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HEALTHY LIVING for your BODY & MORE
MARCH 2018
HEALTHY LIVING for your BODY & MORE
MARCH 2018
2 • BODY AND MORE
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HEALTHY LIVING • 3
The desire for healthy, clean-looking
skin drives the multibillion dollar cosmet-
ics and skincare industry. According to data
from the Semi-Annual Consumer Insight
Snapshot from DermStore, a leading skin
care e-commerce website, 67 percent of
consumers surveyed are very or extremely
interested in trying products for their spe-
cific skin concerns.
The top five skin concerns across the
United States include aging, uneven skin
tone, sensitive skin, dark circles, and sun
damage. To address concerns about their
skin, consumers are increasingly turning to
in-spa and dermatology services, such as
facials, peels and fillers. However, navigating
skin treatment jargon can be tricky. Here are
some popular services and what they entail.
Laser Toning
While a traditional facial typically cleanses
the face using steam to open up pores, laser
toning uses short, concentrated pulsating
beams of light at irregular skin, precisely
removing skin layer by layer. Laser ton-
ing polishes the skin, improves tone of the
skin, brightens the appearance of skin,
and so much more with no downtime.
It also shrinks pores and is a comfort-
able procedure.
Facial Rejuvenation
Chemical and laser peels rely on various
acids or lasers to exfoliate and peel off the
outer layer of skin. The skin beneath is usu-
ally more smooth and less wrinkled. Some
deep treatments target the middle layer
of skin to remove damaged skin cells. The
American Society for Dermatologic Surgery
says that peels can be used to treat anything
from acne to aging skin to scars. Salicylic
acid and malic acid may be used in mild
peels. Trichloroacetic acid, or phenol, is used
for more potent chemical peels, such as a VI
Peel. Peels, specifically medium depth, peels
are best left to be performed by a nurse.
Facial masks & treatments
Masks may contain many different
ingredients designed to treat various skin
problems. A botanical mask, for example,
reveals healthier-looking skin. One treat-
ment is the Epionce Facial Treatment that
uses effective formulas free of parabens, fra-
grance, sulfate and gluten. Masks and treat-
ments are usually applied, and then there is
a waiting period, during which the mask or
treatment is allowed to rejuvenate the skin.
BroadBand Light
BroadBand Light or BBL is the world’s
most powerful intense pulsed light device
on the market. It sets a new standard for
treating skin conditions. This procedure
is gentle and safe with virtually no down
time. The light energy delivered by BBL will
gently heat the upper layers of your skin;
this will stimulate your cells to regenerate.
The regeneration will restore your skin to its
natural beauty, making it clearer, smoother,
vibrant and younger looking. The photother-
mal energy will eliminate fine vessels that
cause redness and reduce unwanted melanin
that produces age and sun spots. BBL can be
used to treat age spots, small facial veins, and
many other skin conditions. BBL can be the
foundation for and used in conjunction with
other treatments.
Microneedling
A newer solution for skin tightening for
the face, neck and body is a comfortable
alternative to invasive procedures. There is
little downtime and has dramatic results.
The Vivace Radiofrequency Microneedling
(also known as collagen induction therapy) is
cleared by the FDA and rejuvenates the skin
using a device with fine needles that create
tiny punctures in the top layer of the skin
that stimulates the body to create new col-
lagen and elastin.
Cosmetic fillers
Injectable dermal fillers can soften facial
creases, reduce wrinkles and improve the
appearance of scars, says the American Soci-
ety of Plastic Surgeons. These procedures are
best left to trained health care professionals.
Brought to you by Associated Dermatology
SKIN CONCERNS? You are not alone
4 • HEALTHY LIVING
GLENNA WORTMAN-OBIE
Please, read that headline
once more — then, one more
time. In the minute or so it
takes you to read that head-
line three times, another two
or three people will go to the
emergency room with a trau-
matic head injury — 1.5 million
Americans each year according
to the Brain Trauma Founda-
tion.
Traumatic brain injury (TBI)
is the leading cause of death
and disability in children and
adults from ages 1 to 44 and
every year, approximately
52,000 deaths occur from
traumatic brain injury. Here are
some other alarming statistics
from BrainTrauma.org:
� An estimated 1.6 million to
3.8 million sports-related TBIs
occur each year.
� At least 5.3 million Ameri-
cans, 2 percent of the U.S.
population, currently live with
disabilities resulting from TBI.
� Males are about twice as
likely as females to experience
a TBI.
The number of people with
TBI who are not seen in an
emergency department or
receive no care isn’t known,
but what is certain is that
concussion in kids is a grow-
ing concern. “Concussion” is a
commonly used term for mild
traumatic brain injury, caused
by a bump or blow to the head,
which changes how your brain
normally functions. Concus-
sions may also occur from a jar
to the body that causes the head
to move rapidly back and forth
and can occur without a loss
of consciousness. Concussions
are common among children
and adolescents and can result
from sporting activities, motor
vehicle accidents, everyday
activities (e.g., playground
accidents), and common mis-
haps, to name a few.
When I fell from my horse as
a child, I remember seeing stars
and having a severe headache.
My parents rubbed my head and
said, “Oh, it’s just a little bump
on the head. Sit down for a bit
and it will get better.” Their
attitude was not unique and
years later, as a young mother,
I still viewed “a little bump on
the head” as a minor mishap to
be shaken off.
Recent research, however, has
highlighted significant short
and long-term consequences
of concussion in children,
including the development of
persistent post-concussive
symptoms that involve physical,
emotional, behavioral, and cog-
nitive changes, some of which
are not commonly associated
with concussion, according to
Dr. Eric Aune, Pediatric Neuro-
psychologist at Intermountain.
