HEALTHYYour Guide to Health and WellnessSUMMER 2018

THE UNMENTIONABLES Gynecological symptoms

you can’t ignore pg.4

“HIDDEN” DISEASES 7 common conditions in women

pg.5

ARTHRITIS ADVANCESGetting a grip on the

latest treatments pg.6

2 H E A LT H Y YO U

3uni tedreg iona l .org

Dr. Olufemi Lawal, Pulmonologist, explains, “COPD and heart disease share risk

factors (age and smoking are the biggest two) and symptoms, especially shortness

of breath.” He adds that COPD and atherosclerosis (disease of the artery walls) are

both associated with inflammation in the body. And because the right ventricle of

the heart pumps blood to the lungs to pick up oxygen, poor lung

function from COPD can affect the right side of the heart.

There is a high rate of overlap between the two

diseases and, although experts are not sure of the

extent of this overlap, they do agree it is worrisome.

Heart disease is difficult to diagnose in patients with

COPD, often delaying appropriate medical treatment.

Why it matters

“Because COPD may produce symptoms that are similar

to heart disease,” says Dr. Lawal, “people with COPD

may not realize they have heart disease, or seek treatment for

heart disease, until it’s too late.” Furthermore, impaired lung function is a strong

predictor of cardiovascular mortality.

How many of these cardiovascular risk factors do you have?

I have COPD.

I am overweight or obese.

I don’t get enough physical activity.

I have high blood cholesterol, high blood pressure or diabetes.

I smoke cigarettes or use tobacco products.

I have a family history of heart disease.

I am over 45 (men) or over 55 (women).

I already have heart disease.

Talk to your doctor TODAY.

Your doctor can help you prevent heart disease. Ask your doctor:

1 What are MY risk factors for cardiovascular disease, and why?

2 What screenings or tests are right for ME?

3 What actions can I take to decrease MY risk for cardiovascular disease?

4 What are the right cardiovascular health goals for ME?

FAST STATS

Approximately 15 million Americans

have been diagnosed with COPD, and

as many as 24 million may actually

have COPD.

COPD is the third-leading cause of

death in the U.S.

Cigarette smoking, the most

common cause of COPD, is

associated with a 50 percent

increased risk of heart failure.

COPD patients, especially those who

have heart failure, are at increased

risk for hospitalization and death due

to cardiovascular disease.

More women than men die from

COPD, and women are more often

misdiagnosed.

PreventiveCare

Are you at risk?If you have chronic obstructive pulmonary disease

(COPD), you should be aware that you are at increased

risk for cardiovascular disease.

Have symptoms

described in this

article? It’s time

to talk to your

doctor. Find more

information about

United Regional’s

physicians, including

pulmonologists and cardiologists, at

unitedregional.org/find-a-physician.

Dr. Olufemi Lawal,

Pulmonology

Cardiovascular Disease

COPD and

4 H E A LT H Y YO U

Women’s Health

Dr. Maxine Lingurar,Obstetrics/Gynecology

Women experience changes

in their bodies throughout

their entire lives. Some of

these changes are due to aging; others

are the result of hormonal changes

during pregnancy, menopause, or

menstrual cycles. While it may feel

awkward to

mention unusual

symptoms in

‘unmentionable’

places to

your doctor,

Dr. Maxine

Lingurar, Ob/

Gyn. suggests

that, “these

changes

often provide

important clues

to your health.

If you notice

any unusual changes in your body, talk

with your doctor to make sure that

what you’re experiencing isn’t serious.”

Here are a few gynecological

symptoms you should not ignore.

Pelvic or abdominal pain. Only

about 20 percent of pelvic pain

women experience is actually due

to gynecological problems, such as

endometriosis or uterine fibroids.

Musculoskeletal conditions and

urinary or bowel problems can also

cause pelvic pain.

Abnormal vaginal discharge. All

women have vaginal discharge. It’s

nature’s way of keeping your genital

area clean and healthy. Normal

discharge is white or clear, with

little or no odor. If your vaginal

discharge changes in color, amount or

consistency, or it takes on a noticeable

odor, see your doctor.

Gynecological symptoms you can’t ignore

Breast changes. Worrisome breast

symptoms include a change in size

or shape of the breast, skin changes

on the breast, a lump, or changes in

the nipple (including discharge). The

symptoms of breast cancer and less

serious breast problems are similar.

