Unity HealthFocus Newsletter: January / February 2013

healthfocusJanuary / February 2013

Page 3Is it just a Sore Throat?

Or is it Strep?

Page 7 Ankle Sprains

Page 5 27 Heart Healthy Tips

Page 9-10 Finding A Doctor Near You

New Year’s resolutions are relatively easy to make but can be difficult to put into practice. This may be due to not thinking a resolution through and placing enough thought on strategy, focus and end goals. Making a New Year’s resolution to start exercising or maintain fitness involves a variety of processes that should be carefully considered for optimal benefits.

1. Be Reasonable. Set realistic expectations and goals for yourself.2. Make a Plan. Develop a plan. Make a to-do list, set deadlines and write them in a calendar. 3. Track Progress Weekly. 4. Enjoy Life. Be Happy!

NEW YEARNEW YOU

RESOLUTIONS intoRESULTSTurn your

Greetings!!Welcome to the winter 2013 issue of the Unity Newsletter. As we turn to February and try to stay healthy, we have several timely topics. Hopefully many of the readers have not been affected by either stomach viruses (norovirus GII.4.sydney) or influenza (A, H3N2). If you have stayed healthy, keep up your hand washing and hygiene protection as there is still plenty of winter left.

In this issue we have some timely reminders from our family practice physicians discussing if a sore throat is strep or something else. While many of us are focused on the winter illnesses, we should not forget the January was glaucoma awareness month and that it is a major cause of eye problems for a large group of patients.

With the new year, many people decide to start a new exercise regimen. Some timely tips from our physi-cal therapist can help you get started. Remember that February is Heart Healthy Month, so all that new found determination to exercise is a great way to keep your heart healthy. Spring will be here soon !

As always, thank you for your confidence in Unity Healthcare and your Unity physician. We welcome your feedback regarding our newsletter or if you have recommendations for future topics.

Dr. Ketan Sheth, Medical Director

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Please Welcome New Physician: Lafayette Kidney CareSudha Rani, MD joined Lafayette Kidney Care on January 1, 2013. Dr. Rani practices with Dr. Paul Shin.

Dr. Rani obtained her medical degree from Gulbarga University, India. She completed her internship at Bellary Medical College, India. After completing her residency at the Long Island College Hospital, Brooklyn, New York, she entered into a fellowship in Nephrology at the same institution as a Fellow of the National Kidney Foundation. Dr. Rani is board certified by the American Board of Internal Medicine and Nephrology.

Dr. Rani is a member of the Tippecanoe County Medical Society, Indiana State Medical Association (ISMA) and American Society of Nephrology. Her practice emphasis is in kidney diseases and hypertension.

Dr. Rani is currently accepting new patients. To schedule an appointment, please call 765.446.5185.

For more information, visit www.unityhc.com.

Early detection and treatment can preserve sight!

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Dr. Seth Kresovsky, Burgett Kresovsky Eye Care, commented that “Glaucoma highlights the importance of regular eye exams. Since the condition is largely asymptomatic prior to irreversible vision loss, diagnosis and treatment is critical. Contrary to popular belief, glaucoma doesn’t just mean high pressure in the eyes. While it is an important risk factor, a sub-population of people with “normal” pressure can have glaucoma as well, so a dilated eye exam with attention to the optic nerve can help to determine a patient’s risk for the development of glaucoma.“

What You Should Know About GlaucomaYour eye is about the size of a golf ball. It is filled with a clear, jelly-like fluid that keeps it round. The eyeball is constantly being filled with new fluid, and the old fluid drains away at the same rate. But if too much fluid is produced or not enough can drain, pressure builds up in the eye. Left untreated, this excess pressure will damage the nerves that let us see. This can result in loss of sight and eventually blindness. Glaucoma sometimes has a known cause, such as an eye injury, cata-racts, scar tissue, or the use of certain medications. But in most cases, the cause is unknown.

In about 5% of cases, glaucoma strikes suddenly, with severe pain and a sudden vision problem. This is called acute or closed-angle glauco-ma. In most cases, pressure builds up gradually, damage progresses slowly, and there is no pain. This is called chronic or open-angle glaucoma.

What Are the Signs of Glaucoma?Glaucoma is often called “the sneak thief of vision,” because in most cases symptoms aren’t noticeable until damage is already done. The chronic form affects peripheral (side) vision first. But this loss of sight is often so gradual that the person doesn’t notice until central vision is affected. You may have other subtle symptoms, such as blurred vision or rainbow-colored rings around lights.

In the acute type of glaucoma, symptoms are severe and sudden. Permanent loss of vision can occur within hours. The symptoms of acute glaucoma include redness of the eye, severe pain, headaches, nausea, sudden noticeable change in vision, and colored rings (“halos”) around lights. Acute glaucoma is a true medical emergency.

January was National Glaucoma Awareness Month

If you have the above symptoms, you should see a health care practitioner immediately.

It is important to catch and treat glaucoma early. People over 40 should have their eyes checked regularly by an ophthalmologist (a medical doctor trained in the diagnosis and treatment of eye disease). The eye care professional will test the pressure in your eye, look at the inside of your eye with a special in-strument, and test your vision to detect any small changes that would suggest glaucoma. The tests for glaucoma are painless. How Is Glaucoma Treated?Unfortunately, affected vision cannot be restored. But medical treatment can prevent further damage. The goal of glaucoma treatment is to reduce the pressure inside the eye. Some medications cut down on the amount of fluid the eye produces; others encourage a better flow of fluid out of the eye. Some drugs are taken in eye drop form, others as pills. It is very important to take your medication as directed.

