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HEALTH
HOLLER
THE CLOVER FORK CLINIC NEWSLETTER
JANUARY - MARCH 2009
CLOVER FORK CLINIC, EVARTS, KENTUCKY
ˆ Contents ˆ
The thyroid gland is a small structure located
over the windpipe, at the lower part of the
neck. It is important for growth and
development from conception on to death. It
releases its hormone into the blood stream
and affects multiple other body systems.
 depression and agitation, especially in
the elderly
 Menstrual problems or infertility in
younger women
 Weight gain (myxedema occurs in some
special cases, causing weight gain)
T h e thyroid can be overa c t i v e
(thyrotoxicosis; hyperthyroidism), or
underactive (hypothyroidism).
Overactive Thyroid
An overactive thyroid gland may produce
these symptoms:
 “Nervousness”
 Heat intolerance
 Weight loss
 Palpitations
 Goiter (mass in the neck)
 Eye changes (bug eyes are specific to
Graves Disease)
 Symptoms of heart failure
Underactive Thyroid
An underactive thyroid is much more
common and may have minimal symptoms
or signs. These may include:
 Loss of energy
 Increased need for rest
 Cold intolerance
 Muscle aches and stiffness
 Hair loss; dry skin
 Constipation
Does My Thyroid
Make Me Fat?..............1
Getting to Know You....2
Having a Root Canal....3
Your Year of Good
Health...................4
Pneumonia Shot............5
Good Food..........................5
Protect Your Hearing.. 6
Diagnosis and Treatment
The diagnoses of thyroid problems depends
on your health history, having a physical
exam, and getting appropriate laboratory
testing. That testing includes a blood test to
determine your blood level of TSH (Thyroid
Stimulating Hormone). If needed, special
tests can also be given to determine the
cause of the thyroid problem.
Continued on page 8
Turn to page 4 to find out
some good ways to do that!
-2-
If you have visited the Clover Fork Clinic in Harlan recently,
you’ve probably noticed a new staff member there. She is
Ashley Howard, who has been working as a Medical
Assistant for the clinic since July 2008. Although she works
primarily in the Harlan Clinic, you might see her occasionally
at the Evarts facility as well if the need arises.
half and got her Medical Assistant degree there in May
2008.
Ashley’s work includes a variety of tasks, such as checking
patients in, taking their vital signs, drawing blood and doing
other lab work when needed. “I miss the folks at Evarts, but
I like being on my own downtown,” Ashley says. “And I like
meeting new people every day.” The one frustration she
mentions happens when the computers go down and
everything then has to be written down on paper.
When Ashley looks ahead to the future, she thinks about
furthering her education, starting with becoming a Licensed
Practical Nurse (LPN) and later on a Registered Nurse
(RN).
Ashley was born in Cawood and raised in Fairview, so she’s
a Harlan County native. She attended Harlan Independent
schools and received her GED in 2004. After that, Ashley
went to Southeast Community College for a year and a
Loyall is home to Ashley now, where she lives with her
husband, Daniel, and their 3 year old son, Bradley. Most of
her free time is spent with the family.
An ideal vacation for Ashley would be a trip to Paris. When
she explains why, Ashley says, “You hear everyone talk
about how great Paris is. And it’s the city of love!”
Ashley is a welcome addition to the Clover Fork Clinic
medical department staff.
Do You want to lose weight?
A 12-week Weight Control class for
adults will begin at Clover Fork Clinic
on Tuesday, February 3, at 4:30 p.m.
To sign up for the class, or for more
information, call 837-2108 Extension 122
before January 23.
-3-
The canal within the tooth that contains
the dental pulp is made up of loose
connective tissue with many blood
vessels. When tooth decay or tooth
fractures occur, bacteria from the
mouth gain access to the pulp
chamber and that causes
inflammation, infection, and eventually
pulp death.
Irritants escape from the root tip and
cause a diseased area in the bone
called an apical lesion. Most people
call it an “abcessed tooth” because
most of the time the tooth is painful,
unless the tooth has died. Sometimes
swelling is present. Antibiotics and pain
relievers may be necessary to provide
relief from the symptoms.
