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FROM THE DOC:
This summer is very special for the practice as it marks the 25th Anniversary of Barbara Johnson's working in this office.
I like to joke with new patients to the practice and point out that Barb has been here longer than me...and it's true. I took over from my Dad 20 years ago, but Barb was here 5 years prior to that!
It's a special place to work, with Barb around. Not only is she the perfect front-office receptionist, but also she is an amazing 'people person'. She knows patients by voice, by habit, and by cologne! She has an uncanny memory for little facts, personal stories, and family and friend 'connections.'
There is no way to adequately express our thanks to Barb for the love and devotion she shows to this office and to the people who work here and who come here for their care. We can just feel grateful inside ourselves and give her a little love back.
Thanks Barb.... from everyone!
Yours in good health,
Dr. Lakin
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| VOL 5 / Issue 6 | Summer 2010 |
Summer. Just reading the word conjures up feelings.
At the end of every summer, if I take time to indulge in reflection, there's always a story. Sometimes it's a story written without any intention, sometimes with not-so-fond memories of heat and humidity and really bad hair days. But this year I'm writing my own Summer Story... With intention.
I'm filling it with sunshine, flip flops, Ferris wheels, early morning runs and lazy afternoons reading in the hammock... What things are making up your Summer story?
Happy Sweet Summer Day my Friends!
By "Robin",June 2010
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10 Symptoms Not To Ignore...........
|  Low energy, backaches, AWOL periods. Sound familiar? You may
need to see your doc, stat! "Harmless" symptoms like these can forecast scary health problems.
1) I'm
not fat, but I do have a muffin top.
What's the big deal? A waist
circumference of more than 35 inches may put you at risk for metabolic
syndrome, a cluster of conditions that raises your risk for diabetes and heart
disease, even if you're at a healthy weight. "Belly fat also presses on the
lungs, especially when you bend at the waist, making breathing more difficult,"
says Gerald Fletcher, M.D., a cardiologist at the Mayo Clinic in Jacksonville,
Florida. And it can release inflammatory chemicals that aggravate airways, so
breathing becomes harder still.
Act now. Fight middle jiggle with
interval training, bursts of intense exercise in your workout that rev heart
rate and burn body fat faster. And swap simple carbohydrates such as white
bread, candy and cookies for whole-wheat toast with peanut butter or lowfat cheese. "The combination of
whole-grain carbs and protein digests slowly, helping you avert spikes in
insulin, a hormone that promotes fat storage," says Molly Kimball, R.D., a
sports dietitian at Ochsner Elmwood Fitness Center in New Orleans. And aim to
get no more than 10 percent of your total calories from added sugar.
2) Sometimes sex hurts.
What's the big deal? (Besides the
obvious, we mean!) You may have endometriosis, a disorder in which the
endometrium, the tissue that lines the uterus, also grows on the ovaries,
pelvis and fallopian tubes. The misplaced tissue still sheds during your
period, causing local inflammation and scarring in the pelvis that can make sex
painful, explains Harvey J. Kliman, M.D., at the Yale School of Medicine in New
Haven, Connecticut. Untreated, endometriosis can lead to infertility and
possibly even tumors that could develop into certain types
of ovarian cancer.
Act now. Consider the Pill, which
thins endometrial tissue, making periods lighter and lowering the chances that
discarded tissue will end up in the pelvis. Another easy remedy? Skip pads and
use tampons. "They help remove tissue debris from the pelvic region," Dr.
Kliman says. And as always, protect the health of your sex life by seeing your
ob/gyn annually.
3) I
always feel sluggish.
What's the big deal? If you've ruled
out the usual suspects (such as fast food addiction, insomnia or a lapsed gym
membership), low energy could signal an underactive thyroid, or hypothyroidism.
The thyroid gland produces hormones that control metabolism, heart rate and
more. "When hormone production is even slightly low, you can suffer a decline
in mental function or develop depression, poor circulation or hypertension, all
of which increase heart disease risk," explains Leonard Wartofsky, M.D.,
chairman of the department of medicine at the Washington Hospital Center in
Washington, D.C.
