Genesys Announces Free Mini-Medical School Classes

Grand Blanc, MI – Back by popular demand, Genesys Learning Institute announces a new semester of free mini-medical school classes for the public – an opportunity to learn more about your health from Genesys medical experts.

Classes are designed to help you become a more educated health care consumer, and also help alleviate concerns you may have about medical conditions that affect you or your family.

Classes begin Monday, March 1, and are held at the Genesys Conference and Banquet Center (on the Genesys Regional Medical Center – Health Park campus in Grand Blanc Township) from 6 p.m. to 9 p.m., every Monday evening through April 5.

Here is the mini-medical school schedule. You can sign up for as many classes as you would like. All are free.

March 1
Diabetes and obesity
Jamal Hammoud, MD, endocrinologist at Genesys

Kidney disease and diabetes
Manjit Grewal, MD, nephrologist at Genesys

March 8
Nutrition for diabetic patients
Ann Batchelor, Genesys registered dietitian; and Jamie Karn, RN, Genesys diabetes educator

Exercise for diabetic patients
Ruth Anne Harmes, certified exercise instructor, Genesys Diabetes and Nutrition Learning Center

March 15
Stress management and depression
Heather Kirkpatrick, PhD, psychologist, Genesys Behavioral Science

Peripheral artery disease/varicose and spider veins/aneurysms
Thomas Shuster, DO, peripheral vascular surgeon at Genesys

March 22
Alzheimer’s Disease warning signs
Gerry Lincoln, program director, Michigan Regional Alzheimer’s Association

Heart bypass surgery
Marc Silver, MD, Genesys cardiothoracic surgeon

March 29
Sleep apnea
Clark Headrick, DO, pulmonologist and medical director of Genesys Home and Hospice Care

Crohn’s disease
Justin Miller, DO, gastroenterologist at Genesys

April 5
Hip and knee replacement
Frederick Schreiber, DO, orthopedic surgeon at Genesys

Minimally invasive spine surgery
Avery Jackson, MD, neurosurgeon at Genesys

To register for these classes, call the Genesys Learning Institute at 810-606-7725.

University of Michigan-Flint graduate students will receive one graduate credit for attending the entire winter semester of classes (paying usual graduate education fees). For details, call 810-606-7725 or check with the university.

Nutrition: May 2008

Do you ever wonder what is causing you to feel lightheaded when you wake up in the morning? How about the source of those achy joints and muscles? Take a good, hard look at your diet? Is it serving you? Often, poor nutrition is the root of our ailments and can often halter the progression, while alleviating symptoms of chronic disease.

As a registered dietitian/nutritionist, exercise physiologist, and registered yoga teacher, I have been serving the metropolitan Detroit area, since the mid 1980’s. With the recent release of my DVD, Reconnect with Food…Unplugged! and the revival of my co-authored book, Nutrition Secrets for Optimal Health, my nutrition clients now span the United States and abroad of serious individuals who take pride in their nutritional health. In my columns ahead, I hope to bring you relevant nutrition information that can help you feel your best, while slowing down the aging process.

In the coming issues of Health & Leisure Magazine, we will explore the many nutritional implications and recommendations for wellness along with disease prevention and treatment. Since this issue is devoted to Women’s Health, let’s take a look at a few relevant women’s health issues and how they can be improved through a healthy diet and lifestyle.

Menopause, PMS and Heart Disease

Since the late 1960’s, menopause has been treated as a disease that must be treated by hormone replacements (synthetic estrogen alone or in combination with synthetic progesterone which is called “progestin”). Hormone replacements have also been used as a heart disease preventive measure in women. As time evolved, natural alternatives to synthetic hormone replacement therapy have come to the forefront which have offered women much relief from the symptoms of menopause without the unwanted side effects of hormone therapy, including the increased risk of breast cancer.

As an adjunct to these natural alternatives, foods themselves are a great place to start if you are trying to keep your heart healthy and achieve menopause symptom relief or even Premenstrual symptom (PMS) reprieve. Although many women are still looking for a pill—even a “natural” pill to find benefits or relief, those who are truly committed to a lifestyle change can try incorporating new and healthy foods into their diet. For instance, soy products (tofu, soymilk, soy meat substitutes) contain substances called phytoestrogens, which can work like estrogens in the body. However, phytoestrogens are not nearly as strong as the estrogens found in synthetic replacements, so they do not cause side effects.

