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The Truth About Crohn’s ∙ Family Focus: Smooth School Transitions FREE!

FALL 2012 ∙ ISSUE 37

Southern Tier’s Source For Family HealthTM

Check us out online at www.HealthyLM.comand like us on Facebook!

HOT TOPIC:

Fresh FallFoodsSPECIAL FEATURE:

Breast Cancer BreakthroughsStay in Shape This Fall

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Publisher/EditorChris Coyne

Staff Writers Chris CoyneChris StrubLisa M. MayersStephanie BlodgettCarol Boughner

DesignerHoward Mitsakos

Advertising SalesJim BlodgettChris Strub

PrinterCarr Printing, Inc.

Healthy Life Magazine is a Division of Ad Elements, LLC607.238.1560

To contact Healthy Life Magazine, email: hlm@adelements.net

The information contained in Healthy Life Magazine is intended to educate and in-form the local population about a variety of medical & health topics. The information is accurate to the best of our knowledge. This publication is not intended as medical, legal or regulatory advice. Healthy Life Magazine and its affiliates disclaim all liability arising from or related information contained in this publication.

Table of Contents:

Children’s Health ∙ 3Hot Topic ∙ 4 The Truth About Crohn’s ∙ 5 Surviving Cancer ∙ 6 Sodium Reduction ∙ 8Don’t Fall Out of Shape ∙ 9SPECIAL FEATURE Breast Cancer Awareness ∙ 11Family Focus ∙ 13 Healthy Recipe ∙ 14Water Cooler Chat ∙ 14

FALL 2012 ∙ ISSUE 37

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Children’s Health

The Return OfWhooping CoughYou may have heard your parents or older relatives talk

about it, someone in the family had a horrific case, and it’s become part of the family lore. But you probably haven’t heard a lot of people talk about whooping cough in the present tense in quite some time, or maybe you have. Whooping cough, which had gone the way of polio in our collective memories’, has made a remarkable and alarming comeback in homes and doctors’ offices across the country. Healthy Life looked into the resurgence of this once waning condition: what to look for, how to protect our children, and general information about what physicians refer to as pertussis.

We suspect there are many factors in today’s society that have contributed to reported cases of pertussis increasing dramati-cally in the past few years. Immunity wears off over time, so those who have had the vaccine in years past but are no longer immune may contract whooping cough. Those affected may not even know they have the disease until after they’ve already passed it along to a young child or anyone else who hasn’t been immunized. There is also the possibility of the disease being reintroduced into the country from immigrants or visitors from countries that don’t have the same pertussis vaccination sched-ules as we do here in the United States.

Whooping cough (pertussis) is a bacterial disease that is highly contagious and can last for months. The bacteria create sticky mucus in the airways that makes it hard to breathe, eat and drink. It’s easily spread through a sneeze or a cough of an in-fected person and is transmitted through droplets from the nose and throat to the mucus membranes of another’s mouth, nose or eyes. It’s less common, but still possible to contract it from droplets left on a surface and transmitted after one touches that surface and then his nose, eyes or mouth. Symptoms start like a mild cold: runny nose, congestion, sneezing, mild fever and dry cough. But after a week or two that cough can get much worse and result in spastic coughing attacks (sometimes accompanied by a wheezy ‘whoop’ sound’ — hence the name) that may pro-voke vomiting, cause red or blue face and, in severe cases, can even result in rib fractures. Infants are particularly vulnerable to more severe cases of whooping cough because their airways are smaller and less developed. Whooping cough in the very young can lead to pneumonia, seizure, encephalopathy and even death.

Talk to your doctor about the proper immunization schedule for your child; usually DTaP is given in the 2nd, 4th, and 6th months — and then later in booster shots. Adolescents and adults who are going to be around infants should also receive booster shots as needed.

by Christopher Coyne

Important Information About Whooping Cough - No vaccination is 100% protective and even if you are immu-nized you can get whooping cough, and still pass the bacteria without knowing.

- Besides the B. Pertussis illness itself, whooping cough can set up the person for secondary infections like ear infections and pneumonia.

