55 and Better — April 30, 2024

Physical therapy plan after total knee replacement surgery

Commentary by Linda Barnes

More than 600,000 total knee replacement procedures are performed each year in the United States. As our population ages and obesity levels continue to increase, knee replacement surgeries are expected to increase.

One of the most important success factors following a total knee replacement is physical therapy and a lifelong exercise program.

Physical therapy typically begins during the hospital stay with the initial goal of getting the individual up and walking, decreasing swelling in the knee and increasing range of motion. On the day of surgery, you likely will be using a walker and taking a few steps with the physical therapist.

In the next few weeks, you will be doing a variety of exercises with the therapist, including, but not limited to, leg raises, ankle pumps, knee straightening and supported knee bends, with a goal of reaching 90-degree flexion.

In three to six weeks, you can expect to use a cane or no device at all for walking. You will start doing normal daily tasks at home such as making your own coffee, showering, dressing, etc. You will also be working on scar mobilization and strengthening as you progress.

In seven to 12 weeks, you should have a wide range of motion and will continue with scar mobilization and strengthening as needed.

Therapy On Wheels physical therapists can help you recover from your knee replacement in the comfort of your own home as an outpatient. Contact our office at 317-332-9861 for information or visit our website at therapyonwheelsinc.com.

Linda Barnes is an occupational therapist and owner/president of Therapy On Wheels. For more on Therapy on Wheels services, call 317-332-9861.

HHearing aids improve

By Mark Ambrogi mark@youarecurrent.com

earing aid technology continues to improve each year.

“When patients who have worn hearing aids for years are fitted with a new one, they definitely notice the improvement,” said Kira VonBlon, co-owner of Meridian Audiology in Carmel. “They are getting smaller. Some of them can be tiny.”

VonBlon and Alison Wyss have owned the practice for nearly three years. They previously worked together at an ear, nose and throat practice in Carmel.

VonBlon, who has a master’s degree in audiology from Purdue University, has been an audiologist for 25 years. Wyss, who has a doctorate in audiology from Indiana University, has been an audiologist for 14 years.

“We moved to private practice, so we can spend all the time we need with our patients,” VonBlon said. “In a medical

center, it’s hard to spend all the time people want or need.”

VonBlon said they meet with the patients to learn their medical history and needs.

“Then we check their hearing to make sure they are a candidate for hearing aids,” VonBlon said. “If not, we’ll spend some time with coping strategies and the people that can help them hear and understand better.”

If the patient is a candidate, they talk with them about different hearing aid options. Accessories can be paired for the television, the phone and meetings.

“We mainly fit Phonak and ReSound hearing aids,” VonBlon said. “We are happy to see patients who have hearing aids from an outside facility if they’re looking for a new audiologist.”

Besides Phonax and ReSound, VonBlon said they can work with other major hearing aid companies, such as

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Foot pain keeping you down? It might be arthritis

Commentary

by Dr. David Sullivan and Dr. Kenneth Stumpf

Arthritis of the foot is a common condition that affects many older Americans. As people age, the joints in their feet may suffer wear and tear, leading to arthritis. The condition can be debilitating, causing pain, stiffness and difficulty walking. In this article, we will explore the causes, symptoms and treatment options for arthritis of the foot in older Americans.

Arthritis is a term that refers to inflammation of the joints. In the case of the foot, arthritis can affect the various joints that make up the complex structure of the foot. The most common types of arthritis that affect the foot are osteoarthritis and rheumatoid arthritis. Osteoarthritis is a degenerative condition that occurs when the protective cartilage that cushions the ends of the bones wears down over time. Rheuma-

toid arthritis, on the other hand, is an autoimmune disease that causes the immune system to attack the joints, leading to inflammation and damage.

Older Americans are particularly susceptible to arthritis of the foot because of the natural aging process. As people age, the cartilage in their joints may deteriorate, leading to arthritis. Additionally, older adults may have had a lifetime of wear and tear on their feet, contributing to the development of arthritis. Factors such as genetics, obesity, and previous foot injuries can also increase the risk of developing arthritis in the foot.

Symptoms of arthritis of the foot can vary depending on the type and severity of the condition. Common symptoms include pain, stiffness, swelling and difficulty walking. In some cases, arthritis of the foot may cause deformities such as bunions or hammertoes. These

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Sycamore Reserve resident had a range of careers

ARenaissance man is someone who has acquired profound knowledge or proficiency in more than one field.

Meet Bertie Morse, a Renaissance woman.

