Food Safety in the Summertime

Grilling and eating outdoors is one of the best parts about summer. But as you know, your backyard isn’t nearly as sanitary as your air-conditioned kitchen. Follow these tips from Laura Ipe, Clinical Dietitian at SJRMC, to ensure your summertime meals are healthy and safe.

Start Clean

• Whether you are using your own grill or a public grill at a park or campground, scrub it with hot, soapy water before each use.
• Wash your hands before, during and after food preparation.
• Pack moist towelettes or a hand sanitizer in your cooler for when soap and water are not readily available.

"Bacteria can easily transfer from the body to foods and surfaces,” said Ipe. “This is especially important when you are handling raw meat.

Safely Thaw & Marinate Meat

• Thaw frozen foods in the refrigerator or microwave, not on the countertop or by the grill.
• Marinate meat in the refrigerator.
• Never use the same brush to baste raw and cooked meat. Wash brushes in hot, soapy water between uses.
• Boil any leftover marinade before using it to baste or season cooking meats.

Don’t Share Ware

• Use separate cutting boards, plates and grilling utensils when handling raw meat and ready-to-eat foods. Color-code them to easily separate items used with raw foods.
• After using knives, grilling tongs, forks and platters with raw meat and poultry – clean them thoroughly with hot soapy water – before using them again on cooked meats/poultry.

Cook It Right

“Grilled meat can be harmful if it’s not completely cooked,” said Ipe. “Many people rely on the color of the meat or the juices to tell them if it’s done, but the only surefire way is to use a meat thermometer.”

Use the following internal temperature guide:

• Steak (medium rare):  145° F
• Steak (well done):  170° F
• Hamburgers: 160° F
• Chicken: 165° F

Watch the Clock

• Don't leave food, even if it's fully cooked, out of refrigeration for extended periods of time.
• Put all dishes in the refrigerator within two hours. In hot weather (90° F or warmer), this time is reduced to one hour.
•  Set out perishable food items in one-hour shifts. After each shift, place uneaten food back in a refrigerator set below 40° F.
•  Lengthen the staying power of perishable foods by keeping them on ice. Keep a refrigerator thermometer on hand to make sure foods stay chilled properly in the cooler or refrigerator.

Let Leftovers Go

• Store leftovers in shallow, airtight containers (two inches deep or less). Write the date on top.
• Reheat leftovers to an internal temperature of 165° F before serving a second time around. Check the temperature with a meat thermometer.
• Boil leftover sauces before reusing them on cooked meat.

“Grilled leftovers have a refrigerator life of three to four days,” said Ipe. “After that, toss it.”

Recipe: Mediterranean Kabobs

Yields 4 servings. Reference:  National Heart Lung & Blood Institute.

Marinade

• 2 tablespoons each of olive oil & lemon juice
• 1 tablespoon each of minced garlic (2-3 cloves) & fresh chopped parsley (or 1 teaspoon dried)
• ½ teaspoon salt (optional)

Kabobs

• 6 oz top sirloin or other beef steak, cubed (12 cubes)
• 6 oz boneless & skinless chicken breast cut into ¾-inch cubes (12 cubes)
• 1 large white onion cut into ¾ inch squares (12 pieces)
• 12 cherry or grape tomatoes, rinsed
• 1 red bell pepper, rinsed & cut into ¾ inch squares (12 squares)
• 12 metal skewers (each 6 inches long).

Directions

1. Preheat grill pan or oven broiler (with rack 3 inches from heat source) on high temperature.
2. Combine marinade ingredients and divide between 2 bowls (one to marinate raw meat and one for cooking & serving).
3. Mix beef, chicken, onion, tomatoes and red pepper cubes in one bowl of marinade and let sit.  After 5 minutes discard remaining marinade.
4. Assemble the skewers:  Place one piece of beef, chicken, tomato, onion, red pepper on each of the 12 skewers.
5. Grill (or oven broil) on each of 4 sides for 2-3 minutes or until completely cooked (minimum internal temp of 145° F for beef & 165° F for chicken).  Spoon most of the second half of the marinade over kabobs while cooking.
6. Serve 3 skewers per serving.  Drizzle the remaining marinade on top of each kabob before serving (use only the marinade that did not touch the raw meat or chicken).

Nutrition Information

1 serving (3 skewers) = 202 calories; 11g fat (2g saturated fat); 333mg sodium (if salt is used).

More Info

Learn more safety tips at www.homefoodsafety.org.  

Reference: American Dietetic Association.

National Running Day: It's Never Too Late to Start!

On National Running Day (http://www.runningday.org), some tips from Stephen Simons, MD, of Saint Joseph Sports Medicine Institute, about trying your first competitive run.

• It's never too late!

 A race isn’t just for athletic enthusiasts. The sense of achievement attached to accomplishing goals you have set for yourself can really kick your self-esteem into shape. Regular activity will also allow you to build up increased levels of strength and stamina so that everyday tasks will take less out of you.

• Stay determined & start out gently.

Gradually build up duration and intensity over a period of time. Starting out, speed should take a back seat while you focus on increasing the distance you can run. It is so much more important to find a comfortable pace that allows you to progress gradually and not feel torn to shreds at the end of each run.