It is thought that soy can regulate estrogen levels in both pre- and post-menopausal women, while helping the body eliminate toxic substances that can be implicated in cancer growth. Women who consume a good quantity and variety of natural soybean products report fewer hot flashes and other menopausal discomforts than women whose diet consists of large amounts of meat and dairy. Soy products can also help to lower your cholesterol, which in turn can keep your heart and circulatory system healthy.

Bone Health

Flaxseeds can protect against bone loss as they contain a significant amount of “lignans.” Several studies show that lignans protect against osteoporosis by preventing bone loss and increasing bone density. Flaxseeds are small, flat and brown in color with a nutty flavor. They can be ground into “meal” in a coffee grinder, or purchased ground, and sprinkled on your cereal in the morning or mixed into yogurt. You can also use flax oil, found in the refrigerated section of health conscious grocery store, and mix with balsamic vinegar for your salads.

Magnesium along with boron helps to transport calcium to the bones in order to aid in the prevention of osteoporosis. If you take a calcium supplement, calcium citrate is the most absorbable form of calcium as this form of calcium creates an acid environment in the digestive tract to more efficiently absorb calcium. Magnesium is found in bananas, bran cereal, brown rice, lentils, peanut butter, spinach and walnuts, while boron is found in purple grapes, pears, apples and leafy, green vegetables.

Fibromyalgia and Other Rheumatoid Conditions

A poor ration of omega-3 fatty acids to omega-6 fatty acids can increase your risk of immune and inflammatory disorders including rheumatoid arthritis. Studies show that individuals with autoimmune conditions in the rheumatoid family such as lupus, fibromyalgia, scleroderma, arthritis and multiple sclerosis fare better eating less meat, dairy, and processed foods, with more emphasis on whole grains, fruits and vegetables as eating lower on the food chain provides a higher ratio of omega-3 fatty acids which aid in improving joint pain. In addition, a poor ration of omega-3 fatty acids to omega-6 fatty acids can increase your risk of heart disease, cancer.

A fairly new finding is that flair-ups of rheumatoid conditions, especially fibromyalgia, can be linked to food sensitivities discovered through Mediator Release Testing (MRT). MRT measures the release of chemical mediators from white blood cells and platelets in response to specific foods, additives or chemicals that are not due to an allergy. A simple blood test can determine your food sensitivities, while nutrition counseling by a registered dietitian trained to interpret this test can help you feel better and also lose those pounds that you cannot seem to shed no matter how hard you try. It could be that your hidden food sensitivities are getting in your way of progress!

Depression

The consumption of omega-3 fatty acids can also affect your mood. Researchers who have analyzed epidemiological studies of several countries suspect that when smaller amounts of omega-3 fatty acids are consumed, the rates of depression increase. This is one more reason to include rich sources of omega-3 fatty acids in your diet—your happiness may be at stake! Specific sources of omega-3 fatty acids are found in fish, soy, flax, walnuts and green, leafy vegetables.

In addition, yoga, meditation and other stress management techniques are also very important in the daily self-care of women today. Health professionals need to take a look at so many of the natural remedies available to women as they reach different milestones in their lives.

If you have topics you would like Beverly to cover in this column, please send your inquiry to editor@healthandleisureonline.com

Fibromyalgia: What You Need to Know

Perhaps you can sleep 10 hours a day and still feel wiped out. Then when you do finally wake up, your body aches all over even though you aren’t showing any signs of the flu. These two symptoms are hallmark features of fibromyalgia, a chronic rheumatologic condition that affects approximately 5-8 million Americans, most of them women.

Sharon Ostalecki, Ph.D is the founder of Helping Our Pain and Exhaustion or H.O.P.E., an organization dedicated to providing support and education to those with, or affected by, fibromyalgia and chronic fatigue syndrome. She is also the author of Fibromyalgia: The Complete Guide from Medical Experts and Patients.

Diagnosed with fibromyalgia 18 years ago, Ostalecki created this organization as way to inform and empower others with this condition.

