens and fails to pump as

well as it should, causing fluid to build up

in the lungs and other body tissues. the

symptoms can include fatigue, shortness

of breath, edema (swelling) in the legs and

ankles, abnormal weight gain (which may

be a sign that you’re retaining fluids), cough

(often worse when you’re lying down), dry

mouth or thirst. Five million americans live

with congestive heart failure, and there are

half a million new cases each year. it’s the

most frequently diagnosed condition in hos-

pitalized patients over age 65, and it costs

life goes on withcongestive heart failure

the nation more than $50 billion annually.

“the two main causes of congestive

heart failure are heart attacks and high

blood pressure,” says Dr. al-Sharif. “in the

long run they can cause the heart muscle

to weaken and fail to do its job of pumping

blood to the organs of the body.”

he describes the condition as “a progres-

sive disease that worsens over time. Patients

can become tired and short of breath with

less and less activity.” and he adds that

congestive heart failure can affect people at

almost any age. “i recently saw a patient who

was 28 years old,” says Dr. al-Sharif. “he

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HeartFailure_SS12_V1.rg.indd 24 7/19/12 3:29 PM

watch the water.Drink no more than half a gallon, or 64 ounces, of fluids in a 24-hour peri-od—less if you can. weigh yourself daily if you tend to retain fluids. If there’s a change of even 5 pounds within a week, call your doctor.

get actIve. If your doctor says it’s OK, take up walking or some other form of aerobic ex-ercise, which can improve the blood flow to the heart. “I tell my patients to plan on walking a mile a day,” says cardiologist Nabil al-Sharif, M.D. avoid repetitive weight lifting over 10 to 15 pounds, though.

SKIp the cOcKtaIlS.while Dr. al-Sharif says a single glass of wine is permissible, you should avoid any more significant alcohol intake if your heart is weakened and damaged.

lOSe weIght.every pound of fat has many miles of blood ves-sels, which your heart has to pump to—and if it’s forced to work too hard, trouble can result. los-ing the fat can improve heart-failure symptoms dramatically.

lIMIt Salt.restrict sodium to one-and-a-half grams (1,500 milligrams) in a day. check labels; anything more than 200 milligrams per serving is probably too much. also skip the salt in wa-ter when you boil rice or pasta.

12 3

45

developed the condition because he ignored

a heart-rhythm problem for 10 years.”

So if you’re experiencing fatigue, short-

ness of breath or heart-rhythm irregulari-

ties, it’s important to see your primary care

physician. “An echocardiogram—an ultra-

sound of the heart—can give us a good idea

about the pump mechanism and how weak

or strong it is,” the doctor says.

If an examination reveals is uncontrolled

blood pressure or arrhythmias, a history of

coronary artery disease or other reasons to

suspect difficulty, your doctor may refer you

to a cardiologist for a fuller evaluation and

possible treatment.

There are several medications that can

assist the heart in pumping more efficiently.

Diuretics such as hydrochlorothiazide can

help rid the body of excess fluid, and ACE

(angiotensin-converting enzyme) inhibitors

such as lisinopril help blood vessels relax

and open up. “ACE inhibitors are the corner-

stone of congestive heart failure treatment,”

says Dr. Al-Sharif. Beta blockers such as

metoprolol reduce blood pressure by block-

ing the effects of the hormone epinephrine,

and spironolactone controls a hormone

called aldosterone that raises blood pressure.

Artificial heart devices, heart transplants

and special kinds of pacemakers can also

improve the heart’s pumping ability and

greatly enhance the quality of life.

If your heart is still healthy, keep it that

way with sensible eating (emphasizing fruits,

vegetables and whole grains, and limiting

fats, salt and sugar), regular exercise and

regular physical exams and consultations

with your physician.

One more tip: When your doctor mea-

sures your blood pressure, take the reading

seriously, counsels Dr. Al-Sharif. “Many

patients will react to a high reading by saying

it’s ‘white-coat hypertension’—that is, an el-

evated reading brought on by feeling stressed

seeing the doctor—so they may neglect to

take any blood-pressure medication that has

been prescribed. Often they’re kidding them-

selves, and that can be dangerous.”