• Try different routes, surfaces & conditions for your runs.

If you enjoy running on the roads, try to give yourself a break now and then by running on grass, around a field, or on a trail. However, be prepared, if it is rainy or cold. Similarly, don’t get caught out in the sun or dark.

• Shoe shop!

What you put on your feet is possibly the most important consideration when starting out. The choice you make can not only enhance your performance but also effect your running enjoyment while remaining injury free. It is worth it to spending some time researching this online or visiting your local specialist sports shop to seek their expert advice. 

• Warm up & cool down.

As important as the run itself, the warm up is the way to prepare yourself. Don’t fall into the trap of going straight at it just to get it over with. Allocate a certain amount of time for preparation. Similarly, each run should end with a cool down. As with the warm up, your body needs to adjust back down.

“Once you start, keep it going,” said Dr. Simons. “Set a challenging but realistic goal and see it through. Challenge yourself, not other runners. Reward yourself and think of the benefits and feelings of eventual achievement. Good luck and see you at the finish line!”

More Info: Go to www.michianarunners.org for information about running and races in and around Michiana.

Athletic Trainers Keep Area Athletes Healthy

Saint Joseph Regional Medical Center is helping to keep athletes on the playing field as eight of its Associates are Certified Athletic Trainers by the National Athletic Trainers Association (NATA). Founded in 1950, NATA has grown to more than 30,000 members worldwide today.

Throughout Northern Indiana, SJRMC Certified Athletic Trainers support Plymouth, John Glenn, Culver, Penn, Mishawaka Marian, and South Bend St. Joseph High Schools, as well as Ancilla College.

“I think our presence on the bench is just as critical as any member of the coaching staff,” said Ryan Carroll, a Certified Athletic Trainer at our Plymouth Campus. “I would encourage parents to find out who is taking care of their young athlete so they will know they are in good hands in the event of an injury.”

The situation has been played out thousands of times before.  Many young athletes are injured during an athletic event.  Except this time it is your child lying on the court or field in pain.  Are you comfortable and knowledgeable with what happens next? And exactly who is taking care of your child immediately after the injury? 

Certified Athletic Trainers are educated and trained for this exact scenario.  Through a 4-year college degree they are taught to handle any type of athletic injury.  Certified Athletic Trainers are not only taught to handle the immediate care of an injury, they are able to continue throughout the whole process up to deciding when the athlete can return to play.  This includes the prevention, evaluation, first aid, referral, treatment and rehabilitation of any athletic injury.

Like many other health professions in Indiana there is a license that needs to be issued to practice athletic training.  The profession is governed by the Indiana Athletic Trainers Board.  There is also a national certification that requires students to pass a 3-part examination to become a Certified Athletic Trainer.  Professionals in this setting need to complete mandatory education hours each year (25 per year) to continue as an Indiana licensed and nationally certified athletic trainer.  Certified athletic trainers also need to renew CPR/AED certifications every year to keep certification.

“It’s work but it’s fun work knowing that we are a valuable part of whatever team we’re working with,” Carroll said. “And, with last month being National Athletic Trainers Month, it is nice to receive recognition for what we do and the time we have put in to keep our young athletes healthy and in the game.”

Mishawaka Certified Athletic Trainers: Carl Landis, Gayle Thomas, Trish Irvin, Ann Micinski and Dr. Stephen Simons 

Plymouth Certified Athletic Trainers: Ryan Carroll, Tom Bolze, Adam Rippy and Kim Richey

Kale: The Super Veggie

National Nutrition Month advice from Whitman Hackman, Registered Dietitian, SJRMC

Kale is a green vegetable that looks sort of like and tastes like curly spinach but it comes from the cabbage family.  It can be found in grocery stores year round but its peak season is mid-winter to early spring. When buying, look for bright green leaves without traces of wilting or browning. 

Kale’s high concentrations of antioxidants and anti-inflammatory agents have linked increased consumption to lowered risk of cancer, obesity and heart disease.  One cup of chopped kale has 34 Calories, 0 g fat, 2 g of protein and 1 g of fiber.  The recipe below is an example of how quick and easy it is to make any night of the week!

Kale with Caramelized Garlic

• 1 ½ lbs of fresh kale (stems removed)
• 2 cups of water
• 1 Tbsp olive oil
• 8 cloves of garlic, thinly sliced
• 1 tsp red wine vinegar
• ¼ tsp salt
• ¼ tsp red pepper flakes

Remove leaves from stems and throw stems away.  Heat oil in a large nonstick skillet over medium heat.  Add garlic and cook until garlic is golden brown.  Add kale leaves to mix and cook covered until it’s softened but still bright green probably about 2-3 minutes.  Add the vinegar, salt and red pepper, stir and serve!

Doctors' Day Celebration

Tonight, in honor of Doctors' Day, we will be celebrating with physicians who have reached milestones in their years of service on our SJRMC Medical Staff. Thank you to all of our doctors for your time, talents and dedication.

Dr. Engel and his wife, Sondra

Dr. Howard Engel will be marking his 50th year with SJRMC. A Chicago native, Dr. Engel received his medical education at the University of Chicago School of Medicine, followed by an internship at Case Western Reserve in Cleveland, a two-year research stint at the National Institutes of Health in Bethesda, Maryland, and then his residency at Washington University in St. Louis at Barnes Hospital.

