leveland linic checkup€¦ · sports physicals: summer is the time practice for fall high school...
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CLEVELAND CLINICWestlake Family Health CenterLakewood Family 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!
SOur family medicine andinternal medicine specialistsnow offer Open AccessFor appointments within 24hours, call 440/899-5555
Open MRI available
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 Korner
Sports Physicals:Summer Is the TimePractice for fall high school sports typically begins
in August. Be sure to schedule a pre-participation
evaluation 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 per-
mits an M.D., D.O., chiropractor, physician’s
assistant or advanced nurse practitioner to per-
form physicals.
High schoolers should also have comprehen-
sive regular exams by their primary care physician
to assess their overall health.
For appointments at Westlake with John R.
Sanderson, D.O., or pediatrician colleagues, or
family medicine specialists, call 440/899-5555.
For appointments with pediatrician Ruthanne
Muniak, M.D., at Lakewood, call 216/521-4400.
Healthy Summer EatingAS 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-carbohydrate 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
nutrition specialists recommend foregoing fad diets.
Instead, adopt healthy weight management tech-
niques. 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 calo-
ries. Eat fewer calories and/or get more exercise, and
you’ll lose weight.
For appointments with registered, licenseddietitians at Westlake, call 440/899-5555.
MANY people temporarily
experience tinnitus (ringing,
buzzing, whistling, hissing
or rushing noises) in their ears or head. For more
than 12 million people, it’s a persistent problem. For
some, it interferes with the demands of everyday life.
If you have tinnitus, Cleveland Clinic family
health center otolaryngologists can rule out health-
related conditions causing the problem. Our audiol-
ogists can then do a thorough hearing evaluation.
Together, they can determine whether you are a
candidate for the Tinnitus Management Clinic at
Cleveland Clinic main campus.
While there is no universal cure, certain mea-
sures provide relief. Tinnitus rehabilitation plans
may include sound therapy and/or noise generators,
biofeedback and behavior modification. For evalua-
tions by Westlake otolaryngologists Edward Fine,
M.D., Ph.D., Richard Freeman, M.D., Ph.D., or
Peter Koltai, M.D., and audiologist Lorraine Lom-
bardo, M.A., CCC-A, please call 440/899-5555.
What’sThatNoise?
When Carpal Tunnel SyndromeInterferes With Work
Plastic surgeon Warren Hammert, M.D.,sees patients with hand and upper extremityproblems at Westlake; for appointments,call 440/899-5555.
CARPAL TUNNEL SYNDROME can make keyboarding, operating a cash register and working on
an assembly line difficult. Swollen tissues in the carpal tunnel at the base of the palm put pressure on
the median nerve, causing pain, tingling, numbness in the fingers, weakness in the thumb, and a
tendency to drop things.
Initial treatment usually involves splinting to restrict movement and allow swelling to subside;
anti-inflammatory medication may be prescribed. If these measures do not help, outpatient surgery
may be recommended.
While repeated use of the hands or wrists at
work does not cause carpal tunnel syndrome,
certain factors increase your risks for it:
■ age (50s and 60s)
■ female gender, especially during pregnancy
and around menopause
■ concurrent illness
■ obesity
■ poor physical condition
■ smoking
To decrease pain at work, keep wrists straight
and minimize repeated flexing, extending or
twisting, and rest your hands periodically.
Meanwhile, address risk factors you can control:
Give up smoking, increase physical activity and lose weight, if necessary.
THE MYSTERIOUS molecule CRP (C-reactive
protein) may be as much of a “smoking gun” for
artery disease as cholesterol, experts believe. An
elevated CRP level indicates inflammation and was
traditionally associated with arthritis. Now it’s linked
to inflammation of the arteries as well. The result
can be instability and rupture of a plaque, the cause
of heart attacks and strokes.
The American Heart Association (AHA) recom-
mends CRP testing for people whose age, blood pres-
sure, cholesterol level, family history or habits put
them at risk for heart disease within10 years.
Cleveland Clinic family health center cardiolo-
gists believe the simple, inexpensive blood test could
supplement cholesterol screening by estimating risk
in those without symptoms of heart disease. The AHA
considers screening unnecessary for people at very
low risk of heart disease; researchers have not proved
that lowering CRP reduces risk.
Presently, everyone with high CRP levels should
begin aggressive preventive measures, including
cholesterol-lowering medication, healthier eating,
exercising and — especially — giving up smoking.
For appointments at Westlake with cardiologists
Caroline Casserly, M.D., Lon Castle, M.D., or
Robert W. Reynolds, M.D., call 440/899-5555.
CRP: New Clue to HeartAttack, Stroke Risk
Bouncing Back After Heart AttackIf you’ve had a heart attack, heart surgery or
both, cardiac rehabilitation is probably in your
future. A comprehensive recovery and educa-
tion program can help you and your family: ■
understand heart disease and risks ■ adopt
good exercise and eating habits ■ shop wisely
for food ■ manage weight better ■ reduce
stress ■ make lasting behavior changes for a
healthier lifestyle.
Counseling can be done individually or in a
group setting with family members.
Patients are closely monitored during the
exercise-based program, which runs three days
a week for eight to 12 weeks. Monitoring is
less intensive afterward as patients continue
rehabilitation — ideally, at a hospital-based
program.