What is a “root canal”?
The infected tissue can be removed
from a tooth by a surgical intervention
commonly called a “root canal”. T h i s
procedure can relieve toothaches, stop
infections, and promote healing. A root
canal is needed when tooth decay has
already caused permanent damage to
the pulp. Once this happens, if a root
canal is not done the tooth will need to
be extracted.
tongue, and skin in that area.
Sometimes nitrous oxide gas will be
used to reduce pain and help you relax.
You may remain numb for a few hours
until the anesthetic wears off.
Ù
The dentist may separate the
decayed tooth from the other teeth with
a small sheet of rubber on a metal
frame. This protective sheet also helps
stop liquid and tooth chips from
entering your mouth and throat.
Ú The dentist will use a drill and other
tools to make an opening in the crown
of the tooth and to remove the pulp
from the pulp chamber and root canals
of the tooth. Tiny files are used to clean
the root canals and shape them to a
form that can be well sealed. Then
the dentist will fill the inside part of the
tooth below the gum line with
medicines, and temporary filling
materials.
Here is what happens:
Ø First, the dentist will numb your
gums with a substance that feels like
jelly. After your gums are numb, the
dentist will inject a local anesthetic that
will completely numb the teeth, gums,
Root canals are a costly treatment
taking several visits to complete. But
if you have a tooth pulled you need to
have a replacement tooth, which is
also costly.
Things to consider
Because a root canal procedure
removes the pulp inside the tooth, the
tooth becomes more fragile and may
break more easily if it is not covered
with a crown or cap.
Some root canals can be done by a
general dentist and some require an
endodontist or root canal specialist.
The root canal procedure
The procedure generally takes about 3
to 5 visits to complete because it is
very tedious working in an area that
can’t be seen directly. Dentists rely on
x-rays to see these canals.
Mostly successful
Root canals have about an 85%
success rate. Pre-existing infections
or severe infection may cause them to
fail. Overall, a root canal procedure is
well worth doing because otherwise,
you would lose the tooth.
Û The temporary filling is replaced with
a permanent filling and/or a crown. If a
crown is needed, the dentist makes an
impression of the tooth. A technician
uses the impression to make a crown
that perfectly matches the drilled tooth.
Ü
The tooth may be fitted with a
temporary crown until the permanent
one is made and cemented into place.
A root canal needs to be done as
soon as possible to avoid severe
infection which can damage the bone
surrounding the root of the tooth and
infect other teeth.
Root canal cost may vary depending
on the severity of your problem, as
well as the tooth’s location and the
number and shape of the canals.
Fees may also vary depending on
the educational experience of the
practitioner.
Continued on page 8
-4-
The most important things you can do to stay healthy in 2009
are:
n Get the recommended screening tests, listed
below.
n Be tobacco free.
n Be physically active.
n Eat a healthy diet.
n Stay at a healthy weight.
n Take preventive medicines if you need them,
including vaccinations.
Here are the screening tests recommended:
For Both Men and Women
” Obesity: Have your Body Mass Index (BMI) calculated to
screen for obesity. You can also find your own BMI using the
calculator at: http://www.nhlbisupport.com/bmi
” High Cholesterol: Have your cholesterol checked
regularly, starting at age 35 for men and age 45 for women.
If you are younger than these ages, talk to your doctor about
whether to have it checked if:
--You have diabetes or high blood pressure.
--Heart disease runs in your family.
--You smoke.
” Colorectal Cancer: Have a test for cholorectal cancer
starting at age 50. Ask your doctor which test is right for you.
If you have a family history of colorectal cancer, you may
need to be tested earlier.
” Diabetes: Have a test for diabetes if you have high blood
pressure or high cholesterol.
” Depression: Your emotional health is as important as
your physical health. If you have felt “down”, sad, or
hopeless over the last 2 weeks or have felt little interest or
pleasure in doing things, you may be depressed. Talk to your
health care provider about being screened for depression.
