Shoes, Uniform, Ball … Mouthguard?


By Polly Blake Buckey, D.D.S., M.S.


Mouthguards are a vital, often overlooked, piece of equipment in the athlete’s arsenal, particularly when competing in contact sports.  This is not an outrageous claim, considering that dental injuries are the most common type of injuries sustained in sports.  Anyone participating in a contact sport has at least a 10 percent chance of sustaining an orofacial injury.  You are 60 times more likely to be injured when not wearing a mouthguard.

The teeth most often traumatized by these facial injuries are the central and lateral incisors (front four teeth), which account for four-fifths of all cases.  A total of five million teeth are knocked out each year.  If these teeth are not properly preserved and replanted, dental costs to treat these traumatized teeth can range from $10,000 to $15,000 each, not including the costs of treating the gums and bone around the teeth.

Mouthguards prevent teeth from perforating soft tissues, such as the lips, tongue and cheeks.  They also play a crucial role in stabilizing the temporomandibular joints and are helpful in preventing jaw fractures.  However, the biggest asset of wearing a mouthguard may not be the protection that they offer to the teeth; a properly designed mouthguard reduces the incidence of concussion by absorbing the majority of the impact dealt to the mandible during a sharp blow.


Three types of mouthguards available:

  • Stock mouthguards are fairly rigid shells designed to be worn without further modification.  Often they have adequate mechanical properties, but the generally poor fit hinders speaking and breathing.  This likely leads to low user compliance.
  • Mouth-formed guards tend to be bulky and deteriorate fairly quickly.  These guards are formed by boiling the material in water, cooling it slightly and biting into it to adapt it to the teeth.  Initially the mouthguard may fit, but repeated usage causes lost retention as the unit slowly hardens.
  • Custom-made mouthguards are fabricated by the dentist by molding thermoplastic sheets to a cast of your child’s mouth.  This type of mouthguard provides the most optimal comfort and fit, with the close adaptation allowing for ease of speech and breathing.  The only drawback to custom mouthguards is a greater cost.

The success of the mouthguard speaks for itself.  In sports where the use of a mouthguard is mandated, there are simply fewer injuries than in other sports where no such rule exists.  But why are orofacial injuries not completely eliminated?  Often it is not a lack of rules, but a lack in enforcement of the rules.  In college hockey, a referee will not stop play simply because a player isn’t wearing his mouthpiece; however, referees in NCAA football watch for mouthguard use and will throw the penalty flag if there is an infraction.

Mouthguards should be introduced to children, as they are more willing to comply with usage and can develop positive attitudes about wearing them in order to reduce the number of orofacial injuries sustained during their athletic endeavors.  As a child’s mouth continues to change in size and number of teeth, a new custom-made mouthguard will need to be fabricated.  Check with your child’s dentist to see if he or she recommends a mouthguard to help protect your child while playing a sport.


Polly Blake Buckey, D.D.S., M.S., is a pediatric dentist.  She graduated from the University of Michigan’s School of Dentistry in 2000 and earned a master’s degree in pediatric dentistry from the University of Michigan in 2002.  She was the director of the dental clinic at Kosair Children’s Hospital from 2003 to 2006.  She loves working with children and making sure every child has the best care possible. 

Dealing with the Picky Eater – The Battle Between Parents and Children

picky girl

By Barbara Day, M.S., R.D., C.N.

Winning the war on what the child should eat or not eat is a continuing issue in every family in every generation.  Strategies such as, “You’ll sit here until you finish every bite on your plate” and “What do you want to eat – whatever you want, darling,” have not proven effective in ensuring that children eat healthier.

These strategies may help you survive the battle.

  1. Avoid the power struggle.  Don’t say, “Do it, because I’m the parent.”  The child needs to understand the why behind the rules, which may help lay the groundwork for lifelong, sound food choices.
  2. Let children participate in the meal preparation.
  3. Children under five are selective eaters.  That’s a fact.
  4. Introduce new foods slowly. Studies have shown children need to be exposed to a new food 10 to 15 times before they will accept it. Limit exposure to one or two new foods a week. When introducing a new food, serve it alongside familiar foods your child likes.
  5. Never use food as a reward.  Rather than using food as a reward, use something physical and fun – such as a trip to the park or a game of catch or basketball.
  6. Beware of over-snacking.  Knowing how many calories your child needs to eat and keeping track of those calories periodically can help ensure they are getting enough calories, but not too many. (See “How Many Calories Should Your Child Eat Each Day?”)
  7. Don’t label foods as “good” or “bad.”  Tie certain foods with things the child might care about , such as, lean protein helps build muscles and bones, whole grains energize sports performance, and antioxidants in fruits and vegetables help keep skin radiant and hair shiny and healthy.
  8. Be a good role model.  If you don’t eat fruits and vegetables, how can you expect the children to do so?  Your mealtime attitudes have a strong influence on your child’s eating behavior.
  9. Keep healthy foods available and accessible.  Your child can only choose foods that you purchase and bring into your home. Keep a low shelf in the refrigerator stocked with cut-up fresh fruit and other healthy food choices.
  10. Be more creative in your food design and preparation.If a child won’t drink milk, add it to oatmeal, pudding or mashed potatoes.  If a child won’t eat vegetables, serve fresh vegetables with low-fat dressing or puree the vegetables and add them to main dishes or side dishes. Don’t give up.
  11. Give your children small portions.  Children don’t need to eat the same portion sizes as adults.  Too much food can be overwhelming; they can always take seconds.
  12. Make sure the food looks and tastes good.
  13. Some children have food jags.  They will only eat certain foods.  Fortunately, children can thrive on a boring diet.
  14. If your child definitely won’t eat vegetables then boost their vitamin and mineral intake by serving more nutrient-dense fruits such as cantaloupes, berries, red or purple grapes, raisins, kiwi and oranges.
  15. If your child won’t eat meatyou can also puree the meat and add it to sauces.  You can also add gravy to meat, serve it with ketchup or mix it into mashed potatoes. A healthy diet doesn’t have to include meat but needs to include enough dairy products, beans and legumes or soy-based products, which can provide adequate amounts of protein, iron and B vitamins.

