BEHealthySETX.

com | November/December 2012 1
November/December
2012
Under the tree:
Healthy gifts
Festive taste,
less weight
’Tis the season
for safety
Sprain, sprain:
Go away
for the Rx
holidays
2 November/December 2012 | BE HealthySETX.com
Paraesophageal Hernia
and Refux Center at
Previty Clinic
40% of Americans
experience heartburn
once a month
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or refux, we are here to help.
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E
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Christopher A. Timmons, MD
Chief, Paraesophageal Hernia and
Refux Center
www.prevityclinic.com
740 Hospital Drive Suite 280
Beaumont, Texas 77701
409.835.9500
610 Strickland Drive Suite 190
Orange, Texas 77630
409.886.1111
BEHealthySETX.com | November/December 2012 3
Receiving nursing’s highest honor means our patients
receive the highest level of care.
/+é ]|«] · »··] -c-«-é+« ·( «''
Once again, our hospitals have earned Magnet status for excellence in nursing.
www.christushospital.org | 1-866-683-3627
Awarded to only seven percent of hospitals nationwide, the highly coveted Magnet
designation from the American Nurses Credentialing Center is the most prestigious
honor bestowed for nursing excellence. To earn it, Magnet hospitals must rise above
their stringent standards for professionalism, teamwork and exceptional patient care.
And while it’s a tremendous achievement for our nurses, they would be the rst to
tell you they didn’t do it on their own. It took the commitment and cooperation of
the entire hospital staff and leadership, working together in a positive, patient-focused
environment. The Magnet designation is high praise indeed. But, in the end, providing
the highest level of care possible for our community means more to us than any award.
4 November/December 2012 | BE HealthySETX.com
Photography by
Guiseppe Barranco
This issue of BE Healthy contains
lots of helpful information for
thriving and surviving during the
holiday season.
O
n

t
h
e

c
o
v
e
r
8
HOLIDAY HEALTH
GIFTS FOR THOSE
WHO GET UP AND GO
From running tours to tasty
teas, these ideas beat sausage
By Meg Gardner
12
HOLIDAY HEALTH
FEAST VS. FIT:
THE CHALLENGE
Season’s meals don’t have
to be nutritional disasters
By Meg Gardner
14
STAYING SAFE
HOME IS THE HUNTER
– IF HE’S CAREFUL
Calm, cool and collected
is safest way to bag game
By Cheryl Rose
6 Peel’d To The News
18 Innovations
18 Crossft puzzle
BE Healthy | November/December 2012 | Volume 3, Issue 6
Contents
BE
Editorial
Contributing Writers
CATHLEEN COLE
MARGARET BATTISTELLI GARDNER
CHERYL ROSE
Contributing Editor
CHRISTOPHER CLAUSEN
Medical Adviser
DR. GARRETT K. PEEL
Photography
Contributing Photographers
GIUSEPPE BARRANCO
Art
Graphic Design
AFFINITY EXPRESS
Graphic Design Consultant
KRISTEN FLORES
Advertising
To advertise in BE Healthy
409.880.0700
Contact Us
BE Healthy
380 MAIN ST.
BEAUMONT, TX 77701
409.880.0700
TO DISPLAY THE MAGAZINE
AT YOUR BUSINESS LOCATION
PLEASE CALL 409.838.2829
SUBMISSIONS
TO SUBMIT AN EVENT, ORGANIZATION
OR PERSON FOR CONSIDERATION
IN AN UPCOMING ISSUE, SUBMIT BY
USPS AT ADDRESS ABOVE.
A DIvISION Of HEArST NEwSPAPErS
Publisher
BILL OFFILL
EDITOr
TIMOTHY M. KELLY
COPYRIGHT © 2012
THE BEAUMONT ENTERPRISE
Visit us online at BEHealthySETX.com
Be part of keeping
Southeast Texas green!
Recycle this magazine.
16
MEDICAL ADVICE
DO’S AND DON’TS
FOR ANKLE INJURIES
The right treatment, follow-up
can heal this common injury
By Cheryl Rose
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A G A
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D R E N A L I N
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B S C E S S
BEHealthySETX.com | November/December 2012 5
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6 November/December 2012 | BE HealthySETX.com
Each edition, BE Healthy
Medical Adviser Dr. Garrett K.