Are you At risk?

It’s possible to have congestive heart failure and not know it—which means it’s important to know both the risk fac-tors and the symptoms.

risk FACtors high blood pressure

prior heart attack

history of heart murmurs

enlarged heart (or family

history of enlarged heart)

Diabetes

syMPtoMs Shortness of breath, which

can develop even during light activities

coughing or difficulty breath-ing at night while lying down

weight pain with swelling in the legs and ankles from fluid retention

Fatigue and weakness

Dry mouth or thirstIf doctors learn about the condition early, they can often slow or stop the progression of the disease.

5 tiPs to heed iF you hAve Congestive heArt FAilure

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PREVENTION

THE TORN ANTERIOR CRUCIATE LIGAMENT IS THE BANE OF THE ACTIVE WOMAN—BUT YOU CAN REDUCE YOUR RISKEACH YEAR NEARLY 250,000 AMERICANS

injure the anterior cruciate ligament (ACL),

an injury that’s been called women athletes’

“Achilles heel”—even though it’s in the knee.

The ACL is a ligament that crosses your

knee joint, acting as a brace to stabilize knee

movement. ACL tears can happen when you

slow down suddenly, cut or pivot with your foot

planted or land from a jump, according to J.T.

Davis, M.D., an orthopedic surgeon and sports

medicine specialist at Orthopedic Institute

of Southern Illinois.

ACL injuries are more common in females

for two primary reasons, says the doctor: “Some

women are anatomically predisposed to ACL

injury due to smaller ligaments and less space

available for the ligament in the middle of the

knee. In addition, the biomechanics of jumping

and pivoting in women does not allow for as

much dynamic muscular support as that seen

in men and therefore puts more stress on the

ligament, making it more susceptible to tearing.”

You may have torn your ACL if you feel

or hear a pop in the knee, have pain and feel

your knee “giving out” when you put weight on

it. You should feel better after a few minutes,

but some knee swelling will probably occur.

“If it’s something where you can apply weight

and have at least some ability to walk, see your

primary care physician. Apply ice, elevate the

knee, use a compressive wrap and take a non-

steroidal anti-infl ammatory (such as ibuprofen

or naproxen) until you can see your physician,”

Dr. Davis says. However, if you are unable to

bear weight and the pain is unmanageable, a

trip to the emergency room makes good sense

to rule out a fracture.

The surgeon will listen to an account of

what happened and do a few hands-on tests to

see if the knee stays in proper position when

pressure is applied from different directions.

“The majority of my diagnoses are made with

a history and a physical examination,”says Dr.

Davis. “Swelling within the joint is a primary

sign I see in the acute stage following the injury.

Imaging always begins with a series of X-rays

to check for bone abnormalities and to make

sure there are no fractures. Ultimately, an MRI

(magnetic resonance image) scan helps me look

at the ACL and other soft-tissue structures in

the knee, which can include other ligaments

and the meniscus (the cartilage at the top of the

shinbone).”

People in their teens and twenties who

want to return to sports usually choose to have

arthroscopic surgery to repair cartilage damage

and reconstruct the ACL. The surgery corrects

the looseness and instability that limit knee

function after a tear. Dr. Davis rebuilds the

ligament by using tissue from either the patient

or a cadaver to substitute for the ligament. “I

put in a scaffold or a framework and the body

builds a new ACL around that framework.”

“The surgery has a success rate of over 90

percent,” says Dr. Davis. However, surgical

patients must commit to working hard in phys-

ical therapy afterwards. “Physical therapy is an

essential component to help the patient regain

motion and strength while not compromising

the surgery during the healing period.”

Physical therapy alone may suffi ce for older

patients who are willing to restrict their activi-

ties to be careful with their knees. If the injury

caused trauma to the meniscus and the patient

decides against ACL reconstruction, some stud-

ies suggest continued wear and tear on cartilage

can lead to arthritis, says Dr. Davis.

Post-surgical therapy helps control swell-

ing, regain range of motion and build muscle

strength. Exercises to improve stability and

balance and sports-specifi c training to move

properly on the court or fi eld also help.