“If you have fibromyalgia, you must be proactive in your care,” says Ostalecki, who has become an advocate working towards a greater awareness and more thorough understanding of this disease through her organization which is hosting a fibromyalgia conference in May.

What It Is:

Fibromyalgia is characterized by muscle, tendon and ligament pain, fatigue, insomnia and tender spots, which are places on the body that are acutely sensitive to slight pressure. Other common symptoms are headaches, depression, irritable bowel syndrome and facial pain.

According to the National Fibromyalgia Research Association, fibromyalgia is the second most common rheumatologic disorder following osteoarthritis and it is the number one cause of severe, generalized, musculoskeletal pain even beating out back pain.

The organization also estimates that it takes five years for a person to be properly diagnosed. This is in large part due to how new this diagnosis is to modern medicine. Therefore basic information about this condition, including causes, risk factors and treatments, is still evolving with doctors, researchers and patients at the forefront of this movement.

Screening and Diagnosis:

Since there is no specific test for fibromyalgia, the condition is often misdiagnosed or not diagnosed at all. A variety of blood tests and x-rays can rule out other diseases like multiple sclerosis or rheumatoid arthritis, but they do not confirm a diagnosis of fibromyalgia.

Recently, The American College of Rheumatology established guidelines for diagnosing fibromyalgia. The individual must have widespread pain for three months and must have 11 points along the body that are tender spots. But many physicians disagree with these classification guidelines and find them too rigid.

Risk Factors:

According to the Mayo Clinic, there are five primary risk factors for fibromyalgia. They are:

• Sex – Females are more likely to have fibromyalgia than men

• Age – The condition typically occurs in early to mid adulthood.

• Sleep Disturbances – Those with sleeping patterns interrupted by restless leg syndrome, muscle spasms and sleep apnea are more likely to be diagnosed with fibromyalgia.

• Family History – Those with a relative with this condition may be more apt to have it.

• Rheumatic Disease – Being diagnosed with lupus or rheumatoid arthritis also increases chances of having fibromyalgia.

Treatment:

There is no cure yet for fibromyalgia. It is a chronic condition that needs to be managed by the individual through medical means and lifestyle behaviors. Drugs such as antidepressants, painkillers and muscle relaxants work to decrease the pain and improve sleep. Lifestyle modifications include eating a healthy diet, reducing stress, exercising and getting enough sleep.

Many suffers who have been recently diagnosed are referred to physical therapy programs to ease pain and improve mobility skills. Loren DeVinney, P.T., is a physical therapist in West Bloomfield who specializes in working with individuals with fibromyalgia. His treatment program uses three modalities of therapy to help the individual relax muscles, improve strength and posture and relearn how to move safely.

Therapeutic ultrasound, heat and electrical waves first mellow out bound-up muscles. Soft tissue massage then coaxes and coddles the muscles to relax further, breaks up knots and improves circulation in and out of the muscle. Finally, gentle stretching exercises are performed to improve flexibility and strength.

Yoga and massage can be important therapies as well but they can also re-injure the already tender and knotty muscles of the individual, says DeVinney, who cautions his patients against going to certain kinds of yoga classes or massage therapists who are not trained in working with fibromyalgia cases.

Alternative Treatment:

Many sufferers of fibromyalgia have benefited from receiving acupuncture, the Chinese medical technique that involves inserting tiny needles in specific locations on the skin to rebalance and redirect the life forces that circulate throughout the body. A 2006 study performed by the Mayo Clinic found that acupuncture significantly improved symptoms of fibromyalgia. Other forms of complementary treatment include chiropractic care, massage and osteopathy.

Additional Support:

Fibromyalgia can be a very frustrating and debilitating condition for those who are directly affected by it including loved ones. As awareness increases both in and out of the medical community, more research and more support will start to glean insight into how this condition manifests and how it is best treated. The good news is that with numerous organizations focused on education, support and funding research, an individual diagnosed with fibromyalgia does not have to cope with their condition on their own.

