Asbury Park Press from Asbury Park, New Jersey • Page 58

B14 Asbury Park PressSunday, April 20, 1 986 Health Study seeks heart defect patterns 1M I I I I I 'I I I pi i Vr hi fe. I I jc A WVslJ CD lJ -IP 'f Vt .1 The physician received her doctor of medicine degree from Madiera Uni: versity in India before coming to U.S. in 1956. She served her internship and medical residency at hospitals on -( Washington and Miami Beach, before. becoming associate director of congenir tal heart disease research and training at the Hektoen Institute for Medical Research in Chicago.

Drs. Maurice Lev, Deborah's laboratory director, and WaJ- ter Christian, are assisting her with the program. Briefly Noted Riverview Med; ical Center, Red Bank, is now offering a new weight reduction program, called Optifast, to anyone who is more than 50 pounds overweight. It consists of a period of modified fasting, during which patients replace regular food with a powder formulation that pro- vides all essential nutrients. For details, contact Fran Fitzsimmons at the tal's immediate medical care center.

Marketing of a new type diaper, whose makers say will help combat diaper rash, has begun in the area. Ultra Pampers, a Proctor product, have won the endorsement of the National Association of Pediatric Nurse Associates and Practitioners." They say the diapers "keep skin dry and control pH which is important in maintaining healthy baby skin." The Ocean County Computer -Club is offering a free membership to disabled county residents. The group meets on the first Friday evening of each month at the planetarium build-v ing at Ocean County College, Dover township a barrier -free building with adjacent parking for the handicapped. Rutgers University has two booklets available for persons with alcohol or drug abuse problems. Both.

"Employee Assistance: Policies and Programs" and "What Shall we Teach the Young About Drinking" can be obtained at $2.50 each from Publica- tions Division, Center of alcohol Stud-1 ies, Smithers Hall, Rutgers University, Piscataway 08854. Additional titles are planned. Kessler Institute for Rehabilitation, West Orange, has expanded into the Bergen-Passaic County area. The institute is developing a 52-bed unit on, the third and fourth floors on the underused Kennedy Memorial Hospi tal, Saddle Brook, and expects to admit, the first patients there in September. By GEORGE W.

BROWN I there a link between seasonal outbreaks of German measles and devel opment of congenital heart defects? Are the toxic waste dumps scattered across New Jersey responsible for an increase in the incidence of heart defects among children. And is the incidence of heart disease more prevalent in some parts of the state than in others? These are among the questions that Dr. Sarojo Bharati hopes to answer as a result of the creation of the state's first congenital heart defect registry at Deborah Heart and Lung Center, Pemberton Township. She's asking all cardiologists and pediatricians in the state, as well as those in eastern Pennsylvania and southern New York State, to report to the registry any patient diagnosed as having a heart defect. Already some 200 physicians have agreed to take part in the study, which Dr.

Bharati said has the support of the state Health Department. She estimates it will be at least five years before the first meaningful data is available. "We see a rise in the number of children born with ventricular septal defect a hole in the wall separating the two lower chambers of the heart and patent ductus arteriosus an abnormal connection between two blood vessels that permits too much blood to go to the lung. "We hope to discover any common denominators or conditions, such as heredity or environmental factors, that cause such defects." The registry is similar to the cancer registry created by the Health Department two years ago to learn more about the incidence of cancer in the state. But while the Health Department can require physicians to report all cases of cancer to that registry, Dr.

Bharati has to rely upon the voluntary cooperation of doctors. "Now I have 30 to 40 percent cooperation," Dr. Bharati says. "I have not reached out to all the doctors yet." Once physicians agree to submit data to the registry, Dr. Bharati sends them forms to be filled out for every new patient, giving a detailed history of their particular heart problems.

Once the form is returned to her, the data is fed into a computer. Only about 20 cases of congenital Dr. Sarojo Bharati, chief of pathology at Deborah Heart and Lung Center, Pemberton Township, discusses aims of the congenital heart defect registry she established there. Asbury Park Press Dr. Diana Trusky and husband, Dr.

Stanley J. Lewis, in their office. Two doctors link career, marriage country. This data will tell me part of New Jersey is (experiencing) this increase. "Then we may look further into the effects of the environmental pollution, whether (incidence of heart disease is greater) near dumping sites.