REDUCE YOUR RISK OF ACL INJURY Maintain strength and fl exibility with year-round exercises geared to these goals, especially on the hamstring muscles. In sports, crouch when you turn and bend your knees when you land from a jump.

WOMEN’S ‘ACHILLES HEEL’: IT’S ACTUALLY THE KNEE

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Knowledge is power when it comes to tummy trouble

staying well

the abc’s ofdigestive disease

the symptoms aren’t fun to talK

about, but persistent diarrhea, constipa-

tion, bloating or abdominal pain can indi-

cate a disease of the lower digestive tract.

Here’s a quick primer on such maladies:

iRRitaBle BOwel synDROMe,

sometimes referred to as spastic colon,

affects about 15 percent of americans,

more than two-thirds of them women. it

causes abdominal cramps, gas, bloating

and constipation and/or diarrhea. if you

have iBs, you should identify the foods

that seem to cause problems so you can

avoid them—and find other sources for the

nutrients they provide.

though iBs isn’t life-threatening, you

should see your physician about it,

because it can mimic the symptoms of a

more serious condition he or she will want

to rule out. if diarrhea is predominant,

an anti-diarrheal product such as loperamide

(imodium) or bismuth (Pepto-Bismol)

or a colon-relaxing medicine called dicy-

clomine (Bentyl) may be appropriate. if

constipation is the main symptom, ask your

doctor about an over-the-counter remedy

called Miralax.

DiVeRtiCUlOsis is a common condi-

tion in which small pouches or bulges

called diverticula form in the digestive

tract. Many people with diverticulosis

feel no symptoms; others may have gas,

abdominal cramps, bloating, diarrhea

or constipation. if you have diverticulosis,

diet and exercise can help. Cut down

on high-fat foods and substitute foods

high in fiber. also, try to exercise for 30

minutes a day most days.

when inflammation or an infection

occurs in a diverticulum, that’s DiVeR-

tiCUlitis. it causes fever, nausea and

abrupt pain, usually in the lower left part

of the abdomen. treatments for diverticu-

litis include dietary restrictions, antibiotic

medications or—especially if it’s recur-

rent—surgery to remove the diseased por-

tion of the colon.

Finally, the inflammatory illnesses

CROHn’s Disease and UlCeRatiVe

COlitis each affect about half a million

people in the U.s., with men and women

equally at risk. Both diseases are marked by

very persistent and sometimes bloody diar-

rhea that can make it hazardous to stray

far from the bathroom. in each, the lining

of the digestive tract is inflamed, but

Crohn’s disease can occur anywhere in

the tract, while ulcerative colitis is typically

restricted to the colon and rectum. Both

conditions, unlike diverticulitis, increase

one’s risk of colon cancer. Doctors aren’t

sure what causes these diseases, but they

now know they’re not the result of stress

or suppressed emotions, as was once

thought. lifestyle changes and a number of

medications, including anti-inflammatory

drugs, immunosuppressants and antibiot-

ics, can ease symptoms for many patients.

But in about 25 to 40 percent of people

who have Crohn’s disease or ulcerative

colitis, surgery to remove all or part of the

colon and rectum is ultimately required.

“it’s usually hard to tell on your own

which of these conditions is affecting you,”

says Zahoor Makhdoom, M.D., a gastro-

enterologist in Carbondale, “so if you have

persistent bowel symptoms, see your family

physician or gastroenterologist.”

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clinical update

HepatitisThe quieT killerA time bomb is ticking AwAy in the lives of hundreds of southern illinoisAns, And most don’t even know it

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EvEn though thE disEasE is not a

frequent topic of conversation, it is one that

everyone should be concerned about says an

area infectious disease specialist.

“Are we seeing it here in southern Illi-

nois? Oh, my gosh, yes,” says Erica Kaufman,

M.D., at the Center for Medical Arts in Car-

bondale says. “When I came here, I thought

I’d see just a couple of cases of hepatitis C,

but unfortunately it’s the No. 1 consultation

I get; it’s a bigger issue than we all thought.”

