Health

Innovative, Minimally Invasive Hip Replacement Surgery with Less Downtime

May 23, 2017

When dealing with persistent hip pain that interferes with day-to-day functioning like walking, performing daily activities or even sitting comfortably, surgery may become necessary. Now surgery for hip replacement isnít the major procedure it used to be...

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The lupus patient and oral care

May 23, 2017

While everyone is encouraged to visit their dentist twice per year, it is imperative that lupus patients do so as well, and those with active lupus disease are urged to visit the dentist in three month intervals, according to Dr. Shamika Strachan.
The associate dentist, who practices out of Impressions Dental, Harbour Bay, says there should be communication between the dentist and the attending rheumatologist or medical doctor to keep updated on the management of the individual, and for the dentist to consult before prescribing any medication for oral conditions that may arise.
"Lupus is a chronic, inflammatory, autoimmune disease, sometimes associated with mucocutaneous lesions, with or without systemic involvement. This disease is an ongoing condition. It results in swelling within mucous membranes [the inner lining of most body cavities] and the skin [cutaneous], which may or may not affect other organs. Lupus is classified as an autoimmune condition because the affected individual's immune system attacks their own tissues/cells; lupus may affect multiple organs (Systemic Lupus Erythesatosus-SLE) or it may only involve the skin and oral cavity (Discoid Lupus Erythematosus-DLE)."
Although it is believed that the disease may be genetic, environmental factors such as smoking, hormonal changes, ultraviolet (UV) radiation and viral infections are thought to increase the likelihood of developing the condition in those who are already genetically susceptible.
The dentist said that the more common of the two forms of lupus is the discoid type and it is found most commonly in middle-aged women. She said the person affected with the discoid form of lupus may be recognized extra-orally by the characteristic butterfly patterned lesions that appear above the neck -- much like singer Seal. Toni Braxton and Selena Gomez are living with the systemic form of the disease. Lady Gaga has been tested borderline.
"Approximately 40 to 50 percent of lupus patients develop mouth sores. These may or may not be painful, but their presence usually indicates active lupus disease," said Dr. Strachan. "That's not to say all mouth sores indicate that a person has lupus. Mouth sores may develop from a range of things -- from stress, trauma, hormonal changes, certain foods and even ingredients in toothpastes. However, in a known lupus patient, all mouth lesions should be biopsied to check for active disease."
The dentist said mouth sores usually appear on the gums, cheeks, inner lip and roof of the mouth; and are characteristically red, ulcerated lesions with a white "halo" and white lines that spread from the center. It is also important to highlight that in some instances the presence of oral lesions may be a direct reaction to medications taken by lupus patients. Changes in the pigment (color) of the oral tissues, or opportunistic oral infections (such as fungal infections), may also develop as a side effect to various medications taken by lupus patients.
Apart from oral lesions and opportunistic infections, the dentist said the patients are also at an increased risk of developing tooth decay due to dry mouth, which may also be accompanied by a burning mouth sensation.
"According to Dr. Paul Freedman in an article written by Colgate, 20 to 30 percent of people with lupus develop Sjogren's Syndrome (SS). SS is an autoimmune disease that attacks salivary glands and other moisture producing glands (including the lacrimal gland that keep the eyes moist, thus dry eyes can result as well). A decrease in salivary flow means a decrease in the antibacterial and antifungal components of saliva, which cleanses the mouth and fights oral bacteria. Reduced production of saliva can contribute to oral fungal infections as referenced previously."
She said SS can be diagnosed through various blood tests, and that a telltale sign of the condition is bilateral (both sides) enlargement of the face due to swelling of the major salivary glands.
Dr. Strachan said there is currently no cure for SS, but that the resultant dry mouth (xerostomia) can be managed; and that stimulation of saliva is encouraged by chewing sugar free gum or candy, or using medications such as pilocarpine from which there are side affects, and as such, she said patients should be advised by a medical doctor when taking. And that there are saliva substitutes available such as biotene, xerostom and aquoral to name a few. Mouth sores in lupus patients are usually treated with topical steroids such as prednisone, more resistant lesions are treated with antimalarials such as plaquenil.
To maintain a healthy month, the dentist recommends that lupus patients avoid direct sunlight (especially for those people whose lesions are triggered by exposure to sunlight); keep stress levels at a minimum; get lots of rest; eat a well-balanced diet that's low in sugar, and avoid foods that they know may activate mouth blisters; take medication as prescribed; take small sips of water; carry out meticulous oral hygiene; and visit their dentist regularly.
Millions of people worldwide struggle with the often debilitating health consequences of lupus, a potentially fatal autoimmune disease capable of damaging virtually any part of the body, including the skin, heart, lungs, kidneys and brain.
While some groups of people develop lupus more frequently than others, lupus develops in people of all ages, races, ethnicities and genders.
Lupus is a hard to diagnose disease, which mimics other diseases. It can be debilitating when a sufferer experiences a flare.
As Lupus Awareness Month is observed during May to increase public understanding of this cruel and mysterious disease that ravages different parts of the body, Dr. Strachan encourages people to be health conscious and to get tested if they are suffering but don't know why.
"To all those in the fight against lupus -- patients, family and friends -- stay healthy and keep strong. You are true fighters. Please pass your knowledge of lupus and its effects on the oral cavity with someone today. #POP"

Formation of support group
The Lupus 242 group offers support to those diagnosed with lupus and their families. Lupus 242 was originally the idea of Debbie Humes who got very sick and was unable to pursue the idea of putting the group together. In 2011-2012, Shanelle Brennen had a rough bout with the disease that put her out of work for almost six months. During that time, she decided to get the group up and running. They launched in April 2012 with Brennen as president and her younger sister Shonalee King Johnson, who does not have the disease, as her vice president and public relations coordinator.
Brennen wanted to start the support group so that fellow sufferers did not feel alone, and to let them know they had support. She felt that a lot of people suffered in silence and came up with the theme, 'Breaking the Silence, Supporting the Cure', which is their motto. The group has regular meetings and provides education. She wanted it to be such that someone who was on the other side of a lupus experience could speak to it.
Brennen lost her two decades battle with the disease on March 2. King Johnson is continuing her sister's mission to break the silence and support the cure.

LUPUS 242 EVENTS (including P.O.P. -- Put on Purple Fridays in support of lupus fighters)
Saturday, May 27: Health talk with rheumatologist Dr. K. Neil Parker at the Harry C. Moore Library at the University of The Bahamas.
To support the cause, persons can attend events and purchase Lupus 242 t-shirts, wristbands or car bumper stickers. Proceeds go towards local awareness initiatives and global research. For more information on the group and upcoming events, visit www.facebook.com/lupus242, email lupus242@outlook.com or call 242-525 9967.