Also we can find out if there is a seasonal occurence factor. If we could show a seasonal increase related to German measles which we know can result in congenital heart misformation we can think in terms of how to prevent it." Dr. Bharati, a Medford resident, said she is so excited at the research possibilities offered by the registry she often finds herself working seven days a week in her attempt to increase the number of cooperating physicians and to improve the quality of data being put in the computer. But she's says she doesn't consider herself a workaholic. "Work is my hobby," she says.

Stress is a fact of all our lives ratings scale from 1 to 10 with 10 the best 8-9 Research Group 111 I Mental health care For inpatient and outpatient care; on 2-3 Z4-5 E36-7 a ALASKA HAWAII Chicago Tribune Map; Source: Public Citizens Symptoms of The Washington Post in tress affects different people different ways. Here are some symptoms. Tense muscles. Backaches. Tight or fluttery stomach.

Pounding or racing heart. Shortness of breath. Increased perspiration. Cold hands or feet. Lack of concentration.

I I Health By MATTHEW A. KARAS Press Red Bank Bureau The doctor is in. If not, the doctor's wife is in. Or perhaps the doctor's husband. No matter.

At the Tindall Road, Middletown Township, dermatology practice of Dr. Stanley J. Lewis and Dr. Diana E. Trusky, the doctors are husband and wife.

"It gives us much more in common," said Lewis of his wife's decision six years ago to join his private practice. "We have the same problems and frustrations. We can empathize with each other's problems," he said. "Most of our patients know (we're married)," Ms. Trusky said, "because we've been in the community for a while.

A few of our patients don't realize, though, and I don't make a point of telling anybody." In the office, they share a desk and refer to each other as "Dr. Lewis" and "Dr. Trusky." No "hi, Stan" or "how ya' doin, Diana." "I think we get along better in the office than we do at home," Ms. Trusky said. "We're both professionals." The doctors, who have been married 14 years, have similar training, so patients can pick and choose when they enter the office.

"I'll get professional women, the women who are very concerned with the way they look," Ms. Trusky said. "I understand them better than Dr. Lewis does. They say, 'I want this red mark removed from my and if they go to Dr.

Lewis, he says, 'what red mark? And I can see it from the doorway." For her first couple of months in the practice, all her clients were women and children, she said, and not by choice. "I don't know how it changed, but it just changed itself," she said. Lewis is more popular with professional men, who may be "embarrassed about going to a woman," he said. There is no confusion at billing time, though. "I just say make all the checks out to Dr.

Lewis," Ms. Trusky said. "I'm going to take it all anyway." The two met when Lewis was a medical student at the Mount Sinai School of Medicine, New York, while Ms. Trusky was director of nursing in the pediatrics ward. She wanted to leave nursing, she said, because her chance to work directly with patients, which she preferred, was overshadowed by her administrative work.

She enrolled at the Medical College of Pennsylvania, Philadelphia, where Lewis was an intern. When Lewis re turned to New York to serve his residency at Columbia Presbyterian Hospital, Ms. Trusky transferred to the Albert Einstein College of Medicine, something she said was easy to do because of her high grades. "In medical school I was discouraged from going into dermatology be-cause (my husband) was a dermatologist," Ms. Trusky said.

"My friends said, 'you're They said go into allergy, and that way you can refer to each other." But not only has the marriage worked out for the better, according to the couple, so has the practice. "We'll get phone calls from colleagues of ours who want another opinion," Lewis said. He and Ms. Trusky, on the other hand, merely have to walk across the hall for a second opinion. Just as Middletown is a quiet haven away from New York city life, so is dermatology something of a haven from the blood-curdling messes that appear more frequently in other branches of medicine.

Ms. Trusky said that as a resident in a Bronx hospital emergency room she earned the nickname "Doc Holli-day" because, "the halls would be just lined with lacerations and bullet wounds, and I used to get all the bullet wounds. The police would wait for me to pull out the bullets so they could put tags on them. "You'd have stretchers everywhere. There was no order.