Like hepatitis A and hepatitis B, the virus

called hepatitis C causes inflammation of

the liver. However, each variety of hepatitis

is unique in the way it spreads, the way it

affects the body and how it is treated. The

problem with hepatitis C is that the disease

can go unnoticed for years, all while attack-

ing the liver, potentially leading to serious

conditions including cirrhosis, liver failure

and even death.

“You can have it for years and not know

it; that’s pretty common,” Dr. Kaufman ex-

plains. “I would say most of my patients are

either in their 20s and just got it or they are

in their 50s and have had it for 30 years.”

She says hepatitis C is similar to high

blood pressure or high cholesterol in that

people do not realize they have the condition

until it is pointed out to them. Unfortunate-

ly, unlike the other disorders, hepatitis C isn’t

something that shows up in normal tests.

“The problem with hepatitis C is that it’s

not something that doctors routinely ask

about and it’s not something that patients

routinely ask to be tested for; women want

their mammograms and men want their

prostates checked and we all need choles-

terol tests, but nobody thinks about hepatitis

C,” she says, partially because of the way the

disease is contracted and spread.

“Hepatitis C is a blood-borne virus,”

explains Dr. Kaufman, who has more than

100 patients with the disease. “It’s not spread

through tears or saliva or skin contact or

breathing.”

Instead, hepatitis C is spread through

blood exposure. Dr. Kaufman says those at

risk include anyone who had a blood trans-

fusion prior to the mid-1990s (“when we

started screening the blood supply”), those

who have used intravenous drugs or snorted

cocaine and some people with tattoos.

“I would say anyone who had a blood

transfusion before 1992 or even once used

IV drugs—even if they think the needle

was clean—or who has a prison or home-

made tattoo should get tested,” she says,

adding that because of the high number of

blood capillaries in the nasal passages, any-

one who has ever tried cocaine should also

be tested.

Yet, she says, people are hesitant to get the

simple blood test either because they don’t

know about the disease or because they are

reluctant to face some of the earlier deci-

sions of their lives.

“I want people to think about their past.

If they ever—even once—had any one of

those exposures, including that one time you

tried IV drugs when you were 17, you need

to get tested,” she says. “I just feel that

there are a lot of people in general, but

especially in southern Illinois, who have

had those exposures and need to be checked

out. Yes, there is a psychological barrier to

getting tested. They don’t want to know. But

hepatitis C is curable. I can understand that

they want to live in ignorant bliss, but I also

see the devastation if they don’t get tested.”

That devastation is a deterioration of

the liver, leading to scarred or dead liver

cells. The progression can take decades, but

unchecked long enough, cirrhosis and liver

failure can result. Both can cause death.

Additionally, chronic inflammation may

lead to liver cancer. In fact, hepatitis C is the

leading cause of liver cancer and the No. 1

reason for liver transplants in the U.S.

The good news is that hepatitis C is

curable.

“You can very slowly reverse the deterio-

ration of the liver,” Dr. Kaufman explains.

“The liver is one of the only organs that

can regenerate. It actually can improve itself,

so we want to get rid of the virus so that

regeneration can happen.”

She says most hepatitis C can be treated

with an intense short-term regimen of medi-

cations, and new pharmaceuticals are in

development to battle the disease. While the

six to twelve months of treatment can be tough

with side effects and frequent doctors’ visits,

Dr. Kaufman says it is worth the struggle.

“If you suffer through it, you’ve got a

really good chance of beating the disease,”

she says. “My patients have done really,

really well.”

She adds that in addition to the medicine,

hepatitis C patients also need support and

understanding from family and friends, who

need to better understand the disease.

“There is a misconception and stigma

against hepatitis C and it’s all wrong,”

she adds. “These people are safe, productive

members of society. They are not lepers;

they are just people with a virus.”

Dr. Kaufman adds that her patients are

fighters, defeating the disease.

“They are so determined. In some cases

they’ve stood up to their past and to the dis-

ease and you get to see the real human spirit.

They’re going to keep going and they’re

going to beat it.”

Erica Kaufman, M.D.

“the liver is one of the only organs

that can regenerate. it actually can improve itself.”

