HealthWatch

NORTHEAST GEORGIA’S HEALTH & PREVENTION MAGAZINE

January 2011

Make sure not to share your germs

Not too late to get a flu shot

Teeth offer stem cell option

FEATURING

... Page 14

Pages 12-13

Fight COPD with exercise

... Page 6

... Page 14

... Page 16

� Sunday, January 30, 2011 The Times, Gainesville, Georgia | gainesvilletimes com

By Lauren [email protected]

Statewide, Hall County used to have one of the lowest percent-ages of people with diabetes. But not anymore.

In 2004, just under 7 percent of Hall County residents had diabe-tes. The latest statistics show that 10 percent of Hall County’s adults have diabetes, right on par with the national average, according to the Centers for Disease Control and Prevention’s National Diabe-tes Surveillance System.

“Diabetes has been declared an epidemic by the CDC,” said Cheryl Williams, registered nurse and certified diabetes educator at The Longstreet Clinic.

Nationwide, the number of dia-betes cases has tripled since 1980, according to the CDC. And more cases of diabetes means more need for prescriptions, doctors and hospital visits.

“Diabetes is a very costly dis-ease,” Williams said, “both in health care dollars and in qual-ity of life.”

When you have diabetes, your body is unable to, or has diffi-culty, regulating blood sugars, which give you energy. Insulin is the hormone that helps keep things under control.

In Type I diabetes, the body cannot make insulin at all. In Type II, the most common type, the body can make insulin, but doesn’t use it properly, Williams said. The CDC’s most current fact sheet from 2007 estimates that up to 95 percent of all current diabe-tes cases are Type II.

“That (Type II) is more directly tied to lifestyle and family his-tory,” Williams said.

There is a link between obe-sity and diabetes, she said. “We already have a population that is 30 percent (obese) in this state.”

There’s more to diabetes than being overweight and the body not being able to handle blood

sugar. What makes it so costly is that it can lead to other com-plications, such as heart disease, strokes, blindness, kidney dis-ease, nerve damage and the need

for limbs to be amputated.The problem, Williams said, is

that patients cannot sense these

Rate of diabetes climbing locally, nationally

Please see Diabetes page 3

While no one knows when an artificial pancreas will be available, at least it’s becom-ing easier to stay on top of your diabetes. The American Diabetes Association keeps track of the latest gadgets to monitor blood sugar levels and regulate insulin. Here are some of the upcoming products from their 2011 Consumer Guide.

Just for Kids: DidgitThis glucose meter turns

keeping track of blood sugar into a video game. The me-ter plugs into the Nintendo DS or DS lite handheld game system. When kids stay on target with their blood sugar levels, they receive points to use in two games that come with the device.

JewelNot yet on the market, the

Jewel is a small patch pump that you can control with your smart phone. While you are adjusting the Jewel’s set-tings, your phone’s normal functions — receiving calls, texts, etc. — are temporar-ily suspended, eliminating the chance of getting inter-

rupted. The ADA says the product is waiting for ap-proval from the Food and Drug Administration, and could be released by sum-mer of this year.

iBG starHere’s another soon-to-be-

released product that incor-porates your phone. A blood glucose meter, the iBG star shows readings by itself, but when you plug it into your iPhone or iPod Touch, you can track your levels and make notes about any trends you see using a special app.

AfrezzaIf you hate injecting insulin,

you’ll look forward to this: Afrezza is insulin in powder form, meaning it’s inhalable. The company says it works just as well as insulin that’s injected, and the FDA is cur-rently evaluating this. But the product isn’t exactly new; it was available under another name a few years ago. Now it’s being distributed by an-other company that thinks the market is ready for inhal-able insulin.

Source: American Diabetes Association

Technical advances for diabetics

Sunday, January 30, 2011 �gainesvilletimes comThe Times, Gainesville, Georgia |

problems arising.“You don’t feel the complica-

tions as they’re developing,” she said, “You don’t physically feel it.”

But, she said, diabetes is not “the end of the world.” If people diagnosed with diabetes find the right combination of medicine, diet and a suitable exercise pro-gram, the risk of complications decreases.

Because obesity and diabetes are correlated, eating right and getting exercise would also de-crease one’s chances of getting diabetes.

“We’ve just got to get moving,” Williams said, “and we’ve got to get motivated.”

DiabetesContinued from page 2


By Branden LeftyHealthWatch

It has been a long day at work, and all you want to do is drive home and relax. When you get there, how-ever, you drop your briefcase, full of office supplies, stacks of paper, and a heavy laptop, right on top of your foot.

Before you start thinking about the damage to your shoe, you should start thinking about the damage to the foot inside. It just might be time to pay a visit to your doctor.

“There are two questions you have to ask to know if you need to see a doctor or not,” said Dr. Char-lie DeCook, orthopedic surgeon at the Longstreet Clinic in Gainesville. “Has an injury occurred, and if so, can you put weight on it?”

If you cannot remember the in-jury happening, the most common visible symptoms that an injury has occurred are swelling, redness, and pain.

However, you can also get a fracture through repetitive use of an area, not necessarily just an in-jury.