Act now. If thyroid disorders run in
your family, or if you have other signs of hypothyroidism such as a puffy face,
weight gain or hoarseness, a blood test can determine if your thyroid's
performance is subpar; if so, taking a synthetic hormone can help.
4) My
gums bleed when I brush my teeth.
What's the big deal? You may have
gum disease, a bacterial infection that affects millions. "Infected gums are a
portal for bacteria to enter the bloodstream and inflame and possibly damage
your heart and other organs," says Steven Offenbacher, D.D.S., at the
University of North Carolina at Chapel Hill School of Dentistry.
Act now. Root cleaning (which rids
your teeth of rough spots where germs gather) can help treat infection, and
severe cases may be managed with antibiotics, Dr. Offenbacher says. For healthy
gums for life, floss and brush at least twice a day and schedule a dental exam
every six months.
5) Heartburn hits me a few times a
week.
What's the big deal? Two or more
heartburn bouts a week could indicate gastroesophageal reflux disease, in which
the valve between the stomach and throat doesn't always keep stomach acids from
splashing up into the esophagus. These acid baths can constrict airways,
leading to asthma attacks and pneumonia, and elevate the risk for esophageal cancer, warns Charlene Prather, M.D.,
associate professor of internal medicine at the Saint Louis University School
of Medicine.
Act now. Weight around your waist
can press on your stomach, forcing up acids, so make sure your body-mass index
is in a healthy range. Avoid large or fatty meals, which worsen reflux, and
record what foods preceded your symptoms and leave them off your grocery list."
6) My
migraines come with aura.
What's the big deal? Up to 30
percent of migraine sufferers have aura - a visual disturbance (such as spots
or flashing lights) and sometimes motor weakness or tingling sensations - which
roughly doubles their risk for ischemic stroke. "One theory is that changes in
brain activity where the aura originates temporarily decrease blood flow to the
area and, in rare cases, do enough damage to cause a stroke," says Elizabeth
Loder, M.D., chief of the division of headache and pain at Brigham and Women's
Hospital in Boston.
Act now. "Think carefully about
using birth control with estrogen, which can also raise your risk for stroke,"
Dr. Loder advises. To head off migraines, ID and avoid your personal triggers
(food preservatives and stress are common ones), and ask your doctor if taking
an Rx at the first sign of headache can help you avert an attack.
7) My
back constantly aches.
What's the big deal? Chronic back
pain that lingers six months or more is linked with a loss of brain volume
that's equivalent to 10 to 20 years of normal aging, research at Northwestern
University Feinberg School of Medicine in Chicago shows. "We don't know why
exactly - it has to do with how the brain adapts to pain - but the decline can
damage our ability to assess emotional cues and control emotion," says study
co-author A. Vania Apkarian, Ph.D.
Act now. Strong ab and pelvic
muscles help support your back, so try core-strengthening pilates or yoga.
Always maintain proper posture, says Jeffrey Gross, M.D., of New York
University School of Medicine in New York City. And keep your computer screen
front and center and at eye level to prevent neck and spine strain.
8) My asthma flares up about once a
month.
What's the big deal? "Asthma-related
inflammation damages lung tissue and, if inadequately treated, can reduce lung
capacity, which strains the heart," notes Rachel Koelsch, M.D., an asthma and
allergy specialist at The Cleveland Clinic in Ohio. In fact, women with asthma
have a 22 percent greater risk for heart disease, reports Kaiser Permanente's
Division of Research in Oakland, California. "Even if you have only occasional
attacks with no symptoms between, you can have hidden inflammation," Dr.
Koelsch says. Act now. Steer clear of cigarette
smoke, perfume and other chemicals that irritate lungs, and see your doctor
every 6 to 12 months to update your easy-breathing plan.
9) I
feel sleep-deprived daily.
