The advice still applies: daily exercise is a healthy habit. Experts recommend 30 minutes of moderate exercise five to six  days per week. For many of us, exercise means expensive health clubs, complicated equipment, sweating, achy muscles and anything but fun.

step one is to think of exercise in terms of “daily activity.” We are meant to move, but over the years we have accumulated more electrical appliances doing our daily activity – we don’t hang out our laundry or even rake leaves anymore. Activity has multiple benefits for our health. It –

• Reduces the risk of developing and/or dying from

heart disease

• Reduces high blood pressure or the risk of

developing it

• Reduces high cholesterol or the risk of developing it

• Reduces the risk of developing colon cancer

and breast cancer

• Reduces the risk of developing diabetes or improves

blood sugar control

• Reduces or maintains body weight or body fat

• Builds and maintains healthy muscles, bones,

and joints

• Reduces depression and anxiety

• Enhances work, recreation and sport performance

step two is to decide why you need to have more activity. Motivation gets us started and then the habit keeps us going. Think of your reasons. Do you want to see your grandchildren grow up? Do you just want to feel better and have more energy?

Step three is to get moving. The best time to do an activity is the time that fits your schedule. The best activity is the one that you will do. Ways to add activity to your daily routine can include:

• Stand up or walk around while talking on the phone

• Walk to a coworker’s desk instead of calling or

sending an e-mail

• Eat for 20 minutes, then walk for 10 minutes

during your lunch break

• Take your groceries into the house two bags at a time

to create more trips

• Walk or move during TV commercials

• Put the remote control on top of the TV

• Get a pedometer, work slowly up to a goal of

10,000 steps per day

• Have walking meetings at work

• Use the stairs

• Park your car farther away

• Don’t use drive up windows. Park and walk in

• Walk the dog

• Garden, weed the flower bed, push-mow the yard

• Play ball or ride bikes with your children or

grandchildren

Be creative – have fun – and get moving! CDS serves as a bridge between you and your health care provider. Call 901-327-9440 to begin classes.

Beth McKinzie, R.N., has been a certified diabetes educator for over 20 years. She served 23 years in the U.S. Navy Nurse Corps and is a member of the American Diabetes Association and the American Association of Diabetes Educators. She has been the clinical director of CDS since October 2006.

Extended hours of bright sunlight or video games can lead to seizures in those with photosensitivity. Camps and vacations can wreak havoc with medication schedules. Staying up late to watch movies, while fun, can compromise sleep quantity and increase probability of seizures or migraines. Studies indicate that lack of quality sleep increases behavioral symptoms of ADD, as was just published in the May 2009 issue of Pediatrics. Dehydration, overheating and overstimulation can make the most compliant patient experience breakthrough symptoms.

A 2004 survey conducted by Eli Lilly and Company showed half of parents of kids with ADHD said they planned to reduce or discontinue their child’s ADHD medication over the summer. This usually occurs when their child’s primary issues with ADHD are related to concentration and symptoms are mild. On the other hand, in a child who struggles daily with hyperactivity, impulsiveness, distractibility and social relationships, discontinuing medication may have a negative impact on the summer and ultimately on the child’s feelings of confidence.

Some questions for parents in adjusting a child’s summer dosages:

Will your child be enrolled in a summer camp or other summer activities? If your child has trouble staying on task, listening to directions, relating to peers and controlling movement, medication may help make this summer more productive.

Will your child will be supervised by adults who are not as familiar with ADHD and its impact on your child’s behavior? Familiarity with your child’s behavior patterns will not be as established in summer activities supervised by an outside adult instead of their regular teacher.

Would the medication help provide support to your child during family vacations? Would your child and your family’s time together be enhanced? It is something to consider.

For all neurological and behavioral conditions managed by medication, in the summer, the best strategy is balance and prevention. Make sure your children:

• Drink plenty of water

• Don’t get overheated

• Have some down time

• Get enough sleep

• Limit video games

• Discuss the medication routine with your doctor

and make informed decisions for changes in ADHD medicine schedules. Keeping seizure medicine schedules is paramount.