“Increases in running or many other kinds of physical activity could cause what’s called a stress fracture,” DeCook said.

Whatever the cause, if the symp-toms, especially pain, continue for more than two to three days, then you should schedule an appoint-ment with a doctor. However, if you suspect a greater injury, then definitely do not hesitate to see a doctor immediately.

“The key is to seek medical treatment as soon as possible for these kinds of injuries,” said Dr. Jeannette Velazquez, podiatrist at Bare Foot Care Specialist in Flow-ery Branch.

In the meantime, there are things you can do to help prevent further complications before you get a chance to seek medical help. Luckily enough, doctors have made them easy to remember.

“We have the mnemonic, RICE: Rest, Ice, Compression, Elevation,” Velazquez said. “These are key af-ter any kind of injury.”

For foot fractures, rest is es-pecially important to making a speedy recovery. Even just walk-ing around can put a lot of stress on the injury, which is why Velazquez recommends crutches to help you get around if you find yourself with any significant foot injury.

There may be a tendency to just ignore hurting feet instead of taking time to actually see a doctor, but se-rious complications can arise if any injury, including a foot fracture, is not treated properly.

It can exaggerate the injury “if you do have a fracture in your foot, and you keep walking on it,” Velazquez said.

While it is possible for a fracture to heal on its own, the long-term consequences of improper treat-ment can range from a non-union to a malunion, DeCook said. In both instances, the fracture remains un-healed.

At this point, surgery is likely necessary for the injury to heal be-cause the bones have to be physi-cally placed back where they be-long.

“Depending on how displaced ev-erything is,” DeCook said, “plates and screws or pins would be used.”

The most important thing, Velazquez stressed, is to not ignore these kinds of injuries. If you sus-pect a fracture, do not hesitate to seek medical attention.

Don’t ignore possible

injuries to your feet


Take steps to keep family from sharing germsBy Alison Johnson

Daily Press (Newport News, Va.)

If one member of your family gets a contagious disease such as flu, is everyone else doomed? Not necessarily, public health leaders say: families can take several protective steps. “They won’t necessarily completely prevent the spread, but they will help,” says Dr. William Berg, director of the Hampton Health District in Virginia.

Isolate the sick person. Best case scenario: the person stays in one room and has just one care-giver; someone with a respira-tory illness ideally should wear a mask if around other family members. You also can desig-

nate a spot on a sofa or chair for the sick person, preferably at a distance from others.

Buy disposable gloves. When cleaning up vomit or diarrhea, gloves are your best protection. Wash your hands before and af-ter wearing gloves to kill as many germs as possible.

Use hand sanitizers correctly. Sanitizers don’t work as well as soap and water if your hands are visibly dirty. Also, make sure a product contains at least 60 per-cent alcohol.

Put bags in all trash contain-ers. Don’t throw used tissues into an unlined can — but do discard them immediately so they aren’t

lying around.

Wash soiled items quickly. Clean dirty clothes, towels, sheets and soft toys with soap and hot water.

Clean surfaces well. Use a bleach solution or disinfectant wipes, especially on door knobs, sink faucets, flush handles, tele-vision remote controls and other frequently-touched items. If you can see dirt, clean that with a pa-per towel and soap while wearing gloves, then wipe the area down.

Wash hands often. Sick or well, family members need to clean their hands frequently.

Don’t share. Make sure the

sick person has his own bedding, clothing, dishes and cups at all times.


Vitamin B deficiency can result in wide range of symptomsBy Tricia L. Nadolny

HealthWatch

Most people should not have to worry about vitamin B deficien-cies. But in certain groups, the di-agnosis can be quite common.

According to Dr. Andy Jaffal, a physician at The Longstreet Clinic, it’s the elderly, those who have had gastric reduction weight loss surgery and strict vegetarians that are at highest risk for vitamin B deficiency, most commonly B12 deficiency.

In most cases, the problem is brought on by malabsorption in the stomach or colon, Jaffal said. Some strict vegetarians also run the risk of having vitamin B defi-ciencies because they’re not tak-ing enough of the nutrient into their system.

Jaffal said the deficiency mani-fests itself in many ways such as neurological problems, demen-tia, anemia, balance issues and numbness in extremities. One of the most common symptoms is se-vere fatigue because not enough red blood cells are being produced and carrying oxygen to the brain.

“Because of the wide range of symptoms that come up from this, we look for it quite a bit in the hospitals and offices and we find quite a few patients with B12 defi-ciency,” he said.

If not treated, there can be serious consequences such as memory loss, nerve damage and severe anemia.

But once diagnosed, Jaffal said, there are several simple treat-ment options such as a muscular injection, nasal spray and an over-

the-counter formula which is put under the tongue.

“We have to supplement the B12 some other way other than doing it through the mouth,” he said. “Because if you think about it, if someone is not absorbing B12, giv-

ing it to them through the mouth is not going to do anything.”

The muscular shot is needed once a month and Jaffal said that it can be self-administered so the

Please see Vitamin B page 8



patients do not need to make regu-lar doctor’s appointments.

“It depends on their comfort,” he said. “If they’re able to give themselves an intramuscular in-jection … that’s fine. Or if there is anybody in the family that can give them an injection.”