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The men: What about Us TOO

May 23, 2017

Eight years ago, the cancer registry at the Princess Margaret Hospital (PMH) identified 85 men who had been diagnosed with prostate cancer that year. That was not a true picture of the national incidence rate, as many affected men sought diagnosis and treatment privately and/or outside the country, and a national registry had not been established. At the time, the Cancer Society of the Bahamas (CSOB) estimated that on average, two cases of prostate cancer were diagnosed each week. This disease was also the most common cause of death in men who died of cancer related causes in The Bahamas.
According to CSOB officials in a prior interview with The Nassau Guardian, approximately one Bahamian man dies as a result of prostate cancer every week.

The prostate gland
The prostate gland, an organ about the size of a key lime hidden deep within the male's body under his bladder and behind his urethra, carries urine from the bladder. A part of his reproductive system, it is responsible for secreting the fluid that is released during sexual intercourse. As a man ages, his prostate tends to grow. This growth can be benign, not harmful to the man's overall health, or it can be malignant. In malignant growth, the cancer cells multiply in the prostate gland, and if not detected and treated effectively, can, and will, spread to adjacent organs, and eventually, throughout the affected man's entire body.
As there are no symptoms in the early stages of the disease, prostate cancer is often very difficult to diagnose. All males 40 years and older are advised to look out for the following symptoms -- difficulty passing urine, a weak or interrupted urine flow, the need to urinate frequently, especially at night, blood in the urine, pain or burning when passing urine, and/or constant pain in the lower back, pelvis or upper thighs.

Prostate cancer diagnosis
All symptoms, they say, can be related to other conditions and not necessarily to cancer, and the only way to conclusively diagnose cancer of the prostate is by three simple procedures -- digital rectal examination (DRE), an examination that is recommended annually for all men beginning at age 40 years; the prostatic specific antigen (PSA) blood test; and the prostate biopsy.
During a DRE examination the doctor inserts a lubricated, gloved finger into the man's rectum and feels or palpates his prostate through the rectal wall. It's a procedure that takes less than one minute and causes minimal discomfort.
PSA is a substance that is produced in the prostate gland. It is secreted in the seminal fluid and trace quantities leak into the blood stream. In men with normal prostate glands, only minimal quantities of PSA are found in their blood streams. Significantly larger quantities of PSA are found if there is cancer in the prostate. While the PSA is specific for the prostate gland, it is not specific for prostate cancer. A number of other factors can cause elevations in PSA levels. These include inflammation of the gland or prostatitis, manually palpating the prostate, and sexual intercourse.
A prostate biopsy is performed in cases where the doctor feels an enlarged prostate gland during the DRE, and/or there is a marked elevation in the PSA level. The results of the biopsy would conclusively rule out, or confirm, the diagnosis of prostate cancer.
CSOB officials say prostate cancer is more aggressive and more fatal in black men than in any other race. Additionally, men with close relatives -- father, grandfather, uncle or brother -- with prostate cancer are at higher risk than others. And that research has found that lifestyle factors -- a diet rich in fats, red meats and refined sugar, and a lack of regular exercise -- are contributing factors in the development of various types of cancers, including prostate cancer.
Us TOO, a support group for men, was organized over more than two decades ago in Chicago, USA, by five males with prostate cancer. It has grown to over 35 groups in Canada and the U.S., including a chapter in The Bahamas that was inducted over 10 years ago with the late Clyde B. Bethell, the founding leader. Its primary objective is to support, educate and advocate with respect to prostate cancer.
The Bahamas Chapter of Us TOO is closely affiliated with the CSOB and meets regularly at 6:30 p.m. on the third Thursday in each month, at the Centre's East Terrace, Centreville, office. Membership is open to all men who are 18 years and older and not only prostate cancer survivors.
The Bahamas chapter of Us TOO has coordinated or assisted with the coordination of numerous activities over the years, all aimed at the prevention, early detection and/or early treatment of prostate cancer.
Over the past years, Us TOO has facilitated the hosting of annual prostate cancer screening clinics on New Providence at which thousands of men have been screened for prostate cancer.
To get in contact with Us TOO members, telephone 325-0823 or 465-2235 or email barrywendell@yahoo.com.

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PM promises new child health and maternity wing at PMH

May 23, 2017

Prime Minister Dr. Hubert Minnis said the government will build a new child health and maternity wing at the Princess Margaret Hospital (PMH), during a recent visit to the hospital.
"I don't know the specifics in terms of when it will be completed, but what I would tell you is that we will build a new child health and maternity wing. The children and women of this country need and deserve the best, and they will get the best," said Minnis during the Monday, May 15 visit. "So what you see out front, the Critical Care Block, they will have something just as great, if not greater.
While at PMH, he toured the maternity ward's antenatal and postnatal units. He also visited staff in the hospital's kitchen and cafeteria.
Minnis, a veteran physician, practiced in the country's largest health institution for some three decades before becoming minister of health and subsequently prime minister.

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Hearing aid use and care

May 23, 2017

A hearing aid is a small electronic device that is constantly exposed to ear oils, hair care products, wax, sweat, moisture, and frequent handling. To ensure your hearing aids function optimally throughout their five to six year life expectancy, it is necessary to provide simple daily care as well as have the hearing aids checked periodically by your audiologist or hearing care professional. Outlined below are tips for successful hearing aid use and care.
Maintenance checks
Listening check
Before wearing, check the hearing aids daily to ensure they sound clear and not weak or scratchy.
Battery check
Check battery strength daily. A battery tester can be used to help with this. Hearing aid batteries should last about five days to two weeks. The life of the battery will depend on the size of the battery and the severity of the hearing loss. The smaller the battery, the shorter the battery life. Likewise, the more severe the hearing loss, the shorter the lifespan of the battery. Still, no matter the battery size or the degree of hearing loss, a full strength battery allows the hearing aids to function at peak performance.
Always keep spare batteries with you.
Store unused batteries in a cool, dry place.
Keep batteries out of reach of children and pets. Discard used batteries properly. Do not mix used and unused batteries together.
Cleaning check
Use a soft, dry cloth to wipe the hearing aids daily. Earmolds, tips and domes should be brushed daily with a soft, unused toothbrush to get rid of wax, dirt, and grime. After cleaning/brushing be sure tips and domes are securely in place. Custom earmolds can be removed periodically from the hearing aids and cleaned with mild soap and warm water. Be sure the earmolds are thoroughly rinsed and dried before reattaching them to the hearing aids.
Minimize moisture
Do not get the hearing aids wet.
Remove the hearing aids at night and place them in their storage container or special hearing aid dryer (purchased separately). The hearing aid dryer will help stop moisture from building up on the inside of the hearing aids; and lengthen the life of the hearing aids.
Remove the hearing aids when taking a bath or going swimming.
Wash face and comb hair before putting the hearing aids on.
Do not store the hearing aids in the bathroom or kitchen.
Open the battery door and/or remove the batteries from the hearing aids before placing them in a drying unit or the storage container.
Chargeable hearing aids should be placed in the charger with the batteries in the hearing aid.
Ensure the hearing aid charger is plugged into a surge protector to avoid it becoming damaged in the event the electrical power goes out.
Prevent feedback
Feedback occurs when amplified sound coming out of the earmold reenters the microphone, causing the hearing aid to make a whistling sound. To prevent feedback always ensure that the hearing aids are properly inserted in your ear; the earmolds are not too small; the earmolds are not damaged or do not need to be replaced; there is not too much earwax in your ear canal; and the hearing aids are working properly.
Regular checks and servicing
To guarantee your hearing aids are always functioning at peak performance, regular visits to your audiologist or hearing care provider are necessary. Use a calendar along with the guide below to assist you in this area.
o Have hearing aid tubes, tips, and/or domes replaced every three months.
o Have hearing aids professionally checked and cleaned by your audiologist or hearing care professional every six months.
o Have your audiologist test your hearing annually and have any necessary adjustments to hearing aids made at that time.

