Story by Megan Whitehead | Jan 01, 2018

Local doctors discuss the importance of wellness and their tips for staying healthy.

If you’re like most, you’re looking toward 2018 wanting to be healthier. Whether you’ve decided to start a new workout routine or diet, cut out an unhealthy habit, or find ways to improve your overall wellness, it can be overwhelming to seek the best way to start the new year right.

Physicians from Capital Region Medical Center, Jefferson City Medical Group, and SSM Health St. Mary’s Hospital want to help you in your wellness journey with their expertise and tips for being well — from head to toe.

Brain

As we age, the diseases and disorders of the brain become more and more prevalent. Memory loss is a huge concern for most Americans, including diseases like dementia and Alzheimer’s. There is a silver lining, though. Day to day, there are ways to help diminish our chances of developing these problems. “General health is very important for the brain,” says Dr. Ruthanna Hunter, Capital Region Physicians – Neurology. “We are learning more and more about the role genetics play in our brain, but also how our lifestyle can affect it. There are genes we have that can lead to certain diseases, but our lifestyle can also impact whether or not those genes are activated. There are things we can do, even if we have one gene for a disease, to keep our brain healthy so years down the road we won’t have Alzheimer’s, strokes, or other disorders.”
Strokes are indeed a major concern for many patients. “It’s very important to monitor things like high blood pressure, high cholesterol, and diabetes,” says Hunter. “While those things can be hard to manage, because we don’t see the impact of those diseases until years down the road, it’s critical to never miss doses of medication. What that’s doing to the blood vessels in your brain when your blood pressure is high or your blood sugar is not controlled — it’s damaging the walls of the blood vessels. Over time, that damage leads to things like strokes.”
Additionally, sleep apnea is a major risk factor for strokes. “More than 70 percent of patients who have strokes have sleep apnea,” says Dr. Hunter.
Dr. Hunter also stresses the importance of seeing a neurologist for headaches. Too often, people with chronic headaches write off their pain as simply sinus or stress headaches. More often than not, their symptoms are indicative of migraines. “If you are dealing with untreated migraines, it could lead to depression and other things that negatively affect your life,” says Dr. Hunter. “There’s something we can do about it to make your life better and help you enjoy your life.”

Dr. Hunter’s Tips:
Exercise
Eat right
Read
Socialize
Play games (brain teasers, card games, etc.)
See your primary care physician to manage risk factors

Ears

Due to modern technology — technology that can be extremely loud — and other factors, hearing loss is becoming a more prevalent problem than ever before. Dr. Keri Salvatore, Capitol Region Physicians – ENT and Audiology, is working to prevent and fix this problem. “Hearing loss has been linked to a lot of issues we need to be aware of, like cognitive decline, dementia, and depression,” she says. “Hearing loss is the third most common chronic health condition in the U.S. It affects 36 million Americans.”
Early detection of hearing loss is key. Untreated hearing loss can lead to fatigue, stress, depression, social withdrawal, increased risk to personal safety, and more. “Older adults with hearing loss are more likely to experience cognitive decline,” says Dr. Salvatore. “In fact, hearing loss was recently identified as the highest potentially modifiable risk factor for dementia — higher than diabetes, hypertension, obesity, physical inactivity, depression, and smoking.”
Dr. Salvatore stresses that we’re all going to lose at least some of our hearing at some point in our lives. “I’ve never tested anyone over the age of about 64 who hasn’t had some degree of hearing loss,” she says. “It’s going to happen. A healthy lifestyle can help minimize some of that, but the best thing you can do is not wait until the point where you stop participating in conversations.”
A big concern of audiologists like Dr. Salvatore is the misconceptions associated with hearing aids. Too many people allow hearing loss to develop past a point of no return because of this. “People assume all hearing aids are huge and bulky, and they don’t want everyone to know they have a hearing problem,” says Dr. Salvatore. “I try to impress upon patients that it’s much more obvious when you’re not participating in conversations than a tiny little hearing aid behind your ear is.”
As far as expenses go, there are many price points for different levels of technology, and payment plans are always available. Plus, the technology of hearing aids has expanded enormously in recent years — the bulky pieces are nearly a thing of the past.