With just a little extra effort, your child can enjoy a balanced, refreshing summer full of fun.

J. T. Jabbour, M.D., is a founding physician of Memphis Neurology, formerly Pediatric Neurology, P.A. He is board-certified in pediatrics and board-eligible in neurology and psychiatry, specializing in epilepsy, migraine, developmental delays, autism and attention deficit. Since 1977, he has been a professor of pediatric neurology at the University of Tennessee.

Restless legs syndrome (RLS) is a prevalent and underdiagnosed condition characterized by:

• An urge to move legs due to unpleasant sensations

described as “creepy-crawly,” internal itch or pain

• The urge to move legs increasing with inactivity

or rest

• Sensations relieved by moving or stretching

the legs

• Symptoms worsening in the evening

Untreated RLS can significantly disturb sleep and produce insomnia. It can also be associated with a condition called Periodic Limb Movement Disorder (PLMD), which is characterized by movement of legs during sleep throughout the night frequently associated with awakening.

The symptoms of RLS worsen when people tend to relax at the end of the day. RLS may run in families. It may worsen with time so that moving does not relieve symptoms. Although the legs are more traditionally involved, the condition may affect the arms also. Patients with severe RLS can usually recall the earlier course of the disease when they could alleviate the pain by movement or when the disease affected the legs only.

Children may also suffer from RLS. Diagnosis of RLS in children requires special expertise because they are not able to verbalize the symptoms well. RLS in children may be misdiagnosed as “growing pains”. A family history of RLS helps toward the diagnosis in children.

RLS is diagnosed by history and clinical examination. Blood testing may reveal contributing conditions. Overnight sleep study in a sleep lab is needed to see the effects of the syndrome on sleep. The sleep study may reveal the delay in sleep onset due to RLS and help estimate the actual sleep time. Sleep study shows if leg movements occurred during sleep and if they were associated with awakenings (PLMD). Patients may be unknowingly waking several times during the night due to the disturbing leg movements, leading to tiredness and sleepiness during the day.

Identification and treatment of contributing factors to RLS helps relieve the symptoms. Pregnancy-related RLS usually improves after delivery. Medications of different classes are used to treat RLS, the most common being used today are the dopamine receptor agonists which compound the action of brain chemical dopamine.

Restless legs syndrome is a treatable condition. Its correct management helps toward a refreshing nightly sleep and a healthy, productive lifestyle.

The cause remains uncertain in many cases, but some factors contributing to RLS include:

• pregnancy

• anemia

• iron deficiency

• kidney failure

• smoking

• certain medications

• nerve diseases

• diabetes

• hypothyroidism

Shameela Ahmed, M.D., is a graduate of

Dow University of Health Sciences,

Karachi, Pakistan. She completed a residency in neurology from Loyola University Medical Center. Her fellowship was in clinical neurophysiology from the University of Tennessee, Memphis, with emphasis on neuromuscular diseases and electromyography. She is a board-certified neurologist and a clinical neurophysiologist.

Chronic daily headaches (CDH) include all kinds of headaches (tension, migraine or cluster) occurring at least 15 days per month. Eighty-five to 90 percent of CDH patients have been diagnosed with tension or migraine headaches.  Many of these patients experience daily or nonstop headaches adversely impacting their personal, professional and social lives.

Most CDH patients are well versed in commonly used treatments: general, abortive, prophylactic and interventional therapies. New hope in interventional medicine may be found for those patients who have tried and failed usual measures. Nerve blocks go directly to the nerve structure responsible for sending the painful message to the brain. Interventional procedures have none of the medication-associated risks, not to mention the cost of buying and monitoring these high risk medications over the course of a lifetime.

