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Health and Wellness

Plymouth Pediatric & Adolescent Medicine to become a Speare medical practice

PLYMOUTH — Speare Memorial Hospital and Dartmouth-Hitchcock have jointly agreed to transition Plymouth Pediatric & Adolescent Medicine from D-H to Speare in April 2017.
"Speare has been working with Dartmouth-Hitchcock for several months to ensure the greater Plymouth community continues to have access to high quality, comprehensive care for our newborns, children and adolescents," said Michelle McEwen, president and CEO of Speare.
The discussions were spurred by recent retirements and changes in the medical providers at the practice, which potentially impacted D-H's ability to continue to provide inpatient newborn care at Speare.
"Speare has a highly regarded obstetrics program that would have been put in jeopardy without the support of local pediatricians," said McEwen. "We are committed to serving the many young families who want to deliver their babies at Speare and have local care thereafter. We have already assembled a great team of pediatric providers to continue serving our communities' children, from infancy to adulthood."
The transition to Speare offers a number of opportunities, such as enhanced communications, care coordination and collaboration. One of the early benefits will be the transition to the same electronic health record as Speare, providing the medical practitioners at Plymouth Pediatric & Adolescent Medicine with the entire clinical view of their patients. D-H will continue to provide specialty pediatric services offered by Children's Hospital at Dartmouth-Hitchcock (CHaD) as needed.
"Our community has been well served by the Plymouth Pediatric & Adolescent Medicine practice for the past 35 years under Dartmouth-Hitchcock's leadership," says McEwen. "The leadership at Speare is committed to continuing their legacy of delivering high quality and accessible patient-centered care."
Medical providers at Plymouth Pediatric & Adolescent Medicine will include: Drs. Eric Shamansky, Nancy Crocker, David Cunis, Kermit Brunelle and Wilma Hyde, APRN, Gabrielle Gray, APRN. Dr. Oliver Salmon and Ashley Francis, APRN will join the practice in the upcoming months.

Daniela Bayer - Alternative health therapies are back


Did you know that complementary and alternative health therapies are moving into the mainstream – again?
Greek physician Hippocrates is a historical figure of great importance. Born 2600 years ago, his philosophical and practical contribution to science and medicine is eternal, and earned Hippocrates the designation of the father of modern medicine. Many wise words and profound statements have been attributed to Hippocrates, and perhaps the most famous among them are...
• "Make a habit of two things: to help; or at least to do no harm."
Medical doctors take the Hippocratic Oath, which requires them to honor and abide by the same ethical standards that Hippocrates originally formulated for his medical school and practice in ancient Greece. Hippocrates authored medical books and introduced a new concept for medicine that involved diagnosing and treating human disease by linking scientific knowledge with compassion and prayer. He developed a medical regimen that combined drug therapy, diet schedules, physical and mental exercise, and "God's help". This method goes well beyond the traditional biological and physiological views on human health and disease and may be seen today as holistic or complementary and alternative to conventional medicine. This holistic approach addresses health and well-being as an integrated system of the individual, emotional, social, psychological and spiritual domains.
"It is more important to know what sort of person has a disease than to know what sort of disease a person has."
Health is so much more than absence of disease. The World Health Organization defined health as 'a state of complete physical, social and mental well-being', underscoring the role of a complex system of personal, behavioral, psychological, social, and environmental variables – above and beyond the physical and biological characteristics of a patient. This whole-system approach is built upon a customized and individualized multidisciplinary orientation and care.
"Natural forces within us are the true healers of disease."
People search for methods that heal the body and the soul. This is not because they are dissatisfied or distrusting of traditional medicine, in fact 95 percent of us choose the holistic or complementary and alternative therapies in addition to or as a complement to the conventional medical approach. Some would argue that complementary and alternative methods are unproven or untested, while others point to the emerging body of scientific evidence base that underscores the contribution of a holistic approach to medicine and concerns of health and well-being.
"The way to health is to have an aromatic bath and a scented massage every day."
Approximately 40 percent of adults and 12 percent of children in the United States say they use some form of holistic or complementary and alternative medicine. They are willing to assume personal responsibility for their health and wellbeing and tailor the choice to specific needs and circumstances. They have great trust in their own ability to discern whether a treatment works for them, and have the interest, time, and money to explore and choose the type of care that suits their objectives and preferences.
"Healing is a matter of time, but it is sometimes also a matter of opportunity."
In the United States, many different modalities are legally practiced. The Center for Disease Control monitors our population's interest and use of acupuncture, Ayurveda, biofeedback, chelation therapy, chiropractic care, energy healing therapy, special diets (including vegetarian and vegan, macrobiotic, Atkins, Pritikin and Ornish), folk medicine or traditional healers, guided imagery, homeopathic treatment, hypnosis, naturopathy, nonvitamin, nonmineral dietary supplements, massage, meditation, progressive relaxation, qi gong, tai chi, and yoga.
"Wherever the art of medicine is loved, there is also a love of humanity."
There are approaches that go beyond the treatment of illness. They help remove obstacles to positive well-being and promote contentment and experience of true health. According to the Mayo Clinic, complementary and alternative medicine is now moving into the mainstream. Hippocrates must be smiling.
Be well!