By Ken Severson editorial@youarecurrent.com Morse

The resident of Sycamore Reserve Senior Independent Living facility in Indianapolis, has accomplished quite a bit in her 88 years.

“I’ve probably had three careers alone,” Morse said, laughing.

A Grand Rapids, Mich., native, Morse has lived at Sycamore Reserve for nearly two years.

Morse, who has bachelor’s and master’s degrees from the University of Michigan, has been a social worker; worked in real estate; owned and operated a company that serviced homeowners associations; owned a women’s consignment store; worked for RCI in Indianapolis; and worked for the federal government performing security background checks before finally retiring.

Morse has also lived in Germany and Mexico, and for 10 years, called Sedona, Ariz., home.

Morse has also lived a mobile lifestyle, buying a recreational vehicle and traveling throughout the United States alone for nearly two years, even stopping off at Yellowstone National Park to work a spell.

“That was a great experience,” Morse said. “One of the highlights for me.”

Shortly thereafter, she moved to Indianapolis to be close to family.

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That was in 2006.

“I have done a lot,” Morse said.

Now that Morse has retired and settled in at Sycamore Reserve, she is simply enjoying the solace of retirement.

“I like to go places and do things, but I don’t have any specific hobby,” she said. “Since moving here, I really don’t do much of anything.”

Morse, who is divorced, has two daughters, one in Fishers and one in Mokena, Ill. She also has seven grandchildren and three great-grandchildren.

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symptoms can have a significant impact on the quality of life of older Americans, making it difficult for them to perform daily activities and maintain their independence.

Treatment for arthritis of the foot aims to reduce pain, improve function and slow the progression of the disease. Conservative treatment options may include rest, ice, physical therapy and supportive footwear. In more severe cases, medications such as nonsteroidal anti-inflammatory drugs (NSAIDs) or corticosteroids may be prescribed to help manage pain and inflammation. In some cases, surgery may be necessary to repair or replace damaged joints in the foot.

Prevention is key when it comes to arthritis of the foot in older Americans. Maintaining a healthy weight, wearing supportive footwear, and staying active can help reduce the risk of developing arthritis. Regular foot care, including proper hygiene and routine check-ups with a podiatrist, can also help detect and treat arthritis early.

In conclusion, arthritis of the foot is a common condition that can affect older Americans. By understanding the causes, symptoms, and treatment options for arthritis of the foot, older adults can take proactive steps to manage the condition and improve their quality of life. With proper care and attention, arthritis of the foot does not have to be a barrier to living a full and active life in older age.

Dr. David Sullivan and Dr. Kenneth Stumpf are both board-certified foot surgeons at Westfield Foot and Ankle, LLC. Contact them at appt@westfieldfoot.com or 317-896-6655.

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UNDERSTANDING HPV-RELATED OROPHARYNX, HEAD AND NECK CANCER

By Dr. Michael Sim, surgical oncologist specializing in Head and Neck Oncology and Microvascular Reconstruction at the IU Health Joe & Shelly Schwarz Cancer Center in Carmel

As we age, staying informed about health risks becomes increasingly important. One such risk that has gained attention in recent years is human papillomavirus (HPV)-related oropharynx (upper throat) cancer of the head and neck. Contrary to popular belief, this type of cancer isn’t just a concern for the younger population; individuals aged 55 and older are also at risk. Therefore, it’s crucial for this age group to understand the connection between HPV and these types of cancers, as well as the preventive measures and early detection methods available.

HPV AND THE RISK OF CANCER

HPV is a common virus that can be transmitted through various forms of intimate contact, including oral sex. While the body’s immune system can often clear the virus, in some cases, it can persist and lead to various health issues, including cancer. In recent years, there has been a notable increase in HPV-related oropharynx cancers, particularly among older adults.

One of the challenges with HPV-related cancers is that they may not present symptoms until the disease has progressed. However, there are certain signs to watch for, including persistent sore throat, difficulty swallowing, ear pain and a lump or mass in the neck. If you experience any of these symptoms, it’s important to consult with a healthcare professional promptly.

HOW TO LESSEN YOUR RISK

Prevention plays a crucial role in reducing the risk of HPV-related cancers. Practicing safe sex and limiting the number of sexual partners can reduce the risk of HPV transmission. However, it’s important to note most HPV infections do not lead to cancer. To learn more, speak with your primary care physician.