People with the sudden, acute form of glaucoma usually need immediate surgery. And in some of the slower, chronic cases, the doctor eventually recommends surgery if medication fails to control the pressure well enough, or if medicines are causing unacceptable side effects, making surgery the better alternative. Glaucoma surgery is relatively safe and painless, usually requiring only a short hospital stay. Today, laser surgery can make the procedure even shorter and easier.

For more information, please call:Burgett Kresovsky Eye Care - 765.446.5130 Jason Burgett. MD Seth Kresovsky, MD

Magnante Eye Care -765.449.7564 David Magnante, MD

Glaucoma 2nd Leading Cause of Blindness in the World

Early detection and treatment can preserve sight!

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Sore Throat. A sore throat often makes it painful to swallow. A sore throat can also feel dry and scratchy. A sore throat is a frequent symptom of the common cold or other acute respiratory tract infections. In some cases, a lab test will need to be done to determine if you or your child needs antibiotics.

Causes of a Sore Throat: Most sore throats are caused by viruses, like ones that cause a cold or the flu. Some sore throats and strep are caused by bacteria; strep throat is caused by Group A Streptococcus. Other causes include: • Allergies• Dry air• Pollution (airborne irritants)• Smoking or exposure to smoke

Signs and Symptoms:• Sneezing & watery eyes• Cough & runny nose• Mild headache• Mild body aches• Low-grade fever (less than 102F)

See a Healthcare Provider If You Or Your Child Has:• A sore throat lasting longer than 1 week• Difficulty swallowing or breathing• Excessive drooling (young children)• Temperature higher than 100.4F• Pus on the back of the throat• Rash• Hoarseness lasting longer than 2 weeks• Blood in saliva or phlegm• Symptoms of dehydration (dry, sticky mouth, sleepiness or tiredness. Thirst, decreased urination or fewer wet diapers, few or no tears when crying, muscle weakness, headache, dizziness or lightheadedness) • Been in contact with someone that has strep throat• Recurring sore throats

Your healthcare provider can determine the cause of a sore throat and if treatment is needed. If your child is younger than three months of age and has a fever, call your healthcare provider right away.

Is it just a Sore Throat?Or is it Strep?

Antibiotics are Needed When…Antibiotics are needed if a healthcare provider diagnoses you or your child with strep throat, which is caused by bacteria. Strep throat cannot be diagnosed by looking in the throat- a lab test must also be done. Antibiotics are prescribed for strep throat for the purpose of preventing rheumatic fever. If the test result shows strep throat, the infected patient should stay home from work, school, or daycare until 24 hours after starting an antibiotic. For information about the bacteria that cause strep throat, visit CDC’s Group A Streptococcal (GAS) Disease website.

A healthcare provider may prescribe other medicine or give you tips to help with other symptoms like fever and cough, but antibiotics are not needed to treat most sore throats.

Antibiotics Will Not Help If…When a sore throat is caused by a virus or irritation from the air, antibiotic treatment will not help it get better. Most sore throats will improve on their own within 1-2 weeks. It is important to take antibiotics only when they are needed. Taking antibiotics when they are not needed can be harmful. Each time you or your child takes an antibiotic,

the bacteria that normally live in the body (on the skin, in the intestine, in the mouth and nose, etc.) are more likely to become resistant to antibiot-ics. Common antibiotics cannot kill infections caused by these resistant germs.

How To Feel BetterRest, over-the-counter medicines and other self-care methods may help you or your child feel better. Remember, always use over-the-counter products as directed. Many over-the-counter products are not recommended for children younger than certain ages.

Preventing a Sore Throat• Practice good hand hygiene• Avoid people who have colds or infections• Avoid smoking• Avoid exposure to second hand smoke.

For more information, please call your Primary Care Physician. If you do not have a primary care physician, please reference pages 9 & 10 for a listing of our Unity Healthcare Primary Physicians. Source: Hogetved, Irene. Winter 2012. Health Happenings. Is it just a sore throat? Or is it strep? Pages 1 and 4. 3

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10 Tips for Winter Driving

Know your route and keep abreast of weather conditions. The Web can be great source of current weather information. Make a list of Department of Transportation road-condition hotlines and consult them every few hours while you’re on the road. Pay special attention to avalanche conditions along your route, because temporary road closures are common in mountain areas.

Drink plenty of water. When the weather is chilly, dehydration might seem unlikely, but according to a study by the Mayo Clinic, as little as a 1-2 percent loss of body weight can lead to fatigue and reduced alertness — both of which can be deadly when you are driving in icy conditions. Carry (and drink) five to six 16-ounce bottles of water per day. Keep them with you in the passenger compartment, as they might freeze in the trunk.

Eat enough food. Your body needs more nourishment in cold weather than it does on a balmy summer day. Avoid candy bars and other quick-sugar-release snacks. Sandwiches, fruit or a thermos of hearty stew are much better choices. Carry a day’s worth of high-energy food and water in a warm area of your vehicle in case you are stranded for a few hours.

Pack a winter travel safety kit. Include a cell phone, an ice scraper and brush, a tow rope, cat litter (for use as a traction aid), blankets, a good flashlight, a candle, matches, a good book, a portable weather radio and a can of lock de-icer. (Never use hot water on glass or locks — it will refreeze and create a bigger problem.) Here’s a more detailed list of road trip supplies.

