L IMA— Imagine every timeyou started to speak, youwere overcome with a fit of

coughing.That’s what John Merricle,

55, of Lima, has been feeling forthe past two months. He hasthe latest confirmed case of per-tussis, commonly known aswhooping cough.

Pertussis is a respiratory dis-ease caused by bacteria that canoften be confused with the com-mon cold. Symptoms include arunny nose, sneezing, fever andsevere coughing that usuallyleads to gasping for breath,which creates a “whooping”sound. But when someone haspertussis, symptoms linger forweeks or months.

Sherry Merricle said her hus-band has felt symptoms of terri-ble coughing, vomiting and astuffy nose since April. She saidher husband saw his doctor atleast six times since then andhad an appointment set forJune 15.

“He looked really bad thatday so we went to the emer-gency room at St. Rita’s Med-ical Center,” Sherry Merriclesaid. “The doctor said he had astomach flu. I had to persistthem to test for whoopingcough, because our daughter,who lives in Michigan, had it inApril.”

In the end the test was

ordered and showed pertussis.Becky Dershem, director of

nursing at Allen County HealthDepartment, said whoopingcough is extremely contagious.Hospitals are required to reportthis disease to the healthdepartment when it is found sohealth officials can determinehow to best handle the poten-tial health threat.

“People think because the dis-ease isn’t seen on an everydaybasis that it’s gone, but it’salive and well,” Dershem said.“The reason it’s not seen a lot isbecause people get immuniza-tions.”

Three days after John Merri-cle’s visit to St. Rita’s, he wasnotified by the hospital and thehealth department that he hadpertussis. The Merricles werequarantined to their housebetween June 18 to 22 and puton antibiotics. John Merricle’sco-workers at Allen Metropoli-tan Housing Authority werealso quarantined for five dayson antibiotics in case they wereinfected. Quarantine in caseslike this is routine, Dershemsaid.

“We had to close the mainte-nance department for a coupledays and contract out work,”said Cindy Ring, executivedirector at Allen MetropolitanHousing Authority. “We did lotsof checking with the health

department to make sure wecontacted everyone that couldhave been exposed to it.”

Dershem said children andadults can tolerate the symp-toms, but whooping cough islethal for babies.

Dr. Scott Stienecker, presi-dent of Infectious DiseasesSociety of Ohio, said he’s wit-nessed two children die fromwhooping cough.

“It’s a killer disease thatwon’t disappear,” Stieneckersaid. “Those deaths were themost awful thing I’ve seen.They were babies that weren’tvaccinated, and their deathswere 100 percent preventable.”

According to the Centers forDisease Control Web site, it’srecommended that infants andchildren receive five doses ofthe diphtheria and tetanus tox-oids and acellular pertussis vac-cine — commonly abbreviatedto DTaP. The vaccines are rec-ommended at ages of 2 months,4 months, 6 months, 15 to 18months and 4 to 6 years.

Stienecker said waning im-munity occurs as the personages and he recommends thosebetween the ages of 12 and 65get a booster vaccine calledTdap.

John Merricle hadn’t beenvaccinated since his initial

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MMccCCllaattcchhyy NNeewwssppaappeerrss

QHave you ever heard oftaking folic acid to help

with depression? I readabout it in a health magazine.

— D.R., Cherry Hill, N.J.

AThere is some researchevidence that links low

folic acid levels to depression.There’s also some researchevidence that taking folicacid supplements along withantidepressants, particularlythe “SSRI” antidepressants(e.g.. Lexapro, Zoloft, Prozac,Paxil), can augment the anti-depressant response in somefolks. But the research gets alittle bit muddy because itturns out that 10 percent ofthe general population pos-sesses a gene defect wherethey lack the enzyme toproperly break down folicacid into its active form usedat the cellular level, “L-methylfolate.” Another 40percent of folks have only alimited ability to convertconsumed folic acid into theactive form, L-methylfolate.

To determine if one iswasting time taking folicacid supplements, lab cluesinclude a low serum and/orred blood cell folic acid level(although the range ofwhat’s normal is wide) andan elevated homocysteinelevel (suggests inadequatefolic acid enzyme). There is aprescription L-methylfolatesupplement (Deplin) specifi-cally for folks with a subopti-mal folic acid level that canhelp boost the levels of sero-tonin, norepinephrine anddopamine when taken withantidepressants. For folkswhose depression is not ade-quately improved with med-ication, Deplin may be usefulin augmenting the antide-pressant drug effect.

