Revisit value and timing of hormone therapy

By David Martin, RN, CEO and President, VeinInnovations

Heading into the holidays, mothers and grandmothers across America ponder recipes between meetings and deadlines, paying bills, and polishing silver. At the same time, many of these women, despite the brave and welcoming front, fight depression and anxiety, and are self-conscious about having packed on a few more pounds since last year. Trying to handle holiday angst on top of regular life, especially with interrupted sleep, has them more emotionally charged than they were, say, five years ago. At the root of much of this oftentimes unspoken stress is the change most women dread: menopause.

A recent NPR report highlighted the ongoing blowback of a shocking and incomplete study that put the kibosh on what was thought to be the fountain of youth that would effortlessly take women through menopause.

The Women’s Health Initiative, published in 2002, found that taking estrogen plus progestin actually increased a woman’s risk of breast cancer and heart disease. Almost overnight, about half of American women taking hormones stopped, cold turkey. According to the NPR report, in women ages 50 and over, today only about 10 percent of women are on hormone therapy.

Paul Cox, an Atlanta physician specializing in anti-aging medicine and bio identical hormone replacement, says the report did an incredible disservice, as it focused only on two medications.

“I’m glad to see that people are now looking at the data instead of just reacting to this 14-year-old study that only applied to Premarin and Prempro, and does not at all apply to the proven benefits of bio identical hormone replacements,” said Cox.

“When women hit menopause, their ovaries cease to function and they lose their primary source of estrogen, progesterone, and testosterone. It is a catastrophic failure of three hormones at one time.  Little wonder there are so many physiological effects,” Cox said.

“The key is to understand that all hormone replacements are not created equally. The drugs studied in the Women’s Health Initiative – Premarin and Prempro – were made from horse-derived estrogen plus a progestin. Progestin was invented for birth control, which came with warnings for an increased risk of cancer and heart disease,” Cox continued.

“More recent studies show that when estrogen is used in combination with bio-identical progesterone – not progestin – there is no increase in breast cancer or heart disease, “ Dr. Cox added.

Dr. Wulf Utian, Director of the North American Menopause Society, would agree with Cox that reaction to the 2002 study was a huge overreaction. According to Dr. Utian, another significant finding from the more detailed analysis also showed that the age at which a woman started hormone therapy had an impact on reducing the risk of heart disease.

One of the lead investigators of the study, Dr. JoAnn Manson, a professor of medicine at the Harvard T.H. Chan School of Public Health, said findings show starting therapy between the ages of 50 and 59 delivers a protective benefit.

“Women who take hormones earlier after the onset of menopause may experience less plaque, blood vessel blockage and atherosclerosis, and possibly even a reduced risk of heart attack. But for women over the age of 60, the benefit seems to disappear. This is probably because older women already have plaque buildup,” Manson says.

Starting hormone therapy earlier has a greater benefit still, according to a study done in Denmark. Women who started hormone therapy between the ages of 45 and 58  “significantly reduced their risk of mortality, heart failure and heart attack,” according to this study of 1,000 healthy women.

Cox agrees wholeheartedly, saying there are clear benefits for women who begin hormone therapy earlier, especially if they can begin within five years of menopause.  Saying many of the benefits “go far beyond controlling hot flashes,” Cox adds that starting bio identical hormone therapy early also helps reduce the risk of bone fractures, diabetes, and “brain fog.”

“It’s a great idea to do a baseline check of women in their mid-thirties or earlier, and to check against that periodically so we can be prepared to help prevent or ease those symptoms of hormone deficiency: weight gain, anxiety, sleeplessness, memory issues, hot flashes, and night sweats.

“Many women treated with estrogen and progesterone in perimenopause will clear up a host of issues. And while it is not an FDA approved treatment in the U.S., the standard of care in Europe and Australia is to replace the physiologic levels of testosterone, too. Testosterone is calming. It helps with brain function and libido. It is also important for lean muscle mass and bone health,” Dr. Cox added.

“One of my patients told me, after she started treatment, that she now tells her friends to forget their nail appointments and hair appointments. The most important appointment to make is to get their hormones right,” said Cox.

Perhaps one of the healthiest gifts a woman can give herself this holiday season is a check of her hormones, and a fresh look at hormone therapy.


Hormones May Help Younger Women With Menopause Symptoms

Paul E. Cox, MD, MS

North American Menopause Society

Effect of hormone replacement therapy on cardiovascular events in recently postmenopausal women: randomised trial

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True costs of alcohol addiction elusive; Atlanta has many supports.

By David Martin, RN, CEO and President, VeinInnovations

The estimated $249 billion dollar hit to the nation’s economy caused by excessive alcohol use in the U.S. in 2010, as reported in a recent Centers for Disease Control report, doesn’t begin to cover the true costs of this epic problem. According to Atlanta addiction experts, there are myriad ways peoples lives are affected by the alcohol abuse of others.

“This in no way begins to estimate the cost, on a personal level, of people drinking excessively,” said Thomas Bradford “Brad” Johns, M.D., and medical director at Atlanta’s Ridgeview Institute.

