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CLEVELAND CLINICWilloughby HillsFamily Health Center
CheckupHealth Information from the
Family Health Center Closest to You
F A M I L Y Spring/Summer 2003
Play it SafeThis Summer!
ummer’s breezes entice motorcyclists to the
open road, beckon boaters and swimmers to lakes
and rivers, and prompt plans for backyard fun.
Cleveland Clinic family health center physicians
hope you’ll enjoy summer by putting safety first.
That wind in your hair may feel great,
but... please wear a helmet! Motorcyclists who cruise
at speeds of just 25 mph can sustain low-impact head
injuries that severely damage the brain. This can lead to
personality changes, coma, disability or death. After 40,
your brain is even more vulnerable to injury, especially
if you take aspirin or other blood thinners to protect
against heart attack or stroke.
Scooters and skateboards: rolling out new
guidelines... The American Academy of Pediatrics rec-
ommends scooters for kids 8 and up, and skateboards for
kids under 10 only if supervised. Scooters have created
a surge in ER visits. In the first nine months of 2001,
84,000 kids were treated in ERs for scooter injuries. Insist
on helmets to prevent head injuries, and encourage wrist-
and kneepads to prevent fractures. Steer skateboarders
toward skate parks with smooth surfaces, far from traffic.
A healthy respect for the water... Water safety
is important for the whole family. Drowning is the second
leading cause of death among children; toddlers and
teens are at greatest risk. Keep an eye on toddlers, even in
wading pools. CPR training for everyone — even your
sitter — can ease your mind. Out on the lake, always wear
your life jacket; have kids wear them dockside, too. Bring
your trusty ship-to-shore radio when venturing out on the
water. Tell a friend where you’re headed — and when
you’ll return. On Ohio rivers, watch for low-head dams,
signaling sudden drop-offs; carry your canoe or kayak
around them to safety.
Backyard trampolines: accidents waiting to
happen... If your kids love the trampoline, schedule
supervised sessions with a gymnastics instructor. The
American Academy of Pediatrics recommends that home
trampolines be banned, noting the 140 percent spike in
trampoline-related injuries between 1990 and 1996, when
83,000 trampoline accidents required an ER visit. Thirty
percent involved fractures, and often hospitalization and
surgery. In rare cases, spinal cord injuries occurred. So
make sure your kids keep their heads up — and their feet
on the ground. And enjoy your summer!
SBack-To-SchoolSports Physicals:Sat., June 218 to 11:30 a.m., $10.Available on a walk-in basis;make sure to bring your signedOHSAA form.
Full Range of ImagingServices Available,including CT and MRICall 440/943-2500
For appointments with our
family health center specialists,
call the Cleveland Clinic
Appointment Center between
7 a.m. and 11 p.m., 365 days a
year, at 216/444-2273 or
800/223-2273.
Kid’s KornerKid’s KornerSports Physicals:Summer Is the TimePractice for fall high school sports typically begins in
August. Be sure to schedule a pre-participation eval-
uation for your athlete beforehand. Now’s the perfect
time to make an appointment.
Ohio High School Athletic Association regula-
tions require participation forms for athletes in
grades 9 through 12 to be completed and signed by a
physician, the participant, and a parent or guardian
before the first practice. Ohio law permits an M.D.,
D.O., chiropractor, physician’s assistant or advanced
nurse practitioner to perform physicals.
High schoolers should also have comprehensive
regular exams by their primary care physician to
assess their overall health.
Mark your calendars for Back-to-School Sports
Physicals at Willoughby Hills on Saturday, June 21.
They are available from 8 - 11:30 a.m. on a walk-in
basis for $10. Make sure to bring your signed OHSAA
form. Call 440/943-2500 to schedule sports physicals
at other times with Willoughby Hills pediatricians.
Healthy Summer Eating As summer approaches, many of us want to shed pounds along
with layers of clothing. According to the American Dietetic Association, the popular high-protein, low-carbo-
hydrate diets suggest that carbohydrates are “bad for you” and make you gain weight. But high-protein, low-
carbohydrate diets tend to be low in calcium, fiber and nutrients that protect against heart disease and cancer.
Dieters who eat more total calories and get less physical activity will wind up gaining weight. Our nutri-
tion specialists recommend foregoing fad diets. Instead, adopt healthy weight management techniques. Eat
fewer fast foods, measure portion sizes, and increase your intake of fruits, vegetables and foods low in fat and
high in whole grains. Eat fewer calories than you burn, and increase your physical activity.