- We immunize to make the illness have less of an impact on our society, especially those that are at high risk for severe complications, such as infants under 1 year of age.

- How to prevent whooping cough? Hand washing and cover-ing your mouth when you cough and sneeze go a long way toward preventing the spread of this disease, as well asthe flu and the common cold.

- After being on antibiotics for 5 days you are no longer con-tagious; however, the cough may remain until the cilia in the lungs recover.

- Getting vaccinated with Tdap — at least two weeks before coming into close contact with an infant — is especially impor-tant for families with and caregivers of new infants.

- Getting the vaccine after being exposed will not help fight off the illness.

- The cough is often worse at night.

- It will start out like a common cold with runny nose, sore throat, low grade temperature but then progresses to coughing fits. The person may look fine in between coughing fits.

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The Advantages of Eating in Season!

Hot Topic!

As summer turns to fall, seasonal crops are quickly changing. While the sweet tastes of summertime may be comfortably familiar, continuing to eat produce that’s out of season in our region may have undesirable effects on the health of you and your family. Sure, nowadays you can get most any vegetable just about any time of year—but are you getting the optimum taste and nutritional benefits from those foods? Fruits and vegetables that are not in season may travel up to 2,500 miles before they reach your kitchen table. They’re also often harvested before they reach full maturity, which can cause vitamin degradation and significant nutrient loss.

Research has found that seasonal eating clearly has nutritional ramifications. A study conducted on dairy cows in London in 1997 found that iodine in pasteurized milk was higher during the winter, while the milk’s beta carotene content was higher in the summertime – a direct correlation with the cows’ diets.

Eating in season brings a natural variety to your diet as well. Like to sprinkle blueberries on your breakfast cereal during the summer? Try switching to pomegranate in the fall — and when winter rolls around, bring on the grapefruit! Stocking fresh fruits and vegetables that are timely choices can bring a sense of excitement as your favorite season – no matter which season it may be – comes to an end.

There are plenty of healthy, local options to keep around the house as autumn arrives:

Cranberries: Cranberry beds are flooded in the autumn to facilitate harvest.Onions: Sweeter onions harvested in summer develop a sharper flavor into the fall.Zucchini: A great low-calorie source of folate, potassium and vitamin A.Potato: The world’s fourth-largest food crop (after wheat, rice and maize) is a fall staple.Broccoli and Cauliflower: The kids may shudder, but the anticarcinogenic properties are important.Pumpkin: Don’t be scared: this backyard vegetable is low in calories and filled with antioxidants.

You can find many of these seasonal treats at a local farmer’s market, which do extend into the autumn months. The Downtown Binghamton Business Association puts on the twice-weekly Binghamton Farmers’ Market on Tuesdays & Fridays, between 8:30 a.m. and 2 p.m., through Oct. 31. The Vestal Farmers’ Market is held every Wednesday and Saturday from 9 a.m. to 1 p.m. at the Vestal Public Library, until the day before Thanksgiving (Nov. 21). In Owego, you’ll find the Owego Farmers Market in the Rite Aid parking lot on Main St. on Tuesdays and Fridays from 9 a.m. to 1 p.m. through October. And in Endwell, a farmers market is held every Tuesday through October from 4 to 7 p.m., at Highland Park.

by Chris Strub

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The Truth About Crohn’s DiseaseAs recently as ten years ago, most people had never heard of a condi-tion called Crohn’s Disease. Today, we’d venture to guess that most people have not only heard of it, but know someone that has it. But what do we really know about this disease, and what can be done about it? Even with its increased presence, Crohn’s is still a relatively misunderstood disease; and Healthy Life thought it would be help-ful to pass along some of the facts and myths about a condition that affects more and more Americans every year. (According to Crohn’s and Crohn’s and Colitis Foundation of America: disease may affect as many as 700,000 Americans. Men and Women are equally likely to be affected, and while the disease can occur at any age, Crohn’s is more prevalent among adolescents and young adults between the ages of 15 and 35.)

