Cosmetic Dentistry Can Give Even Ordinary Mortals Movie Star-Quality Teeth

By Patrick Yeagle
A dazzling white smile can be a great asset. Just ask Natalie White.
“I get a lot of compliments on my smile, White said. “Someone at church said I have a Pepsodent smile.”
But her smile wasn’t always so bright. During childhood, White had to take
asthma medicine that turned her teeth a dull yellow. After having her teeth whitened professionally, White said she feels more confident with her new smile.
For anyone seeking a brighter, whiter smile, there are a few options from which to choose. Those with only slight discoloration may want to save money by opting for home kits available over the counter. For more persistent stains, a trip to the dentist for professional whitening may be in order.
The whitening process consists of applying a bleaching gel to the teeth, usually with a mouth tray or plastic strip, while some products are simply brushed onto the teeth. In general, dentists use the same types of bleaching agents for teeth whitening as are contained in the home kits, but dentists have a few advantages. A dentist can create custom mouth trays to fit closely, increasing the bleaching gel’s contact with the teeth. Many dentists also use an ultraviolet lamp to accelerate the action of the bleaching gel, getting more noticeable results in a shorter time.
“The one-hour technique has the benefit of getting pretty significant results in a short period of time,” said Dr. Ken Berley, a dentist who owns a practice in Rogers. “It has the negative of that’s the technique that causes the most amount of sensitivity.”
If patients don’t need their teeth whitened by tomorrow, Berley prefers using the take-home technique. He creates custom trays and sends them home with patients who bleach their teeth at home for a few weeks before returning to the dentist’s office.
“We check them in two weeks and make sure that they’re not having any sensitivity and that we’re getting the kind of progress that we want,” Berley said.
The effects of the bleaching process might vary from person to person, but if done correctly, patients will notice a difference quickly. “Within a two week period of time, if the patient bleaches daily they can get maybe seven, eight, nine shades brighter,” Berley said.
Bleaching is not a permanent solution and patients who want their brighter smile to last will have to continue treatment.
“The negative with all bleaching is it definitely has to be touched up,” Berley said.
Improving someone’s smile is oftentimes one part of a makeover. People sometimes start with a brighter smile because its one of the less expensive parts to fix, Berley said.

The Morning News’ correspondent Antoinette Grajeda contributed to this report.

By Wen Hui Tan
Diabetes mellitus has been characterized by the Centers for Disease Control and Prevention as a “growing public health concern.” The CDC noted between 1958 and 1997 the number of people diagnosed with the disease increased from 1.6 million to 10 million. Today, more than 16 million people have diabetes and five million of them don’t know it. Another 800,000 people are diagnosed each year.
With the national media fixated on the childhood obesity epidemic and its link to type 2 diabetes, it’s easy to forget that type 1 diabetes is just as devastating. According to the National Institutes of Health, type 1 diabetes affects one in 400 to 600 children and adolescents. An additional 13,000 young people, most younger than age 10, are diagnosed with it each year.
Two groups where type 1 diabetes is most common are 4- to 6-year-olds and 10- to 14-year-olds, said Dr. Shamsul Alam, a nephrologist at the Northwest Health Center in Bentonville. However, the disease can occur in other age groups. For example, one-fifth of type 1 diabetes patients first develop the disease when they are adults, Alam said.
Understanding diabetes requires understanding how the body regulates blood glucose levels. Cells break down glucose to fuel the body. The hormone insulin regulates the amount of glucose that enters cells from the bloodstream. Insulin is produced in the beta cells of the Islets of Langerhans, clusters of specialized cells in the pancreas that generate hormones. Type 1 diabetes is an autoimmune disease in which the body attacks its own cells, halting insulin production. This sets it apart from type 2 diabetes, in which the body makes insulin but doesn’t respond to it.
While there is still much to learn about this disease, Alam said race and geography combined can create interesting results. For example, if a Chinese child moved to the United States, his risk of developing type 1 diabetes would increase, despite the fact that his race typically has a lower chance of developing the disease.
For reasons not understood, type 2 diabetes often strikes people who are old, don’t exercise, or are overweight, and as a result, type 2 diabetes is stigmatized as a “fat person’s” disease. Hence, some type 1 patients believe their plight deserves more sympathy and research dollars. To them, it is not their fault their body is at war with itself. However, both are linked to genetics, environment and nutrition in ways not fully understood and a significant fraction of patients with type 1 diabetes are overweight as well.
Yet, no matter the population affected, the complications arising from type 1 diabetes are dire and varied.
“This is one of the diseases that cause severe long-term health problems in terms of complications that this disease induces in patients affected with it,” said Dr. Matthias von Herrath. A professor and researcher at the La Jolla Institute for Allergy and Immunology in San Diego, von Herrath has devoted the last 15 years to finding a cure for type 1 diabetes.
“These are complications of the vessels system,” he said. “It puts patients at severe risk for heart attack and kidney problems.”
Other long-term complications include blindness and nerve damage.
The affects of type 1 diabetes are known, but physicians are still in search of a cure.
“We’re hoping that will come,” Alam said.
Alam’s specialty is kidneys, but he said he is still affected by diabetes because more than half of his patients’ kidney problems stem from the disease. When dealing with diabetes, he suggested being watchful of signs of the disease, having a good medical family history and educating the community about diabetes.
Although type 1 diabetes is incurable, it is manageable.
To find a cure for type 1 diabetes, researchers must first understand what causes beta-cell death in the first place, something that has confounded scientists for years. Despite research, the mechanism behind type 1 diabetes remains a mystery. Scientists disagree over which source sends the signal for beta cells to die.
Despite these challenges, researchers have made significant strides in finding a cure. One strategy being explored is to partially suppress B cells, the cells in the immune system that produce antibodies. Because B cells have been implicated in the development of diabetes in mice, researchers are testing whether B cell-depleting drugs like Rituxan (Genentech) can be used against type 1 diabetes. Another avenue is to inject certain kinds of regulatory T cells to prevent the death of the insulin-producing beta cells. In the immune system, regulatory T cells are a “self-check,” ensuring that the immune system does not attack the body’s own
tissues.

