Cara Lyle
The 2013 Commonwealth Medical College Healthcare Journalism Award: Congratulations to Cara A. Lyle, as the recipient of the 2013 TCMC Healthcare Journalism Award by Dr. Paul Mackarey! The award recognizes Cara’s excellence and dedication as a medical student and healthcare journalist.
Cara A. Lyle is a 4th year medical student and a member of the second class at The Commonwealth Medical College (TCMC). She was born in Pittsburgh, PA and raised in Ford City, PA. She earned a Bachelor of Science in Biology with a Minor in Chemistry at The University of Pittsburgh. She is currently applying for a residency in General Surgery. She enjoys spending time with her family, art and art history, traveling and staying active by working-out, going for walks or playing sports. Writing has also been a special interest of hers throughout her education and she is excited to continue to pursue this interest while in medical school.
Part 1 of Adolescent Medicine provided a better appreciation for the field of adolescent medicine, while Part 2 provided the warning signs of depression and risks for one of the leading causes of death in the adolescent population. Today, Part 3 will present tips for addressing concerns with adolescents.
Dr. Deborah Spring, MD, a family practice physician who is board certified in adolescent medicine contributed to this column. Dr. Spring’s interest in adolescent medicine developed while she was in group practice. As the only female in the group she saw many women, adolescents and children. Around the same time sub-specialties in family medicine were being formed, Dr. Spring sat for the adolescent exam in order to keep her skills current.
Under the tutelage of Dr. Spring, along with the guidance from Dr. Linda Thomas-Hemak, MD contributor in Part 2, we have formulated five tips for addressing concerns with adolescents. The following tips are intended to assist in the parenting of the adolescent in your life.
These articles are a great place to start, but don’t stop here. Beyond depression adolescents may face many other challenges including social isolation, bullying, eating disorders, substance use and/or abuse, risky behaviors, sexually transmitted diseases and more. Dr. Spring recommends the following educational online resources:
Dr. Spring emphasizes “the most important aspect of caring for adolescents is to ensure a relationship of mutual trust and respect.” She believes that this is really the focus of adolescent care and as such she feels that most family physicians and pediatricians are very capable of caring for adolescents. If either physician or adolescent are not comfortable with the relationship a change is warranted and then perhaps a physician with more expertise in adolescent medicine would be a better fit.
Creating open lines of communication is an important aspect of communicating with teens. Dr. Thomas-Hemak states “transparency is really important.” She goes on, “parents really need to understand being non-judgemental and not think that allowing free flowing communication condones behaviors you don’t approve of.” Maintaining open communication while parenting can be a tough balance to strike. It is important that your teens know they can come to you in need, and yet parents should not try to be one of their friends. “Supervision is so important…you need to know what they’re doing,” says Thomas.
For adolescents who seem isolated be persistent. Reach out and continue to attempt to build a relationship. Dr. Spring acknowledges that depression is not uncommon and that “the “quiet” adolescent can be the most vulnerable.”
“Don’t assume they’re knowledgeable on topics such as STDs, sexuality, relationships, mental health, etc. and give them information even if they pretend to “know” or pretend to be ignoring you,” says Dr. Spring.
One way to approach difficult topics is to take advantage of teachable moments recommends Dr. Thomas-Hemak. A visit to the pediatrician for a check-up or immunizations provides a great opportunity to discuss and establish healthy thinking and lifestyles. For a difficult topic such as sexuality, a visit for the HPV vaccination could provide a great opportunity for you or the physician to discuss this often challenging topic.
If you have identified a problem with a teen in your life there is a variety of NEPA resources available. In addition to your teen’s physician, Dr. Spring and Dr. Thomas offer these suggestions for local resources:
For More Information About this topic:
Pediatric Research: < http://www.adolescenthealth.org/Fellowships_Training/3635.htm>.
MEDICAL CONSULTANTS:
Dr. Linda Thomas-Hemak, MD: President/CEO of The Wright Center for Graduate Medical Education and The Wright Center Medical Group, P.C. She is dually board certified in Internal Medicine and Pediatrics. She leads The Wright Center for Primary Care Mid Valley Practice; a level 3 NCQA designated Patient-Centered Medical Home.
Deborah Spring, MD: is board certified in Family Practice with board certification in the sub-specialties of Adolescent Medicine and Geriatric Medicine. She practices in Kingston, Pa.
Visit your doctor regularly and listen to your body.
Keep moving, eat healthy foods, exercise regularly, and live long and well!
Read Dr. Mackarey’s Health & Exercise Forum in the Scranton Times-Tribune every Monday.
This article is not intended as a substitute for medical treatment. If you have questions related to your medical condition, please contact your family physician. For further inquires related to this topic email: drpmackarey@msn.com
Paul J. Mackarey PT, DHSc, OCS is a Doctor in Health Sciences specializing in orthopaedic and sports physical therapy. Dr. Mackarey is in private practice in downtown Scranton and is an associate professor of clinical medicine at The Commonwealth Medical College.
Cara Lyle
The 2013 Commonwealth Medical College Healthcare Journalism Award: Congratulations to Cara A. Lyle, as the recipient of the 2013 TCMC Healthcare Journalism Award by Dr. Paul Mackarey! The award recognizes Cara’s excellence and dedication as a medical student and healthcare journalist.
Cara A. Lyle is a 4th year medical student and a member of the second class at The Commonwealth Medical College (TCMC). She was born in Pittsburgh, PA and raised in Ford City, PA. She earned a Bachelor of Science in Biology with a Minor in Chemistry at The University of Pittsburgh. She is currently applying for a residency in General Surgery. She enjoys spending time with her family, art and art history, traveling and staying active by working-out, going for walks or playing sports. Writing has also been a special interest of hers throughout her education and she is excited to continue to pursue this interest while in medical school.
Teen 1 is a 16 year old female involved in volleyball and student government. She does well in school and often achieves honor roll. She recently got into an argument with her best friend that has left her alienated from her larger group of friends. Since the argument, she is very moody and refuses to discuss any details with her parents. She has however, been able to talk to her older sister about the problem. She still attends and enjoys participating in her extracurricular activities. She continues to maintain her good grades.