Peel will cut through the previous
month’s medical and health news
and bring you the most relevant
and interesting tidbits to help you
make informed health decisions.
Peel’Dto
MedicalNEWS
A recent study by the Mayo Clinic showed a
strong association between a pre-cancerous disease
of the esophagus and diabetes. Patients with Type
2 Diabetes may face an increased risk for Barrett’s
Esophagus (BE), regardless of other risk factors,
including smoking, alcohol consumption, obesity
and gastroesophageal refux disease.
Researchers report that this risk may be higher
in men with diabetes, probably because men tend
to carry more fat in the abdomen, compared to
women, who tend to carry weight around the hips
and thighs.
Type-2 diabetes is the most common form of
diabetes, with millions of Americans living with the
disease. BE is a condition in which the tissue lining
the esophagus is replaced by tissue that is similar
to the lining of the intestine. No signs or symptoms
are associated with BE, but it is commonly found in
people with GERD. About 5 to 10 percent of patients
with chronic GERD will develop BE.
Obesity is associated with an increased risk of
BE and esophageal cancer, but it is unclear if this
is caused from mechanical and/or metabolic efects
such as hyperinsulinemia, according to researchers.
They report a two-fold increase risk of developing
BE among diabetics.
If you are a diabetic and sufer from heartburn
or refux, alert your physician. You may need
further testing to include an endoscopy to diagnose
possible BE.
More than 40 percent of breast cancer survivors
sufer from a debilitating condition called lymphede-
ma. Researchers at the University of Missouri have
found that full-body exercise and decongestive therapy
may relieve symptoms and improve quality of life.
The full-body exercising includes weight lifting
and stretching. Decongestive treatments incorporate
skin care, exercise, manual lymphatic drainage and
bandaging of swollen limbs.
If you sufer from lymphedema ask your doctor
for a referral to wound care centers that specialize in
lymphedema therapy.
The Mayo Clinic reports that statin use is associ-
ated with protection from esophagus cancer. A sys-
tematic review of eleven studies reporting 8,613 cases
of esophageal cancer from studies including almost 1
million patients showed the incidence of esophageal
cancer is increasing in the United States, especially
esophageal adenocarcinoma in patients with Barrett’s
esophagus.
The meta-analysis of these studies showed a
signifcant 30 percent reduction in esophageal cancer
incidence with statins use.
An analysis of a subset of patients with Barrett’s
esophagus, a pre-malignant condition associated with
chronic acid refux or GERD, revealed that, in this
higher risk population, statin use was associated with
a signifcant 41 percent decrease in the risk of adeno-
carcinoma of the esophagus.
If you have Barrett’s Esophagus ask your doctor
about the beneft of taking a statin medication that
may reduce your risk for esophageal cancer.
A University of Illinois study suggests avoiding
cooking methods that produce the kind of crusty bits
you’d fnd on a grilled hamburger, especially if you
have diabetes. A recent study found that preparing
foods that are crusty, might lead to coronary artery
plaque build-up.
Think of the edge of a brownie or the crispy
borders of meats prepared at very high tem-
peratures. These produce advanced glycation
end products (AGEs), which are associated with
plaque formation, the kind we see in cardiovascu-
lar disease.
If you are diabetic, you should bake, broil or
grill your food, instead of over-heating or baking
or even frying. Boiling or stewing meat will reduce
your AGEs intake further. Scrambling an egg with
cooking spray instead of frying leads to a signifcant
reduction in AGEs as well.
Type-2 diabetes may increase risk of esophageal problems
Better ways to manage lymphedema
Statins may protect against esophageal cancer
Stay away from crusty burned foods
BEHealthySETX.com | November/December 2012 7
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Face it, the best gifts are those that really
take into account the recipients’ interests,
tastes, predilections, etc. And if you have
health warriors or ftness freaks on your list,
there are lots of ways to please them. Here
are a few ideas that are just a bit more inter-
esting than an exercise ball or running shoes.
