CLEVELAND CLINIC

CheckupHealth Information from the

Family Health Center Closest to You

F A M I L Y Spring/Summer 2003

Play it SafeThis Summer!

ummer’s breezes entice motorcyclists to the

open road, beckon boaters and swimmers to lakes

and rivers, and prompt plans for backyard fun.

Cleveland Clinic family health center physicians

hope you’ll enjoy summer by putting safety first.

That wind in your hair may feel great,

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

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

injuries that severely damage the brain. This can lead to

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

your brain is even more vulnerable to injury, especially

if you take aspirin or other blood thinners to protect

against heart attack or stroke.

Scooters and skateboards: rolling out new

guidelines... The American Academy of Pediatrics rec-

ommends scooters for kids 8 and up, and skateboards for

kids under 10 only if supervised. Scooters have created

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

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

on helmets to prevent head injuries, and encourage wrist-

and kneepads to prevent fractures. Steer skateboarders

toward skate parks with smooth surfaces, far from traffic.

A healthy respect for the water... Water safety

is important for the whole family. Drowning is the second

leading cause of death among children; toddlers and

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

wading pools. CPR training for everyone — even your

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

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

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

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

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

signaling sudden drop-offs; carry your canoe or kayak

around them to safety.

Backyard trampolines: accidents waiting to

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

supervised sessions with a gymnastics instructor. The

American Academy of Pediatrics recommends that home

trampolines be banned, noting the 140 percent spike in

trampoline-related injuries between 1990 and 1996, when

83,000 trampoline accidents required an ER visit. Thirty

percent involved fractures, and often hospitalization and

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

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

on the ground. And enjoy your summer!

SSunday appointmentsfor urgent problems canbe scheduled between8:30 a.m. and 12:30 p.m.through Nurse on Call:

216/444-1234

Free Health Talk:Occupational Medicine

June 12Call 216/444-3641

Coming: CT Scanner

Solon Family Health CenterChagrin Falls Family

Health Center

For appointments with our

family health center specialists,

call the Cleveland Clinic

Appointment Center between

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

year, at 216/444-2273 or

800/223-2273.

Kid’s KornerKid’s Korner

Sports Physicals:Summer Is the TimePractice for fall high school sports typically begins in

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

uation for your athlete beforehand. Now’s the perfect

time to make an appointment.

Ohio High School Athletic Association regula-

tions require participation forms for athletes in

grades 9 through 12 to be completed and signed by a

physician, the participant, and a parent or guardian

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

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

nurse practitioner to perform physicals.

High schoolers should also have comprehensive

regular exams by their primary care physician to

assess their overall health.

To schedule sports physicals with Solon pediatri-

cians or family medicine specialists, call 440/519-

6800. To schedule them with Chagrin Falls family

medicine specialists, call 440/893-9393.

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

processed with peanut products. Experts say that may

be why peanut allergies — lifelong in 80 percent of

cases — are so common, and the leading cause of

fatal or near-fatal food reactions.

A promising genetically engineered drug made

headlines in March when early studies showed it pre-

vented allergic reactions to peanut flour. However, it

has not yet been commercially developed.

So avoiding peanuts — and foods processed or

flavored with them (sometimes labeled as “natural”

flavors) — remains a must.

Check the ingredients of every snack and meal

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

dish. Be wary in restaurants — traces of peanut

products may be found in oil, pans or utensils used

to prepare “peanut-free” dishes. Warn children

against sharing food, especially at school. Some chil-

dren can develop reactions by touching those who’ve

just eaten peanut butter, or toys or play equipment

they’ve handled.

Reactions range from itching in the mouth and

throat, to airway closure within minutes. Keep self-

injectable epinephrine and a liquid antihistamine

on hand, and be sure that teachers and child

care providers know how to handle an emergency.

For appointments with Solon pediatricians and

family medicine specialists, please call 440/519-

6800; for Chagrin Falls family medicine specialists,

call 440/893-9393.Svetlana B. Pomeranets, M.D., a board-certifiedpediatrician practicing at Solon, provides gen-eral pediatric care. She has a special interest inthe care of internationally adopted children.