On May 13, H.O.P.E. will be hosting Fibromyalgia Awareness Day, a one-day conference at the Courtyard Marriott in Farmington. The organization also holds monthly support meetings around the Detroit area. For more information visit H.O.P.E.’s website: www.hffcf.org

Recognizing Bipolar Disorder in Your Loved One

By David H. Averbach, MD, MSIA

Bipolar Disorder, or Manic Depressive Disorder, can have a devastating impact on the individual with the disorder, as well as on the families who have to deal with the individual on a daily basis. Coming from a family with a long history of Bipolar Disorder, I can say that identification of Bipolar Disorder in the individual is the key step in understanding and treating this illness.

Bipolar Disorder is characterized by episodes of manic behaviors, which may be short lived for a portion of a day, to long episodes lasting weeks or even months. The individual’s behaviors during these episodes are devastating to the family unit. Mood swings, irritability, needing little sleep, impulsivity, compulsions such as gambling or higher than normal sexual interest, and paranoia may be present during these manic episodes. These episodes may become so severe that the individual is at high risk of hurting themselves or others. Their intention may be rational, but the behaviors and interaction with others are usually irrational and bizarre.

Depression is usually a component of Bipolar Disorder. Episodes of depression may consist of crying, sadness, hopelessness, excess sleep or poor sleep, overeating or not eating enough, isolation from others, and losing interest in things that they used to find enjoyable. Feeling that life is not worth living and thoughts of suicide may also be present during the depressive episodes. Episodes of depression may last hours, days, weeks, or months, and often occur after a period of mania.

Identification of bipolar symptoms or behaviors is crucial in helping the individual and family cope with the disorder and begin to heal. The earlier the person is identified with Bipolar Disorder, the better the prognosis for managing the illness effectively. Individual and family education, support of the individual by their families, and compliance with treatment are crucial in managing the illness effectively.

It is easiest to illustrate Bipolar Disorder in men by using a common but fictitious case example. John S. is a 37 year old married man with three children. His wife has periodically expressed concern over his behaviors throughout their 10 years of marriage. There were times of mania when he would be impractical and impulsive, such as deciding to paint the outside of their house without the proper thought or tools. He would go through friends rather quickly because of his lack of tact and social awareness. He undertook extensive projects that would keep him up for several nights in a row. He would be irritable, loud, and argumentative for periods of time, and at other times he would appear to be happy and passive. He would also mismanage money and was a disaster to the family when he would do banking. During these episodes, he truly believed that he was right, reasonable, and rational when defending his ideas and impulsivity.

However, when he recovered from an episode, he would usually become depressed and isolated himself from his family and friends. He slept for 80 percent of the day, and during the other 20 percent he was tired and lethargic. His memory would be poor, he felt slowed down, and he lost interest in his hobbies and going out with his friends. At times during these episodes of depression, he had wishes of not being around and thought that his death would be the only option for preserving his family. During one episode, he talked to his wife about a plan he had for suicide, but he said that he did not have any intent to pursue the plan.

Needless to say, the family was always walking on “pins and needles” when they were around him, not knowing what his mood was like that minute, and not knowing when he would flip into a manic or depressive state. The frequency and intensity of his episodes caused chaos in the family. His wife would take the children to her parent’s house when his behaviors begin to get out of hand. Divorce was mentioned but not pursued, in part due to his wife feeling that it was her job to keep him under control. At times he seemed to be sorry for his behaviors that occurred during an episode, but he usually tried to rationalize them and blamed others for causing the behaviors. He also has no history of therapy, psychiatric intervention, or medication use for his behaviors.

This case example shows us the devastating impact that Bipolar Disorder has on the individual and family. It can be seen that the intensity and frequency of the episodes would most likely be much more manageable with early diagnosis, education, and treatment. Even if the person with the disorder refuses to seek help, education and therapy for the family by a trained professional skilled in Bipolar Disorder will help keep the family intact and help with their understanding of the illness and behaviors. Many times, the family member with the disorder will accept help when they are not in an episode, but maintaining therapy or medications during an episode is a significant challenge for the family and professionals dealing with this individual.

In summary, Bipolar Disorder can be well managed if identified accurately and prudently. Always seek professional help by a psychiatrist who can diagnose, educate, and provide treatment options for the individual and family. Remember that the earlier an accurate diagnosis is made the sooner the individual and family can begin to heal.