Running tours
This is a pretty cool idea for the runners
on your list, especially if they travel a lot. A
company called City Running Tours provides
both guided personalized and group running
tours of major cities across the country.
Personalized runs can be designed to ft
the guest’s preferences (he or she decides
when, how long and even if the run stops or
slows to a walk). Group runs have several
guides ready to lead diferent running paces.
Either way, the guided run/tours ofer run-
ners a chance to exercise while learning
about history, urban myths and unofcial
landmarks native to the cities where they
take place.
The closest location to southeast Texas
with running tours is Austin, but if you have
running friends who travel, they are also
available in Boston, Charleston, Chicago,
Minneapolis, New York, Philadelphia, San
Francisco, Seattle, and Washington, D.C.
Information: cityrunningtours.com
Yoga shapes cookie cutters
Got a yoga lover with a sweet tooth and a
sense of whimsy on your list? Baked Ideas, a
custom baking company in New York, ofers
sets of cookie cutters in yoga shapes. They
come in two collections — the Lotus Group
and the Down Dog Group — and include a
recipe for the bakery’s famous gingerbread.
Yummy Yogi also ofers yoga cookie cut-
ters by collection and individually.
Information: bakedideas.com/store and
yummiyogi.com/shop.
Good thinGs in
packages
holiday health
Keep your friends’ health and ftness goals in mind
this year by giving some of these off-the-wall fnds.
By MeG GaRdneR
E
verybody loves
sausage, right? So
it’s OK to handle
your entire
holiday shopping
list at Hickory
Farms, right? Not so fast. You
better ask your vegan cousin.
>>
BEHealthySETX.com | November/December 2012 9
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Tea time
If your friend thinks tea is terrifc,
consider a Tea of the Month club. A
ton of them pop up in Google search
results, but The Republic of Tea ofers a
Wellness Tea of the Month package that
includes teas that are formulated for
specifc wellness needs.
The 12-month collection includes blends such as Get Clean, Get
Limber, Get Relaxed, Get Charged, Get Burning, Get Happy, Get
Hydrated, Get Some ZZZs and Get Gorgeous.
Information: republicoftea.com
T-shirt with ‘tude
Your anti-meat warrior friends who have an
eye for fashion and snarky T-shirts will love
a 100-percent cotton, organic “Tofu Never
Screams” shirt, with an image of happy little
block of tofu that is blissfully unaware of the
cleaver wedged in its head.
Information: etsy.com/listing/38150005/
sale-tofu-never-screams-organic-mens-t
Stuck on yoga
Function gets funky with this cool-looking
magnet set. It includes 63 one-inch tiles, each
representing a diferent yoga position. The yogi
in your life need only snap them apart and then
arrange in any of an endless variety of ways on
the hanging backer board to create complete
personalized yoga routines.
Added bonus: The magnets and board are
colorful and captivating enough to double as
décor — for a studio or even just at home on the
fridge.
Information: greggomagnets.com/product/magnetic-yoga
Running water
Nobody wants to have
to hold on to a water bottle
while working out. Show your
athletic friends how much you
care with a cool Amphipod
RunLite AirStretch 4 hydra-
tion belt.
It’s a belt — duh — with
four docking bases that each
hold an 8-ounce fask, along with compartments for a cell phone,
music player, keys, ID, cash and even snacks.
The fasks are included; what your friends put in them is up to
them.
Information: rei.com/product/813464/amphipod-runlite-air-
stretch-4-hydration-belt-32-f-oz
Grown-up lunch box
Healthy eaters fnd it easier to stick
to their guns when they bring food
from home rather than relying on the
lunch wagon outside the ofce or a
drive-through disaster while on the
road. But brown-bagging can be so
inconvenient. Help out by giving him
or her a sturdy, no-fuss container to
tote food to and fro.
They come in all shapes and sizes,
and can be made from plastic, stainless
steel or even bamboo. One cool choice is Laptop Lunches Bento-
Ware, a line of recycled and recyclable, compartmentalized boxes
that lets you keep lunch items fresh and separated. They’re also
lead-, BPA-, phthalates- and PVC-free.