In fact, only 20 percent of breast

lumps are due to cancer, so don’t let

fear of a cancer diagnosis keep you

from discussing any breast changes

with your doctor.

Abnormal vaginal bleeding. See

your doctor if you experience heavy

bleeding that lasts longer than

normal, occurs more frequently

than every three weeks, after sex, or

between periods. You should also pay

attention to spotting or bleeding in

between periods.

Pain during sexual intercourse.

Don’t be embarrassed. According to

the American College of Obstetrics

and Gynecology, nearly three-

quarters of women will experience

pain during intercourse at some

point in their lives, particularly after

menopause.

Difficult or painful urination,

excessive chronic bloating, or

painful periods. It’s important to

talk with your physician about these

issues, as there a variety of reasons

for these symptoms to occur.

CHANGES DURING MENOPAUSE

Menopause is uneventful for some women,

but for others the transition can be a time

when new and disruptive symptoms suddenly

appear. Although menopause symptoms can

be uncomfortable, they aren’t necessarily

signs of a more serious problem.

Commonly, women experience one or more

menopause symptoms, including:

• Hot flashes

• Night sweats

• Sleep disruption

• Vaginal burning or itching

• Decreased libido during intercourse

• Painful intercourse

• Bleeding after intercourse

• More frequent vaginal or urinary tract

infections

• Frequent urination

“Every woman is different,” says Dr. Lingurar,

“so it’s important to know what is normal

for you, so you can recognize changes that

may signal a possible health problem. Don’t

be afraid to speak with your doctor about

changes or irregularities you discover.”

GYNECOLOGICAL CANCER

SCREENING

The goal of screening is to find cancer

early when treatment is more effective.

Dr. Lingurar agrees that women should

undergo regular screenings for cervical

cancer; frequency varies for individual

women within age groups. Ask your doctor

about the right screening test and frequency

for you. She also highly recommends that

women between the ages of 30 and 65 be

tested for the high-risk HPV virus as part of

your routine cervical cancer screening. Learn

what is normal for YOU so you can recognize

new or unusual symptoms and visit your

doctor with any concerns. Make sure you

keep track of any recommended screenings

and annual visits. Find an Ob/Gyn by visiting

www.unitedregional.org/find-a-physician.

Unmenti nablesThe

“Every woman is different, so it’s important to know what is normal for you so you can recognize changes that may signal a possible

health problem.”

Dr. Maxine Lingurar, Ob/Gyn

5u n i te d re g i o n a l .o r gu n i te d re g i o n a l .o r g 5

Medical Matters

Top

A CALL TO ALL WOMEN: YOUR HEALTH IS DEMANDING YOUR ATTENTION! Women, what are you waiting for? It’s understandable that,

as the primary caretakers of your family, you can easily put

your own health on the back burner, but today, make the

choice to make a change and give your health the number-one

priority in your life that it DESERVES.

The numbers are alarming. According to Dr. Olawunmi

Lawal, 35% of women over the age of 20 are obese, and 33%

of women over the age of 20 have hypertension. Dr. Lawal

says, “Many times, women unknowingly put their health at

risk by ignoring certain telltale symptoms. There are several

common hidden diseases secretly attacking a woman’s

health.” These ‘hidden’ diseases include:

1 POLYCYSTIC OVARY SYNDROME: the most common

hormonal disorder among women of reproductive age. As

many as one in every 10 women of childbearing age will

develop it, which is the leading cause of infertility.

2 FIBROMYALAGIA: acquired in early to mid-adulthood,

it’s also known as Central Sensitivity Syndrome and affects

three to six million women in the U.S. alone.

3 CHRONIC FATIGUE SYNDROME: forces mental and

physical inactivity and does not improve with rest. Women,

especially in their 40s and 50s, are four times more likely to

develop this condition than men.

4 LUPUS: there are four types, but the most common is

Systemic Lupus Erythematosus and is a malfunction of

the immune system where the body becomes its own worst

enemy. Women make up 90% of its victims.

7

5 MULTIPLE SCLEROSIS (MS):

causes your immune system to attack

the protective covering of the nerves

in the brain and lets your nervous system break down the

communication between the brain and the body. It may

even destroy the nerves entirely. Women are three times

more likely than men to develop MS and it generally appears

between the ages of 20 and 40.

6 RHEUMATOID ARTHRITIS (RA): attacks the linings

of the joints through the immune system. Women make up

three-quarters of RA cases and usually peak between the

ages of 40 to 60.