Dr. David Averbach is board certified in psychiatry and neurology.  He received his medical degree from University of Pittsburgh School of Medicine, and completed his M.S.I.A. in business from Carnegie Mellon University, Graduate School of Industrial Administration.  He is a member of the American Psychiatric Association and the American Academy of Child and Adolescent Psychiatry.

Is Winter Making You S.A.D.?

If you have not heard of SAD, you may have heard of a more common term: “the winter blues.” It is a disorder that is most common during fall and winter months; however, a milder version does affect some people in the spring or summer.

Symptoms of SAD vary as much as the seasons. Those suffering from the “winter blues” may experience loss of energy, anxiety, oversleeping, daytime fatigue, decreased sexual interest, weight gain, social withdrawal and moodiness.

Those feeling SAD during the spring and summer months may experience insomnia, irritability, agitation, weight loss, poor appetite and increased sexual energy.

So what causes SAD? There are many different hypotheses but no true known cause. Like most mental illness, genetics, chemical imbalances and other outside stimuli may have an affect on this illness.

Some suggest that the change in seasons affects our serotonin level; a chemical known to play a role in depression. The less sunlight, the less serotonin the body produces.

A similar hypothesis surrounds melatonin which is a sleep hormone. As daylight becomes shorter and the nights become longer, the production of melatonin increases and can also have an affect on depression.

There are different ways to treat the “winter blues” such as antidepressants and psychotherapy. Another option that is commonly employed is light therapy. This unique treatment option involves the patient sitting under light that simulates natural sunlight. The process is supposed to stimulate chemicals in the brain that relieve the depression, much like the sun’s light does during the spring and summer months.

Many therapists believe this is a useful treatment option, however, data is not very clear as to its success, and it has not been approved by the Food & Drug Administration.

If left untreated, SAD can result in complications similar to depression. These can include one or more of the following: social withdrawal, drug or alcohol abuse, suicidal thoughts or tendencies, or even problems at work or school.

You should seek medical attention if any of the symptoms of SAD arise, especially if these symptoms persist over several days in a month. Many people may feel depressed on any given cold, winter’s day, but when these feelings become consistent and frequent, this is the sign of a more severe situation.

Because SAD is a recognized mental illness, many physicians are able to diagnose and treat the condition. The severity of the illness and the patient’s ability to participate in treatment will ultimately determine which options a doctor will utilize.

Ultimately, your best outcome will depend on your own ability to recognize that you have a problem and seek out the proper medical attention from your family physician or psychiatrist.

Signs & Symptoms of S.A.D. (Seasonal Affective Disorder)

Source: www.MedicineNet.com

You should seek medical attention if any of the following symptoms persist over several days in a month.

• Tiredness
• Fatigue
• Depression
• Crying spells
• Irritability
• Concentration problems
• Body aches
• Loss of sex drive
• Disruption in sleep patterns
• Social Withdrawal
• Decreased activity levels
• Overeating (especially carbohydrates)

Unmask Bipolar Disorder in Your Child

By David H. Averbach, MD, MSIA and Audra Ann Averbach, MSW of Oakland Behavioral Health

Bipolar Disorder, also known as Manic Depressive Disorder, is a chronic condition effecting 1 to 2 percent of adults. Very often, symptoms begin in childhood and can cause significant problems with social, developmental, and academic functioning. Children who display symptoms such as irritability, agitation, hyperactivity, sleep disturbance, and mood swings may fit criteria for a bipolar spectrum condition. However, the diagnosis is difficult and many other conditions in children have symptoms that mimic bipolar symptoms. Therefore, it is very important that an evaluation by a child psychiatrist trained in Bipolar Disorder be undertaken in order to arrive at the correct diagnosis.

It is very common for children to be irritable, emotional, and irrational. However, when these symptoms begin to cause problems with functioning, the parents should consider seeking a trained professional’s opinion. Many conditions, such as Attention Deficit Hyperactivity Disorder, depression, and substance abuse, may also be present or may be the primary condition affecting the child. All possibilities need to be explored before the diagnosis of Bipolar Disorder is made.