Teen 2 is a 17 year old male involved in wrestling and science club. He does well in school and often achieves honor roll. He recently got into an argument with his best friend that has left him alienated from his larger group of friends. Since the argument he is very moody. He refuses to discuss any details with his parents. He has never been very close with his older sister and does not feel comfortable discussing any details with her either. He started acting out in class which has led to his first detention. He is unable to concentrate during class and as a result his grades have declined. He stopped attending wrestling practice because he no longer enjoys participating in the activity and his father discovered an empty bottle of alcohol in his dresser drawer while putting his clothes away.
Can you find the similarities and differences between these two teens? Which teen is showing signs of depression? What are the signs of depression that the teen is demonstrating? Which teen is at an increased risk for death by suicide? In an interview with Dr. Linda Thomas-Hemak, President/CEO of The Wright Center, she discussed the difficulty in differentiating between normal adolescent hormonal mood swings from the abnormal. It is the purpose of this column to assist you in this challenge through improved education and heightened awareness in order to seek appropriate intervention.
According to The National Institutes of Health, the top three most common causes of death for children and teens ages 5-14 are accidents, cancer and genetic conditions present since birth. The top three most common causes of death for teens and young adults ages 15-24 are accidents, homicide and suicide. This dramatic shift in the types of causes of death for adolescents and young adults accounts for the increase in death rates following puberty.
This shift in the types of causes of death also brings in the concept of “preventable” causes of death. Preventable is in quotations to signify the challenges we face in trying to prevent suicide. According to an article in the Journal of the American Medical Association, of the many suicide-prevention interventions they examined, only physician education in depression recognition and treatment and restriction of access to lethal means of taking one’s life reduced suicide rates, while all other strategies need more evidence to demonstrate an effect.
Lastly, by recognizing the warning signs of depression and risk factors for suicide we can begin to understand the differences between normal and abnormal teen mood swings and behavior changes.
Dr. Thomas-Hemak also discussed her view on the warning signs during our interview:
"Most mood swings are not pathological, but if you mix them with a lack of social support, with substance abuse and complex substance utilization, they all are linked and enable each other. One of the warning signs is if social, school or work performance or behaviors are affected. If anyone (parent, teacher, and friend) thinks there’s a problem, then it deserves attention."
Signs of Depression
Risk Factors for Suicide
With this information, let’s return to our two teens. The similarities among the two teens include involvement in extracurricular activities, good school performance and a recent psychosocial stressor.
The difference between the two teens is how the psychosocial stressor has affected them. Teen 1’s coping mechanisms are more likely to be the normal mood swings of adolescence in the setting of a psychosocial stressor. Teen 2 lacks social support and his personality is changing. Teen 2 is showing signs of depression including loss of interest or pleasure in activities he used to enjoy and lack of concentration. Teen 2 has also begun abusing alcohol. All of these put Teen 2 at greater risk for suicide.
Now that we better understand the difference between normal adolescent mood swings and behavioral changes and those that are cause for concern, what do we do? Find in Adolescent Medicine Part 3 of 3: “Tips for Addressing Concerns with Adolescents.”
For More Information About this topic:
Pediatric Research:
The Journal of the American Medical Association (JAMA)
http://www.adolescenthealth.org/Fellowships_Training/3635.htm>
http://www.nlm.nih.gov/medlineplus/ency/article/001915.htm
MEDICAL CONSULTANTS:
Dr. Linda Thomas-Hemak, MD: President/CEO of The Wright Center for Graduate Medical Education and The Wright Center Medical Group, P.C. She is dually board certified in Internal Medicine and Pediatrics. She leads The Wright Center for Primary Care Mid Valley practice, a level 3 NCQA designated Patient-Centered Medical Home.
Deborah Spring, MD: is board certified in Family Practice with board certification in the sub-specialties of Adolescent Medicine and Geriatric Medicine. She practices in Kingston, Pa.
Visit your doctor regularly and listen to your body.
Keep moving, eat healthy foods, exercise regularly, and live long and well!
Read Dr. Mackarey’s Health & Exercise Forum in the Scranton Times-Tribune every Monday. Next week: Adolescent Medicine Part 3 of 3.
This article is not intended as a substitute for medical treatment. If you have questions related to your medical condition, please contact your family physician. For further inquires related to this topic email: drpmackarey@msn.com
Paul J. Mackarey PT, DHSc, OCS is a Doctor in Health Sciences specializing in orthopaedic and sports physical therapy. Dr. Mackarey is in private practice in downtown Scranton and is an associate professor of clinical medicine at The Commonwealth Medical College.
Cara Lyle
The 2013 Commonwealth Medical College Healthcare Journalism Award: Congratulations to Cara A. Lyle, as the recipient of the 2013 TCMC Healthcare Journalism Award by Dr. Paul Mackarey! The award recognizes Cara’s excellence and dedication as a medical student and healthcare journalist.
Cara A. Lyle is a 4th year medical student and a member of the second class at The Commonwealth Medical College (TCMC). She was born in Pittsburgh, PA and raised in Ford City, PA. She earned a Bachelor of Science in Biology with a Minor in Chemistry at The University of Pittsburgh. She is currently applying for a residency in General Surgery. She enjoys spending time with her family, art and art history, traveling and staying active by working-out, going for walks or playing sports. Writing has also been a special interest of hers throughout her education and she is excited to continue to pursue this interest while in medical school.
Parents, you know the feeling of a hug from your young child. Though their arms barely reach beyond your shoulders, they throw their light weight on you and you feel their heavy love. There’s nothing quite like it. This love and admiration continues to grow as they do and a great bond is built between you and your child. Then…they become teenagers.
I am very familiar with this transformation despite being a childless twenty-something. Not too long ago I made this transition myself… we all have. Beyond this commonality we all share, I have developed a special interest in the needs and care of adolescents.
I grew up in a small town in Western Pennsylvania. Most of mother’s family lives within a few miles of each other, which allows for my aunts, uncles and cousins to be a constant presence in my life. As one of the older cousins in a group of 20, I loved babysitting for my younger cousins. I have had many of those love-filled hugs and have watched a few of them transition into adolescents and young adults. Through their difficult times, I’ve tried my best to help in a role mixed of friend, sibling and parent. Now, as a medical student, I recognize the importance of bringing awareness to adolescence. My history as a confused teen and study of medicine at TCMC have sparked a keen interest in adolescent medicine because I hope to make the journey a little easier and healthier for the next parent – teen conflict.