“Lack of awareness of symp-
toms can lead to delay in diag-
nosis and treatment, resulting
in significant problems for
children and adolescents alike,”
Dr. Aune says.
Aune names common
post-concussion symptoms
to include: headache, nausea,
visual/auditory disturbances,
attention difficulties, memory
problems, fatigue, emotional
disturbances such as anxiety
and depression, dizziness,
behavioral changes, irritability,
sleep problems, and academic
difficulties. He advises that
the child or athlete immedi-
ately be removed from play or
routine activities if concussion
is suspected.
“Another concussion during
recovery from previous concus-
sion can lead to more serious
problems,” Dr. Aune notes.
Studies show that up to
one-third of children still have
symptoms after one month,
10 percent at three months,
and less than 5 percent are
still symptomatic at one year.
Therefore, while most children
who sustain an isolated concus-
sion will recover within one
month, many children remain
symptomatic long-term, and
those children often experience
problems with school, daily
living skills, sporting achieve-
ment, and social activities.
When a child has experienced
a concussion, Dr. Aune rec-
ommends a multidisciplinary
treatment approach that may
include immediate medical
attention, pediatrician moni-
toring, rehabilitation services
(e.g., physical therapy, etc.),
and assessment and consulta-
tion from a qualified pediatric
neuropsychologist. In cases of
persisting concussion symp-
toms (e.g., more than two
weeks), treatment is often best
determined by a licensed medi-
cal professional and neuro-
psychologist, and may include
individualized treatment plan-
ning that involves a detailed
return-to-play and return-to-
school protocol.
“These recommendations
cannot be understated,” Aune
says. “Prematurely returning
to activities risks worsen-
ing pre-existing symptoms
and prolonging recovery,
both of which are commonly
observed in pediatric concus-
sion. Conversely, inappropri-
ate recommendations of rest
and restriction from sporting,
academic, and social activities
can magnify already exist-
ing symptoms.”
Concussion is a complex and
ever-evolving medical condi-
tion that has the potential to
affect multiple aspects of a
child’s functioning.
Meanwhile, we hope you
will take the time to learn
all you can about traumatic
brain injury and concussion
so that you can react without
hesitation should you or your
child suffer “a little bump on
the head.”
Provided by Glenna Wort-
man-Obie, MA, Director of
Communication, Intermountain
March is Brain Injury Awareness Month
Remember When You Could KissTheir Hurts Away?
Outpatient Clinical Services:• Occupational Therapy • Co-occurring Substance Use & Mental Health Therapy• Adolescent Substance Use Assessment & Treatment • Psychological Assessment• Home Support Services • Youth Case Management • Individual & Family Therapy• Psychiatric Medication Management • Therapeutic Foster Care & Adoption
Intermountain has over 900 children and families in care every day.If we can help your family, please call.
3240 Dredge Drive | 406.442.7920
www.intermountain.org
HEALTHY LIVING • 5
EMILY HEDUM
Growing up, my family saw
our primary care provider (PCP)
for all routine care and sick
visits. I enjoyed the relation-
ship that developed between my
family and our PCP, and since
medicine had always been my
dream job, I knew early on that I
would become a PCP.
PCPs are generally family
nurse practitioners, internists
or family medicine specialists.
We see patients on an on-going
basis and provide care through-
out a patient’s life.
PCPs are good for both your
health and your pocketbook.
Here’s why:
1) A PCP’s goal is to build
a relationship with his or her
patients. While trips to Urgent
Care and the Emergency
Department are sometimes
necessary, the providers you see
in those settings are focused
on stabilizing and treating the
acute issue. Your PCP, on the
other hand, learns over time
what combination of treatments
and medications work best for
you and fit with your lifestyle.
2) When I see a patient, I
believe in a holistic approach
that focuses on the whole
person. Although many of my
patients see specialists as well
for specific health issues, my
focus is to treat the entire body
and find ways for you to main-
tain or regain optimal health.
3) I think the phrase “in sick-
ness and in health” also applies
to a PCP’s relationship with
patients. When we establish
a complete health history by
seeing patients when they’re
healthy, it helps us identify
concerns early, before they can
become significant issues. If
PLEASE SEE PRIMARY, Page 6
5REASONSprimary care provider
to have a
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6 • HEALTHY LIVING
something concerning were to
pop up in a routine lab test, it
can often be addressed simply
by adjusting your lifestyle or
trying a new medication or
treatment. Focusing more on
preventive care saves you money
and helps prevent conditions
from worsening.
4) Consider your PCP your
own personal health care hub.
We help patients access the
right specialists by making
referrals when necessary, and
reducing unnecessary duplica-
tion of services like lab tests.
Our goal is to help facilitate your
care, so sharing information
about your health history may
eliminate the need for additional
tests and save you time, money
and unnecessary stress.
5) The most important thing
to remember is that patients
can choose their primary care
physician. Everyone has unique
preferences, personalities and
communication styles. I often
tell people not to just choose
the first PCP they see, because
being comfortable in this rela-
tionship matters. The more our
patients open up to us and share
their symptoms, concerns and
health goals, the better care we
can provide to them.
I also encourage people to
ask friends and family members
they trust to recommend a PCP
in the community. Another
important consideration is to
make sure you choose a provider
who participates in your insur-
ance network. Coverage infor-
mation can either be accessed
on your insurance company’s
website or by calling the insur-
ance company or the provider’s
business office. A provider’s
location and hours of operation
can also be a factor for those
looking for care close to work
or home.