Image from:

Barbara Day, M.S., R.D., C.N., is a registered dietitian with a Master’s Degree in clinical nutrition.  The former publisher of Kentuckiana HealthFitness Magazine, Kentuckiana Healthy Woman magazine and radio show host of Health News You Can Use, Barbara has over 30 years of experience in promoting healthy lifestyles to consumers.  Barbara worked as Nutrition Consultant to the Navy SEALs (8 years) and the University of Louisville Athletic Department (10 years). Barbara has private practice, DayByDay Nutrition,, where she counsels clients on weight loss, cholesterol management, performance nutrition and an array of other medical issues.  Visit Barbara’s new website which is an on-line health & wellness magazine, Barbara writes nutrition and health columns for as well as a weekly nutrition column for the Southeast Outlook. She also designs and presents employee wellness programs to small and large businesses. Barbara is a runner, cyclist, hiker and a mother and grandmother to 13 grandchildren.     

How Sure Are You About Your Surefootedness This Winter?


By Matt Hall, PT, DPT, OCS.

How sure are you about your surefootedness this winter? As we approach the heart of winter in Kentucky, this is the opportune time to seriously ponder this question.  Your response may portend idyllic enjoyment of the outdoors, or could reveal your heightened risk for injury.  In attempting to answer this question it may first be helpful to consider a wide spectrum of influences.  Here are just a few:

Shoes– Due to the increased risk of slipping, it is advisable to utilize aids that provide added traction.  While spray-on resins can provide rubbery grip to the soles of any shoe, for those tackling more serious terrain or who require maximum traction, screw in metal cleats can be manually attached using a specialized tool.  A more likely option for most  might be crampons like YakTrax, or Sandys that can be easily secured to and removed from the soles most styles of shoes before stepping out into inclement weather.  Additionally, these devices spare the floor from damage.

Canes or walking sticks– Whether you routinely use one or not,  a cane or walking stick can provide added support and enhanced stability when walking on slick or uneven terrain.  However, before you venture forth into the elements one very important modification should be made.  The rubber tip should be replaced by one that has small spikes that does not slip when planted.  The tip may need to be switched again to rubber for indoor use or may be retractable.  Check with the vendor before purchasing.

Eyewear– This one can be easily “overlooked”, no pun intended, because the risk usually occurs when returning to the warmth of a shelter.  Often the sudden temperature change causes glasses to fog up for a few moments and this could lead to a trip or fall.  Another risk is the self- tinting feature that can likewise render the wearer’s vision momentarily impaired when coming from sunlight into an indoor lighting environment.  One solution is simply pausing upon entry until the glasses stabilize; another is to leave a spare pair near the entry way that can be swapped.

Clear walk ways– Sidewalks and porches should be cleared of snow as soon as possible.  Walking on freshly fallen sow only serve to compact it making it more difficult to remove latter, and hastening its transformation to ice.  However, as we Kentuckian’s are all too acquainted, snow is usually not the issue but rather it seems that ice is our nemesis.   One effective solution is to spread deicer upon walkways.  Keep a container near doorways for convenient use when needed.  Sand and cat litter can be substituted but they will not melt the ice and can be a bit messy.

Finally, I’d like to leave you with a few additional suggestions to keep you safer this winter.

  1. Walk like a penguin, exit your automobile like a cat burglar, and if you find yourself falling, do so like a gymnast.
  2. Keep a wide stance and walk “flat footed”.  Imitating a penguin greatly increases your stability on slick surfaces.
  3. When exiting a car, do not jump out!  Think cat burglar.  Gingerly step out and down while holding onto the handle, seat and door until your footing is assured.
  4. And lastly while the physicality of a gymnast is well beyond the capabilities of most, their approach to tumbling does effectively illustrate my point.   Gymnasts use their hands to “soften” their landing.  Therefore, if you are carrying objects attempt to throw them out of the way don’t try to hold onto them.  It is paramount, in the event of a fall, to protect your head and you can only do this if your hands are free.  Furthermore, don’t attempt to twist away from or stiffen as one falls.  Instead, roll with the fall as this can reduce the potential for injury.