Slow down. A good rule of thumb is to reduce speed by 50 percent in snowy conditions. Blasting through snowdrifts may look cool in TV advertisements, but it’s way too hard on your vehicle to be worth it. Equally important: Don’t go too slow. Your car needs momentum to keep moving through snow on grades.

Keep a light touch on the controls. Smooth operation is the key to keeping control in slippery situations. Nervousness can lead to a hard clench of the steering wheel, which can result in loss of control. Consciously loosen your grasp or stretch out your fingers from time to time to help prevent that white-knuckled grip.

Know how to recover from skids. When braking on a slippery road, it’s all too easy to “lock up” your wheels by stepping on the brakes a little too hard. If you start to skid, steer the vehicle gently in the direction you want the front of your vehicle to go and don’t touch your brakes. This used to be called “turning into the skid,” but tests have shown that drivers often misinterpret these words in real-life situations. Here’s a detailed explanation of skid recovery.

Keep your tires in good condition and properly inflated. Cold weather reduces tire pressure, so check and adjust frequently. Tire tread depth should be at least 1/8-inch, and good snow tires with lugs will outperform just about any all-weather tire on the market. Carry (and be able to install) traction-control devices like snow chains whenever you know you’ll be in a snowy area. Sometimes such devices are required, and if you don’t have a set, you’ll be forced to pay a premium to acquire them on the spot.

Make frequent rest stops. Winter travel is much more fatiguing than summer cruising, so stop every hour or so. Get out, stretch — maybe even make a few snow angels! It takes only five minutes to significantly improve your level of alertness.

If you get stuck, stay in your vehicle. Stay warm and wait for assistance. Make sure that your exhaust pipe is clear of any obstructions, including snow and ice; if you don’t, carbon monoxide gas can build up inside the vehicle.

Whether you’re hitting the road in winter for work or for pleasure, preparation and knowledge can help keep you whistling “Let it Snow” instead of fighting frostbite in a snowdrift.

Source: “10 Tips for Winter Driving.” msnbc.com. MSNBC Digital Network, 07 Dec. 2006. Web. 06 Dec. 2012.

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If you find yourself hitting the road during adverse conditions, consider these 10 tips to stay safe on your journey.

27 Healthy Heart Tips

Unity Healthcare offers you 27 ways to power up, slow down, have fun, and get fit - all in the name of a healthy heart. Pick your favorites, and work them into your regular routine.

1. Stop smoking-no ifs, ands, or (cigarette) butts.People still need to be reminded of this? Yes, they do. This nasty habit is one of the top controllable risk factors for heart disease. The AMA, the AHA, the NIH, and more than likely your MOM recommend you stub out this addiction to make a huge difference in your overall health.

2. Focus on the middle.Your middle, that is. You don’t have to be super thin to reap the benefits of a smaller waistline, but carrying too much weight around the middle raises blood pressure, affects blood lipids (and not in a good way), and does other damage to the heart. Abdominal exercises are good, but remember it’s calories in (what you eat), calories out (how you exercise) that will make a difference in the tape measure.

3. Knit a scarf.Put your hands to work and your mind will unwind. Engaging in activities like knitting, sewing, and crocheting helps relieve stress that does the ole ticker a world of good. For the “uncrafty” lot who don’t do needles, a jigsaw puzzle works great too!

4. Power up your salsa.A good salsa rich in antioxidants is a great snacking choice when paired with low-fat chips or fresh veggies. When you mix in a can of black beans (rinsed and drained) you get a two-for-one special because adding soluble fiber (such as that found in beans and other legumes) into your diet helps lower bad (LDL) cholesterol. Add a dash of lime juice and a chopped jalapeno for extra kick to jumpstart your metabolism. Munch on that!

5. Let the music move you.Whether it’s a rumba beat or a two-step tune that gets your body moving, dancing raises your heart rate, burns some calories (between 150-300 calories an hour), and makes for a great heart healthy workout.

6. Go fish.Studies have shown that including fish with omega-3 fatty acids (i.e. salmon, herring, sardines, and to a lesser extent tuna) into your diet can reduce the risk of dying from heart disease by a third or more. To those concerned about the mercury or other contaminants, the Mayo Clinic states the heart healthy benefits outweigh the possible risks of exposure to contaminants.

7. LOL.Not in an email, not on Twitter or Facebook, but really... laugh out loud. Whether you like watching “The Family Guy” or “Seinfeld” reruns, whatever gets you chuckling is good for your heart. Research (from the University of Maryland School of Medicine) shows that laughter helps relieve the stress that damages the endothelium (the tissue that forms the inner lining of blood vessels and helps the blood flow) and promotes the healthy function of blood vessels.

8. Stretch it out.Practicing yoga not only makes you more limber and helps you relax (which combats stress), but according to recent research from India, it also positively affects the heart rate variability (HRV) that is an indicator for heart health.

9. Raise a glass.Moderate consumption of alcohol can raise your HDL (good cholesterol) levels, reduce blood clot formation, and help prevent artery damage. Some studies say red wine offers more benefits than other alcoholic beverages. But other studies conflict with this. Moderation is key here, and you should talk to your doctor about potential benefits and risks.