The Morning News’ correspondent Antoinette Grajeda contributed to this report.

Gardasil May Be Effective for Males
Merck announced the results of a clinical trial that indicated Gardasil’s efficacy in preventing HPV-related genital warts and other lesions without any serious safety concerns.
According a report by The Associated Press, the trial involved 4,000 males between the ages of 16 and 26, and the vaccine was 90 percent effective in preventing external genital lesions.
At least 50 percent of sexually active men and women acquire genital HPV infection at some point in their lives, according to the Centers for Disease Control and Prevention.
About 20 million Americans are currently infected with HPV, and another 6.2 million people become infected each year.
Merck intends to apply to the U.S. Food and Drug Administration to license the vaccine for use in males.
It isn’t clear from the reports if the advisory committee will recommend broad use of the vaccine in males.

Teen drinkers face greater health risks
An Australian study found teen drinkers having their first full drink of alcohol by age 15, which could put them at greater risk for dependence and mental health issues.
Women older than 60 reported having their first drink at about age 23, but those between 20 and 29 reported starting in their mid-teens.
The study’s lead researcher said statistics indicated girls were starting to drink as early as boys, in part because of exposure to advertising.
Easy access to alcohol, ample disposable income and early maturity among teens were listed by researchers as contributing factors to the trend of early drinking.
Teens can start drinking for a variety of reasons such as curiosity, peer pressure or as a way to deal with pain or unresolved issues, said Dr. Mark Lee family medicine physician at the Rogers Medical Center. Although the contributing factors to early drinking can be identified, the trend is not always easy to prevent.
“When it comes to prevention and treatment, that’s where it gets a little tricky because the only thing you can do is to identify these children early as a risk,” Lee said.
In 2004, 393 people from ages 12 to 20 years old were admitted for alcohol treatment in Arkansas, according to the International Institute for Alcohol Awareness. This accounted for 6 percent of all treatment admissions for alcohol abuse in the state.
The good news? Another study found that 45 percent of college students reduced their drinking substantially after exposure to online education about acceptable consumption.

Study links sex on TV  to teen pregnancy
The RAND Corporation conducted a study of teens 12 to 17 years old monitored until reaching 15 to 20 years of age and found a possible link between exposure to sexual content on television and teen pregnancy.
Researchers said factors leading to teen pregnancy are complex, but added there is little doubt that TV can be one of those factors. The study’s authors urge parents, pediatricians and educators to be aware of television’s potential influence on teens’ health decisions.
Teenagers spend an average of three hours per day watching television, and researchers say TV’s impact on teen health choices is still not well understood.
Of the 2,003 teenagers included in the study, those who had watched the most sexual content on television were twice as likely to have experienced a pregnancy or gotten a girl pregnant as the teens with the lowest levels of exposure.
Researchers cautioned that while it is clear television has an impact on teen sexual behavior, its extent isn’t yet known because there are many other factors involved in a teen’s choices about sex.
According to a report released in January by the Centers for Disease Control and Prevention, Arkansas ranks fourth in the nation for its teen pregnancy rate.

The Morning News’ correspondent Antoinette Grajeda contributed to this report.

Seniors could benefit from a substance that bodybuilders and athletes use, according to recent research.
Researchers from the University of Oklahoma recently released a study that showed elderly men and women were able to improve their fitness by using beta-alanine, which is a dietary supplement. The study’s authors said this could be an important discovery because it can add to seniors’ overall quality of health and could prevent falls.
To come to this conclusion, researchers split the elderly participants into two groups. One group received a 90-day dosage of the BA supplement, while the other group received placebos. To gauge their progress, the participants’ fitness levels were tested before, during and after the treatment.
Over the course of the study, the group who used the supplement saw a 67 percent increase in their overall fitness measurements while the placebo group only saw an increase of about 22 percent. The study was published in the Journal of the International Society of Sports Nutrition.