Dr. Engel married Sondra, the love of his life and his wife of 53 years, before starting his practice in South Bend in 1960. He supervised many local doctors while they were residents at what was then the Saint Joseph Hospital, a testament to his many contributions to the health and welfare of Michiana.

Throughout his 50 years of service, Dr. Engel has been driven to improve the quality of healthcare in our area and the lives of his patients. Due to his warm and caring manner and his genuine interest in the people he encounters every day, he continues to leave his mark on all of us at Saint Joseph Regional Medical Center and the entire community.

Additional doctors who will be recognized tonight include:

40 Years

Keim T. Houser, MD     

35 Years

Stephen L. Anderson, MD

Robert S. Austgen, DDS

Elliott J. Blumenthal, MD     

David L. Clayton, MD

John L. Jenkins, MD

Mark S. Sandock, MD

30 Years

Rafat H. Ansari, MD

Frances D. Dwyer, MD

Gail A. English, MD

Nels R. Leininger, MD

Douglas N. MacGregor, DO

Robert J. Tomec, MD

25 Years

Thomas P. Barbour, MD

Sandra R. Brown, MD

Thomas E. Capannari, MD

Michael A. Englert, MD

Walter J. Filipek, MD

J. Michael Kelbel, MD

Robert B. Kolbe Jr., MD

Douglas S. Kuehn, MD

Michael J. O'Connell, DO

John W. Oren, MD

Stephen R. Ribaudo, MD

Carol A. Royer, MD

Robert A. Yount, MD

Stephen E. Zucker, MD

20 Years

Mark S. Cantieri, DO

Vinod Chauhan, MD

David A. Cory, MD

Ellen B. Crowe, MD

Scott B. Edwards, MD

Todd A. Graham, MD

Charles J. Lamb, MD

Mark G. Lewis, DO

Catherine B. Maxwell, PhD

Timothy W. Noveroske, MD

William Rozzi, MD

Gregory Spiritoso, MD

Arthur F. Wang, MD

Daniel E. White, DDS     

Emeritus

Ronald Aigotti, MD

John P. Eichorst, DO

Brian D. Saine, MD

Robert M. Sweeney, MD

Portion Control: Measuring Serving Sizes

During the last week of National Nutrition Month, here is some advice on portion sizes from SJRMC's Whitney Hackman, RD.

Portion sizes have been growing in this country right along with obesity rates, heart disease and diabetes.  Restaurants portions are almost twice the size they were in the 1960’s and our waistlines are reflecting the increase! 

Research has shown that portion control is an important component in healthy weight maintenance, but it can be frustrating if you plan on stepping outside of your house without your measuring cups and a scale at any point in your life. Here are some comparisons to help keep your portion sizes in line!

• 1 ounce of cheese (1 serving) is the same size as four dice or a 9-volt battery 
•  1 meat serving (about 3 ounces) is similar to a standard deck of cards 
• 3 ounces or 1 serving of fish will look similar to a checkbook
• A serving of peanut butter or mayonnaise is equal to a ping-pong ball
• A serving of ice cream or mashed potatoes is ½ cup, which will look about the same size as a tennis ball
• One serving of an apple or orange should look like a woman’s fist
• A baked potato should look comparable to a computer mouse
• A serving of nuts is comparable to a medium-sized egg 
• The diameter of a pancake should be the same as a CD
• A serving of chocolate looks like a standard packet of dental floss

We are faced with oversized portions everyday and it’s a tough battle!  Hopefully these visuals give you a good idea of what you should be comparing your meals to!

Guys: Time to Man Up & Schedule Your Prostate Exam

Guys: Time to Man Up & Schedule Your Prostate Exam

By Dr. Michael Helms, Northwest Family Medicine & Saint Joseph Physician Network

As tough as we all like to think we are, men have a long way to go in terms of manning up to a simple medical procedure that could end up saving our lives or at least improve our quality of life. 

For men approaching the age of 40 and above, a prostate exam – while admittedly slightly uncomfortable – only takes a minute but is as necessary a preventative health measure as a blood pressure test or cholesterol check.

Why a prostate exam? The primary reason is to check for the presence of three conditions:

1. Rectal Cancer, which is very rare.
2. Prostate Cancer, slightly little more common but still fairly rare.
3. BPH, or enlarged prostate. BPH is not life threatening but can nevertheless be quite disabling at times. The benefit here is that if we find a prostate that is enlarging, we can treat it before symptoms become severe.

 Fear Not

But why do men fear something that is so quick and simple and could save your life? First and foremost, I think there’s a stigma that it is somehow unmanly to get a prostate exam. We prefer to believe there should be some type of electronic or blood test to prevent a man from having a finger put in a place he really doesn’t want it.

Also, some men fear the discomfort of the test. To address this, I always like to reference the size of my index finger versus the size of an average bowel movement and submit it as “exhibit A.”

Sure, it’s uncomfortable but, by comparison, women often have to endure far worse. Not surprisingly, the women in our lives are not very sympathetic about our complaints.