10. Shun the salt.Overwhelming research shows that if the entire US population reduced its salt intake (just a half teaspoon a day), it would significantly reduce the num-ber of new cases of coronary heart disease. Studies also concluded that salt is one of the leading culprits fueling the rise in healthcare costs in America. Most of our high salt intake comes from processed food and restaurant-prepared food. Think twice before filling up on your favorite fast-food fix.

11. Move it, move it, move it.A new study from Australia found that sitting for long periods of time can shorten your life regardless of your body weight. It appears that being a couch potato has an unhealthy influence on blood fats and blood sugar. At the office, work in “get up” breaks, and go for a short stroll around building. 5

12. Know your numbers.Keeping your blood pressure, blood sugar, cholesterol, and triglycerides in check are important for good heart health. Learn the optimal levels, and don’t skip your regular physical exams.

13. Eat chocolate.No guilt required. Rich, dark chocolate tastes delicious, and according to a study published in the American Journal of Clinical Nutrition, it can help stave off heart disease because of the flavonoids it contains. Preliminary research also suggests that chocolate can positively affect blood clotting.

14. Let your housework work for you.Vacuuming or mopping the floors may not be as invigorating as a Body Slam or Zumba class, but these activities and other household chores do burn calories. Put your favorite music on, and put some pep in your weekly chores.

15. Go nuts.Almonds, walnuts, pecans, and other tree nuts deliver a powerful punch for lowering your risk of cardiovascular and coronary heart disease. Studies show that substituting saturated fats with fat from nuts actually helps reduce bad (LDL) cholesterol.

16. Be a kid.Fitness doesn’t have to be boring. Plan an evening out roller skating or bowling. Do both, and you can burn, on average, around 600 calories.

17. Consider pet therapy.Our pets give us more than unconditional love; they offer numerous health benefits. Studies show that owning pets can lower the rate of dying from heart disease and possibly improve heart and lung function.

18. Start and stop.And start again. During aerobic workouts, interval training (varying your speed and intensity in short bursts) will boost your calorie burn. Wear a heart rate monitor to make sure you are hitting your target heart rates. 19. Cut the fat.Slicing your fat intake to no more than 30% of your daily calories will help cut your risk for heart disease. If you’re not into reading labels or count-ing calories, think twice before you savor your next meal. Do a mental calculation of what you are eating. 20. Take the scenic route home.Put down your cell phone, forget about the driver who cut you off, and enjoy the ride. Eliminating stress while driving will help lower your blood pressure, which your cardiovascular system will appreciate. 21. Make time for breakfast.This is the one meal you shouldn’t skip. The good-for-you benefits of eating a healthy breakfast are numerous. What is included in a healthy breakfast? Whole grains (whole grain rolls, cereals, etc.), low-fat protein (i.e. hard-boiled egg, turkey bacon), low-fat dairy (skim milk, low-fat yogurt or cheese), and fruits and vegetables.

22. Fake your fitness.It’s a no-brainer that exercise has substantial benefits to your coronary health. Why not sneak it in at every opportunity? Park on the far side of the parking lot, take the stairs, walk and talk with a friend instead of e-mailing, play with your kids at the park. It all adds up to better health.

23. Brew up a heart healthy potion.No magic needed when you sip on green or black tea. Different studies (some focusing on black tea, others on green tea) show that drinking tea can improve arterial health. 24. Smile and say, “How does my heart look?”Good dental hygiene does more than keep your pearly whites glistening. It may affect your overall health. Research suggests that several types of cardiovascular disease, including coronary artery disease, may be connected to your oral health. 25. Walk it off.Next time you feel overwhelmed, get mad, or are totally exasperated, take a stroll. A five-minute walk will do wonders for clearing your head and lowering your stress levels.

26. Pump some iron.Aerobic activities may be the star players in fitness for a healthy heart, but strength training needs to be part of the team. Its effect on weight control is awesome-more muscle mass means burning more calories. The American Heart Association gives strength training a thumbs-up for lowering the risk of heart disease. 27. Find your happy place.A sunny outlook is good for your heart. Research from the University College London shows that those who are happy tend to have lower levels of the

potentially harmful hormone cortisol and other stress-inducing chemicals.

Source: “28 Healthy Heart Tips | Strong Heart | Healthline.” Medical Information & Trusted Health Advice: Healthline. N.p., n.d. Web. 3 Jan. 2013.

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Ankle SprainsComments By: David Cobb, Miracles Rehabilitation

Phase 2 - Rehabilitation PhaseThe rehabilitation phase begins when swelling starts to decrease and pain lessens. This means the ligaments have reached the point in the healing process where they are not in danger of being re-injured from mild stress. As long as you are avoiding end range joint stress to the damaged ligament complex it is not only safe but advantageous to begin the “Rehabilitation Phase” at day 1 of the injury.

Improve Mobility and Flexibility • Starting the first day of the injury, you should start moving the ankle up and down AND in and out. This will help increase mobility and start to strengthen it up. Do as much as pain will allow. Try 2 sets of 40 reps whilst the ankle is iced and elevated and build up on that. • Manual joint mobilization can be carried out by a sports injury professional in the anteriorposterior direction: forwards and backwards as well as other motions especially those that improve the subtalor to midtarsal joint mobility. • Stretching the calf muscles and Achilles tendon several times a day is important. There are a number of methods which can be used for stretching the calf and Achilles, including using a slant board. This is very important and should be performed in such a way that is proprioceptively mimics the biomechanics of function.