What's the big deal? Your fatigue
could stem from obstructive sleep apnea, a condition in which throat muscles
temporarily relax and block airways while you sleep. "This activates a surge in
adrenaline that spikes your heart rate and blood pressure so you start
breathing again," says Carol Ash, D.O., a pulmonary and sleep medicine
specialist in Jamesburg, New Jersey. Over time, OSA increases your risk for
diabetes, stroke and more. Act now. Lose excess pounds to
relieve pressure on your breathing passages, and sleep on your side to prevent
your tongue from sliding back and blocking your airway. Also, avoid alcohol,
which slows the brain's response to paused breathing. Still exhausted? Your doc
may prescribe a continuous positive airway pressure machine, a mask that sends
air into your nose or mouth as you sleep.
10) I
missed a period, but I'm not pregnant.
What's the big deal? You might not
mind if your period does a disappearing act, but it could mean your estrogen
levels are low, possibly due to a hormone disorder like hypothyroidism. That's
bad news, because estrogen helps regulate new bone formation and maintain a
healthy heart. "Just three months without a period could affect your fertility
and increases your risk for osteoporosis and heart disease," says Nanette
Santoro, M.D., professor and chair of obstetrics and gynecology at the
University of Colorado at Denver. Act now. If your period is MIA for
more than three months, ask about getting screened for hormone
disorders. Maintaining a healthy weight can also help restore your estrogen
levels and menstrual cycle.
By Stacey Colino, Self Magazine
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| New Drug For Melanoma Treatment...... |  Scientists say that a new drug to treat melanoma, the first in its class, improved survival by 68 percent in patients whose disease had spread from the skin to other parts of the body. This is big news in the field of melanoma research, where survival rates have refused to budge, despite numerous efforts to come up with an effective treatment for the increasingly common and fatal skin cancer over the past three decades. "The last time a drug was approved for metastatic melanoma was 12 years ago, and 85 percent of people who take that drug have no benefit, so finding another drug that is going to have an impact, and even a bigger impact than what's out there now, is a major improvement for patients," said Timothy Turnham, executive director of the Melanoma Research Foundation in Washington, D.C. The findings on the drug, called ipilimumab, were reported simultaneously Saturday at the annual meeting of the American Society of Clinical Oncology (ASCO) in Chicago and in the June 5 online issue of the New England Journal of Medicine. Ipilimumab is the first in a new class of targeted T-cell antibodies, with potential applications for other cancers as well. Both the incidence of metastatic melanoma and the death rate have risen during the past 30 years, and patients with advanced disease typically have limited treatment options. "Ipilimumab is a human monoclonal antibody directed against CTLA-4, which is on the surface of T-cells [which fight infection]," explained lead study author Dr. Steven O'Day, director of the melanoma program at the Angeles Clinic and Research Institute in Los Angeles. "CTL is a very important break to the immune system, so by blocking this break with ipilimumab, it accelerates and potentiates the T-cells. And by doing that they become activated and can go out and kill the cancer. This drug is targeting not the tumor directly, but turning the T-cells on by blocking their brakes and allowing the T-cells to do their work, which is very different from chemotherapy and other targeted therapies directed at cancer cells." The drug was developed and the study funded by Bristol-Myers Squibb and Medarex. For this study, 676 patients at 125 centers around the world were randomly assigned to one of three treatment groups: ipilimumab plus gp100, a peptide vaccine which has shown some benefit in melanoma cases; ipilimumab on its own; or gp100 alone. All participants had stage 3 or 4 melanoma, and had been previously treated. Those in both the combination arm and the ipilumumab-alone arm lived a median of 10 months vs. 6.4 months in the gp100-alone arm, a 68 percent increase in survival time. "This is important because this is a disease where the average survival is six to nine months, so an increase on average by an additional four months is a very large difference in this population," O'Day said. "Even more importantly than the median survival are the one- and two- year landmark survivals, which were nearly doubled in the two ipilimumab arms, going from 25 to 46 percent at one year and 14 to 24 percent at two years." Fourteen of the patients (2.1 percent) died because of reactions to the treatment, seven of those from immune system problems. It's not entirely clear at this point which patients will benefit most but, Turnham pointed out, a large proportion of patients benefited from this therapy, whereas other therapies help only 5 percent to 15 percent of patients with metastatic melanoma. The drug has not yet received approval from the U.S. Food and Drug Administration, but it is available at many medical centers and some patients may be able to get access to it, O'Day said. .