o For further information on any hearing-related disorder, please contact Dr. Deborah Nubirth, doctor of audiology, in New Providence at Comprehensive Family Medical Clinic, Poinciana Drive at 356-2276 or 677-6627 or 351-7902 in Grand Bahama; or email dnubirth@yahoo.com.

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"Mechanical Circulatory Support in Children with Congenital Heart Diseases Expands Life Expectancy"

May 17, 2017

The expected outcomes and management of congenital heart disease has changed considerably over the last 20 years wherein conditions such as hypoplastic left heart syndrome were uniformly fatal before the 1980ís but where we now have multiple...

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The daily struggles of living with Lupus

May 16, 2017

For a month, Petrell Lloyd, who was then in her early 40s, didn't remember she had a toddler at home. It's a time in the mother's life that she looks back on as terrifying, but with some degree of relief as well, because what transpired from her forgetting she had recently given birth to a son, led to her being diagnosed with lupus, after years of being treated for everything else under the sun, including arthritis.
"I kept going to the doctor, and they kept giving me medications. I kept telling them something was wrong with me."
In 2011 Lloyd was found at home, unresponsive, by her mother; Lloyd had caught encephalitis, an inflammation of the brain that causes flu-like symptoms such as a fever or severe headache.
It can also cause confused thinking, seizures, or problems with the senses or movement. Many cases of encephalitis result in only mild flu-like symptoms or even no symptoms. Severe cases of encephalitis, while relatively rare, can be life threatening.
Lloyd said her temperature had spiked to over 200, her brain had swollen and she had bleeding on the brain.
"It was a good thing my mother knew what to do," said Lloyd. "The infection to the brain they said triggered it. I had lupus in my system from 2003, but we never knew. They were treating me for arthritis and other things, but not knowing that's what it really was. What really kicked it off was I caught encephalitis on the brain, and I went into the hospital in 2011. The brain was swollen and bleeding and I had a fever over 200. I basically was between ..." she recalled.
Lloyd spent eight weeks in hospital, one month of which was in the intensive care in New Providence before her husband took her to the Cleveland Clinic for a second opinion, at which time she was diagnosed with lupus.
At her diagnosis, her question to the doctor was, "What does that mean?"
"Even though he told me it, and I had heard one or two persons say they had it, I didn't know what to expect or what my next step was. Where do I go from here? It's like everything in me just went to the bottom."
In lupus something goes wrong with the immune system, which is the part of the body that fights off viruses, bacteria, and germs ("foreign invaders" like the flu). Normally, a person's immune system produces proteins called antibodies that protect the body from these invaders. Autoimmune means your immune system cannot tell the difference between the foreign invaders and the body's healthy tissues, and creates antibodies that attack and destroy healthy tissue. The autoantibodies cause inflammation, pain and damage in various parts of the body.
Lloyd is one of millions of people worldwide struggling with the often debilitating health consequences of lupus, a potentially fatal autoimmune disease capable of damaging virtually any part of the body, including the skin, heart, lungs, kidneys and brain.
The former nail technician had to quit working, because even though she wore a mask she said the chemicals got to her. She would get headaches, and she would get tired and fatigued on a daily basis. She said she was always painful.
Life with lupus she says is a daily struggle.
"It's a challenge everyday -- the pain, the tiredness, the fatigue, the headaches."
Battling the disease isn't cheap either. Lloyd estimates that she averages up to $1,000 per month on medications, but she says National Insurance benefits help cover the cost of her medication bill.
She encourages others diagnosed with the disease to not give up and to fight.
"This is a struggle and a challenge everyday. And the thing about it, a lot of persons -- even within the family -- don't understand the depths of the disease itself. Even with my husband [Keith Lloyd], trying to explain to my husband on a daily basis how I feel ... what I go through on a daily basis -- because sometimes it's a struggle to get out of bed, it's difficult."
Lloyd said she daily has to make up her mind that she has to continue to live life, and do all the things she has to do for her six-year-old son Keiron, the child she for a month had forgotten she gave birth to. She gets him off to school daily.
"I have to struggle to get up to deal with him on a daily basis -- ensure he's bathed, his bag is packed, his lunch is packed and he's dressed properly. I tell my husband I will deal with the little one and he just deals with himself. It's a struggle, but he's like, 'Mommy I want you to help me'."
Despite what she may be feeling she helps him, because she can vividly recall the period when she could not remember him.
"With the encephalitis to the brain, I didn't remember that I'd had a baby. I was in ICU. I heard them, but I couldn't respond for about three weeks or so. After four weeks or so, I said Keith I had a baby right. He said, 'Yes Petrell.' It's a good thing I kept pictures on my phone. He let me see the pictures on my phone, and I was like oh my God. The baby was about two years old. When I looked at the photos
I just burst out crying, because that Tuesday morning I had dropped him to school and promised to pick him up and he was expecting me to pick him up. But I ended up in hospital."
Lloyd's older children Keith Lloyd 21, and Keitra, 18 are both in university.
Lloyd said she strives to teach her family about lupus, and that she voraciously reads whatever she can. She's also encouraging her children to get tested, now that she has had a positive diagnosis.
"I want them to get tested, because they might not get it, but their children or their children's children [might]. And I want them to be prepared -- be more knowledgeable about the disease itself. It's something like cancer, people say it's in my family, but I ain't going to get it. Don't have that kind of laid-back attitude that you won't get cancer or you won't get this. Have an open mind."
During Lupus Awareness Month Lloyd encourages those people diagnosed with lupus to stay strong and strive to remain positive. She also encourages families to support the lupus afflicted.
"It's a struggle for the family, but it's more of a struggle for the person who has the disease. You have to get information and find out how best you can help the person and what can you do for the person on a daily basis, because they need the support," she said.

