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• Publications Library
• WH - A Guide to Women's Health
• Spring 2006

The incidence of diabetes has reached epidemic proportions in the United States. Although the problem is daunting, vital steps toward prevention—eating well, getting regular exercise, maintaining a healthy body weight—must begin with each individual. This issue's feature article explores this timely topic and also highlights key health concerns among women who have or care for someone with diabetes, and advanced treatments available to them at John Muir Health. Read on for the latest in the battles against skin cancer and degenerative disc disease plus reports on leading-edge technology in medical imaging and our new cath lab. Other articles give updates about everything from head lice and herbal cold remedies to PMS and pedometers. It's all informative, all useful and all for you.

—J. Kendall Anderson
President and CEO,
John Muir Health

Parenting Strong-Willed Teenagers

The Parent Project® is a nationally proven program for changing destructive adolescent behavior that has helped hundreds of families in Contra Costa County and beyond. Parents who complete the course learn to

• improve their teen's self-esteem and school performance.
• identify and intervene with drug and alcohol abuse.
• reduce family conflict and improve family relationships.
• actively deal with negative peer associations.

Classes, co-sponsored by Mt. Diablo Unified School District and John Muir Behavioral Health Center, are held on Wednesday nights from 6:30-9:30 p.m. at the Behavioral Health Center, 2730 Grant St., Concord. Consultations are available before and after class. For more information or to register ($40), call (925) 687-0374.

Find a Physician For a referral to the more than 800 primary care and specialty doctors in the John Muir Physician Network in East Bay communities from Antioch and Brentwood to Livermore, call (925) 941-2244.

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Relief For Degenerating Discs

If you're among the countless Americans who suffer chronic low back pain, the root of your problem may be degenerative disc disease, which experts say is the culprit in as many as half of such cases.

You might call this condition "advanced aging of the spine," says Jason A. Smith, M.D., orthopedic spine surgeon on staff at John Muir Medical Center, Walnut Creek Campus and Concord. "As the spine ages normally, there is drying out and thinning of the discs over time. In degenerative disc disease, the process happens more rapidly than normal." Why the routine wear and tear of life takes a harder toll on some people's discs than on others' is poorly understood, adds Abid Qureshi, M.D., orthopedic spine and trauma surgeon on staff at John Muir Health. "But it's a major source of morbidity— greatly impacting patients' quality of life, hours lost from gainful employment and more."

Diagnosis is typically based on physical exams (patients often present with long-standing pain in the back and legs), plus X-ray and MRI findings. "On X-ray, the first stages of degenerative disk disease show loss in height, increased density of the disc and some bone-spurring around the disc," explains Dr. Smith. "Ultimately we treat the patient's symptoms. Many people can have abnormal MRIs but feel completely normal."

To treat acute flare-ups, doctors typically prescribe antiinflammatory medications and a few days' rest, plus ice followed later by intermittent heat. If discomfort continues, physical therapy, which emphasizes strengthening of core muscles, good body mechanics, and flexibility exercises, often brings relief. Therapeutic massage or acupuncture may be helpful, too. "What usually works best is a combination," says Kim Bradshaw, John Muir Health senior physical therapist. "We teach people ways to put cumulatively less stress on the spine, which can lead to less pain."

"For most patients, symptoms are resolved with this group of treatments," adds Dr. Smith. "But if symptoms persist, the next step would be more diagnostic testing. This may lead to the patient being offered epidural steroid injections, which often relieve the acute pain associated with inflammation around the discs."

If all other treatments fail, patients should check with their physician to see if they may be a candidate for surgery. Options include spinal fusion, in which bone grafts are used to join adjacent vertebrae, or disc replacement using the Charité artificial disc, the groundbreaking device that won FDA approval in 2004.

"People who have a reasonable chance of success with surgery are patients whose disease is limited to one or two discs," explains Dr. Qureshi. "Fortunately, minimally invasive procedures are now being performed and are speeding the time of recovery."

Gene therapy and stem cell research aimed at disc regeneration hold promise for the future, he adds. "Someday these tools may modulate this disease and others."

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Rehabilitation Services Ask your physician if you could benefit from physical therapy, back education classes or other specialized rehabilitation programs offered at John Muir Health's outpatient physical rehabilitation centers. Physician prescription is required. For more information, contact the following John Muir Outpatient Physical Rehabilitation centers, or click here. Walnut Creek, (925) 947-5300 Brentwood, (925) 240-0334 Health and Fitness Institute, (925) 685-1779 Concord, (925) 674-2125 Danville, (925) 831-1414 Rossmoor, (925) 988-7595 For more information, call Orthopedic Services at (925) 941-5010 or click here.

Copyright © 2006 by John Muir Health. WH is published quarterly by John Muir Health as a community service and is not intended for the purpose of diagnosing or prescribing. WH Editorial Advisory Board: American Heart Association; Office on Women's Health, U.S. Public Health Service; and the American College of Nurse- Midwives. Produced by DCP.

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