Regular screenings are also essential for early detection and treatment. During routine dental and medical check-ups, discuss with your healthcare provider about including screenings for oral, throat, and head and neck cancers as part of your preventive care plan. These screenings may involve a visual examination of the mouth, throat, and neck, and additional tests if needed.

TREATMENT OPTIONS

Fortunately, HPV-associated oropharynx is very treatable. Both nonsurgical treatment via chemotherapy and radiation and surgical treatment are highly effective treatment methods.

Transoral robotic surgery (TORS) is a robotic surgery technique that allows for removal of tumors in difficult-to-reach areas of the back of the throat and voice box. It is a minimally invasive procedure with access through the mouth. The procedure is performed under general anesthesia. A surgeon operates specialized robotic arms. This allows for grasping and precise incisions (small cuts) in the tissue. It also gives 3D and magnified views of the affected area. Our team at the IU Health Joe & Shelly Schwarz Cancer Center in Carmel and I were the first in Indiana to perform

this robotic surgery with the newest, state-of-theart robotic platform that uses a single port for the robotic instruments, and we are the only providers of this advanced surgical technique in Indiana.

The IU Health Schwarz Cancer Center is also conducting a clinical trial, led by me, for qualifying patients with HPV-related oropharynx cancer. Participants undergo transoral robotic surgery followed by no radiation or reduced radiation, depending on the pathology findings and aggressiveness of the disease, and do not receive chemotherapy. The goal is to maintain high cure rates for patients while decreasing long-term side effects and treatment toxicity.

At IU Health, patients are evaluated by head and neck surgical oncologists. Their cases are then discussed in a multi-disciplinary head and neck tumor conference attended by head and neck cancer experts across many specialties. These providers come to an agreement about the best treatment options for patients. This allows for the highest level of care possible for the best outcomes.

Learn more about IU Health’s Head and Neck Cancer program by visiting iuhealth.org/ find-medical-services/head-and-neck-cancer.

Dr. Michael Sim

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Carmel resident excels on mound in baseball league for older adults

By Mark Ambrogi mark@youarecurrent.com

Scott Metzinger was a standout pitcher for Butler University’s baseball team in the early 1990s.

Then, he stepped away from the game for more than 20 years.

“I didn’t start pitching again until I was 45. Some friends talked me into pitching for a competitive league,” said Metzinger, who pitched for Butler from 1990-93.

The Carmel resident played in the Indiana Baseball League for ages 45 and older for nine seasons but will concentrate only on the Hoosier Adult Baseball League this season.

Metzinger, 54, has played in the Hoosier Adult Baseball League for players 48-and-older for five years. The team plays its games at Grand Park.

“I plan to do it for the next three to five years until my body tells me not to,” Metzinger said.

Metzinger said his fastball still averages between 75 and 80 mph. At Butler, his fastball averaged 88 to 90 mph.

“Scott has been the top pitcher in the HABL since he joined in 2019,” said John Dearth, the league president. “There are certainly other pitchers who have entered the conversation as the top pitcher in our league in a given season – Mike Shadoan, Steve Powell and Brent Steele, among others, but no pitcher stepped in and elevated the play of the league like Scott. His velocity is down a bit from the first few seasons he was with us, but he knows how to pitch and is still considered the league’s top arm. That isn’t to take anything away from the other guys, but he has earned the title of the top pitcher in Hoosier Adult Baseball. I could go so far as to say for the sake of comparison, based on his performance over his five years in our six-year history, he would be our Cy Young.”

Metzinger pitches for the Monarchs, who have won four of the last five championships, losing in the championship game the other season.

“I’ve developed some great friends over

the last nine years,” he said of playing in the two leagues.

BULLDOG LOVE

Like Scott Metzinger, Carmel resident Rob Yeary is a former Butler player in the Hoosier Adult Baseball League.

“When ‘Metz’ left Butler, he had the all-time (low) earned run average,” the 60-year-old Yeary said. “When I left Butler, I had 16 school records at that time. I had the second all-time batting average. We’re still competitive and ‘Metz’ hates it to the nth degree when I get a shot off him. I always say, ‘Dude, I’m six years older than you and I’m still going to hit you.’ I love him. After the game and before the game, there’s always a hug. I know how to get in his head. The more I tell ‘Metz’ I love him, the more difficult time he has with me on the mound.”

Yeary said when he started in the league five years ago, it was the first time he hit a baseball in more than 25 years. He had a left knee and femur replacement prior to that.