Ultimately, Jaffal said, diag-nosis is the most important part of the process. And with proper treatment, individuals who suffer from B12 deficiency can live nor-mal lives.

“Once you get the diagnosis, the treatment is very easy,” he said. “The treatment, most of the time, if you get the injection or the nasal spray, we follow up on the levels and once we know where the level is where it should be, that’s it.”

Vitamin B Continued from page 6

Vitamin DeficienciesVitamin B6Causes: The deficiency is most

often caused by poor diets. The vitamin is essential to creating red blood cells and maintaining a properly functioning metabo-lism.

Symptoms: The deficiency is rare, but is most often found in older Americans. Symptoms include skin inflammation, de-pression, a sore tongue, confu-sion and convulsions.

Found in: The vitamin is found in many foods including beans, fortified cereals, meats and some fruits and vegetables.

Vitamin DCauses: Vitamin D deficiency

is most commonly caused from limited exposure to the sun or lower than recommended intake of the vitamin. Diets connected to vitamin D deficiency are often associated with milk allergy, lac-tose intolerance, ovo-vegetarian-ism and veganism.

Symptoms: In children, vita-min D deficiency can cause rick-ets, where bones fail to mineral-ize. Symptoms center around weakened bones and include muscle weakness and pain. Vi-tamin D was first added to milk in the 1930s and since then, the deficiency is rare.

Found in: Vitamin D is found in very few foods, but it is added to some and it also is available as a dietary supplement. It is also obtained through sun exposure.

Vitamin ACauses: The deficiency is rare

in the United States but common in developing countries. In the United States, the deficiency is connected with alcoholism and strict diets. Also, young children are at risk as well as children living below the poverty level or with inadequate health care and immunizations.

Symptoms: The first noticed symptom is often night blindness. The deficiency also hinders the body’s ability to fight infections, making illnesses such as pneu-monia common.

Found in: Vitamin A is found in liver, whole milk, eggs and many colorful fruits and vegetables.

Source: The Office of Dietary Supplements at the National Insti-tutes of Health


The Longstreet Clinic, P.C. is pleased to welcome

Ronald G. Beebe, M.D.Allergy, Asthma &

Immunology specialist.

Ronald G. Beebe, M.D., joins The Longstreet Clinic with over 25 years of experience.

Dr. Beebe earned his medical degree from the Medical College of Georgia in Augusta. He went on to complete his residency in internal medicine at Memorial Medical Center in Savannah and a fellowship at Emory University in Atlanta.

Dr. Beebe is board certified in internal medicine, as well as allergy and immunology. He has medical staff privileges at Northeast Georgia Medical Center.

Dr. Beebe is now accepting patients in his new location at 705 Jesse Jewell Parkway in Gainesville. To schedule an appointment, please call 770-536-0470.

www.longstreetclinic.com • 770-536-0470

Doctors you know. Care you trust.

Allergy, Asthma & Immunology

705 Jesse Jewell Parkway • Suite 275 • Gainesville, GA 30501

www.facebook.com/LongstreetClinic

Advertorial provided byDr. Ronald G. Beebe Longstreet Clinic

Allergy and asthma sufferers often have more trouble during the colder months.

The post-holiday rush only adds to the unique health challenges. Cold air, busy schedules, family reunions, and the inevi-table rise in stress level all add to work of staying healthy during this time.

Surviving, and even enjoying, the colder months is possible if you plan ahead and take preventive measures. Following are some tips to help you have a happy and healthy winter season.

During colder weather, we often visit friends and relatives and enjoy meals in their homes. Unfortunately, for children with food allergies, the opportunity for a serious allergic reaction becomes even more likely.

Children should be protected from foods and candies they know they are allergic to. Family members and friends should be informed to avoid serving these foods. Food-allergic patients may even want to bring along “safe foods” to be sure appropriate items are available.

Eating out always presents special situations. Restaurant menus should be checked ahead of time to be safe. Per-haps talking to the owner or chef can be arranged to discover how the items are prepared. There have been reported cases of fish-allergic individuals reacting to a beef dish because the same spatula was used to turn both items.

Mold-allergic patients often encounter obstacles this time of year. Raking wet leaves or choosing logs for the fireplace can often trigger an allergy attack.

Remove wet leaves from the founda-tion and gutters of your house to prevent outdoor mold from accumulating near windows and doors. Keep firewood out-side, bringing in only what is needed for immediate use.

Live plants and trees are beautiful, but often contain mold and mold spores. Blowing the plant with a leaf blower prior

to bringing it inside will get rid of many potential threats. Even rubbing the trunk of a small tree with a solution of dilute bleach can help kill mold.

Cold weather is a known trigger for asthma; therefore, appropriate measures should be taken to avoid attacks. By wear-ing a scarf over your mouth and nose, the winter air will be warmed and humidi-fied and thus cause less of a threat. If this is not enough, medication taken prior to going outdoors may be needed. This would allow you to do all the fun outdoor activities you like this time of year.