It is important to note that
there is a shortage of PCPs in
Helena and around the country;
however it is generally agreed
upon that people with PCPs are
healthier and pay less for their
health care. As a result, there
is a nationwide effort to invest
in primary care, and St. Peter’s
Health is one of 2,900 primary
care practices participating in
a five-year pilot program called
Comprehensive Primary Care
Plus (CPC+). CPC+ was devel-
oped and funded by the Center
for Medicare and Medicaid Ser-
vices (CMS), and is designed to
improve access to primary care
providers and improve health
outcomes for patients through
team-based care. Instead of
having just a single PCP, your
physician leads an entire team
of health care professionals –
nurse practitioners, pharmacists
and nurses – who are working
collaboratively to support you
before, during and after your
office visit. The team-based
approach means patients can be
seen sooner and receive more
comprehensive care each time
they interact with the provid-
er’s office.
No matter who you choose,
having a PCP is important for
your overall health. If you or a
loved one does not have a PCP, I
encourage you to ask for recom-
mendations and find one you
can trust.
Emily Hedum, D.O. specializes
in Family Medicine at St. Peter’s
Health Medical Group- North
Clinic. Hedum earned her Doctor
of Osteopathic Medicine degree
from Kansas City University
of Medicine and Biosciences
in Kansas City, Mo. She com-
pleted her residency at Montana
Family Medicine in Missoula,
Mont. where she served as Chief
Resident. Hedum is certified by
the American Board of Family
Medicine and is a member of the
American Medical Association
and American Osteopathic Asso-
ciation.
PrimaryFrom Page 5
HEALTHY LIVING • 7
LAUGHING WATER
Obesity is not your destiny.
Some experts say we were
built to be overweight.
Their story is that humans
evolved in times of food scarcity.
So our prehistoric ancestors ate
whatever and whenever they
could, storing as much fat as
possible to survive lean times.
Now we’re surrounded by
food, but we’re still genetically
programmed to eat it and store
it as fat whether we need it or
not. In other words, obesity is
our destiny.
I disagree. Think about it.
Would a hundred extra pounds
help you escape predators
and enemies?
Your body knows better. Given
the chance, it signals when
you’ve eaten enough. Even bet-
ter, it seems to be endowed with
a rich set of cravings for specific
foods you need to eat. How else
could our ancestors have eaten
balanced diets ages before they
knew anything about nutrition?
Let’s look at how we got the
extraordinary brain that makes
us homo sapiens (“wise man”
in Latin).
Brains don’t come cheap,
biologically speaking. Ours is
very large relative to other pri-
mates, and although it’s only 3
percent of our weight, it burns
20 percent of our energy. Its
evolution required a bigger head
(cranium) and more calories.
Hunting and cooking were
technologies that meant more
calories and less chewing.
It’s interesting that the size of
the cranium was apparently lim-
ited by gorilla-style jaw muscles
attached to a Mohawk-like
sagittal crest. You can see that in
today’s mountain gorillas, which
spend half their day chewing.
About 10,000 years ago
humans applied those big brains
to agriculture, the technology of
raising foods rather than hunt-
ing them. Starchy foods, such as
grains and beans, represented a
major dietary shift.
A greater shift came 200 years
ago with the industrial age when
we started producing refined
foods, particularly white flour
with few nutrients and white
sugar with no nutrients, just
calories. And today, with even
more modern technology, you
can get maximum calories with
minimum time and effort, no
chewing necessary. That’s a per-
fect formula for obesity.
The problem is not that our
genes failed. Like I said, your
body knows better. But you need
to give it a chance.
Your body has a really good
Your body knows
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8 • HEALTHY LIVING
insufficiency, prolonged immobility) or trauma inside a vein. Surgery, pregnancy and certain cancers can also make blood less fluid.
The most common form is superficial phlebitis, in which the clot forms inside a surface vein. Inflammation, pain and discomfort are the main symptoms. This type of phlebitis
greater blood flow and pressure, clots in deep veins are more likely to detach, travel to
If you lack the will to work out, pop in your earbuds and let music come to the rescue.
It’s been proven that music has a stimulating effect during physical activity. This is easily observed in settings such as aerobics and spin classes, where music and exercise are inexorably linked, with increases in tempo naturally encouraging participants to push themselves harder. Nevertheless, it seems that the benefits of listening to music are pretty much the same, regardless of the tune’s tempo and pace. Listening to songs that are of particular significance to you may further enhance music’s motivational power, according to some researchers.
Studies show that music helps improve athletic performance. For one, focusing on whatever’s playing in our ears makes fatigue less apparent. It also works wonders for endurance, energy and strength. Walking or running in rhythm, for example, helps keep energy levels high.
So, what are you waiting for? It’s time to create your workout playlist!
greens, is packed with health benefits.
pesky undesirables that damage healthy cells. In addition to having anti-inflammatory,
Because vitamin E deficiencies are very rare, it’s strongly recommended that you
The motivational power of music
disorder can be defined by the tendency to anticipate and blow potential difficulties
problem. Severe cases
Humans’ body temperature normally hovers around 37 °C. It’s generally a bit lower in the morning and a bit higher in late afternoon. A body temperature above 38 °C (100.4 °F), measured orally, is considered a fever. Fevers mainly occur as a symptom of infection and are selflimiting in most cases.
If you have a fever, it’s important that you get plenty of rest and drink lots of water (avoid ice-cold water, though) to replenish fluids lost from sweating. Acetaminophen, ibuprofen and cold compresses can also be used to reduce unpleasant symptoms. Dress lightly and turn down the thermostat slightly (or turn on a fan) for further comfort.
If the fever is high (39.5 °C or higher), persists for more than 72 hours, occurs in a child younger than six months old or is accompanied by other worrisome symptoms (e.g. neck stiffness, rashes or convulsions), seek medical attention immediately.
How to deal with a fever
flammation. This is due to the spread of
Consuming lots of fluids will also dilute
The answer: it’s fiction! Despite the common belief, white spots on nails are not caused by a lack of calcium. If you notice some on your own nails, then, no need to run to the store to stock up on milk.