“It was an amazing revitalization at our age to think I can still do this,” Yeary said. “I can still throw. I’ve got a good arm. If my leg bothers me and we’re playing a game and I get a hit, I can look at somebody on the bench and say, ‘I need a runner, my leg is not strong today.’ Some days are better than others.”

Yeary said it’s great to see players he played against in high school and college still playing.

“We do take offense when people say, ‘You’re playing softball.’ No, no we’re playing baseball,’” said Yeary, who plays for the Reds. “We’ve lost in the championship twice, but in my third year we were 0-14. We had some injuries and (some) guys moved away. But it was just so fun being out there. It’s competitive, but we look out for each other.”

Yeary played center field at North Central High School and Butler, but now plays third base.

For more, visit Hoosieradultbaseball.com.

ON THE COVER: Scott Metzinger is a premier pitcher in the Hoosier Adult Baseball League. (Photo courtesy of John Dearth)

Yeary

Scott Metzinger played for the Dodgers in the Indiana Baseball League. (Photo courtesy of Scott Metzinger)

Keeping PACE provides home health care

By Mark Ambrogi mark@youarecurrent.com

Shane Hardwick is a firm believer in the value of community paramedicine.

Hardwick is the owner of Keeping PACE, which stands for “patients and clinicians engaged.”

“Community paramedicine is a relatively new concept,” Hardwick said. “It’s a new way to do home health.”

medical technician to make frequent contact to make sure patients are making their doctors’ appointments.

“We meet them where they are, in their home,” Hardwick said.

Hardwick, who has been an EMT for nearly 30 years, said it’s like going back to the past when doctors made house calls. The Zionsville resident said there is a certain segment of the population who call 911 to go to the hospital because it is the only way they get access medical care.

“The main two reasons are people are transportation-insecure or mobility impaired,” Hardwick said. “There are people that can’t get there because they are confined to a wheelchair or a bed or they live alone, and they have no one to drive to the doctor’s office.”

Hardwick said some people don’t have a vehicle to make it to the doctor or to pick up their prescriptions.

“Their only recourse is to go to (the) ER, get seen by a physician and sent home with a script with follow-up orders to follow up with the primary care doctor,” Hardwick said. “That starts the whole cycle again because they can’t get to the pharmacy or have the money to pay the copay, or they can’t get to the doctor.”

Hardwick said community paramedicine allows a paramedic or emergency

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Signia, Oticon, Unitron and Starkey.

“We will help them determine style, technology and pricing that meets their lifestyle the best,” VonBlon said. “Within a week, we will bring them back in and fit them with the devices they chose. We help them how to use their hearing aids, helping them with the Bluetooth on their phone, making sure they hear well, and they can get them out and clean them.”

VonBlon said they follow up with patients every six months to make sure the

Hardwick said paramedics can build relationships with the patients.

“We can encourage them to make better health choices, which ends up a better health outcome,” he said. “We did a pilot program with an insurance company, and we saw a couple of hundred people a month last year and we showed a 63 percent reduction in ER visits and hospital admissions through our work in the patient population.”

Hardwick said his company can assist a doctor in a telehealth appointment to do an assessment of the patient’s vitals, analyze lab work and give them a real-time EKG.

“As a paramedic, that’s what we do. We typically work in people’s homes,” he said.

Hardwick said they have weekly encounters with their patients.

“If you have an issue, we can keep a close eye on your vital signs and if they are taking their medication correctly,” he said. “We can make sure they are keeping on track with their physician’s orders. It’s more preventative medicine than the transactional emergency encounters that we would typically see with paramedics.”

Hardwick said his company, which started about 18 months ago, has seven available paramedics.

For more, visit keepingpace.us.

hearing aids are working well.

“We also can work with patients that have tinnitus, a ringing or buzzing in their ears,” VonBlon said. “If they have a loud hobby or a loud job, we can help them with the appropriate hearing protection.”

Although hearing loss can happen at any age, VonBlon said most patients are 50 and older.

The office is open 9 a.m. to 4 p.m. Monday through Friday by appointment only. For more, visit meridianaudiology. com.

Hardwick

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Supporting aging parents

Commentary by Valerie J. Weesner

New members at the gym have shared they moved back to the greater Indianapolis area to reestablish connection with their adult children. Others have left to live near adult children out of state. On occasion, we hear of an adult child or grandchild coming back to town to help an aging parent or grandparent as well. Why do family members make those choices?