” Sexually Transmitted Infections: Talk to your doctor to
see whether you should be tested for chlamydia, gonorrhea,
syphilis, or other sexually transmitted infections.
” HIV: Talk to your doctor about HIV screening if you:
–Have had unprotected sex with multiple partners.
–Have used or now use injection drugs.
–Exchange sex for money or drugs or have sex
partners who do.
–Have past or present sex partners who are HIVinfected, are bisexual, or use injection drugs.
–Are being treated for sexually transmitted diseases.
–Had a blood transfusion between 1978 and 1985.
–Are a woman who is pregnant.
Also for Women
 Breast Cancer: Have a mammogram every 1 to 2 years,
starting at age 40.
 Cervical Cancer: Have a Pap smear every 1 to 3 years if
you:
–Have ever been sexually active.
–Are between the ages of 21 and 65.
 Osteoporosis: Have a bone density test beginning at age
65 to screen for osteoporosis.
Also for Men
 Abdominal Aortic Aneurysm: If you are between the
ages of 65 and 75 and have ever smoked (100 or more
cigarettes during your lifetime), you need to be screened
once for abdominal aortic aneurism, which is an abnormally
large or swollen blood vessel in your abdomen.
More Information
These recommendations are made by the Agency for
Healthcare Research and Quality, part of the U.S.
Department of Health and Human Services. For more
information on staying healthy, you can request free
publications by sending an e-mail to:
[email protected]
The two publications to ask for are:
˜ The Pocket Guide to Good Health for Adults
˜ The Pocket Guide to Staying Healthy at 50+
-5-
Most of us have had our flu shots this season, although if
you haven’t had it yet, it’s not too late. But many people don’t
realize that there is also a vaccination available to prevent
another serious respiratory disease: pneumonia.
Unlike the flu vaccine, pneumococcal vaccine is not given
each year. One dose in a lifetime is usually all that is
needed, although in some cases a second dose is given if
the health care provider recommends it.
Who should get the pneumonia vaccination?
There are three groups of people who should get this shot:
Ø Persons aged 65 or older who have never had the
pneumonia shot.
Ù Adults and children aged 2 or older who have underlying
medical conditions, including:
ºChronic cardiovascular disease
ºChronic pulmonary disease (but not asthma)
ºDiabetes
ºAlcoholism
ºChronic liver disease
ºCerebrospinal fluid leaks
ºFunctional or anatomic asplenia, such as sickle
cell disease or splenectomy
Ú Adults and children aged 2 or older who have impaired
immune systems, including those who have:
ºGeneralized malignancy
ºLeukemia
ºLymphoma
ºHodgkin’s disease
ºMultiple myeloma
ºChronic renal failure
ºConditions associated with immuno-suppression
(organ or bone marrow transplant; chemotherapy)
ºHIV infection
ºNephrotic syndrome
If you’re not sure whether you should get a pneumonia
vaccination, talk with your health care provider. This shot can
be taken at any time of year.
Here are some recipes to try that not only taste good,
but are also healthy.
Corn Chowder
1 Tbsp. vegetable oil
2 Tbsp. celery, finely diced
2 Tbsp. onion, finely diced
2 Tbsp. green pepper, finely diced
1 package (10 oz.) frozen whole kernel corn
1 cup raw potatoes, peeled and diced
2 Tbsp. fresh parsley, chopped
1 cup water
1/4 tsp. salt
black pepper to taste
1/4 tsp. paprika
2 Tbsp. flour
2 cups lowfat or skim milk
1.Stir-fry the celery, onion, and green pepper in the
oil for 2 minutes.
2.Add the corn, potatoes, water, salt, pepper, and
paprika.
3.Boil and reduce to medium heat. Cover and cook
10 minutes, or until potatoes are tender.
4.Place ½ cup of milk in jar with tight-fitting lid. Add
flour and shake vigorously.
5.Gradually add the milk/flour mixture to the cooked
vegetables. Then add the remaining milk.