Common and largely benign, white spots on nails are mainly caused by mild trauma to the nail’s base, or matrix, which can lead to issues with keratinization. Put simply, the matrix synthesizes keratin, which overlaps in several layers to allow nail growth. A slight impact can cause an irre
gularity in how these layers overlap, leading to a transparency defect in the shape of a small white spot.
Less common causes of white spots include allergic reactions (usually to nail polish), fungal infections, eczema and thyroid problems. If the white spots on your nails seem unusually numerous or persistent, consult your doctor. If not, all you need to do is wait for your nail to grow long enough to make the white spot disappear with a clip.
Calcium deficiency causes white spots on nails: fact or fiction?
Hemorrhoids are blood vessels in the anal canal that, when inflamed or swollen, can bleed and cause itching and pain. Here are some tips on how to prevent and soothe them.
TO PREVENT HEMORRHOIDS
• Eat lots of fibre-rich foods to prevent constipation.
• Drink lots of water to aid digestion.• Be physically active to stimulate your di
gestive tract and prevent obesity (a risk factor for hemorrhoids).
• Don’t stay seated for prolonged periods (try to get up every hour), as this increases pressure around the anus.
• Use the bathroom as soon as you feel the
need to (or else your stool will be hard and dry), don’t stay on the toilet for longer than necessary (this position relaxes your muscles and increases blood flow to the anal region), and don’t strain to help evacuate the stool.
TO RELIEVE HEMORRHOIDS
• Avoid heavy lifting, which increases pressure in the veins.
• Use an unscented moist towelette to wipe after each bowel movement.
• Apply cold compresses for ten minutes, three or four times a day, to relieve itchiness.
• Take a 15minute sitz (hip) bath two or three times a day with warm water to reduce pain from external hemorrhoids.
• Avoid consuming foods and beverages known to irritate mucous membranes (e.g. coffee, very spicy dishes).
Finally, certain overthecounter medications (creams, suppositories) can help relieve symptoms related to hemorrhoids; ask your pharmacist for recommendations. Acetaminophen can be used to reduce pain, but avoid ibuprofen and aspirin, which may increase bleeding. If the situation persists for more than seven days, or if you experience heavy bleeding or intense pain, seek medical assistance.
Health tips for preventing and relieving hemorrhoids
Are some juices healthier than others?
Your best bets when it comes to massproduced juices are those that are 100 per cent pure fruit juice. As their name suggests, pure juices don’t contain any added sugars, colours or flavours. They’re nu tritious and count as a serving of fruit. But even though the sugars they contain occur naturally, fruit juices are still highly sugary beverages. That’s why it’s important to drink them in moderation — no more than one or two servings a day.
Usually made from concentrate, beverages labelled as fruit “punch” or “drink,” on the other hand, almost always contain added sugars. Nectars can also be extremely sugary. Bottom line: make it a habit to read the ingredients before you buy.
HEALTHY LIVING • 9
EMERSON GODBOLT
The secret has been out for a while and
the understanding is becoming deeper
and deeper by the day. You can go for your
annual check up only to fall victim to a heart
attack or stroke with even a small amount
of arterial plaque build up. The old adage
that plaque in your arteries from a fatty diet
caused the heart attack is no longer held as
fact. Yes, it is plaque that blocked the artery
but even after a bypass people have heart
attacks in arteries that were thought to be
open. Inflammation is what dislodged the
plaque and what caused plaque formation in
the first place.
This inflammatory process can come
from a variety of factors. But one silent
area that can cause a tremendous amount
of inflammation is our mouths. The most
chronic infection in Americans is gum dis-
ease, and cardiac specialists are now finding
dental bacteria related to heart disease in
arterial plaques. So it is safe to say if you
have plaque build up in your mouth, you
may be putting your overall health at greater
risk than once thought. The American Jour-
nal of Cardiology and The Journal of Peri-
odontology issued a consensus that:
� Patients with moderate to severe gum
disease be warned of their potential cardio-
vascular danger.
� Annual blood pressure and complete
physical should be completed on patients
with gum disease.
� Diabetes, high cholesterol and family
history of cardiovascular disease should also
be evaluated.
� People with gum disease and one or
more other cardiovascular disease risks
should be treated with lifestyle changes and
medication, if necessary.
The 2014 book Beat the Heart Attack
Gene by Bradley Bale and Amy Doneen
discusses many of these risk factors, as well
as prevention strategies. One study tracked
the oral habits of 5,611 seniors. They found
that not seeing a dentist in the previous
12 months raised their risk of death by 50
percent, never flossing increased their
mortality by 30 percent, and never brushing
increased their mortality by 20-25 percent.
Dr. Bale writes that with “the right care, all
heart attacks and strokes are preventable.”
According to the Center for Disease
Control, every 40 seconds someone is hav-
ing a heart attack. There are many things
that can increase our risk for a heart attack
or stroke, but these risk factors can be
identified and managed by your doctor and
dentist working together. A key example of
this is insulin resistance. You may not even
be pre-diabetic, but you could have insulin
resistance. If you have periodontal disease,
it will worsen your insulin resistance, and
as your insulin resistance increases, so will
your gum disease.
Very simple tests can be performed to
unravel your overall risks for a heart attack
or stroke. There is a wealth of information
surfacing since the publication of this book.
Entire organizations have devoted their
research to linking the oral systemic con-
nection in hopes to aid in prevention. For
more information please go to http://beat-
theheartattackgene.com.