Information: laptoplunches.com
Food for thought
Far be it for you to try to dictate
anyone’s lifestyle, but if you have
friends who are fast-food fanatics in
need of a little enlightenment, you
can’t beat “Fast Food Nation: The Dark
Side of the All-American Meal” by Eric
Schlosser.
Even if the reality of pink slime and
mechanically separated chicken didn’t
sway them from fast food, this just
might.
Information: amazon.com/Fast-
Food-Nation-Dark-All-American/
dp/0060938455
10 November/December 2012 | BE HealthySETX.com
BEHealthySETX.com | November/December 2012 11
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12 November/December 2012 | BE HealthySETX.com
holiday health
By MeG GaRdneR
H
oliday food traditions are
hard to break. Take it from
someone whose father
once left the Thanksgiving
dinner table in a huff,
only to return a few
minutes later with two cans of Ocean Spray
cranberry sauce. He had gotten whiff of a
rumor that his traditional favorite would be
replaced on the table that year by homemade
cranberry-orange relish with walnuts —
oh, the horror — and he made sure to be
prepared.
Meals don’t need to be nutritional
disasters. Rely on simple recipes,
bold favors and colors, and
festive presentations to make then
memorable.
h
e
a
l
t
h
here’s
t
o
y
o
u
r
holiday
holiday health
There’s much to be said for our tried-and-try holiday fare. But most of it
is a nutritional nightmare. Although many folks subscribe to the “it’s a spe-
cial occasion so I’m not going to worry about fat, calories, carbs, etc.,” many
others would appreciate making it through the holidays without derailing
11 months of sane eating.
Believe it or not, it’s possible to create relatively healthy holiday meals
that keep the party going without all of the nutritional regret. The key is to
keep them festive and in keeping with the celebratory feel of the occasion.
Be creative. Serving skinnied-down versions of traditionally fat- and
calorie-laden fare often backfres, since they rarely match the richness that
has come to be expected, and they wind up leaving everyone’s (holiday)
stockings in a bunch.
If you’re ready to take the plunge into serving healthier holiday fare, here
are a few recipes to get you started. Note that simplicity is key. Not only does
this approach allow you to eliminate fatty, complicated sauces and such, but
it lets the bold favors and colors of nutritional food take center stage to add
to the festive feel.
Remember also to present your healthy
meals with fair, incorporating seasonal
touches into your presentation.
Crab martinis
This is a cool-looking, elegant appetizer
that is simple to put together but special
enough for the holidays. A table set with one
of these “martinis” in the middle of each
plate looks tres chic. For a larger crowd, try
making them in shot glasses and setting
them up amid sprigs of holly on a silver tray.
Carefully pick through lump or jumbo
lump crabmeat (from the refrigerated sea-
food section, not the shelf-stable kind you
fnd with the canned tuna) to remove any
shell fragments. Be sure not to break up the
crabmeat pieces; this dish is so simple that
the meat is part of the visual appeal.
In a bowl, combine the crabmeat with
a few squeezes of fresh lime, freshly and
coarsely ground mixed peppercorns, and a
very small amount of salt. Toss together well
but gently.
To the bottom of each glass, add a layer
of fresh, mild salsa or pico de gallo. (You
can make it yourself or fnd the really fresh
bottled kind from the refrigerated section at
the market – don’t use the mush you fnd in
the chips aisle. The veggies chunks should be
big, fresh and bright.)
Top that with a portion of the crabmeat,
then sprinkle lightly with ground cayenne
pepper. Stand a red tortilla chip into the
mound of crab. A short spiral of lime rind
also makes for an extra festive touch.
Baked salmon with apricot
You might have seen the episode of
“Everybody Loves Raymond” where his
wife serves fsh on Thanksgiving. Chaos, of
course, ensues. But don’t worry if you decide
to go that route — life’s not a sitcom, right?
If you’re really afraid of causing a
culinary scene by forgoing turkey on T-Day,
you can always save this recipe for Christ-
mas. Culturally, there seems to be a bit more
wiggle room with entrees then.
This can be made using a large slab of
salmon, which would be best for bufet-style
meals. But using one nice, thick salmon flet
per person for a sit-down dinner allows you
to control portions.