What is Crohn’s Disease?Crohn’s is a chronic inflammatory condition of the digestive tract that, along with ulcerative colitis falls under the heading of IBD, or Inflammatory bowel disease. In the simplest terms, with IBD the body’s immune system attacks harmless bacteria that aids in digestion causing inflammation. It is NOT the same as IBS, or irritable bowel syndrome, which is a functional disorder of the intestines. Crohn’s can occur anywhere in the digestive tract from the mouth on down, but most commonly affects the lower part of the small intestine. The most common symptoms are abdominal pain, diarrhea, rectal bleeding, and weight loss.

What’s the cause of Crohn’s Disease?That’s a tough one. There are many theories; factors such as diet and stress can aggravate Crohn’s disease, but are not thought to cause the disease on their own. Research suggests that heredity, genetics and environmental factors may contribute to the development of Crohn’s, but the science is still not definitive. It’s this uncertainty that makes

Crohn’s difficult to initially diagnose. Once it is diagnosed however, it’s important to follow doctor’s recommendations, as without treatment Crohn’s can result in many very serious health issues—some that may require surgery.

What is the cure for Crohn’s?As of right now, there is no scientifically proven medical cure for Crohn’s disease. Although some people have experienced easing of their symp-toms by altering their diets in different ways, there is no ‘miracle’ diet to cure Crohn’s. There are medical treatment options, however, that can control inflammation, manage symptoms and prevent damage caused by inflammation. Crohn’s is a chronic disease that may lessen or worsen in severity over time periods, but will always be present. The good news is that with a good strategic medical plan, and vigilant adherence to that plan, along with frequent check-ups, a person with Crohn’s disease can live a productive, happy life.

For more information on Crohn’s Disease and IBD go online to the Crohn’s and Colitis Foundation’s website at www.ccfa.org.

Additional info from www.fda.gov.

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Tremendous progress has been made over the past two decades in diagnosing, treating, and even curing many cancers. While it remains a very serious and life-threatening disease,

many of those who are diagnosed with cancer now go on to live a healthy, cancer-free life. In fact, according to the American Cancer Society there are more than 13 million cancer survivors living in the United States (as of January 1, 2012) and it is estimated that by the year 2020, that number will increase to as many as 18 million survivors.

Cancer survivors do face some special needs however, to recover and stay healthy, particularly in the first year or two following active treatment.

“As our patients complete their treatment, we work with them individually to provide a plan of care going forward that is tailored specifically to their needs,” explains Laura Balmer, ANP, AOCNP a Radiation Nurse Practitioner with the Falck Cancer Center at Arnot Ogden Medical Center, in Elmira. “Not only does the care plan ensure ongoing support and monitoring, but knowing that there is a plan in place can be very reassuring to the patient.”

Many survivors find that from the point of diagnosis, through much of their treatment they are so focused on doing what they need to do to heal – often a combination of tests, surgeries, chemo and radiation – that it is only after those treatments end that they begin really processing the emotional aspects of their disease.

“For months, sometimes longer, cancer patients are undergoing active treatment and seeing their health care providers on a constant basis. Then, treatment ends and there may be months that pass without a doctor’s visit. Survivors can suddenly feel vulnerable and alone,” cautions Balmer.

by Lisa M. MayersSurviving Cancer:You’re Not Alone!

Fear of recurrence, anxiety about getting back out into the world, coping with the unknowns of a “new normal” and what to expect going forward, as well as issues such as finan-cial stress due to the cost of treatment or going an extended period without income can catch survivors off guard when treatment ends.

“Strong emotions are to be expected when a person’s treat-ment ends. We always do our best to reassure patients that it is completely normal, and to let them know that we are still here for them,” says Balmer. “An oncology social worker is available to patients during and after treatment for emotional support, as well as practical needs such as finding resources to help with insurance co-payments and the cost of medica-tions.”

When you are part of a survivor’s personal support network, it is also important to understand that they will need your support long after treatment ends. Often survivors feel like the support they received so generously and abundantly during treatment evaporates the day treatment ends – just when they often need it the most. Understanding that this is the case will help you stay present and available for those you love.