Emerson Godbolt, DMD, Associate Dentist,
South Hills Dental, Helena
Unraveling the oral systemic connection
Minimally Invasive Cosmetic &Reconstructive Dentistry
Emergency Care | Nitrous OxideSleep Apnea Appliances
Dry Mouth Therapy | Implants | IV SedationNew Patients Welcome
2480 Tracy Drive, Helena, MT 59601
406-443-2780
southhillsdental.com
Joel Maes
DDS, MAGD
Emerson Godbolt
DMD
Kathryn Sealey
DDS
Serving Helena since 1981!
10 • HEALTHY LIVING
DR. SARAH EVANS
Once considered only the
realm of celebrities, cosmetic
surgery is now accessible and
increasingly common for mil-
lions of Americans. In 2016,
more than 17.1 million cosmetic
procedures were performed in
the United States, according to
the American Society of Plas-
tic Surgeons.
Plastic surgeons perform
both reconstructive and cos-
metic procedures. Reconstruc-
tive procedures are typically
medically necessary procedures
that are covered by insurance
and restore the form, function
or appearance of areas of the
body affected by trauma, con-
genital or development abnor-
malities or tumor removal. On
the other hand, cosmetic sur-
gery is elective. Although it is
not typically paid for by insur-
ance, it can have a profound
impact on your life.
When I talk to my patients,
many express they have chosen
to have cosmetic surgery to
restore a more youthful appear-
ance, restore body contour after
a pregnancy or massive weight
loss, or reshape and enhance
the body to achieve a preferred
appearance. Many can achieve
their desired results with non-
surgical cosmetic procedures
like injections (such as Botox)
or dermal fillers. For those
who pursue surgical options,
the most common cosmetic
surgery procedures are breast
augmentation, eyelid sur-
gery, facelift, liposuction, and
nose reshaping.
There are three important
things anyone considering
plastic surgery should know:
1. Expect to have a candid
discussion about your expecta-
tions with your surgeon prior
to surgery.
I encourage patients to come
to their initial consultation
with their surgeon able to share
what bothers them about their
appearance and what improve-
ments they would like to see.
This allows the surgeon to make
recommendations on what pro-
cedures will best address their
specific concerns. I always want
my patients to feel comfortable
openly and honestly relay-
ing their expectations from
the surgery. It’s then the sur-
geon’s responsibility to share
whether their expectations
can realistically be met with a
particular procedure. When a
surgeon and patient understand
each other’s expectations ahead
of time, I find patients are usu-
ally thrilled with their results.
2. Plan ahead.
Thinking about cosmetic
surgery ahead of a big event?
It’s important to plan ahead.
Final results from cosmetic
procedures are usually not
immediate and they do not last
forever. Before undergoing a
cosmetic procedure, it’s impor-
tant to understand the healing
time. For example, it may take
6-12 months for the swelling
from a liposuction procedure
to completely resolve. There-
fore, if you’re planning to get
cosmetic surgery ahead of a
planned event like a vacation
or reunion, be sure to ask your
surgeon when you can expect to
see final results.
3. Men get cosmetic sur-
gery, too!
According to the American
Society of Plastic Surgery, 8
percent of all cosmetic proce-
dures in 2016 were performed
on men. There are a few cos-
metic procedures that are spe-
cific to men, including breast
reduction for gynecomastia and
pectoral implants. However, the
majority of men seek cosmetic
surgery for the same reasons
women do: to restore a more
youthful appearance or reshape
their face or body.
Having an elective cosmetic
surgery is a very personal
choice. As a plastic surgeon,
I believe it is important that
those who get cosmetic surgery
are doing it for themselves. I
have seen cosmetic surgery
change people’s lives in amaz-
ing, positive ways by improving
their appearance, self-esteem
and confidence. Most impor-
tantly, if one chooses to have
cosmetic surgery for the right
reasons, they’re likely to be
pleased for many years by their
results and decision.
Sarah Evans, M.D. is a plastic
surgeon at St. Peter’s Health
Medical Group-Broadway Clinic.
Evans earned her medical degree
from Duke University School
of Medicine in Durham, N.C.
She completed her residency in
plastic surgery at the University
of Cincinnati Division of Plas-
tic, Reconstructive, and Hand
Surgery in Cincinnati, Ohio,
and residency in general surgery
at Duke University Depart-
ment of Surgery. Evans is board
certified by the American Board
of Surgery.
cosmetic surgery?Considering
3 things to know
HEALTHY LIVING • 11
ALANA LISTOE
The saying “sleeping like a
baby” suggests that babies sleep
hard and are often not impacted
by the noises that surrounds
them. But for many, there was
nothing sound about the way
their children slept. In fact,
some parents say that when
their children were very little,
getting a good night’s sleep
was a luxury they rarely, if ever,
experienced.
Later in development many
moms and dads attest to strug-
gling a time or two with their
teenager about sleep. Some say
their teen sleeps all day long,
while others express concern
knowing their teen regularly
stays up all night with their eyes
glued to a screen.
According to the National
Sleep Foundation, sleep is
essential for a person’s health
and wellbeing at any age. Yet,
millions (more than 40 million
in the US) of people don’t get
enough. In addition, more than
40 percent of adults say they
experience daytime sleepiness
severe enough to interfere with
their daily activities. Further-
more, around 70 percent of
children are experiencing sleep
problems as well.
It’s fair to say that most
people don’t get enough sleep.
We are a society that burns the
candle at both ends, a nation
where people stay up all night to
study, work, or have fun. How-
ever, going without adequate
sleep carries with it both short-
and long-term consequences.
In the short term, a lack of
adequate sleep can affect
judgment, mood, ability to
learn and retain information,
and may increase the risk of
serious accidents and injury.
Long-term sleep deprivation
may lead to a host of health
problems including obesity,
diabetes, cardiovascular dis-
ease, and even early mortality.
The American Psychological
Association says contrary to
common myth, the need for
sleep doesn’t decline with age,
but the ability to sleep for six
to eight hours at one time may
be reduced.