I say “our” because I’m in the same situation. As a 47-year-old, I get my prostate exam every year from my physician so I’m doing what I am telling patients they need to do. And in reality, about 90 percent of the discomfort is psychological. Believe me, there are a lot of procedures out there that are worse than a prostate exam. Again, our better halves have been getting pelvic exams from the time they’ve been around 18, gone through childbirth and the exams that go with it – all of which are exponentially worse than a prostate check.

Finally, there’s a fear of the unknown. We are afraid of what the doctor will find or what the doctor will tell us we have to do. Certainly, the fear of prostate cancer is real and understandable. But there’s also anxiety about prostate cancer treatment as well –specifically, that treatment could render the patient impotent.

This fear is less prevalent than it used to be and for good reason. Cancer is seldom found. Most exams reveal a normal prostate condition. Plus, treatments are much better than they used to be in the sense that active surveillance (the strategy of closely monitoring patients with low-risk prostate cancer before prescribing specific therapy) is more common.

Other times, the condition is treated with hormones – some of which can cause impotence but this is less likely than it used to be. Prostate cancer can also be treated with radiation and, when it does require surgery, many times the procedure can be nerve sparing – meaning it will not impact sexual performance. These are certainly better treatment options than what used to be available to men.

How ‘bout those Bears?

Being mindful that most of the discomfort of a prostate exam is psychological, I like to do what I can to get the patients’ mind off the task at hand. For example, talking about sports – like Jay Cutler’s bum knee, sports cars, mutual funds, telling jokes – anything to lighten things up or put the patient at ease while he’s wearing a gown with no back and bending over. As a doctor, you have to build a rapport so that it is not psychologically threatening. One way to accomplish this is by conducting the bulk of the physical first – while engaging them in these discussions – before doing the prostate exam.

Additionally, a standard practice for me is to schedule physicals in the morning so I can tell guys I am making the rest of their day seem much better in comparison. Plus, I remind them that getting a prostate exam isn’t nearly as bad as going to the dentist. And while some may disagree, I can’t resist using this line as a good-natured tweak at my dentist friends.

Fortunately, most of the time I recommend giving an exam to a patient, they agree to it. Then again, if they are already in to see me, they are somewhat resigned to doing what comes with a physical. However, I worry about men of that certain age who may not be coming in for a standard physical – perhaps simply because of fear of this exam. If there are any of you out there, you may be forced to give back your “man card” if that’s really what’s keeping you away from an annual doctor visit.

Need to find a new primary care physician or want to learn more about Dr. Helms?  Go to www.saintjoedocs.com.

National Nutrition Month: Eating for Sustained Energy!

As National Nutrition Month continues, Sherry Flemming, RD, Clinical Dietitian at SJRMC, provides some tips on how to keep your energy level steady throughout the day:

• Eat 3 smaller meals per day, with frequent healthful snacks.
•  Make your meals “mixed energy fuels." These include high fiber carbohydrates, lean protein and healthy fats such as olive oil, nuts or seeds.
• Eat a variety of colors!
• Hydrate!  Start the moment you get up in the morning.
• Limit sugary foods to 2 (or fewer) small servings a day, and ONLY with meals.
• Eat whole-grain carbs at each meal, like brown rice, whole wheat pasta, corn tortillas or oatmeal.
• Eat 2 - 4 fresh fruits per day, starting early in the day.
• Take a 1 - minute stretch and focus on your breathing every 90 minutes.

National Nutrition Month: The Power of SPINACH

No wonder Popeye was so strong.

Spinach is packed with powerful nutrients and is a good source of folate, beta-carotene, iron and vitamin K. Like other leafy greens, spinach also provides fiber, magnesium and calcium.

Green fruits and vegetables have lutein and indoles, phytochemicals that help promote vision health, boost immunity and prevent certain cancers.

Tips on getting the most nutritional value out of spinach:

• Buy it fresh. Between travel and storage at warmer temperatures, some of the nutrient content may be lost.
• Unwashed spinach should be packed loosely in a plastic bag and placed in the refrigerator crisper where it will remain fresh and retain its nutrient content for about four days.
• Frozen spinach retains more of its nutrients because it is flash frozen.

Tips from Rosannah Mack, RD, CD, Saint Joseph Regional Medical Center

In Memory of Dr. Roland Chamblee

Dr. Roland Chamblee

November 23, 1923 – September 23, 2010

The community lost one of its pioneers in medicine and civil rights, a very dear friend, and a good and giving man with the passing of Dr. Roland Chamblee.

Born in Atlanta, Dr. Chamblee served the United States in World War II reaching the rank of First Lieutenant with the Army Corps of Engineers. He received a Purple Heart for injuries he suffered during the Normandy Invasion. Following the war, Dr. Chamblee earned a Bachelor of Science degree from Tennessee State University and a PhD from Meharry Medical College in Nashville. That’s where he met his wife Dorothy and the couple went on to have six children. Dorothy passed away in 1995.

Dr. Chamblee arrived in South Bend in 1953, serving an internship at what is now Saint Joseph Regional Medical Center. He went into private practice a year later.