Dr. Daniela Bayer, PhD is a consulting psychologist, behavioral coach, and a contributing writer for Laconia Daily Sun. Have a question or need additional information? Call Dr. Bayer toll-free at 1 (888) DrBAYER, or 1 (888) 372-2937.

Comfort Keepers - What routine eye exams can reveal about your health (950)

By Martha Swats, Owner/Administrator, Comfort Keepers

Regular eye exams are even more important as you reach your senior years. After turning 60, several eye diseases may develop that can permanently affect your vision. A comprehensive dilated eye exam by an optometrist or ophthalmologist (eye doctor) is necessary to find eye diseases early, when treatment to prevent vision loss proves most effective.

There are warning signs for age-related eye health problems that could cause vision loss, but many eye diseases have no early symptoms. They may develop painlessly, and you may not notice changes to your vision until the condition has already progressed. Of course, see your eye specialist immediately if you notice changes in your vision. Here are some vision disorders all seniors should know about:

• Age-related macular degeneration (AMD) is an eye disease that affects the macula (the center of the light-
sensitive retina at the back of the eye) and causes central vision loss, while peripheral (side) vision remains
unaffected. The macula allows us to see fine detail and colors. Activities like reading, driving, watching TV, and recognizing faces all require good central vision.
• Cataracts are cloudy or opaque areas in the normally clear lens of the eye. Depending upon their size and location, they can interfere with normal vision. Usually cataracts develop in both eyes, but one may be worse than the other. Cataracts can cause blurry vision, decreased contrast sensitivity, dulling of colors, and increased sensitivity to glare.
• Diabetic retinopathy is a condition that occurs in people with diabetes. It is the result of progressive damage to the tiny blood vessels that nourish the retina. These damaged blood vessels leak blood and other fluids that cause retinal tissue to swell and cloud vision. The condition usually affects both eyes. The longer a person has diabetes, the greater the risk for developing diabetic retinopathy. At its most severe, diabetic retinopathy can cause blindness.
• Dry eye is a condition in which a person produces too few or poor-quality tears. Tears maintain the health of the front surface of the eye and provide clear vision. Dry eye is a common and often chronic problem, particularly in seniors.
• Glaucoma is a group of eye diseases characterized by damage to the optic nerve, resulting in vision loss. People with a family history of glaucoma and older adults have a higher risk. Glaucoma can be painless, with no symptoms. It can take away peripheral (side) vision.
• Retinal detachment is a tearing or separation of the retina from the underlying tissue, and most often occurs spontaneously due to changes to the gel-like vitreous fluid that fills the back of the eye. Other causes include trauma to the eye or head, health problems like advanced diabetes, and inflammatory eye disorders. If not treated promptly, it can cause permanent vision loss.

Other conditions eye exams can reveal about your health
During your eye exam, visual acuity (sharpness), depth perception, eye alignment, and eye movement are tested. Eye drops are used to make your pupils larger so your eye specialist can see inside your eyes. In addition to eye health, he or she may spot other health conditions, too.