Sleep is important for all
of us. Chris Bates, director of
clinical services at Shodair
Children’s Hospital says that
adolescents need 9 to 10 hours
of sleep per night and school-
aged children, closer to 10 to
11 hours per night. Bates said
sleep problems are more likely
to affect patients with psychi-
atric disorders than people in
the general population.
“Sleep problems may
increase risk for developing
particular mental illnesses,
and treating the sleep disorder
may help alleviate symptoms
of the mental health problem,”
Bates said.
“Signs of sleep problems
may include a pattern of irri-
tability, fatigue, slipping or
poor academic performance,
difficulty getting out of bed in
the morning, and emotional
lability,” Bates said. “Devel-
oping good sleep hygiene is
essential and should include
PLEASE SEE SLEEP, Page 13
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Together we canchange the stigmaof mental illness
Individuals of all ages, races, neighborhoods,
annual household income or education levels
can have mental illnesses. Together, we can
offer support, advocate, and end the stigma
associated with mental illness!
Shodair Children’s Hospital
is at the forefront of that effort!
To heal, help and inspire hope
406.444.7500 • 1.800.447.6614
shodair.org
12 • HEALTHY LIVING
As we age, we tend to take
more medications for differ-
ent ailments and conditions.
Multiple medicines—either pre-
scribed or over-the-counter—
put us at a greater risk for an
adverse drug event.
What is an adverse
drug event?
It is the misuse of or an acci-
dent involving medications that
can cause injury, make a person
sick or can even cause death.
According to the Centers for
Disease Control and Preven-
tion (CDC), adverse drug events
cause more than 700,000 trips
to the emergency room every
year. And people over age 65
are twice as likely to go to the
emergency room and almost
seven times as likely to be hos-
pitalized because of an adverse
drug event.
What can you do to keep
yourself safe and out of
the hospital?
� Keep an updated list of all
your medicines and take it with
you every time you see a doctor
or your pharmacist.
� Pay close attention to your
doctor’s instructions. Read the
directions on the medication
and follow them exactly.
� Be sure to ask your doctor or
your pharmacist any questions
you have about new medicines.
For example, should the medica-
tion be taken with food or on an
empty stomach? What should
you do if you miss a dose?
These tips will help you
decrease your risk for an adverse
drug event. But if you take an
opioid, an anticoagulant or
medication for diabetes, you
need to pay special attention.
These are the “big three” for
causing adverse drug events,
especially among older adults.
Opioids
Opioids are pain killers.
Methadone, oxycodone and
hydrocodone are all examples.
Every year, tens of thousands of
Americans die from uninten-
tional overdoses of opioids—
more deaths than from cocaine
or heroin overdoses. While
opioids can reduce pain, when
used incorrectly, they can slow
down your breathing and your
heart rate.
If you take an opioid, do
exactly as your doctor tells you
and take your medication only
as prescribed. Make sure all your
doctors know what other medi-
cines you are taking, because
some medicines can contribute
to an overdose when taken with
pain relievers.
Anticoagulants
Anticoagulants are blood
thinners. For example, the oral
blood thinner warfarin is an
anticoagulant. Patients might
be prescribed anticoagulants if
they have a history of stroke, if
they have just had a knee or hip
replaced or have certain heart
conditions. Anticoagulants help
prevent blood clots and can be
lifesaving. But they can also
be dangerous.
Anticoagulants are tricky,
because there is a fine line
between using them correctly
and using them incorrectly and
accidently harming yourself.
Too little, and you could form a
blood clot. Too much, and you
could suffer potentially danger-
ous side effects such as nose-
bleeds, bleeding in the gums,
unusual bleeding while shaving
or bruising.
To avoid an adverse drug
event, tell all your health care
providers you are taking an
anticoagulant. Get your blood
tested regularly to make sure the
anticoagulant is not interacting
with other medicines, vitamins
or even foods. And of course,
ask your doctor or pharmacist if
you have any questions.
Diabetes medications
The CDC reports the number
of Americans with insulin-
treated diabetes has gone up
in the last decade. Insulin is
an important part of treating
diabetes, but doses and the nec-
essary routine to control blood
sugar levels can be difficult
to manage.
The improper use of insulin
can lead to shock, seizures or loss
of consciousness. It sends nearly
100,000 people to the emergency
department each year, and about
one-third of those are admitted
to the hospital. About half of
these cases are from a meal-
related mishap, meaning the
person failed to eat soon enough
after taking fast-acting insulin
or did not adjust the amount of
insulin when eating less.
If you use insulin, work with
your doctor to safely and effec-
tively manage your diabetes.
Talk with a certified diabetes
educator about meal planning,
how to safely give yourself insu-
lin and when adjustments might
be necessary.
Adverse drug events are a
big patient safety problem, but
many are preventable. Take an
active role in your own health
and safety by talking with your
doctor, pharmacist or other
health care professionals about
your medications. And though
they may be part of your daily
routine, do not let them become
a mindless habit. Pay attention
to what you take and when you
take them, so you do not make
a dangerous mistake. For more
information, visit bit.ly/ade-
prevention.
Provided by Mountain-Pacific
Quality Health, which holds
federal and state contracts that
oversee the quality of care for
Medicaid and Medicare members.
THE BIG 3 of adverse drug eventsAre you paying attention to your medications?
Did you know that adults 65 years ofage and older are twice as likely asothers to land in the emergencydepartment because of problemswith their medications? And if you
are taking opioids, diabetesmedication or an blood thinner,
your risk is even greater.
Read "The Big 3 of AdverseDrug Events" article to findout what you can do to stayout of the emergencyroom. You can also visitbit.ly/ade-preventionfor more information.