Because we spend more time indoors during the holiday and winter seasons, the indoor air quality is very important. It may be important to clean the chimney prior to the first fire of the season. The fireplace flue should be checked to make sure it is working properly. Wood-burn-ing stoves and fireplaces often trigger asthma attacks; therefore, gas logs may be more appropriate.

Air purifiers with a HEPA filter are an excellent way to improve the indoor air quality. Filters for the furnace should be replaced regularly to avoid the dust and debris that accumulates over time. Get-ting winter clothes out of storage often will expose you to dust and mold. Storing them in sealed boxes may just allow you to have a sneeze-free winter.

On cold, wintry days, visiting other homes is a joy — unless allergy triggers await. If you are allergic to cats, and Grandma keeps her three cats indoors, you will be miserable. It is better to take an antihistamine one hour before going to her house. This measure will often block the allergy symptoms.

Of course, if Grandma will board the pets during your visit, it will be even bet-ter. A courteous host will limit the use of potpourri, air fresheners, scented candles and plant arrangements for the allergy-prone guest.

In closing, the winter is tough enough with colds and flu. You should not have to suffer with allergies, also! With proper planning, allergies can be kept under control, even when the environment is out of control. Have a happy and healthy winter. Remember, spring is just around the corner – then we can worry about springtime allergies!

(Ronald G. Beebe, MD is a specialist in allergy, asthma, and immunology at The Longstreet Clinic.)

A winter survival guide

10 Sunday, January 30, 2011 The Times, Gainesville, Georgia | gainesvilletimes com

By Jessica YadegaranContra Costa Times

Ten years ago, pediatrician Gary Bean began noticing a trend in his Oakland, Calif., practice. Babies were increasingly big-ger, and they weren’t thinning out by the time they were crawl-ing and walking. Toddlers came to appointments clutching Jack in the Box bags, and when Bean asked parents what else their youngsters ate, they rattled off processed foods.

To help educate parents, Bean hired a chef and nutritionist and even built a kitchen in his practice where he held weekly workshops on healthful meal planning. He did it for three years, until he ran out of money.

Today, 30 percent of the chil-dren in his practice continue to be clinically obese, he says.

“Girth is often associated with prosperity, but what we need to encourage now is a leaner child,” Bean says.

Bean’s practice reflects a na-tional trend. A Wayne State Uni-versity study published in this month’s issue of the American Journal of Health Promotion re-veals that one third of infants in the United States are obese or at risk for obesity. Children above the 95th percentile on standard growth charts were considered obese. Those in the 85th to 95th percentile were considered at risk for obesity.

While there are many culprits, from overfeeding babies to sed-

entary toddlers and processed foods, some pediatricians and obesity experts say parent edu-cation is the most important fac-tor in preventing the undesir-able weight gain that can lead to obesity-related diseases later in childhood.

“There is a generation or two of parents who have not received food or nutrition education from their parents or grandparents,” Bean says. “They’ve lost the idea of what food is really for. It’s become more about picking up something on the go.”

But obesity is surfacing before babies celebrate year one. Ac-cording to Detroit sociologist Brian Moss, lead author of the Wayne State University study, 31.9 percent of 9-month-olds are

obese or at risk for obesity. The study of 8,000 infants was one of the first to monitor weight sta-tus changes of a nationally rep-resentative sample of children 2 and younger.

While the study doesn’t con-done putting babies on diets or even conclude that overweight babies are doomed to be obese adults, Moss says that being overweight or obese at 9 months puts you on track for being over-weight or obese in childhood. And that’s a reality: According to the U.S. Centers for Disease Control and Prevention, child-hood obesity has more than tri-pled in the past 30 years.

So, tips on breast and bottle

Obesity epidemic hits the diaper set

Please see Baby fat page 11

Sunday, January 30, 2011 11gainesvilletimes comThe Times, Gainesville, Georgia |

feeding are essential. Bean says parents need to remember that hunger is observational. They should look for visual cues that their baby is satiated, like slower sucking or boredom, instead of assuming that their tears and fussiness mean they want more milk.

“There’s a misperception that more is better,” Bean says. “But remember that sucking is a reflex after eating. Babies still may suck, but it doesn’t mean they’re still hungry. It might be time to introduce a pacifier or let them soothe themselves with their thumb.”

Marinela Miclea of Pleas-ant Hill, Calif., uses those tech-

niques, among others. Obesity runs in her family, and even though her 3-month-old, Olivier, is not overweight, Miclea says she is aware of overfeeding and had to “retrain” herself not to go for the milk every time he cried.

“Now I know when he’s hun-gry,” says Miclea. “It’s some-thing in the way he cries. It’s just different.”

Miclea has a 2-year-old toddler named Colin and admits that the cues are easier to spot the sec-ond time around. Now, if Olivier cries after he eats, she looks for other culprits.

“Maybe his big brother was bothering him, or the TV was on too loud,” she says. “You have to teach your children how to soothe themselves.” A familiar toy or blanket, or letting him suck on his fingers, works well, she says.

“If you just wait five minutes, you can find a solution,” Miclea adds. “You don’t want to train people from the time they’re babies to reach for food when they’re uncomfortable.”