“Just in grief and suffering and emergency room visits – the indirect costs are hard to measure.  It’s estimated that each alcoholic affects 75 other people around him.  That impact ripples through healthcare market in so many ways: illnesses, interventions, the need for family and individual therapies.  Not to mention the cost of accidents caused by drunk drivers.  It is hard to measure all the social ramifications of this biological disease,” Johns said.

Another Atlanta-area resident, Robert Anda, MD, MS, formerly of the CDC, has spent a career looking at the cost of adverse childhood experiences, one of which is growing up in a home where there is alcohol abuse. Anda and has written much about the original Adverse Childhood Experiences (ACE) Study as he and his and his colleagues have studied the long-term health impact of these experiences.

One of Anda’s colleagues, Dr. Vincent Felletti, wrote of the ACE Study that it “reveals a powerful relationship between our emotional experiences as children and our physical and mental health as adults, as well as the major causes of adult mortality in the United States. It documents the conversion of traumatic emotional experiences in childhood into organic disease later in life.”

Estimates are that as many as one-in-four children in the U.S. experiences living in a home adversely impacted by alcohol abuse, and that these children are many times more likely to have issues with alcohol themselves.

Atlantans who are ready to get help with alcohol abuse are fortunate to have a “robust offering of treatment centers and supports available,” according to Johns.

In addition to scores of treatment centers, including well-known centers such as Ridgeview, Talbots, Charter Peachford, and Black Bear Lodge in Dahlonega, there are nonprofit, community based centers such as the Atlanta Union Mission, which has a variety of programs.

Further, Johns is quick to point out that Alcoholics Anonymous, which is free and open to anyone with a desire to stop drinking, has, literally, hundreds of meetings available in the Atlanta area.

According to the AA website for Atlanta, there are more than 1100 weekly meetings available in the metropolitan Atlanta area. For family members of people who abuse alcohol, or who may be alcoholics, there are hundreds of Al-Anon and Al-Ateen support group meetings.

“The good news is that addiction is an illness that can be treated. It’s not hopeless situation. Treatment is available.  People do get sober all the time. They can heal,” Johns added.

Resources include:

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CDC Report on the High Price of Alcohol

By David Martin, RN, CEO and President, VeinInnovations

A new report by the Centers for Disease Control takes a topline look at the high cost of excessive alcohol use in the U.S., detailing the impact on workplace productivity, crime, and the costs associated with treating people for the plethora of health concerns caused by over-imbibing.  There are other costs as well, not the least of which is that one-in-ten deaths among working aged Americans (ages 20-64) can somehow be attributed to excessive alcohol use.

Focusing on the economics of the report, the study reveals an estimated a $249 billion wallop to the nation’s economy caused by excessive alcohol use in 2010. This was up significantly from the prior study’s estimate of $223.5 billion in 2006, a disturbing trend to say the least.

Drink by drink, that means every alcoholic beverage consumed in 2010 cost the economy $2.05, whereas the per-drink cost in 2006 was $1.90. The state with the highest cost to the economy per drink in 2010 was New Mexico, at $2.77 a drink.

How are those costs estimated?

CDC researchers look at reduced productivity in the workplace, crime associated with excessive alcohol abuse, and the high cost of treating people whose health problems are caused or exacerbated by excess alcohol consumption.

For men, drinking five or more drinks at one time, and for women, four or more drinks – the practice called binge drinking – put 77 percent of the costs on the tab. Who is paying those costs?  More than $100 billion  — two out of every five dollars – was paid by your taxes.

The fact that people were drinking more from 2006 to 2010, in light of the economic downturn during that time, was of special concern to the head of the CDC’s Alcohol program, Robert Brewer, M.D., and M.S.P.H.

“The increase in the costs of excessive drinking from 2006 to 2010 is concerning, particularly given the severe economic recession that occurred during these years. Effective prevention strategies can reduce excessive drinking and related costs in states and communities, but they are under used,” said Dr. Brewer, who was also one of the authors of the study.

With regard to deaths caused by alcohol, he reported alcohol consumption as being responsible for an average of 88,000 deaths a year, which translates to be one in 10 deaths among Americans ages 20-64: working aged Americans.

Breaking the costs of excessive alcohol use down further, the range paid by state went from $488 million in North Dakota to $35 billion in California, with the median for all states and the District of Columbia coming in at $3.5 billion. This means that in Washington, D.C., economic cost of a person who drank excessively was $1526, as compared to the national average of $807.

The CDC explains that 2010 figures were derived by looking at the occurrence of alcohol-related problems in 2010 and the cost of paying for them, vs. the same figures for 2006.

Even though difference was significant, researchers believe that the study “underestimates the cost of excessive drinking because information on alcohol is often underreported or unavailable, and the study did not include other costs, such as pain and suffering due to alcohol-attributable harms.”

The costs of pain and suffering are much harder to calculate, but we will take a look at those, and some local organizations working to raise awareness of problems caused by excessive alcohol use, in “Live Healthy Atlanta” columns to come.