For many parents, their teen takes on an alien form, a direct opposition to that adorable, loving child. Hugs are repulsing and painful behaviors and admiration for parents is an uncomfortable and disturbing feeling. In the world of a teenager, the planet can be as complicated as their form: filled with desires for social acceptance, or the emptiness of social isolation, adjustment to a changing body, positive or negative body image, peer pressures, the journey to self-acceptance and more.
Recognizing such manners in our past adolescent selves, or in the adolescents among us, makes it easy to understand why adolescents would need their own subspecialty, or narrow area of study or concentration, in medicine. However, this need wasn’t always so obvious. It took some time, historical change and scientific advancements for this subspecialty to emerge.
According to,The History of Adolescent Medicine, the predecessors to formalized adolescent medicine as early back as the late 19th century in England. Physicians in England treating adolescent boys at boarding schools established an association. During the post-World War I era, universities began offering medical services for college students. Then, came the post-World War II era, the period in which the adolescent masses grabbed the much needed attention of society and the medical community.
According to the journal, Pediatric Research, by the early 1960s, America saw its teenage population increase dramatically from 30 million to 40 million. The change in the values and numbers of the youth of America led to what the authors described as: "rejection of traditional religious, work, and interpersonal values by an increasingly independent and growing youth population in the 1960s led to more sexual experimentation, inconsistent contraceptive practices, wide use of illicit drugs, cigarettes and alcohol and secondary as well as postsecondary school failure."
Advances in various fields of medicine fortunately followed these changes and increases in high risk behaviors. Psychiatry recognized that mental health problems show up in adolescence. Gynecology had technological advancements including, but not limited to, the Papanicolau or “Pap” smear. Named after Dr. Papanicolau, the Pap smear revolutionized preventative medicine for sexually active teens. Chronic disease management saw improvements as well. Children once at risk for dying during childhood began living into adolescence because of advancements in surgery, organ transplantation, chemotherapy and others.
These fields of medicine had been working independently and without focus on the adolescent patient, but came together to address the needs of the nation’s masses of adolescents. A formalized field of adolescent medicine was established in the late 20th century. By 1994, the first exam for certification in adolescent medicine was given by The American Board of Pediatrics. Training programs in adolescent medicine quickly followed. According to the Society for Adolescent Health and Medicine,there are presently 26 adolescent medicine training programs, 2-3 years in duration, available to medical doctors who first specialized in pediatrics or internal medicine.
Adolescence is a difficult and trying time for many teens. More than ever, the medical community is prepared to address the needs of adolescents. I hope readers have gained awareness, an appreciation for and a better understanding of the subspecialty of adolescent medicine. Yet, how does a parent or friend, know if the teenager in their life is navigating through adolescence without cause for concern? Find out in Adolescent Medicine Part 2 of 3: “When is erratic behavior cause for concern?”
For More Information About this topic:
Pediatric Research <http://www.adolescenthealth.org/Fellowships_Training/3635.htm>.
Visit your doctor regularly and listen to your body.
Keep moving, eat healthy foods, exercise regularly, and live long and well!
Read Dr. Mackarey’s Health & Exercise Forum in the Scranton Times-Tribune every Monday. Next week: Adolescent Medicine Part 2 of 3.
This article is not intended as a substitute for medical treatment. If you have questions related to your medical condition, please contact your family physician. For further inquires related to this topic email: drpmackarey@msn.com
Paul J. Mackarey PT, DHSc, OCS is a Doctor in Health Sciences specializing in orthopaedic and sports physical therapy. Dr. Mackarey is in private practice in downtown Scranton and is an associate professor of clinical medicine at The Commonwealth Medical College.
I am sure that many of you feel as I do…it is beyond my comprehension that in two days I will be living in the year two thousand and fourteen! Moreover, I hope you share my sentiments that each year, each month, week, day, and minute is a gift, not to be taken for granted. And that is why we resolve at this time each year to make a concerted effort to improve ourselves; mentally, physically and spiritually, so that we may live a longer and healthier life, in order to spend more time with the friends and family we love.
Not surprisingly, getting physically fit and losing weight are the top resolutions to begin each New Year. According to the University of Pittsburgh Medical Center, 10 million Americans choose to join one of the 45,000 health clubs and hope to get fit and healthy for life. Unfortunately, if starting an exercise program is the hard part, than sticking to it is the hardest part.
Once the initial excitement and enthusiasm wears off, so too does the discipline and determination necessary to overcome the many distractions in our lives to make exercise a priority for life. Diane Klein, PhD polled long-term exercisers (those exercising at least 3 times per week for more than 13 years) what motivated them to “stick with the program.” The answers are in order of importance. Please note that “appearance” was NOT at the top of the list.
Fitness
Feelings of well-being
Pep and energy
Enjoyment of the exercise
Making exercise a priority
Sleeping better
Feeling alert
Being relaxed
Weight management
Appearance
Add variety to your program – stick to your basic program to meet your goals but add variety to stick to your program. On off days walk in the woods, play tennis, ride a bike, and swim. One day do upper body and the next lower body.
Find an exercise buddy – no one wants to let their buddy down so the likelihood of compliance is much greater when you have someone depending on you. Make sure it is a good match…someone with positive energy!
Make exercise a priority – friends and family must understand that this is important to you. It is a non-negotiable part of your day, like taking a vitamin or brushing your teeth.
Exercise first thing in the morning – For many people it is best to exercise before all of the demands of the day come into play
Exercise on the way home from work – For others, it is best to exercise after they fulfill their other obligations but before they get home, eat and settle in. Some days it will vary.
Exercise even when you are tired – keep in mind that you will be energized after you exercise.
Keep a log of your exercise – writing down the dates, times, speed, distance, reps and sets can help you monitor your progress.
Look for signs of progress – the scale is only one sign of progress. Make note of how your clothes fit, how much energy you have, the pep in your step and the improvement in your exercise log.
Walk – incorporate walking into your daily routine. Walk to the store, walk the dog, walk when you play golf and take the stairs.
Reward yourself – this is an individual preference but try to avoid a food overdose. For example, buy a new dress when you lose 10 pounds, go away for the weekend for the next 10 pounds. Do whatever works for you.