While there can never be a 100% guarantee that winter falls can be prevented, following some or all of the aforementioned suggestions can only serve to improve your overall safety.  Godspeed.

Image from:

Matt Hall PT, DPT, OCS is a graduate of Transylvania University and the University of Kentucky. A board certified specialist (OCS), he is a member of both the Kentucky and the American Physical Therapy Associations. He has been a practicing physical therapist since 1995 and has experience in both inpatient and outpatient facilities. Matt’s areas of professional interest include general orthopedics, industrial/workplace preventative and rehab services, and foot orthotics to correct mechanical gait deviations. For more information about injury prevention and treatment, check  out 

Getting Older, Day by Day


By Nancy Clark, MS RD CSSD

Like it or not, every one of us is getting older, day by day. As a fitness exerciser or an athlete, you might wonder how aging impacts performance—and what you can do to retain youthful fitness. The following information is gathered from a workshop ( presented by Dr. William Evans, an exercise physiologist and expert on aging, muscles, and protein. The following information can help you chart a healthy course into your future.

• The average person loses about 1% of their fitness per year. Aerobic capacity goes down, particularly after age 60. Staying active helps maintain a slighter higher ability to uptake oxygen than a non-athlete, but the rate of loss is the same.

• Muscle is an active tissue (as compared to body fat). The more muscle you have, the more calories you can eat without getting fat. Yet muscle loss creates a subtle change in metabolism that can contribute to weight gain with aging.

• We lose muscle as we age, starting as young as age 20, with a steady decline year after year. To treat this age-related loss of muscle, you need to lift weights or do other forms of resistance exercise. Yet, even strong athletes still lose some muscle with aging.

• With aging, the average person loses more fast-twitch muscle fibers (used in sprinting) than slow-twitch fibers (used for endurance). This loss starts early in life and explains why elite sprinters peak in the early 20s. In comparison, elite distance runners maintain their slow-twitch muscle fibers until age 40ish. But even top athletes notice they slow down after age 40, at which time the nerves that connect to muscles start to die off, resulting in a loss of both slow- and fast-twitch fibers. Athletes can lose about 20% of their muscle fibers between ages 40 and 70.

• With age, we not only lose muscle but also tend to gain fat. It’s easy to eat more even though we need less. The cause of weight gain is not due to a “slow metabolism.” Metabolic rate remains constant, but daily activity easily declines. A study with obese people suggests they sat three hours more per day than their lean peers; this saved them about 350 calories a day.

• Body fat secretes adipokines (hormones) that have negative effects on muscle strength and contributes to increased inflammation, particularly after ages 60 to 70. Inflammation leads to heart disease and diabetes. Hence, fatness can be a powerful predictor of disability in people ages 50 to 75. Stay lean!

• When young people gain weight, about one-third of the weight gained is lean muscle. When older people, in particular older women, gain weight, it’s all fat. When older people lose weight (due to illness or a low-calorie diet), half of the weight lost is muscle. Hence, yoyo dieters who gain fat and lose muscle are on a downward spiral. Being fat but fit is preferable to going on and off diets.

• Muscle loss is the key reason why older people become frail and end up in nursing homes. When they stop exercising, they experience a steep drop in strength. The good news is they can do something about frailty: lift weights! In only12 weeks, 60- to 70-year-old men regained the fitness they had lost over 15 years.

• To maintain (but not gain) strength, a person can lift weights just one day a week. Lifting weights does not stress the heart nor increase blood pressure. Aerobic exercise actually causes a greater increase in blood pressure because it uses more muscles and more oxygen, which means the heart has to pump more blood than with strength training.

• Even 90-year-olds in a nursing home can triple their strength in 10 weeks. That means they can walk faster, get to toilet by themselves, be less depressed, and stay in the independent living part of elder-care housing. Tell your parents and grandparents to start a weight lifting program so they can stay out of the nursing home!

• How much weight should people lift to build muscle? Three sets; the first two sets should have 8 reps; the final set is to exhaustion. If you can lift a weight 12 times in the final set, you need to lift heavier weights the next time. Because muscle damage stimulates muscles growth, you want to spend more time lowering the weight than lifting it.

• Most strength gains occur in the first 3 months of starting a lifting program, due to early neuro-muscular changes. The nervous system learns how to recruit muscles more efficiently and this stimulates more muscle cells.

• Strength training helps prevent bone loss. In a year-long study with post-menopausal women, all of the women who lifted weights improved their bone health. Those who did not lift weights lost ~2% bone density in one year. Exercise is better than osteoporosis drugs—plus, you’ll get stronger!