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7 S's of Summer
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To fill your summer first-aid kit, remember the seven S's: sprains, strains, splinters, stings, scrapes, scalds and sun.
Sprains and strains. Your summer kit should contain elastic wrap bandages (2-, 3- and 4-inch wraps are a good start).
Splinters. Keep safety pins, tweezers and alcohol (for cleaning and sterilizing the instruments) handy to remove splinters.
Stings. Anesthetic sprays or lotions can ease stings. For bugs that leave stingers (such as bees) or for bugs that hang on, tweezers can be used for removal. Oral antihistamines such as Benadryl are good for hours-long relief from itching and allergic reactions, while the spray gives short-term relief. Use hydrocortisone creams or lotions to "turn off" the inflammation.
Scrapes. In addition to non-stick adhesive bandages in various sizes, sterile 4-by-4-inch gauze pads and adhesive tape have countless uses. Optional: transparent film (Tegaderm-type) bandages protect a wound and let it "breathe."
Scalds. Use non-stick (Telfa) pads to cover the burn site.
Sun. Aloe lotion is soothing for minor burns, as are cool compresses, so keep some soft cloths in your kit.
- USA Weekend
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| Lab Requests From Specialists Update! |  Paul and Sonora Quest Need Your Help! As a service to you as our patient, we have asked Paul, our phlebotomist from Sonora Quest, to honor lab requests from other doctors I have referred you to. Our goal is to make getting lab work as convenient as possible for you, but Sonora Quest needs you to furnish them with the correct form and to know there may be some limitations to Paul's station. If you wish to come back to our office to have your blood work, please be sure to have the specialist fill out their 'Sonora Quest requisition' slip. Paul can only work off this form, not a 'RX' or 'copy paper' request. Please be aware that there may be some tests that Paul can not perform at his station, and he may need to refer you to an outside Sonora Quest drawing station. Sonora Quest also asks for your patience if you come back to our office for your blood draw, as Paul is expected to service my scheduled patients first. Our front desk has more information and options where you can go for phlebotomy services if you can not wait or so wish. Thank you for your help. This will make Paul a very 'happy phlebotomist!' Dr. Lakin & Staff
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| Give Your Liver the Respect It Deserves. . . . . | 
The liver is sometimes treated like the Rodney Dangerfield of organs: It doesn't get any respect.
Though many people understand that the liver has a role in digestion, they don't comprehend how vital it is for such body functions as protein production, blood clotting, and the processing and storing of fats and sugars.There are several ways to keep your liver healthier. These include:
Limit Alcohol.
Heavy drinking is associated with several liver ailments, including fatty liver, alcoholic hepatitis, cirrhosis and liver cancer.
Watch Your Weight.
One of the many problems associated with obesity is a condition known as non-alcoholic fatty liver disease. This occurs when excess fat accumulates in the liver, which eventually can lead to scarring if not addressed. Weight loss will improve the condition.
Avoid Elevated Cholesterol.
Some people who have this also develop non-alcoholic fatty liver disease. Treatment of their cholesterol will decrease the fat in the liver.
The liver will continue to work hard even when we neglect it, but taking simple steps can pay big dividends.
-Dr. Tedd Mitchell, USA Weekend
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| Stave Off Weight Gain After Menopause. . . . | 
Many women say losing or even maintaining weight after menopause is difficult, and now a study from Pennington Biomedical Research Center in Baton Rouge sheds light on why.
Scientists have found that women have a lower metabolism after menopause.
The research shows that postmenopausal women burned 100 to 150 fewer calories a day just resting and doing everyday activities, and they were less physically active, for an overall average decrease of 200 calories a day burned after menopause. The lower metabolism could be tied to lower estrogen levels, not muscle loss, says lead researcher Jennifer Lovejoy, formerly with Pennington.
And it looks as if lower estrogen may increase appetite and cause cravings for carbohydrates and fats, she says. So watch out for cookies, cakes and chips.