Lastly, if nothing else motivates you to continue your exercise routine, remember that researchers have found that the benefits of regular physical activity are numerous:
Loss or Maintained Body Weight
Reduces LDL /Raises HDL Cholesterol
Improves Circulation and Blood Pressure
Reduces Risk of Heart Disease
Prevents Bone Loss
Reduces Stress/Muscle Tension
Lowers Risk of Depression
Improves Sleep Pattern
Improves Strength and Flexibility
Improves Balance/Reduces Risk of Falls
Improves Immune System
Improves Pain Threshold
Source: WebMD
Visit your doctor regularly and listen to your body. Keep moving, eat healthy foods, exercise regularly, and live long and well!
NEXT MONDAY – Read Dr. Paul J. Mackarey “Health & Exercise Forum!” in the Scranton Times-Tribune.
This article is not intended as a substitute for medical treatment. If you have questions related to your medical condition, please contact your family physician. For further inquires related to this topic email: drpmackarey@msn.com
Paul J. Mackarey PT, DHSc, OCS is a Doctor in Health Sciences specializing in orthopaedic and sports physical therapy. Dr. Mackarey is in private practice and is an associate professor of clinical medicine at The Commonwealth Medical College.
Guest Author: Carolyn Murrer, The Commonwealth Medical College
Guest Author Carolyn Murrer, is a graduate student in The Masters of Biomedical Sciences Program at The Commonwealth Medical College where she is a social chair on the graduate student council. She received her Bachelor of Science Degree in Movement Science from the University of Michigan and plans to continue her education in medicine. In her free time she volunteers at the local hospital and makes time for cooking and exercising as much as possible and is always looking to try new, fresh foods.
Overindulgence during the holidays causes many to make New Year's resolutions related to diet and exercise. But, this year, I propose that you incorporate healthy habits during the holiday season, and you may find that your resolutions are not as hard to keep.
Generally, over the holidays many people seem to worry about staying healthy and maintaining a healthy diet. Often you hear the phrase “Come January I’ll hit the gym”… or something along those lines. I can see why this mentality may be prevalent and I am certainly not suggesting that you forgo all of the special holiday treats that only come around this time of year. Enjoy them. Be jolly. Be Merry. But be moderate. Moderation is vital to living a healthy life. Despite all of the fads, it is well-documented that there is no magic diet pill or weight loss program that will solve all of your problems. In fact, the cornerstone of all successful healthy life-style programs is the emphasis on balance between energy expenditure and caloric intake. If you expend more energy than you intake you will most likely lose weight. On the flipside, however, if you intake more than you expend then you may end up putting on a few extra pounds. Rather than go to extreme measures with dieting and exercise, it is best to maintain certain lifestyle habits that will translate into a happy, healthier you. With this in mind… it is important to relax and enjoy the holidays this time of year. In order for you to enjoy the holidays as much as possible and leave the guilt at the front door of the party, I am proposing 12 healthy holiday habits that you can adopt now and ultimately continue as part of your lifestyle throughout the year.
1. Make time for exercise… Even when you may be busy doing many holiday related errands/activities. Investing only twenty minutes a day will benefit your health. I’ve always believed that taking time out of your day to exercise is an investment for good health, it may take extra time and effort now but it is an important lifestyle habit to adopt. The more you do it, the less it will seem like a chore and instead will begin to feel like it is part of your everyday routine.
2. Relaxation is Key… So make time for yourself. Spend twenty minutes a day reading that good book. This helps reduce stress levels.
3. Sleep … Maintaining adequate sleep time helps the body stay healthy. Sleep allows time for your organs to recharge in order to prepare you for the next day.
4. Get Fresh Air… Staying inside all day in recycled air may lead towards sickness due to the fact that you continuously breathe in other’s germs. It is advantageous to open the windows for even only five minutes to allow fresh air to circulate throughout your house Walk around the block to look at all of the holiday lights or take your dog for a walk.
5. Moderate Cookie and Sweet Consumption … People bake an array of holiday desserts. Allow yourself to enjoy the sweet delicious treats, yet try not to overindulge. Nothing tastes too great after the fifth one… does it?
6. Try New Fruits and Vegetables ... New varieties of fruits and vegetables are in season this time of year. Every week at Wegman’s I try to sample a new vegetable. Many vegetables at Wegman’s come from local farms, allowing for them to be fresh and for new varieties to be continuously available. Give those fresh artichokes a chance… you never know what you may have been missing out on all of this time.
7. Be Active --Go Ice Skating or Hit the Slopes … Again, get outside and enjoy the fresh, crisp, pure air.
8. Stay Hydrated … Water is essential for maintaining health. It plays a vital role in nourishing our organs. Mayo Clinic recommends: Men drink 13 cups of liquid a day. Women drink 9 cups of liquid a day.
9. Add Green … Make sure your dinner plate is full of color as much as you possibly can. Green, leafy, vegetables are full of vitamins, fiber, and protein. Fiber is essential for maintaining proper digestion and thereby, aids in maintaining a healthy colon.
10. Limit Sugary Drinks … The coffee shops tend to offer many delicious, sugary, caloric drinks this time of year. Allow yourself to enjoy the caffeine treats of the season, but do not allow it to become a daily habit. If you usually drink black coffee most days of the week, keep to that habit. There are a lot of hidden calories in the festive, holiday drinks.
11. Treat yourself to a gym membership or a spa day … If you have been planning to buy that Yoga membership or gym membership, treat yourself now. It is important to take care of yourself and exercise is an essential component of any wellness program.
12. Spend time with your family and friends … Laughter is a great stress reliever. Find some fun people with positive energy!
NEXT MONDAY – Read Dr. Paul J. Mackarey “Health & Exercise Forum” in the Scranton Times-Tribune.
This article is not intended as a substitute for medical treatment. If you have questions related to your medical condition, please contact your family physician. For further inquires related to this topic email: drpmackarey@msn.com
Paul J. Mackarey PT, DHSc, OCS is a Doctor in Health Sciences specializing in orthopaedic and sports physical therapy. Dr. Mackarey is in private practice in Scranton, PA and is an associate clinical professor of medicine at The Commonwealth Medical College.