Variety and moderation are key, as are total calories. Eat fewer calories and/or get more exercise, and
you’ll lose weight. Registered dietitians are available for consultation at Cleveland Clinic Willoughby Hills.
For appointments, please call 440/943-2500.
Remote Friendships:Wave of the Future?With the popularity of high-speed Internet service ex-
ploding, kids can become so engrossed in online
“gaming” that friendships become more “remote”
than real. They meet in cyberspace for role-playing
games, chess or cards, and chat through instant-
messaging or on the phone as they play.
Communicating online can help overcome social
barriers for shy or awkward kids. But they miss the
subtleties of voice, gesture and expression that come
with face-to-face interaction. Messages are sent and
received differently in person, which teaches kids
how to communicate with empathy as adults.
To encourage “face time” with friends as well as
physical activity, Cleveland Clinic pediatricians sug-
gest limiting kids’ combined Internet, video game
and TV time to an hour or so a day. Young computer
buffs can be encouraged to teach older, isolated
relatives how to use e-mail or play cards online.
Willoughby Hills pediatrician M. Deborah Lonzer,
M.D., is available to consult with families.
For appointments with Willoughby Hillspediatricians, call 440/943-2500.Jon Kannensohn, M.D., practices general
pediatrics at Willoughby Hills.
Guarding AgainstWest Nile Virus
Mosquitoes — once mere annoyances— now pose a threat due to West Nile virus,which can infect mosquitoes, birds, horsesand people. Last summer, eleven of 211Cuyahoga County residents with infectionsdied.
Typically, West Nile virus causes nosymptoms, the Centers for Disease Controland Prevention reports. In 20 percent of cas-es, mild fever, headache, body aches, skinrash and swollen lymph glands develop. Inone of 150 cases, severe illness ranges fromheadache, high fever and stiff neck to stupor,coma, convulsions and paralysis.
West Nile virus doesn’t appear to spreadfrom animals to people, or directly fromperson to person. In rare instances, it hasbeen transmitted through breast milk andorgan transplantation, but risks are slight,experts say.
Meanwhile, protect yourself with insectrepellent containing DEET (N, N-diethyl-meta-toluamide) on skin and clothing out-doors, and wear long-sleeved shirts andpants. Stay inside at dawn, dusk and earlyevening, when mosquitoes are hungriest.And eliminate standing water (mosquitobreeding grounds) from your yard.
Willoughby Hills internal medicine spe-cialists and pediatricians are available to dis-cuss your concerns; call 440/943-2500.
Lisa G. Hanna, M.D., board-certified in internalmedicine and pediatrics, specializes in preven-tive medicine for both adults and children.
If sores on your feet or lower legs refuse to heal
completely, podiatrists and vascular specialists
can help you get back to normal. Stubborn foot
and leg wounds, sores or ulcers often result from
poor circulation, frequently affecting people with
diabetes, circulatory disorders or other medical
problems.
After a thorough history and examination,
doctors will order X-rays, scans or noninvasive
vascular studies to help pinpoint the cause of
your problem. With this information, they can
create a customized treatment program designed
to relieve pain and speed healing, taking your
health status and ability to care for your wound
into consideration.
Treatment may involve:
■ antibiotics
■ anti-clotting medication
■ new topical (surface) wound-care
therapies
■ compression stockings
■ orthotics or prosthetics to improve function
and reduce areas of increased pressure
■ debridement (removal of dead or callused
tissue) overlying the sore
Education is key; you will be carefully instructed
on how to care for your wound at home and how
to prevent it from recurring. To schedule an ap-
pointment with podiatrist Georgeanne Botek,
D.P.M., at Willoughby Hills, call 440/943-2500.
Help for Sores thatWon’t Heal
COMPUTERS CAN NEVER REPLACE physicians, but are excellent tools for improving effi-
ciency, convenience and privacy in a doctor’s office. That’s why primary care physicians and
many specialists at our family health centers rely on a state-of-the-art software program for
medical record-keeping.
During your office visit, you’ll experience the usual doctor-patient interaction as your physi-
cian inquires about symptoms. But instead of hand-writing notes on paper, your doctor will enter
information into a personal computer in the exam room.
With the click of a mouse, the doctor can review or add to your medical record, order tests or
send information to another physician for a second opinion. To ensure privacy, the information
can only be accessed by a physician or nurse, pledged to maintain confidentiality.