Spray a baking dish with cooking spray
and line with rounds of thinly sliced mild or
sweet onion. Season salmon lightly with salt,
pepper and garlic powder. Arrange salmon
flets on top. In a separate bowl, combine
1/3 cup white wine (you can use chicken or
vegetable broth instead) with 1/3 cup all-fruit
apricot preserves and about ½ teaspoon of
grainy mustard. Spread mixture over the
salmon. (This will cover about six flets.)
Bake at 375 degrees for 15 to 20 minutes
or until the fsh fakes easily with a fork. This
looks really pretty served alongside some wild
rice and a bright, green veggie; the apricot is
especially compatible with Brussels sprouts.
Fennel salad
This salad is light and fresh, and fennel
is well-known for its ability to aid digestion,
so it’s a great addition to a big meal (not that
that’s what you’re going for here).
Cut three or four bright, juicy oranges
(if you can get blood oranges, all the better)
into sections, then cut away from skin and
remove as much of the pith and membranes
as possible. You want pure orange and no
seeds. Salt these slightly and set aside as you
prepare the fennel. Wash a large bulb of fresh
fennel really well (they tend to be sandy) and
trim of the leaves. Quarter the bulb and cut
it into thin slices. Toss it with the oranges
and season with lots of fresh-ground black
pepper. Drizzle with olive oil and balsamic
vinegar, then toss. Garnish with fennel leaves
before serving.
Dessert
Desserts can be tricky, of course, when
you’re looking to serve healthy fare. One
great idea is small, individual fresh fruit and
cheese platters. Or a few pieces of really di-
vine dark chocolate with some fresh berries
and homemade whipped cream (no sugar
needed).
BEHealthySETX.com | November/December 2012 13
“Some people can’t control their emotions
– they get excited and anxious, get in a hurry
and start making mistakes,” Boone said.
“People need to take their time and control
their emotions in the wild.”
In the State of Texas, anyone born after
1971 is required to take a one-time hunter
education class that covers frearm safety,
basic frst aid, hunting ethics and more. As
the hunting season begins, Boone reviewed
some of the common precautions to prevent
injury:
Wear orange
Wearing blaze orange is only required on
public land, such as the Big Thicket National
Preserve. Wearing orange is not enforced on
private land. “You’re not required to, but it’s
a good idea,” Boone said. “You never can be
overcautious.”
Identify the target
and the line of fre
“One of the most common hunting
accidents we have is because people are
mistaken for game and it’s just senseless,”
Boone said. “The hunter is not identifying
his target, not sure of what his target actu-
ally is and knowing what’s behind it.” With
high-powered rifes that can carry a bullet
300 to 500 yards, hunters need to consider
where the bullet could go beyond the target.
In hunting, safety comes from calm
and concentration
By CheRyl RoSe
WIld gaMe,
cool emotions
T
he adrenaline rush that comes with bagging a target
is part of the appeal of the sport for hunters, but
it can also be a time of danger when excitement
overcomes caution. Mike Boone, a game warden
in Hardin County for 20 years, has seen the
results of careless accidents many times, after the
commandments for hunter safety were forgotten in the critical
moments of excitement or in the distractions of the aftermath.
safety frst
14 November/December 2012 | BE HealthySETX.com
All wild meats are leaner than free-range chicken and
most fsh, according to Mary Ellen Vivrett, a registered dieti-
tian. Venison, for example, is a low-cholesterol, low-sodium
protein that has typical farm-raised meats beat. Compare
venison’s .5 grams of fat per serving (zero saturated) to an
ounce of chicken breast, which has approximately 3 grams
of fat (.84 grams saturated).
However, Vivrett cautioned that venison and other game
meats can lose their health advantage depending on prepa-
ration. “When venison is processed, typically 60/40 with
pork fat, it negates its healthiness with fat and sodium,”
she said. “However, if prepared in a low-fat method, using
a low-fat/low-salt marinade and a low-fat cooking method,
without breading or frying, it is a healthful choice.”
Chef Monica Cobb, a local proponent of using wild
game in cooking, also believes it is a healthier alternative.
“In my opinion, wild game is healthier because it’s not fed
hormones and grains laden with chemical additives and
preservatives.”