Pediatric weight management expert Lydia Tinajero-Deck agrees. She says the training should start earlier — in utero. She sees patients as young as 15 months in the hospital’s Healthy Hearts weight management pro-gram.

“Pregnant women must have a healthy diet and not gain more than the suggested weight,” she says. She also advocates for ex-clusive breast-feeding in those first six months because it is eas-ier to watch for satiation cues, and it’s one person tracking the feedings. “When you use a bot-tle, different people have differ-ent judgment,” she says.

As Tinajero-Deck puts it,

proper nutrition is not just about maintaining a healthy weight and preventing obesity. It is cru-cial to everything, including a baby’s bone and brain develop-ment.

So, while it doesn’t mean we have to say goodbye to the be-loved image of a chubby baby, we do have to change our ways before they’re struck with seri-ous diseases, like hypertension, that were once limited to older adults.

“We’re just not seeing them (babies) thin out anymore, es-pecially the bottle-fed ones,” Tinajero-Deck says. “It’s part of a societal shift. We’ve become sedentary and rely on processed foods because they’re cheaper and easier to feed to kids. I’m not saying a child should never have a cookie, but I see toddlers com-ing in with orange soda in their bottles. And that’s not OK.”

Baby fatContinued from page 10

1� Sunday, January 30, 2011 The Times, Gainesville, Georgia | gainesvilletimes com

7 0 5 Je s s e Je w e l l Pa r k w a y, S E , S u i t e 2 0 0 , G a i n e s v i l l e • P h o n e 7 7 0 . 5 3 4 . 9 0 1 4 • w w w. g h v g . n e t

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At Gainesville Heart & Vascular Group, we believe that the patient is the center of our practice. We are committed to providing the best possible care through diligent clinical evaluation and appropriate use of state-of-the-art technol-ogy. Guided by compassion for each individual, we strive to provide convenience and peace of mind to our patients by providing most services under one roof. Our ultimate goal — help our patients achieve a better quality of life.


SERVICES OFFERED• Adult Consultative Cardiology• ECG, Holter and Event Monitoring• Exercise Treadmill Testing• Echocardiography• Transesophageal Echocardiography• Stress Echocardiography• Myocardial Perfusion Imaging (Nuclear Scans)• Peripheral Vascular (claudication) Testing• Cardiac Catheterization (leg and wrist access)• Coronary Angioplasty and Stenting• Peripheral Vascular Angioplasty and Stenting• Renal Angioplasty and Stenting• Pacemaker Implants• Loop Recorder Implants• Pacemaker and ICD Management• Anticoagulation Management• Lipid Management• Pulmonary Hypertension Testing

David P. Johnson MD, FACCBoard Certified in Cardiovascular Disease and Nuclear Cardiology.

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Lungs suffer in patients with COPDBy Lauren Blais

HealthWatch

You’ve seen the commercials for Spiriva and Advair, products that help people diagnosed with COPD breathe better. But there’s more to COPD than the asthma we’re familiar with.

David Paris is an exercise physiologist working in pulmo-nary rehabilitation at the North-east Georgia Medical Center. He works with COPD patients to help them breathe more comfortably.

“I know that COPD is definitely on the rise,” he said.

COPD is actually a couple of dis-eases that hinder lung function.

Chronic bronchitis is the first. Sometimes asthma falls under this category, Paris said. The breathing tunnels become swol-len and narrowed, and patients spend a lot of time coughing up mucus.

“You’re always concerned with trying to clear your lungs of secre-tions,” Paris said.

With emphysema, the structure of the lung is damaged, specifi-cally, the little air sacs called al-veoli. This impairs the lung’s abil-ity to transmit oxygen and carbon dioxide.

Both emphysema and chronic bronchitis make it difficult to breathe. And it can be hard to dis-tinguish between the two.

“You don’t necessarily have one with the exclusion of the other,” Paris said.

For this reason the American Lung Association prefers to use the umbrella term COPD. Ac-cording to its website, at least 12 million people have COPD, but actual numbers may be twice as high; it is believed that many are not aware they have the disease.

COPD is caused by air pollut-ants, but particularly cigarette smoke, says the ALA. Paris cites emphysema specifically as a disease resulting from cigarette smoking.

“Most of the time — 90 percent — emphysema is a smoker’s dis-ease,” he said.

The problem with emphysema and COPD in general is that there is no cure, and current surgical methods only help so much. One recent effort is lung reduction surgery, where surgeons remove part of the emphysema patient’s lung that doesn’t work.

“It gives them a feeling of be-ing able to breathe more deeply,” Paris said.

But, he said, patients are not truly rid of their emphysema, and the benefits are short-lived: within a few years the lungs get worse as they continue to lose tis-sue.

Surgeons have also tried lung stints to keep lungs open, but they’ve had mixed results with that, Paris said.

“They keep trying to come up with new things, but so far I haven’t seen anything,” Paris said.

While other diseases have sur-gical options that make the per-son feel like they’re cured — like bypass surgery for heart disease, for example – nothing exists for the person with COPD.

“There’s nothing out there that all of a sudden eliminates their shortness of breath, Paris said. “They’re reminded with every breath that they have lung dis-ease.”