In addition to the emotional issues survivors must deal with once treatment ends, there are often lingering or long term physical side effects as a result of cancer treatments. Fatigue can last for more than a year after treatment is complete, as the body heals from all it has been through. The fatigue can be minimal and resolve in weeks or months, or linger in a

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more profound way, impacting a survivor’s quality of life for much longer, depending on the individual and their specific circumstances.

De-conditioning of muscles contributes to the fa-tigue, reducing physical stamina. Depending on the age and physical condition of the individual when they began treatment and the course of treatment they received, restoring muscle health and strength can take time.

“Proper nutrition is essential when recovering from cancer and the associated treatments. Your body needs quality nutrients, particularly protein, to rebuild itself. A higher calorie, higher protein diet is generally recommended for at least six months fol-lowing treatment. If a patient’s appetite lags we can prescribe appetite stimulants,” says Balmer.

Exercise is also important in alleviating fatigue and rebuilding muscle strength and stamina. Simple things like walking and stretching can be a good way to start getting back to your normal activities and lifestyle. Physical activity also contributes to a positive outlook and helps to keep worry and stress at bay.

While fatigue can be a normal side effect of cancer treatments, it’s important to let your health care provider know if it becomes extreme during or after treatment, making it impossible for you to maintain the normal activities of daily life. Contributor Laura Balmer, ANP, AOCNP, Radiation Nurse Practitioner, Falck Cancer Center,

Arnot-Ogden Medical Center, Elmira, NY

Many survivorship issues are very specific to the age, condition, and treatment an individual receives – whether that’s radiation therapy, chemo therapy, or surgery. The younger a person is when they are diagnosed and treated, the longer and more closely they will be followed by their medical team for long term side-effects and possible recurrences.

It’s important that survivors play an active role in their post-treatment care plan. Laurie Balmer offers these tips:

•Listen and make sure you understand your care plan, as outlined by your medical team at the end of treatment. • Ask questions – write them down before your visit and make sure they are answered so that you feel comfortable in your understanding of them.• Follow the advice of your care providers – keep all of your follow up appointments and continue with any prescribed medications or dietary recommendations.• Make any necessary lifestyle changes – smokers have a much higher rate of recurrence than non-smokers. Assistance is available to help smokers quit. • Maintain a healthy weight and a healthy level of fitness, through proper diet and exercise. • Stay aware of issues related to your own individual situation – if you experience symptoms that concern you, it’s better to ask about it than to worry about it.

“Often patients and survivors have such a myriad of specialists that it can be overwhelming just knowing which one to call when a question arises, but the most important thing is to simply reach out. Any one of your providers will be happy to assist you and connect you to the most appropriate resource,” advises Balmer.

Additional Resources for cancer patients, survivors, and caregivers: www.cancer.orgwww.livestrong.orgwww.nccn.orgwww.asco.org

Most health care is delivered locally.Collaboration to address today’shealth care issues and plan fortomorrow’s needs also should belocal. Excellus BlueCross BlueShieldcollaborates with local businesses,community and civic organizations,educators, members and health careproviders to make high-qualityhealth care accessible and affordablefor the people who live and workhere. That’s why we’re here.

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CollaborationThe operative word in health care.

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More and more people are making a conscious effort to improve their diet, and that’s a good thing. Checking calo-ries and fat on food labels is more common than ever; you may even do it yourself--but do you read the WHOLE label? Do you know how much sodium is in that low-calorie item you’re buying? Most Americans consume more than twice as much sodium per day than is recommended. Most of the sodium we consume comes from processed and pack-aged foods and too much sodium can lead to serious health problems including high blood pressure, heart attack, stroke and others. The Broome County Health Department has re-cently started a campaign that is designed to raise awareness about the dangers of a diet too high in sodium. The Sodium Reduction in Communities Project is hoping to make people more vigilant about the amount of sodium they consume, and to educate the public about what we can do to lower our sodium intake. The campaign suggests that you aim for 1500mg of sodium or less per day as your goal, and here are some recommendations to help you do it:

• Read Labels! Just because something is Low-Cal, or Fat-Free, doesn’t mean it’s Sodium-Free. Even some items labeled as ‘lower sodium’ still contain surprisingly high amounts of sodium.