—Erica kaufman, m.d.

attention, boomers:

in a new development, the government is proposing that all Baby Boomers be tested for hepatitis c. the centers for disease control and Prevention recently released draft recommendations that anyone born from 1945 to 1965 should get a one-time blood test to see if they have the liver-destroying virus. according to the cdc, Baby Boomers account for more than 2 million of the 3.2 million americans infected with the blood-borne virus. to find out more about testing, contact the sih call center at 866-744-2468.

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staying fit

counting cals

a roundup of activities

that do your body

soccer, casual1 hour

476 calories

good

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Dr. Erica Kaufman

88 calories

READING1 hour

156 calories

SHOPPING, GROCERIES, WITH CART1 hour

68 calories

KISSING 1 hour

204 calories

BALLROM DANCING 1 hour

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Don’t suffer in silence with the pain of fibromyalgia

better care

the mysterydisease

fibromyalgia is the roDney

Dangerfield of health problems: It gets no

respect. Its symptoms are quite tangible—

overall ache and pains, chronic fatigue,

sleeping problems, headaches, stiffness,

bowel irregularity and depression—but

there is no definitive diagnostic blood test or

imaging scan and no cure. treatments may

help, but only about half of those with

fibromyalgia find lasting relief. One thing

seems certain: doubting that this mystery

illness is “real” only adds to the woes of

those who have it.

Fibromyalgia is defined as a chronic

musculoskeletal condition marked by

sustained pain or tenderness in the body’s

fibrous tissues—muscles, ligaments and

tendons. Fortunately, it is not progressive,

crippling or fatal.

because there are no objective biomark-

ers to help physicians diagnose fibromyalgia,

they must first rule out other possible causes

of pain, such as lupus or rheumatoid arthri-

tis. according to the american college of

rheumatology, a clinical diagnosis is made

by examining the patient and identifying

“tender points”—areas over the extremities

and paraspinal region, often where tendons

are inserting into bone, that are tender to

the touch. current guidelines say that pain

in 11 of those 18 points signals fibromyalgia.

In fact, the National Fibromyalgia associa-

tion estimates that it takes an average of five

years for a fibromyalgia patient to receive

an accurate diagnosis.

treatment is targeted to the patient’s

symptoms. antidepressants, the mainstay of

treatment options, have been shown to help

some patients. Nonsteroidal anti-inflam-

matory agents (NSaIDs) such as ibuprofen

sometimes help ease the pain, but it’s not

clear why, as fibromyalgia is not an inflam-

matory condition. because stress is often

a contributing factor, seeing a psychologist

or other mental health professional may

help as well.

Many physicians refer their patients to

physiatrists like brent Newell, M.D., at the

rehabilitation Institute of chicago at

Herrin Hospital. a physiatrist specializes

in physical medicine and rehabilitation.

Dr. Newell works to increase function

and mobility and find ways to help his

patients’ get a good night’s sleep, something

often difficult for fibromyalgia sufferers.

“Sometimes, patients may need a sleep

study to diagnose problems,” he says. “Initial

treatment will sometimes involve medications

to address the sleep issues, and I really stress

the importance of exercise. In particular,

aerobic exercise is important. I tell them to

find something they enjoy like walking, biking,

aqua exercises, Zumba or Pilates and to gradu-

ally increase their activity. I don’t care if they

start with five minutes and work up from

there, but they need to do something that will

get their heart rate up,” says Dr. Newell.

Physical therapy can be helpful for people

who are significantly de-conditioned, the

doctor adds. “this is the challenge because

it hurts. It hurts to exercise but exercise is

helpful. You have to get patients to distin-

guish between good discomfort and pain,

which can be very difficult for individuals

with fibromyalgia.”

Patients may have more answers in the

future. New research suggests that the likely

mechanism for fibromyalgia is related

to the way pain signals are processed in the

brain, explains Dr. Newell. “We’re learning

that patients with fibromyalgia have areas of

their brains that are more active than those

without fibromyalgia.” to find out more,

visit www.fmaware.org.

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It’s a kInd of magIc, really: an elIxIr that enrIches

civilizations, enlivens cultures and enhances health. And has been doing so

for millennia. The olive tree is tenacious, a scrappy survivor—these trees

often live 700 years or more, making them seem immortal—that needs

minimal water and cultivation.