Bipolar Disorder is displayed differently in various age groups. In younger children, moods cycling from irritability to anger, followed by normal moods may be present in Bipolar Disorder. These children usually overreact to minute issues and carry on for an extended period of time. Parents note this as a “Jekyll and Hyde” personality. In adolescents, moods are more classically either depressive or “manic.” Mania is a state of hyperactivity, racing thoughts, irrational thinking or actions, and a distinct change in personality. This more closely resembles the adult form of Bipolar Disorder.

Many children are misdiagnosed with other conditions when in fact they are more closely on the bipolar spectrum. One of the most difficult conditions to sort out is Attention Deficit Hyperactivity Disorder (ADHD) and Bipolar Disorder. ADHD does not come and go, although symptoms may be worse or lessened depending on the environment or treatment. Children with ADHD usually do not exhibit rapid cycling mood swings and usually do not get irritable and angry to the point where they become out of control and explosive. They do become frustrated, bored, and impatient, but it is not to the degree of Bipolar Disorder.

In addition, children and adolescents with Bipolar Disorder tend to exhibit moods that are more unpredictable and dysfunctional than children with ADHD. Parents know their children best – when in doubt, an evaluation by a child psychiatrist who will look at the symptoms and come up with a reasonable diagnosis and comprehensive plan is imperative.

A comprehensive evaluation consists of input from the parents and the child or adolescent. It is important that this be in their own words describing their problems. Interviewing the family about symptoms present in the child, as well as getting a detailed family history, is also very important. Many families seek out a child psychiatrist after their child has been diagnosed with multiple conditions by doctors or therapists with varying levels of expertise. Sorting out past diagnoses is usually very difficult and takes a trained child psychiatrist who has extensive experience in children with Bipolar Disorder and has seen their share of kids with bipolar and other conditions. They also can determine if the child’s current treatment is adequate and appropriate.

Other families present to the child psychiatrist with no history of evaluation or treatment. As with all evaluations, making the family feel comfortable and able to talk about difficult topics is of the utmost importance. There is usually one chance to develop a trusting relationship between the psychiatrist and the family, and this opportunity should not be wasted. The importance of ensuring the family that every effort will be made to interview, diagnose, and educate cannot be understated.

Bipolar Disorder is treatable. Depending on the functioning issues and the severity of the illness, treatment may take the form of therapy, medication, or both. Psychotherapy focusing on the importance of regular and quality sleep, good nutrition and meal planning, the need for exercise and being active, and exposure to sunlight, is essential for all families effected by Bipolar Disorder. Therapy also must involve the different parts of the family unit – the parents, extended family members, the siblings, the child/adolescent, and possibly friends. The child’s academic setting should also be considered at an evaluation. Without the help of these people, it is impossible to determine when a child is cycling and in a bad state versus when they are stable and functional.

A comprehensive review of medication for Bipolar Disorder is outside the scope of this article. However, if medication is needed, the classic family of medications used to treat this condition is the mood stabilizers. A good child psychiatrist skilled in the medication treatment of Bipolar Disorder in children and adolescents is invaluable and can save years of misdiagnosis, functioning decline, and suboptimal treatment.

Seek out resources that provide information about Bipolar Disorder in children and adolescents. Going to your local bookstore and browsing is one way to familiarize yourself with this condition. Going online to sites sponsored by the National Institute of Mental Health (NIMH) or specialty sites such as www.bpkids.org provide information from a research and health administration perspective, and from a member-driven foundation consisting of family members and concerned individuals, respectively. Choose your favorite method of educating yourself on Bipolar Disorder in kids. Make sure the information you gather is reputable. If you are concerned about you or your child, pursue an evaluation from a highly skilled and reputable child psychiatrist.

Dr. David Averbach is board certified in psychiatry and neurology. He received his medical degree from University of Pittsburgh School of Medicine, and completed his M.S.I.A. in business from Carnegie Mellon University, Graduate School of Industrial Administration. He is a member of the American Psychiatric Association and the American Academy of Child and Adolescent Psychiatry.

Audra Ann Averbach, M.S.W., received her Master’s in Social Work from the University of Pittsburgh. She is a member of the National Association of Social Workers. She completed her undergraduate work in psychology at the University of Michigan, and completed her College of Education, MAT candidate at Wayne State University, Detroit, MI.