Dr. Chamblee worked just as tirelessly to promote racial justice as he did as a physician. He became deeply involved in efforts to end discrimination in South Bend, accepting patients of all races and assembling an integrated staff.

A longtime advocate of public health, Dr. Chamblee helped establish the Sister Maura Brannick, CSC, Health Center on Chapin Street and Western Avenue in South Bend, serving as its medical director while volunteering much of his time to provide healthcare for the poor and underserved. He also volunteered at many free health screenings.

“He loved this community,” said Carla Bice, manager of the Health Center. “He loved the clinic and he loved serving all of our patients.”

Always looking for ways to improve the delivery of healthcare throughout the entire community, Dr. Chamblee served as the Director of the St. Joseph County Board of Health.

“Dr. Chamblee was motivated by all the right values,” said Dr. Steven Gable, SJRMC’s Vice President of Medical Quality Improvement. “Love of his patients, the good and ethical practice of medicine, generosity of his time and his talents, and a strong belief in the Mission of Saint Joseph Regional Medical Center.”

May he rest in peace.

Welcome to SJRMC, Dr. Piazza!

Saint Joseph is excited to welcome Plymouth native Brian L. Piazza, MD to the Medical Staff.

Dr. Piazza specializes in general surgery as well as upper and lower Endoscopy. He has been in practice for 15 years and will be joining the staff at Marshall County Surgery Associates.

After graduating from Plymouth High School in 1982, Dr. Piazza attended Valparaiso University and then Indiana University School of Medicine. In addition, one of his professional highlights included a teaching stint at Michigan State University’s Department of Surgery, where he worked with an expert office and hospital staff and had the opportunity to touch the lives of many patients.

Dr. Piazza takes a team approach to patient care – for the physician, the patient and the patient’s loves ones.

“We are all on the same team,” he said. “The patient is the coach and the doctor serves as the quarterback, acting in the coach’s best interests.

Most patients are apprehensive when they are coming in for a surgery or procedure, no matter how invasive it may be. While many patients ask about the benefits, risks and possible outcomes, it can be a lot of remember. Dr. Piazza encourages his patients to bring a family member or trusted friend to appointment.

“I also truly believe each person is created in God’s image,” he said. “It’s my personal philosophy to treat every patient with the utmost dignity and respect.”

Dr. Piazza enjoys spending time with his wife and two children, all while trying to keep in touch with his six brothers. In his spare moments he enjoys staying active in his church, photography and downhill and cross-country skiing.

For more information on services offered by Dr. Piazza, contact:
Marshall County Surgery Associates
1919 Lake Ave Suite 102
Plymouth, IN 46563
(574) 941-2967

Give Your Body a Sporting Chance Against Injury this Summer

By Dr. Stephen Simons, Sports Medicine Institute

In my line of work, it’s a common occurrence. People coming into my office with muscle pain, or worse, shortly after declaring that this is it, they’re going to get in shape this summer. Right now – this week, this month – they’re going to reverse what is sometimes months or years of relative inactivity to lose those extra pounds, improve their cardio, or simply scratch that competitive itch.

There are obviously many reasons to embark on athletic endeavors and, more than most, I’m in favor of people getting out and being active. However, as both an athlete and doctor, I advise patients that they need to gradually get into a consistent pattern of exercise. It doesn’t happen overnight ... at least not without first suffering the sensation of pain and/or injury.

If you’re looking to get into jogging or biking – maybe you want to enter that 5k race at the end of the summer – that’s great. Such time-based activities are naturally conducive to beginners because you can start slow and gradually increase your minutes over time. Just make sure to give your muscle tissue the proper time it needs to recover from the stress you apply to it. Perhaps start off by only participating in the activity every other day instead of daily. As a general rule, one shouldn’t increase exercise time by more than 10 percent each week as your body needs time to adapt to a new level of workout.

Weekend Warriors
What if your buddies need another player for a weekly pickup basketball or soccer game? You’re pretty good, need the exercise, and don’t mind getting back out there and playing. Unfortunately, it’s also been a few years.

This is where you really have to be disciplined because the decision of how long to exercise is no longer just about you ... the individual. In other words, if your group normally plays for two hours and you are just getting started with them, it takes a fair amount of discipline to say that you’ll play for 30 minutes the first week and then increase your time next week ... and so on. Peer pressure comes into play and it’s easy to succumb to that – especially if you’re feeling good at the time.

Like everything else, the older you get, the more likely you are to run into some type of problem just jumping into an activity. An 18-year old can get away with a lot more than a 48 year old.

One of the main problems that occur in these situations is DOMS (delayed onset muscle soreness) – when the connective tissue gets strained and produces subtle swelling in the muscle. That is manifested through muscle soreness 24 to 48 hours later. People often call it a ‘good hurt’ but there’s not much good in feeling that way. When suffering from DOMS, a little muscle movement (i.e. stretching the muscle) is advisable because it helps massage that interstitial fluid that results from a subtle vascular leak at the point of the injury.

Tendonitis and bone stress injuries are also potential risks. However, unlike DOMS, symptoms of these injuries generally occur following repeated heavy activity over time. Symptoms of such injuries involve continuing achiness in a narrowly focused area of the body – even while at rest. Finally, muscle strains become more common in 40 and 50 year-old athletes as the result of their bodies becoming stiffer with age.