Strengthening the Ankle Joint • Again as the ankle improves you can start to do strengthening exercises where you pull the foot and toes up and hold for 10 sec’s and then push down and hold for 10 sec’s. This can also be done for inversion and aversion as pain allows. Try 3 sets of 10 reps twice a day and build on that. • Strapping and taping may still be beneficial here to provide compression and support the ankle as you return to full weight bearing.

Return to full fitness / functional training • Cardiovascular exercise is important and should begin as soon as possible after injury depending on what pain will allow. It is important that the athlete maintain some kind of CV exercise not just for the physical benefits but for psychological well being as well. Stationary cycling, hand cycle ergometer, running in water and swimming are all possibilities depending on severity of injury and what pain will allow. • Running may begin as soon as walking is pain free. Ankle taping can be very beneficial when starting running training particularly during early sessions until confidence, proprioception and strength has returned. A laced ankle brace can also provide support and is less expensive in the long run, particularly if laxity in the ligaments means a support needs to be worn permanently. • Running should begin on a clear flat surface such as a running track. Grass or bumpy surfaces will increase the risk of re-injury. Jog the straights and walk the curves. In order to restore full function and injury prevention, ultimately, the athlete will need to be trained on the bumpy surfaces. • Speed should be gradually increased over time to a sprint. • Sports specific drills using cones can be introduced. Changing direction, running in a figure of 8 pattern and zig zagging between cones.

For more information, please call: Miracles Rehabilitation Lafayette / West Lafayette: 765.807.2773 | 765.463.2200 Lafayette Rehabilitation Services: 765.447.5552 Lafayette Orthopaedic Clinic: 765.447.4165

Aims of RehabilitationThe aims of rehabilitation of an ankle sprain can be broken down into separate phases: · Decrease initial pain and swelling. · Improve mobility and flexibility. · Improve the strength of the joint. · Re-establish neural control and co-ordination. · Return to full fitness.

Phase 1 - Early StageDecreasing pain and swellingThis should start the same day you have injured the ankle. This phase can last from 2 days to 2 weeks (or more) depending on how bad the injury is. • Protection of the ankle from further injury by resting, non-weight bearing and using an ankle support or taping technique. Conventional wisdom many years ago was a period of non-weight bearing. Today progressive specialists in Sports Medicine realize that weight bearing as tolerated with return to normal gait patterning is perhaps the single most important early intervention technique one can do with an ankle sprain. • A useful support at this stage is the aircast gel type ankle support which prevents most sideways movement but still allows limited use of the ankle. • Rest - this is essential. Use crutches with partial weight bearing to get about with if necessary for the first few days. A healing ligament needs a certain amount of stress to heal properly but overdoing it early on in the rehabilitation process can prevent healing. Full weight bearing should be introduced as soon as pain allows. “Active Rest” is the best medicine. As mentioned above full weight bearing with NORMAL patterning with or without the use of the assistive devices (the fewer the better) is preferred. • A properly trained sports injury professional knows that ligaments restrain the joint at end range of certain angles and movements and they provide neural information to the body that end range motion is nearing in. Resuming full NORMAL range of motion as quickly as possible is important to promote proper scar tissue alignment and provide reduction of the protective inhibitory mechanisms your body assumes after any injury if left under rehabbed. • Ice - use cold therapy throughout the rehabilitation process. Apply ice for 15 minutes every hour initially for the first day then reduce this to 4 to 5 times a day from then on. In the acute stage ice will constrict blood vessels and further bleeding. Longer term benefits include reduction of pain and muscle spasm. The frequency of ice usage can be determined by your sports injury professional as they see how your joint is responding to the therapy. Ice should not be used for longer than 30 min as prolonged cooling has the reverse effect of increasing blood flow, also known as Huntington’s Reaction. Long periods of cooling can also cause nerve palsy. Ice should be used for as long as it is beneficial. • Compression - A compressive bandage coupled with rubber ¼” thick horseshoe padding around each malleoli is the very most effective and efficient means of swelling reduction and early stage protection while weight bearing. • Elevation - put your feet up and read all about your injury! Elevating the leg will help swelling drain away from the site of the injury. Elevate the leg while icing and for 10 minutes after. (This is a good tip for the acute to sub-acute injury.)

Ankle sprains are some of the most common sports injuries, often recurring again and again. In most cases the ankle is rolled outwards, resulting in damage to the lateral ligaments. This is known as an inversion sprain. A full rehabilitation programme is essential for optimum recovery from ankle sprains as well as to prevent recurrance. We outline some simple steps to get you back to full fitness.

Source: “Ankle Sprain Rehabilitation.” Virtual Sports Injury Clinic - Sports Injuries, Treatment, Exercises, Sports Massage. N.p., n.d. Web. 4 Feb. 2013.

Healthy Recipe Li’l Smoky Cheese Ball Ingredients2 cups shredded smoked Gouda cheese, room temperature2 packages (8 ounces each) cream cheese, room temperature1/2 cup (1 stick) unsalted butter, room temperature2 tablespoons milk2 teaspoons steak sauce1 cup toasted chopped walnuts or pecansCrackers, for serving

Directions:Place Gouda, cream cheese, butter, milk, and steak sauce in the bowl of an electric mixer fitted with a paddle attachment; mix until well combined. Transfer mixture to refrigerator; let chill overnight. Roll cheese mixture into a ball. Place nuts in a shallow dish. Roll cheese ball in nuts to fully coat. Serve with crackers.