When you have trouble breath-ing, even simple activities like

Please see COPD page 15

Tom Reed/The TimesExercise physiologist David Paris works with Quincy Webb at the Pulmonary Rehabilitation

Center recently. The center helps patients with light exercise and education about COPD.


walking can become difficult. This causes many COPD patients to become sedentary, which leads to other health problems.

In the pulmonary rehabilitation center, Paris combines education with exercise to help participants become more active and breathe better. By the end of the 18-week program many can walk at a nor-mal pace again.

“They’re able to function at home and not be so short of breath,” Paris said.

With no way to repair the lungs, patients must rely on medication and pulmonary rehabilitation to get by each day.

“When you can’t breathe, it is frightening — these people are looking for hope,” Paris said.

COPDContinued from page 14


By Tricia L. NadolnyHealthWatch

They start to pop up in October, signs on the side of the road pro-moting flu clinics of all shapes and sizes.

It used to be that getting a flu shot meant making an appoint-ment at a doctor’s office, but in the past few years pharmacies, grocery stores and big-box re-tailers have gotten into the busi-ness.

But are all flu shots created equal?

Dr. Andrew Reisman, a fam-ily physician at The Longstreet Clinic, said there’s no difference between the shots received at a doctor’s office and those given out at other locations.

“Regardless of what brand you get they’re generally made the same way,” he said.

But it wasn’t always legal for flu shots to be given at pharma-cies and grocery stores without a prescription.

In 2009, the Georgia General Assembly approved the Access to Flu Vaccines Act, which al-lowed physicians to partner with pharmacists and registered nurses in giving flu shots with-out a prescription. The legisla-tion came after the Composite Board of Medical Examiners an-nounced that the flu shot was a “dangerous drug” and required those seeking it to have a pre-scription.

Legal change allows flu shot without perscription

Please see Flu page 17Sara Guevara/The Times

Licensed Practical Nurse Melanie Boestfleisch, right, administers a flu shot to Veronica Vargas of Gainesville at the Health Department.


FluContinued from page 16

To ensure safety, the law re-quired that physicians could only partner with 10 pharmacists and nurses within their health de-partment district.

“The flu affects thousands of people each year and our citi-zens should be able to access flu vaccines to protect themselves and their families,” former Gov. Sonny Perdue said when the leg-islation passed. “This legislation

makes it easier for Georgians to receive flu shots and allows the state to respond quickly and ef-fectively to any flu outbreak.”

The changed law opened the door for flu shots to be made more readily available. Cur-rently there are more than a dozen Gainesville pharmacies and grocery stores offering the shots, according to the Centers for Disease Control’s Flu Vac-cine Finder. Most cost between $25 and $30.

“The law’s been in affect for several years,” Reisman said. “And more and more pharma-cists are getting trained.”

Doctors say it’s not too late to get vaccinatedThis flu season hit

Georgia hard

In December, the Cen-ters for Disease Control an-nounced that Georgia had seen a higher volume of flu cases than any other state, with cases appearing at more than twice the national level. Even as the season moves past its peak, Georgia is still one of a handful of states classified as having “wide-spread” flu activity.

Although the season nor-mally peaks in January, phy-

sicians say it’s not too late to get a shot.

“I encourage people to get vaccinated up until March 1 and even beyond, especially if they have any chronic health conditions,” said Dr. Andrew Reisman, a family physician at The Longstreet Clinic.

Reisman added that many people toss around the term “flu” when talking about other illnesses, but the real flu comes with severe aches and pains.

“People describe it as being hit by a baseball bat on a regu-lar basis,” he said. “They say things like, ‘My skin hurts.’ They are some of the sickest looking people you can see, and without treatment that extreme illness … will last for up to five days.”


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Sweet solutions for kids who have food allergiesBy Julie DeardorffChicago Tribune

Children with food allergies often learn to say “no” when they’re of-fered tempting cupcakes or cook-ies that may trigger rashes, wheez-ing or land them in the emergency room. And they grow used to bring-ing their own treats to class cele-brations or birthday parties.

But the necessary precautions can leave them feeling alienated, said “Food Allergy Mama” Kelly Rudnicki, who transformed her family’s diet after her oldest son, John, was diagnosed with a severe dairy, egg, peanut, tree nut and le-gume allergy and asthma.

“Most children want to be like any other kid, to not feel differ-ent,” said Rudnicki, who blogs at

foodallergymama.com to raise awareness and increase funding for food allergy research. “That’s why treats are so important; it’s a chance for them to feel included.”

An estimated 6 percent of chil-dren have a food allergy, or a re-action triggered by the immune system. The vast majority of food allergies are caused by eight foods: tree nuts, peanuts, milk, eggs, soy, wheat, fish and shellfish. But chil-dren can also suffer from food in-tolerance or sensitivity, when food triggers unpleasant symptoms but the immune system isn’t involved.

The signs can include reactions such as a runny nose, hives, a chronic cough or life-threatening breathing issues. Though dairy and nuts are the most common triggers, some parents deal with

multiple allergens, which makes buying prepackaged food nearly impossible.