General measures include treatment for rebound headaches. Unfortunately, many times the very drug taken to relieve a headache may actually contribute to the onset of the next one. The only way to relieve these rebound conditions is through drug withdrawal, which depending on the drug, may require inpatient detoxification to minimize risk of seizures. Abortive therapies are started immediately following headache onset and usually include triptans, non-steroidal anti-inflammatory drugs (NSAIDs) and ergotamines. Due to other health problems, not all patients are candidates for these high risk medications. High risk opioids (controlled, habit-forming drugs) are sometimes used when abortive medications fail. Prophylactic medications are considered if headaches occur greater than twice a week and are started only after rebound medications have been tapered. Prophylactic agents include tricyclic antidepressants, anticonvulsants and beta-blockers. These drugs have risks for heart attacks, strokes, gastrointestinal bleeding, fatal irregular heart beats, liver/kidney/heart failure, asthma attacks, addiction or death.

Interventional nerve blocks serve two purposes: they aid in the correct diagnosis and/or provide immediate reduction in pain once the affected nerve has been correctly identified. Nerve blocks are not curative, but provide relatively long-term relief and reduce the need for high risk medications. Radiofrequency denervation blocks may provide even longer term pain reduction, usually lasting anywhere from six months to two years, depending upon the diameter of the affected nerve.

Chronic daily headaches, especially those failing to respond to usual treatments, markedly reduce quality of life. In the hands of an experienced, board-certified pain management specialist, interventional pain procedures/nerve blocks offer new hope for reduction of chronic, daily pain. All interventional procedures should be done in a certified facility capable of providing pre- and post-procedure monitoring by licensed, credentialed staff.  Local anesthesia, inhaled anesthetics, and intravenous conscious sedation are customized to meet your individual needs. These procedures are done on an outpatient basis. Headache sufferers should see a health care provider immediately upon experiencing any of the following “red flag” symptoms with a headache: fever, stiff neck, weakness or numbness, “worst headache” ever, “thunderclap” headache, change in headache pattern, or new onset headache after age 50.

Kathlene Hodges, M.S.N., R.N., C.S., C.F.N.P., graduated from Delta State University with a clinical specialty in family practice. She has over 30 years experience in health care with the last 12 in advanced practice. Ms. Hodges is a member of the Society for Pain Practice Management and a charter member of the International Honor Society for Nursing. She serves as a speaker and pain consultant for the pharmaceutical industry.

Place your thumb and forefinger about six to eight inches from your  ear and rub them together.  Do you hear any friction noise?  If not, you may ask yourself:

Do I turn up the television or radio up to the point where others complain?

Do I strain to hear conversations or misunderstand words and ask people to repeat themselves?

Do I watch the faces of others intently when they talk?

Am I tired or frustrated at the end of the day from straining to hear?

Do I accuse other of mumbling or not speaking up?

Do I cause my family to have arguments regarding my hearing?

If so, it’s time to ask “How much longer do I intend to wait before I get help?” You may have waited because you can still hear one on one but just can’t make out all the words when there is more than one person speaking or in noise.  Most hearing losses are greatest in the high frequencies and some consonant sounds such as “s, th, f, k, cannot be distinguished.  Words seem to “run together.”

Regardless of which type of hearing loss you may have, through accurate testing we can determine the best hearing aid fitting for you.  Your personal lifestyle is also an important part of this process.

Today’s hearing aids are virtually hands-free.  Programs automatically change to your hearing needs in any type of hearing environment – even in noise.  Evencell phone use is hands-free thanks to the new core Bluetooth technology by Phonak. All this and no more feedback!  Even profound hearing losses are not the challenge they once were thanks to hearing aids like the Naida.  This amazing Bluetooth technology is available even in our entry level technology.

Arnold Hearing Aid always offers the latest in hearing aid technology   Counseling and instructing you on the use of your hearing aids as well as follow-up service are as important as the quality instrument itself. For over 63 years, Arnold Hearing Aid has consistently earned your trust for offering quality hearing care.  Our experience makes the difference in a quality hearing aid fitting that can literally change your life.  Call us today at 726-0044 and enjoy life again to its fullest.

“I have hearing loss and my hearing aids are my lifeline to my family, friends and business. I’m confident even in the most difficult listening situations.”