"Just cutting out one of these calorie-rich items could put you back in energy balance," she says.
Lovejoy recommends that women who are in their early to mid-40s "begin gradually increasing physical activity and become more aware of dietary habits to help offset metabolic changes that can lead to weight gain with menopause."
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| Have You Scheduled Your Annual Physical Yet? |
With the hot Arizona summer months upon us, I would like to offer a healthy option for your personal medical care program.
As you all know, I am a strong supporter of annual physicals. This is a time we can visit and explore any unresolved medical problems and any new health issues that need to be addressed. Annual physicals are one of the best ways to safeguard your health. The American Medical Association recommends that if you are between the ages of 40 - 49 years, physicals should be done every two years. If you are 50 years plus, it is recommend you have yearly exams, especially if you have any chronic medical conditions that need to be monitored. The summer tends to be more relaxed and is an ideal time to take care of needed medical procedures and tests. Please call today so we can offer you the best appointment time to fit your summer schedule.
Dr. Lakin & Staff
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Use The Arts To Fight Early Alzheimer's
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For 5.3 million Americans and their families and friends, Alzheimer's disease is life-altering.
Although the duration of early Alzheimer's varies, whatever time one has left still can be enjoyed, says Deborah Mitchell, author of How to Live Well With Early Alzheimer's. A few examples:
View art. Researchers say art has a positive effect on emotions and can reduce aggression, agitation, apathy and anxiety. At galleries, let paintings "evoke whatever memories come up." Doing art projects at home can improve hand-eye coordination and stimulate neuron activity in the brain.
Play music. Music can relax patients. Songs they enjoyed in the past can foster conversation.
Dance. Lessons can "provide physical exercise, increase the level of brain chemicals that stimulate nerve cells to grow and help some people recall forgotten memories when they dance to music they used to know."
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How To Get the Best Seats On the Plane
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AIRLINES ARE looking for ways to add fees on your flights. Paper tickets, snacks, headphones and checked baggage are only the beginning.
Charging to reserve a seat is bringing in new revenue to airlines, including United and JetBlue, and adding a financial hit to families who don't want to sit apart.
If you have to pay, get the most for your money by becoming familiar with your aircraft's configuration and seat locations. Here are some tools:
Airline websites. Each flight servicing your route will have a seating chart. Different-sized aircraft often fly the same routes but at different times. You could go from a domestic narrow-body jet to an international wide-body jet by flying an hour or two earlier.
SeatGuru.com. See seat reviews for different airlines and aircraft. Remember that airlines may have the same aircraft but configure them differently. Space between coach seats ("pitch") can vary a few inches, but the big difference is in business class, where seat pitch can vary from 38 to 60 inches.
SeatExpert.com. Enter your travel date and flight number to view the aircraft assigned to your flight. You'll see tips on seats that don't recline, have blocked storage or blocked windows, or are next to lavatories.
- LAURA MCKENZIE, USA Weekend
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| Prolong the Relaxing Effects of a Vacation | 
Dutch researchers found the anticipation of a vacation makes people happy, but after a break, there's not much difference in mood between those who took a trip and those who stayed put.
But if the time off was relaxing, the researchers found slightly increased happiness even two weeks after the holiday. After eight weeks, the effect was gone.
A team from Erasmus University Rotterdam and NHTV Breda University of Applied Sciences looked at the effect of vacations among 1,530 adults, 974 of whom vacationed during the study. It's published online in the journal Applied Research in Quality of Life.
Researchers suggest two or more short breaks instead of one longer break may give a bigger mood boost. David Rock, author of Your Brain at Work, says that even when planning trips, "the expectations of the events themselves activate the reward center in the brain in an intense way." |
| AT THE MOVIES WITH BARB A. |
A MUST SEE * * * * *
GREAT * * * *
ENTERTAINING * * *
RENT THE MOVIE * *
FORGET IT! *
* * * * OCEANS
This was a breath of fresh air. It was probably the best documentary I have ever seen. You go to the earth's seas out of California, Africa, South America, Australia and New Zealand. I was mesmerized the whole time. Pierce Brosnan narrates the film. Such a sexy voice!!!!!