Patients benefit from their physician’s electronic access to test results, and X-ray and pre-
scription information, which can be printed out at their visit.
Cleveland Clinic Willoughby Hills offers a new type
of appointment for weight management that com-
bines the traditional one-on-one physician visit with
participation in a shared medical appointment led
by a physician and a behavioral health specialist.
The advantages of this program, called “Clinic
Care Plus,” include improved access to and more
time (90 minutes) with your physician, advice and
support from other patients, and a more relaxed
visit.
According to the American Academy of Family
Physicians, group visits allow a therapeutic dynamic
to take place that has the potential for patients to
share information with one another, opening discus-
sions on psychosocial issues related to health.
Irene L. Druzina, M.D., the internal medicine
physician leading shared appointments for those
with weight management and medical concerns at
Willoughby Hills, says the sessions are a huge suc-
cess. Regina Josell, Psy.D., serves as the behavioral
health specialist for the sessions.
“In shared medical appointments, the patient is
getting a better education and more inspiration, not
just from the traditional medical system, but from
their peers and their life experiences,” says Dr. Druzi-
na. “Weight management is a lifelong problem, and
patients can fall back on the experiences of others in
the group when challenging circumstances present
themselves.”
Dr. Druzina notes that these appointments do not
take the place of your personal physical evaluation,
but are an added benefit, or enhancement, of your
medical service. The appointments cost the same as
office visits and are covered by insurance.
Computers Now Keep Medical Records
“Clinic Care Plus Physicals” are shared medical
appointments in which patients receive a private
exam and can still spend 90 minutes with their
physician. Willoughby Hills internist and pedia-
trician Thomas J. Morledge, M.D., who has a
special interest in wellness and preventive medi-
cine, offers Clinic Care Plus Physicals with
nurse practitioners Michele Kline, R.N.P., and
Annette Zeldin, R.N.P. Internist Joan McDon-
ough, D.O., a specialist in preventive health
care, diabetes and women’s health, offers them
with Jill Byrne, R.N., and, Michele Kline,
R.N.P. To schedule Clinic Care Plus appoint-
ments and physicals at Willoughby Hills, call
440/943-2500.
For a free brochure, call 216/444-3178.
Irene L. Druzina, M.D., board-certified ininternal medicine, provides general internalmedicine for adolescent, adult and geriatricpatients, with an emphasis on preventive care.
Shared MedicalAppointments aSuccess
Clinic Care Plus Physicals
Other Family Health Centers
Beachwood 216/839-3000
Brunswick 330/225-8886
Chagrin Falls 440/893-9393
Creston 330/435-5400
Elyria 440/366-8822
Independence 216/986-4000
Lakewood 216/521-4400
Lorain 440/204-7400
Solon 440/519-6800
Strongsville 440/878-2500
Westlake 440/899-5555
Wooster 330/287-4500
AppointmentsCleveland Clinic Willoughby Hills2570 SOM Center RoadWilloughby Hills, OH 44094
440/943-2500 or 800/807-2888Monday through Thursday:
8 a.m. to 8:30 p.m.
Friday: 8 a.m. to 5 p.m.
Saturday: 8 a.m. to noon
Cleveland Clinic Cancer Care Center atWilloughby HillsTo see one of our medical oncologists about cancer
diagnosis or treatment, please call
440/943-2500
To speak with a nurse about cancer symptoms or
concerns, Monday through Friday from 8:30 a.m. to
4:30 p.m., please call the Cleveland Clinic Cancer
Answer Line:
216/444-7923 or 800/862-7798
www.clevelandclinic.org/fhcCleveland Clinic Family Health Centers on the Web
Visit our Web site for■ information and services for each
family health center
■ physician directories
■ community calendars
■ free health information
■ maps
■ Family Checkup newsletter
www.clevelandclinic.org/fhc
CLEVELAND CLINIC
Nurse on CallTo speak with a nurse, 8 a.m. to 11 p.m.,
Monday through Friday, about your adult and
pediatric health concerns, call
216/444-1234800/801-2273
Cleveland Clinic Family Checkup is published by theDivision of Marketing to provide up-to-date health infor-mation and news about Cleveland Clinic Family HealthCenter services. The information contained in ClevelandClinic Family Checkup is for educational purposes onlyand should not be relied upon as medical advice. It hasnot been designed to replace a physician’s medical assess-ment and medical judgment.