For more information:

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Your brain, strokes, and Atlanta’s Designated Stroke Centers

By David Martin, RN, President and CEO of VeinInnovations

The Medulla Oblongata comprises the lower part of the brainstem (the upper part is called the Pons), and contains, among other things, the centers for respiration, cardiac function, and vomiting (yes, there really is a vomiting center).

Other autonomic (involuntary) reflexes such as heart rate, blood pressure, coughing, swallowing, gagging, and sneezing also reside here, making this a completely necessary structure for life.

Sounds crazy, but without the Medulla, we would not even survive going to sleep since we wouldn’t remember to breathe, or keep our hearts beating. In fact, these are among the reflexes neurologists test for when establishing brain death.

A common cause of brain death is stroke, which is the fourth-leading cause of death in the U.S. One person dies of a stroke every four minutes, but one person in the U.S. has a stroke every four seconds! That works out to be about 800,000 strokes in the U.S. annually. Only heart diseasecancer and chronic lower respiratory diseases are more deadly.

Strokes happen when there is a problem with the blood supply to the brain. A ruptured blood vessel in the brain or a blockage in blood supply to the brain cause this medical emergency, which requires immediate medical attention. The faster someone is treated for stroke, the greater the likelihood that he or she can limit the damage. If a person whose stroke is caused by a blockage is treated with tPA (tissue plasminogen activator) within 4.5 hours, their chances of returning to normal increase by 30%. (Know, however, that tPA only works in strokes caused by blockage; in strokes caused by a brain bleed, tPA could cause additional bleeding.) Unfortunately, recent studies show only about 4% of stroke victims who could benefit from the drug actually receive it. That is why it is so important that people not ignore the signs of a stroke, and that they seek treatment immediately if a warning sign is suspected. Too often warning signs are passed off as “just feeling strange,” or as problems that will go away on their own. For your sake, and for that of your loved ones, it is important to remember the acronym FACE to be able to recognize stroke symptoms:

  • FACE: Ask your loved one to smile. Does one side of his or her face droop?
  • ARMS: Ask your loved one to raise both arms. Does one arm drift downward?
  • SPEECH: Ask your loved one to repeat a simple phrase. Does his or her speech sound slurred or strange?
  • TIME: Time is crucial. Call 9-1-1 immediately if you or your loved one has any of these symptoms.

With regard to the medulla oblongata, a brain stem stroke can have complex symptoms, and can be difficult to diagnose. Vertigo, dizziness, and severe imbalance – without the classic stroke symptom of weakness on one side of the body – may be signs of a brain stem stroke. According to Dr. Richard Bernstein, assistant professor of neurology in the Stroke Program at Northwestern University in Chicago, the symptoms of vertigo, dizziness, or imbalance usually occur together; dizziness alone is not a sign of stroke. Brain stem stroke can also cause double vision, slurred speech, and a decreased level of consciousness.

Even though all motor control for the body, as well as all basic activities of the central nervous system, including consciousness, flow through the brain stem, it is possible to treat a brain stem stroke. Says Dr. Bernstein, “These complications are often predictable and, with prompt recognition, can be treated. If complications are dealt with quickly, there is a good chance of recovery.”

Brain stem stroke risk factors are the same as those for strokes in other areas of the brain, and include diabetes, high blood pressure, heart disease, atrial fibrillation and smoking. Further, brain stem strokes are like strokes in other parts of the brain, as they can be caused by a clot or a hemorrhage. In rare instances, an injury to an artery due to sudden head or neck movements could cause a brain stem stroke.

Atlantans are fortunate with regard to having more than twenty Primary Stroke Centers in the area, among them being the Emory Comprehensive Stroke Center, the Marcus Stroke and Neuroscience Center at Grady Health, DeKalb Medical Stroke Center, the Northside Hospital Stroke Center, and the WellStar Stroke Center.

For more information, visit these links:

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The Boss of Your Body

By David Martin, RN, President and CEO of VeinInnovations

The pituitary gland is an endocrine (hormone secreting) gland nestled in at the base of the brain, resting in a small, bony cavity known as the sella turnica.

This tiny gland is the size of a pea, and weighs in at around 0.5 grams, but don’t let its miniscule size fool you. This overachieving little guy secretes no fewer than nine different hormones that regulate homeostasis: our normal bodily functions. It is, in many ways, the boss of your body.

For starters, the pituitary gland controls growth hormones, and regulates your thyroid gland, which controls metabolism. It also controls the adrenal glands, which sit atop your kidneys and control your body’s response to stress.

Most people are surprised to find out, however, that their pituitary gland also controls the sex organs – the testicles in men and the ovaries in women – that basically result in sexual drive, sexual growth and development, and sexual function and reproduction.

On top of all of this, the pituitary gland also produces prolactin, the hormone that regulates production of breast milk.

Likely suspect not often investigated

While the pituitary gland regulates many functions, it is, unfortunately, not often suspected as being the primary cause of problems leading people to visit their physicians.