Vegetarianism & One Doctor’s Attempt At Being a Healthy Role-Model: Part 3 of 3
by Luana J Hossain, MS3 TCMC, and Paul J Mackarey, PT, DHSc, OCS
This column is written in celebration of Dr. Jennifer Sidari’s life. Dr. Sidari, a native of Pittston, was a member of the first class to graduate from The Commonwealth Medical College (TCMC) and truly represented everything that is good about TCMC and NEPA. Dr. Sidari passed away unexpectedly in May of 2013. She was bright, strong, genuine, energetic and compassionate. She was a breath of fresh air and lit up any room she entered; her positive spirit was contagious. Her classmate, Luana Hossain, and I spent many hours with her, collaborating on ideas, projects, drafts, and columns for the Healthcare Journalism Club at TCMC. Her presence is deeply missed by our group and everyone who knew her.
According to the Oxford English Dictionary, the word “vegetarian” was derived from the word vegetable. The Latin word “vegetus” means lively or vigorous. How very appropriate for Dr. Jen Sidari!
The only foods a vegetarian eats are fruits and vegetables: Strict vegetarians, such as vegans, eat only fruits, vegetables, legumes, grains, nuts and seeds. However, as discussed in Part II of this series on vegetarianism, there are many varieties of vegetarians such as pesco-vegetarians, who also eat fish and seafood.
Vegetarianism is a “new fad” that began in the 1970’s “hippie” era: The complex-hunter gatherer developed once man became more domesticated and practiced less time-consuming activities such as hunting and relocating. Man had more permanent shelter and developed agricultural skills. In ancient Greece and Rome, scholars, preachers, and philosophers promoted the use of vegetarianism for ethical, moral and health reasons. Many religions follow some degree of vegetarianism as well. Today, this lifestyle is growing in popularity for the same reasons.
Vegetarians are not as healthy as those who consume meat because they don’t get enough protein and other nutrients: On the contrary, vegetarians are very healthy, as long as they consume enough varieties of fruits and vegetables, especially dark leafy greens like kale. The American Dietetic Association states that a vegetarian can meet all of the protein requirements and essential amino acids and vitamins, fats and minerals to be very healthy. In fact, according to peer-reviewed scientific studies in 2012, vegetarians are healthier and live longer (7.2 years longer for men and 4.4 years longer for women) than their carnivorous counterparts. They have a lower body mass index with fewer incidences of kidney stones, type II diabetes, coronary artery disease, and cancer.
Providing food for vegetarians in large numbers will stress the environment: Actually, calorie to calorie, a vegetarian diet uses 1/5 the amount of water that is needed to produce 1 pound of beef. Additionally, in states where livestock graze, 85% of the land is unusable for agriculture and 80% of the streams are damaged. Lastly, raising animals for food creates 18% of global greenhouse gases.
Man was anatomically designed to eat meat …not vegetables: For the same reason man no longer walks on all four limbs, man has evolved and adapted for survival and advancement. Humans do not have large mouths, pointed teeth, or short intestines like those found in true carnivores. Instead, our short, flat teeth assist in chewing and long intestines promote full digestion of vegetables.
Children of vegetarians are not fully developed and don’t get adequate protein: Not true. As noted above, a vegetarian diet, with adequate nutritional variety, provides a growing body with all of the nutrients, vitamins and minerals it needs.
Vegetarians develop an offensive body odor: Recent studies found that males who did NOT eat red meat secreted a body odor with greater sex appeal than those who ate meat. . But, just in case, remember to continue showering.
There are no vegetarian role models: Paul McCartney, Brad Pitt, Albert Einstein, Henry Ford, and Leonardo da Vinci are pretty good role models for anyone!
Vegetarian food tastes bad: Food preferences are as varied as the billions of people on the planet! All foods, with a modicum of effort, can be prepared appetizingly. Conversely, any food can be prepared badly. Think back to mystery meat day in grade school – one example of unappetizing meat. Because there is such a wide range of flavors in the world of vegetables, fruit, nuts and spices, many different and delicious meals can be prepared without the use of meat.
Being a vegetarian is too difficult: Making any big lifestyle change required perseverance and dedication initially. However, our culture has grown to accept special diets such as vegetarian, lactose free, gluten free and more. This means that grocery stores and restaurants frequently have vegetarian options, and planning vegetarian meals doesn’t take any more time than planning a meaty meal. Browse your local grocery store or online and find out what vegetarian options are available to you.
Guest Columnist, Luana Hossain, 3rd Year Medical Student, TCMC:
Embarking on her third year as a medical student at The Commonwealth Medical College (TCMC) on Pine Street in Scranton, Luana aims to practice obstetrics and gynecology in an urban underserved region. She is the youngest of three girls and, though born in Switzerland, she has lived on both coasts of the US. Luana received her undergraduate degree in Environmental Science and Anthropology from the University of Virginia, where she was also the section editor of the university paper’s Health and Science section. She is currently the president of TCMC’s Healthcare in Journalism Club and one of four class officers. When she needs a break from studying, Luana loves to do anything outdoors, travel, and cook for her friends. She grew up speaking German and English, and picked up Spanish and some French along the way as well.
Paul J. Mackarey PT, DHSc, OCS is a Doctor in Health Sciences specializing in orthopaedic and sports physical therapy. Dr. Mackarey is in private practice and is an associate professor of clinical medicine at The Commonwealth Medical College.
Read “Health & Exercise Forum” – Every Monday This article is not intended as a substitute for medical treatment. If you have questions related to your medical condition, please contact your family physician. For further inquires related to this topic email: drpmackarey@msn.com
Vegetarianism & One Doctor's Attempt at Being a Healthy Role Model: Part 2 of 3
by Luana J Hossain, MS3 TCMC, and Paul J Mackarey, PT, DHSc, OCS
This column is written in celebration of Dr. Jennifer Sidari’s life. Dr. Sidari, a native of Pittston, was a member of the first class to graduate from The Commonwealth Medical College (TCMC) and truly represented everything that is good about TCMC and NEPA. Dr. Sidari passed away unexpectedly in May of 2013. She was bright, strong, genuine, energetic and compassionate. She was a breath of fresh air and lit up any room she entered; her positive spirit was contagious. Her classmate, Luana Hossain and I spent many hours with her, collaborating on ideas, projects, drafts, and columns for the Healthcare Journalism Club at TCMC. Her presence is deeply missed by our group and everyone who knew her.
According to the Oxford English Dictionary, the word “vegetarian” was derived from the word vegetable. The Latin word “vegetus” means lively or vigorous. How very appropriate for Dr. Jen Sidari!