1. Diabetes: Diabetes affects the small capillaries in the eye's retina. These blood vessels may leak blood
or a yellowish fluid, which may be discovered in an eye exam. If your eye specialist notices this, you may have a condition called diabetic retinopathy.
2. Hypertension: Blood vessels in the eye may exhibit bends, kinks, or tears, which may indicate high
blood pressure, a known risk factor for heart disease, diabetes, metabolic syndrome, and other illnesses, including blindness.
3. Autoimmune disorders: If the eye is inflamed, this may be a sign of Lupus or another disorder.
4. High cholesterol: The cornea may have a yellowish appearance or a yellow ring around it which can
be a sign of high cholesterol. There also may be plaques in the blood vessels of the retina, which could indicate elevated cholesterol.
5. Thyroid disease: One of the signs of thyroid disease are bulging eyes or protruding eyeballs. This condition is also known as Graves Disease.
6. Cancer: Just like you can get freckles and melanoma on your skin, you can also get skin cancer of the
eye. If you see a speck in your eye, ask your eye specialist to examine it. He or she will also check your eye color and pattern to make sure everything looks normal.
7. Tumors: You will be checked for blurry vision, improper pupil dilation (one eye dilating more than the other or remaining fixed), and optic nerve color. If something seems irregular, you may be referred to a neurologist.
8. Mental Health: People with mental illnesses like schizophrenia and bipolar disorder usually have different eye tracking patterns. Eye specialists can now map those movements through technology.
9. Aneurysm: Tell your eye specialist if you're experiencing blurry vision, eye pain, headaches, or loss of vision. You will also be checked for drooping eyelids (a sign that a blood vessel may have ruptured or is leaking), increased pressure in your eye, bleeding in the retina, and swelling of your optic nerve. Crossed eyes can be a sign of bleeding in the brain, possibly from an aneurysm, or even a stroke.
10. Multiple Sclerosis: Most eye tics are benign, but can also be an early indicator of neurological diseases like multiple sclerosis and Parkinson's. Your eye specialist can help with early diagnoses by checking for anomalies in your retina and optic nerve.
11. Vitamin A Deficiency: If you're not getting enough fruits and veggies (from foods like sweet potatoes, greens, cantaloupe, and carrots), you may develop night blindness and vision loss. Your eye specialist will check the surface of your eye for damage. Mention if you're having trouble seeing at night.

Lakes Region has a very active adaptive ski program

GILFORD — The Lakes Region is proud to be home to New England's premier adaptive snow-sports program. This year, 65 volunteer instructors and 10 junior volunteer instructors at Lakes Region Disabled Sports at Gunstock Mountain will have delivered more than 450 ski and snowboard lessons by the end of the season. LRDS provides its lessons every day to children and adults with disabilities, including veterans, with disabilities ranging from autism and cerebral palsy to traumatic brain injury, amputation, and blindness.
A significant part of the LRDS program involves the Barrington school SNAPS program, students from local school outreach programs, and the Monarch School of New England in Rochester. Monarch's students range in age from 5 – 21 and have significant physical, medical, developmental, behavioral, and emotional disabilities. Four days a week, LRDS gets different groups of students from Monarch and other schools out on the snow. Few things in life are more rewarding than seeing these children smiling and laughing as they learn to ski.
LRDS also hosts the annual Boston VA Winter Adaptive Sports Program. With some help from the wider community, this year's three-day veteran's event was a great success. LRDS hosted 16 disabled veterans from around New England and New York. Gunstock Mountain donated the lift tickets for the first day, and the instructors at the Alpine Ski School at Gunstock donated lift passes for the second day. Marriott gave LRDS a group veterans discount on two nights of lodging.

On the first day, the Wolfeboro Rotary Club provided lunch, and Bintliff's Ogunquit Restaurant of Ogunquit, Maine, provided dinner. On the second day, the Knights of Columbus of Wells, Maine, provided lunch, and Rolling Thunder of New Hampshire provided dinner at Fratello's Italian Grille, which also gave a veterans discount. Sal's Pizza provided lunch on the third day. LRDS, which funded the rest of the costs, thanks these businesses for their generous donations.
LRDS is a 501 c3 non-profit funded solely by donation. Gunstock Mountain generously provides discounts on lift tickets and rentals, and local businesses underwrite some events, but the bulk of the funding for this program comes through donations from the members of the Lakes Region community and beyond. 100% of all donations go directly to running the program.
On Saturday, March 18, LRDS holds its major annual fundraiser: Party on the Snow. This all-day event at the LRDS adaptive building at Gunstock Mountain Resort includes lift ticket, breakfast, BBQ lunch, t-shirt, costume contest and prize raffles. Come make a team of 4 and commit to fundraising a minimum of $500.
People can also support this worthy cause by visiting http://lradaptive.org/takeaction and clicking on the "Give" button, or by sending a check to Lakes Region Disabled Sports at Gunstock, Inc., PO Box 1307, Laconia, NH 03247. Lakes Region Disabled Sports at Gunstock Inc. is a 501 (C)(3) charitable non-profit organization, so the donation is tax-deductible.


03 09 Adaptive Ski


Lakes Region Disabled Sports at Gunstock Mountain will have delivered more than 450 ski and snowboard lessons by the end of the season. (Courtesy photo)

There are several types of heart attacks

By Martha Swats, Owner/Administrator, Comfort Keepers

Your heart muscle needs oxygen to survive. A heart attack occurs when the blood flow that brings oxygen to the heart muscle is severely reduced or completely cut off. This happens because coronary arteries supplying the heart muscle with blood flow can gradually become narrow from a buildup of fat, cholesterol, and other substances that together are called plaque.