For example, weight problems, or a woman’s period stopping, or fatigue, can be symptoms of many different conditions. But most physicians will look at scores of other causes before they would look at an underlying problem with the pituitary gland.

According to Lewis Blevins, MD, of the California Center For Pituitary Disorders, and a former professor at Emory Medical School, “It really behooves the doctor to consider pituitary diseases in the list of possibilities, but unfortunately the exposure to endocrinology in medical school is very little during the first and second years, and then only occasion throughout the third and fourth years. And as people get into their training after medical school, if they have an occasional patient with endocrine disorder, maybe they learn something about the disease process, but generally speaking, most physicians do not have a great exposure to endocrinology, and I think that contributes to the fact that they disease processes are really and truly under diagnosed.”

Expert believes incidence of pituitary disease is one in five

According to Dr. Blevins, pituitary disease is typically diagnosed in about 18 people out of 100,000. But that number is, literally, more than a thousand times too low. He believes the number is closer to 20,000 people per 100,000, or one in five.

“If you look at magnetic resonance imaging, or MRI studies of the brain, as many as one in 10 patients will have what radiologists think could be a pituitary tumor. We do know that one in five people will have a pituitary tumor diagnosed at autopsy if they die of some other reason, and have their pituitary looked at under the microscope. Then we find that t one in five people can have a pituitary tumor, and many of those were undiagnosed during life.

“However, if you look at the medical records of those patients, you see that sometimes those patients had irregular menses and had a prolactinoma (benign tumor) diagnosed at autopsy. So I think that there’s this wide chasm of 18 per 100,00 to 20,000 of 100,000 who are not being diagnosed, because it’s just not registering with the physicians or with the patients that there might be a problem.”

Dr. Blevins says irregular periods and erectile dysfunction are so common that doctors often don’t go further than prescribing hormones or Viagra, because too often neither the physician or the patient asks “why” there is a problem, but instead skips ahead to the “what are we going to do about it” question.

“Men are given a prescription for Viagra just because it’s quick and easy. The doctor can get to the next patient. What needs to happen there is the physician needs to figure out why does this man has erectile dysfunction, and then in the process of evaluating that if the testosterone level is low, figure out why the testosterone is low. If the testosterone is low and if it’s a pituitary tumor, you arrive at that diagnosis rather than just simply giving, several steps removed, a prescription for Viagra and sending the patient on their way.”

Dr. Blevins sees much the same treatment for patients with sleep apnea, hypertension, diabetes, and weight gain. Hey says many of those patients may have metabolic syndrome, or Cushing’s syndrome, caused by a pituitary tumor.

Fortunately for Atlantans concerned about problems with the pituitary gland, Emory Healthcare has a one of a the handful of medical centers recognized for excellence in treating pituitary disorders, as well as one of the premier research facilities. Emory Pituitary Center, which is led by Nelson Oyesiku, MD, PhD, FACS, has performed more than 2,000 pituitary adenoma surgeries, and oversees a tumor bank containing more than 600 pituitary specimens.  The Center belongs to the prestigious Pituitary Network Association, which develops uniform standards for early diagnosis, surgery, radiation, pharmacological treatment and follow-up of pituitary diseases.

This is good to know, should you ever suspect the boss of your body is working double time, or sleeping on the job.



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Torrential rains give rise to a couple of concerns: car caution in floods; keeping watch on proliferation of mushrooms with children and pets.

By David Martin, RN, President and CEO of VeinInnovations

Relentless torrential rains plaguing the East Coast for days two weeks ago bring to mind many health concerns, including the hazards of flooding, and the dangers of our sudden profusion of mushrooms.

With regard to the dangers of flooding: one needs look no further than South Carolina. There have been 17 deaths so far; in Richland County alone sevens deaths were blamed on people trying to drive though flooded streets. Little wonder the State law enforcement keeps promoting the warning:  Turn Around Don’t Drown.

From the National Weather Service:

Each year, more deaths occur due to flooding than from any other thunderstorm related hazard. The Centers for Disease Control and Prevention report that over half of all flood-related drownings occur when a vehicle is driven into hazardous floodwater. The next highest percentage of flood-related deaths is due to walking into or near floodwaters. People underestimate the force and power of water. Many of the deaths occur in automobiles as they are swept downstream. Of these drownings, many are preventable, but too many people continue to drive around the barriers that warn you the road is flooded. A mere 6 inches of fast-moving floodwater can knock over an adult. It takes just 12 inches of rushing water to carry away a small car, while 2 feet of rushing water can carry away most vehicles. It is NEVER safe to drive or walk into floodwaters.

When the torrential rains hit Atlanta in 2009, ten Georgia residents died. Eight of those died driving across flooded roads. The National Weather Service Weather Forecast Office says  “improved forecasting tools and greater availability of real-time data – such as flood inundation mapping and increased river gage density – should aid hydrologists, meteorologists and decision makers when the next big flood strikes.”

Still, as Fall – historically our wettest season – progresses, and global warming seems to evoke even more extreme weather, South Carolina’s battle cry of Turn Around Don’t Drown, sounds like a good thing to remember for Georgians – and all other Americans – as well.