QDo you have any suggestions on how

best to manage someonewith sundowner’s syndrome?

— M.W., Charleston, S.C.

AFor those of my readersunfamiliar with the

term, “sundowner’s syn-drome” describes agitated,disruptive and/or anxiousbehavior seen in the typicalsetting of an Alzheimer’s orother demented patient inthe late evening hours as thesun goes down. It’s a periodof irrational thoughts andbehavior.

Causes for sundowner’ssyndrome include: sensoryoverload during the day;fatigue and stress at the endof the day; anxiety due to agradual loss of visual cues asthe room gets dark; anddrugs that can furtherimpair cognition in a predis-posed person. The first stepsin dealing with sundowner’s

CAADDVVIICCEE from Margo

HowardC2

TThhee LLiimmaa NNeewwss

Dr. MitchellHecht

PHYSICIAN

Syndicated columnist

Will takingfolic acidhelp with

depression?

See DOCTOR • C2

See COUGH • C2

TOMORROW

REMINISCE: SeeWednesday’s Reminiscefor details on Mirror Lake.

By GAIL APPLESONMcClatchy Newspapers

The generic drug doxazosin is assafe and effective as the widelyadvertised drug Flomax for treatingthe symptoms of enlarged prostate,

and could save consumersnearly $3,000 a year,according to ConsumerReports “Best BuyDrugs.”

Flomax was one of the20 most commonly pre-scribed drugs in 2008,

according to the report. Half of allmen over age 50, or about 20 millionmen in the U.S., have an enlargedprostate, as a normal part of aging,

though not all experience bother-some symptoms.

The Best Buy Drugs report, whichrates more than 200 prescriptiondrugs to treat more than 20 commonconditions, is part of a larger initia-tive by the newly launchedConsumer Reports Health RatingsCenter to provide consumers withhealth ratings based on independentreview of the best scientific evidenceavailable.

“Flomax is the new ‘it’ drug andthat’s a testament to the marketingmuscle of Madison Avenue. It’s agreat example of how costly drugsare driving up health costs whenthere are other drugs that are equal-ly safe and effective, such as the $10

a month generic doxazosin,” said Dr.John Santa, director of theConsumer Reports Health RatingsCenter. “This drug has been on themarket for decades and its safety andefficacy profile is well established.”

Consumer Reports research showsthat when prescribing medication,physicians do not routinely considerthe cost of a drug and Santa urgesdoctors to pay attention to a drug’scost, since part of their oath is to be afiduciary for the patient.

In 2008, more than $1.2 billion dol-lars were spent by consumers andtheir insurance companies onFlomax alone, an increase of 23 per-cent over 2007; ranking it Number27 on the top 100 list of branded

drug by retail dollars, Best BuyDrugs said.

A man’s prostate becomes largeras he ages, a condition known asbenign prostatic hypertrophy, orBPH. It’s usually not a serious orlife-threatening condition, but it cancause problems with urinating, pri-marily in men age 50 and older.

Best Buy Drugs recommends try-ing lifestyle changes first, which canoften provide relief. Those changesinclude going to the bathroom whenyou first feel the urge, reducing oreliminating intake of alcohol and caf-feine, and limiting fluid intake beforebedtime. If these don’t bring relief,the next step is usually to considermedication.

2News

use

Generic for enlarged prostate is safe and effective

Disease disguised as common cold can be deadly

TTuueessddaayy,, JJuunnee 3300,, 22000099

whooping coughSymptoms of

pertussis

• Runny nose or congestion• Sneezing• Mild cough• Fever• After 1 to 2 weeks,severe coughingbegins

Best way to

prevent pertussis:

• In children: fivedoses of DTaP vaccination, at ages 2months, 4 months, 6months, 15 to 18months and 4 to 6years• In adults: 1 boostershot of Tdap vaccina-tion, once betweenthe ages of 12 to 65

For details on whoop-ing cough or how toget vaccinated, visitwww.cdc.gov andwww.allencounty-healthdepartment.org.

By HANNAH POTURALSKI• hpoturalski@limanews.com • 4419-993-2091

Lifestyle/Special Sections Editor Adrienne McGee 419-993-2072; e-mail amcgee@limanews.com

HOROSCOPESWhat’s in your stars? /C3

CALENDARUpcoming events /C3

COMICS, PUZZLES &TV LISTINGS /C4-5

Health

series as a toddler. He planson getting vaccinated assoon as he feels better, aswill his wife.