6.Cook, stirring constantly, until mixture boils and
thickens. Serve garnished with fresh parsley.
Makes 4 servings, each serving with 186 calories and
205 mg sodium.
Turn to page 7 for more recipes.
-6-
We often take our hearing for granted
until we begin to lose it. There are
some steps we can take to keep good
hearing for a long time.
side. This tilting causes channels on
the surface of the bristles to open up.
Then certain chemicals rush in,
creating an electrical signal.
How hearing works
Hearing depends on a series of events
that change sound waves in the air
into electrical signals. Then your
auditory nerve carries these signals to
your brain through the following series
of steps:
ñ Your auditory nerve carries this
ì Sound waves enter your outer ear
and travel through a narrow
passageway called the ear canal,
which leads to your eardrum.
electrical signal to your brain, which
translates it into a “sound” that you
recognize.
Harmful sounds
When we are exposed to sounds that
are too loud or loud sounds that last a
long time, the sensitive hair-like cells in
our inner ear can be damaged,
causing hearing loss. Once they are
damaged, our hair cells cannot grow
back.
í Your eardrum vibrates from the
incoming sound waves and sends
these vibrations to three tiny bones in
your middle ear. These bones are
called the hammer, anvil, and stirrup.
î These tiny bones increase the
sound vibrations and send them to
your inner ear containing the cochlea,
which is shaped like a snail and filled
with fluid. An elastic membrane runs
from the beginning to the end of the
cochlea, splitting it into an upper part
and a lower part.
ï The sound vibrations cause the fluid
inside your cochlea to ripple, and a
traveling wave forms along the
membrane. Hair-like cells sitting on top
of the membrane “ride the wave”.
ð As the hair cells move up and down,
their bristles bump against an
overlying membrane and tilt to one
When a person is exposed to loud
noise over a long period of time, the
sounds heard may become muffled or
distorted and it may be difficult to
understand speech. The person may
not be aware of the loss, but a hearing
test can detect it.
How loud is too loud? How long is
too long?
The answers to these two questions
are related: the louder the sound, the
shorter the time before damage
occurs.
The loudness of sound is measured in
decibels. Decibel levels begin at zero,
which is near total silence and the
weakest sound our ears can hear. A
whisper is 30 decibels and a normal
conversation is 60 decibels. The way
the scale is determined, a sound that
is 100 times more intense than near
silence is 20 decibels, and a sound
1,000 times more intense than near
silence is 30 decibels. The sound of an
ambulance siren at 120 decibels is
about 1 trillion times more intense that
near silence. Sounds that reach 120
decibels are painful to our ears at
close distances.
How can you protect your hearing?
Your ears can be your warning system
for potentially harmful noise. The noise
is too loud when:
—you have to raise your voice to be
heard by someone close by.
—the noise hurts your ears.
—you develop a buzzing or ringing
sound in your ears, even if temporary.
—you don’t hear as well as you
normally do until several hours after
you get away from the noise.
If you are around noises at this level,
take protective action:
˜Block the noise with earplugs or
earmuffs.
˜Avoid the noise; walk away.
˜Turn down the sound.
You need to know...
Regular exposure of more than 1
minute to 110 decibels (such as at a
rock concert or from a chain saw),
risks permanent hearing loss.
No more than 15 minutes of
unprotected exposure to 100 decibels
(such as in a wood shop or on a
motorcycle), is recommended.
Prolonged exposure to any noise at or
above 85 decibels (such as from a
power mower, or heavy city traffic),
can cause gradual hearing loss.
-73. Place chicken on baking sheet lined with aluminum foil
and broil for 10 minutes on each side to seal in the juices.
4. Turn oven to 3500 and add remaining sauce to chicken.
Cover chicken with aluminum foil and continue baking for 30
minutes.
Makes 6 servings, each with 176 calories and 199 mg
sodium.