Alzheimer’s
Alzheimer’s disease doesn’t just affect the elderly people who suffer from it.
A new study published in the Journal of General Internal Medicine says that about 25 percent of the people who care for their loved ones who have Alzheimer’s eventually become hospitalized themselves because of high stress levels.
The study, which was led by researchers from the University of Indiana, detailed that about one in four caregivers either were hospitalized or made a trip to the emergency room every six months because of caring for someone with Alzheimer’s. The study’s authors noted that their research should change what is defined as the patient.
Not only should it be categorized as the person with Alzheimer’s, but they say the caregiver should also be considered a patient. The study is also the first to officially recognize the correlation between caring for someone with Alzheimer’s and the actual stress it includes. To come to these conclusions, researchers looked at more than 360 people. Half had Alzheimer’s and the other half were their caretakers.
Aside from the one-in-four caregivers being hospitalized, researchers found that the average age of a caregiver is about
60 years old.
The number of people in Arkansas
65 years old and older with Alzheimer’s disease is expected to reach 60,000 by 2010, according to a report by the Alzheimer’s Association.
The study also showed in 2007 the state contained 110,789 Alzheimer’s and
dementia caregivers.

Bone strength
If your bones are becoming frail, you might benefit from popping an
MK-677 pill. A University of Virginia Health System report suggests that taking one of those pills can help seniors in the fight against weakening bones. The study, which was published in the Annals of Internal Medicine, suggests that the
MK-677 pill helped seniors regain about 20 percent of muscle mass loss compared with those who did not take the pill.
Also, the study’s authors note there have been no serious recorded side effects, which they say is important. Because of this, they hope the supplement can help older adults live independently longer. Because of frail bones, many elderly people cannot live unassisted into their 80s. The study was paid for by the National Institutes of Health and it lasted for two years. It involved 65 men and women who were between 60 and 81 years old.
Half of the participants were given the MK-677 pill, while the other half was
given a placebo.

Heart failure
There are more medicines and more advanced treatments. That, however, hasn’t stopped the rate at which seniors are experiencing heart failure. A recent study by researchers at Drexel University School of Public Health suggests that elderly people are having heart failure at alarmingly high rates. The study, which tracks heart failure hospitalization data over a 27-year period, shows a drastic increase in the number of heart failure-related hospitalizations.
The study looks at data from people who are at least 65 years old, which includes more than 2.2 million cases. The study broke down the cases into three different groups. One group consisted of patients between the ages of 65-74, the other tracked 75-year-olds through age 84, and the last covered patients 85 years and older. The research found staggering increases across the board in all age groups.
Overall, there were 131 percent more reported cases in 2006 than in 1980, the first year of the study. In 1980, there were about 348,000 cases. In 2006, that number skyrocketed to about 807,000. Aside from getting worse over the years, the research found heart failure hospitalizations also worsened the older a person was.
People in the 85 and older age group were 400 percent more likely to find themselves in the hospital because of heart failure than the group of people between the ages of 65 and 74.

Muscle growth
Elderly women packing on muscle doesn’t necessarily relate to a decrease number of falls, a recent study found. A University of New Hampshire study showed that older women can gain muscle in the same way that younger women can, but the muscle gain doesn’t give them any more leniency in preventing falls. To come to this conclusion, researchers studied two groups of women.
There was an older group of women, and a younger group. Heading into the study, all participants were relatively inactive. Then, the elderly and younger women participated in an eight-week training program aimed at helping them improve their fitness and gain muscle.
The good news for women was they gained strength at about the same pace as the younger women did. However, the elderly group did not increase their power as quickly. Elderly women saw only about a 10 percent increase in their power gains while the younger group saw a 50 percent increase. Power is associated with preventing falls, the study’s authors said.
About 50 women participated in the study. The older group was comprised of women between the ages of 65 and 84 while the younger group was made up of women between ages 18 and 33. They participated in exercises such as stair climbing and resistance training.

The Morning News’ correspondent Antoinette Grajeda contributed to this report.

By Sarah Lohman
The heat of summer is gone, the humidity has dissipated and the cold of winter has set in. For many, this change in temperatures is a relief from hot, humid summers.
But the disappearance of humidity and a thermostat set to summer-like temperatures can lead to dry, brittle, cracked and painful skin.
“Cold, windy weather outside compounded by dry air indoors from heating cause the skin to be depleted of moisture,” said Missy Clifton, board certified dermatologist and owner of Premier Dermatology and Skin Renewal Center in Bentonville.
Skin is often drier in the winter because cold air holds less humidity than warm air and furnaces dry out the air more. Showers tend to be longer and hotter to fight back the cold air and chase the chills out of our bodies.
Dr. Mary Sheu, a board certified dermatologist on faculty at the Johns Hopkins University school of medicine’s department of dermatology, said winter is a very important time to remember to keep skin moisturized and healthy.
The National Health Interview Survey found that 81 million Americans suffer from dry winter skin. Older individuals, whose oil glands produce less, women going through hormonal fluctuations such as menopause, and African Americans, who tend to have drier skin, are at a higher risk for winter skin irritation. People who spend a lot of time outdoors are also more exposed to the dry air and should take more precautions, like protecting their skin from the cold with scarves, hats and gloves.