• By lifting weights and building muscle, older people should be able to eat more calories (which boosts their intake of health-promoting protein, vitamins, minerals). Yet, adding exercise does not always entitle a person to eat more calories. In a study with 62-year-old people who walked briskly for one hour a day (five days/week) for 3 months, their daily energy expenditure remained stable—despite the brisk walking. How could that be? They became more sedentary the rest of the day; they napped more and slept longer. They compensated for having exercised…

• About 25- to 33-percent of people older than 65 years are eating too little protein. This results in loss of muscle and bone—and leads to expensive medical problems. The goal is to eat at least 0.55 grams of protein per pound of body weight each day to maintain and build muscle. For a 140-pound person, this equates to about 75 grams of protein, or 25 grams per meal (for example, Breakfast: 3 eggs; Lunch: 1 can tuna; Dinner: 4 oz. chicken).

The Bottom Line: Stay young by staying active and by lifting weights or doing some type of resistance exercise to strengthen both muscles and bones. And remember the words of gerontologist Water Bortz: “No one really lives long enough to die of old age. We die from accidents and most of all, from disuse.” Use it or lose it!

Image from:

Nancy Clark, MS, RD CSSD (Board Certified Specialist in Sport Dietetics) counsels active people in her private practice in Newton, MA (617-795-1875). For more information, read the new 5th edition of her Sports Nutrition Guidebook or her food guides for marathoners, soccer players, and cyclists. They are available at Also see for online CEUs.


Crockpot Lasagna Made Simple


If you are short on time but love homemade lasagna here’s the perfect recipe for you. You can even fix it the night before in your removable crockpot casserole dish,  refrigerate & then pop it into the crockpot. Serve with a spinach salad with mandarin slices & you have a healthy family meal.

Nutritional Information Per Serving: 347  calories,  32 grams protein,  12 grams of fat,  25 grams of CHO,  3 grams dietary fiber,  813 mg sodium.

Preparation Time: 15 minutes Slow Cooker Time: 4 – 6 hours low

Serves:  8


  • 1 pound extra lean ground beef
  • 1 jar (24-ounce) spaghetti sauce
  • 1 cup water
  • 1 container (15 oz) reduced fat cottage cheese or ricotta cheese
  • 1 pk Shredded Mozzarella cheese (7 oz), divided
  • ¼ cup grated reduced fat Parmesan Cheese, divided
  • 1 egg, whisked
  • 2 tbsp fresh or dried chopped parsley
  • 6 lasagna noodles, uncooked


Brown the beef in a large skillet & drain.  Add spaghetti sauce and water to the meat. Mix in the cottage or ricotta cheese, 1 ½ cup of mozzarella cheese, 2 tbsp parmesan cheese, egg and parsley. Spoon 1 cup of meat sauce in the bottom of the slow cooker, then ½ noodles (broken to fit) and ½ cheese mixture. Cover with 2 cups of the meat sauce. Next layer: top with remaining noodles cheese mixture, and meat sauce. Cover with lid. Cook on low for 4 to 6 hours or until the liquid is completely absorbed. Note: For best results, do not cook on high. Sprinkle with the rest of the mozzarella cheese and parmesan cheese. Let stand, covered, around 10 minutes or until cheese is melted.

Note: You can make ahead by layering the lasagna using a crockpot liner & store in the refrigerator overnight and then pop in the crockpot the next day.

Revised from

Shopping List

  • 1 pound extra lean ground beef
  • 1 jar (24-ounce) spaghetti sauce
  • 1 container (15 oz) reduced fat cottage cheese or ricotta cheese
  • 1 pk Shredded Mozzarella cheese (7 oz)
  • grated reduced fat Parmesan Cheese
  • 1 egg
  • fresh or dried chopped parsley
  • lasagna noodles

 Image from:

Barbara Day, M.S., R.D., C.N., is a registered dietitian with a Master’s Degree in clinical nutrition.  The former publisher of Kentuckiana HealthFitness Magazine, Kentuckiana Healthy Woman magazine and radio show host of Health News You Can Use, Barbara has over 30 years of experience in promoting healthy lifestyles to consumers.  Barbara worked as Nutrition Consultant to the Navy SEALs (8 years) and the University of Louisville Athletic Department (10 years). Barbara has private practice, DayByDay Nutrition,, where she counsels clients on weight loss, cholesterol management, performance nutrition and an array of other medical issues.  Visit Barbara’s new website which is an on-line health & wellness magazine, Barbara writes nutrition and health columns for as well as a weekly nutrition column for the Southeast Outlook. She also designs and presents employee wellness programs to small and large businesses. Barbara is a runner, cyclist, hiker and a mother and grandmother to 13 grandchildren.    


What is Fifth Disease?

By Ashli Collins, M.D.