With regard to mushrooms: if your yard is anything like mine, the eight or so days of non-stop rain gave rise to a proliferation of many different types of mushrooms. Atlanta is in a prime location for the growth of all manner of fungi. The good news is we are not in a drought. The concern is that of all the thousands of species of  mushrooms that grow in Georgia, there are probably more than 100 species that are poisonous, and with all the rain, there are more mushrooms of every kind.

Within hours of noticing all the “new” mushrooms in my yard, news came out that no doubt saddened many pet lovers. Dwayne Johnson, AKA The Rock, of action-hero fame, had recently taken to posting amusing stories about his two French bulldogs, one of which seemed to constantly be in some type of peril. Recently the peril-prone pup, Brutus, found and ate poisonous mushrooms in Johnson’s yard, and Johnson mournfully posted the sad news that Brutus would not survive the poisoning.

As any veterinarian will confirm, dogs will eat anything.  As almost any parent will confirm, if a toddler can get it into his hand, a toddler will put it in his or her mouth. So if you’ve spotted a new outcropping, it pays to check the yard for mushrooms, remove them, and dispose of them safely before letting the children or the dogs out to play.

Many types of mushrooms will make a child or dog very ill. But the most common poisonous mushroom is the Amanita, nicknamed the “Death Cap.” It is mostly white, with a flat edge on top and white gills underneath. This species causes the highest number of mushroom-poisoning deaths in humans.

In the case of human ingestion, get to an emergency room as quickly as possible. According to mushroom expert Dave Fischer, depending on the species ingested, the outcome could range from flu-like symptoms, to extensive damage to the liver requiring a transplant, to death.

Signs that your dog has eaten something toxic? Vomiting, diarrhea, stumbling, drooling, even seizing. These symptoms can be fatal, as, according to Dr. Terry Randolph, “it’s not necessarily the mushroom toxicity that’s fatal, but the seizures and the increase in body temperature can cause fatality.”

Veterinarians can only treat the symptoms of mushroom poisoning. Pet owners are advised to take a sample of the mushroom ingested with them so it can be identified. Depending on the type of mushroom eaten, the amount eaten, and the onset of treatment, outcomes range from illness to liver damage to death. Hence the warning to do a serious check of the yard, and to watch your pet, especially if your dog is the kind that eats whatever it finds.

With more rain in the forecast, I hope you will share these concerns regarding flood safety and cars, and the danger mushrooms can be to children and animals, with loved ones and friends. And, as the rains will probably feed many other poisonous plants in and around Atlanta, I’d also recommend a check of the Georgia Poison Control Center, which is another great resource.

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Nearby State parks can help you prevent Nature Deficit Disorder; live healthier!

By David Martin, RN, President and CEO of VeinInnovations

While the term Nature Deficit Disorder  (NDD) isn’t a formal medical term with a diagnosis recognized and written about in scholarly journals, the popularity of author Richard Louv’s books and work would lead one to believe that it should be. Especially if you are among those of us who believe that a day outside – whether it’s hiking, gardening, golfing, or just being – is good for the body, and the soul. Fortunately for Atlantans, we are in abundance when it comes to the ability to get a “forest fix,” thanks to the foresight of State leaders who were among the first in the country to set aside land for state parks. First, more on NDD:

Louv and his followers report that Nature Deficit Disorder results in:

  • diminished use of the senses
  • attention difficulties
  • conditions of obesity
  • and higher rates of emotional and physical illnesses.

The Web site further states, “research also suggests that the nature-deficit weakens ecological literacy and stewardship of the natural world. These problems are linked more broadly to what health care experts call the ‘epidemic of inactivity,’ and to a devaluing of independent play.”

Man has been spending more and more time indoors for the last several hundred years. But the last 30 years, ever-present technology and its attendant screens, reduction in natural space, increased traffic, and parents being more and more afraid of letting their children out in the woods to explore, have accelerated the move inside. One of the biggest downsides? Louv believes the importance of the natural world has been greatly diminished in public and private education.

Louv’s 2011 book, “The Nature Principle: Reconnecting with Life in a Virtual Age,” includes adults in the conversation. The book’s central question “What could our lives and our children’s lives be like if our days and nights were as immersed in nature as they are in technology?

Some of the answers to that question could be found in information from recent studies showing that spending time in nature decreases stress and anxiety, and in some cases, lowers the feeling of depression. A study performed in Korea’s Chonnam University, wherein study participants were shown images of wilderness settings while undergoing MRI scans,  showed higher activity in parts of the brain associated with emotional stability, positive outlook, and the recollection of happy memories.

Another study reveals that women spending two-to-five hours in the woods for two days in a row have a 50 percent increase in white blood cells, which helps in fighting cancer!