LUPUS 242 EVENTS
(Including P.O.P. -- Put on Purple Fridays in support of lupus fighters).
Saturday, May 20: Hope Floats annual balloon release ceremony at the top of Fort Charlotte, to remember those persons who have died from lupus. This year's balloon release will be held in honor of deceased Lupus 242 president Shanelle Brennen.
Saturday, May 27: Health talk with rheumatologist Dr. K. Neil Parker at the Harry C. Moore Library at University of The Bahamas.
To support the cause, persons can attend events and purchase Lupus 242 t-shirts, wristbands or car bumper stickers. Proceeds go towards local awareness initiatives and global research. For more information on the group and upcoming events, visit www.facebook.com/lupus242, email lupus242@outlook.com or call 242-525 9967.

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Adjusting to new hearing aids

May 16, 2017

When it comes to enhancing a hearing impaired person's ability to hear and communicate, hearing aids are by far the most effective means of staying tuned in to the rest of the world. Although hearing aids do not restore normal hearing, they do help you understand what is being said to you, and those around you will be appreciative of your efforts to improve your ability to communicate with them.
Studies have shown that a person with hearing loss usually suffers about seven years with untreated hearing loss before purchasing their first hearing aid. Unfortunately, during this time their world becomes more and more silent as they no longer hear the hundreds of sounds others hear every day in their regular listening environment. Therefore, when the person with hearing loss finally gets their new hearing aids a whole new world of sounds opens up for them. Often they are surprised, and sometimes even startled, at the countless sounds they had been missing and are now able to hear. Many of the sounds they no longer even recognize and have to relearn what they are. Also, because they waited so long to be fitted with hearing aids, sounds that others listen to each day and take for granted may sound loud or abnormal to the new hearing aid user.
Adjusting to wearing hearing aids for the first time may take anywhere from a few days to a few weeks of continual hearing aid use. This process involves listening to and identifying all the "new" sounds that have not been heard in years, as well as a subconscious "retraining" of the brain in how to listen and hear again. Those who have a more severe degree of hearing loss, and who have never worn a hearing aid before, may take a bit more time adjusting as they begin hearing sounds they have probably not heard in many years.
To enjoy and use your hearing aid to its fullest, it is important to understand that the first few weeks of hearing aid use is a period of adjustment and is vital to communication success.
Tips to help you adjust to your new hearing aids.
o Expect your own voice to sound a bit strange and louder during the first few days of hearing aid use. People with hearing loss tend to speak a bit louder to more easily hear themselves. So, when wearing your hearing aids for the first time your voice will sound a bit different and louder to you. However, with daily hearing aid use you will soon learn to recognize your own voice, and to regulate the loudness level of your voice, which will result in you speaking in a more normal manner.
o Become familiar with the use of your hearing aids and its features. The more acquainted you are with your hearing aids the more quickly you will adjust to them. Learn how to put them on and take them off, how to identify right from left, how to change the batteries, how to clean and care for them, and which features are activated on them. Your hearing aids may be set to automatic so that it self-adjusts as you move from one listening environment to the next. Or the volume control can be activated allowing you to adjust the loudness level. Additionally, the program button on the hearing aids may be set to several situational options that you can manually adjust for more precise tuning as you move from one listening environment to another.
o Try to gradually get accustomed to all of the new sounds you are hearing by starting off in a quiet environment and slowly moving on to more complex sound environments. Do not instantly go into a complicated listening environment like a mall, restaurant, or party, as it may be confusing and frustrating. Start using your new hearing aids in your home environment by listening to the TV or radio, before moving on to other environments like church and restaurants. Give yourself time to understand how the hearing aid changes what you hear and eventually your brain will get very good at listening to and filtering all the sounds you are now hearing. Have a friend or loved one help you identify sounds you may not be sure of.
o Understanding speech when other noises are present in the background is a difficult thing for most people, even for those who have no hearing loss. However, persons who have a hearing loss due to auditory nerve damage may find this type of listening environment extremely challenging, even with the help of hearing aids. If you struggle with speech in the presence of background noise, ask your audiologist to adjust the hearing aids to help you hear speech as precisely as possible in these environments. With daily hearing aid use, patience, and practice, you will learn how to successfully listen to several voices at the same time, even in the presence of background noise.
o Take your cell phone with you when being fit with your new hearing aids to see if it will work well with the hearing aids. Some people who wear hearing aids experience problems with the radio frequency interference caused by phones, resulting in a buzzing noise when they place the phone near the hearing aid. If your cell phone is hearing aid compatible, your audiologist can activate the telephone feature on the hearing aids that will link the two devices to each other without interference, giving you a clear conversation via phone. Otherwise, you may want to ensure your next phone purchase is one that is hearing aid compatible. When purchasing a hearing aid compatible phone be sure to ask if it has a hearing aid rating (HAC) M3 or T4.
o If your hearing aid has a whistling sound coming from it, check to ensure the hearing aid or earmold is properly seated in your ear canal. Whistling sounds from your hearing aids can also be caused by wax buildup in the ear canal, fluid clogs, or from the hearing aid itself needing an adjustment or repair. If you are unable to identify the cause of the whistling sound, contact your audiologist for assistance.
o Allow your hearing aids to become a part of you. After a few weeks of acclimatization you should be wearing your hearing aids during all of your waking hours. As soon as you get up in the morning, even if you are home alone with no one to communicate with, you should put your hearing aids on and they should remain on until you go to bed at night. Since the majority of our hearing is done with the brain and not our ears, hearing aids are only a conduit to get the sounds to our brain at the precise level needed for proper auditory functioning. Studies show that those who wear their hearing aids all day, even when home alone, are in fact retraining their brain to hear again with the use of hearing aids. Such persons become significantly more successful hearing aid users than those who only wear their hearing aids when they are going out or when other people are around.
o Be patient! Remember, it may take anywhere from a few days to a few weeks to get adjusted to wearing new hearing aids. This adjustment period varies from person to person depending upon many varying factors. The key is to be patient. Before you know it, wearing your new hearing aids will become an enjoyable, discreet, and vital part of your daily routine.

o For further information on any hearing-related disorder, please contact Dr. Deborah Nubirth, doctor of audiology, in New Providence at Comprehensive Family Medical Clinic, Poinciana Drive at 356-2276 or 677-6627 or 351-7902 in Grand Bahama; or email dnubirth@yahoo.com.