Kid Concerns
What about our children? What are their risks associated with participation in summer sports and other activities? For those aged around 9 to 16 – before skeletal maturity – the issue is dealing with their open growth plates. Because they are still growing, it’s easy for kids to have heel pain, knee pain, ‘little leaguers elbow’ – all those problems that result from overuse of the growth plates.

Such injuries usually occur during a growth spurt – about the time you notice your son or daughter has already outgrown the pair of pants you bought them four months ago. That’s when they are more susceptible to the growth plate injuries.

Typically, I see heel pain at younger ages (10 to 12 years of age) and knee pain two to three years later. And in any sport where there is constant throwing, there are always potential growth plate problems in the elbow or shoulder.

The key here is that, just because they are kids – young and strong – they are not impervious to muscle and bone injury. In fact, because of the growth plate issues, at times they are more prone to injury than adults.

Therefore, kids need to make sure they are properly stretched before exertion and that they keep their muscles loose and warm during the game to keep them pliable. We’ve all seen the little league outfielder standing out there an entire game and then – all of a sudden in the seven inning – having to make a long throw to home plate. Not a good situation for the arm, shoulder or elbow.

Summer is a special time of year for most people – regardless if they are looking to get out on the court, field or diamond again, or simply trying to look a little better for the beach. Just keep in mind that you may find your way back inside on the couch quicker than you think if you try to make it all happen overnight.

More Info
Dr. Stephen M. Simons is board certified in sports medicine and family medicine. An avid runner, Dr. Simons also served as a US Olympic Team Physician in 2004. He can be reached at the Sports Medicine Institute at 611 E. Douglas in Mishawaka at (574) 335-6214.

Moisturizers: The Cream of the Crop

By Aaron Young, MD, Saint Joseph Family Medicine

I’m often asked what is the number one preventive measure people can take to keep their skin looking as youthful as possible for as long as possible. Quite simply, the biggest factor regardless of age or gender is sun protection – especially for those in their 20s and 30s – because, if you’re taking care of your skin during this time in your life, it will positively affect how you look in your 40s and 50s.

For women, there is makeup and moisturizers that already have SPF 15 in them. If you incorporate these products into your daily routine – with base products, lip stick, lip gloss, etc. – you don’t even have to think about being caught off guard by being out in the sun for a prolonged period of time when maybe you don’t anticipate it. By using these products, you’re already covered.

While such SPF protective makeup has been around for a few years, they are now more common and attainable to the general public. Until recently, they were viewed as more of a high-end, specialty product but now the technology and applications have trickled down to the less expensive brands.

What I also recommend for all age groups is the use of skin moisturizers as they are effective treating those fine lines that start to become apparent around the eyes and the mouth with aging. Moisturizers plump up and lessen the appearance of facial lines. Also, like makeup, you don’t have to purchase an expensive brand that you find at the department store for it to be effective. It can essentially be any type of moisturizer – even something you find at the corner drug store. What is important is buying a moisturizer that works for you and sticking with that particular brand.
One cautionary note: if you suffer from acne and you’re looking to purchase a moisturizer, try to use a brand that is non-comedogenic (oil-free) so you are not compounding your problem.

As you approach middle age, it’s best to continue these healthy skin practices that ideally were established in your 20s and 30s. As you get older, however, the pursuit of youthful looking skin obviously becomes a little more complicated. For many women, the approach of menopause signals the onset of hair in places where it hadn’t grown previously. Combating this commonly means the use of electrolysis, tweezers or doctor-prescribed creams. While there are hair removal creams available over-the-counter, they tend to either not work very well or not at all. So, if you really want something that will work – talk to your doctor about it.

Finally, there’s a lot of focus these days – especially through TV commercials and infomercials – on collagen formation. Collagen is the primary structural protein in your skin that determines how firm and tight it is. Unfortunately, as we grow older, natural collagen formation does not occur as frequently as it does in our youth. Thus, the proliferation of wrinkles and lines as we age.

However, despite the popularity of these anti-wrinkle creams in some circles, I tend to recommend that people stick with a basic moisturizer. That’s going to fill in those lines just as well and you don’t have to worry about them damaging your skin. But, if you do put an over-the-counter cream on your face and it just doesn’t feel right – perhaps it burns slightly or tingles – stop using it immediately. Also, never combine the use of multiple skin products as it is sometimes difficult to predict how these products will interact with one another.

While perhaps a medical cliché, the key to maintaining healthy skin is – as it is with most healthcare issues – prevention. And if you find yourself starting this process a little late in life, don’t try to make up for lost time through quick fixes. At the risk of using another medical cliché – see your doctor first.

More Info
Dr. Young is a certified family practitioner within the Saint Joseph Physician Network with a special interest in dermatology. He currently practices out of the Saint Joseph Family Medicine - Elm Road office. He can be reached at 574-252-3616.

Physician's Personal Experience Helps SJRMC Provide Unique Cancer Care

Dr. Mohamed Farhat, MD

September 1, 2009, is the day cancer treatment was dramatically enhanced in Michiana. That’s when Mohamed Farhat, MD, joined Michiana Hematology Oncology at Saint Joseph Regional Medical Center’s Cancer Institute.