Dr. Salvatore’s Tips:
Wear hearing protection (If it hurts your ears, it’s too loud)
Keep headphone volume at 50 percent or below
Start seeing a doctor for hearing loss at age 50 (even if you don’t notice symptoms)

Sinuses and Airways

Dr. Reese Thompson is an ENT at Jefferson City Medical Group. As an ENT, he deals with all the structures of the head and neck, the upper airway, ears, nose, sinuses, and oral health. All these, as Missourians know thanks to our horrible allergy seasons, can present issues.
From Dr. Salvatore, we know the importance of keeping our hearing intact, but Dr. Thompson wants to drive home the idea of watching how today’s tech affects our hearing. “With the advent of MP3 players, we’re seeing hearing loss develop in younger patients because of incorrect use,” he says.
In addition, Dr. Thompson sees a lot of patients for simpler things, like build up of earwax. “One of the things we recommend to patients is just simply flushing the ear gently maybe once a week with plain white vinegar,” he says. “If you don’t have any underlying ear problems, this can help keep the ears clean of unwanted organisms and excessive wax and things like that.
“As far as things like the airway,” he continues, “there are new, interesting techniques for helping patients with obstructive sleep apnea.” This is a problem occurring more and more in recent years, and can significantly increase your risk of heart disease, respiratory problems, and death.
To aid in this problem, Dr. Thompson has some advice: “Some things you can do would be to treat any underlying or associated conditions such as hypertension, diabetes, and others.”
For your nose, Dr. Thompson stresses reading the instructions on nose spray for daily versus temporary use. “Decongestant spray says it right on the box — do not use it for more than three days without consulting your physician,” he says. “Prolonged use of those sprays on a daily basis will damage the lining of the nose. We frequently recommend to our patients for nasal and sinus health a regular irrigation with a salt water solution. It naturally decongests the nose and flushes out allergens.”

Dr. Thompson’s Tips:
Be cognizant of noise exposure for you and your children
Avoid excessive consumption of alcohol
Reduce nicotine consumption
Monitor caffeine consumption
Maintain a healthy weight
Exercise regularly
Do not — repeat, do not — use cotton swabs in the ear excessively
Avoid ear candles

Heart

Dr. Allyson Walker at SSM Health St. Mary’s Hospital would prefer to not see you. Don’t be offended — she’s a cardiac surgeon, so seeing her means you already have a significant problem. “Usually by the time people see me, they’ve already been in a place where medications and less invasive procedures have not worked,” she says. “So if you want to be in a place where you don’t get to see me, that’s where the importance of heart health comes in.”
Unfortunately, genetics plays a huge role in heart health. However, there are ways we can live our lives to lower our risks. “I tell folks it’s like building on sand,” says Dr. Walker. “If the genetics is sand, and you’re already on shaky ground, you can’t blame genetics when you start building on top of that shaky ground.”
One of Missouri’s biggest risk factors for heart problems is smoking, and not just cigarettes. “It’s also e-cigarettes,” says Dr. Walker. “It’s not simply the carbon and particulate matter in the cigarette itself — it’s also the nicotine. Nicotine has a really significant vasoactive component which hardens the arteries. Simply going from old-fashioned cigarettes to the new vapes does not help. You need to stop smoking altogether.”
A good way to avoid Dr. Walker’s office is regularly seeing your primary care physician. Something Dr. Walker hears often is “I was perfectly healthy until I got here.” She says this is not true 99 percent of the time. “If you take a look at their statistics, they weren’t,” she says. “People just feel good until they don’t.”
Also, if you’re on medication for blood pressure, cholesterol, or diabetes, it’s very important to continue taking that medication, even if you’re feeling better. “You’re feeling better because the medication is doing its job,” says Dr. Walker.
“There’s only so much a physician can do,” she continues. “You may get to a point where there is nothing we can do for you to get you to a lifestyle where you want to be because science has its limits. You have to help us help you. If the need arises for you to undergo cardiac surgery, we are here to help.”