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Falls and footwear

May 16, 2017

Every year in the United Kingdom, one in three people over 65 will fall. This rises to almost half with people aged 80 and above. Falls are the single, biggest reason for admission to the hospital and presentations to the emergency department in people aged 65 years and over. Falls account for over four million days spent in the hospital a year in England alone.
Ninety-five percent of hip fractures occur as a result of a fall, and they can also result in impaired mobility, disability, fear of falling and reduced quality of life. In a research study by Irwanto et al. (December 2014), a fall is the cause of most fractures in older people.
In the United States, falls are the leading cause of fatal and non-fatal injuries among older people. In 2010, 2.3 million fall injuries sent older persons to the emergency room where 662,000 of them were admitted to hospital, and falls cost $30 billion in direct medical costs.
A fall can have a huge impact on the life of the older person. It destroys their confidence, increases isolation and reduces independence, and often they can no longer live alone.
Reducing your personal risk factors
Our bodies continue to change throughout our lives as part of normal aging. Some of these changes can increase the risk of falling. These include poorer eyesight, can't see quite as clearly, can't judge distances and depth, or can't cope with sudden changes in light or glare; weaker muscles and stiffer joints which makes balance worse and changes the way you walk (gait) and move around; neuropathy or less feeling in the feet and legs, increased likelihood of pain -- numbness, tingling and burning in the feet and even changes to the shape and flexibility of the feet; slower reaction times and more difficulty concentrating or paying attention.
Footwear is one of a number of risk factors in the prevalence of falls. Some shoes or slippers can make you more likely to slip, trip or stumble.
Other conditions, such as diabetes, Alzheimer's disease, dementia or gait disorders such as Parkinson's disease can all increase the risk of falling. Make sure your medical conditions are under control to prevent falls.
Factors that can contribute toward falls
Foot conditions such as bunions, claw toes, ingrown toenails or very long nails and general foot pain can all cause problems with gait and balance. Older people should be advised to check their feet regularly and speak to their podiatrist if they have any reduction in foot sensation or develop foot pain.
Following a simple foot care routine can help reduce the risk of falls by preventing some of the conditions that cause pain and problems -- such as washing and drying feet daily to prevent infection, applying moisturizer to keep skin healthy, cutting toenails regularly and regular podiatry care for the management of foot problems.
Exercise also plays a vital role in preventing falls. Research has shown that a program of strength and balance can be very effective in reducing the risk. Older people are encouraged to do regular exercise to improve toe and ankle strength as this can help to improve balance.
Shoe types that increase the risk of falls
Some footwear can increase the risk of slips, trips and falls by making people more prone to poor balance and bad gait, or by making it difficult to judge surface friction and distance from the floor. Examples of unsuitable footwear for the elderly include loose, worn or backless slippers which are one of the most common causes of older people falling; slip-on shoes such as sling backs or flip-flops can slip and trip you up; shoes with slippery or worn soles can cause you to slip, especially in wet weather; shoes with a heel higher than one inch, or with a narrow heel, can make your foot unstable and can cause you to twist your ankle.
Preventing falls
There are some simple things people can do to help themselves stay steady on their feet and prevent falls.
Preventing falls among older Americans is a top health priority, and improved balance can help reduce the risk of a fall. Proper footwear can help improve balance, especially in older people who may be struggling with mobility and balance issues.
A study published in the British Medical Journal found that a multi-faceted foot care program could reduce the number of falls by 36 percent. It stated that foot and ankle exercises, foot orthoses and wearing appropriate footwear are all key to preventing falls.
The best shoes to prevent falls
Wearing well-fitting shoes can improve walking and gait, and prevent falls. Safe shoes have a high back or collar to support the ankle, a hard, slip-resistant sole, and a heel height lower than one inch.
A house shoe that can offer the comfort of a slipper, but the stable support of a shoe, can be worn in the house rather than walking barefoot, or in socks or tights because they are slippery and can lead to falls. A strong Velcro fastener or leases on the front of the shoes to ensure they won't slip off; a wide opening to make it easier to get your foot in and out of the slipper/shoes with restricted mobility.
Shoe shopping tips
o Have both feet professionally measured every time you shoe shop. Natural aging and health changes can cause the size of your feet to change.
o Shoe shop in the afternoon, as your feet tend to swell throughout the day.
o Bring the type of socks you plan to wear with the shoes, and walk around the store in the shoes before you purchase them.
o If you don't feel comfortable or steady in the store, don't purchase the shoes. Shoes should feel comfortable and supportive right away; if they don't, breaking them in won't improve things.
o If you have specific health challenges or foot issues, talk to the podiatrist about the best footwear for your needs.
o If your podiatrist has prescribed orthotics (biomechanical inserts that go into your shoes) take them with you when you shoe shop and try them out in the shoes you're considering.
o Quality shoes can be an investment, so purchase the best quality shoes you can afford.
If you or a parent of loved one has fallen more than once in the past six months, you or they are more likely to fall again, if no action is taken to prevent it. It is important to talk to your doctor about your risk of falls. Falls are serious, and can be a sign of a new or worsening medical problem, muscle weakness, balance problems, medication side effects or a combination of these and other problems. Wearing proper footwear is an easy way to help improve balance and prevent falls in older people who may be struggling with mobility and balance issues.

o For more information email foothealth242@gmail.com or visit www.apma.org. To see a podiatrist visit Bahamas Foot Centre on Rosetta Street, telephone 325-2996, or Bahamas Surgical Associates Centre, Albury Lane, telephone 394-5820, or Lucayan Medical Centre on East Sunrise Highway, Freeport, Grand Bahama, telephone 373-7400.

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Remain open

May 16, 2017

As we all know only too well we have some good times in life and, of course, ultimately we'll have some not so good times as that's the way the cookie crumbles, as that well-known saying puts it. Now the real test of anyone and how successful they will be in the end, is of course how they handle the occasional bad times, the down cycles, which we all have to deal with at times, across the board.
Some people are able to handle these down times in a level-headed manner, knowing that the down cycle is just a temporary setback and will not last. Now unfortunately others do not fare so well when things get rough in business, in the employment field or maybe in a personal relationship, and they just recede into their shell and start to hibernate, not having anything to do with anyone. Why, it's as if they've become a completely different person with a whole new, very negative, non-communicative personality that is so very unlike their normal behavior.
Believe me, this sort of reaction is not at all good for anyone as it will keep you in a bad mood, affect your health in a detrimental way and not help in any way whatsoever. So what should I do under such circumstances D. Paul, you may understandably query? Well you've simply got to do as we say -- psych yourself up. And as the simple title of today's article puts it, remain open to new ideas and open to assistance from others.
Yes my friend, it may feel temporarily okay to retreat into your shell and continue to feel sorry for yourself; however, believe me, this is not good as it will not help you to find your way back onto the road to success. So, as today's title simply and succinctly puts it, stay open -- open to assistance from others, open to new ideas and new opportunities to succeed and you'll make it again. Yes you will.

o Think about it!
Visit my website at: www.dpaulreilly.com.
Listen to "Time to Think" the radio program on STAR 106.5 FM at 8:55 a.m. & 6:20 p.m.

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"Mechanical Circulatory Support in Children with Congenital Heart Diseases Expands Life Expectancy"

May 12, 2017

ďThe expected outcomes and management of congenital heart disease has changed considerably over the last 20 years wherein conditions such as hypoplastic...