Not only is Dr. Farhat triple Board Certified in the areas of Hematology, Oncology, and Medicine, he is also an Assistant Professor at Rush University Medical Center in Chicago, where he completed his Fellowship and Residency.

“We are so happy to be here in this area,” said Dr. Farhat. “Not only is this a great place to live and raise a family, but being here helps provide a university-based cancer treatment program to this area. We have at our disposal whatever we want and access to some of the greatest minds in cancer treatment.”

Rush University is home to one of the first medical colleges in the Midwest and one of the nation’s top-ranked nursing colleges, as well as graduate programs in allied health, health systems management, and biomedical research.

For more than 170 years, Rush has been leading the way in developing innovative and often life-saving treatments. Today, Rush is a thriving center for basic and clinical research, with physicians and scientists involved in hundreds of research projects developing and testing the effectiveness and safety of new therapies and medical devices.

This unique combination of research and patient care is now available in Michiana thanks to the connection and care provided at SJRMC by Dr. Farhat, as well as some poignant personal motivation.

“The patients have been very happy and enthusiastic about receiving the same care as they would in Chicago,” said Dr. Farhat. “I’ve always wanted to bring what I know to an area like this – a place where I can do the most amount of good.”

It wasn’t until his second year at Chicago Medical School that Dr. Farhat realized what “the most amount of good” would be.

Arriving in the United States with his family from France in 1988, Dr. Farhat took four years off between high school and the beginning of undergraduate work at Loyola University in Chicago to help his parents and two older siblings make ends meet at home. When he arrived at Chicago Medical School after graduating from Loyola, he still wasn’t sure what route medicine would take him.

“But during my second year of med school, one of our uncles who was very close with our immediate family developed Leukemia and died two weeks after being diagnosed,” Dr. Farhat explained. “I wanted answers – wanted to know how and why something like this could happen so fast. But nobody could tell me.
“From that point on, I decided that I wanted to be that person who could give answers and help patients and their families,” he continued. “Since that day, I’ve never looked back.”

Using an inherited work ethic from parents who took on extra work to make sure their children would have a solid foundation when it was their time to have families of their own, Dr. Farhat took extra classes and rotations to better prepare him.

“It’s very hard to do but you really have to lock yourself in a room or the library from 8am – 10 pm to just study, study, study,” he said. “But like anything, you get out of it what you put into it.”

At age 35, triple Board Certification and Assistant Professor status on his resume is all the proof one needs to see that Dr. Farhat has made the most of his young life.

“Needless to say, our parents are very proud,” he said with a big smile. “My sister is a lawyer in California and my brother is in his final year of Residency in neurosurgery in Miami. We are blessed with great parents.”

Local cancer patients and their families are feeling the results.

“When you treat cancer patients, many times you are committed to life-long therapy and patients become more like your own family members,” Dr. Farhat said. “It can be tough when you see them go when you have completely cured them because you’ve been a part of each others’ lives for a long time. But you can never experience anything quite like it when you know your patient is feeling better.”

National Nutrition Month: Ways to Shave Calories

Tips from Chris Senff, RD, CD, Saint Joseph Regional Medical Center 

When it comes to healthy weight management, small steps add up. In fact, little changes in eating and activity level have a more positive impact on health than drastic ones. This is because you are more likely to stick with smaller changes over time. Extreme diets and intensive exercise regimens may work well at first, but they rarely last over the long term.

Healthy weight is all about balancing food intake with physical activity. Most of us could improve our energy balance by shaving just 100 calories a day off our usual intake. It’s not difficult:

• Lighten up your favorite coffee drink with non-fat milk and sugar-free syrup
• Trim all fat from beef, pork and chicken. Remove the skin from poultry
• Dish up slow-churned, reduced-calorie ice cream in place of regular
• Enjoy raw vegetables with salsa or fat-free ranch dip instead of chips

Small Changes Add Up:  Here are more great ideas that will cut calories from your daily intake, possibly without your even noticing:

• Downsize Your Dishes. Use smaller plates and bowls to help you eat less. We tend to fill up the dish we’re using and then eat it all. Our brains also think we are getting more when the same amount of food is placed in a smaller dish.
  
• Savor Your Meals. Eating slowly helps you consume only what your body needs to feel satisfied. Eating too quickly, in less than 20 to 30 minutes, leads to overeating and feeling uncomfortably full afterwards.
  
• Leave Some Food on Your Plate. This is especially important if you grew up in the “clean plate club.” By leaving even a few bites, you can focus more on your internal signals of satisfaction and less on eating food just because it is there.
  
• Don’t Eat Out of a Bag or Box. When you eat out of a package, you are likely to keep eating until it’s all gone – no matter how many servings the package actually contains. Pour one serving into a small bowl.
  
• Choose Your Glass Wisely. Here’s another place where our eyes play tricks on us. When glasses are short and wide, we tend to fill them with more fluid and to drink more. Use a slender glass for any beverage except water.
  
• Rethink Your Drinks. High-calorie beverages like soft drinks, juice drinks, energy drinks, specialty coffees and alcohol add calories just like solid foods.