My patients and parents often give me help in ideas for this column. This month, when I informed a dad that his child had Fifth Disease, he responded by saying, “Well, Doc, I don’t know…I’ll have to check with my wife to see if he’s had the first four yet.” Confusion over names of diseases is common but by adding a number, instead of a descriptive term (like hand, foot and mouth disease), makes it hard on both parents and medical students trying to learn all the different childhood illnesses!

Years ago, when diseases were being categorized and named, “first disease” was measles. Thankfully, with the help of vaccines, that is no longer a common illness we see. Second disease was scarlet fever or strep throat with a rash. Rubella, also vaccine preventable, was third disease, and fourth disease honors go to Staph aureus infections. Fifth disease has remained without a common name in our culture and mystifies parents with its name.

Fifth disease also goes by erythema infectiosum or slapped cheek disease. To our infectious disease physicians, it is parvovirus B19. I always thought that sounded like a parasite with a vitamin deficiency. With all this confusion and funny naming, a description of this common childhood illness follows.

Fifth’s is a viral illness that has infected around 50-60% of people by adulthood. In children, agesfour to tenare most affected. It can affect girls and boys equally and is most common in the winter and spring months.

Symptoms of fifth disease can range from mild to severe. Many adults who test positive as having the disease before do not recall ever having the illness. The most common symptoms are fevers and mild joint/muscle achiness followed by a slapped cheek appearing rash with a lacy rash on arms and legs. The rash itself may last five to seven days (on average), but it is not uncommon to see it last for a few weeks. While the child has the fever, it is often difficult to differentiate from many other viruses. It is the classic rash that makes the diagnosis.

Some children will have fairly severe myalgias and pain. Rarely, but occasionally, children will have lingering arthritis type pain for weeks to months. Knees, fingers and wrists are the most common joints to have arthritis, but interestingly, the arthritis is usually symmetric with both sides of the body affected.

While a child has the fever, they are generally considered contagious. However, once the fever dissipates and the rash occurs, they are no longer able to spread the disease. During the contagious period, the virus is spread via droplets. Sneezing, coughing, drooling and runny nose are all mechanisms to pass on the virus.

One major concern with this disease is for pregnant women. Pregnant women who have not had the disease should avoid people with fifth’s disease. Fifth disease virus can cause miscarriages in 2-10% of unprotected (not previously infected) moms. Protecting these moms from infected children is tricky in that the diagnosis is usually made at the time the rash appears, but during the rash phase, a patient is no longer contagious. If you are pregnant and find out a child you have had close contact with has fifth disease, you should contact your obstetrician.

Treatment for fifth disease is mostly supportive. Rest, acetaminophen and fluids are the mainstay. As with any virus, antibiotics will not be helpful. If there is significant joint pain/arthritis, anti-inflammatories, such as ibuprofen (Advil/Motrin) or naproxen (Aleve), may be helpful.

Image from:

Dr. Collins is a pediatrician with Oldham County Pediatrics, PLLC. They have offices in LaGrange and in Louisville near the Summit. For more information, call 502-225-6277 or


Healthy Back. Healthy Life.

By Julie L. Lyles, DC

One of the least understood but most important parts of the human body is the spine.  The spine is the lattice work and foundation for every other soft tissue and organ.  The spine is composed of 26 moveable segments.  Hear that?  Moveable! Each joint is angled in a certain way to provide optimal motion and optimal protection.  When loaded correctly and free of fixation, there is nothing more brilliant!   So, why such confusion?  Why such a lack of respect?  Why so little education on the value and importance of healthy joint mobility and postural balance?  Maybe it’s a lack of understanding of the complex simplicity of the spine and its care.

When a child is born, she has 2 curves in her spine:  the mid-back and the sacrum.  As the child starts to get nosey, she lifts her head while on her belly and starts to develop the curve in her neck.  The forces that the back part of her neck feels is what triggers her body to pour calcium in the right places until the age of 25.  (Wolff’s Law” of Physics states that bone models and remodels in response to the mechanical stresses it experiences so as to produce a minimal-weight structure that is ‘adapted’ to its applied stresses.”)

Later on, she gets a little more nosey and goes to all fours, dropping her belly with her head lifted up, developing the curve in her low back.  And, off she goes…through a stage of crawling, building necessary brain and body strength, and mechanical and neurological synchronization.  Then, only when she and her spine are ready, she will start to pull up, with ideally, a properly curved spine that has been fortified by normal instinctive motions and body positions.

When the curves in the spine are not properly formed, as is becoming the norm due to a decrease in “belly-time,” walking too soon without first crawling, more sedentary lifestyles and of course, technology posture, the body reacts profoundly!  Look at the body this way, the back or posterior, is the foundational structure, whereas, the front or the anterior, is where all of the organs and pipes are that supply the body with nutrition and eliminate waste.  If you place the weight of your head, shoulders, and hips in the back and heels, you are correctly putting stress in the purposefully larger, denser bones intended to carry such weight and leaving the front to “flow.”  If you place the weight of the head, shoulders, and pelvis in the front, you are blocking flow of nerve supply, blood supply, and lymphatic supply and compressing all of your vital organs, ultimately leading to dysfunction and disease.