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Minimally Invasive, Innovative Surgical and Non-Surgical Treatment Options for Epilepsy Now Available

May 12, 2017

Globally, there are more than 50 million people living with epilepsy Ė with 80 percent living in low-to-middle class income countries, and 75 percent without treatment, according to the World Health Organization...

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PM Christie: NHI Primary Care-Investment in Nationwide Health Improvement

May 09, 2017

Prime Minister and Minister of Finance the Rt. Hon. Perry Christie said, on May 8, 2017, that, with the roll-out of the primary care phase of National Health Insurance (NHI), the Government was not only improving access to primary care for all Bahamians...

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A body under attack

May 09, 2017

Imagine some days waking up and your entire body aches -- you're fatigued to the point that you're completely drained. Then there are days you wake up and have problems with your vision; another day your hands or feet could be purple (caused by bleeding); or you have ulcers on your tongue that don't allow you to eat -- sometimes for days at a time. Welcome to Shawnette Guerrier's world, and that of anyone who has been diagnosed with lupus.
"Some days you can be on top of the world and want to do anything, including clean the whole house, and the next day you go down to like a zero, and sometimes you just don't want to be bothered," said Guerrier, 45, diagnosed with lupus 13 years ago.
Experiencing what she thought were flu-like symptoms in 2004, Guerrier went to get checked out at a clinic and was told to go the Princess Margaret Hospital where she had surgery to remove fluid buildup around her heart and lungs. She was hospitalized for approximately four months, as she underwent a battery of tests to determine what was wrong with her. She was eventually diagnosed with lupus. It was a word that was completely foreign to her at the time. She had never heard of it and didn't even know that it was a disease.
In lupus something goes wrong with the immune system, which is the part of the body that fights off viruses, bacteria, and germs ("foreign invaders" like the flu). Normally, a person's immune system produces proteins called antibodies that protect the body from these invaders. Autoimmune means your immune system cannot tell the difference between the foreign invaders and the body's healthy tissues, and creates antibodies that attack and destroy healthy tissue. The autoantibodies cause inflammation, pain and damage in various parts of the body.
Guerrier is one of millions of people worldwide struggling with the often debilitating health consequences of lupus, a potentially fatal autoimmune disease capable of damaging virtually any part of the body, including the skin, heart, lungs, kidneys and brain.
"First I had to admit that I was dealing with something that I didn't know about," she recalled. "When I was discharged they gave me a lot of information to read up on it."
Guerrier is the first person to be diagnosed with lupus in her family.
In today's technological world she Googles everything -- even if she gets a rash on her hand. And she makes the most of the Lupus 242 support group. She takes in all sessions when medical personnel are present to speak to them, and she speaks to other lupus diagnosed persons to see how they cope with flare-ups from the disease.
Guerrier joined Lupus 242 after a chance meeting with deceased Lupus 242 president, Shanelle Brennen, who visited Lickety Split Ice Cream Parlor where Guerrier worked. Through their conversation they found out that they both had lupus. Brennen invited her to a Lupus 242 meeting.
While some groups of people develop lupus more frequently than others, lupus develops in people of all ages, races, ethnicities and genders.
Lupus is a hard to diagnose disease, which mimics other diseases. It can be debilitating when a sufferer experiences a flare.
"A lot of times people look at you and say you look normal and like everything is okay, but deep down inside we go through a lot, and people don't know that. They think you're lazy, like you don't want to pull your weight, but it's not that. It's just that some days you can be on top of the world and want to do anything, including clean the whole house, and the next day you go down to like a zero and sometimes you don't want to be bothered, because it has you in a depressed state too," she said.
Guerrier said a positive mind gets her through flares. She said she prays a lot to try to remain calm, as one way to reduce the onset of flares is a calm, stress-free life.
"I tell myself I can do all things through Christ who strengthens me, and being around positive people like the lupus group and my family and grandchildren."
Two years ago she had a particularly bad flare-up, as the stress of her son being killed took its toll on her.
"I didn't eat for days. My body was painful ... feet hurt, bones hurt ... everything was hurting on me. I had headaches ... and everything was purple. They say people with lupus aren't supposed to endure stress. That we're supposed to be carefree -- nothing to worry about, because when you start to put pressure on your body the lupus flares up. His death was stressful."
Her daughter, Michela Sampson-Gayle, who is in her late 20s, was tested for the disease six months ago after she had her baby and complained of increased fatigue; the result was negative, which was a relief to Guerrier.
As Lupus Awareness Month is observed during May, and World Lupus Day is recognized tomorrow, to increase public understanding of this cruel and mysterious disease that ravages different parts of the body, Guerrier encourages people to be health conscious and to get tested if they are suffering but don't know why.
"In that time in my life I didn't know what was going on. I was a person who always walked and jogged, and at that time I thought I was healthy, until I went to hospital with flu-like symptoms and they diagnosed me with lupus. Make sure you get checked up, because a lot of times we think we look healthy, but we're not."
More than a decade after being diagnosed, Guerrier said she is able to work for months and feel upbeat before the disease takes its toll and she becomes tired and fatigued. She said her boss and co-workers are understanding of what she goes through, and even recognize the signs when she's suffering through a flare.
"They tell me when I look good and when they see me limping, or my eyes getting red, they tell me I'm having a flare."

Formation of support group
Lupus 242 was originally the idea of Debbie Humes who got very sick and was unable to pursue the idea of putting the group together. In 2011-2012, Brennen had a rough bout with the disease that put her out of work for almost six months. During that time, she decided to get the group up and running. They launched in April 2012 with Brennen as president and her younger sister Shonalee King Johnson, who does not have the disease, as her vice president and public relations coordinator.
Brennen wanted to start the support group so that fellow sufferers did not feel alone, and to let them know they had support. She felt that a lot of people suffered in silence and came up with the theme, 'Breaking the Silence, Supporting the Cure', which is their motto. The group has regular meetings and provides education. She wanted it to be such that someone who was on the other side of a lupus experience could speak to it.
LUPUS 242 EVENTS (including P.O.P. -- Put on Purple Fridays in support of lupus fighters)
Wednesday, May 10 (World Lupus Day): Commemorated globally, and serves to draw attention to the impact that lupus has on people worldwide. The annual observance focuses on the need for improved patient healthcare services, increased research into the causes of and cure for lupus, earlier diagnosis and treatment of lupus, and better epidemiological data on lupus globally. World Lupus Day serves to rally lupus organizations and people affected by the disease around the world to embrace the common purpose of bringing greater attention and resources to efforts to end the suffering caused by the disabling and potentially fatal autoimmune disease. This year the date falls on the day of The Bahamas' general election. Lupus 242 members encourage Bahamians -- especially persons who would like to dress in neutral colors while voting at the polls -- to put on purple, vote, take photos, post them online using the hashtag#PopAtThePolls and tag their group.
Friday, May 12: Lupus 242 and Big Picture Paint & Sip Studio will host a POP, Paint & Sip fundraising event.
Saturday, May 20: Hope Floats annual balloon release ceremony at the top of Fort Charlotte, to remember those persons who have died from lupus. This year's balloon release will be held in honor of deceased Lupus 242 president Shanelle Brennen.
Saturday, May 27: Health talk with rheumatologist Dr. K. Neil Parker at the Harry C. Moore Library at the University of The Bahamas.
To support the cause, persons can attend events and purchase Lupus 242 t-shirts, wristbands or car bumper stickers. Proceeds go towards local awareness initiatives and global research. For more information on the group and upcoming events, visit www.facebook.com/lupus242, email lupus242@outlook.com or call 242-525 9967.