People bleeding everywhere, reaching out their hand, saying, 'doc, help Although dermatologists encounter acute, lethal diseases on occasion, the field represents a more cheerful side of medicine, they said. Lewis said as an intern in internal medicine, "I would see patients hospitalized, a couple of months later they'd be back with the same problem." With dermatology, he said, "most people we're able to help and they're happy." He recently discovered, he said, a skin problem he calls Club Med Syndrome. He said patients who had been on Club Med vacations and played a game in which they had to pass a lime drink from person to person using their legs developed black streaks on their legs because of the mixture of hot sun and lime juice. "You can actually see a (dermatology) patient getting better," said Ms. Trusky, who is program director for the Monmouth-Ocean Women's Physicians Group.

"It's a very happy-type specialty." In their spare time they are restoring the Victorian house in the township's Locust session where they live with their 8-year-old daughter, Jenny. stress variable I Your Health heart disease are in the computer's memory bank now, far too few to answer any of Dr. Bharati's questions. But she's optimistic the trickle of forms into her office will become a flood as more and more doctors learn of the registry. She's already alerted hospital officials to be prepared to expand the capacity of the computer to meet future needs.

Dr. Bharati says she has gotten excellent cooperation from hospital officials since outlining plans for the registry to them shortly after her appointment as chief of pathology three years ago. "I hope to accomplish many, many things," the physician says. "It has been shown there is an increase in congenital heart defects on the East Coast of our the background and resources of the person under stress. In a long-term study of 200 third- to sixth-grade children, psychologists Norman Garmezy and Ann Masten of the University of Minnesota found that children with high IQs, high family incomes and positive family backgrounds perform better than average in high stress situations, such as divorce or moving.

The way a person perceives stress can go a long way toward blunting its ill effects, even with chronic, long-term exposure to stress. Studies of people living near the Three Mile Island nuclear power plant found that residents have slight suppression of the immune system, increases in blood pressure and higher levels of stress hormones. The worst effects appear in those residents who feel powerless and blame their predicament on others, says psychologist Baum, who is conducting an ongoing study. Job stress by itself is "not problematic," reports psychologist Leonard Syme of the University of California at San Francisco. "But high job stress with little latitude or flexibility causes trouble." But some jobs with high psychological strain take the least toll on health.

The significant difference is that these jobs also give employes a great deal of control. Among the jobs that fit this bill are architect, forester, natural scientist, dentist, skilled machinist and auto repairman, reports Robert A. Ka-. rasek, an industrial engineer at the University of Southern California. Another example of how control and skill can help cut the effects of stress is in athletics.

Professional players often face high stress. In a recent basketball game against the Washington Bullets, Boston Celtic Larry Bird sunk a foul shot in the last few seconds of regulation time to tie the score and put the game into overtime. For Bird, who makes 90 percent of his foul shots, "the" demands of were extraordinary," says University of California's Syme. One reason people often have trouble managing stress is that the body is programmed to maintain an equilibrium. Stress is "the reaction of our bodies to any threat or change" in the status quo, says Dr.

George Chrousos, a stress researcher at National Institute of Child Health and Development (NICHD). When the temperature rises to the 90s, the body responds by sweating to lose heat and cool off. Eat a big meal, and the body shifts the gastrointestinal system into action to digest food for immediate use and store the rest. Get angry or become frightened, and the body mobilizes resources with the primitive response known as "fight or flight." Physical stresses include "malnutrition, pain, surgery, anesthesia, blood loss, burns, infection and inflammation," Chrousos says. Emotional stresses range from the separation of a young child from a parent to death.

By SALLY SQUIRES The Washington Post Call it strain. Call it pressure. Call it tension. By any name, stress is almost as certain as death and taxes. "There is no such thing as a stress-free environment," says Dr.

Philip Gold, a stress researcher at the National Institute of Mental Health. "There are situations where stress is not overwhelming, where it's something that people might call (part of) the fabric of a rich life." Most people perceive of stress as negative. That's probably because, by definition, it is "a perceived threat or demand which somehow exceeds one's capabilities to easily deal with it," says medical psychologist Andrew Baum of the Uniformed Services University of the Health Sciences. Yet stress has a positive side. Living without stress is unthinkable it is the emotional equivalent of friction.

Imagine trying to walk without friction, or attempting to ride a bike without the resistance of the road. It simply can't be done. The same goes for stress. Low levels act as motivators, as devices that challenge and promote interest. But none of the potential positives overrides the well-known connection between too much stress and disease.