The great news for Atlantans, with regard to using nature as medicine?  We have an abundance of State Parks and Historic Sites nearby, and the information about these sites, and how to visit them, is easily accessible.From the USA Today Travel Tips, written by freelance writer Lisa Floyd and based on information from Georgia State Parks, here are your best bets for visits within a two-hour drive of Atlanta:


About 40 miles northwest of Atlanta, at Cartersville, is Red Top Mountain State Park. Just off Interstate 75, the 1,776-acre park features the 12,000-acre Lake Allatoona, complete with boating and water skiing, fishing, swimming and amenities like marinas, ramps, docks and beaches. Also at the park, you will find tennis courts, miniature golf, picnic and group buildings, and tent, trailer, RV and cottage camping. The park has more than 15 miles of trails for hiking and biking.


In Lithia Springs, about 18 miles west of Atlanta, is Sweetwater Creek, near Interstate 20. The 2,549-acre park has a 215-acre lake for fishing and canoeing. It has nine miles of hiking trails with views of river rapids. About 50 miles from Atlanta, south of Interstate 20, is the 138-acre John Tanner State Park, featuring two lakes with swimming and boating. There are nature trails, tent, trailer and RV campsites, as well as a lodge and motel-like units. Both include picnic areas, group shelters and playgrounds.


Along Interstate 20, about 50 miles east of Atlanta is the nearly 6,000-acre Hard Labor Creek State Park in Rutledge. The secluded park is home to a golf course; two lakes with swimming, fishing and boating; equestrian centers; group camps; picnicking; nearly 25 miles of hiking; a playground and cottage, tent, trailer and RV camping. North of Hard Labor Creek, about 55 miles northeast of Atlanta in Winder, is Fort Yargo State Park along state highway 11. On more than 1,800 acres, you’ll find a lake, camping, hiking, pavilions, tennis and disc golf.


About 20 miles southeast of Atlanta is the 1,300-acre Panola Mountain in Stockbridge. Partake in hiking, biking, birding, tree climbing, fishing on two lakes, picnicking and seasonal events throughout the year. Just over 50 miles southeast of Atlanta in Flovilla, you’ll find Indian Springs State Park covering more than 500 acres. It has a 100-acre lake and beach, picnic, museum, playground, small nature trail, group pavilions, and cottage, group, tent, trailer and RV camping.

Other Parks

In addition to the large state parks surrounding Atlanta, there are a couple of Georgia State Park historical sites. At the Etowah Indian Mounds at Cartersville, you can visit a museum and picnic area.
Archaeologists believe the Muscogean Indians built the pyramid-shaped burial mounds between 950 and 1450 A.D. Among artifacts turned up at the site are two marble statues of humans, possibly ancient worship figures. About 30 miles northwest of Atlanta in Dallas, you’ll find the 765-acre Pickett’s Mill Battlefield, a Civil War battlefield featuring a visitor’s center, trail hiking and group centers.


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Fall in Atlanta – Bursts of color; clouds of mold…

By David Martin, RN, President and CEO, VeinInnovations

Fall’s harvest of fruits and vegetables is a wondrous thing in the Atlanta area. State farmers’ markets that welcomed truckloads of peaches and watermelons a month ago will soon be bursting with pumpkins, squash, apples, and corn.

Summer’s dry spell will hopefully give way to a little more rain, and Georgia, which receives 27% more rain each year than the national average (for the last 30 years), will begin to produce another of its prolific bumper crops: mold.

A couple of weeks ago we focused on ways the increase in ozone pollution (in large part due to climate change) is setting us up for rampant ragweed problems this fall.  Ragweed is not alone as an allergen finding our area as a veritable petri dish of growth possibilities. Mold loves Atlanta, and Georgia, too. Those sprays of spores are abundant here in large part because we are in a warm, damp, and humid place.

Fungi and molds grow outside and inside, and there are literally thousands upon thousands of species – possibly as many as 300,000.  And some of them have spores that can survive in all manner of environmental conditions, for many years.  So a long dry spell in Georgia doesn’t necessarily mean there will be good news for mold allergy sufferers the next year. Molds will spread and reproduce by making spores in any conditions.

As bad as Georgia is – especially those areas that have experienced heavy flooding, as we saw in several Metro areas in 2009 – Georgia is not as bad for molds as Louisiana is, according to Alana George, MD, a local Ear Nose and Throat physician and allergy expert. “Louisiana is still affected by all the damage done by Katrina.

“In Georgia, we see more patients with mold issues after there are rains. People have to be conscious of repairing roofs and leaks and being sure all mold has been eliminated, as, if not, it just keeps coming back,” she explained.

People who are sensitive to mold will experience stuffy noses, itchy or irritated eyes, skin irritations, and wheezing as they breathe. If you have a serious allergy to mold, reactions can be much more severe, especially among farmers, landscapers, and livestock managers – people who must be around moldy hay. Fever and shortness of breath can occur. In the case of those with chronic lung illnesses, including obstructive lung disease, a mold infection can develop in the lungs.

Recent studies link the possibility of early mold exposure to the development of asthma in some children, in particular, those with a genetic predisposition to asthma.

Children and adults known to have issues with mold should steer clear of shady, damp areas – compost piles, woods with a lot of downed trees, and corners of recently raked yards – where vegetation is decomposing. Basements and showers are danger zones indoors, as high humidity levels encourage a proliferation of mold spores.