1. For connection.

2. To help care for grandchildren and be involved in their lives.

3. To share with their family the benefit of their wisdom.

4. To be close and accessible should they need each other.

I have been involved in many conversations regarding aging parents and their adult children. I am at the age where I can see situations both ways. I can see the issues adult children of elderly adults have in managing their parents’ affairs, helping with recovery from medical issues, helping with home and yard maintenance and hoping to safe-

There is no perfect formula for how decisions get made in a family with aging adults. What I suggest is asking these questions before seeking answers:

1. How do we identify each individual’s needs?

2. How do we respect and value what each person needs?

3. How do we see that there is mutuality in the caregiving scenario?

My hope is that we are kind, compassionate and considerate to one another.

Valerie Weesner, Ph.D., HSPP, is a licensed clinical psychologist and advisor to Motion 4 Life Fitness. guard parents from predators who seek to cheat them out of their hard-earned money. I can also see the older parents’ perspective – wanting to age in place, wanting to age with dignity, to not give up their possessions nor downsize or feel stuck in assisted living. Parents have spent a lifetime caring for their offspring and often hope for emotional and physical support from them as they age.

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Three phases of planning

Commentary by Brad Owen

Estate planning is a topic that many people prefer to avoid or postpone, often considering it something to address later in life. However, the truth is, estate planning is a crucial aspect of financial management and personal responsibility that everyone should undertake regardless of age or financial status. It’s not just about the distribution of assets after death; it’s about ensuring your wishes are carried out, protecting your loved ones and securing your legacy.

At Applegate & Dillman Elder Law, we understand the importance of comprehensive estate planning, which is why we’ve divided our estate planning strategy into three phases to ensure your plan encompasses your unique circumstances and goals.

Guardianship avoidance

The primary step in creating an estate plan is establishing your advance directives. These essential documents include a power of attorney, health care representative designation, HIPAA au-

-

thorization form, living will and funeral declaration. Having these documents in place is crucial for protecting your family in the event of your incapacitation or passing. They designate who you would like to manage your affairs and make medical decisions on your behalf, ensuring that your wishes are carried out according to your preferences.

Further, anyone who is older than 18 is considered a legal adult. Parents of children 18 and older are no longer their child’s legal guardian, meaning they cannot access their child’s medical records or make decisions on their behalf in case of an emergency. Having a plan in place can ensure you and your child’s wishes are upheld and avoid unnecessary delays in medical care. Probate avoidance

Phase 2 in estate planning concerns the distribution of your assets following your passing. It’s essential to understand that an “asset” can encompass various types of property and financial resources, including real estate, invest-

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ments (such as IRAs and 401(k), financial accounts, personal property (like jewelry and vehicles) and any other resources you own. When you pass away, assets held solely in your name may trigger the probate process, which can be costly and time-consuming. In Phase 2 of planning, we look at potential strategies to avoid probate court – including the use of trusts, beneficiary designations, and transfer on death designations. Using these strategies allows your assets to transfer privately and efficiently to your heirs.

Asset protection

You’ve worked hard throughout your life to build a nest egg, but unforeseen circumstances like long-term care expenses can quickly deplete your assets. In Phase 3 of our estate planning strategy, we focus on asset protection. For example, by placing hard-earned assets into an Irrevocable Living Trust, also known as a Medicaid Asset Protection Trust, at least five years prior to needing long-term care, assets are protected from long-term care expenses, creditors and more.

In conclusion, estate planning is not

“You’ve worked hard throughout your life to build a nest egg, but unforeseen circumstances like long-term care expenses can quickly deplete your assets.”

— Brad Owen

just about drafting a will or creating legal documents; it’s about taking proactive steps to protect yourself, your loved ones and your legacy. By working with experienced professionals like those at Applegate & Dillman Elder Law, you can develop a comprehensive estate plan that addresses all aspects of your financial and personal affairs, providing peace of mind for you and your family both now and in the future. Don’t delay – start planning today to secure your legacy for generations to come.

Meridian Audiology LLC:

Meridian Audiology LLC is a small private Audiology Practice owned and operated by Dr. Alison Wyss and Kira VonBlon, M.S. We have 40 years of Audiology expertise between us and pride ourselves on being able to give as much of our time to our patients as they need. We won’t rush you through the process like those in ENT or Retail Audiology, but we will spend the necessary and wanted time with you to help you know your questions are valuable and your patient experience is our top priority.

Mention this ad and receive 1 10 % O F F a set of Entry, Advanced or Premium Technology hearing aids. Offer expires 9/30/24.

Brad Owen is an attorney with Applegate & Dillman Elder Law.

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