Developed by Mountain-Pacific Quality Health. Contents do notnecessarily reflect CMS policy. 11SOW-MPQHF-AS-C3-18-02
er.y
HEALTHY LIVING • 13
idea how to handle whole foods.
If your diet was fresh raw fruits
and vegetables, you could spend
half your day eating like a moun-
tain gorilla. Crunchy, juicy and
sweet, those foods are high in
fiber and moisture, along with
essential vitamins, minerals
and a host of brightly-colored
phytochemicals that protect
against illness and aging. But
they’re slow-digesting and low
in calories. So you might end up
losing weight.
You could add raw nuts and
seeds to get more protein and
essential fatty acids. The oldest
tools, as well as chimpanzee tools
today, were for cracking nuts.
Studies find that nut-eaters live
longer and weigh less.
The argument for a strictly
raw plant-based diet is flawed,
but that’s another story. If you
progress to a Stone Age diet and
include cooking and wild or
grass-fed meat and fish, you’d
have an excellent diet.
For most of us, even venturing
into the foods of the Agricultural
Age—whole grains, beans—can
work pretty well.
Many of us have the genes
it takes to digest starches and
milk sugar (lactose, which gets
turned by culturing into lac-
tic acid).
I believe the key is to stick with
whole foods. That’s what it really
means to give your body a chance
to show how smart it is. We’ve
had a long evolutionary history
of eating whole foods and a very
short one of refined, stripped,
separated “food-like substances,”
as Michael Pollan calls them,
not to mention all the un-food-
like additives.
It only makes sense that you’re
hungry until you’re fed and that
you’ll crave more foods until all
your nutritional needs are met.
That’s where nutritional supple-
ments can play a role. Again,
that’s another story.
Lastly, I’ll mention that while
your body may be wise, it’s also
subject to individual quirks—
genetic, biochemical, social and
more. So please note that the
information contained in this
article is strictly educational and
is not intended for the diagnosis,
prevention or treatment of any
individual’s health condition.
For that I recommend seeking
the advice of a qualified health
professional.
Laughing Water is the longtime
co-owner and general manager of
the Real Food Market & Deli.
before bed, regular exercise,
and ability to manage worries
and anxiety.”
No matter what age, there are
two main factors that affect how
sleepy or how alert a person is
at any given time in a day. The
first is length of wake time.
This is called the sleep-wake
balance. Staying awake for too
long will create an imbalance of
sleep-wake and likely causing
tiredness. It also affects level of
sleepiness in the internal body
clock. This clock controls the
“circadian rhythms” in your
body, meaning “to occur in a
24-hour cycle.” These rhythms
create feelings of sleepy or alert-
ness at regular times every day.
The internal clock communi-
cates to the body when it is time
to sleep at night and to be awake
during the day. Everyone’s body
has this natural timing system,
and it’s the circadian rhythms
that makes us sleep, saying it is
time to go to bed.
Most people feel a mild need
for sleep in the afternoon. This
need to sleep grows much stron-
ger at night. Because of this set
rhythm, the urge to sleep will be
triggered at these times of day.
This occurs no matter how much
sleep gotten the night before, but
a lack of quality sleep can also
make us tired at the wrong times
of day.
Some research has shown
that a lack of sleep can often be
confused with attention-deficit/
hyperactivity disorder (ADHD).
Those folks say that sometimes
young people are thought to
have ADHD when in reality
they are having a problem with
their sleep.
As we age into our senior
years sleep repairs blood ves-
sels, repairs blood vessels, and
decreases risk of Alzheimer’s.
Sleep expert says that good sleep
for seniors prevents impaired
cognitive function.
While there is no perfect num-
ber of hours of sleeps per age
groups there are many guild lines
that provide a starting point.
The bottom line is that atti-
tude is half the battle so having
the proper view of sleep is the
foundational starting point for
any person wanting a healthy
sleep hygiene. Sleep is not
something to fight off or try
to avoid, and greatly benefits
those who make it a priority,
because it helps people to feel
more alert, have more energy,
think more clearly, and make
better decisions. People that get
good sleep will be happier and
enjoy life more, not to mention
be healthier.
Alana Listoe is the Community
Relations Director at Shodair
Children’s Hospital.
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14 • HEALTHY LIVING
ROBERT PHILLIPS
Now is a good time to consider
how you can improve your health
and reduce your risk of develop-
ing coronary artery disease, or
heart disease. Heart disease is a
significant problem in America
and, according to the Center for
Disease Control and Prevention
(CDC), it may be the cause of
death for up to 25 percent of men
and women.
Coronary disease is the devel-
opment of cholesterol laden
plaque within the wall of the
coronary arteries, the blood
vessels that supply blood to the
heart. This problem develops
slowly over a long period of time
and may not cause any notice-
able symptoms for a while.
Symptoms may only be noticed
with exercise or exertion, but
become more evident when
there is a severe limitation to
blood flow. A heart attack can
then occur when blood flow is
so limited that a portion of the
heart can’t get adequate oxygen
and nutrients and part of the
muscle dies.
We don’t know all the factors
that lead to coronary disease or
heart attacks, but we do know
some risk factors and therefore
have some practical advice
to follow:
Smoking
A study by the U.S. surgeon
general suggests that 30 percent
of cardiovascular deaths are
related to smoking. Second hand
smoke can also increase the risk
of developing heart disease or
stroke by 25 – 30 percent. People
that smoke (or are exposed to
smoke) are more likely to develop
a buildup of plaque in the walls
of arteries and inflammation
within those plaques, which lead
to heart attack. Stopping the
use of tobacco products is dif-
ficult, but quitting significantly
reduces deaths related to heart
disease Free help is available
from the Montana Quit Line
at 1-800-quit-now or www.
QuitNowMontana.com. Another
resource is the American Indian
Commercial Tobacco Quit Line
at 1(855)372-0037 or www.MTA-
mericanIndianQuitLine.com.