What are common symptoms of joint fixation and postural distortion?  Headaches, neck and back pain, numbness, tingling, and weakness in the upper and lower extremities.  Big deal?  Motrin or Tylenol can help you live with those symptoms, right?  Well, every seven years when the body remodels bone and every year when your organs try to replace their tissues, you are allowing dysfunction and disease to continue…until, of course, you get the symptoms that you can no longer cover up and no longer live with.  What are some conditions that are on the rise, linked to postural distortion and joint fixation: hypertension, migraine headaches, ADD/ADHD, sinusitis/allergies/asthma, reflux and GERD, osteopenia/osteoporosis, infertility, and constipation to name a few.  All of these conditions typically lead to a less active you.  The decreased motion in your body further accelerates the deterioration of the joints and the organs through fixation and stagnation.

What can you do?  Look at yourself and your family and notice if the center of your ear is close to the back of your neck and in line with your shoulders?  Are your shoulders lined up with your hips?  Are your hips lined up with your heels?  Do you have any of the aforementioned conditions and use a lot of over the counter medications? Do you have trouble turning your head or bending it forward, backward, or sideways?  Do you avoid bending over or leaning back? Have you become less active and accepted “feeling bad” as your norm?  Or, has disease set in?

Seek out a health care professional whose specialty is the structure and function of the human form, one whose skills, through manual correction, proper education, and physical retraining can help restore your body to the strong balanced flowing structure capable of brilliant healing powers: The Doctor of Chiropractic.

Image from:

Dr. Julie Lyles, DC is a doctor of chiropractic who practices chiropractic care and also owns GetWell Solutions which is focused on Nutrition Counseling, Well Coaching, and Corporate Wellness Programs. For more information, contact Dr. Lyle directly at  




‘Tis the Season…for Allergies

By Ashli Collins, MD

As springtime comes to our area, local doctors offices are filling up with itchy, watery eyes, runny noses, sneezing and coughing.  Adults certainly know the telltale signs of allergies in theOhioValleybut for our younger counterparts, the symptoms are sometimes less obvious. Louisvilleand the surrounding areas often rank in the top five of highest allergy sufferers.  Many families that move to the area are amazed at just how much of an impact allergies can cause on their lives.  An estimated 44 million Americans suffer from allergies-a lot of which are kids.  Allergies rank as the sixth leading cause of chronic disease!

For children, the single most important factor for having allergies is the family history.  A strong family history of allergies, asthma or eczema predisposes the child significantly.  It is estimated by theAmerican Academyof Allergy, Asthma and Immunology that if one parent suffers from allergic disease, the child’s risk is 48% and if both parents are sufferers, that risk is 70%.

Allergies are triggered by allergens-pollens, molds, pet dander, foods to name a few.  When a susceptible child encounters the offending allergen, the immune response occurs and a series of reactions occur causing the typical allergic responses.

The most common allergic symptoms in children are clear nasal discharge, sneezing, sniffing, watery eyes, scratchy throat and nasal itching.  Parents are often greeted with the “allergic salute”, which is the child rubbing their nose vertically to alleviate the itching and stuffiness.  Other frequent symptoms are eye blinking, itchy watery eyes, headaches, restless sleep, coughing, rashes and post nasal drip.  These children often have dark circles under their eyes and stuffy swollen nasal passages.  For some children, ongoing nasal symptoms with stuffiness can lead to sinus infections or ear infections.  Allergies can trigger asthma attacks in some children.

Diagnosing allergies is usually made by the history and physical exam of the child.  Sometimes a referral to an allergist will help the child’s pediatrician make an accurate diagnosis.  There is occasionally the history of “frequent colds” or recurrent ear infections that will prompt the referral as well.  In infancy, rashes and reactions to certain foods often trigger an earlier referral to the allergist whereas in toddlerhood it is more commonly the constant drippy nose or watery eyes.  As children get to school age, full blown allergy symptoms are usually observed.

Testing for allergies is often done by skin testing.  This test is very useful in identifying certain allergens that can potentiate a child’s symptoms.  There are blood-based tests that are used, but skin or scratch testing has remained the gold standard.

Once a diagnosis of allergies has been made, a treatment plan is established.  For many allergens, strict avoidance is preferred, however, it is nearly impossible to eliminate all allergens from a child’s environment.  House dust, or dust mites, is the most common trigger of year round allergies in children.  Frequent vacuuming, encasing pillows and mattresses in dust-proof plastic will help.  Carpet tends to harbor these mites so for many, changing to hardwood floors may be beneficial.