7 IRRITABLE BOWEL SYNDROME: chronic abdominal

cramping and pain, bloating, gas, diarrhea and constipation

that may be caused by a malfunction in the way the brain

interacts with the gut. 20% of Americans suffer from IBS,

but it is two times more likely in women.

Dr. Lawal urges women to, “Be aware of the signs your body is

giving you.” Know your body, and if you experience a sign of

abnormality—like pain or fatigue—don’t ignore it. Dr. Lawal

also encourages women to take small steps like making slight

diet changes or increasing physical activity in order to feel

your best. You deserve good health, so treat yourself to it!

Dr. Olawunmi Lawal, Internal Medicine

Learn more about Dr. Olawunmi Lawal

or the role of an Internist by visiting

urphysiciangroup.org/services/

internal-medicine.

“HIDDEN” DISEASES

Most Common

in Women

HealthyBody

H E A LT H Y YO U6

The numbers look daunting: more than 100 different

types of arthritis, more than 50 million Americans

affected by these painful joint diseases.

But the leading cause of disability in the United States is

also the subject of widespread research into new and better

treatments and, of course, the ultimate goal of a cure.

“With a larger focus on categorizing forms of arthritis

through genetic causes, we are closer to

a cure and more effective treatments,”

says Rheumatologist, Dr. Vanya Wagler.

Taking matters into your

own hands

One of the most promising avenues

of pain relief involves becoming

proactive about managing and

treating your arthritis.

Medication advancements

New developments in arthritis

medication look encouraging, says

Dr. Wagler. “The development of

biologic response modifiers, or biologics, has been a game

changer for people living with inflammatory arthritis.

Biologics are drugs that are genetically engineered from a

living organism, such as a virus, gene or protein, to simulate

the body’s natural response to infection and disease. They

target proteins, cells and pathways responsible for the

symptoms and damage

of rheumatoid arthritis

and other types of

inflammatory arthritis.”

Dr. Wagler explains

that before biologics,

arthritis treatment was

limited to non-steroidal

anti-inflammatory drugs

(NSAIDs), non-biologic

disease-modifying anti-rheumatic drugs (DMARDs), and

corticosteroids. While these older medicines still have a role in

treating arthritis, biologic drugs have made effective treatment

possible for many patients with difficult-to-control arthritis.

Early efforts pay off

Prompt treatment of arthritis is key. Dr. Wagler says, “In the

near future, new tools that help patients provide accurate

information to their doctors may enable more timely

diagnoses of arthritis. And in the not-so-near future, research

may lead to arthritis being diagnosed from bloodwork at an

annual physical – before symptoms even surface.”

But no matter which type of arthritis is diagnosed,

certain actions will be helpful to patients across the board:

maintaining healthy body weight, getting adequate sleep,

reducing stress and exercising regularly.

Dr. Vanya Wagler,

Rheumatology

Getting a Grip on the Latest

Arthritis Advances

Arthritis symptoms

Let your physician know if

you’re experiencing such

joint symptoms as:

• stiffness

• pain

• swelling

• decreased range of motion

Recipe

Roast Beet and Blue Cheese Salad2 medium-size beets

1 tablespoon olive oil, divided

2 packed cups washed, trimmed and chopped beet greens (about

7 or 8 large leaves)

1 large scallion, chopped

2 cups chopped romaine lettuce

2 tablespoons crumbled blue cheese

2 hard-cooked eggs, peeled and chopped (see note)

4 teaspoons white balsamic vinegar

4 teaspoons apple juice

¼ teaspoon each salt and pepper1/8 teaspoon curry powder

Scrub beets; cut vertically in half and place cut-side down on

foil-lined baking sheet. Roast in preheated 400-degree oven 50

to 60 minutes or until fork tender. When beets are cool enough to

handle, peel and cut into ¼-inch thick slices. Place in salad bowl.

Heat 1 teaspoon olive oil in medium-size skillet. Add beet greens

(no need to dry after washing) and sauté over medium heat

3 minutes, stirring frequently, or until leaves are slightly limp,

not completely cooked. Add to beets. Add scallion, lettuce, blue

cheese and eggs.

In a small bowl stir together balsamic vinegar, remaining 2

teaspoons olive oil, apple juice, salt, pepper and curry powder.

Pour over salad and toss gently but well.

Note: If desired, substitute 6 ounces cooked chicken breast,

cut into bite-size pieces, for the eggs.