Although Vivrett agreed in principle with Cobb, she noted
that some hunters fll feeders with corn and other supple-
mental food so not all game has a purely foraged diet.
WIld gAME oFFERS lEAn pRoTEIn
“You might be shooting towards the pub-
lic roadway or a residential area,” Boone
cautioned. He said hunters can be proactive
about their lines of fre when they set up
their deer stands or feeding stations to be
sure that when the shot is taken, it will be in
a safe direction.
Firearm safety
There are several cardinal rules in gun
safety, but top of the list is always point the
muzzle in a safe direction. Inattention, care-
lessness and excitement can all cause hunt-
ers to forget this rule and injure themselves
or a companion. “It’s like when a kid shoots
his frst squirrel and they run of to take
pictures of it and their guns are pointing in
every direction,” Boone said. “The gun is not
going to go of by itself normally. It’s usually
human error.”
Safety harnesses
Any hunter using a tree stand should
wear a safety harness at all times, Boone
emphasized. Tree stands are popular with
bow hunters, but gun hunters also use these
elevated stands, sometimes as high as 60 feet
of the ground. The safety harness reduces
the risk of major injury if the hunter should
fall. “It is not required by law, but it is a big
safety tool,” Boone said. “It’s highly recom-
mended that it should be worn every time.”
Deer stand integrity
Hunters should check the durability of
their deer stands before entering. “A lot of
injuries occur with rickety old deer stands
that have been out there for years – rotten,
steps not secure and some just plain fall over
when you’re in them,” Boone said. “Bees and
hornets love to nest in those deer stands, too.
Hunters climb up the ladder, bees swarm
them and they have to dive out.”
Getting lost
Boone said an increasingly common call
to the game wardens is to rescue hunters
who have become lost in the woods. He
recommends carrying GPS and cell phones,
along with a compass, tools and rations.
“With technology now, we can get a ping
on their cell phone and get an idea of their
general area,” Boone said. “It’s a good idea to
hunt with a partner or at least let someone
know where you intend to hunt so we will
have an idea where to look.” Also, Boone
cautioned that children behave in the woods
as they do in a shopping mall – they like
to stop and wander, following their curios-
ity. “Turn your back and they are gone,” he
warned.
Mental checklist
Knowing the commandments of frearm
safety, keeping emotions in check and using
safety equipment and clothing will limit the
risks for hunters. In a last caution to always
concentrate on safety, Boone said, “One
thing about a frearm: Once it goes of, you
can’t take that shot back.”
According to statistics kept by Texas parks and Wildlife, hunting injuries and fatalities from
a weapon have been steadily declining since mandatory hunter education became effective in
1988, with 2011 setting a record low of only 23 reported incidents, including two fatalities. With
the state issuing more than 1.1 million hunting licenses last year, these incidents represent a
tiny percentage of the potential hunters. However, not all hunting injuries involve frearms or
bows.
of the reported weapons incidents, nearly half were self-inficted due to careless handling
of frearms, particularly around vehicles, noted Terry Erwin, the hunter education manager for
Texas parks and Wildlife. The most common injuries to others occurred in dove hunting, where
the hunter swinging on the fight of the bird did not stay in the safe zone of fre. Erwin attributed
this statistic to the popularity of dove hunting (increased numbers of hunters) and a failure to
wear blaze orange on private land because it is not required. The most injuries per game animal
occurred in feral hog hunting. Erwin pointed out that hogs may be hunted year-round, unlike
other game animals.
TEXAS HUNTING
INCIDENTS
TEXAS HUNTING
INCIDENTS
BEHealthySETX.com | November/December 2012 15
16 November/December 2012 | BE HealthySETX.com
Josh Yonker, head athletic trainer at La-
mar University, has seen ankle injuries in ev-
ery sport, from soccer to diving. “In football,
for example, we see a couple a week, several
dozen over the course of a season,” he said.
Stretched ligaments
Though an ankle sprain can occur at
any age, Abraham sees it mostly in youth
and seniors, but for diferent reasons. With
younger people and teens, the cause is
usually activity-related – organized sports
or recreational play such as skateboarding.
With mature adults, ankle sprains commonly
link to poor balance, slips and falls.