Arthritis Not a ForegoneConclusion for Aging Backs

MILLIONS OF OLDER AMERICANS ACCEPT BACK PAIN as an inevitable part of aging, along

with arthritis. But neither condition comes naturally with age. However, arthritis — particularly

osteoarthritis — is a common cause of back pain, according to the Arthritis Foundation, and can occur

anywhere along the spine.

Osteoarthritis causes the cartilage cushioning the joints to wear away, allowing bones to rub against

each other. It causes mild to severe pain, restricted movement and sometimes, numbness. Different fac-

tors set the stage for osteoarthritis:

■ excess weight or obesity putting pressure on joints

■ sports or work injuries

■ cartilage defects occurring at birth

Seeing a doctor when back pain first develops can prevent disability. A safe, effective management

plan may include physical therapy, anti-inflammatory or pain medication, and nutrition advice to pro-

mote weight loss. Physical therapists can provide exercises to keep the back limber and increase muscle

strength. Braces or supports for the spine, and heat or cold for pain relief, can also be prescribed.

Family medicine specialist Fredrick P.Wilson, M.D., specializes in the treatmentof low back and neck pain. For appoint-ments with Dr. Wilson at Solon’s Back andNeck Center, call 440/519-6800.

Healthy Summer EatingAS SUMMER APPROACHES, many of us want to

shed pounds along with layers of clothing. According

to the American Dietetic Association, the popular

high-protein, low-carbohydrate diets suggest that

carbohydrates are “bad for you” and make you gain

weight. But high-protein, low-carbohydrate diets

tend to be low in calcium, fiber and nutrients that

protect against heart disease and cancer.

Dieters who eat more total calories and get less

physical activity will wind up gaining weight. Our

nutrition specialists recommend foregoing fad diets.

Instead, adopt healthy weight management tech-

niques. Eat fewer fast foods, measure portion sizes,

and increase your intake of fruits, vegetables and

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

calories than you burn, and increase your physical

activity.

Variety and moderation are key, as are total calo-

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

you’ll lose weight.

Peggy Zeller, R.D., L.D., is a registered dietitian

available for consultation at Cleveland Clinic Solon.

For appointments, please call 440/519-6800.

Guarding Against West Nile Virus

Mosquitoes — once mere annoyances — now pose a threat due to West Nile

virus, which can infect mosquitoes, birds, horses and people. Last summer, eleven

of 211 Cuyahoga County residents with infections died.

Typically, West Nile virus causes no symptoms, the Centers for Disease Control

and Prevention reports. In 20 percent of cases, mild fever, headache, body aches,

skin rash and swollen lymph glands develop. In one of 150 cases, severe illness

ranges from headache, high fever and stiff neck to stupor, coma, convulsions and

paralysis.

West Nile virus doesn’t appear to spread from animals to people, or directly from

person to person. In rare instances, it has been transmitted through breast milk and

organ transplantation, but risks are slight, experts say.

Meanwhile, protect yourself with insect repellent containing DEET (N, N-diethyl-

meta-toluamide) on skin and clothing outdoors, and wear long-sleeved shirts and

pants. Stay inside at dawn, dusk and early evening, when mosquitoes are hungriest.

And eliminate standing water (mosquito breeding grounds) from your yard.

Solon family medicine or internal medicine specialists and pediatricians are avail-

able to discuss your concerns; call 440/519-6800. To consult Chagrin Falls family

medicine specialists, call 440/893-9393.

MANY people temporarily

experience tinnitus (ringing,

buzzing, whistling, hissing

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

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

For some, it interferes with the demands of every-

day life.

If you have tinnitus, Cleveland Clinic family

health center otolaryngologists can rule out

health-related conditions causing the problem. Our

audiologists can then do a thorough hearing eval-

uation. Together, they can determine whether you

are a candidate for the Tinnitus Management

Clinic at Cleveland Clinic main campus.