Chicken Caesar WrapsIngredients3 cups shredded romaine lettuce2 cups chopped cooked chicken4 slices OSCAR MAYER Bacon, cooked, crumbled¼ cup KRAFT Grated Parmesan Cheese¼ cup croutons½ cup KRAFT Classic Caesar Dressing4 flour tortillas (8 inch)

Directions:PLACE first 5 ingredients in large bowl. Add dressing; toss lightly. SPOON onto tortillas; roll up tightly.

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Tick RemovalIf you find a tick attached to your skin, there’s no need to panic. There are several tick removal devices on the market, but a plain set of fine-tipped tweezers will remove a tick quite effectively.

How to remove a tick1. Use fine-tipped tweezers to grasp the tick as close to the skin’s surface as possible. 2. Pull upward with steady, even pressure. Don’t twist or jerk the tick; this can cause the mouth-parts to break off and remain in the skin. If this happens, remove the mouth-parts with tweezers. If you are unable to remove the mouth easily with clean tweezers, leave it alone and let the skin heal. 3. After removing the tick, thoroughly clean the bite area and your hands with rubbing alcohol, an iodine scrub, or soap and water.

For more information, please call: Unity Immediate Care Center: 765.446.1362

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Choosing A Primary Care Physician - The Smart WayChoosing a new physician can be a difficult task. Asking for recommendations is a good way to start, but ultimately you will have to decide which physician is best suited to your individual needs and situation.

It is important to establish a relationship with a primary care physician (PCP), especially before you ever get sick. Primary care doctors should be the first line of defense in protecting your health, but millions of Americans don’t have a PCP. Even patients who regularly visit specialists don’t always have a PCP, leaving them unprepared when the flu or an infection strikes.

Everyone gets sick at some point, so selecting a PCP ahead of time means you don’t have to scramble around when you need medical care.

Here are some questions and answers that can help you select a PCP who understands your particular needs.

What information should I find out about the doctor?It may help to ask the doctor’s office these questions: • At which hospitals does the doctor have privileges? • How long does it take to get in to see the doctor for a routine visit and for urgently needed care? • Who covers for the doctor when the need arises? • Is the doctor board certified? (This means he or she has had training after medical school and has passed an exam to be certified as a specialist in a certain field.)

What personal qualities should I look for in a doctor?Find a doctor who listens carefully, explains things clearly, anticipates your health problems and allows you to ask questions.

What information should I bring to my appointment?It is important to provide your doctor with the following: • Your health history • A list of medications you’re taking • Any vitamins or supplements you take • A description of any current health problems you’re having. If you have symptoms, the doctor will want to know when they first appeared, how often • A list of questions. Ask your doctor to explain any answers you don’t understand

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Find A Doctor...Near You. Allergy & Asthma Lafayette Allergy and Asthma Clinic Ketan Sheth, M.D. 1345 Unity Place, Suite 145 A Lafayette, IN 47905 PH: 765.446.5040 | FX: 765.446.5041 Anesthesiology Lafayette Anesthesiologists Barbara Conard, M.D. J. Joseph Farrell, M.D. David Gray, M.D. Robert Lempke, M.D. Cynthia Meyer, M.D. 1411 South Creasy Lane, Suite 200 Lafayette, IN 47905 PH: 765.446.5000 Esthetics Lafayette Regional Vein & Laser Center Marlin Schul, M.D. 985 South Creasy Lane Lafayette, IN 47905 PH: 765.807.2770 | FX: 765.807.0348

Family Medicine Diane Begley, M.D. 3801 Amelia Avenue, Suite C Lafayette, IN 47905 PH: 765.446.5161 | FX: 765.446.5160

Benton County Medical Center Steven Martin, M.D. 1004 South East Street Fowler, IN 47944 PH: 765.884.1111 | FX: 765.884.1605

Clinic of Family Medicine Mallik Chaganti, M.D. Robert E. Darnaby, M.D. D. Todd Detar, D.O. Stephen C. Spicer, M.D. James G. Wakefield III, M.D. 1103 East Grace Street Rensselaer, IN 47978 PH: 219.866.4135 | FX: 219.866.0803

Louck Family Medicine Christopher Louck, M.D. Nicholas Finley, M.D. 716 South College Street Rensselaer, IN 47978 PH: 219.866.4300 | FX: 219.866.7591

Pickerill, Adler & Associates Jeremy Adler, M.D. Casey Pickerill, M.D. Darren Reed, D.O. 2525 South Street Lafayette, IN 47904 PH: 765.807.2320 | FX: 765.807.2330

Rossville Family Medicine Duane Estep, M.D. Wanda Estep, M.D. 5450 West State Road 26, Suite 300 Rossville, IN 46065 PH: 765.379.2222 | FX: 765.379.3222

Southside Family Practice John Cusack, M.D. Shadi Resheidat, M.D. 3554 Promenade Parkway, Suite F Lafayette, IN 47909 PH: 765.471.9146 | FX: 765.477.0277

Gastroenterology Lafayette Gastroenterology Ravish Mahajan, M.D. 5 Executive Drive, Suite B1 Lafayette, IN 47905 PH: 765.807.0531 | FX: 765.807.0534