Anthropologists agree that before farming and domesticated animals, our ancestors relied on hunting wild game and gathering what they could find for food. Since the game migrated with the seasons, humans followed. Because hunting was a time and energy consuming activity, and because early humans did not have permanent homes where they could grow crops, the majority of their diet was plant-based. Over the centuries, humans began to domesticate animals, like dogs, which could help with hunting. They learned to cultivate seeds in small areas for a few months at a time, meaning they could move less frequently; this lifestyle is termed “complex-hunter gatherer”. Eventually, humans stopped following game, cultivated all the plants they required, and raised livestock for meat so that there would be a relatively constant supply. This shift in food production changed the human diet to one of larger portions of meat and animal products.
Across the world, cultures have been vegetarian or vegan for centuries. The more recent revival occurred on our part of the globe in the early 1800’s with the American Vegetarian Society, founded in 1850. Vegetarian and vegan lifestyles became celebrated in the 1960s counterculture movement and then again in the 1970s, markedly through Peter Singer’s book Animal Liberation. In recent times, the environmental impact of meat production has come into the public eye as well as health concerns. “Red meat” like beef and pork has been shown in many studies to increase the risk of heart disease, a leading cause of death in the United States. Thus, vegetarian diets and healthy lifestyles have become a mainstream focus
Lacto= dairy (milk, cheese, yogurt, ice cream etc.)
Ovo= eggs
Legumes = beans, peanuts, soy, lentils, chickpeas etc.
|
Eat |
Avoid |
|
|
Lacto-Ovo Vegetarian |
fruits, vegetables, grains, nuts, seeds, eggs, dairy |
Meat, fish and seafood, poultry |
|
Ovo-vegetarian |
Fruit, vegetables, grains, nuts, seeds, eggs |
Meat, fish and seafood, poultry, dairy |
|
Lacto-vegetarian |
Fruit, vegetables, grains, nuts, seeds, dairy |
Meat, fish and seafood, poultry, eggs |
|
Pescatarian/ Pesco-vegetarian |
Fruit, vegetables, grains, nuts, seeds, fish and seafood |
Meat, poultry, eggs, dairy |
|
Pollo-vegetarian |
Fruit, vegetables, grains, nuts, seeds, poultry (chicken, turkey), eggs, dairy |
Meat, fish and seafood |
|
Vegan |
Fruit, vegetables, legumes, grains, nuts, seeds |
Meat, fish and seafood, poultry, eggs, dairy Vegans also do not use any products from animals like honey, leather, wool, silk and more |
|
Macrobiotic diet |
Grains, vegetables, legumes primarily Some fruit, nuts, seeds |
Meat, fish and seafood, poultry, eggs, dairy |
|
Raw diet |
Any raw fruit, vegetables, grains, nuts, sometimes eggs and dairy |
Meat, fish and seafood, poultry |
|
Fruitarian |
Fruit, nuts, seeds |
Any produce product that results in harm to the plant, grain, meat, fish and seafood, poultry, eggs, dairy |
According to the US Department of Agriculture and the US Department of Health and Human Services, vegetarians consume less overall calories, fewer calories from fat (especially saturated fat), more fiber, potassium, vitamin C and other vitamins than non-vegetarians. Studies found that adults adopting a vegetarian-style eating pattern have overall improvement in health outcomes. Additionally, studies found fewer incidences of obesity, lower blood pressure, less cardiovascular disease and lower total mortality.
Moreover, there are a number of diseases transmitted by the consumption of meat that vegetarians avoid. Some studies found E. Coli, a deadly bacteria in more than 35.% of chicken and 19.% of beef while salmonella has been found in 33.% to 50.% of all chicken and bovine leukemia virus (BLV) has been discovered in 20.% of all cows in the US according to the US Department of Labor.
While health remains the primary motive for vegetarianism, many practice this lifestyle for economic and ethical reasons. Many religions and cultures believe that eating the flesh of non-human animals is taboo. Others feel that the inhumane methods of raising and slaughtering animals for food are unethical. Furthermore, it is widely known that the mass production of meat and animal products cannot be sustained according to the 2006 United Nations initiative. These methods contribute to pollution of the air and water, destruction of land, and global warming. A vegetarian diet, for example, uses 1/5 the amount of water that is needed to produce 1 pound of beef. Agriculture produces 18% of CO2 global greenhouse gases. The amount of land for grazing and water necessary to sustain livestock is not proportional to the number of mouths fed. Livestock herds stress grasslands and stifle agricultural opportunities. With the decline in available land and water per capita, lowering meat consumption would allow a greater opportunity to grow more efficient foods, such as grains, to feed the hungry around the globe.
Next week: “The Five Common Myths About Vegetarianism.”
Guest Columnist, Luana Hossain, 3rd Year Medical Student, TCMC:
Embarking on her third year as a medical student at The Commonwealth Medical College (TCMC) on Pine Street in Scranton, Luana aims to practice obstetrics and gynecology in an urban underserved region. She is the youngest of three girls and, though born in Switzerland, she has lived on both coasts of the US. Luana received her undergraduate degree in Environmental Science and Anthropology from the University of Virginia, where she was also the section editor of the university paper’s Health and Science section. She is currently the president of TCMC’s Healthcare in Journalism Club and one of four class officers. When she needs a break from studying, Luana loves to do anything outdoors, travel, and cook for her friends. She grew up speaking German and English, and picked up Spanish and some French along the way as well.
Paul J. Mackarey PT, DHSc, OCS is a Doctor in Health Sciences specializing in orthopaedic and sports physical therapy. Dr. Mackarey is in private practice and is an associate professor of clinical medicine at The Commonwealth Medical College.
Read “Health & Exercise Forum” – Next Monday read Part 3 of 3 on Vegetarianism-one doctor's attempt at... This article is not intended as a substitute for medical treatment. If you have questions related to your medical condition, please contact your family physician. For further inquires related to this topic email: drpmackarey@msn.com
Vegetarianism & One Doctor's Attempt to Be Healthy Role-Model: Part 1 of 3
by Luana J Hossain, MS3, TCMC, and Paul J Mackarey, PT, DHSc, OCS
This column is written in celebration of Dr. Jennifer Sidari’s life. Dr. Sidari, a native of Pittston, was a member of the first class to graduate from The Commonwealth Medical College (TCMC) and truly represented everything that is good about TCMC and NEPA. Dr. Sidari passed away unexpectedly in May of 2013. She was bright, strong, genuine, energetic and compassionate. She was a breath of fresh air and lit up any room she entered; her positive spirit was contagious. Her classmate, Luana Hossain and I spent many hours with her, collaborating on ideas, projects, drafts, and columns for the Healthcare Journalism Club at TCMC. Her presence is deeply missed by our group and everyone who knew her.