Dr. Keith Hill, an orthopedic surgeon with
Beaumont Bone and Joint who specializes in
the foot and ankle, explained that a twisted
ankle injures the ligaments that hold the
joint in place. Those fbrous ligaments can
be stretched or torn by the injury. Ligament
injuries are divided into three degrees with
grade-1 being slightly stretched to grade-3
being a complete tear.
“Typically, 85 percent of ankle sprains
will get better and you can speed up the
process and increase your odds by treating
promptly and doing rehab exercises,” he
said. “Other patients get chronic pain and
instability, and of those, 85 percent will re-
spond to physical therapy. Only a very small
percentage of patients require surgery.”
Abraham said her clinic sees grade-2
sprains most frequently. “We seem to catch
them a few days after the injury, when they
are concerned the swelling hasn’t gone
down,” she said.
Treatment
A sprain does not always require an X-ray
and rarely needs an ER visit, Hill said. “I
would discourage anyone from going to the
ER, even if they are limping,” he said. Some
pain, swelling and bruising are common
reactions. “If there is an inability to bear full
weight on the foot, then an urgent care or
physician visit in a couple of days is warrant-
ed,” he said. “An actual ER visit is not neces-
sary as this injury is not an emergency.”
Yonker uses that weight-bearing test
whenever a player is injured on the feld.
Watch
your
step
The common sprained ankle creates
vulnerability if not treated and rehabbed
By CheRyl RoSe
S
omewhere in Southeast Texas, someone is
grimacing over a wrong step. According to a variety
of tracking statistics, ankle sprains are one of the
most common injuries incurred. “We see one to
three a day,” said Dr. Aleyamma Abraham, the
director of Christus Minor Care in Beaumont, with
a spike in those numbers in the summer months, she added.
When she sees teens with sprains, Abraham said often her greatest challenge is how to handle the expecta-
tions of parents, who can be very aggressive in wanting their child to go back to play immediately.
At the collegiate level, Yonker said a player may receive a sprain in the frst half of a game and with immediate
treatment, still be able to play in the second half. “When considering when to put that athlete back in, he must
show that he has a full range of motion, that he can run and cut without limping,” Yonker said. “He doesn’t have
to be pain free – there may be some pain.”
Abraham and Hill both agree that sprains in children under 12 may need more thorough follow-up because of
the potential for micro-fractures to the growth plate, which can be very diffcult to assess. “When I see a kiddo 11
to 12 years old with a bad sprain, I will typically treat them more aggressively, as if they have a fracture,” Hill said.
For normal sprains, he said to begin R.I.C.E. therapy
right away to decrease swelling and speed recovery.
An acronym, R.I.C.E. stands for rest, ice, compression,
elevation.
Abraham said that two to four weeks are a normal
recovery period. “After we rule out a fracture, we ofer
crutches, an Ace wrap or a modifed splint to stabilize
the ankle and anti-infammatory medication,” she said.
Rehab
Once the pain and swelling recede, that is often the
end of the treatment, but it’s a mistake to think the
healing is done. Once stretched, the ligaments are never
quite the same, which also afects the nerve receptors
located within them, Hill explained. If patients don’t
follow through with some rehab exercises, the weakness
caused by the injury leaves them vulnerable to a repeat
occurrence and potentially a chronic issue.
“If you strengthen the ankle, improve overall balance
and get the nerve control better, you can help avoid
these problems,” Hill said. All of these aspects can be
addressed through rehabilitation exercise. “It doesn’t fx
the ligaments, but it does maintain the stability of the
ankle.”
Hill recommends patients visit a physical therapist
if possible, but there are some exercises that they can
do at home with very little equipment. One exercise is
to practice balancing. “It’s not fancy, but it works,” he
said. Yonker said he also uses balance exercises with his
injured athletes. He has the athlete stand on one foot for
30 seconds, then switch feet. Then the athlete repeats
the routine, but with his eyes shut. The routine is then
repeated again on an unstable surface, such as a piece of
foam.
After a month of healing, the injury shouldn’t require
a brace. “Ideally, you don’t want to use a brace. What
you want to do is rehabilitate the ankle,” Hill said. “If
you feel like you have to use a brace for any type of
exercise, your ankle probably isn’t where it should be
and you should consider some kind of rehabilitation.