Another consideration to avoid a bad reaction to mold exposure, according to Dr. George, is watching the foods you eat.  “Fermented foods and drink: cheeses, wine, and beer, will cause or make a reaction worse. Watermelon and almonds can also cause a reaction.”

Mold is relentless when it comes to wanting to get into your home.

How does mold get inside your house if you keep windows and doors closed? Vents, heating and air conditioning systems, and even your pets and clothing can “import” molds into your home.  And because mold loves wood, cardboard, paper, insulation, drywall, fabric, and upholstery, your home is a wonderful environment.  For good information about how to prevent mold, look to the CDC’s Mold Prevention Tips.

In its report on mold, the CDC says,” If mold is growing in your home, you need to clean up the mold and fix the moisture problem. You can tell if you have mold by sight and smell. The growth looks like spots, and can be any color. And it smells musty.

While some commercial mold removal companies will tell you that you need to identify what kind of mold you have, the CDC doesn’t recommend sampling for mold identity, instead recommending that “no matter what type of mold is present, you should remove it.“

For tips on how to safely remove mold, visit the Environmental Protection Agency’s website for a guide on mold removal.

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Heart health and sleep: Is your doctor asking you how you’re sleeping?

By David Martin, RN, President and CEO of VeinInnovations

This coming weekend between 15,000 and 18,000 people will gather in Atlanta’s Centennial Olympic Park to participate in the Atlanta Heart Walk, a time-honored tradition and wonderful event promoting exercise as a way of helping prevent heart disease. This is important because heart disease is the county’s Number One Killer of women; one in three women will die of heart disease.

A new study out of South Korea this week makes a strong case for all of us to make sure that before we walk – or in addition to our walk – we also get a good night’s rest. And that we make this a daily, or nightly, priority, regardless of age. (This means young adults, too.)

Over the years, Americans have been sleeping less and less. One of last year’s revelations about sleep and brain health was stunning. We learned than during the night, interstitial space in the brain actually increases, allowing for the flow of a brain cleansing substance called glymph. Having a foggy brain suddenly made a lot more sense when we learned that not giving the brain enough time to “clean up” leads to that sense of having a head full of cobwebs.

The study released this week points to the risk of heart disease for people who don’t get enough sleep, don’t get enough good quality sleep, or get too much sleep. There is, apparently, a sweet spot in the number of hours of uninterrupted, good sleep one needs to stay heart-healthy.

Researchers  at the Center for Cohort Studies at Kangbuk Samsung Hospital and Sungkyunkwan University School of Medicine in Seoul, South Korea studied more than 47,000 young and middle-aged men and women, with the average age being 41. Study participants answered questions about how long and how well they slept, and were then given tests to measure their heart health.

The critical factors in determining heart health? Calcium buildup in arteries of the heart, and whether or not blood flowing through arteries in the upper arm and ankle was slowed by the arteries being “stiff.”

The measure of calcium in the heart told researchers whether or not participants had early signs of coronary lesions. This, and arterial stiffness, are early warnings with regard to who will suffer from heart disease.

So what’s the right amount of time to sleep to avoid calcium buildup in one’s arteries?

Adults who slept fewer than five hours a night had 50 percent more calcium in their coronary arteries than those who slept seven hours.

Sleeping too long resulted in even worse outcomes, as those who slept nine hours or more a night had 70 percent more coronary calcium compared to those who slept seven hours.

The quality of one’s sleep also had an impact: there was 20 percent more calcium built up in the arteries of those who had interrupted sleep verses those who said they had a good night’s sleep.

The results of measuring arterial stiffness in the leg and upper arm mirrored results of the measure of calcium buildup in heart arteries. Dr. Yoosoo Chang, co-lead author of the study says the best heart health was found in adults who slept, on average, about seven hours a night and reported good sleep quality.

Dr. David Meyerson, a Johns Hopkins cardiologist and spokesman for the American Heart Association says these findings are profound. “You wouldn’t imagine that too little sleep, too much, or not sleeping well is going to influence your blood vessels so quickly or so early in life.”

While the study doesn’t prove that the sleep problems cause heart problems, it does raise questions as to the “why” there is an increase in calcium buildup when the amount of sleep or quality of sleep fall out of this seven-hour, high-quality sleep sweet spot.

Meyerson says hormones, metabolic factors produced by sleep, and chemical changes in the body during sleep that can increase blood pressure, factor into our overall health, but that “we just don’t know yet how all the mechanisms really and truly work.”

The big take-away, according to Meyerson?

“These findings should be a heads-up for health care providers and cardiologists to discuss sleep habits with patients when they evaluate cardiovascular risk and overall health status.”

My question? Since patients can control the amount of exercise and sleep they get, perhaps it’s also time for physicians to look at what keeps them from getting the proper amount of sleep and exercise. Is it stress? Other health factors?  A crazy schedule? A spouse who snores? Problems with feet and legs?