While the ancient Greeks didn’t necessarily fully appreciate the taste,

they did pour oil over their bodies, and they used the tree’s branches to

fashion crowns for Olympian athletes. In The Odyssey, Homer called

olive oil “liquid gold,” acknowledging its worth as an economic

engine for many Mediterranean countries. The Romans

also treasured it, and to this day, many different cultures

use it for important ceremonies—baptisms, blessings,

anointing the dead.

In homes around the world, olive oil elevates

domestic rituals. It delights the eye with a variety of

gorgeous shades, from green through gold,

and features taste notes from apple through

butter, grass, lemon, pepper, herbs

and more. Plus it moisturizes skin,

conditions hair and helps people

get a close shave.

Immortal oIl

PH

OTO

S:

SH

UT

TE

RS

TOC

K

the fruIt of the ancIent olIve tree yIelds one of nature’s most sublIme creatIons

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All that and it’s good for you too. Back in

the ’60s, scientists noted that few people living

in countries near the Mediterranean Sea were

afflicted with cardiovascular disease or cancer. They

theorized the reason was the abundance of heart-

healthy olive oil in their diets. Subsequent research

showed that olive oil contains unsaturated fats that

may help lower a person’s risk of heart disease,

“bad” cholesterol levels and blood sugar. Plus, it

boosts the HDL, or “good” cholesterol, which helps

combat heart disease. In addition, its high levels of

vitamin E and oleic acid support healthy bones.

Perhaps that’s why Americans have been having

a gastronomic love affair with olive oil. Between

1982 and 2001, U.S. consumption grew from 64

million pounds to 380 million pounds.

Still, health benefits aside, the truth is that the

thrill of olive oil is really in the eating. For those

whose palates have tasted only the bland, mass-

produced imported blends, you’re in for a wake-up

call: even the mildest artisanal oils are bursting with

flavor. And because there are more than 700 kinds of

olives, it’s impossible to say what the “best” olive oil

is, any more than one could choose the “best” wine.

As with wine, the fun is in the trying and tasting.

Nonethless, aficionados have given us a few solid

guidelines for selecting olive oils:

1 Olive oil should be stored out of light and

away from heat, lest it turn rancid. Don’t buy

unless the seller is displaying it according to those

guidelines.

2 As with most things, higher quality tends to

correlate with higher price.

3 Look for a harvest or best-by date on the label;

don’t purchase olive oil that is more than

two years old.

4 Know the differences between various grades of

oil (see sidebar below), so you can match your

purchase to its intended purpose: High quality for

skin moisturizing, for health and to drizzle over

bread or salad; light for baking; a cheap kind to use

if you happen to have an oil lamp.

To best understand olive oil, set up an informal

tasting. As with wine, pour a bit in a small wine

glass or other small container (experts use a round

glass that fits in the palm of the hand, the better

to warm up the oil). Swirl it around. Bring your

nose close to the glass and inhale deeply. Let your

mind free-associate to help you describe what you

smell—is it fresh-cut grass? Cinnamon? Avocado?

Nuts? Butter?

Then, take a good sip. Holding the oil in your

mouth, suck in air, then close your mouth and

breathe out through your nose. This is called

“retronasal perception” and will expose your palate

to an even wider range of flavor notes. You will also

pick up bitter notes—not surprising, as olive oil is

made from non-cured olives, which are naturally

bitter. Though an acquired taste, a bit of bitterness

is a good thing when it comes to olive oil. (A good

example is Cobrancosa from Portugal.)

When you swallow the oil, be aware of a

pungent, peppery sensation—a sort of chemical

irritation that’s present in all olive oils. It can range

from barely noticeable to intense.

Test two or three different kinds of oil if you

like, cleansing your palate between each with plain

or sparkling water, or a piece of neutral-tasting

bread. Choose oils in different price ranges. You

will likely be surprised by the wide variation

between them.

This remarkably versatile substance is key to

countless recipes, from salad and pasta dressings

to sauces and even cakes. Of course, it’s also the

basis for an excellent dipping experience—not only

of crusty bread, but of fresh mozzarella, bread,

ripe tomatoes, cubes of grilled chicken, roasted

vegetables and more. Take your pleasure, and enjoy!