Editor: Cora Liderbach
Art Director: Amy Buskey-Wood
Photographer: Tom Merce
Illustrations: Doreen Klimkiewicz
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BREAST CANCER IS TREATED most effectively in its early stages. Mammography, togeth-
er with regular breast exams by a health care professional and monthly breast self-exams,
offer women the best chance for early breast cancer detection.
The American Cancer Society recom-
mends “screening” mammograms every
one to two years for women between 40
and 50, and annually for women over
50, unless you have a family history of
breast cancer.
If you, your doctor, or the screening
mammogram detect a possible abnormal-
ity, a “diagnostic” mammogram is your
next step. Using the same equipment as
screening mammograms, it zeroes in on
the questionable area.
Should you require treatment for
breast cancer, our Willoughby Hills
Cancer Care Center provides compre-
hensive services.
Call 440/943-2500 for appointments.
At Willoughby Hills, medical oncologistArmin Green, M.D. (right), specializesin breast cancer, lung cancer and hema-tologic disorders. Aric Greenfield, M.D.(left), an internist with a subspecialty inmedical oncology, treats breast cancer,lymphoma and Hodgkin’s disease.
Screening vs. Diagnostic Mammograms
Women’s Health
Is Menopausal HormoneTherapy for You?The National Institutes of Health recently changed
the name of the supplemental estrogen and pro-
gestin given to menopausal women from “hormone
replacement therapy” to “menopausal hormone
therapy.” This reflects the true goal of treatment:
short-term control of menopausal symptoms, rather
than restoration of hormones to youthful levels.
A recent Women’s Health Initiative study cast
doubt on the ability of one popular estrogen and
progestin supplement to improve women’s quality
of life.
However, the North American Menopause Society
reports the study did not target younger women
(aged 40 to 50) more likely to suffer symptoms: hot
flashes, sleeplessness, painful vaginal tissue thinning
and mood swings. When such symptoms interfere
with quality of life, women should consider meno-
pausal hormone therapy in the lowest possible doses,
for the shortest time necessary, the society suggests.
To make an informed choice about whether
menopausal hormone therapy or alternatives are
right for you, seek a mid-
life evaluation from your
doctor to determine your
personal risk profile. At
Willoughby Hills, obstetri-
cian/gynecologist Diane
Young, M.D., specializes
in menopause manage-
ment, infertility, and
normal and high-risk
obstetrics.
First Step in Family Planning:Stop SmokingMost women realize smoking causes serious lung
and heart problems. Some are aware that smoking
prematurely ages their skin. But few know that it can
harm their reproductive systems.
Women smokers have higher rates of infertility,
and miscarriage and other complications during
pregnancy and childbirth. Their newborns often
weigh less than they should, and are prone to illness
during their early years. Smoking also triggers earli-
er menopause, and increases risks of os-
teoporosis, bladder problems and female
cancers.
Smoking reduces fertility in men
as well.
If you smoke, make quitting your
first step in family planning. Ask your
doctor’s advice about several options
now available to help you. The Wil-
loughby Hills OB/GYN team is available
for help.
Obstetricians recommendthat women who are try-ing to get pregnant:
Quit smoking at leastfour months beforehand,
Avoid secondhandsmoke, and
Keep homes smoke-freebefore and after thebaby arrives.
Women can make appointments atCleveland Clinic Willoughby Hills bycalling 440/943-2500.
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When’s the Best Timefor Her First GYN Exam?Cleveland Clinic family health center specialists rec-
ommend that a girl have her first gynecologic exam
when she:
■ develops abnormal bleeding or severe men-
strual cramps
■ approaches her 18th birthday or
■ considers becoming sexually active
It’s easy to know that your daughter needs to see
a health care professional if she develops severe
cramps or is approaching 18. Knowing when she is
considering sexual activity is far more difficult.
However, statistics show sexual activity is common
before age 18, so attempt to keep the lines of com-
munication open.
If your daughter expresses an interest in seeing a
health care provider for a gynecological problem,
she may be anticipating sexual activity and want
protection. Encourage her to share any concerns or
problems with you, but do not discourage her from
seeing her doctor. If you accompany your daughter
to her appointment, expect to be excused for part of
the visit so she can speak freely with her health care
professional.
Dalia Mossad, M.D., is one of our women’s
health specialists available for consultation.
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