Luke Fortner, President –

Arnold Hearing Aid

Although the H1N1 virus (swine flu) is still fresh on our minds, there is another more prevalent issue in the country today. The Asthma and Allergy Foundation of America (AAFA) states that more than 60 million people have asthma and allergies in this country, resulting in 2 million emergency room visits, 500,000 hospitalizations and 5,000 deaths each year.

According to Lloyd Robinson, M.D., of OccuMed/Robinson & Associates, a family practice and occupational health clinic, spring is the most challenging time for those who suffer with the symptoms. He offers the following advice for recognizing and preventing asthma and allergies:

“Asthma is a chronic disease of the lungs characterized by the hypersensitive airways that react to allergens or irritants by narrowing or obstructing, making it difficult to move air in and out,” he said, noting symptoms include chronic coughing, wheezing and shortness of breath leading to difficulty breathing.

Seasonal allergies are a chronic disease of the immune system characterized by an overreaction to inhaled allergens, such as pollen. The result is in inflammation in the upper respiratory system. According to the AAFA, 35 million Americans suffer from these symptoms, which include chronic sneezing, runny nose, watery eyes and itch/scratchy throat leading to severe congestion, headache, fatigue and difficulty breathing.

Food allergies are also a chronic disease of the immune system and are characterized by an overreaction to food allergens, such as milk, eggs, peanuts, wheat, soy, or shellfish causing severe inflammation of various parts of the body. Symptoms include swelling of the lips, tongue or throat, hives, difficulty breathing or anaphylaxis (an allergic reaction that can be deadly due to the fact that multiple organs are affected).

OccuMed partner Marlah Mardis, M.D., said that the key is not to let asthma and allergies manage you. “You should learn your irritants and be able to adjust accordingly,” she said. “Even asthma sufferers can normalize lifestyle to the point that they can participate in virtually any activity he or she wishes; they can prevent the condition from disturbing their sleep, reduce the need for relief or bronchodilator medications and normalize or optimize lung function.”

Both physicians agree that the first step for asthma and allergy sufferers is to take control of their environment and take appropriate medications. “If exposure to inducers or allergy and asthma triggers can be avoided, less medication is required,” explained Dr. Robinson. “Identifying what inducers make conditions worse often means reviewing the history of symptoms carefully and keeping track of them. For those who have identified their allergens, the inside and outside environment at home and work should be controlled as much as possible.”

Dr. Mardis outlines a list of many common allergens that should be eliminated:

House dust mites- dust mites are small parasites that live off the dead skin that we shed. Decrease exposure by enclosing mattress and box spring in plastic and washing all bed sheets and blankets in hot water once a week.

Pets- if one is allergic to animals, pets such as dogs, cats, gerbils and birds should not be allowed in the house.

Smoke- smoking in the home should not be allowed at any time.

Mold- use bleach to remove mold wherever and whenever it is found, and try to eliminate the source of it.

High humidity- increased moisture in the home can encourage mold growth and house dust mites. Humidifiers, if not cleaned properly, can grow bacteria and produce a residue which can irritate the lungs.

Pollens- it may be necessary to avoid being outside during times of high pollen counts, such as days that are hot, dry and/or windy.

Dr. Mardis also stressed that asthma is a chronic disease that requires long-term therapy, even when asthma symptoms may not be present. “Many asthma sufferers believe their asthma is under control when they no longer experience symptoms, but the fact is that people with asthma suffer from chronic lung inflammation, which can lead to progressive loss of lung function and other severe consequences,” she said. “Additionally, asthma maintenance medications have been shown to improve lung function when taken over a consistent long period of time; just consult with your physician about when it might be suitable to stop using it.”

Robinson said it is important to know that research indicates notable proportions of patients who have stopped taking their controller medications in the past 12 months have experienced a sudden asthma episode that led to some consequence, including emergency visit, missed work or some other serious health consequence. “Those with asthma and allergies should take control of their life and avoid unnecessary emergency trips or time off from work. It is always important to take medication as prescribed,” he said.

For more information about living with asthma or allergies, contact OccuMed at 901-345-6700.