Thyroid disorders, malnourishment and medications to lower cholesterol or lipids also can have a drying effect on skin. People with eczema, psoriasis or ichthyosis are already prone to dry skin need to protect from winter weather induced flare-ups.
Sheu recommended using gentler soaps made for sensitive or dry skin, such as Dove sensitive skin or Aveeno moisturizing cleanser. Showers should be kept short, around 10 to 15 minutes, and areas that need to be cleansed more often, such as the underarms, should be spot cleansed.
“Just let the water rinse the other areas,” Sheu said.
Longer exposure to water in the shower will not increase skin moisture.
“Contrary to what one would think, water actually depletes skin of moisture so short showers and baths are better,” Clifton said.
Lukewarm baths with oatmeal or baking soda can soothe dry skin without drying it out too much.
Sheu said shower water should feel comfortably warm but should not be hot enough to turn the skin red.
“For some people it is very comforting to have that really hot shower if their skin is itchy, but in the long run it will probably worsen the condition,” Sheu said.
After showering, she recommended drying off quickly and slathering on a moisturizing cream within the first minute or two of exiting the shower.
“It is more helpful to put a moisturizer on skin that is moist to begin with,” Sheu said.
Moisturizing creams tend to have a higher content of oil, emoluments and humectants and lock more moisture in. They are often thicker and must be scooped out of a jar or squeezed out of a tube. Lotions are thinner, water-based and can be squeezed out of a pump.
Sheu said dry hands should be moisturized every time they are washed. An article written by Rebecca Kazin, assistant professor of dermatology and director of the Johns Hopkins Cosmetic Center, suggests using hand soap that contains moisturizing ingredients or an alcohol-free hand sanitizer.
Soaking hands in warm water for a couple minutes and then applying cream before bedtime will keep them from getting cracked and chapped. Cotton gloves can help hold in the moisture at night as well.
When treating dry skin, Clifton said heavily fragranced soaps and lotions can cause significant irritation of already dry skin.
“I usually recommend unscented soap such as Dove for sensitive skin, Cetaphil or CeraVe soap substitutes for cleansing,” she said. “For moisture replacement my favorites are CeraVe, Cetaphil, Lubriderm and Eucerin brands.”
Fragrance-free products are less likely to irritate dry skin.
“The barrier that normally keeps irritating chemicals and substances outside of the skin, that barrier can break down and detergents and chemicals that our skin is not normally exposed to can enter through these little cracks and cause more irritation,” Sheu said. “It’s important to apply something that improves the barrier.”
She said especially itchy patches
can be treated with hydrocortisone
1 percent for a week or so, but if the patch doesn’t improve a physician should be consulted.
Sheu said dry lips should be exfoliated with a warm, wet washcloth before applying pure Shea butter. It is also important to make sunscreen part of your year-round skin care regimen, because the sun reflects off of snow.
Acne medications can further dry out skin, and people with acne-prone skin may need to switch to milder acne products during the winter months. A report published on http://www.About.com suggests switching cleansers if your normal product makes your skin feel tight and dry. Salicylic acid and benzoyl peroxide can be especially drying. It’s also beneficial to incorporate a moisturizing gel or light lotion into your acne care as well.
Sheu said drinking excess water may not help improve the skin moisture, but dehydration can cause skin to dry out more quickly. Maintaining a healthy intake of healthy fats, mono and saturated fats, can help keep skin healthy and moisturized as well.
Foods rich in antioxidants as well as essential fatty acids can also improve winter skin health, according to an article written by Kazin, director of the Johns Hopkins Cosmetic Center.
Dr. Maoshing Ni, an anti-aging specialist with the American Board of Anti-Aging Health Practitioners who practices in Santa Monica, Calif., also suggested consuming the recommended daily amount of vitamins A, B-Complex and E because they support healthy skin. Vitamin E can be applied directly to dry skin on the elbows, knees, hands, feet or anywhere that is especially dry. Feet should also be exfoliated and treated with a petroleum jelly or glycerine.
Clifton agreed vitamin supplements can help dry skin, but cautioned they should not replace the use of mild soap and regular skin lubrication.
“I recommend that everyone take a daily multivitamin for overall prevention of vitamin deficiency,” she said. “In addition, for people with dry skin or skin disorders, omega-3 fatty acids, such as those found in fish oils, can help to replace the essential oils of the skin. Biotin is a B vitamin that is essential for overall skin, hair and nail health. Both fish oil and biotin can be taken safely in addition to a daily multivitamin.”
WebMD suggests using humidifiers to keep inside air from drying out skin. Wet socks and gloves can also draw more moisture out of the skin, irritating skin. Waterproof and leather gloves and waterproof shoes can keep phalanges comfortable and dry in wet winter weather. Rough wool gloves can irritate dry skin, but slipping on a cotton glove first can protect skin while wool gloves keep hands toasty.
Sheu said extremely dry skin can split open, forming deep and painful cracks, if not moisturized enough.
“It’s definitely easier to prevent these conditions, once they occur we can certainly treat them,” Sheu said. “But it’s easier to prevent it from occurring in the first place.”
To keep skin healthy year-round, Clifton recommended regular dermatologist visits.
“Yearly skin examination and evaluation by a dermatologist can give you lots of great information about what is going on with the skin and how to improve the health and beauty of your skin,” she said.