During exercise rehabilitation, you will be
hooked up to an EKG machine as a cardiologist
or primary care physician looks for unsuspect-
ed changes in heart rate or rhythm that may
signal problems. The cardiologist will monitor
stress testing on the treadmill. You may also
exercise on a stationary bike, rowing machine
or with weights.
Since you need a physician referral for car-
diac rehabilitation, most insurance companies
cover this service.
For information about cardiac rehabilita-tion at Westlake, call 440/899-5555.
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 cir-
culation, frequently affecting people with diabetes,
circulatory disorders or other medical problems.
After a thorough history and examination, doc-
tors 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.
Westlake podiatrist Robert Dushin, D.P.M.,specializes in diabetic foot care and generalpodiatry.
Help for Sores thatWon’t Heal
Treatment may involve:
■ antibiotics
■ anti-clotting medication
Guarding AgainstWest Nile VirusMosquitoes — 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.
Family or internal medicine specialistsand pediatricians are available to discussyour concerns at Westlake; call 440/899-5555. To consult Lakewood internists andpediatricians, call 216/521-4400.
■ 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 instruct-
ed on how to care for your wound at home and
how to prevent it from recurring.
For appointments at Westlake, please call440/899-5555.
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
Lorain 440/204-7400
Solon 440/519-6800
Strongsville 440/878-2500
Willoughby Hills 440/943-2500
Wooster 330/287-4500
AppointmentsCleveland Clinic Westlake30033 Clemens RoadWestlake, OH 44145440/899-5555 or 800/599-7771
Monday through Thursday: 8 a.m. to 8 p.m.
Friday: 8 a.m. to 6 p.m.
Saturday: 8 a.m. to noon
Cleveland Clinic Lakewood16215 Madison AvenueLakewood, OH 44107216/521-4400 or 800/760-1513
Monday through Thursday: 8 a.m. to 8 p.m.
Friday: 8 a.m. to 6 p.m.
Saturday: 8 a.m. to noon
Cleveland Clinic Cancer Care Center atWestlakeTo see our medical oncologists about cancer
diagnosis or treatment, call
440/899-5555
To speak with a nurse about cancer symptoms or
concerns Monday through Friday, from 8:30 a.m. to
4:30 p.m., 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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Cleveland Clinic Westlake
Daniel Allan, M.D., board-certified in family
practice, provides comprehensive care for family
members of all ages. After earning his medical
degree from Case Western Reserve University, he
completed a family medicine residency at
Exempla Saint Joseph Hospital in Denver.
For appointments, call 440/899-5555.
Cleveland Clinic Lakewood
Ruthanne Muniak, M.D., board-certified in
pediatrics, has practiced general pediatrics for
26 years. She is a graduate of the Allegheny
University School of the Medical Sciences and
the Woman’s Medical College of Pennsylvania.
Dr. Muniak completed her postgraduate train-
ing at MetroHealth Medical Center in Cleveland.
For appointments, call 216/521-4400.
Women’s Health
NONPROFIT ORG.
U.S. POSTAGE PAID
CLEVELAND, OH
PERMIT NO. 4184Family Checkup / W149500 Euclid Avenue, Cleveland, OH 44195
THE CLEVELAND CLINICFOUNDATION
Detecting Breast CancerBreast cancer can be most effectively treated when
detected early in its development. Mammography,
together 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 recommends that
women over age 20 perform breast self-exam every
month, five to seven days after the first day of a
menstrual period, or the first of the month for post-
menopausal women. It recommends “screening”
mammograms every one to two years if you are be-
tween 40 and 50, and annually if you over 50, unless
there is a family history of breast cancer.
If you, your doctor or a screening mammogram
detect a possible abnormality, a “diagnostic” mam-
mogram, which zeroes in on the questionable area,
is your next step.
Westlake’s Cancer Care Center offers both diag-
nostic mammography and treatment for breast can-
cer by medical oncologists Timothy Spiro, M.D.,
and Hamed Daw, M.D.
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.
Women can make appointments atWestlake by calling 440/899-5555, andat Lakewood by calling 216/521-4400.
Adolescent GYN exams can be scheduledwith Westlake family medicine specialistLisa Marsh, M.D.
New Shared MedicalAppointments OfferedRESEARCH SHOWS a new health trend has mark-
edly increased patient satisfaction. In shared medical
appointments, patients gain much faster access to a
physician, with whom they can spend 90 minutes —
far more time than a traditional visit allows. They
also have the opportunity to share experiences with
other patients during the session.
Many Cleveland Clinic family health center pri-
mary care physicians, and some specialists, offer the
new option, called “Clinic Care Plus,” for patients
with certain health problems. In a shared appoint-
ment setting, patients see a physician for prevention,
treatment and follow-up. A behavioral health spe-
cialist is also on hand to address medical concerns.
Talk to your doctor to see if these sessions might be
appropriate for you.
When required, “Clinic Care Plus Physicals”
allow patients to receive a private physical as part of
their 90-minute shared medical appointment. Clinic
Care Plus Physicals can be scheduled sooner than
standard exams.
At Westlake, internist Derrick C. Cetin, D.O.,
will offer shared medical appointments addressing
weight management for those having medical
problems such as diabetes or hypertension with
behavioral health specialist Jean Forster, R.N. Inter-
nal medicine specialist Mary Walborn, M.D., will
offer Clinic Care Plus Physicals at Westlake.
Call 440/899-5555 to schedule an appointmentfor a Clinic Care Plus appointment or physical;for a free brochure, call 216/444-3178.