Whatever the problem, the evidence is irrefutable: exercise and rest are critical to heart – and brain – health.  And making time for exercise and rest ultimately means more time – in the long run – for, and with, family and friends.  And that’s good cause to take a walk or turn off the lights.

The findings were published in the October issue of the journal Arteriosclerosis, Thrombosis and Vascular Biology.

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Ragweed and ozone –What’s the impact of this combination on Atlanta air quality and your health?

By David Martin, RN, President and CEO, VeinInnovations

If runny eyes, a drippy and itchy nose, and the likelihood of coming down with a related respiratory infection are a concern to you as we roll into fall, a new report, “Sneezing and Wheezing: How Climate Change Could Increase Ragweed Allergies, Air Pollution and Asthma,” is important to note, as Atlanta is among the top 10 cities in the U.S. to have a new type of air pollution concern. It’s also good to know some measures that may to help minimize the impact.

This report is one of the first to show the nexus of high ozone smog and how it exacerbates respiratory allergies a couple of different ways. First, and this we knew: high ozone smog is an irritant in and of itself.  Second, and this is the newer information: high ozone smog, as it increases temperatures, is making some areas of the country ripe for explosions of allergens. Increased allergens will make many millions more Americans especially vulnerable to the likelihood of developing severe respiratory allergies and asthma.

Granted, the report is put out by the National Resources Defense Council, an environmental action group. But their track record (and board of directors, which includes Robert Redford, Leonardo DiCaprio, James Taylor, and leaders in education, industry, and law) points to credible information and reliable spokespeople, among them, Dr. Samantha Ahdoot of Alexandria, VA, who said, in response to the study, “As a pediatrician, I care for the group most vulnerable to the health consequences of climate change-our children. Children today are already experiencing worsening respiratory and allergic disease due to impacts on air quality and plant pollen production. These impacts are expected to increase as carbon dioxide concentrations and global temperature continue to rise.”

While there are some who counter the fact that that climate change pushes temperatures upward, my guess is that most reading this column would agree that that Global Warming is a reality.

Whether you agree or not, science shows warmer temperatures make conditions ideal for the formation of ozone pollution, and that ozone exposure irritates the lungs, which can lead to inflammation, problems with lung function, and increased asthma attacks.

Fulton County gets a grade of F for ozone, according to the American Lung Association.  

Ozone is formed when smoke from tailpipes, smokestacks, and fossil fuels like gasoline, oil, or coal are burned and come into contact with sunlight.  The gasses react and form ozone smog, which causes a damaging chemical reaction with lung tissue. Way above the earth, the ozone layer is a help, as it offers protection from ultraviolet radiation from the sun. At ground level, however, ozone is serious bad news.

For us, the increased warmth and ozone production mean ragweed plants will be putting out more pollen right about now and throughout the fall. And other pollen producers such as birch, oak, and pine trees are likely to produce pollen earlier in spring, and for a longer time.

That means inflammation and irritation of the nose, sinuses, throat, eyes, and ears, as well as sneezing, runny nose, and itchy eyes, are commonplace for the estimated

50 million Americans with some type of nasal allergy. It also means that for the more than 26 million Americans with asthma, fall will be a bumpy ride.

According to the NRDC’s report identifying cities now faced with both ragweed pollen and ozone pollution, and the associated threats to respiratory health, here are the top 20 cities.

  1. Richmond, VA
  2. Memphis, TN
  3. Oklahoma City, OK
  4. Philadelphia, PA
  5. Chattanooga, TN
  6. Chicago, IL
  7. Detroit, MI
  8. New Haven, CT
  9. Allentown, PA
  10. Atlanta, GA
  11. Pittsburgh, PA
  12. Louisville, KY
  13. Springfield, MA
  14. Milwaukee, WI
  15. Dayton, OH

What’s an outdoorsy Atlantan to do to protect himself or herself from the dual ravages of ozone and ragweed? On fall days with high pollen counts or high ozone levels, especially if you or family members have allergies or asthma, the NDRC recommends that you:

  1. Keep track of pollen counts in your area by following newspaper, radio, or television reports or checking online at
  2. On especially high pollen or ozone days during allergy season, put car and home air conditioners on recirculate, and keep doors and windows closed.
  3. After working or playing outdoors, take a shower and wash your hair (or towel off with a damp cloth) to remove pollen, and change your clothes.
  4. Try to save your most strenuous outdoor activities for days with relatively low ozone smog levels, or do them in the morning, when ozone levels are lower. Check online resources like for forecasts of local ozone conditions.
  5. If you have allergies or asthma, see a medical professional. Take appropriate medication and precautions; consider wearing a filter mask before doing outdoor chores.

Longer-term solutions for Atlanta? We could look into reducing the number of cars on the road via more use of carpooling and public transportation.  The health benefits of that action may extend beyond reducing ozone levels, as they could also include a reduction in accidents and outbreaks of road rage, and an increase in on-time appointments for allergy shots.

The “Sneezing and Wheezing” report is available by clicking here:

A map showing the intersection of ragweed and ozone hot spots is available by clicking here:

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