Morning News reporter Antoinette Grajeda contributed to this story.

By Washington Regional Medical Center
Many women under the age of 55 aren’t seeking timely treatment for heart attack because they expect the warning signs and their reaction to follow a Hollywood script — tightening in the chest, shortness of breath, clutching the chest while dropping to one knee. The truth is that not all heart attacks conform to the stereotype of a man clutching his chest in pain. And nearly half the time, it is not a man whose heart is under assault — it’s a woman. Every year hundreds of thousands of women die as the result of a heart attack or other cardiovascular disease. Coronary heart disease, which causes heart attack, is the leading cause of death for American women over all forms of cancer, including breast cancer.
According to the American Heart Association, a recent study revealed that women lack the understanding of the dangers and symptoms of heart disease. “Only 13 percent of women consider heart disease their greatest health threat,” stated Amy Jetton, director of cardiovascular services at Washington Regional Medical Center. “In fact, heart disease kills six times more women than breast cancer each year. Nevertheless, our mental images still portray it as a man’s illness. Here at the Walker Family Heart & Vascular Institute at Washington Regional, we feel as if it is time for women to take control of their health by screening for heart disease and educating themselves on the signs and symptoms,” continued Jetton.
Researchers have found that women actually experience heart attacks differently than men. Some women have chest tightness as a symptom and some don’t ever have chest pain. Some women complain of pressure in the lower chest along with fatigue and easily mistake this as a stomach ailment. Most women who experience these symptoms fail to connect theme with a heart condition, thus are slower to seek medical attention and therefore at greater risk of dying from a heart attack than men.

Even though chest pain is the most common symptom, studies show that a heart attack for a woman plays out quite differently.
Major symptoms a woman experiences before a heart attack:
• Fatigue
• Sleep disturbance
• Shortness of breath
• Anxiety and a sense that something is terribly wrong
• Indigestion
• Brief episodes of pain or discomfort between the shoulder blades weeks before (especially upon exertion)
Major symptoms a woman experiences during the heart attack:
• Shortness of breath
• Weakness and sudden fatigue
• Cold sweats with nausea
• Dizziness
• Chest pain along with neck and jaw pain (sometimes the chest pain is not present)
• Throbbing in one or both arms
• Back pain that persists

There are several factors that increase the risk of heart disease in women. The more risk factors a woman has, the greater her risk of having a heart attack. Some of the risk factors you can’t control, such as increasing age, family health history, race and gender. But a woman can modify, treat or control most risk factors to lower her risk.
The following tips can
help lower your risk of heart attack:
• Maintain a regular schedule of aerobic exercise
• Eat heart-healthy meals and if you are overweight, work with your physician on a diet plan that best fits your needs
• Get your blood pressure, cholesterol levels and sugar levels checked regularly. If your numbers are high, work with your physician to control your numbers
• Cut back on caffeine and drink plenty of water
• If you smoke, quit!
• Drink alcohol in moderation. Excessive intake increase heart attack risk
If the heart of a woman is her greatest strength, it can also contain her greatest vulnerability. Almost every minute, another woman dies of cardiovascular disease, according to the American Heart Association. Disease of the heart muscle and blood vessel system is the No. 1 killer of women, accounting for one in every
2.6 deaths.
“The truth is that 40,000 American women die of breast cancer each year but 400,000 die of heart disease and stroke,” said Dr. Mary Ann Bauman, medical director for women’s health and community relations for INTEGRIS Health Inc. and a spokesperson for the Go Red For Women campaign. “It’s good that they get their mammograms, of course, but women still have a tendency to ignore or discount symptoms of heart disease.”
Part of the reason women’s heart disease symptoms sometimes go ignored is because they differ from men’s, said Dr. Philip Riley, cardiologist at Northwest Arkansas Heart and Vascular Center in Bentonville. Females were underrepresented in early heart studies so their symptoms are often considered atypical.
“I think that from our perspective, from a physician’s perspective, we haven’t had an adequate number of females in our trials to identify the problem,” he said. “Breast cancer is by far a female issue and so that’s where female health issues get a lot of attention.”
— Antoinette Grajeda

By Doug Eaton
Most people who suffer from a migraine headache (often referred to as “migraineurs”) think they may be merely experiencing a severe headache. In actuality, migraine is a disease and the headache is only a symptom.
“Most people equate the term migraine with the term headache and truly headache is a component of a migraine,” said Dr. Dimitry Fomin, a neurologist with Mercy Medical Specialties in Rogers.
Another little-known fact is that the cause of migraine pain is the opposite of the cause of headache pain.
Migraine pain is caused by vasodilation in the cranial blood vessels (expansion of the blood vessels), while headache pain is caused by vasoconstriction (narrowing of the blood vessels). During a migraine, inflammation of the tissue surrounding the brain, i.e., neurogenic inflammation, increases the level of pain. Therefore, medicine often prescribed to treat a headache, such as beta-blockers, dilate the blood vessels and consequently can actually make a migraine worse.