General Surgery Lafayette Surgical Clinic John Francis, M.D. Jerry Jefson, M.D. David Halter, D.O. Nathan Huber, M.D. Gerritt Smith, M.D. Thomas Summer, M.D. 1345 Unity Place, Suite 235 Lafayette, IN 47905 PH: 765.446.5065 | FX: 765.446.5170

Immediate Care / Lab Unity Immediate Care Center Elizabeth Riggs, M.D. 1321 Unity Place, Suite B Lafayette, IN 47905 PH: 765.446.1362 | FX: 765.446.1007

Internal Medicine Abramovitz Internal Medicine Ruth Abramovitz, M.D. 500 West Navajo Street West Lafayette, IN 47906 PH: 765.742.6774 | FX: 765.742.6914

Gagan Chadha, M.D. 166 Sagamore Pkwy W West Lafayette, IN 47906 PH: 765.497.2428 | FX: 765.497.4251 Gary Prah, M.D. 1318 Main Street Lafayette, IN 47901 PH: 765.742.5254 | FX: 765.742.4991

West Lafayette Internal Medicine Carlos Gambirazio, M.D. 152 Sagamore Parkway West West Lafayette, IN 47906 PH: 765.423.6556 | FX: 765.423.6024

Medical Oncology / Hematology Lafayette Cancer Care Nancy A. DiMartino, M.D. Glen Papaioannou, M.D. 1345 Unity Place, Suite 135 Lafayette, IN 47905 PH: 765.446.5050 | FX: 765.446.5119

Nephrology

Lafayette Kidney Care Sudha Rani. M.D. Paul Shin, M.D. 1345 Unity Place, Suite 145 Lafayette, IN 47905 PH: 765.446.5185 | FX: 765.446.5186 Neurology

Lafayette Neurology Khaled Hammoud, M.D. 1345 Unity Place, Suite 310B Lafayette, IN 47905 PH: 765.446.5220 | FX: 765.446.5221

10

Gastroenterology Lafayette Gastroenterology Ravish Mahajan, M.D. 5 Executive Drive, Suite B1 Lafayette, IN 47905 PH: 765.807.0531 | FX: 765.807.0534

General Surgery Lafayette Surgical Clinic John Francis, M.D. Jerry Jefson, M.D. David Halter, D.O. Nathan Huber, M.D. Gerritt Smith, M.D. Thomas Summer, M.D. 1345 Unity Place, Suite 235 Lafayette, IN 47905 PH: 765.446.5065 | FX: 765.446.5170

Immediate Care / Lab Unity Immediate Care Center Elizabeth Riggs, M.D. 1321 Unity Place, Suite B Lafayette, IN 47905 PH: 765.446.1362 | FX: 765.446.1007

Internal Medicine Abramovitz Internal Medicine Ruth Abramovitz, M.D. 500 West Navajo Street West Lafayette, IN 47906 PH: 765.742.6774 | FX: 765.742.6914

Gagan Chadha, M.D. 166 Sagamore Pkwy W West Lafayette, IN 47906 PH: 765.497.2428 | FX: 765.497.4251 Gary Prah, M.D. 1318 Main Street Lafayette, IN 47901 PH: 765.742.5254 | FX: 765.742.4991

West Lafayette Internal Medicine Carlos Gambirazio, M.D. 152 Sagamore Parkway West West Lafayette, IN 47906 PH: 765.423.6556 | FX: 765.423.6024

Medical Oncology / Hematology Lafayette Cancer Care Nancy A. DiMartino, M.D. Glen Papaioannou, M.D. 1345 Unity Place, Suite 135 Lafayette, IN 47905 PH: 765.446.5050 | FX: 765.446.5119

Nephrology

Lafayette Kidney Care Sudha Rani. M.D. Paul Shin, M.D. 1345 Unity Place, Suite 145 Lafayette, IN 47905 PH: 765.446.5185 | FX: 765.446.5186 Neurology

Lafayette Neurology Khaled Hammoud, M.D. 1345 Unity Place, Suite 310B Lafayette, IN 47905 PH: 765.446.5220 | FX: 765.446.5221

Occupational Medicine ROCC Elizabeth Riggs, M.D. Michael Krauss, M.D. 1321 Unity Place, Suite A Lafayette, IN 47905 PH: 765.446.2450 | FX: 765.446.1083 Ophthalmology Burgett Kresovsky Eye Care Jason Burgett, M.D. Seth Kresovsky, M.D. 1345 Unity Place, Suite 245 Lafayette, IN 47905 PH: 765.446.5130 | FX: 765.446.5131

Magnante Eye Care David Magnante, M.D. 975 Mezzanine Drive, Suite B Lafayette, IN 47905 PH: 765.449.7564 | FX: 765.807.7943

Orthopaedics Lafayette Orthopaedic Clinic John T. Bauman, M.D. Daniel J. Daluga, M.D. Robert J. Hagen, M.D. Michael E. Highhouse, M.D. Michael D. Krauss, M.D. Mark C. Page, M.D. Peter J. Torok, M.D. 1411 South Creasy Lane, Suite 120 Lafayette, IN 47905 PH: 765.447.4165 | FX: 765.447.4168

Orthopaedics Spinal Surgery Indiana Spine Center John Gorup, M.D. Mario Brkaric, M.D. 1345 Unity Place, Suite 310 Lafayette, IN 47905 PH: 765.446.5210 | FX: 765.446.5211