National Nutrition Month: Your Nutrition Questions, Answered!

Questions answered by SJRMC Registered and Clinical Dietitian, Kylie Harrold

What are considered lean cuts of meat? 

There are several cuts of red meat that are considered lean. Cuts that include the words "round", such as top round or bottom round, or "loin", such as sirloin, tenderloin and top loin are lean choices. Flank steak is also a lean cut. Also, look for any cut that is labeled 95% lean ground beef. 

Any cut of meat can be made leaner by trimming off visible, solid fat before cooking. Healthy cooking methods include roasting, broiling, grilling, stir-frying, braising, steaming and stewing.


Does "Made with Whole Grains" mean the food is a good whole-grain source? 

Not necessarily. "Made with whole grains" means that the product has some whole grain in it, but the product is not 100% whole grain. When looking for whole-grain choices, make sure the label says "100% whole grain" and the ingredient label says "whole" before the grain. Whole grains include brown rice, bulgur, oatmeal, whole-grain corn, whole oats, whole rye, whole wheat and wild rice.


If I am trying to cut back on caffeine, will switching from espresso to coffee help? 

Actually, espresso has less caffeine than coffee! On average, one 8-ounce cup of brewed coffee has 85 milligrams of caffeine, and one ounce of espresso (plain or in a coffee-drink) has 40 milligrams. If you are trying to decrease your caffeine intake, consider changing to black or green tea (with 40 milligrams of caffeine per 8-ounce serving) or half regular coffee and half decaffeinated coffee. 

If you normally drink quite a bit of caffeinated beverages, be sure to cut back slowly. For some people, cutting back quickly will cause headaches and drowsiness for the first few days. 

Medical Team to Leave for Haiti Tomorrow

Tomorrow, February 2, a team of physicians and nurses will travel to Haiti to provide much needed medical relief. They will be working at Sacred Heart Hospital in Milot, Haiti where it is expected they will perform surgery from 8 am until 11 pm with 30-minute breaks for lunch and dinner.

Every day, 10 - 12 helicopters carrying up to 10 patients each land in Milot. These are patients with critical orthopedic needs, and many of them will have to undergo amputations. 

Please keep these brave volunteers and their families in your prayers:
Dr. George Friend
Dr. Meredith Wierman
Dr. Jeff Lindquist
Dr. Rick Skupski
Dr. Mark Walsh
Dr. Fred Ferlic
Dr. Henry DeLeeuw
Dr. Randy Ferlic
Dr. Michael Yergler
Michelle Crawford, RN
Donna Dickens, RN
Doug Gibson, RN
Kyonna Charlston, RN
Dana Brackett, PA
Dr. Joey Garcia
Dr. James Wierman

In addition, thank you to our physicians here at home for taking call and seeing extra patients as needed while their colleagues are in Haiti. Bless everyone who has worked to make this relief effort possible.

We are accepting monetary donations to assist with the group’s travel expenses. If you would like to donate, send a check to the Foundation of SJRMC, 837 E. Cedar St., Suite 350, South Bend, IN 46617. Write “Haiti” on the memo line. To donate online go to Click here to make a secure donation online. 

Cooking with Your Kids

Gwen D. Ehlers, RD, Clinical Dietitian, SJRMC

Cooking with Your Kids

Quick Tips from Gwen D. Ehlers, RD, Clinical Dietitian

How can you get yours kids to beg for bananas instead of brownies?  What could convince them to choose carrot sticks over candy bars?

• Eating healthy is a lifestyle, and needs to begin at an early age. Help your kids start by including them in the selection and preparation of food.
  
• Ask your little ones to pick out their favorite color fruit or vegetable at the store.
  
• Snack with dips that include peanut butter, light salad dressing, low fat yogurt or salsa. This will encourage young ones to expand their choices of fruits and vegetables.
  
• Cook with your kids! While you’re spending quality time together, they are learning new skills, whether it is mixing, measuring, or cutting.

Try these recipes with your child:

Wonderful Stuffed Potatoes

• 4 medium baking potatoes
• ¾ C low-fat (1%) cottage cheese
• ¼ C milk
• 1 TB soft margarine
• 1 tsp dill weed
• 2 tsp grated Parmesan cheese

Prick potatoes with fork. Bake at 425° for 60 minutes or until fork is easily inserted. Cut potatoes in half lengthwise. Carefully scoop out potato leaving ½” pulp inside. Mash pulp in large bowl and mix in remaining ingredients, except Parmesan cheese. Spoon mixture into shells and sprinkle top with 1/3 tsp Parmesan cheese. Place on baking sheet and bake 15-20 min until tops are golden brown.

Chicken & Veggie Wrap

• Flour tortillas
• 1 C diced cooked chicken
• ½ C chopped cucumber
• ½ C chopped red bell pepper
• ½ C chopped raw sugar snap peas
• ½ C chopped lettuce
• ½ C hummus

Combine chicken, cucumber, bell pepper, peas, and hummus in a bowl. Lay the wraps on the counter and cover each with a lettuce leaf. Divide the vegetable mixture among them and spread, leaving half-inch border around the edge. Roll up tight, tucking in the edges as you roll. Cut in half.