How Much SaltIs Too Much?

• Choose plenty of fresh fruits and vegetables. They’re good for you for so many reasons, one of them being, they’re generally quite low in sodium.

• Order smaller portions from restaurants, or take food home. Many restaurant meals are very high in sodium and unfortunately unless we specifically ask the chef to prepare a low-sodium meal, there’s not much we can do about it.

• Ask your grocer about lower sodium alternatives to common items you buy. He may even carry a better op-tion, you just need to know where to look.

If you’re making smarter food choices for the sake of you and your family’s health, good for you! Just remember to be salt smart, too!

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The leaves are changing, and unfortunately for a lot of us, so are our exercise habits. The softball glove gets put away and the volleyball shorts are tucked in a drawer, not to be seen until next Spring. Then there’s the double-whammy that is a human’s natu-ral tendency to eat heartier, higher calorie foods as the weather gets cooler and the days get shorter. It doesn’t have to be this way! Don’t fall out of shape in fall! Just because you’re not getting out-side as much as you did in the summer, doesn’t mean you have to give in to the couch. We asked Kelsey Newman, the owner of Positive LifeForce Fitness and Wellness in Endwell, to give us a few tips for staying motivated and in shape during autumn. Here are her suggestions:

STAY FIT THIS FALL!

#1 - There are indoor volleyball leagues too! And lots of other indoor sports you can join by yourself or with a friend or two. Racquetball, tennis - even adult kick-ball leagues are fun ways to keep yourself moving in every season!

Don’t Fall Out of Shape

#2 - Cardiovascular exercise is very important. If you’re a walker or runner but don’t like doing either in the dark, try to get outside in the middle of your day—take a walk, or a short run at lunch. Or try swimming or an indoor cycling class to get that cardio workout.

#3 - If you are packing in some higher-calorie meals this season, take that into consideration when you think about burning them off. Make sure your exercise is a mixture of cardiovascular and resistance training. Consult with a Personal Trainer to find out what a good weekly fitness program looks like for you, and make it your goal to stick to it!

The key to staying on track is to choose activities that you actually enjoy. If your workout routine is designed solely to keep you in shape, with little variation and no fun, you’ll dread it and therefore be more likely to skip a week…or two..or every week. Mix it up a little! Keep your exercise fresh and fun, and you’ll look forward to doing it. And this year you won’t fall out of shape.

Contributor Kelsey Newman, Owner, Positive LifeForce Fitness and Wellness, Endwell, NY

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UHS Primary Care

uhs.net

The members of our medical teams work together to provide you and your family with high quality family medicine. Our providers are well known in the community and offer patient-centered care for people of all ages, including children, adolescents and adults.

With more than 30 locations, we’re never more than minutes away. Visit www.uhs.net for a listing of locations.

Same day appointments are available.

All locations are accepting new patients!

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S P E C I A L B R E A S T C A N C E R A W A R E N E S S F E A T U R E

Genetic Testing and Breast Cancer: Consider the Implications

October is Breast Cancer Awareness Month and Healthy Life talked to area Health Professionals about some of the latest developments in the ongoing mission to help women and their families understand and cope with the disease.

As genetic research progresses, more is becoming understood about the causes and contributing factors that lead to diseases like breast cancer. While it is estimated that only 5-10% of all breast cancers can be linked to inherited genetic mutations, such as BRCA1 and BRCA2, knowing your family health history has never been more important.

“Knowledge translates to vigilance,” says Dr. Camelia Lawrence, MD, a Board Certified, Fellowship Trained Breast Surgeon at the United Health Services Breast Center in Vestal. “A family history can tell us a lot about the big picture and lead us to the proper testing and surveillance of patients.”