Outpatient Physical / Occupational Therapy

Lafayette Rehabilitation Services 1411 S. Creasy Lane, Suite 100 Lafayette, IN 47905 PH: 765.447.5552 | FX: 765.449.1054

Miracles Rehabilitation Lafayette / West Lafayette 3806 Amelia Avenue Lafayette, IN 47905 PH: 765.807.2773 | FX: 765.807.2774 257 Sagamore Parkway West West Lafayette, IN 47906 PH: 765.463.2200 | FX: 765.463.3625

Outpatient Surgical Center Unity Surgical Center 1411 S. Creasy Lane, Suite 200 Lafayette, IN 47905 PH: 765.446.5000 | FX: 765.446.5011

Pain Management Innovations Pain Management Group Tonia Kusumi, M.D. 3738 Landmark Drive, Suite A Lafayette, IN 47905 PH: 765.807.2780 | FX: 765.807.2781 Pain Care Center Robert Bigler, M.D. Ferdinand Ramos, M.D. 975 Mezzanine Drive, Suite C Lafayette, IN 47905 PH: 765.807.7988 | FX: 765.807.7989

Pediatrics Froberg Pediatric Center Lara Boggess, M.D. Linda Froberg, M.D. Anna Wildermuth, M.D. 324 N. 25th Street Lafayette, IN 47904 PH: 765.447.6936 | FX: 765.447.2536

Preferred Pediatrics of Lafayette M. Ann Jonkman, M.D. Jewel Salvador Marino, M.D. 3774 Bayley Drive, Suite Lafayette, IN 47905 PH: 765.807.8180 | FX: 765.807.8181

Phlebology Lafayette Regional Vein & Laser Center Marlin Schul, M.D. 985 South Creasy Lane Lafayette, IN 47905 PH: 765.807.2770 | FX: 765.807.0348

Plastic Surgery Lai Plastic Surgery Khoa Lai, M.D. 1345 Unity Place, Suite 210 Lafayette, IN 47905 PH: 765.446.5432 | FX: 765.446.5431

Podiatry Family Foot Clinic Nicholas Costidakis, D.P.M. 975 Mezzanine Drive, Suite B Lafayette, IN 47905 PH: 765.447.4776 | FX: 765.447.4809

Greater Lafayette Foot Care William Oliver III, D.P.M. David Sullivan, D.P.M. 1345 Unity Place, Suite 225 Lafayette, IN 47904 PH: 765.449.2436 | FX: 765.449.1817

Hoover Foot Clinic James Hoover, D.P.M. 2020 Union Street, Suite 100 Lafayette, IN 47904 PH: 765.447.7644 | FX: 765.448.9009 Christopher Moon, D.P.M. 750 Park East Boulevard, Unit #4 Lafayette, IN 47905 PH: 765.449.4700 1256 S. Jackson Street Frankfort, IN 46041 PH: 765.659.1843 | FX: 765.654.5380

Psychology Sycamore Associates Patricia Moisan-Thomas, Ph.D. Ryan Oetting, Ph.D. Norman Phillion, Ph.D. 2020 Union Street, Suite 101 Lafayette, IN 47904 PH: 765.449.8286 | FX: 765.449.0445

Radiation Oncology Lafayette Radiation Oncology Kazumi Chino, M.D. Irene Gordon, M.D. Mary Margaret Rhees, M.D. Bedatri Sinha, M.D. Faith, Hope & Love Cancer Center 1425 Unity Place Lafayette, IN 47905 PH: 765.447.7460 | FX: 765.447.8396

Radiology Unity Radiology John Fiederlein, M.D. Steven Hossler, M.D. Kent Lancaster, M.D. Stephen Matthews, M.D. InnerVision Advanced Medical Imaging 1411 S. Creasy Lane, Suite 130 Lafayette, IN 47905 3801 Amelia Avenue, Suite A Lafayette, IN 47905 3750 Landmark Drive, Suite A Lafayette, IN 47905 InnerVision West 3482 McClure Avenue, Suite 100 West Lafayette, IN 47906 PH: 765.447.7447 | FX: 765.447.1767

Urology Lafayette Clinic of Urology Jeffrey Cooper, M.D. Richard Selo, M.D. 1345 Unity Place, Suite 110 Lafayette, IN 47905 PH: 765.447.9308 | FX: 765.447.2387

1250 South Creasy Lane Lafayette, IN 47905

765.447.8133 | www.unityhc.com

Jamie Proffitt | Marketing Manager

Unity Immediate Care CenterNo Appointment Necessary When you, your family or employee needs immediate medical attention, you want quality care that’s close to home. That’s why Unity Immediate Care Center is open daily, to get you the care you deserve. Our experienced physicians see patients on a walk-in basis when your primary care physician may not be available.

The Unity Immediate Care Center provides prompt medical attention for many of your health care needs while bridging the gap between your primary care physician and the emergency room. Some of the many advantages of using the Unity Immediate Care Center include:

• Extended hours. • No appointments are necessary. • Walk-ins are always welcome. • Less costly than most emergency room visits. • Convenient and easy access. • Patient friendly environment. • Less intrusive than a hospital emergency room environment. • Full service with lab and x-ray capabilities.

No Appointment Needed. Open 8 am to 8 pm.

7 days a week, except Holidays.

765.446.1DOC (1362) 1321 Unity Place | Lafayette

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Love Your Heart ~ Heart Healthy!Health questions or suggest a topic for our next newsletter...we want to hear. Please email us at [email protected].