CLEVELAND CLINICBeachwoodFamily Health Center

CheckupHealth Information from the

Family Health Center Closest to You

F A M I L Y Spring/Summer 2003

Play it SafeThis Summer!

For appointments with our

family health center specialists,

call the Cleveland Clinic

Appointment Center between

7 a.m. and 11 p.m., 365 days a

year, at 216/444-2273 or

800/223-2273.

ummer’s breezes entice motorcyclists to the

open road, beckon boaters and swimmers to lakes

and rivers, and prompt plans for backyard fun.

Cleveland Clinic family health center physicians

hope you’ll enjoy summer by putting safety first.

That wind in your hair may feel great,

but... please wear a helmet! Motorcyclists who cruise

at speeds of just 25 mph can sustain low-impact head

injuries that severely damage the brain. This can lead to

personality changes, coma, disability or death. After 40,

your brain is even more vulnerable to injury, especially

if you take aspirin or other blood thinners to protect

against heart attack or stroke.

Scooters and skateboards: rolling out new

guidelines... The American Academy of Pediatrics rec-

ommends scooters for kids 8 and up, and skateboards for

kids under 10 only if supervised. Scooters have created

a surge in ER visits. In the first nine months of 2001,

84,000 kids were treated in ERs for scooter injuries. Insist

on helmets to prevent head injuries, and encourage wrist-

and kneepads to prevent fractures. Steer skateboarders

toward skate parks with smooth surfaces, far from traffic.

A healthy respect for the water... Water safety

is important for the whole family. Drowning is the second

leading cause of death among children; toddlers and

teens are at greatest risk. Keep an eye on toddlers, even in

wading pools. CPR training for everyone — even your

sitter — can ease your mind. Out on the lake, always wear

your life jacket; have kids wear them dockside, too. Bring

your trusty ship-to-shore radio when venturing out on the

water. Tell a friend where you’re headed — and when

you’ll return. On Ohio rivers, watch for low-head dams,

signaling sudden drop-offs; carry your canoe or kayak

around them to safety.

Backyard trampolines: accidents waiting to

happen... If your kids love the trampoline, schedule

supervised sessions with a gymnastics instructor. The

American Academy of Pediatrics recommends that home

trampolines be banned, noting the 140 percent spike in

trampoline-related injuries between 1990 and 1996, when

83,000 trampoline accidents required an ER visit. Thirty

percent involved fractures, and often hospitalization and

surgery. In rare cases, spinal cord injuries occurred. So

make sure your kids keep their heads up — and their feet

on the ground. And enjoy your summer!

SFree Health Talk:

Preparing Your Child forAthletics

June 24, 6:30 to 8 p.m.Mandel JCCCall 216/444-9090

Full Body CT Scans AvailableCall 216/839-3000

Kid’s KornerKid’s KornerSports Physicals:Summer Is the TimePractice for fall high school sports typically begins in

August. Be sure to schedule a pre-participation eval-

uation for your athlete beforehand. Now’s the perfect

time to make an appointment.

Ohio High School Athletic Association regula-

tions require participation forms for athletes in

grades 9 through 12 to be completed and signed by a

physician, the participant, and a parent or guardian

before the first practice. Ohio law permits an M.D.,

D.O., chiropractor, physician’s assistant or advanced

nurse practitioner to perform physicals.

High schoolers should also have comprehensive

regular exams by their primary care physician to

assess their overall health.

At Beachwood, sports physicals can be scheduled

with pediatricians Conrad Foley, M.D., or Joseph C.

Lock, M.D., or our family medicine specialists.

Peanut Allergies: Cause for ConcernFrom potato chips to hot chocolate, many foods are

processed with peanut products. Experts say that may

be why peanut allergies — lifelong in 80 percent of

cases — are so common, and the leading cause of

fatal or near-fatal food reactions.

A promising genetically engineered drug made

headlines in March when early studies showed it pre-

Run With Care Warm weather seems to bring runners out of the woodwork. Run-

ning improves muscle mass, balance, strength and sleep, and reduces risks of heart disease, stroke,

colon cancer, osteoporosis, diabetes, obesity and depression.

But the American Academy of Orthopaedic Surgeons reports that runners are prone to overuse

injuries such as stress fractures — often in the foot or ankle. These occur when muscles become

fatigued and can’t absorb added shock, eventually transferring stress to bone, causing a tiny crack.