At Memphis Orthopaedic Group, we see several hundred anterior cruciate ligament (ACL) patients a year, ranging from adolescents to people in their 50s. Their injuries can range from simple strains or partial tears to complete tears, as the ACL is the most common ligament in the knee that is completely torn.

The ACL is one of the four major ligaments of the knee, originating from deep within the notch of the femur (thigh bone). It attaches to the end of the femur at the back of the joint and passes down through the knee to the front of the flat upper surface of the tibia (the shin bone). It passes across the knee in a diagonal direction and with the PCL (posterior cruciate ligament) makes a cross shape (hence the name cruciate ligaments).

The most important thing for people to know about ACL injury is its ability to mimic minor knee injury.  The sensation of the knee giving way, buckling or feeling unstable is a common sensation of those developing ACL insufficiency over time. Frequent repetitive injuries to the knee can result in a more severe, compounded injury. So, when in doubt, let a trained professional evaluate the knee.

A torn ACL is a relatively common knee injury among athletes, occurring through a twisting force being applied to the knee. A torn ACL can also result from a direct blow to the knee from the outside, as might occur during a football or rugby tackle. Many careers involve some of the same type maneuvers as would be required during certain sporting activities, and the result can be hurt ACLs.

Symptoms of ACL injury:

• an audible and palpable pop or crack at the time

of the injury

• feeling of initial instability (yet may be masked

later by extensive swelling or bleeding in the knee)

• restricted movements, especially inability to fully

straighten the knee

If you suspect an injury, go to the emergency room, your personal physician or orthopedic surgeon. Injuries to surrounding area might be made worse by repetitive weight bearing associated with walking. Evaluation by a qualified medical specialist will allow for damage containment and a shorter recovery time. Partial tears may be rehabilitated in two to three months. A complete tear with surgical reconstruction can require up to 6 to twelve months to return to full function. Therapy or intervention for an ACL injury depends heavily upon the injury’s severity, other associated injuries, activity level and age of the patient.

John Lochemes, M.D., is a board-certified orthopaedic surgeon and has been practicing with Memphis Orthopaedic Group for 12 years. He completed his specialty training at the Campbell Clinic in 1993. He practices at all four MOG locations and can often work patients in the same or next day.

There are so many tooth products on the market promising to prevent tooth decay or gingivitis. It is difficult to determine what toothbrush, rinse or toothpaste is the best. Even with all these products, surveys report that nine out of 10 people get gum disease and 91.3 percent of adults experience tooth decay. As a periodontist, I am sometimes asked what I use.

I recommend a good electric toothbrush, like Braun Oral-B®.  This cleans as much as 40 times better than a person can do by hand and is less likely to result in gum recession.  Although “sonic” is good, in my opinion, even Braun has not yet successfully combined sonic waves with an effective head action. A physical scrubbing of plaque to dislodge and disorganize bacteria is sufficient.

Something I don’t recommend is using a Water-Pic®.  It does dislodge food that feeds bacteria, but it can drive bacteria deep into inflamed tissue, accelerating gum disease. I also tell patients not to use peroxide. It does kill bacteria, but it can kill bone and other tissue as well.

Overusing mouthwashes is another problem. They increase plaque counts, while people think they are hiding bad breath, which is not so. Bad breath is caused by millions of bacteria around the teeth and on the tongue. Put a dry manual brush in your purse or desk and scrub off the stinky.

My routine is to brush (always with an electric brush) in the morning with kitchen baking soda.  This is less abrasive than toothpaste, releases oxygen and kills germs.  In the evening, I brush with a baking soda/fluoride toothpaste and floss.  I change the brush head the first of each month so that the bristles are still strong enough to get into the space around the teeth.

I follow this with Gel-Kam® four percent stannous fluoride gel or rinse, which can be found over the counter, applied with my electric brush. After spitting out the excess, I go to bed.  The reason for the fluoride is twofold. First, it eliminates root sensitivity. Second, as we get older, our saliva gets less watery and we tend to get root decay. Fluoride each night will help you avoid this new dental adventure.

Everyone misses spots within two to three months. At that point, the plaque starts calcifying and becoming calculus or tartar, needing to be removed by a professional. Left on the roots, it makes people lose bone and attachment. Gum disease sets in and leads to eventual tooth loss. Don’t let this happen to you!