Healthy Role Model
Dr. Sidari, as described by her classmates, was an amazing friend with an infectious smile. She was an inspiring colleague who embarked on new undertakings with a sparkle in her eye and unwavering enthusiasm. Her spirit for adventure was boundless and she loved a challenge. One day in her third year of medical school, she excitedly proclaimed that she was going to be vegan after watching a documentary about the benefits of avoiding animal products. In order to help promote a healthy diet and lifestyle in her patients, she felt the need to experience the trials and tribulations of such a way of life firsthand. However, Dr. Sidari also valued balance, understanding, and kindness. She would have been pleased with any attempt to improve one’s life and lifestyle. Thus, while she chose a vegan lifestyle, it will be the purpose of this series of columns to educate the public about all forms of vegetarianism and inspire our readers to make just one healthy change in her honor.
Vegetarianism is truly a lifestyle, not just a diet fad. For vegans, without proper education and preparation, cutting out meat, cheese and dairy might lead to eating a lot of pasta and potatoes. Deciding to pursue produce, nuts, seeds and grains for nourishment instead of a just a meatless diet means wiping the menu board clean and establishing an entirely new and different approach to food. And, while this worked for someone with Dr. Jen’s determination and discipline, it may not be the best choice for all. A simple vegetarian diet of vegetables, fruits, nuts and fish without any red meat is appropriate for some. For others, a well-balanced Mediterranean diet, consisting of fresh vegetables, fruits, nuts and fish, with limited amounts of red meat and red wine is best. Limiting meat consumption to one day a week is an admirable first step.
But the cheese…“Vegan? Really?” “Yup,” she replied pushing away the cheese and crackers arranged temptingly on the paper plate. “It’s not that bad, the only thing I really crave is cheese.” Jen’s gaze lingered on the cheese cubes for just a moment more and I could almost hear her appetite screaming, Eat it!, but her determination won, as it usually did. Instead, she delved into the rationale for becoming vegan.
The primary motive for Dr. Jennifer Sidari’s journey into veganism, the strictest form of vegetarianism, relates to her study of medicine:
The documentary, Forks Over Knives, set the wheels in motion. Led by Dr. Caldwell Esselstyn, surgeon and head of the Breast Cancer Task Force at the Cleveland Clinic and Dr. T. Colin Campbell, a nutritional scientist at Cornell University, the film investigated the possible health effects of eating animal protein, including a potential link with cancer and heart disease. The pair’s research seemed to suggest that there was a link between animal protein and disease.
The American Heart Association showed in 2010 that red meat, specifically, contributes to increased heart disease risk. The American Journal of Gastroenterology included a 2012 study that found an increase in inflammatory bowel disease, like Crohn’s disease or ulcerative colitis, in those who had a diet high in saturated fats, meat, and several other dietary lipids.
Health is a common reason people choose a meat-free diet. Former President Bill Clinton adopted a vegan diet to improve his heart health on his doctor’s advice after a heart procedure in 2010, preceded by quadruple bypass coronary artery surgery in 2004.
Additional reasons to make the diet change include animal welfare, religious indications, environmental burden of supporting livestock and large crops, and even taste preference.
For more information about the benefits of a vegetarian diet:
http://www.nature.com/ajg/journal/v106/n4/full/ajg201144a.html
http://circ.ahajournals.org/content/122/9/876.short
http://www.forksoverknives.com/about/synopsis/
Next week the history and different types of vegetarianism
Guest Columnist, Luana Hossain, 3rd Year Medical Student, TCMC,:
Embarking on her third year as a medical student at The Commonwealth Medical College (TCMC) on Pine Street in Scranton, Luana aims to practice obstetrics and gynecology in an urban underserved region. She is the youngest of three girls and, though born in Switzerland, she has lived on both coasts of the US. Luana received her undergraduate degree in Environmental Science and Anthropology from the University of Virginia, where she was also the section editor of the university paper’s Health and Science section. She is currently the president of TCMC’s Healthcare in Journalism Club and one of four class officers. When she needs a break from studying, Luana loves to do anything outdoors, travel, and cook for her friends. She grew up speaking German and English, and picked up Spanish and some French along the way as well.
Paul J. Mackarey PT, DHSc, OCS is a Doctor in Health Sciences specializing in orthopaedic and sports physical therapy. Dr. Mackarey is in private practice and is an associate professor of clinical medicine at The Commonwealth Medical College.
Read “Health & Exercise Forum” – Next Monday read Part 2 of 3 on Vegetarianism- One doctor’s attempt at... This article is not intended as a substitute for medical treatment. If you have questions related to your medical condition, please contact your family physician. For further inquires related to this topic email: drpmackarey@msn.com
Part 2 of 2: “Hospice Programs for the Community”
November is National Hospice Month! During this time we celebrate the tireless work of the hospice professionals who assist patients and their families during the weeks and months that they journey with a serious or terminal illness.
However, in addition to the service of providing pain and symptom management, assisting with personal care, providing volunteer, counseling and social work services, there may be many other services that your local hospice program may be able to offer to patients, families and caregivers alike.
Please keep in mind that each hospice agency provides unique services to the community. Before you decide, it is important to reach out and ask which agency offers services that best meet your needs.
Some community support programs that are offered by hospice agencies that are routinely available include:
Bereavement Support --Dealing with the death of a loved one can be a difficult and often lonely endeavor. All hospice agencies offer bereavement services to families of patients that have died. In addition, many hospices offer community support programming to help those who have suffered a loss. Some support programs are in groups, but often individualized help is available. Most times the bereavement services for the community are without charge.
Pet Bereavement Support--The death of a pet can often be quite traumatizing, especially when the pet has been a long standing member of the family. Hospice agencies are offering bereavement counseling for those who suffered the loss of a pet. Call and reach out if you have suffered a loss and require support.