To prevent overuse injuries: ■ stretch muscles before and after running, to increase flexibility

and maintain range of motion ■ avoid hard, unforgiving terrain ■ begin strength training to im-

prove muscles’ ability to handle repetitive stress ■ replace shoes every few months and ■ consider

the amount and intensity of your exercise; pushing too

hard can cause injury.

The keys are to listen to your body — it will tell you

if a running program is too vigorous — and allow

plenty of time for rest and recovery.

To have a running injury evaluated by Beachwoodfoot and ankle specialist Brian G. Donley, M.D.,call 216/839-3000.

vented allergic reactions to peanut flour. However, it

has not yet been commercially developed.

So avoiding peanuts — and foods processed or

flavored with them (sometimes labeled as “natural”

flavors) — remains a must.

Check the ingredients of every snack and meal

for children; if ingredients aren’t labeled, pass on the

dish. Be wary in restaurants — traces of peanut

products may be found in oil, pans or utensils used

to prepare “peanut-free” dishes. Warn children

against sharing food, especially at school. Some chil-

dren can develop reactions by touching those who’ve

just eaten peanut butter, or toys or play equipment

they’ve handled.

Reactions range from itching in the mouth and

throat, to airway closure within minutes. Keep self-

injectable epinephrine and a liquid antihistamine

on hand, and be sure that teachers and child

care providers know how to handle an emergency.

Pediatric allergist Mercedes E. Arroliga, M.D.,

is available for consultation at Beachwood.

“Low-Tech” Treatment for ClubfootClubfoot is one of the most common congenital

orthopaedic conditions. Deformities of one or both

feet make walking very difficult. Fortunately, babies

today have an excellent chance of having clubfoot

deformities corrected without extensive surgery.

In the past, scar tissue, stiffness and early arthri-

tis in the foot often resulted from extensive surgery.

Now, positioning the foot differently for casting cor-

rects clubfoot in 90 to 95 percent of the cases. A series

of casts is required from birth to 3 months of age,

followed by several years of wearing corrective shoes.

This often corrects the deformity without any sur-

gery. Sometimes, a simple outpatient operation to re-

lease one heel tendon is all that’s needed.

Beachwood pediatric orthopaedic surgeon R.

Tracy Ballock, M.D., has special training in this

new nonsurgical treatment of clubfoot deformities.

To schedule an appointment foryour child at Cleveland ClinicBeachwood, call 216/839-3000.

MANY people temporarily

experience tinnitus (ringing,

buzzing, whistling, hissing

or rushing noises) in their ears or head. For more

than 12 million people, it’s a persistent problem. For

some, it interferes with the demands of everyday life.

Our family health center otolaryngologists can

rule out health-related conditions causing the prob-

lem. Our audiologists can then do a thorough

hearing evaluation. Together, they can determine

whether you are a candidate for the Tinnitus Man-

agement Clinic at Cleveland Clinic main campus.

While there is no universal cure, certain mea-

sures provide relief. Tinnitus rehabilitation plans

may include sound therapy and/or noise generators,

biofeedback and behavior modification. For evalua-

tions by otolaryngologists Tom Abelson, M.D.,

or Alan Kominsky, M.D., and audiologists Ann

Guzauskas, M.A., CCC-A, or Kellie Tortorea, M.A.,

CCC-A, call 216/839-3000.

What’sThatNoise?

Healthy Summer EatingAS SUMMER APPROACHES, many of us want to

shed pounds along with layers of clothing. According

to the American Dietetic Association, the popular

high-protein, low-carbohydrate diets suggest that

carbohydrates are “bad for you” and make you gain

weight. But high-protein, low-carbohydrate diets

tend to be low in calcium, fiber and nutrients that

protect against heart disease and cancer.

Dieters who eat more total calories and get less

physical activity will wind up gaining weight. Our

nutrition specialists recommend foregoing fad diets.

Instead, adopt healthy weight management tech-

niques. Eat fewer fast foods, measure portion sizes,

and increase your intake of fruits, vegetables and

foods low in fat and high in whole grains. Eat fewer

calories than you burn, and increase your physical

activity.

Variety and moderation are key, as are total calo-

ries. Eat fewer calories and/or get more exercise, and

you’ll lose weight.

Computers Now KeepMedical RecordsCOMPUTERS CAN NEVER REPLACE physicians,

but are excellent tools for improving efficiency, con-

venience and privacy in a doctor’s office. That’s why

primary care physicians and many specialists at our

family health centers rely on a state-of-the-art soft-

ware program for medical record-keeping.