Makes 2 (2-cup) servings

Per serving: 215 calories / 15 grams total fat / 10 grams protein / 9 grams carbohydrates / 192 milligrams cholesterol / 540 milligrams sodium / 3 grams dietary fiber

Roots are matched with their tops for this robust

and easy to make entree.

7u n i te d re g i o n a l .o r g

Healthy Eating

TOP TO BOTTOM

VEGGIE DELIGHTST

he summer season is prime time for freebies at

the farmers market and supermarket produce

department. For the price of a bunch of beets,

turnips, carrots, radishes and similar root vegetables,

you get the tasty leafy green tops too.

Boosting nutrition

Not only are you getting more edible plant, but you’re

getting a greater variety of colors, textures and nutrients

when you include the tops in your meals. Green vegetables

are something we tend to not eat enough of. If the greens

come attached, it’s easier to include in the diet!

Plant greens are a valuable source of vitamins,

sometimes in greater amounts than in roots.

Tops for taste

But nutrition is only part of the appeal: Taste is just as

important, and tops deliver exciting new flavors. Pesto

made with carrot tops has become popular in some areas.

Some say radish leaves remind them of arugula. Celery

leaves have a fairly strong taste; they’re wonderful in a

salad mix.

Handling vegetable topsTo maintain the flavor and delicacy of tops,

treat them as you would other fresh greens:

Trim off greens. Wash and keep moist

in paper towels in the refrigerator

and use as soon as possible.

Although plant tops aren’t buried in soil,

they still need a good cleaning.

Unfortunately, some leaves—such as

rhubarb—are inedible. Do your research before

tasting a leaf you’ve never seen used in a recipe.

Healthy Living

8 H E A LT H Y YO U

Does your body sound like a bowl of breakfast

cereal—you know, snap, crackle, pop? Many

of those joint sounds are actually normal. But, if

you’re singing the achy-breaky blues, it’s time to stop ignoring

your symptoms and make an appointment to see your doctor.

Musculoskeletal problems, such as low back pain, and chronic joint

pain, affect more than one out of two adults in the U.S., especially those

65 and older.

Dr. Edward Walker, Orthopedic Surgeon, explains, “Musculoskeletal

disorders affect your bones, muscles, ligaments, tendons, and nerves.

They can come on suddenly, or persist over time, be local to a specific

joint or muscle, or be widespread throughout your body. Often, the pain

worsens with movement. Musculoskeletal problems

interfere in activities of daily living, cause people

to miss work, and are a source of significant pain.

The top three areas affected are the knees, back,

and shoulders.”

We’ve all experienced bouts of sore, achy muscles

and joints following rigorous activity or a minor

injury. However, if you have persistent or severe

musculoskeletal symptoms, don’t ignore them.

“Sometimes, what appears to be a musculoskeletal

symptom can be due to an unrelated problem that

requires immediate medical attention,” Dr. Walker

says. For example, arm pain is a symptom of a

heart attack and back pain could indicate kidney

stones. Rheumatoid arthritis (RA) produces joint and muscle symptoms,

especially in the knuckles and middle joints of the fingers.

You don’t have to live with chronic muscle or joint pain. Dr. Walker adds,

“It’s not a normal sign of aging and today, doctors can offer many effective

treatments.” Lifestyle changes, such as exercise and losing weight, physical

therapy, and medication can relieve your pain and improve your quality of

life. When these treatments are not enough, your doctor may recommend

surgery. Joint replacement surgeries are now one of the most widely

performed operations in the U.S.

Get help for muscle and joint pain

Musculoskeletal

symptoms you

should not ignore

• Pain in the muscles, joints, ligaments, or

tendons (can be deep, penetrating, or dull)

• Swelling, warmth, or redness in a joint

• Recurring or constant pain or tenderness

in a joint

• Joint stiffness

• Difficulty using or moving a joint,

especially after movement or activity

• Crunchy feeling or sound of bone on bone

• Fatigue

• Sleep disturbances

• Twitching muscles

• Numbness, pain, or tingling that radiates

into the arms or legs

If you have one or more of the symptoms

listed above and have been in an accident

or experienced sudden trauma, you should

seek emergency medical treatment.

Otherwise, make an appointment

with your primary care physician to

discuss your options for treatment.

Visit urphysiciangroup.org/services/

orthopedics for information regarding

orthopedic conditions and treatments.

Dr. Edward

Walker,

Orthopedic

Surgeon

Achy BreakyMy

Body