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Purchasing hearing aids

May 09, 2017

People always ask me how they will know which kind of hearing aid is best for them. There are essentially tens of thousands of different possible hearing aid manufacturers, numerous hearing aid styles, unlimited hearing aid features, and varying levels of hearing instrument technology available today. Additionally, there are many options to purchasing a hearing aid that makes the process seem extremely overwhelming at first. However, once a complete diagnostic hearing evaluation is done, the choice of hearing aid selection becomes a bit easier. Here are some things to consider when making your hearing aid purchase.
First rule of thumb, never purchase a hearing aid without first having a complete diagnostic hearing evaluation. A diagnostic hearing test determines the degree of hearing loss, the possible cause of the hearing loss, whether or not the hearing loss is one that can be corrected medically, either by medication or surgery, or if it is a hearing loss that needs to be managed with hearing aids or other hearing technology, like a cochlear implant.
Secondly, a hearing screening cannot determine if hearing aids are needed. A hearing screen just lets you know whether further testing is needed. If you fail the hearing screen it is simply an indication that there is a need for a complete diagnostic hearing evaluation. There are instances when a hearing aid is not an appropriate recommendation for a hearing loss. Again, only the results of a thorough diagnostic hearing evaluation can make this determination.
A diagnostic hearing evaluation will also validate how much of the speech sounds are affected by the loss of hearing, verifying exactly how much conversational speech as well as environmental sounds can and cannot be heard by the person with the hearing loss. The results of the hearing evaluation are then used as a "prescription" to assist with the proper fitting of the hearing aids if a hearing aid recommendation is made. So the best time to purchase a hearing aid is after you have had a complete diagnostic hearing evaluation, and after hearing aids have been recommended.

Online purchases
Always think twice before purchasing a hearing aid online, from a kiosk in a mall, or from someone who is not a certified audiologist or hearing care professional. Today's hearing aids are small, extremely complex, digital devices that use a tiny computer to process sounds and precisely customize itself to the hearing loss of the wearer. They need to be professionally programmed to the frequency specifications of the person with the hearing loss. The hearing aid programming may include adjustments for background noise, telephone, television, and different listening environments.
Some hearing aids have the ability to automatically switch back and forth between settings as the wearer moves from one place to the next. Keep in mind that new, digital hearing instruments are best fitted when they are in your ears and both you and the hearing aids are simultaneously connected to a computer using cords or wirelessly via Bluetooth connection. The computer then inputs the precise measurements needed into the hearing aids based upon your hearing loss, speech results, the size of your ear cavity, and your subjective requirements.
An online sales person, or a person who has no educational training in the area of hearing care, hearing loss, and hearing aids, is therefore not considered a wise choice when making a hearing aid purchase. Additionally, there is the possibility of such persons selling devices that may be incorrectly programmed and, in fact, may end up causing more damage to your already impaired hearing system.
Another consideration is that online hearing aid purchases do not offer the personalized care needed during and following the fitting of new hearing aids, nor do they provide the managed care needed throughout the extended life of the hearing aid wearer. Think of a hearing aid as you would a car that has to go in for basic oil servicing two to three times a year. Because a hearing aid is worn all day it is subject to earwax, hair oils, sweat, moisture, etc. After a while, this constant wear and tear on the hearing aids makes it necessary to have them professionally serviced, usually about twice a year. If you purchase your hearing aids online, you will need to figure out where you will take it when servicing becomes necessary or when a repair is needed. So think twice before purchasing a hearing aid online.

Where to purchase hearing aids
Audiologists and hearing care professionals receive extensive education and training in hearing, hearing loss, disorders of hearing, and the fitting of hearing aids. They ensure that you are given a comprehensive hearing evaluation and a treatment plan is selected to meet your communication needs. Additionally, when you purchase your hearing aids through an audiologist you ensure appropriate fitting of the device and a proper management plan is established. This includes receiving:
o A comprehensive diagnostic evaluation of your hearing.
o Appropriate selection of the hearing aids.
o Correct ear size measurement.
o Precise computerized fitting of the hearing aids while the aids are in your ear to obtain exact acoustical measurements of the ear cavity, best speech understanding settings, and accurate listening comfort based on your subjective feedback.
o An aural rehabilitation and follow-up plan that meets your communication needs.
o Ongoing servicing and repairing of your hearing aids, if needed.
Purchasing your hearing aids from a certified audiologist or hearing care professional who is specifically trained in the field of hearing healthcare, and who is able to determine a proper management plan for your hearing needs is always the best choice for you to make.

How hearing aids help
Hearing aids make it much easier for you to understand basic conversational speech with people around you. The better you are able to hear them, the more your confidence improves, making conversations less of a struggle for you. This often results in less stress, improved energy levels, and a renewal of social activities that may have been pushed aside because of hearing difficulties.
Hearing aids help improve your ability to hear the everyday sounds of life you may have been missing, like the telephone ringing, birds singing, and tap water running. Hearing aids also help you enjoy listening to music, the TV and radio again.
Hearing aids help in delaying cognitive decline and dementia. And finally, studies show that 91 percent of adults who use hearing aids during all their waking hours, report a significant improvement in their everyday life, and greater satisfaction communicating in their relationships, when compared to adults who have a hearing loss and receive no treatment for it.
Studies also show that the longer an adult with untreated hearing loss waits to be fit with hearing aids, the more it affects his or her ability to understand conversational speech. If the wait is extremely long, like several years, and if speech understanding becomes significantly diminished, the result can lead to limited success once hearing aids are finally obtained. When most adults finally get their hearing aids, they usually wonder why they took so long to get one.

o For further information on any hearing-related disorder, please contact Dr. Deborah Nubirth, doctor of audiology, in New Providence at Comprehensive Family Medical Clinic, Poinciana Drive at 356-2276 or 677-6627 or 351-7902 in Grand Bahama; or email dnubirth@yahoo.com.