Dementia Support Groups-- Nancy Reagan always referred to the diagnosis of President Reagan as the ‘long goodbye’. Dealing with a loved one suffering with dementia is difficult---but you do not have to deal with this alone. Many hospices have dementia support groups that educate, support and guide.
Supporting Children through a Loss--Often it is difficult for children to understand or process the death of a parent, sibling, and grandparent or loved one. There are specialized programs for children to understand and live with the loss----developing a new normal. These programs are usually done in a series of 5 sessions so that proper education and guidance can be accomplished.
Community Education Series-- Not only are your local hospices taking the lead to advance end of life care, but many are helping to educate the professional and lay community alike. Ask about monthly seminars, educational programs and other topics of interest to you and your family/co-workers.
Memorial Services-- Hospice agencies routinely celebrate the lives of those patients who have died within the last 6 months or a year. Surrounding yourself with others who have suffered a loss can often be healing and certainly supportive. Call and ask your local hospice about planned memorial services that honor lives well lived through prayer and testimonials.
Volunteer opportunities--There can be no better way to give back to your community than through volunteering opportunities. Hospice offers a wide array of ways to volunteer ranging from direct patient contact to more administrative tasks. Whatever the job, the act of volunteering is what makes hospice care so special.
Mentoring Programs-- As hospice programs are traditionally interdisciplinary in approach; students working with hospice programs are provided an optimal environment to learn not only hospice care, but also the ever important concept of team. Many hospice agencies work with students regularly from nursing schools, universities and our local medical college.
Transitions Program-- Often patients are referred for hospice services, but do not meet eligibility requirements for this level of care. However, many hospice agencies offer a transitions program, which is a volunteer supported program to monitor the frail elderly in the community and reporting changes back to the physician for advice and guidance. These programs are free of charge, volunteer supported and a valuable asset for the independent senior who may need that extra set of eyes and ears of a skilled volunteer.
So, in honor of National Hospice Month, we say, thank you to all the hospice professionals, volunteers and families who work so diligently to care for those in our community with a serious or terminal illness. But remember too, that your local hospice agency can be a wonderful resource for education, mentoring, dementia support and grief counseling. Ask questions, attend a seminar, inquire about memorial services or look for support when caring for a loved one with dementia. Help, support, guidance and education are available----just make the call to your local hospice agency.
To find out which hospices serve your community, call NHPCO’s HelpLine at 1-800-658-8898 or visit www.caringinfo.org/
Medical Contributor: Ralph DeMario, MD, CMO, Hospice of the Sacred Heart
Read Dr. Mackarey’s Health & Exercise Forum – Every Monday in the Scranton Times-Tribune. This article is not intended as a substitute for medical treatment. If you have questions related to your medical condition, please contact your family physician. For further inquires related to this topic email: drpmackarey@msn.com
Paul J. Mackarey PT, DHSc, OCS is a Doctor in Health Sciences specializing in orthopaedic and sports physical therapy. Dr. Mackarey is in private practice and is an associate professor of clinical medicine at The Commonwealth Medical College
Part 1 of 2: “Hospice Care--- Place the Focus on Life and Living”
November is National Hospice Month! Each November, the community of hospice and palliative care professionals celebrates National Hospice Month. Although, at first glance, spotlighting the concept of death and dying may seem a bit gloomy, it’s actually the concept of quality of life and the focus on living that is truly being celebrated.
It is true that hospice serves those patients and their families who are on the journey of a serious or terminal illness. But as any hospice professional from the nurse to the social worker to the volunteer to the pastoral counselor will attest------our focus is ALWAYS on the value of life being maintained and the quality of living for each and every one of our patients.
Placing the focal point of hospice care on living, instead of dying, enables the patient and family to focus on:
Remember that your hospice team will make suggestions to improve your pain and symptoms-----all with the ultimate goal of allowing you to live your life as fully and functionally as possible. Pain alleviation will allow for improved activities, help with personal care will conserve energy for visiting with family and friends, and allowing a volunteer into your home will give caregivers much needed time for rest and relaxation.
There are a number of myths surrounding hospice care--and this is good a time as ever to help dispel them.
Myth #1--- Hospice is for patients in the last days of their lives
Actually, hospice care was designed to care for patients and their families for the last 6 months of their lives----the longer patients are under the care of hospice professionals, the better their symptoms are controlled and the better their quality of living…..
Myth #2-- Pain medications are given in large doses to sedate the patient and hasten death
Pain medications are used in as small of doses as required to control pain, and to maintain patients’ alertness, always focusing on living life to the fullest. Medications are never given to hasten death, only to control pain and maintain quality of life.
Myth #3-- Once patients start hospice services, death will come soon
The statistics on this issue are interesting. In a major study, patients who received hospice care for congestive heart failure actually lived 29 days longer!!! Also, on average 15% of patients are actually discharged from hospice services because of significant improvement in symptoms.
Myth #4-- Patients receiving hospice services cannot leave the home or travel
The truth is that patients receiving hospice care can drive, travel as able, go to bingo/hairdresser/casino, actually come and go as they are able. So the goal is to improve symptoms so that patients can enjoy their lives as fully as possible while on the journey of a serious illness.
So although the topic of death and dying has been rather taboo in the US, hospice professionals celebrate the living potential that their patients still have. The focus is on quality of relationships, maintaining a functional lifestyle and living the life they were meant to live. Hospice professionals also celebrate the many lives they have improved, all the lives they have touched and the fact that they were chosen to dedicate their professional lives to helping others live more fully……
To find out which hospices serve your community, call NHPCO’s HelpLine at 1-800-658-8898 or visit www.caringinfo.org/
Medical Contributor: Ralph DeMario, MD, CMO, Hospice of the Sacred Heart
Read Dr. Mackarey’s Health & Exercise Forum – Every Monday- Next week read Hospice Care Part 2 in the Scranton Times-Tribune. This article is not intended as a substitute for medical treatment. If you have questions related to your medical condition, please contact your family physician. For further inquires related to this topic email: drpmackarey@msn.com
Paul J. Mackarey PT, DHSc, OCS is a Doctor in Health Sciences specializing in orthopaedic and sports physical therapy. Dr. Mackarey is in private practice and is an associate professor of clinical medicine at The Commonwealth Medical College.