Headaches
Almost all people experience a headache at some time in their lives. One study estimates that more than
50 million people in the U.S. suffer from headaches. Although most headaches do not indicate serious illness, they are a major cause of suffering and missed work, and rank as one of the most common reasons people consult a doctor. The International Headache Society has actually classified 129 different types of headaches. The most common headaches come from the muscles (muscle tension), blood vessels (migraines), joints (from the neck, called cervicogenic), or systemic conditions (such as with fevers or low blood sugar). Doctors of Chiropractic have had considerable success in relieving the cause of headache pain. State-of-the-art techniques not only rid you of your headaches, but eliminate them from your life. These techniques include chiropractic, acupuncture and rehabilitation. If you suffer from headaches, you owe it to yourself and your family to have them evaluated for their cause. The only thing you have to lose is your pain.

Impact
According to the Migraine Awareness Group, A National Understanding for Migraineurs (M.A.G.N.U.M.), migraine disease affects approximately 30 million Americans, with perhaps up to 38 million Americans having a genetic propensity to suffer from migraines. M.A.G.N.U.M. is a nonprofit health care public education organization conceived in 1993 and incorporated in 1994 in order to bring public and government awareness to issue and study of the migraine disease.
Those who suffer from the most disabling type of migraine, intractable migraine, often face an uphill battle just to hold jobs and to support families.
The corresponding cost to industry and the health care system because of migraine is estimated to be between $5 billion and $17 billion dollars a year.
Although most migraine sufferers attempt to continue to work despite their affliction, many people who are inflicted often suffer as their income and productivity decrease over time. In one of the latest studies on the economic cost of migraine, the unemployment rate in individuals with severe migraine is 10 percent to 20 percent, which is several times higher than the general population.

Symptoms
Unlike a headache, the migraine disease has many symptoms, including nausea, vomiting, auras (light spots), sensitivity to light and sound, numbness, difficulty in speech, and severe semihemispherical head pain. One migraine attack can last for up to eight hours, several days, or even weeks.
Although a headache is a common symptom of migraine, it is not always a symptom.
“There are also some migraines that even don’t have a headache,” Fomin said. “So you have all of those other symptoms, but no headache.”
Like many other diseases, symptoms can vary from person to person and from migraine to migraine. Therefore, what a patient experiences before, during and after an attack cannot be defined exactly. The four phases of a migraine attack listed below are common but not necessarily experienced by all migraine sufferers.
Prodrome: A variety of warnings can come before a migraine. These may consist of a change in mood (for example, feeling “high,” irritable, or depressed) or a subtle change of sensation (for example, a funny taste or smell). Fatigue and muscle tension are also common.
Aura: This is commonly a visual disturbance that precedes the headache phase.
Some migraineurs develop blind spots, see geometric patterns or flashing, colorful lights or lose vision on one side.
Headache: Although migraine pain usually appears on just one side of the head, as much as 40 percent of migraines may occur on both sides of the head. Throbbing pain may be present. More than 80 percent of migraineurs feel nauseated and some may vomit. About 70 percent become sensitive to light and sound. This phase may last anywhere from four to 72 hours.
Postdrome: These signs of the migraine (such as fatigue, inability to eat, or problems with concentration) may linger even after the pain has gone.
Triggers
Identification and management of what causes a migraine is an important component of managing migraine disease. Migraine triggers are physical things that, when exposed to a migraineur, bring on a migraine attack.
“Not everyone knows what their triggers are,” Fomin said. “Those people that can identify triggers are better off than those that cannot because if you know what your trigger is, you can avoid it.”
There are a wide range of migraine triggers. Once triggers are identified, it is often possible to reduce the likelihood of migraine attacks by avoiding those triggers.
Food triggers are common. Not everyone who suffers from migraines may have food triggers, but it should be investigated. Often migraineurs can identify food triggers easily by noting that every time they eat something, they have a migraine. Other migraineurs employ an elimination diet to investigate food triggers. To do an elimination diet, eliminate all the potential trigger foods from your diet, then add them back to your diet one food at a time, with at least a week between adding each food.
Potential trigger foods include vegetables, beans, pickles, chili peppers, olives, fruits, bananas, avocados, red plums, breads, any fresh yeast product straight from the oven, pretzels and pizza. Meats and seafood, any preserved or processed meat, bacon, hot dogs and sausage are also triggers for many people.
Dairy products, including aged cheeses, sour cream, and whole milk and beverages, such as alcoholic beverages (especially red wine), chocolate beverages and caffeinated beverages often bring on a migraine. Other triggers can include food products containing artificial sweeteners, MSG and even vinegar.
often underdiagnosed
Many top neurologists admit migraines are greatly misunderstood and often misdiagnosed.
According to noted neurologist Dr. Joel Saper, “Migraine is a serious and underestimated health problem. Patients with migraine are shunted along an assembly line of misdiagnosis, undertreatment or frank mismanagement. They are subjected to unnecessary procedures and preventable consequences.”
It has been estimated that 60 percent of women and 70 percent of men with migraine have never been diagnosed with migraine. It has been reported that more than 60 percent of migraine sufferers have encountered unfavorable experiences with physicians, and often never return.
However, much of the genetic and other research on migraines has been done in the last few years. General practitioners and others receive continuing education, but little or any of the training may involve migraine. Overall, many physicians simply do not have updated information about migraine.
Fomin said physicians “still don’t know the exact nuts and bolts” about migraines, but what they do know is some migraines tend to run in families, are more common in women than in men, can occur in children and typically become less common with age. “There are some benefits to getting older,” he said.
This seems to be particularly true for women who have a strong correlation between migraines and their reproductive cycle. “As the woman goes through menopause, for most women with migraines, that’s usually the end of migraine,” Fomin said. “Not uniformly, but more so than not.”
If a family member has a history of headaches, it doesn’t necessarily mean the headaches are connected to migraines. Some headaches are related to other conditions such as blood pressure, diabetes or are a result of the medications someone has taken for another condition, Fomin said. To help get an accurate diagnosis, he suggested visiting a general practitioner.
Treatment and prevention
Obviously, the first line of defense is identifying and avoiding migraine triggers. Making individual lifestyle changes as appropriate is very important. Changes as simple as avoiding certain types of foods and certain emotional situations may help.
Simply managing care at home can often control migraines. Many migraineurs are able to manage mild-to-moderate attacks at home by the following treatment: using a cold compress to the area of pain; resting with pillows comfortably supporting the head or neck; resting in a room with little (or even no) sensory stimulation, such as light, sound or odors; withdrawing from stressful surroundings; sleeping; or drinking a moderate amount of caffeine.
Other treatments that don’t involve medication involve avoiding common biological triggers like sleep deprivation, dehydration and overheating, Fomin said.
When a pharmacological approach is taken, physicians can prescribe two types of medications: prophylactics and abortive. Prophylactics are usually taken on a daily basis in hopes of keeping headaches from occurring, while abortive medication is taken during a headache in order to stop it, Fomin said.
Certain over-the-counter headache medications may also provide relief. Nonsteroidal anti-inflammatory drugs, including medications like aspirin, ibuprofen (Motrin, Advil) and naproxen (Naprosyn, Aleve). Stomach ulcers and bleeding are serious potential side effects. Therefore, this type of medication should not be taken by anyone with a history of stomach bleeding. Talk to your doctor or pharmacist and ask about possible medicine interactions if the migraineur is taking other drugs.
Acetaminophen (Tylenol) may be safely taken with nonsteroidal anti-inflammatory drugs for an additive effect. Taking acetaminophen by itself is usually safe, even for those with a history of stomach ulcers or bleeding. Be aware that acetaminophen should not be taken if the migraineur is suffering from liver problems or imbibes with three or more alcoholic drinks daily.
“Maintaining a headache diary is particularly important,” said M. Gabriela Gregory, a neurologist at Nevada Neurosciences Institute at Sunrise Health. “This can identify patterns.” Some patients have clusters of headaches in the spring and summer, and allergy medications can sometimes clear this up.