Other common triggers, including pets and pollen are hard to avoid.  10-15 percent of the population suffers from pet allergies.  Pet dander, or microscopic flakes of the pets skin are the main component of the allergic reaction with cats being twice as likely to cause allergies as dogs.  If the pets are in the home to stay, keep them out of the child’s room and frequently change the air conditioner filters.  For pollen sufferers, keep children inside in late afternoon as that is when pollen falls from its source.  Also, monitor for high pollen count days and keep children indoors.

Many allergy sufferers, including children, rely heavily on their pharmacy to help them cope with their symptoms.  The most commonly used medicine is an antihistamine.  These medicines work by blocking the chemicals released in an allergic reaction.  There are now 24 hour, non-sedating antihistamines available for children.  Intranasal sprays are also very helpful in calming the chronic drippy nose allergy sufferers and will also help stop the allergic reaction before it gets started.  Allergy shots are also available for some sufferers.  Newer medicines are also available and may be discussed with your child’s doctor.

Children suffering from allergies are able to live happy, healthy lives.  Often times avoidance of potential allergens is all that is needed, however, if further evaluation is needed, speak to your child’s doctor or allergist for an in depth evaluation.

Image from:

Ashli Colins, MD.  Dr. Collins is a pediatrician with Oldham County Pediatrics, PLLC.  They have offices in LaGrange and in Louisville near the Summit.  Dr. Collins is the mother of  twins, Sarah and P.J.  For more information call 502-225-6277 or


Helping Your Children Adjust To Divorce

By Dr. Kelly McGraw Browning, Psy.D.

It is no surprise that divorce affects a large number of children every year.  Children respond in a variety of ways including sadness, anger and feelings of abandonment.  While many children do struggle emotionally, others adjust quite well particularly if their parents are handling the divorce in a positive way.  It is also helpful if your kids know other children and families who have adjusted to divorce.  It is important to remember that children of divorce can grow up to be happy, healthy, confident and stable individuals.  It is easy for parents to lose sight of this due to alarming statistics, unfavorable predictions from divorce studies and negative stereotypes.  There are many things you can do to promote healthy adjustments to divorce and to make sure your children are on the path to a bright future.

How to Help Your Child Cope

  • Keep open lines of communication with your children.  Be up front and communicate what is going on before your child develops misconceptions or hears news from someone else.  Children should be encouraged to discuss their thoughts and feelings about the divorce in a caring, supportive environment.  Allow your child to ask questions. While open communication is critical, giving your child intimate details about why the divorce is happening may not be appropriate, particularly if your child is still young.
  • Explain to your children that the divorce is not their fault and that you still love them very much.  Young children tend to blame themselves for the divorce, particularly if they overheard arguing over discipline or parenting decisions.
  • Shield your children from any negative feelings you may have toward your ex-spouse. Talk to your friends or other important adults in your life about any anger or resentment you may be experiencing.  Never criticize the ex-spouse in the presence of the kids. You want to avoid putting your kids in a situation where they feel as if they must chose sides.
  • Give your children choices to increase their sense of control.  When parents divorce, children feel even more out of control than they already are.  Depending on the age of the child, you may want to have them participate in the visitation schedule.  They may also want to choose special outings or activities to do with the each parent.
  • Maintain family traditions or rituals.  Change is an inevitable part of divorce.  However, if you can continue family get-togethers and maintain as many activities and routines as possible, children will have an easier time adjusting.  Such events may include  attending church, dinner at grandma’s house, or helping carve the turkey for Thanksgiving.  While some events may be difficult to continue, the message to your child should be that both parents are doing everything possible to continue these activities.  Also, consider developing new traditions to supplement the old.
  • Build and strengthen your relationship with your children.  Spend as much quality time with your children as possible and focus on strengths.  Be positive with your children and always avoid preferential treatment of siblings.  Avoid splitting up siblings.
  • Find a way to effectively communicate with your ex-spouse and develop a parenting plan.  Discuss upfront how you will come to agree on decision making for the children.  Consult with your attorney if assistance is needed.  Avoid talking through your children to communicate with your ex-spouse. This can cause a great deal of distress for the children.  When this occurs, children feel they are caught in the middle.  If you are unable to have a calm, logical conversation with your ex-spouse, try using email or text messaging.
  • Continue to provide structure and discipline.  Children need discipline to help them understand and develop self control.  Many parents who are divorcing feel sorry for their children and tend to be more lenient on discipline and give in too easily.  This will only make matters worse in the long run.  Make sure your rules and expectations are clear up front, particularly if you have different rules and parenting styles than your ex-spouse.
  • Take care of your own emotional needs.  Divorce can be a painful and difficult experience for many parents.  If you are having trouble controlling your emotions in front of the children, you may want to talk to a professional.  This will help to ensure that your own emotions are not getting in the way of your child’s needs and feelings.
  • If your child does not seem to be adjusting well to the divorce, it may be time to seek professional assistance.  Mental health professionals can help children develop effective coping skills and  process thoughts and feelings related to the separation and changes within the family.