While genetic mutations are relatively rare in the general population, women who have a strong family history of any type of cancer – not just breast cancer – should consider genetic counseling. The counselors are trained to look for patterns that signal the need for genetic testing and to go one important step further by recommending which specific test(s) are indicated. Once you’ve been tested, their expertise is also very valuable in accurately interpreting the results. Just because you have tested negative for one gene mutation does not mean you don’t have another.

An under-utilized community resource, genetic counselors can also assist you in understanding the implications a positive result can have on your ability to obtain life insurance or disability insurance in the future. There are laws in place to protect your privacy with regard to health insurance and employment discrimination, but no such laws exist for life insurance and disability.

The testing itself is fairly simple – a blood test, or buccal mouthwash that is sent to a specialized lab for analysis. When test results come back, genetic counselors and physicians assist you in interpreting the results – which can be positive, negative, or ambiguous. They can also guide you in making decisions about whether or not to include family members in the counsel-ing and who to include.

“Many people don’t realize that inherited gene mutations such as BRCA1 and BRCA2 can be carried and passed down by both the male and female members of a family,” explains Dr. Lawrence.

For some women, though, genetic testing is not just about assessing future risk. If you’ve already been diagnosed with breast cancer, and fit the criteria for testing, the process takes on a different tone – and speed can be of the essence.

“If a woman diagnosed with breast cancer tests positive for BRCA1 or BRCA2 her treatment protocol can shift, so it becomes important to have those results before deciding on a surgical plan,” says Dr. Lawrence.

The treatment for BRCA1/BRCA2 gene-positive breast cancer is risk reduc-ing bilateral mastectomy. If the woman is over 40 or at the end of her child-bearing years, risk reducing oophorectomy (surgical removal of the ovaries) is also performed. The recommendations also apply to women who test positive, but have not been diagnosed with cancer.

The knowledge gained through genetic testing benefits family members as well.

“Genetic testing can be a powerful tool of protection, particularly for a person’s sons and daughters,” says Dr. Lawrence.

Counselors encourage patients to include family members in the process and to share their test results. The final decision, however, will always rest with you, and it is not always an easy or straightforward one to make. At what age for instance, should a daughter be made aware of her risk? At what age should she be tested?

“If a woman’s mother is gene positive, I would recommend that the daugh-ter receive genetic counseling and be tested. If the daughter is positive, most clinicians recommend high risk surveillance from age 25 - clinical breast exams twice per year, annual mammography and MRI imaging. Once she is 40 or past her child-bearing years, risk reducing mastectomy and oophorectomy is recommended,” says Dr. Lawrence. “If she tests nega-tive, the protocol would include annual mammography and clinical breast exams beginning ten years earlier that the age her mother was diagnosed.”

While our knowledge of genetics is evolving, the potential implications of genetic testing require careful thought. No matter your age, whether you have a cancer diagnosis or if testing was recommended due to high risk, and regardless of whether or not you choose to include your family, genetic counseling before and after testing is an important part of a complex pro-cess that must not be overlooked.

Contributor Camelia Lawrence, MD, Board Certified, Fellowship Trained Breast Surgeon, UHS Breast Center, Vestal, NY

by Lisa M. Mayers

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S P E C I A L B R E A S T C A N C E R A W A R E N E S S F E A T U R E

For a woman, breast cancer is about as personal as it gets. More than just an appendage, a woman’s breast is part of what makes her who she is – part of her feminine being, a symbol representing her capacity to nurture. A woman’s self-image can also be dramatically affected by breast cancer and the loss of a breast, impacting not only the woman herself, but her intimate relationships as well.

Fortunately, advances in surgical techniques and cancer treatments are giving women more options than ever to regain their health, appearance, and positive self-image. Plastic surgeons working side-by-side with breast oncology surgeons can begin breast reconstruction during the same surgical procedure. This gives women the psychological advantage of waking up with a new breast already being formed – something that experience has shown to be very beneficial to the healing process.

