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.

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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.