During your office visit, you’ll experience the

usual doctor-patient interaction as your physician

inquires about symptoms. But instead of hand-writ-

ing notes on paper, your doctor will enter informa-

Guarding AgainstWest Nile Virus

Peggy Zeller, R.D., L.D., is a registered dietitianavailable for consultation at Beachwood Nutri-tion Services; call 216/839-3000.

tion into a personal computer in the exam room.

With the click of a mouse, the doctor can review

or add to your medical record, or send information

Mosquitoes — once mere annoyances— now pose a threat due to West Nile virus,which can infect mosquitoes, birds, horsesand people. Last summer, eleven of 211Cuyahoga County residents with infectionsdied.

Typically, West Nile virus causes nosymptoms, the Centers for Disease Controland Prevention reports. In 20 percent of cas-es, mild fever, headache, body aches, skinrash and swollen lymph glands develop. Inone of 150 cases, severe illness ranges fromheadache, high fever and stiff neck to stupor,coma, convulsions and paralysis.

West Nile virus doesn’t appear to spreadfrom animals to people, or directly fromperson to person. In rare instances, it hasbeen transmitted through breast milk andorgan transplantation, but risks are slight,experts say.

Meanwhile, protect yourself with insectrepellent containing DEET (N, N-diethyl-meta-toluamide) on skin and clothing out-doors, and wear long-sleeved shirts andpants. Stay inside at dawn, dusk and earlyevening, when mosquitoes are hungriest.And eliminate standing water (mosquitobreeding grounds) from your yard.

Beachwood family medicine or internalmedicine specialists and pediatricians areavailable to discuss your concerns; pleasecall 216/839-3000.

CRP: New Clue to HeartAttack, Stroke RiskTHE MYSTERIOUS molecule CRP (C-reactive

protein) may be as much of a “smoking gun” for

artery disease as cholesterol, experts believe. An

elevated CRP level indicates inflammation and was

traditionally associated with arthritis. Now it’s linked

to inflammation of the arteries as well. The result

can be instability and rupture of a plaque, the cause

of heart attacks and strokes.

The American Heart Association (AHA) recom-

mends CRP testing for people whose age, blood pres-

sure, cholesterol level, family history or habits put

them at risk for heart disease within10 years.

Cleveland Clinic family health center cardiolo-

gists believe the simple, inexpensive blood test could

supplement cholesterol screening by estimating risk

in those without symptoms of heart disease. The AHA

considers screening unnecessary for people at very

low risk of heart disease; researchers have not proved

that lowering CRP reduces risk.

Presently, everyone with high CRP levels should

begin aggressive preventive measures, including

cholesterol-lowering medication, healthier eating,

exercising and — especially — giving up smoking.

For appointments with cardiologists Joel B. Hol-

land, M.D., or Michael B. Rocco, M.D., please call

216/839-3000.

Board-certified family medicine spe-cialist Kenneth I. Goodman, M.D., hasa special interest in the integrationof computers and medicine.

to another physician for a second opinion. To ensure

privacy, the information can only be accessed by

a physician or nurse, pledged to maintain confi-

dentiality.

Patients benefit from their physician’s electronic

access to test results, and X-ray and prescription in-

formation, which can be printed out at their visit.

AppointmentsCleveland Clinic Beachwood26900 Cedar RoadBeachwood, OH 44122216/839-3000 or 866/318-2491

Monday through Thursday: 8 a.m. to 8 p.m.

Friday: 8 a.m. to 5 p.m.

Saturday: 8 a.m. to noon

Cleveland Clinic and Hillcrest HospitalRehabilitation and Sports Health(Mandel Jewish Community Center)26001 S. Woodland RoadBeachwood, OH 44122216/378-6240

Monday through Thursday: 7:30 a.m. to 7 p.m.

Friday: 8:30 a.m. to 5 p.m.

Cleveland Clinic Cancer Care Center atBeachwoodTo see our medical oncologists about cancer diagno-

sis or treatment, please call

216/839-3000

To speak with a nurse about cancer symptoms or

concerns, Monday through Friday from 8:30 a.m. to

4:30 p.m., please call the Cleveland Clinic Cancer

Answer Line:

216/444-7923 or 800/862-7798

Cleveland Clinic Family Checkup is published by theDivision of Marketing to provide up-to-date health infor-mation and news about Cleveland Clinic Family HealthCenter services. The information contained in ClevelandClinic Family Checkup is for educational purposes onlyand should not be relied upon as medical advice. It hasnot been designed to replace a physician’s medical assess-ment and medical judgment.