Occasionally wearing a brace is OK, but relying on one
for normal activity can actually weaken the ankle over
time.”
BEHealthySETX.com | November/December 2012 17
Youth athletes: When is it oK to play?
18 November/December 2012 | BE HealthySETX.com
SE Texas Medical
Innovations
Options for bowel control disorder include innovative new therapy
If you suffer from bowel control problems, you are
not alone. As many as 1 in 13 adults has signifcant
problems with bowel control but most are too embar-
rassed to discuss it — even with their doctors.
Although bowel incontinence is a common con-
sequence of childbirth and the aging process, many
sufferers incorrectly think there are no real solutions.
But there is now hope for those who failed frst-line
therapy. It’s called the SECCA procedure and is offered
right here in Southeast Texas at previty — Clinic for
Surgical Care.
Bowel Incontinence or BCd (bowel control disorder)
is the involuntary leakage of gas, liquid or stool. The
most common cause of BCd is injury to a nerve or
muscle during childbirth, which is why women tend to
suffer a higher rate of BCd than men. Childbirth-related
BCd can present immediately but often doesn’t occur
until later in life.
leading causes of causes of fecal incontinence (FI) are:
• Age-related loss of muscle tone in both genders
• Anorectal surgery
• Accidents resulting in trauma to the sphincter muscle
• Anatomic birth defects
• Deterioration of nerve function due to diseases
such as diabetes and MS
Treatment options for bowel control disorder often
depend on the cause and severity of the condition and
may include the following:
• Dietary changes: Food affects the consistency of
stool and how quickly it passes through the diges-
tive system. Adjusting what is eaten and when may
be helpful in management of FI. Avoid gas-pro-
ducing foods such as beans and cabbage as well
as caffeine, alcohol, fried or spicy foods and foods
high in fat. Also, certain sweeteners, honey and
some fruits are poorly absorbed by the bowels.
• Prescription medications: In certain patients
chronic diarrhea is the cause of FI and can be
addressed by antidiarrheal medications such as
loperamide or diphenoxylate and bulk laxatives to
create a more regular bowel movement pattern.
• Bowel training: Some people can relearn to control
their bowel movements by strengthening their
pelvic foor muscles or conditioning the bowels to
empty at a specifc time of day.
• Invasive surgery: Various procedures involve
surgical repair of damaged tissue. They typically
require general anesthesia and might require
overnight or multiple-day hospital stays. They
include implanting an artifcial anal sphincter,
replacing the anal muscle with a graft from a limb
and implanting a nerve stimulation device similar
to a pacemaker.
• The Secca Treatment: Secca is an effective out-
patient procedure for patients who prefer a less-
invasive option and who have failed to respond
to frst-line therapies. It is a 60-minute procedure
that can be done as an outpatient with no hospital
stay. It has shown effective results, with a 1-2 day
return to normal activity.
If you experience bowel control disorder and/or fecal
incontinence, ask your doctor about your options. You
can get control of your life with the Secca procedure.
Dr. Garrett K. Peel is the medical adviser to
BE Healthy magazine.
Edited by dr. garrett K. peel, BE Healthy Medical Adviser
crossft
By Myles Mellor
By dr. Garrett K. Peel
Across
1 Healthy salad
5 Making better physically
9 Jogged
10 Solution to soothe the eye
11 Ice pieces
12 Criticize a lot
13 It’s secreted in response
to stress
16 Chills
18 dosage instruction, ___
per day
19 Compass direction
20 liver or kidney
22 Ulcerous sore
24 Musical literary piece
26 Retirement amount
27 oval fruits
29 Example
30 Infamed area
Down
1 lettuce and spinach
2 Cook, Rachael
3 get-up-and-go
4 What goes around
comes around principle
5 Too much blood sugar
6 Shade
7 Instability
8 Flatulence
14 Have to have
15 Consistent with
17 Honeyed wine
19 Salt
21 Secretory organ
23 Things you don’t do
25 puts into service
28 Back to square __
BEHealthySETX.com | November/December 2012 19
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