Exercise
Regular exercise reduces the
risk of developing heart disease
in addition to other diseases that
can lead to heart disease and
heart attack, like diabetes and
high blood pressure. The good
news is that you don’t have to
become a super athlete to reduce
your risk. Simply having a life-
style that incorporates regular
activity is recommended, and
you can choose from activities
you enjoy, like walking, pool
exercise, or even dancing. If you
have trouble getting out a chair
you can do chair exercises, just
make sure to do them every day.
The goal is to exercise at what
feels like moderate intensity for
30 minutes a day, five days a
week. If you can only work this
into your schedule three days
a week, then up the intensity.
Exercise is beneficial even when
you’re not losing weight, so you
should strive to do it consis-
tently.
Nutrition
Food is a controversial and
confusing topic because there is
conflicting data and advice. This
is partly because many diets are
trying to achieve a specific and
sometimes short-term goal. In
my opinion, your diet is part of
your lifestyle and will need to
incorporate a variety of foods. I
tell patients that it’s important
to eat foods that will be digested
slowly. This causes lower peaks
in blood sugar and insulin levels
in your body, which decreases
the risk of developing vascular
inflammation. An easy tip is
to avoid processed and ultra-
processed foods and instead eat
foods that come from a variety of
whole grains, fruits, vegetables
and healthy protein. I don’t tell
people to stop eating meat, but I
do recommend choosing wisely.
If you enjoy red meat, venison is
a great choice because it’s high
in protein and low in fat.. Wild
fish, lean pork, and chicken that
is boneless and skinless are also
healthy sources of protein. It’s
also important to limit processed
meats. I love bacon as much as
anyone, but you should enjoy
tasty treats like this sparingly.
Medications
If you have conditions that can
lead to heart disease and heart
attacks like diabetes, high blood
pressure or dyslipidemia, see
your doctor to make sure that
you are on the appropriate medi-
cations. Your doctor can help
determine appropriate medica-
tions and what level of control is
adequate to lower your risk.
Being heart healthy and the
active Montana lifestyle go hand
and hand. Go outside, enjoy
the fresh air and get some exer-
cise in our beautiful state. Eat
locally sourced healthy foods
that include a variety of Mon-
tana whole grains, dairy, fruits,
vegetables and healthy protein
to enjoy and live a long and
healthy life.
Robert Phillips, MD is a Cardiolo-
gist at St. Peter’s Health Medical
Group. Phillips earned his medi-
cal degree from the University of
Washington School of Medicine.
He completed an internship at
the University of Kansas Medical
Center, internal medicine resi-
dency at the University of Wash-
ington and a cardiology fellow-
ship at the University of Wash-
ington and the University of New
Mexico. Dr. Phillips specializes
in invasive non-interventional
cardiology and is certified in both
comprehensive adult echocar-
diography and nuclear cardiology.
He is a member of the American
Board of Internal Medicine and
is board certified in internal
medicine and cardiology. Phillips
accepts patients by referral.
HEALTHY HEARTPractical advice in pursuit of a
HEALTHY LIVING • 15
Tinnitus (TIN-ih-tus) is the
perception of noise or ringing
in the ears. A common prob-
lem, tinnitus affects about 1 in
5 people. Estimates of patients
with tinnitus range from 10-15
percent of the population (30-40
million people). Tinnitus isn’t a
condition itself — it’s a symp-
tom of an underlying condition,
such as age-related hearing loss,
ear injury or a circulatory sys-
tem disorder.
Tinnitus involves the annoying
sensation of hearing sound when
no external sound is present.
Tinnitus symptoms include these
types of phantom noises in your
ears: ringing, buzzing, roaring,
clicking, and hissing.
The phantom noise may vary
in pitch from a low roar to a high
squeal, and you may hear it in
one or both ears. In some cases,
the sound can be so loud it can
interfere with your ability to
concentrate or hear actual sound.
Tinnitus may be present all the
time, or it may come and go.
Although bothersome, tinnitus
usually isn’t a sign of something
serious. Although it can worsen
with age, for many people, tinni-
tus can improve with treatment.
Treating an identified underly-
ing cause sometimes helps.
Other treatments reduce or
mask the noise, making tinnitus
less noticeable. Manufacturers
being aware of this condition
have done a lot of research and
put tinnitus maskers in their
hearing aids.
Microscopic hairs form a
fringe on the surface of each
auditory cell in the chochlea.
If hairs are damaged, they may
move randomly, sending electri-
cal impulses to your brain as
noise, or tinnitus. Tinnitus can
also be caused by turbulence
in carotid artery or jugular
vein, and temporomandibular
joint problems.
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Tinnitus affects about 1 in 5 people
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�o �ou su�er with �nnitus?
�hen was the last ��e �ou ha� �our hearing �he��e�?
How’s Your Hearing Health?
Today is a new day at St. Peter’s Health. We’re expanding our services,
building regional collaborations and raising the bar for the care we
provide. Your grandma was probably delivered here, but this is not
your grandmother’s St. Peter’s. We’re a nationwide iVantage “Top 20
Rural & Community Hospital” and one of just three hospitals in Montana
to earn an A grade for safety from The Leapfrog Group. But the most
exciting part is—we’re just getting started. We’re not only committed
to helping you get better, but also to getting better ourselves. And we will
never stop striving for a higher state of care.
WE KEEP GETTING BETTER.
SO YOU CAN TOO.
sphealth.org
Alissa Abentroth, MD, FACS
Surgeon and breast cancer prevention advocate
REGIONAL MEDICAL CENTER • MEDICAL GROUP • CANCER TREATMENT CENTER • URGENT CARE • HOME HEALTH • HOSPICE