* * * * THE SECRET IN THEIR EYES
This is beautiful film directed with cleverness and grace by Juan Jose Campanella - It is full of fear and love. Even one who does not like subtitles (I love them) will be enraptured. You grow to actually know the actors. It is a crime thriller regarding the power and bureaucracy in Argentine government.
* DEAR JOHN
The movie based on the novel by Nicholas Sparks was just as stupid as the book. I was unable to finish the book so don't ask me why I saw the flick. I think I thought I should add a movie that the younger set sees. Am I saying I am not a teenybopper or baby boomer? The answer is yes.
Going on vacation..... See you in the fall!
Barb A.
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| Dog Compulsions Could Hold Clues for People | 
Dogs don't compulsively wash their hands, but then again, people don't chase their tails.
Nicholas Dodman, director of the animal behavior clinic at Tufts University's Cummings School of Veterinary Medicine in North Grafton, Mass., treats canine compulsive behaviors like tail chasing and a common Doberman affliction: repeatedly sucking on the flanks. For years, Dodman has said compulsive behaviors are essentially the same in people and animals, all originating in the same place in the brain.
He could be right. Looking at the DNA of nearly 100 compulsive Dobermans, Edward Ginns of the University of Massachusetts Medical School in Worcester found a chromosome alteration that appears almost always in those dogs.
The National Institutes of Health is trying to determine whether the same alteration appears in the same chromosome of people who have compulsive disorders. If that's confirmed, scientists could work on better treatments for humans and animals with compulsive disorders.
In the meantime, if your pet seems obsessed, don't assume it's compulsive behavior. It could be another problem, from fleas to chronic pain. See your veterinarian - and bring video of the behavior, since your dog probably will not repeat it on cue.
- USA Weekend
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| Burgers That Taste So Good, No One's Asking: Where's the beef? | 
It's time for your annual summer cookout. There was a time when a box of hamburgers and a couple of packages of hot dogs would do it. These days you might want to check with your guests first: You may find some wanting (or needing) to eat a little less red meat. If so, here is one delicious option. Also, check out buildabetterburger.com, to enter for the $100,000 winning burger.
Herbed Salmon Burgers with Lemon Tartar Sauce
Serves 6
1½ pounds skinless salmon filet, finely chopped
¼ cup chopped fresh parsley, divided
2 Tbs. chopped fresh dill
7 scallions, thinly sliced, divided
2½ tsps. finely grated lemon zest, divided
12 saltines, finely crumbled
1 large egg, beaten
½ tsp. salt
1 Tb. olive oil
¾ cup light mayonnaise
¼ cup drained chopped capers
6 whole-wheat sandwich buns
4 tsps. lemon juice
Thoroughly mix salmon, 2 Tbs. parsley, dill, 6 of the scallions, 2 tsps. of the lemon zest, crackers, egg and salt in medium bowl. Divide into 6 equal portions and form into firm patties. Cover and refrigerate until ready to grill.
About 15 minutes before serving, preheat gas grill - all burners on high for about 10 minutes. Use a wire brush to clean grill rack, then use tongs to wipe a vegetable oil-soaked rag over it. Close lid and return to temperature. Alternatively, build a hot charcoal fire.
Brush burgers with olive oil. Place burgers on hot grill rack; cook, covered, until first side develops impressive grill marks, about 3 minutes. Turn and grill, covered, on other side, 2 to 3 minutes. Grill buns until spotty brown, just a minute.
Meanwhile, mix mayonnaise, capers, remaining parsley, scallion, lemon zest and the juice. To serve, spread a portion of sauce over each bun half. Set burger on bun bottom. Cap with bun top and serve immediately.
Per serving: 399 calories, 31 g carbohydrates, 30 g protein, 17 g fat (2 g saturated), 110 mg cholesterol, 5 g fiber, 998 mg sodium
- PAM ANDERSON, USA Weekend
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| May your summer be filled with joy and
plenty of sun shine!
Douglas Lakin & Staff
Paradise Valley Medical Clinic PC
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