The Morning News’ correspondent Antoinette Grajeda contributed to this report.

New Web site offers help to pet owners

By Brian Feldt
The idea was simple: create a consumer-driven Web site that would encompass any and all pet health needs while offering new and fresh feature stories for pet lovers.
The result was unexpected: a
consumer-driven Web site that simultaneously benefited veterinarians creating a mixed-target audience that for the first time included pets, their owners and their doctors.
“It really is a great site,” said Hope Schultz, co-founder, president and chief operating officer of WebVet, a new WebMD-esque pet health Internet craze.
“If people use the site properly, it really can and does benefit the veterinarians and their business. I mean we created the site with consumers in mind but the residual effects have had a great impact on the veterinarians.”
WebVet (webvet.com) launched
Aug. 4, 2008, has taken a life of its own since arriving on the Internet scene.
Schultz, a self-described pet lover with a business sense about her, said the concept is pretty basic. In the age of Google searching, consumers were being redirected to as many as six or seven different pet health sites in order to find answers to their specific questions. Schultz simply made a site that had all the questions a pet lover would need and put them in one all-encompassing site.
WebVet does not diagnose or suggest treatment for pets or their owners. Instead, it provides adequate information to understand the issue at hand. Schultz said she made sure the site consistently refers to a pet’s veterinarian for all medical decisions.
Sometimes the vet’s office is closed when a pet needs help. In those instances, instead of immediately turning to the Internet, Chris France, a veterinarian at the Pea Ridge Veterinary Clinic, recommended calling a clinic that takes after-hour phone calls such as the Animal Emergency Clinic of Northwest Arkansas in Springdale.
“I always think consult with a veterinarian first and then if you have to fall back on something, you can fall back on the Internet,” France said.
WebVet is the first site to offer a “whole pet” platform that identifies the physical and mental health of dogs, cats, birds and small pets.
Schultz said features such as a virtual lost-and found-feature or a nationwide database of dog-walkers and pet-sitters are on the horizon.
Another feature expected to hit the site soon is a “Manage My Pet” section that allows pet owners to detail their pets health history to a great extent.