Fortunately, several books of-fer appealing dessert options for children with special diets. If your child doesn’t have a food allergy, consider making allergy-free treats for a class party or Valen-tine’s Day celebration; that way the child with the allergy will feel like one of the group.

Gluten allergies and intolerance: “The Ultimate Gluten-Free Cookie Book,” by Roben Ryberg (Da Capo Long Life, $16.95)

Gluten-free baking can be frus-trating because gluten is the pro-tein that holds the dough together. The beauty of Ryberg’s approach

Please see Sweets page 22


�0 Sunday, January 30, 2011 The Times, Gainesville, Georgia | gainesvilletimes com

Clayton L. Cox, MD, FACOGStephen Little, MD, FACOG

D. Holt Harrison, MD, FACOGFrancis T. Lake, Jr., MD, FACOG

Toinette O. N. Chin, MDTiffany Jones Tucker, CNM

To schedule an appointment, call 770 531-1515.

theheritageobgyn.com

Medical Plaza 1, Suite 140 | 5875 Thompson Mill Road in Hoschtonand 668 Lanier Park Drive in Gainesville

• 3D/4D Ultrasound

• Routine and High RiskObstetric Care

• Advanced Laparoscopy andTreatment for Pelvic Relaxation

& Urinary Incontinence

• In-Office Endometrial Ablation

• Full Body Bone Density Scan

• Robotic Surgery (Dr. Lake)

• In-Office PermanentSterilization

By Fred TaskerMcClatchy Newspapers

Naidelys Montoya didn’t wait for her son’s baby teeth to fall out. She took the boy to an oral surgeon to have two of the loose ones extracted.

“He was a bit scared,” said Montoya, of Hialeah, Fla. “He’s not that brave.”

The dentist shipped the teeth in a temperature-controlled steel container to a lab in Massa-chusetts, where their stem cells will be spun out, frozen to more than 100 degrees below zero and stored — in case her son, Raul Estrada, 6, might need them for a future illness.

“I believe in this,” Montoya

said. “I did as a precaution against things that could happen.”

Montoya and her son have joined a major new medical movement.

In South Florida and around the world, dentists are extract-ing baby teeth, wisdom teeth and even healthy adult teeth, and re-searchers are spinning out stem cells that they believe can be used to regrow lost teeth, someday even to repair damaged bones, hearts, pancreases, muscles and brains.

It could put the Tooth Fairy out of business.

“These are teeth we’ve been discarding as dental waste,” said Dr. Jeffrey Blum, the Miami Beach oral surgeon who pulled

Raul’s teeth. “We might as well get some use out of them.”

“I can’t help but feel excite-ment for their potential use in regenerating different tissues in the human body,” said Dr. Jer-emy Mao, director of the Regen-erative Medicine Laboratory at Columbia University. Mao also is chief science advisor to Stem-Save, a New York City company that freezes the stem cells and stores them for later use.

There are concerns. It’s expen-sive, costing $590 upfront plus $100 a year to store the stem cells from up to four teeth for up to 20 years. It’s speculative, with the first FDA-approved practical use of such stem cells years away.

“Every treatment using den-

tal stem cells is still in the clini-cal testing phase, and won’t be ready for general use for at least five years,” said Art Greco, Stem-Save’s CEO.

Montoya understands: “Things are evolving so quickly, who knows what they will be able to do in 15 or 20 years?”

Other researchers welcome the new source of stem cells.

“Perhaps it does make sense to save” dental stem cells, said Dr. Joshua Hare, director of the Inter-disciplinary Stem Cell Institute at the University of Miami Medical School, who is not involved with dental stem cells. “Within human adults and children there are lots

Pulled teeth being stored for future stem cells

Please see Stem cell page 21

Sunday, January 30, 2011 �1gainesvilletimes comThe Times, Gainesville, Georgia |

of reservoirs of stem cells. We get them from bone marrow; others use umbilical cord blood. It seems teeth are also a good source.”

The National Institutes of Health concluded in 2003 that teeth are a rich source of stem cells. Every child has about 20 baby teeth that fall out between ages 6 and 12. Adolescents have wisdom teeth that often are re-moved between ages 14 and 25 because they crowd the jaw or grow in crookedly.

Blum and other oral surgeons must extract baby teeth before they fall out naturally, so they still have a blood supply to keep them healthy. He puts them in a temperature-controlled steel container and overnights them to the StemSave facility.

Stem cells are the body’s repair system, Hare said. Stem cells beneath the skin are constantly spinning off new skin cells to re-place skin that is sloughed off or damaged in daily life. The same is true for hearts, livers, pancre-ases — except that as the body weakens from age, injury or dis-ease, those stem cells start to lose the ability to keep up and need help. Today, stem cells from bone marrow, blood and now perhaps teeth can be reprogrammed to help those ailing organs.

Also, by using these stem cells, researchers avoid involving hu-man embryonic stem cells, which are controversial because their creation involves destroying hu-man embryos.

The first practical use of dental stem cells probably will be to re-pair human teeth and jawbones,

researchers say. At Boston Uni-versity’s School of Dental Medi-cine, researchers have used stem cells from baby and wisdom teeth to generate dental pulp, the soft interior of a tooth, and dentin, its hard white casing.