Know the labelsCold-pressing is a chemical-free process using only pressure, which produces the highest- quality olive oil.Though the term lingers, most makers now achieve the same result by using centrifuges for the first press.

exTra-virgin is the highest quality of olive oil. Just 1 percent acid, it’s made from the first cold-pressing of the olives, which best preserves their nutrients.

virgin olive oil is also a first-press oil, with an acidity level of between 1 and 3 percent.

Fino olive oil is a blend of extra-virgin and virgin oils.

lighT olive oil is not lighter in fat. rather, it’s been processed until it’s lighter in color and essentially flavorless, making it a good choice for baking.

reFined olive oil (sometimes called “pure” olive oil) is low-quality olive oil that has been treated with charcoal and other filters. The term “olive oil” used alone refers to a blend of refined and virgin olive oil.

Olives are a fruit; olive oil is their “juice.” Like any fresh juice, it should be enjoyed as soon as possible after extraction.

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Playing in grassy or wooded

areas? Try wearing a hat, long sleeves and

pants and tucking your pants legs into your

socks. That may help you avoid being one

of about 30,000 Americans diagnosed with

Lyme disease each year.

Bacteria in the spirochete family cause

the condition. Deer ticks primarily carry

the disease to animals and humans through

bites. Illinois had 135 cases in 2010, a

jump of nearly 300 percent from 10 years

ago, according to the Illinois Department

of Public Health. “It’s not as common in

our area as it is in Wisconsin and the New

England states; but for that reason, it’s

important to tell your physician if you have

travelled to these areas,” says Linda Bobo,

M.D., an infectious disease specialist at

Center for Medical Arts in Carbondale.

Lyme disease is tricky, because the time

from the tick bite to the first symptoms

may make cause and effect hard to con-

nect—and some patients may not even no-

tice a characteristic rash, sometimes in the

shape of a bull’s-eye. It can appear from

three to 30 days after a bite. Besides the

bull’s-eye, there can be a systemic illness

associated with Lyme disease. Symptoms

include fever, chills, headaches, fatigue,

muscle aches, joint pain and stiff neck and

can go on for months to years. “In these

more unusual cases, the living organism

is no longer present, therefore antibiotics

are not helpful,” adds Dr. Bobo. The doc-

tor adds that you can be simultaneously

infected with the more common bacteria

that cause tick-borne illness in Illinois, like

Rocky Mountain Spotted Fever, Ehrlichio-

sis and a few others.

If you’re bitten, removing the tick from

your skin properly can decrease your odds

of infection (see box at right). Says Dr.

Bobo: “Never mind those old wives’ tales

about burning the tick with a match or

smothering it with petroleum jelly. These

things are more irritating to the tick, mak-

ing it more likely to regurgitate—and that’s

how it transmits the disease.”

If identified early, Lyme disease can

be successfully treated in most cases

with a short course of antibiotics. When

it progresses to later stages, its effects

can include nervous system difficulties

such as facial paralysis, as well as arthritis,

lyme disease

Remove a tick the Right way

Using fine tweezers or a special tick

remover, grasp the tick gently at the

head as close to your skin as possible

and pull straight out.

save the tick to be identified by placing

it in a plastic bag or a jar of alcohol to kill it.

Clean the bite wound with disinfectant.

Then take the tick to your doctor to find

out if you need treatment.

as the outdooRs beckons, bewaRe of Lyme spRead by tick bites. this disease can be moRe than a nuisance if it’s not caught eaRLy

SEASoNAL HEALTH

meningitis and heart problems.

So take precautions. Besides long sleeves

and pants, wear light colors so you can see

a tick. Consider using insect repellants with

DEET on clothes and exposed skin (except

for face, hands or irritated areas). You can

also buy clothing infused with the insecti-

cide permethrin, which is good for 25 wash-

ings. And make your yard tick-unfriendly by

keeping grass mowed and leaves raked.

“Teach your kids not only to survey

themselves, but also to have others check

them carefully for ticks when they have

been outdoors,” advises Dr. Bobo. “It’s also

important for them to shower and wash

their hair immediately.”

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