Lee McCallum, M.D., was born in Jackson, Tennessee and raised in Henderson, Tennessee. He received his B.S. degree from Rhodes College in Memphis. After performing bladder cancer research for two years in Memphis with a nationally known urologist, he completed his medical training at the University of Tennessee, Memphis.

Dr. McCallum attended the Family Medicine Residency program in Jackson, Tennessee and is board certified by The American Board of Family Practice. He has practiced with The Family Physicians Group, P.C. since July of 1988. He enjoys golf and spending time with his family.

Role model? My father, Oscar McCallum, who practiced family medicine for over forty two years.

What motivates you? A sense of accomplishment, hard work, making a difference in my patients’ lives.

If you were not a doctor? I truly do not know. I have known from an early age that medicine would be        my career choice.

What is the most exciting medical breakthrough you’ve witnessed in your career? The many landmark trials research has given us and the tremendous impact on healthcare – healthier patients, longer life spans.

How do you maintain a work/life balance? Being a member of The Family Physicians’ Group with       multiple providers allows me the ability to enjoy more time at home with my family, because we share evening and weekend call.  Technology, such as beepers and cell phones, also plays an important role, allowing me to attend more family functions.

What is your greatest accomplishment? My two children, Michael and Mark

What is your favorite quote? Illegitimi Non Carborundum, a Latin phrase, which loosely translated means “Don’t let life’s stressful times get you down”.

Where do you see your specialty in 10 years? Back where it started – “nuts and bolts” medicine, coordination of care, taking care of patients on a daily basis, not necessarily ordering numerous tests.

My patients… know I care.

How do you actively support the community? My associates and I treat hundreds of Church Health Center patients yearly and we help teach medical students at our office. Personally, I also donate to various local charitable organizations.

Good health advice? Obesity is a major problem in our society today.  It is a risk factor for many diseases, such as heart disease, high blood pressure and diabetes.  The key to weight loss is not diet.  It is eating sensibly and exercise.  I advise my patients to try some form of cardio exercise 30 to 60 minutes, five to seven days a week.

On Friday, August 7, at 7 p.m. the  Pale is the New Tan® 5K (PINT 5K) will be held on Ridgeway Loop in East Memphis. Formerly known as the Run from the Sun Memphis, proceeds from the run benefit the Scarlet Lawrence Akins Foundation. Akins died of melanoma, the deadliest form of skin cancer, at age 27. The SLA Foundation’s mission is to raise funds to find a cure for melanoma as well as raising public awareness of disease prevention.

Scarlet Lawrence Akins (1978-2006)

A 1997 graduate of Collierville High School, Akins received a degree in English in 2001 from the University of Mississippi. She later earned a master’s degree in journalism and mass communication in 2003. She moved to Atlanta and served as an assistant editor for Atlanta Homes and Lifestyles magazine and later as the editor of European Homes and Gardens magazine. She later returned to her love of education and accepted a position at Memphis City Schools. Then she moved on to teach journalism at Northwest Mississippi Community College. She and her husband Jody rejoiced in the news a baby was on the way, but Akins had a difficult pregnancy. She was horribly weak, had a persistent cough and began losing weight. In April 2006, a CT scan and various tests found that melanoma from a mole on her leg had metastasized to her groin, back, brain and “too many tumors to count” in her lungs. The pregnancy had made the cancer spread faster and had weakened her immune system. A few days after the diagnosis, doctors removed a grapefruit-sized tumor from her leg. The next month, as early as they could, doctors took the baby, Madison Grace. She was not even four pounds. Preterm birth treatment helped Madison to grow as treatments for Akins’ cancer continued. Akins died August 4, 2006, the day before her 28th birthday. Akins’ mother, Cheryl Lawrence-Moore, co-parents now 3-year-old Madison Grace with Madison’s dad, Jody. Lawrence-Moore also helps organize the PINT 5K Run and activities of the Scarlet Lawrence Akins Foundation.