While there is no universal cure, certain mea-

sures provide relief. Tinnitus rehabilitation plans

may include sound therapy and/or noise genera-

tors, biofeedback and behavior modification

For evaluations by Solon otolaryngologists

Tom Abelson, M.D., Robert Katz, M.D., or Steve

Hunyadi Jr., M.D., and audiologists Sally Rachek,

M.A., CCC-A, or Sheryl Booher, M.A., CCC-A, call

440/519-6800.

What’sThatNoise?

CARPAL TUNNEL SYNDROME can make key-

boarding, operating a cash register and working on

an assembly line difficult. Swollen tissues in the car-

pal tunnel at the base of the palm put pressure on

the median nerve, causing pain, tingling, numbness

in the fingers, weakness in the thumb, and a tenden-

cy to drop things.

Initial treatment usually involves splinting to re-

strict movement and allow swelling to subside; anti-

inflammatory medication may be prescribed. If these

measures do not help, outpatient surgery may be rec-

ommended.

While repeated use of the hands or wrists at work

does not cause carpal tunnel syndrome, certain fac-

tors increase your risks for it:

■ age (50s and 60s)

■ female gender, especially during pregnancy

and around menopause

■ concurrent illness

■ obesity

■ poor physical condition

■ smoking

To decrease pain at work, keep wrists straight and

minimize repeated flexing, extending or twisting,

and rest your hands periodically. Meanwhile, address

risk factors you can control: give up smoking, in-

crease physical activity and lose weight, if necessary.

To schedule an appointment at Solon withMark Hendrickson, M.D., call 440/519-6800.

When Carpal TunnelSyndrome InterferesWith Work

Plastic surgeon Mark Hendrickson, M.D., spe-cializes in hand and wrist surgery, congenitalhand surgery, microsurgery, reconstructivesurgery, melanoma and aesthetic surgery.

Other Family Health Centers

Beachwood 216/839-3000

Brunswick 330/225-8886

Creston 330/435-5400

Elyria 440/366-8822

Independence 216/986-4000

Lakewood 216/521-4400

Lorain 440/204-7400

Strongsville 440/878-2500

Westlake 440/899-5555

Willoughby Hills 440/943-2500

Wooster 330/287-4500

AppointmentsCleveland Clinic Solon29800 Bainbridge RoadSolon, OH 44139440/519-6800 or 800/648-0022

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

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

Saturday: 8 a.m. to noon

Cleveland Clinic Chagrin Falls551 East Washington StreetChagrin Falls, OH 44022440/893-9393 or 800/232-0263

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

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

Saturday: 8 a.m. to noon

Urgent Care Center

440/542-6868

Monday through Friday: 8 a.m. to 6 p.m.

Saturday: 9 a.m. to 1 p.m.

www.clevelandclinic.org/fhcCleveland Clinic Family Health Centers on the Web

Visit our Web site for■ information and services for each

family health center

■ physician directories

■ community calendars

■ free health information

■ maps

■ Family Checkup newsletter

www.clevelandclinic.org/fhc

CLEVELAND CLINIC

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

Monday through Friday, about your adult and

pediatric health concerns, call

216/444-1234800/801-2273

Cancer Answer LineTo speak with a nurse about any cancer

symptoms and concerns from 8:30 a.m. to

4:30 p.m., Monday through Friday, call

216/444-7923800/862-7798

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

Editor: Cora Liderbach

Art Director: Amy Buskey-Wood

Photographer: Tom Merce

Illustrations: Doreen Klimkiewicz

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RESEARCH SHOWS A NEW U.S. HEALTH TREND has markedly increased patient satisfaction. In

shared medical appointments, patients gain much faster access to a physician, with whom they can

spend 90 minutes — far more time than a traditional visit allows. They also have the opportunity to

share experiences with other patients.

Cleveland Clinic family health centers are now of-

fering this new appointment option, called “Clinic

Care Plus,” for patients with certain health problems.

In a shared-setting medical visit, patients see a physi-

cian for prevention, treatment and follow-up. A behav-

ioral health specialist is also on hand to address

medical concerns. Talk to your physician to see if

these sessions might be appropriate for you.