Decisions about breast reconstruction are intensely personal and individual. Choosing the type of reconstruction surgery, whether to have the surgery im-mediately or to delay it, and even whether to have breast reconstruction at all, are decisions that can only be made by a woman, together with her significant other and team of health care providers. Presently, only 20% of mastectomy patients are having breast reconstruction because they are often not informed of its availability. New laws have made it mandatory that every woman having mastectomy be so informed. Not all women are candidates for every type of surgery. The specific course of treatment for her breast cancer can influence recommendations, as can her body type, overall health and lifestyle, and personal preferences.

“If a woman chooses breast reconstruction surgery, our goal is to give her a result that leaves her feeling good about how she looks in clothing, as well as without clothing,” says Mark Walker, MD, F.A.C.S. a Board Certified Plastic Surgeon and Board Certified General Surgeon in Binghamton. “While a reconstructed breast will never be the same as the breast she lost or have the same sensation, a recon-structed breast can look and feel very natural.”

There are two primary differences in breast reconstruction surgery – one uses the woman’s own tissue to form the breast and the other uses an implant. There are advantages and disadvantages to both.

Surgery that uses a woman’s own tissue, called a “flap” technique, repositions muscle, fat, and skin from another site on her body - generally either the abdomen or the upper back – to form the breast.

Tissue expansion is a much simpler surgery, where an implant pocket is created under the healthy skin and muscle conserved from a mastectomy. A temporary implant, with a port attached, is placed in the pocket and gradually expanded with saline injections over several weeks to months. When the expansion process is complete, the same incision is reopened, usually in a simple outpatient surgical procedure, and the temporary implant is replaced by the permanent one.

Women who have undergone breast-conserving surgeries such as lumpectomies or partial mastectomies may also choose some form of breast reconstruction after treatment. Cosmetic issues may arise for a woman directly as a result of surgery, or after time passes as a result of radiation treatments, which can cause a contracture of the breast tissue. In this case, options such as a breast lift or even breast reduc-tion in the opposite breast may be offered to correct issues of asymmetry.

A newer, less invasive procedure called lipo-grafting (or fat grafting) is also avail-able to women who want to correct cosmetic damage caused by breast cancer treatments. Lipo-grafting “transplants” fatty tissue from one area of the body to another – in this case, to fill and sculpt the breast.

“With lipo-grafting, fatty tissue is carefully removed using a small device, from a selected site on the woman’s own body – generally the abdomen, thigh, or but-tocks. Once collected, the fat cells are separated out and re-injected into very spe-cific, targeted areas of the breast in thin strands. These strands of fat cells integrate with the healthy tissue and develop their own blood supply,” explains Dr. Walker. “The result is added volume, better symmetry, and a more sculpted natural look, with a minimally invasive technique and no added scarring.”

The fat that is collected and grafted into the breast also contains stem cells, which stimulate growth and healing. A small percentage of the cells that are injected will die, so initially more cells will be injected to accommodate that anticipated loss, while still providing the desired cosmetic outcome. Healing is complete and the results are final after about six months.

“Lipo-grafting can be done at any time after breast surgery or breast cancer treat-ments and can be an ideal solution for issues of contracture and symmetry,” says Dr. Walker. “As with any kind of breast reconstruction, the decision is a personal one and as a plastic surgeon, I am honored to be able to assist women with this very important part of their healing process.”

As techniques continue to evolve, it is expected that lipo-grafting may someday be used to completely reconstruct breasts in a natural and minimally invasive way.