Editor: Cora Liderbach

Art Director: Amy Buskey-Wood

Photographer: Tom Merce

Illustrations: Doreen Klimkiewicz

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CLEVELAND CLINIC

Nurse on CallTo speak with a nurse, 8 a.m. to 11 p.m.,

Monday through Friday, about your adult and

pediatric health concerns, call

216/444-1234800/801-2273

Other Family Health Centers

Brunswick 330/225-8886

Chagrin Falls 440/893-9393

Creston 330/435-5400

Elyria 440/366-8822

Independence 216/986-4000

Lakewood 216/521-4400

Lorain 440/204-7400

Solon 440/519-6800

Strongsville 440/878-2500

Westlake 440/899-5555

Willoughby Hills 440/943-2500

Wooster 330/287-4500

Cleveland Clinic Beachwood

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Joseph Golish, M.D., head of the

Cleveland Clinic’s Section of Pulmonary

and Critical Care Medicine, now sees

patients at Beachwood as well as main

campus. He is a pulmonary specialist

and board-certified sleep specialist.

A graduate of the Ohio State Univer-

sity College of Medicine and Public Health in Columbus, he completed his

internship, residency and fellowship at The Cleveland Clinic.

For appointments, call 216/839-3000.

Women’s Health

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PERMIT NO. 4184Family Checkup / W149500 Euclid Avenue, Cleveland, OH 44195

THE CLEVELAND CLINICFOUNDATION

Is Menopausal HormoneTherapy for You?The National Institutes of Health recently changed

the name of the supplemental estrogen and pro-

gestin given to menopausal women from “hormone

replacement therapy” to “menopausal hormone

therapy.” This reflects the true goal of treatment:

short-term control of menopausal symptoms, rather

than restoration of hormones to youthful levels.

A recent Women’s Health Initiative study cast

doubt on the ability of one popular estrogen and

progestin supplement to improve women’s quality

of life.

However, the North American Menopause Society

reports the study did not target younger women

(aged 40 to 50) more likely to suffer symptoms: hot

flashes, sleeplessness, painful vaginal tissue thinning

and mood swings. When such symptoms interfere

with quality of life, women should consider meno-

pausal hormone therapy in the lowest possible doses,

for the shortest time necessary, the society suggests.

To make an informed choice about whether

menopausal hormone therapy or alternatives are

right for you, seek a mid-life evaluation from your

doctor to determine your personal risk profile.

Physicians at Beachwood OB/GYN Specialtiesare available for consultation at 216/839-3100.

Screening vs. DiagnosticMammogramsBreast cancer is treated most effectively in its early

stages. Mammography, together with regular breast

exams by a health care professional and monthly

breast self-exams, offer women the best chance for

early breast cancer detection.

The American Cancer Society recommends

“screening” mammograms every one to two years

for women between 40 and 50, and annually for

women over 50, unless you have a family history of

breast cancer.

If you, your doctor, or the screening mammo-

gram detect a possible abnormality, a “diagnostic”

mammogram is your next step. Using the same

equipment as screening

mammograms, it zeroes in

on the questionable area.

If you require treatment

for breast cancer, Beach-

wood’s Cancer Care Center

provides comprehensive

services. Oncologist Vinit K.

Makkar, M.D., is one of

the specialists available;

call 216/839-3000.

First Step in Family Planning:Stop SmokingMost women realize smoking causes serious lung

and heart problems. Some are aware that smoking

prematurely ages their skin. But few know that it can

harm their reproductive systems.

Women smokers have higher rates

of infertility, and miscarriage and other

complications during pregnancy and

childbirth. Their newborns often weigh

less than they should, and are prone to

illness during their early years. Smok-

ing also triggers earlier menopause,

and increases risks of osteoporosis,

bladder problems and female cancers.

Smoking reduces fertility in men

as well.

If you smoke, make quitting your

first step in family planning. Ask your

doctor’s advice about several options

now available to help you.

Obstetricians recommendthat women who are try-ing to get pregnant:

Quit smoking at leastfour months beforehand,

Avoid secondhandsmoke, and

Keep homes smoke-freebefore and after thebaby arrives.

If you are having difficultiesconceiving, infertility spe-cialist James Goldfarb, M.D.,and colleagues at BeachwoodOB/GYN Specialties can helpyou; call 216/839-3100.