Merricle was the second

person with whoopingcough in Lima this year.The first was of a child inApril.

“This is alarming because

there have been other out-breaks in the region sincethe beginning of the year,”Dershem said. “This showswhy it’s important to con-tinue getting vaccinated.”

Karen Smalley, infectioncontrol nurse at MercerHealth, said MercerCounty has seen five casesof pertussis so far this year.All five were in the monthsof January and February.

“They were outpatientcases, so they tested posi-tive but weren’t sickenough to be hospitalized,”Smalley said. “A couple ofthe cases were related to

each other.”In the majority of pertus-

sis cases, sources said, thecommon thread is peoplenot being vaccinated.There is a lot of worry byparents that vaccinationswill have adverse effects ontheir children, includingsusceptibility to autism.But Dershem said therehave been 16 studiesshow-ing no correlation betweenvaccinations and autism.

You can comment on this story atwww.limaohio.com.

CCOOUUGGHH •• from C1 ––––––––––––––––––––––––––––––––––––––––––––––––––––––––––––––––––––––––––––––––

C2 Tuesday, June 30, 2009 The Lima NewsL I F E S T Y L E

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ADVICE

Woman worries husband’s emotional affair with boss will ruin marriageQ

Dear Margo: I am a mid-dle-aged woman with

two girls in college. My prob-lem is my husband’s emo-tional affair with his boss.My husband works at acomputer company thatrequires quite a bit of histime, even weekends. Overthe past eight months, he’sdeveloped a very closefriendship with his femaleboss that includes havingdrinks after work (leavingme home alone), buying hergifts on various occasions,taking many pictures of herwhen they travel togetherfor business, spendingweekend time taking her todinner without me, andsending her e-mails on theweekend that don’t involvework. My husband admitsbeing sexually attracted to

her but says they only sharea special friendship be-cause they work together.He tells me he’s in love withme ... but has no intentionof giving up his specialfriendship with her. My hus-band feels that sincethere’s been no physicalcontact between them,there is no threat to ourmarriage and, furthermore,that it isn’t consideredcheating! We are in our sec-ond round of marriage coun-seling. My question is: Sincemy husband is so cavalierabout his involvement in thisemotional affair, will we everbe able to get past thisproblem? We’ve neverbefore had a problem likethis over the course of our25 years together.

— Frantic and Crushed

ADear Fran: Are you sit-ting down? Computer

dude is clearly in a romance,and it ain’t just emotional. Isuspect male menopause. Nodisrespect, but I think yourcounselor is out to lunch ifhe or she hasn’t made thisthe issue, and I also thinkyour husband is lyingthrough his teeth while try-ing to put you on the defen-sive. Sorry to be the bearerof bad news, but your mateis trying to give you the oldrazzle-dazzle, and I hope yousee through it. I suggest you

tell him to take his “specialfriendship” and move it intoan apartment. That, or giveup the babe and the job.What he is doing to you isdisgraceful.

— Margo, wistfully

QDear Margo: I am 42with two young children.

I am married to a kind andloving man who caresdeeply about our family. Theproblem is, he is not sexu-ally attracted to me. I realizenow that he never was.When we met, I was theaggressor, and once Istopped trying to have sexwith him, all sex stopped. Hesays it’s not me, it’s him.(Does that argument everwork?) I feel unattractive,old and dried up. I don’twant to think that the rest ofmy life will be celibate, and I

am not the type to have anaffair. We have tried therapya couple of times, but it has-n’t worked. I don’t know howyou can talk someone intowanting to have sex with youanyway. To make mattersworse, I no longer want tohave sex with him. I don’tlook at him in a sexual, mas-culine way anymore.Because of the young chil-dren, I don’t know whetherdivorce is the answer. Also,due to my age, I don’t knowwhether I would find anyoneelse. Everything else in ourmarriage works, but I amdesperately un-happy with-out any physical connection.Please shed some light on acourse of action for me.

— Not Dried Up Yet

ADear Not: I am readingbetween the lines that

your husband is either indif-

ferent to sex or gay. What Iwould urge you to try todetermine, even if it takes adifferent therapist, is thereason underlying the no-sex situation. Once youknow what’s really going on,you will be in a better posi-tion to evaluate the situationand then make your choiceabout how you want to live.Knowledge really is power.And trust me, 42 is definitelynot over the hill when itcomes to finding romanceagain.