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Simple ankle stretches you can do at home

May 09, 2017

One of the most common issues that prevent people from participating in regular physical activity are weak, stiff, or painful ankles. It is often the result of a recent or chronic ankle sprain. Following an ankle sprain, strengthening exercises should be performed until you can bear weight on the ankle comfortably and your range of motion is near full.
There are several types of strengthening exercises. The easiest to begin with are isometric exercises that you do by pushing against a fixed object with your ankle. Once this has been mastered, you can progress to isotonic exercises, which involve using your ankle's range of motion against some form of resistance. You can do isotonic exercises with a resistance or TheraBand, which can be purchased from the pharmacy, a therapist or a sports store.
The following are simple stretches that can be done at home to help ensure that your ankles are strong and remain flexible, and can also help with healing and avoiding injury.

Isometric exercises
The wall stretch: Stand facing a wall with both feet together. Place your hands at shoulder height and width on the wall in front of you. Take a step forward with your right foot so that it is now only a few inches from the wall. Shift your weight onto your right leg and bend at the knee. Keeping both heels on the ground, lean your upper body slowly toward the wall until you feel a good stretch happening along the calf muscles of your left leg. Hold the stretch for 30 seconds. Return to your original position with both feet together. Repeat the stretch, this time putting your left leg forward. Do this exercise three times on each foot.

Toe to wall stretch: To begin this stretch, the heel should be on the ground and the toes on the wall. Place the opposite foot behind you. Keep the legs straight and move the entire body forward. Do not move your upper body forward and stick your backside out. You should feel a very strong stretch in the back of the calf and some stretch in the arch. To increase the stretch, move your heel closer to the wall and increase the angle of your foot. To decrease the stretch, move your heel back and lower your toes. Hold for 60 seconds and repeat 3 times.
Place your ankle in the down and in position against a fixed object such as a couch. Hold this position for a count of 10. Repeat 10 times.
Place your ankle in the up and out position against the same object. Hold this position for a count of 10. Repeat 10 times.

Isotonic exercises
Active flexion: Flex or pull your foot up toward you as high as it will go, hold for a few seconds, then point your toes as far as they will go and hold for a few seconds. Repeat 2 sets of 20 reps on each foot every day to keep ankles mobile. If your ankles are sore or swollen, you can do this gentle stretch while the ankle is iced and elevated if necessary.

Side to side: Flex your foot and begin to rotate your ankle side to side. Begin with rotating your foot so the sole first faces outward, then inward then outward. Another option for this exercise is to move your ankles gently in a circular motion.
Using a resistance band around your forefoot, hold the ends of the band with your hand and gently push your ankle down as far as you can and then back to the starting position. Repeat 10 times.
Tie the resistance bands around a fixed object and wrap the ends around your forefoot. Start with your foot pointing down and pull your ankle up as far as you can.
Return to the starting position and cycle your ankle 10 times.
Tie the bands around an object to the outer side of your ankle. Start with the foot relaxed and then move your ankle down and in. Return to the relaxed position and repeat 10 times.
Tie the ends of the bands around an object to the inside of your ankle and hold your foot relaxed. Bring your foot up and out and then back to the resting position. Repeat 10 times.
Once you have regained the motion and strength in your ankle, you are ready for sporting activities such as gentle jogging and biking. After you feel your ankle strength is approximately 80 percent of your other side, then you can begin cutting or twisting sports.

Proprioceptive exercises for balance, coordination and agility
Stand on one leg with your affected leg on a pillow. Hold this position for a count of 10. Repeat 10 times.
Stand on your affected leg with the resistance band tied to your unaffected leg. Bring your unaffected leg forward and then back to the starting position. Repeat 10 times.
Start slowly and progress to a faster speed for a more difficult workout.
Again, start slowly and increase your speed at your own pace, moving the unaffected leg forward and then back to the starting position.
For a more advanced exercise, swing your unaffected leg behind you and then back.
If you had an ankle sprain or are prone to ankle sprains and you are ready to return to sports or exercise, it is important to stretch and exercise the ankle first to be sure it's ready for exercise and to prevent injury. If you have pain during these exercises, consult your doctor who will review your ankle and may send you back to the physical therapist for professional help with the ankle rehabilitation after a sprain.
You should always consult a physician licensed in all matters relating to your health.

o For more information email foothealth242@gmail.com or visit www.apma.org. To see a podiatrist visit Bahamas Foot Centre on Rosetta Street, telephone 325-2996, or Bahamas Surgical Associates Centre, Albury Lane, telephone 394-5820, or Lucayan Medical Centre on East Sunrise Highway, Freeport, Grand Bahama, telephone 373-7400.

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Poor is a state of mind

May 09, 2017

The late film producer who made the movie "Around The World In 80 Days" and who at one time was married to Elizabeth Taylor -- Mike Todd -- once said the important phrase that is the title of this article, poor is a state of mind. Yes indeed it is. But D. Paul could you please explain what he actually meant by that, because I'm poor, real poor, but it has nothing to do with my state of mind.
Well maybe you don't realize that your state of mind has a whole lot to do with just about everything that happens in all aspects of your overall life. You see, some people live in a poor neighborhood and their parents are poor, they don't have a whole lot of money or material possessions. The sad thing is that so many of these people never get out of living in ghetto conditions simply because they are thinking with a poor state of mind. They feel being poor is normal for them and that they'll never be able to get out of the ghetto.
This is what Mike Todd referred to as a poor state of mind. However, if one does not accept that they have to remain poor and starts to formulate plans in their mind to get out of the ghetto and make something of himself or herself, and thus gets an education and works real hard, they can indeed make it big in life.
Yes my friend, if you perchance have a poor state of mind, you need to immediately replace it with a rich state of mind. Use the wonderful mind that your Creator gave you -- your imagination to actually see yourself as being rich in your mind's eye. Once you develop a rich state of mind and start to work real hard, you will indeed become successful, across the board.

o Think about it!
Visit my website at: www.dpaulreilly.com.
Listen to "Time to Think" the radio program on STAR 106.5 FM at 8:55 a.m. & 6:20 p.m.

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2017 Atlantic Medical Walk: 19 years and counting
2017 Atlantic Medical Walk: 19 years and counting

May 05, 2017

Atlantic Medical Insurance Limited held its much anticipated Annual Fun Run Walk on Saturday April 29, 2017 with many participants enjoying the event, which is just one of several initiatives the insurance...

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LUPUS242 is now officially powered by ALIV!
LUPUS242 is now officially powered by ALIV!

May 05, 2017

Itís a great day to be ALIV! Aliv, The Bahamasí newest mobile network company, is extremely delighted to announce our partnership with LUPUS242...

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Atlantic Medical Fun Run Walk

May 03, 2017

For the past 18 years, Atlantic Medical Insurance Company Limited has hosted the most popular fun run walk event in the country. Once again, this year, the Walk with over 1000 participants took place on Saturday April 29th at Montagu Beach...

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