From allergies and asthma to cancer and heart attack, numerous studies suggest that high levels of stress help promote illness by altering the immune system and placing an added load on the heart and blood vessels. New research is now fine-tuning that picture. Studies are indicating that the relationship between stress and disease is not a simple cause-and-effect connection, but rather a complex equation that can change with the situation and the individual. Approach a crisis with a different outlook, throw in greater control or more flexibility, and suddenly the tension-filled situation takes on a whole new demeanor. This may explain why some people appear able to let pressures and stress roll off their backs despite seemingly impossible situations.

Among the most recent findings: Stress seems closely related to anxiety and depression. The biggest clue for this linkage is a brain chemical called corticotropin releasing hormone (CRH). During stress, anxiety and depression, the brain produces extra CRH, thereby setting off a series of chain reactions throughout the body. "We know that small amounts or moderate amounts of stress are alerting," explains Gold of NIMH. "We think better, we move faster and we adapt better." But too much stress tips the scales the wrong way.

Then people "can't function," he says. "They can't remember, they can't adapt to a situation. Stresses can accumulate, but the amount of damage depends in part on Quiz gauges stress Desire to cry or run away. Loss of self-confidence. Irritability or edginess.

Frequent anger. Frustration. Increased use of alcohol, tobacco or drugs. Forgetfulness. Accident proneness.

Crying, yelling, blaming. Nail biting or teeth grinding. Decline in productivity. Absenteeism from work. Avoiding others.

I Change in personal appearance. 8. If during the week you do something that you really enjoy and is "just for you," give yourself five points. 9. Do you have some place in your home that you can go to relax or be by yourself? If so, score 10 points.

10. Give yourself 10 points if you practice time management techniques in your daily life. 11. Subtract 10 points for each pack of cigarettes you smoke in an average day. 12.

Do you use any drugs or alcohol to help you sleep? If so, subtract five points for each evening during an average week that you do this to help get to sleep. 13. During the day, do you take any drugs or alcohol to reduce anxiety or calm you down? If so, subtract 10 points for each time you do this during the course of an average week. 14. Do you ever bring work home in the evening? Substract five points for each evening during an average week that you bring office work home.

Scoring Calculate your total score. A "perfect" score would be IIS points. Short of that, the higher the score, the greater the ability to cope with stress. A score of 50 to 60 points indicates an adequate ability to cope with most common sources of stress. 'Elderly' may not be minority The Washington Post medical science makes steady pro gress against the diseases that kill The Washington Post How do you cope with stress in your life? Gauge your ability with the following quiz, created by University of Maryland psychologist George S.

Everly Jr. for the U.S. Department of Health and Human Services. You'll need a paper and pencil. 1.

Do you feel that you have a supportive family? If so, score 10 points. 2. Give yourself 10 points if you actively pursue a hobby. 3. Do you belong to some social activity group that meets at least once a month (other than your family)? If so, score 10 points.

4. Are you within five pounds of your "ideal" body weight, considering your health, age and bone structure? If so, give yourself 1 5 points. 5. Do you practice some form of "deep relaxation" at least three times a week. These include meditation, imagery, yoga, etc.

If so, score 1 5 points. 6. Give yourself five points for each time you exercise 30 minutes or longer during the course of an average week. 7. Give yourself five points for each nutritionally balanced and wholesome meal you consume during an average day.

4 "Delayed retirement will almost certainly be required to save Social Security from bankruptcy," predicts James W. Vaupel of the University of Minnesota. "If more of the elderly hang onto their jobs, however, promotional opportunities will diminish for the Vaupel and fellow researcher Ann E. Gowan discuss the prospect of an older America in their article, "Passage to Methuselah." Among their predictions: Society will face the "major challenge" of letting old people continue to work while giving young people a chance. People will work 28 hours a week from age 22 to age 82, taking off two months a year and an entire year every decade "for ongoing education." 4 older people, then people 85 or older will make up 18 percent of the population in 100 years.

Such a dramatic change from the 1 percent figure of today is at least "conceivable," a study in the American Journal of Public Health concludes, and even without any medical progress, the percentage of people in that age group will more than double by the year 2080. If, on the other hand, death rates drop by just 1 to 2 percent a year, then 40 percent of the 2080 U.S. population will be over 65..