— Margo, searchingly

Dear Margo is written byMargo Howard, AnnLanders’ daughter. All let-ters must be sent via e-mail to dearmargo@cre-ators.com. Due to a highvolume of e-mail, not allletters will be answered.

Margo HowardSyndicated columnist

dearmargo@creators.com

Dear Margo

syndrome are to antici-pate its occurrence andkeep the individual safefrom injury, continuallyorienting the person to their surroundings dur-ing those hours when sun-downers can be expected.Other suggestions in-clude: naps during the dayhelp to reduce daytimefatigue; Alzheimer’s drugslike Aricept or Exelon;antidepressants like Zo-loft or Lexapro to reducestress and improve mood;schedule activities earlierin the day; distraction andredirection to addressinappropriate and unchar-acteristic behavior; avoid-ance of caffeine and

sweets after lunch; andexposing the person tolight in the evening hoursand in the early morningto help set/maintain thebody’s internal sleep/wake clock; regular toilet-ing in the evening; anduse of a nightlight. Formore info, check outwww.sundownerfacts .com.

Dr. Mitchell Hecht is aphysician specializing ininternal medicine. Sendquestions to him at: “AskDr. H,” P.O. Box 767787,Atlanta, GA 30076. Dueto the large volume ofmail received, personalreplies are not possible.

DDOOCCTTOORR •• from C1 ––––––––––––––––––––––––

By JAY LINDSAYTThhee AAssssoocciiaatteedd PPrreessss

BOSTON — Yes, he’sobsessed with grooming,and he occasionally barks atyou, but in most ways Isaacis not your typical fitnessinstructor. He weighs in at350, eats 16 pounds of foodat a time and he’s only 9years old. And he’s a seal.

Isaac is one of five north-ern fur seals to be featuredin a new exhibit at the NewEngland Aquarium thataims to entice an increas-ingly obese generation ofkids to get moving.

The seals twist, stretch,leap out of the water, run ontheir flippers and shoot likemissiles under and betweenthe fiberglass rocks. Isaaceven stands on his head. The“Move It!” program at theNew Balance FoundationMarine Mammal Center,which opens Wednesday,uses the seals’ athleticism asan example for children.

“Those marine animalswill do things that are jaw-dropping at times,” saidTony LaCasse, an aquariumspokesman. “We wantedkids to be inspired by them.”

The seals will dart aroundan open-air space in the $10million center, built at theback of the aquarium onBoston Harbor.

The animals are rarelythis close to the Atlantic.They live in the Pacific fromSouthern California toJapan, and north to theBering Sea. Males grow toup to 7 feet long and 600pounds, while females areabout 5 feet and 110 pounds.

The seals are considereddepleted under the MarineMammal Protection Act,and a big reason is thehunters who pursued its pelt— two layers thick andstuffed with 300,000 hairsper square inch. The peltdemands constant groom-ing, and the seals attend tothemselves in an endearing

way, contorting their bodiesso their long flippers can getthe job done.

Kathy Streeter, the aquar-ium’s marine mammalscurator, calls the northernfur seal a “Dr. Seuss animal”— a quirky combination of asea otter and sea lion. It hasears, unlike the harbor sealscommon around Boston, hasa distinctive bark and canprop itself up on its long flip-pers to look at visitors face toface.

That charisma, plus itsstory as a hunted and scarceanimal, made it a goodchoice for a marine mammalcenter that seeks to helppeople relate to ocean life,Streeter said.

“They help give people aperspective on how theocean affects everybody,”she said.

The center opening is asign of health at the aquar-ium three years after itregained its accreditationafter repairing shakyfinances. The accreditation

was pulled in 2003 by theAssociation of Zoos andAquariums after financialstruggles and layoffs fol-lowed two major expansionsin the late 1990s.

The new center’s child-hood fitness push comes asstatistics from the Centersfor Disease Control and Pre-vention estimate 32 percentof American kids ages 2 to19 are overweight, including17 percent who are obese.

Panels around the aquar-ium will show seal moveslike stretching, jumping andswimming, explain the waysthe moves are similar tohumans and encourage kidsto “Try It!”