This slow process is known as atherosclerosis. When a plaque in a heart artery breaks, a blood clot forms around the plaque. This blood clot can block the blood flow through the heart muscle. When the heart muscle is starved for oxygen and nutrients, it is called ischemia. When damage or death of part of the heart muscle occurs as a
result of ischemia, it is called a heart attack or myocardial infarction (MI).

Various types of heart attacks and related events
STEMI heart attacks: STEMI heart attacks are the deadliest type of heart attacks. STEMI is short for ST-segment elevation myocardial infarction. Sometimes called a massive heart attack or a widowmaker heart attack, a STEMI heart attack happens when a coronary artery is completely blocked. As a result, a large portion of the heart cannot receive blood, and the heart muscle quickly begins to die. Treatment options include angioplasty and stenting; clot-busting medication; and coronary artery bypass graft surgery (CABG).

NSTEMI heart attacks: NSTEMI stands for non-ST segment elevation myocardial infarction. NSTEMI heart attacks happen when blood flow to the heart through a coronary artery is severely restricted but not entirely blocked. An NSTEMI heart attack, often referred to as a mini or mild heart attack, usually causes less damage to the heart. It is likely that any coronary artery blockages are partial or temporary, and damage usually doesn't go through the entire heart muscle. Also, they are caused by different types of blood clots than STEMI heart attacks, with differing amounts of clotting proteins and platelet blood cells. Therefore, the treatment of NSTEMI heart attacks differs from the treatment of STEMI heart attacks. Clot-busting medications, for example, are not effective, and although PCI may be part of the treatment, opening the artery within 90 minutes is not a primary goal.

Demand Ischemia: Demand ischemia is another type of heart attack where blockages in the arteries may not be present. It happens when a patient's heart needs more oxygen than is available in the body's supply. It may occur in patients with infection, anemia, or abnormally fast heart rates. It also may be triggered by exercise or emotion. It is characterized by angina because of the increased oxygen demand. Blood tests will show the presence of enzymes that indicate damage to the heart muscle.

Silent heart attacks: A heart attack does not always have obvious symptoms. In fact, a heart attack can actually happen without a person knowing it, and are often referred to as silent heart attacks. Though they come with no symptoms, silent heart attacks are not harmless. They can cause permanent damage to the heart muscle.

Coronary artery spasm: A coronary artery spasm is when the artery wall tightens and blood flow through the artery is restricted, potentially leading to chest pain, or blood flow is cut off completely, causing a heart attack. Coronary artery spasm comes and goes. Because there may not be a build-up of plaque or a blood clot in the artery, a coronary artery spasm may not be discovered by an imaging test called an angiogram that is typically performed to check arteries for blockages. Treatment for a coronary artery spasm consists of medications such as nitrates and calcium channel blockers.

Cardiac arrest: Cardiac arrest is not a heart attack. With cardiac arrest, a person's heart stops beating. It can be due to a heart attack, but can also occur as a primary event. Cardiac arrest can occur for other reasons besides a blockage in the artery, including electrolyte disturbances, such as low or high potassium or low magnesium, congenital abnormalities, or poor pumping function of the heart. In a heart attack, the heart keeps beating, but can cause life-threatening arrhythmias that result in cardiac arrest within a few minutes, because the heart is not pumping blood to the lungs to pick up vital oxygen that circulates back to the heart and to the body.

Initial treatment will consist of cardiopulmonary resuscitation (CPR) and defibrillation – delivery of an electrical shock to restore the heart's rhythm. For people who are resuscitated and have a heartbeat, yet are unconscious, hypothermia protocols can be used, where the body is cooled for 24 hours, then gradually warmed. This has been shown to improve the odds of a good neurological outcome.

Seconds count in treating both heart attack and cardiac arrest. Cardiac arrest is especially critical, as the odds of survival go down by about 10 percent for every minute until the person is resuscitated. After 10 minutes the risk of permanent brain injury is very high.

Heart attack symptoms to watch for
Heart attack symptoms vary widely. One can experience minor chest discomfort, or excruciating pain. The classic symptoms of heart attack include a feeling of extreme pressure on the chest and chest pain, including a squeezing or full sensation. This can be accompanied by pain in one or both arms, jaw, back, stomach, or neck. Other symptoms include shortness of breath, nausea, vomiting, light-headedness, and breaking out in a cold sweat. Women are somewhat more likely than men to experience more of the other symptoms, such as light-headedness, nausea, extreme fatigue, fainting, dizziness, or pressure in the upper back. One thing applies to everyone, though: if you suspect you're having a heart attack, call for emergency medical help immediately.