Dr. Walker’s Tips:
Stop smoking
Exercise (minimum 30 minutes a day)
Eat healthy, with plenty of colorful vegetables and very few fried foods
Go to your primary care physician regularly

Lungs

We hear it all the time: exercise is important. But Dr. Mohammad Jarbou, MD, pulmonologist at SSM Health St. Mary’s Hospital, can’t stress its importance enough for general and lung health. “The more you exercise, the more you benefit,” he says. “To have it be part of your daily routine is priceless. If you cannot go to the gym, you need to at least do daily walking, using the stairs instead of the elevator. Even dancing is considered a good physical activity.”
Another important aspect of lung health is, obviously, avoiding exposures. “Number one is smoking,” says Jarbou. Smoking can cause lung disease by damaging the lungs’ airways and is the main cause of chronic obstructive pulmonary disease (COPD). Also, cigarette smoking causes most cases of lung cancer says Dr. Jarbou. “Smoking lung diseases are the number one reason for people coming to see me in the clinic. Second hand smoke can be just as bad as smoking itself.”
Asthma is another common medical problem. Dr. Jarbou believes that allergen avoidance is an essential part of effective allergy and asthma management. Living in Mid-Missouri exposes us to multiple allergies. “It’s a very common problem,” says Dr. Jarbou. “Allergy and asthma management can be tricky. We don’t want our patients to live in a bubble. We don’t want them to stay away from everything. We live in Mid-Missouri, so there are going to be environmental allergies. There’s a simple maneuver we recommend, and I think everyone should do it – nasal irrigation. I tell most of my patients, if you live in Mid-Missouri, you should do it like brushing your teeth, on daily basis.”
Dr. Jarbou has another call-to-action for us as well: if you experience any abnormal breathing symptoms, see your primary physician immediately. “If patients are experiencing persistent cough, wheezing, night symptoms, or anything disturbing their daily life, they need to be seen,” he says. “We also like to recommend people buy local products, like honey, to help with allergies.” That’s a simple diet change that can help reduce allergy symptoms.

Dr. Jarbou’s Tips:
Exercise
Do not smoke
Regular nasal irrigation
For patients with severe allergy symptoms: Avoid curtains, carpet, and pets (particularly cats and birds) in the bedroom; wash your comforter once a week in hot water; vacuum once a week

Stomach

“The most important thing I do is screen for colon cancer,” says Dr. Sara Echelmeyer, gastroenterologist at Jefferson City Medical Group. “That’s huge for us because colonoscopy allows us to not only screen, but also detect and prevent cancer.”
Dr. Echelmeyer also urges her patients to understand that the brain and the stomach are very closely related. “When you’re stressed or anxious, a lot of that plays in your gut,” she says. “The same receptors in your brain are also in your intestines. So that stress and anxiety may seem well controlled, but it’s creating problems in your stomach. It’s important to understand that physiology, because it really affects people. It can cause diarrhea and constipation.”
Fortunately, there are a few ways to relieve the stress or anxiety affecting your stomach. Finding a way to meditate that works for you, exercising regularly, and eating well can really help control those symptoms.
“In my field, one of the most important things to do in your daily life is eat well,” says Dr. Echelmeyer. “Eat foods high in fiber, eat fruits and vegetables, and avoid a lot — not all — of red meat. Also, avoid tobacco. Tobacco increases all risks of colon cancer.”
Another important aspect of stomach health is managing daily stressors and anxieties as much as possible. While it’s impossible to completely avoid these problems, there is a big difference between normal stress and excessive stress. If you’re feeling overwhelmed, or nearly there, it’s important to take a few moments to unwind. Whether you’re simply stepping outside for some fresh air or taking a half hour to watch an episode of your favorite show on Netflix, clearing your mind is also clearing your gut of the damaging effects of excess stress or anxiety.

Dr. Echelmeyer’s Tips:
Have your first colonoscopy at age 50, then every 10 years thereafter
If you have a family history of colon cancer, go earlier
If you’re African-American, go at age 45
Manage stress and anxiety through meditation
Exercise
Eat healthy

Spine

“The spine is a big deal to people,” says Dr. Jeff Lehmen, a spine surgeon at SSM Health St. Mary’s Hospital. “This is simply because it affects our quality of life so much. We’ve all had knee pain, hip pain, and ankle pain, but I think when someone truly has neck or back pain, it can be very debilitating. If you don’t have your neck or your back, you can’t really do much.”
With neck, back, and nerve pain being so common and incapacitating, Lehmen is excited about the new technology and minimally invasive techniques becoming increasingly available. “Now you’re able to offer people surgery where they’re not going to have a year recovery and be in a nursing home for three to four months like it used to be,” he says. “You can actually operate on someone in their mid- to late-80s and expect a good outcome.”
It may or may not surprise you, but one thing Dr. Lehmen highly recommends for keeping your spine healthy is avoiding smoking. “I can look at an X-ray, look at [the patient’s] age, compare the two, and I can tell if they’ve smoked or not because everything degenerates much quicker,” he says.
Something that gives doctors like Dr. Lehmen a lot of concern is “phone neck.”
“Everybody is in a forward — what we call a positive sagittal — balance, so everybody is forward these days,” says Dr. Lehmen. “That puts a lot of stress on your neck and back.”
An interesting issue spinal specialists have found is a correlation between tight hamstrings and back pain. Therefore, Dr. Lehmen recommends stretching, particularly your hamstrings, if you’re having mild back pain. Yoga is also great for relieving pain. “Flexibility is always your friend,” he says.
As far as chiropractic care is concerned, Dr. Lehmen says, “I think it is fine.” He recommends seeing a specialist, though, if the pain continues. Chronic pain is almost always indicative of a deeper problem.