Now they are inserting the ma-terial into a broken human tooth and implanting it into a mouse to access a blood supply. When the technology reaches humans, the pulp material would be in-jected into a spongy “scaffold” where a tooth has been removed and prompted to grow into a hu-man tooth. It’s at least five years away.

Across the world, the use of stem cells to heal the human body is exploding. At the Univer-sity of Miami’s med school, Hare is doing human trials using stem cells from bone marrow to inject around hearts damaged by heart attacks, hoping to regenerate damaged heart tissue.

For years, stem cells from um-bilical cord blood have saved the lives of patients with leukemia, lymphoma, multiple myeloma, aplastic anemia, sickle cell and other diseases.

So far, only private banks are storing dental stem cells, although Mao says a public bank would be valuable and appropriate.

The American Dental Associa-tion, while cautiously optimistic about the potential of dental stem cells, urges parents considering banking their children’s dental stem cells to consider both the cost and the rarity of use before joining private donation pro-grams.

“That’s the question people have to ask themselves,” Blum said. “Am I saving this for no reason? Is it worth what I’m pay-ing? Essentially it’s an insurance policy.”

Stem cellContinued from page 20

�� Sunday, January 30, 2011 The Times, Gainesville, Georgia | gainesvilletimes com

is that she mimics glutinous cook-ies by embracing everyday ingre-dients. Most of the cookies use brown rice flour or sorghum; no complicated rice blends are re-quired. Ryberg, author of several gluten-free cookbooks, also offers egg- and dairy-free cookies and recipes with single flours.

Nut-, egg- and dairy-free recipes: “The Food Allergy Mama’s Baking Book” by Kelly Rudnicki (Agate Surrey, $19.95); foodallergymama.com

Rudnicki targets three of the most common food allergens— nuts, egg and dairy — and offers advice on how to deal with classroom festivi-ties and birthday parties. For class celebrations, Rudnicki suggests

decorating her sugar cookies with allergen-safe icing and sprinkles. “The cookies double as a cookie-decorating activity,” she said. For birthday parties, vanilla cupcakes with vanilla frosting are her go-to dessert because “kids never sus-pect they’re allergen-free,” she said.

Multiple allergens: “My Kid’s Al-lergic to Everything Dessert Cook-book” by Mary Harris and Wilma Selzer Nachsin (Chicago Review Press, $16.95); mykidsallergicto-everything.com

What do you do when your 4-year-old child is allergic to wheat, eggs, dairy, soy, corn and nuts? The authors, who both raised children with multiple food allergies, have compiled more than 100 recipes for sweets that can be slipped into lunchboxes or served at holiday dinners. The book also has recipes for those who must limit sugar in-take or avoid gluten.

SweetsContinued from page 18

Blood donations desperately needed

Severe winter weather through-out much of the United States has caused the cancellation of more than 14,000 blood and platelet do-nations since Jan. 1.

There is a critical need for donors now. In fact, someone is counting on you at this very

moment.All blood types are needed,

but type O negative donors can make the difference between an adequate blood supply and a shortage.

The Red Cross urges all eli-gible donors in unaffected areas to make an appointment to give blood or platelets in the coming days. Call 1-800-RED CROSS (1-

800-733-2767) or visit online at redcrossblood.org.

Donations will help replenish the blood supply to ensure that blood continues to be

available for patients with seri-ous medical needs.

Sunday, January 30, 2011 ��gainesvilletimes comThe Times, Gainesville, Georgia |

By Shari RoanLos Angeles Times

Antidepressants can help peo-ple recover from major depres-sion, but some people dislike the medications because of their effects on sexual function. An antidepressant approved by the Food and Drug Administration this month, however, appears to have fewer sexual side effects.

The drug, called Viibryd (or vilazodone), is the first anti-depressant that is a selective serotonin reuptake inhibitor combined with and a 5HT1A re-ceptor partial agonist. Many of the so-called SSRI antidepres-sants, such as Prozac or Zoloft, work on the serotonin system of the brain. Viibryd is a dual-mechanism medication in that

it also affects the 5HT gene.In a phase-3 study published

in 2009, researchers found the drug improved symptoms of major depression as early as one week after starting the therapy. The most common side effects were diarrhea, nausea and headache. But there was no difference in sexual function-ing scores between the people taking Viibryd and those taking a placebo. The study was pub-lished in the Journal of Clinical Psychiatry.

In all of the studies on the drug so far, about 4 percent of patients reported decreased li-bido compared to 1 percent of people taking a placebo and 2 percent of men reported erec-tile dysfunction compared to 1 percent in the placebo groups.

The manufacturer of the drug, Clinical Data Inc., said the prod-

uct will become available in a few months.

FDA approves antidepressant with fewer sexual side effects

�� Sunday, January 30, 2011 The Times, Gainesville, Georgia | gainesvilletimes com

Northeast Georgia Medical Center, Inc.Gainesville, GA | 770-219-3840 | www.nghs.com

Northeast Georgia Medical Center, Inc.Gainesville, GA | 770-219-3840 | www.nghs.com

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