A guide that visitors getwith their tickets includesmore exhortations to movelike the seals, and also eatsome of the healthy fish theydevour. In the center itself,the seals will performstretches and moves withtrainers, and some kids willbe allowed into the shallowend of the seals’ swimming

area to exercise with them. Paul Boyle, an environ-

mental biologist and a vicepresident at the Associationof Zoos and Aquariums, saidthat other institutions havepushed programs that getkids engaged outdoors, butthat tying seal moves to kidfitness was unique and inno-vative. He added that thecenter has a strong draw inthe sleek, engaging fur seals— though attendance willultimately be a measure ofjust how strong.

Figuring out whether theseals can inspire fitness is atougher task, but Boyle did-n’t see it as much of astretch.

“You can almost see a childin front of the exhibit, gyrat-ing, trying to mimic the sealand saying, ‘Well this ispretty cool,”’ he said. “Thenthey go home and they mayroll around in the backyardand then they may start to,you know ... run.”

• Associated Press

A northern fur seal is rewarded with food after completing an exercise at the NewEngland Aquarium in Boston on Friday. A new program titled “Move It!” featured in anew exhibit at the aquarium aims to entice an increasingly obese generation of kidsto get moving.

Aquarium hopes obesekids flip for athletic seals

Cognitive tests arefirst step to spot

Alzheimer’sBy JUDITH GRAHAM MMccCCllaattcchhyy NNeewwssppaappeerrss

The sooner someone isdiagnosed with dementia,the better.

Increasingly, that’s themantra of experts inAlzheimer’s disease, a con-dition that robs people oftheir memories and abilityto think.

The Alzheimer’s Associa-tion is highlighting themessage in a new mediacampaign that began lastmonth on television and iscontinuing with print adsin local markets.

How does this work? Andwhy deliver a diagnosis ofAlzheimer’s, an incurablecondition that many olderpeople fear, sooner ratherthan later?

If a family member isbecoming confused and for-getful much more often,experts recommend a brieftest that can suggest poten-tial dementia. (For 10 pos-sible warning signs ofdementia, go to theAlzheimer’s AssociationWeb site, alz.org.)

The most common is theMini Mental State Exam,which asks takers to nameseveral objects, identify theyear, date and season, andcount backward, amongother tasks.

Limitations of the examinclude its length and rela-tively poor ability to iden-tify people with mild cogni-tive impairment, explainedWilliam Thies, chief med-ical office for the Alz-heimer’s Association. Mildcognitive impairment isoften a precursor todementia.

A new test by researchersin Britain, called Test YourMemory, may become analternative. In a recentarticle in the British Med-ical Journal, researchersreported the five-minute,self-administered examdetected 93 percent ofpatients with Alzheimer’s.

These brief cognitivetests are “a first step,” saidDr. Raj Shah, an Alz-heimer’s expert at RushUniversity Medical Centerin Chicago. Further evalu-ation involves ruling outother conditions that cancompromise memory, such

as stroke or depression,and taking a thorough his-tory with the person and afamily member.

Often, more extensivecognitive testing will alsobe ordered. “It’s unrealisticto expect a very brief test todiscriminate between nor-mal aging and mild cogni-tive impairment,” said Dr.Ronald Petersen, head ofthe Mayo Clinic’s Alz-heimer’s Disease ResearchCenter.

What’s the value

of a diagnosis?People with mild cogni-

tive impairment or early-stage Alzheimer’s canmake lifestyle changes —exercise more, eat dietsrich in vegetables and fish,engage in cognitively stim-ulating activities — thatmay improve their qualityof life, Shah said.

Also, people who receivediagnoses early can partici-pate in decisions abouttheir treatment and con-nect with communityresources. For instance,those newly diagnosedcould put their financialaffairs in order or get coun-seling for depression.

It’s important to notethat the Food and DrugAdministration hasn’tapproved any medicationsfor use in people with mildcognitive impairment.Researchers have testeddrugs commonly used totreat Alzheimer’s in thesepatients, but results areinconclusive, Petersennoted.

With Alzheimer’s dis-ease, the medications pro-duce a slight benefit — arelief of some symptomsfor 6 to 12 months forabout half of people whotake them. No medicationhas been shown to alter thedisease’s progression.

For all the emphasis onearly detection, many peo-ple may not want to knowthey’re at risk for Alz-heimer’s disease. Indeed,almost two-thirds of peoplewith dementia haven’treceived a diagnosis, theAlzheimer’s Associationreports. Currently, 5.3 mil-lion Americans are livingwith Alzheimer’s disease.