Contributor Mark A. Walker, MD, F.A.C.S., Binghamton, NY, www.drmarkwalker.com

Breast Reconstruction by Lisa M. Mayers

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Now that the school year is in full swing, some parents are ex-periencing new issues and anxieties from their children. Some of the most significant change comes from moving on to anoth-er level in school; whether it’s from pre-school to kindergarten, elementary to middle school, middle to high school, or high school to college; each step up can present new challenges and concerns. And, even if they are not expressing it, sometimes transition can be intimidating. If your child is not ‘getting it’ in their new school situation, and it remains unchecked, it could lead to longer-term difficulties, and even make your child dread going to school. If your child’s not being forthcoming about their school day, ask questions. Don’t push, but try to find out what they’re feeling and how they are adjusting to their new environment. You know your child best. If you sense that the back to school anxiety may be rooted in something more seri-ous, such as an anxiety disorder or a problem with a bully, talk with your child, your child’s teacher, and/or the school counsel-or. Some of the characteristics of anxiety to look for include:

Family Focus: Making Smooth School Transitions

• Headaches• Chronic stomachaches (many stomachaches over a long period of time)• Trouble sleeping • Grouchiness • Personality/behavioral change• Feeling overwhelmed• Feeling tired • Hard time making decisions • Is afraid to be left in a room alone • Clingy; follows a parent around • Worries a lot about getting hurt • Worries a lot about people she loves getting hurt • Nightmares • Tantrums/excuses to get out of going to school

Spend time talking to your child about how the day went and positive/negative points of the day. By giving your child more attention, he or she will feel more secure about the connec-tion to you and home. If things get a little rough, try not to overreact. Reassure them that you love them, that you’ll think of them during the day, and you will talk to them about their day later. Remain calm and positive.

And remember to try to relax yourself as much as possible. Changing school environments can also be hectic for parents, so taking care of yourself by eating right and getting enough sleep and exercise is a good idea during this transition. Try to remind yourself that any anxiety or stress you or your child may be feeling is only temporary. If you show your enthusi-asm for new school challenges, your kids are sure to pick up on it, and the nervous energy will turn into excitement. Be-fore you know it, your family will be back in the good school habits-groove.

by Carol Boughner

201 Oakdale Rd. • Johnson City

(607) 770-3870

“Where advanced technology and affordable prices meet!”

Always FREE:•Hearing Evaluation •Live Speech Mapping•In-house Repairs •Real-Ear Veri�cation

•Hearing Aid Service •Hearing Aid Evaluation

14 • HLM

Healthy Recipe

3 cups green leaf lettuce, rinsed and torn

1 Bartlett or Anjou pear1/3 cup pomegranate seeds

1 tablespoon vegetable oil2 tablespoons pomegranate juice

1 tablespoon lemon juice1 teaspoon prepared

Dijon-style mustard1/2 tablespoon honey

ground black pepper to taste

Pear & Pomegranate

Salad To Nap or Not to Nap…An afternoon nap always sounds appealing…doesn’t it? For those suffering from insomnia an afternoon nap may not help; in fact, it may be counterproductive. If you don’t have a problem getting sleep at night, a 30-40 minute nap can work wonders to pull you through a long day. In fact, a study conducted in 2008 found that a 45-min-ute daytime nap can improve memory function and even lower blood pressure. If you have insomnia, naps present a problem, however. Although you might feel tired during the day, lying down to take a nap can perpetuate bad sleep habits. Even a small amount of sleep can reduce your nighttime sleep drive and becomes another period of fragmented sleep.

Benefits of Napping• Relaxation • Reduced fatigue • Improved mood• Improved performance, including quicker reaction time, better memory, less confusion, and fewer accidents and mistakes

Downfalls of Napping• Sleep Inertia-Feeling groggy

and disoriented after waking up from a nap

• Nighttime Sleep Problems• One study has indicated

that napping is associated with increased risk of heart failure

in people already at risk

Water Cooler Chat

Recipe Yields 2 Salads

Divide the lettuce between two bowls. Halve and core the pear, then cut each half in slices. Divide the pear slices and pomegranate seeds among the two bowls and mix gently.

Combine the vegetable oil, pomegran-ate juice, lemon juice, mustard, honey, and pepper in a saucepan. Bring to a boil over high heat; reduce heat and simmer, stirring frequently, until the dressing thickens slightly, about 2 minutes. Pour the warm dressing over the salads and serve.Source: allrecipes.com

HLM • 15

Coming up in the next • Being Overweight is Bad for Your Back• Out & About in the Southern Tier• Asthma for Life?

16 • HLM