The outcome of divorce can be positive with appropriate communication strategies.  Communicate with your child.  Communicate as much as possible with your ex-spouse for the sake of the children. Communicate your own feelings to those you trust.  Remember that children tend to model behavior from parents.  The better you are handling the divorce, the better your children will cope and adjust.

Dr. Kelly McGraw Browning, Psy.D., is an adjunct professor of psychology at Spalding University and practicing child psychologist at Pediatric Psychological Associates, a private practice specializing in children, teens and families with a variety of emotional, behavioral, and developmental problems.  For more information visit or call (502) 429-5431. 



Nutritional Strategies for Staying Healthy as We Age

By Barbara Day, M.S., R.D., C.N.

As we age, there are a number of physiological changes that occur. Calorie needs may be decreased depending on one’s activity, so eating less calories may be warranted or you may end up gaining weight.  Specific issues like constipation and dehydration can also impact our health as well. Here are a few specific nutrients that should receive careful consideration as we age are: calories, dietary fiber, and fluids.

The Specifics – Calories:

       To help manage our weight as we age, knowing how many calories you need per day is helpful. Reading food labels can help you determine how many calories you are eating per day. Don’t forget there are also calories in beverages that you drink as well.

Caloric Levels for Women and Men Over 50

Activity Level Women over 50 Men over 50
Low – activities with typical day-to-day life 1,600 calories/day 2,000-2,200 calories/day
Moderately active – walks 1.5 to 3 miles/day at 3-4 miles per hour 1,800 calories/day 2,200 – 2,400 calories/day
Active – walk more than 3 miles per day at 3 – 4 miles per day 2,000 – 2,200 calories/day 2,400 – 2,800 calories/day

The Specifics – Dietary Fiber:

Dietary fiber should be emphasized because constipation is often a major concern as we age. Men over 50 should eat at least 30 grams of dietary fiber per day and women over 50 should eat at least 21 grams of dietary fiber per day. There are two types of dietary fiber: soluble and insoluble. Good sources of soluble fiber – oats, oat bran, barley, legumes (e.g. dried beans, lentils, & split peas), flaxseed, apples, pears and citrus fruit. Soluble fiber helps to lower cholesterol and blood sugar levels. Insoluble fiber promotes regularity, adds bulk and softness to stools and helps with weight regulation. Good sources: wheat bran, whole wheat and other whole grain cereals like Wheaties, Shredded Wheat, Bran Flakes, nuts and vegetables.  Dietary fiber can help decrease the risk of heart disease, diabetes and stroke.

The Specifics – Fluids:

Chronic dehydration in the elderly may be associated with a decline in physical function and also a decline in their cognitive status and can account for frequent emergency room visits and hospital stays. Dehydration can be due to a reduced thirst sensation which occurs as we get older. Some drugs, like SSRI’s, ACE Inhibitors and also anti-Parkinson drugs, that seniors routinely take may also suppress their thirst.

Some of the signs and symptoms of dehydration can be identical to senile dementia symptoms, age dementia symptoms and Alzheimer’s symptoms. Correcting dehydration can allow the senior to return to a full and normal life. But, not correcting the dehydration may actually result in hospitalization of the senior.

The Institute of Medicine advises men to consume about 104 ounces of fluids  per day and women should consume about 72 ounces of fluids per day. Another way to determine hydration is the color of one’s urine. Urine color for the first void of the day is typically yellow but as the day goes on urine color should be pale (slightly yellow) to colorless. If not, more fluids need to be ingested. Here’s a Urine Color Chart that you might find useful,

Your Plateful of Food

The type of food we eat is critical to keeping us healthy. Since our calorie needs may go down if our activity goes down, making wise food choices can help keep you out of your doctor’s office.  For example, eating whole grain  foods like 100% whole wheat bread instead of white bread or eating old fashioned or steel cut oatmeal instead of eating cornflakes would provide more nutrients and dietary  fiber.   Eating more brightly colored fruits and vegetables will also provide more nutrients, dietary fiber and fluids, as well. If you have a chewing problem, you can drink your fruits and vegetables by making fruit and vegetable smoothies.

Barbara Day, M.S., R.D., C.N., is a registered dietitian with a Master’s Degree in clinical nutrition.  The former publisher of Kentuckiana HealthFitness Magazine, Kentuckiana Healthy Woman magazine and radio show host of Health News You Can Use, Barbara has over 30 years of experience in promoting healthy lifestyles to consumers.  Barbara worked as Nutrition Consultant to the Navy SEALs (8 years) and the University of Louisville Athletic Department (10 years). Barbara has private practice, DayByDay Nutrition,, where she counsels clients on weight loss, cholesterol management, performance nutrition and an array of other medical issues.  Visit Barbara’s new website which is an on-line health & wellness magazine, Barbara writes nutrition and health columns for as well as a weekly nutrition column for the Southeast Outlook. She also designs and presents employee wellness programs to small and large businesses. Barbara is a runner, cyclist, hiker and a mother and grandmother to 12 grandchildren.