The Morning News’ correspondent Antoinette Grajeda contributed to this report.

Sugar substitute toxic to canines
The sugar substitute Xylitol has some not so sweet effects on dogs. Xylitol, a sugar alcohol found in many products including some sugar-free candies, baked goods and gum, is poisonous to dogs and can even be fatal.
When dogs ingest products containing Xylitol, it affects their glucose levels. Dogs experience a sharp drop in blood sugar and may rapidly show signs of weakness, lethargy, loss of coordination, collapse and seizures. The symptoms can show up in as little as 30 minutes and cause brain damage and even death. Dogs should be taken for emergency veterinarian care immediately.
Dog owners who live more than an hour away from a veterinarian or emergency clinic can call the ASPCA Animal Poison Control Center 24 hours a day at (888) 426-4435. The ASPCA recommends keeping an emergency first-aid kit on hand for your pet that includes a fresh bottle of hydrogen peroxide (3 percent) and a turkey baster or bulb syringe (to administer the peroxide) to induce vomiting. In a small dog, as little as two or three pieces of sugar-free gum sweetened with Xylitol can be fatal. Xylitol is also thought to cause severe liver damage in dogs.
Northwest Arkansas pet owners needing emergency assistance can call the Animal
Emergency Clinic of Northwest Arkansas at (479) 927-0007. The office is located at 777 Mathias Drive, Suite B, in Springdale.

Older dogs can develop Cushing’s Disease
Older pets, especially dogs, can fall victim to Cushing’s Disease. The condition occurs when the adrenal glands secrete an excessive amount of the hormone cortisol. Cortisol is released in times of illness, stress, pain and injury to help the body cope. Too much cortisol can cause many problems. Signs of the disease include a large increase in water consumption and urination, caused by damage to the kidneys. Your pet may also become extremely hungry as excess cortisol can also affect the brain’s appetite centers. Excessive cortisol can cause muscle wasting and a change in distribution of body fat, causing a dog to appear pot-bellied. Hair loss, thin or fragile skin and increased skin infections are also signs. The disease can also lead to high blood pressure, heart failure, pancreatitis, diabetes and blood-clotting problems. Veterinary care is very important as the disease is generally fatal if left untreated.

Submitted By Northwest Medical Center
When Fred Pettit heard the word “cancer,” he didn’t think about making history. He just wanted to get rid of it and get back to his life as soon as possible. In the end, he did that and made it into the history books, too.
On Aug. 22, Pettit became the first patient in Northwest Arkansas to undergo a robot-assisted partial nephrectomy (removal of part of the kidney). Robert Zimmerman, a Rogers urologist who serves on Northwest Health System’s active medical staff, performed the milestone procedure at Northwest Medical Center — Springdale. Only three doctors in Arkansas (Zimmerman included) have performed the procedure, and only on a handful of patients so far.
It all began last February with what Pettit thought was a pulled muscle. When the ache wouldn’t go away, he visited his family physician, who subsequently ordered a CT scan. The scan showed something unexpected — a small mass in Pettit’s right kidney. He and his physician decided to keep a close eye on the mass to see if it was growing.
Pettit, who lives in Bentonville and works as a paralegal for Wal-Mart, is an active 40-year-old who prefers to take the stairs up to his third-floor office. He is otherwise healthy, but he has a history of cancer in his family. Both his mother and father have had cancer surgery, so he was naturally concerned, particularly after observing what they had gone through.
Follow-up ultrasounds in May and July confirmed that the mass was, in fact, getting bigger. And to complicate matters, it was in a hard-to-get-to spot. One surgeon advised against surgery.
Pettit sought a second opinion from Zimmerman, who has undergone special training in robot-assisted surgery, using the da Vinci system. Da Vinci’s tiny remotely controlled, articulated “hands” and scopes go into tight spaces inside the body where a surgeon’s hands cannot go without requiring a large, invasive incision. By contrast, a da Vinci incision usually is no wider than a dime.
“It was very important to me that we get the cancer out, but it was also very important to me that I not be ‘taken out of my life’ for four or five or six months,” Pettit said. “I knew I didn’t want to go through what I had seen other people go through if I didn’t have to. It seemed like this was worth trying if it could take care of the problem and get me back to my life sooner.”
The spherical 2.2-centimeter encapsulated tumor was successfully removed. And just a few weeks later, Pettit knew he had made the right decision — historic or not.
“It looked like a marble that was stuck inside the wall of my kidney,” he observed. “And my recovery has been amazing. The swelling was gone within two to three weeks, and the area is not sore at all. There is very little scarring, and in just two months, I even started taking the stairs up to work again.”
Zimmerman explained that the size and location of Pettit’s tumor made using the da Vinci an appealing approach. “It was the right solution for this situation,” he said. “Not every kidney tumor would be a good fit for robot-assisted surgery, but this one was.”
He added that using technology to its fullest advantage (in the proper clinical context) ultimately benefits the patient, the surgeon and the community.