Crispy Oven-Fried Chicken
Continued from page 5
Oven Barbecued Chicken
5 Tbsp. tomato paste (3 oz.)
1 tsp. ketchup
2 tsp. honey
1 tsp. molasses
1 tsp. Worcestershire sauce
2 tsp. white vinegar
3/4 tsp. cayenne pepper
1/8 tsp. black pepper
1/4 tsp. onion powder
2 cloves garlic, minced
1/8 tsp. ginger
1 ½ lb. chicken, breasts and/or drumsticks, skinless
1. Combine all ingredients except chicken in a saucepan.
Simmer for 15 minutes.
2. Wash chicken and pat dry. Place chicken on a large
platter and brush with half the sauce mixture. Cover with
plastic wrap and marinate in refrigerator for 1 hour.
½ cup skim milk or low-fat buttermilk
1 tsp. poultry seasoning
1 cup cornflakes, crumbled
1 ½ Tbsp. onion powder
1 ½ Tbsp. garlic powder
2 tsp. black pepper
2 tsp. dried red pepper flakes, crushed
1 tsp. ginger
8 pieces chicken, skinless (4 breasts, 4 drumsticks)
a few shakes of paprika
1 tsp. vegetable oil
1. Preheat oven to 3500.
2. Add ½ tsp. poultry seasoning to the milk. Combine all
other spices with cornflake crumbs and place in a plastic
bag.
3. Wash chicken and pat dry. Dip chicken into milk, shake to
remove excess, then quickly shake in bag with seasonings
and crumbs.
4. Refrigerate for 1 hour. Then remove from refrigerator and
sprinkle lightly with paprika for color.
5. Place chicken in one layer on oiled baking pan.
6. Cover pan with foil and bake 40 minutes. Remove foil and
continue baking an added 30-40 minutes or until meat can
be easily pulled away from bone with a fork. Do not turn
chicken during baking.
Makes 6 servings, each with 256 calories and 286 mg
sodium.
Beef and Bean Chili
2 lbs. lean beef stew meat, trimmed of fat and cut in 1inch cubes.
3 Tbsp. vegetable oil
2 cups water
2 tsp. garlic, minced
1 large onion, finely chopped
1 Tbsp. flour
2 tsp. chili powder
1 green pepper, chopped
3 cups tomatoes, chopped
1 Tbsp. oregano
1 tsp. cumin
2 cups canned kidney beans, (reduced sodium)
1. Brown meat in large skillet with half the oil. Add water and
simmer, covered, 1 hour.
2. Heat remaining oil in second skillet. Add garlic and onion
and cook over low heat until onion is softened. Add flour and
cook 2 minutes.
3. Add the garlic-onion-flour mixture to the cooked meat.
Then add remaining ingredients and simmer 30 minutes.
Makes 9 servings, each with 284 calories and 162 mg
sodium.
-8-
 Replacement of thyroid hormone with daily synthetic
thyroid medication. This is followed carefully for a few
months and then at least yearly for life; more often in
some cases.
A concern with babies
Babies may have decreased thyroid function and are
screened in the early weeks of life. If thyroid problems are
not found and treated quickly, these babies will be slowed in
development both physically and mentally.
Continued from page 1
Treatment
The treatment for overactive thyroid may include:
 Medications for 12 to 24 months and lifetime surveillance
 Radioactive ablation (destruction) and then lifetime
surveillance for recurrence of hypothyroidism.
The treatment for underactive thyroid includes:
Return to normal
Once properly regulated with appropriate treatment, all the
patient’s body functions are returned to normal. So it is what
you eat and whether or not you’re physically active that
makes you fat!
˜ By Rachel Eubank
Continued from page 3
Ask for a cost estimate before treatment begins.
An excellent chance for success
With a permanent restoration (filling), regular brushing and
flossing, proper diet and regular dentist’s visits, your tooth
has an excellent chance for success.
˜ By Mia Sellars
February is
Ì
American
Heart
Month
HEALTH
HOLLER
is published quarterly by
Clover Fork Clinic
P.O. Box 39
Evarts, Kentucky 40828
606-837-2108
606-573-1499
606-573-1975
http://www.cloverforkclinic.org