At Cleveland Clinic Solon, shared medical appoint-

ments are offered by Fredrick P. Wilson, D.O., a spe-

cialist in low back and neck pain, assisted by

behavioral health specialist Cathy DeGross, R.N. Dr.

Wilson will perform spinal manipulation as needed.

This fall, Solon rheumatologist Rochelle Rosian,

M.D., will also offer Clinic Care Plus appointments.

For a free brochure, call 216/444-3178.

New Shared Medical Appointments Offered

Clinic Care Plus PhysicalsWhen required, patients can signup for “Clinic Care Plus Physicals”to receive a private exam and stillspend 90 minutes with their phy-sician. Solon family medicinespecialist Richard P. Kratche,M.D., who has a special interestin health maintenance and sportsmedicine, offers Clinic Care PlusPhysicals with the assistance ofMarianne Harris, R.N. For moreinformation on Clinic Care Plusand Clinic Care Plus Physicals,call 440/519-6800.

Women’s Health

NONPROFIT ORG.

U.S. POSTAGE PAID

CLEVELAND, OH

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

THE CLEVELAND CLINICFOUNDATION

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

and heart problems. Some are aware that smoking

prematurely ages their skin. But few know that it can

harm their reproductive systems.

Women smokers have higher rates of infertility,

and miscarriage and other complications during

pregnancy and childbirth.

Their newborns often weigh

less than they should, and

are prone to illness during

their early years. Smoking

also triggers earlier meno-

pause, and increases risks of

osteoporosis, bladder prob-

lems and female cancers.

Smoking reduces fertility

in men as well.

If you smoke, make quit-

ting your first step in family

planning. Ask your doctor’s

advice about several options

now available to help you.

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

Quit smoking at leastfour months beforehand,

Avoid secondhandsmoke, and

Keep homes smoke-freebefore and after thebaby arrives.

If you are having problemswith infertility and wouldlike to see reproductiveendocrinologist Jeffrey M.Goldberg, M.D., at Solon,call 440/519-6800.

When’s the Best Timefor Her First GYN Exam?Cleveland Clinic family health center specialists rec-

ommend that a girl have her first gynecologic exam

when she:

■ develops abnormal bleeding or severe men-

strual cramps

■ approaches her 18th birthday or

■ considers becoming sexually active

It’s easy to know that your daughter needs to see

a health care professional if she develops severe

cramps or is approaching 18. Knowing when she is

considering sexual activity is far more difficult.

However, statistics show sexual activity is common

before age 18, so attempt to keep the lines of com-

munication open.

If your daughter expresses an interest in seeing a

health care provider for a gynecological problem,

she may be anticipating sexual activity and want

protection. Encourage her to share any concerns or

problems with you, but do not discourage her from

seeing her doctor. If you accompany your daughter

to her appointment, expect to be excused for part of

the visit so she can speak freely with her health care

professional.

Jessica M. Strasburg, M.D., board-certified infamily medicine, specializes in women’s healthand general preventive medicine at Solon.

Women can make appointments at ClevelandClinic Solon by calling 440/519-6800.

If sores on your feet or lower legs refuse to heal com-

pletely, podiatrists and vascular specialists can help

you get back to normal. Stubborn foot and leg

wounds, sores or ulcers often result from poor circu-

lation, frequently affecting people with diabetes, cir-

culatory disorders or other medical problems.

After a thorough history and examination, doc-

tors will order X-rays, scans or noninvasive vascular

studies to help pinpoint the cause of your problem.

With this information, they can create a customized

treatment program designed to relieve pain and

speed healing, taking your health status and ability

to care for your wound into consideration.

Treatment may involve:

■ antibiotics

■ anti-clotting medication

■ new topical (surface) wound-care therapies

■ compression stockings

■ orthotics or prosthetics to improve function

and reduce areas of increased pressure

■ debridement (removal of dead or

callused tissue) overlying the sore

Education is key; you will be care-

fully instructed on how to care for

your wound at home and how to

prevent it from recurring. To schedule

an appointment with podiatrist

Patrick McKee, D.P.M., at Solon,

call 440/519-6800.

Help for Sores thatWon’t Heal