Dr. Lehmen’s Tips:
Don’t smoke
Exercise (keep your core strong)
Watch your posture
Stretch often
Watch your weight

Bones

“Orthopedic medicine’s purpose is to provide excellent care for any type of muscular, tendon, bone, or any other type of injury we see with athletes or the general population,” says Dr. Bradley Sloan, family and sports medicine physician with Jefferson City Medical Group.
“From my perspective, as a non-operative provider of the orthopedic group, I’m big into the prevention of these types of injuries,” he continues. “In the Jefferson City community and the surrounding areas, we’re huge sports fans. So, we see a lot of the athletes in the area, and we talk about early prevention of injuries we see during their seasons.”
What does this prevention look like? If you’re an athlete or are anticipating a very active period, prepare a few weeks early with exercise and stretching. For the general population, as well, always remember to eat and sleep well, and stay as active as you can. An object in motion stays in motion, right? The same is true for our bodies. The more stagnant we are, the more likely we are to injure ourselves when we have to be active.
An important aspect of this is picking activities that are appropriately challenging — meaning don’t push too hard. “We talk a lot about the different types of programs folks can get involved in in the area, from swimming to yoga and a lot of the non-weight-bearing stuff as we get older,” Sloan says.
For athletes and more active people, Sloan has been working with new strides in regenerative medicine — a minimally invasive and technologically advanced method of healing muscle, tendon, and bone injuries — for the last 12 years. “I now do platelet therapy where we use our own platelets to heal tendon issues like tennis elbow or plantar fasciitis,” he says. “Then we have umbilical cord stem cells, which we get from a lab in Utah. We can use these cells to repair almost any kind of bone, cartilage, or muscle injury. It’s pretty exciting.”

Dr. Sloan’s Tips:
Eat well
Sleep well
Stay active to your ability level
Prepare well for strenuous activity

Feet

Easily ignored but equally important to our overall health are our feet. Too often, people ignore foot pain, assuming it’s simply a part of life that will go away eventually. This is a major concern for Dr. Jonathon Strong with Capital Region Physicians Podiatry. “Our feet are our base, our mode of transportation,” he says. “People neglect them a lot, and, ultimately, people struggle with chronic pain, and they don’t have to. Foot pain is not normal. If you’re having pain, you need to seek treatment.”
He continues: “When people develop a sudden onset of pain, swelling, or redness, these are the signs something is wrong. Those kinds of things can lead to delayed healing and can make them harder to fix.”
Most people don’t go to podiatrists unless they already have a problem (for example, chronic pain, injury, diabetic ulcers, etc.), although preventative medicine does play a major role in podiatry. Podiatrists treat everything medical or surgical related to the foot and ankle, including skin, bones, ligaments, tendons, and more.
While everyone should keep an eye on their feet, it’s vital for people with autoimmune diseases, like diabetes, to take extra precaution. Autoimmune diseases can hinder the healing processes and eventually cause nerve damage if they’re not well controlled. “Nerve damage or decreased feeling in your feet can also be caused by vitamin deficiencies, a thyroid problem, or a pinched nerve in the lower back, among other less common problems,” Strong says.
There are more obvious health issues to consider too. If you have a cut, blister, or other foot wound, immediately disinfect and cover the area, then see a doctor. “Of course, if you’ve got great blood supply and no other health conditions that you’re worried about, keeping it clean and covered until it heals is fine,” Strong adds. “If it’s not better in a week or two, or if it becomes red, swollen, or painful, see your physician. It’s a lot easier to take care of or treat something if you treat it sooner than later.”

Dr. Strong’s Tips:
Check your feet everyday
Keep your feet clean
Wear supportive, properly fitted shoes
Moisturize
Stretch and exercise