MarApril2011

Grand Living

Vol. 3 Issue 2 - March/April 2011

Complimentary

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Delmarva’s Premier 50+ Magazine

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Green Remodeling

Tax Tips

Lasik Surgery

Spring Gardening

Choosing the Right Surgeon

Where do you turn when you want the best for your loved one?

I Chose Security...

With Brandywine’s on-site licensed nurses 24/7 and attentive staff, I have no worries because I know someone will always be there when I can’t be.

I Chose Five-Star Dining...

Brandywine’s chefs provide a gourmet dining experience with exquisite cuisine that is sure to satisfy the most discerning palate.

I Chose Wow...

With Brandywine’s social calendar, game room and excursions...

I knew there would be plenty to do to maintain his active lifestyle.

There are so many good choices available — but there is only one great one...

Choose Brandywine!

Call the location nearest you to schedule a tour & complimentary lunch

FENWICK ISLAND

21111 Arrington Drive | Selbyville, DE 19975 | 302.436.0808

SEASIDE POINTE

36101 Seaside Blvd. | Rehoboth Beach, DE 19971 | 302.226.8750

Brandywine Senior Living has Locations throughout NJ, PA, DE, CT, NY www.Brandycare.com • 1-877-4BRANDY

Announcements

Grand Living Magazine Publisher Sandy Phillips Associate Publisher Farin Phillips Editor Lou Ann Hill

Azar Eye Institute, Accurate Optical & Atlantic Retina prescribe a new business model for the Ocean Pines area. This new venture offers a one-stop-shop for all your eye care needs.

When Dr. Alex Azar saw an opportunity to expand his practice into the Ocean Pines area, he didn’t waste any time. He immediately reached out to his colleagues at Accurate Optical, whom he shares building space with at the practice’s Salisbury and Laurel locations, and his next-door-business-neighbor, Atlantic Retina, to see if they would be interested in sharing the market and office space in Northern Worcester County.

“Economically it made sense to share office space in the Pines and bring all of our specialties together in one centralized location,” said Dr. Azar. “Not only do we share equipment, office space and exam rooms, but we all value the ability to deliver expert eye care in a convenient and comfortable setting.”

Two key elements were factored into the decision to expand in the Ocean Pines/ Berlin area: the Pine’s growing, Grand Citizen population, coupled with existing patient-bases.

“The number of patients driving from the Ocean Pines/Berlin area, for appointments to our Salisbury office is greater than it’s ever been before,” said Dr. Azar. “Now we are bringing the same quality care closer to those existing patients and exposing other residents in the area to a one-stop-shopping experience for all their eye care needs.”

The new office provides comprehensive eye health care, an extensive selection of eyewear and specialized services and surgeries.

Initially, each practice will begin treating patients on a limited schedule, then ramp up by adding more days and times: • Azar Eye Institute will treat patients on Monday, Wednesday and Friday.

• Accurate Optical will treat patients on Wednesday and Friday.

• Atlantic Retina will treat patients once a week on Friday.

Accurate Optical will have retail hours daily. The new office is located at the South Gate of Ocean Pines at 11031 Nichols Lane.

You are invited to a Cinema Therapy Grief Group at Brandywine Assisted Living at Fenwick Island on Monday April 11, 2011. There will be two showings of the film “Things We Lost in the Fire” The first show will begin promptly at 1pm and the second show will begin promptly at 6pm. Join Brandywine Assisted Living at Fenwick Island with VITAS Innovative Hospice Care for a movie, refreshments, and a short supportive discussion after the movie.

This event is open to anyone who is grieving the loss of a loved one. To RSVP contact Teri Busch, VITAS Bereavement Manager at 302 451-4000 or teri.busch@vitas.com.

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Creative Sandy Phillips Farin Phillips Photography Kyle Hughes, Nextwave Studios Contributing Writers Zaaira Ahmad, MD, Valery Cordrey Polly Elliott Therese. H. Ganster, LCSW, MPM Christopher D. Hoen, CRPC Joseph Kim, D.O. Marie Nottingham Emerson Que, M.D. David T. Walker, MD For Advertising Call: Grand Living Main Office (410)726-7334 grandlivingmag@verizon.net Field Management Brandon Phillips

Cover:

It’s finally just around the corner, Spring!

Grand Living Magazine is published six times a year; Jan., Mar., May, July, Sept., and Nov. It is circulated throughout Worcester, Wicomico & Sussex counties, by Grand Living Magazine LLC. Grand Living Magazine is protected under trademark registration. “Grand Citizens”™ is also protected under trademark. No portion in whole or part maybe reproduced without written permission of the publisher. Copyright 2010 ©, Grand Living Magazine LLC. All rights reserved. Content in Grand Living Magazine is intended to provide information only and is in no way meant to treat or diagnose.

Always consult with a speciality professional (i.e. medical, financial, etc.) to address your own personal needs. The company makes every effort to ensure that all information presented is correct. However, we do not make any representations or warranties as to the accuracy of the information, and reliance on information provided is solely at your own risk.

contents Vol. 3 Issue 2- March/April 2011

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Spring is Just Around the Corner 8

The Grand Life Green Remodeling

11

My Life

Betty’s New Friends

13

Finanical Strength

New Tax Rates Could Create New Opportunities

14

Benefit Fashion Show

Well Being 15 Lasik Changed My Life 16 A Clearer Understanding of Macular Degeneration 18 Early Detection: Best Protection Against Breast Cancer 20 Use Your Senses, Be Good to Yourself

21 Well Being Supplemental Finding a Physican That’s Right for You

22 Fare

Vegetable Madness

24 Heart’s Desire

Grand Calendar

Now online at www.grandlivingmag.com www.grandlivingmag.com

Grand Living Magazine

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Spring is Just Around the Corner

by Valery Cordrey

The most popular flowers, at our garden center, is the Knock-Out Rose. The Knock-Out provides great color continuously from April/May thru November/December. It is disease and insect resistant–not disease-proof, but resistant. It averages 4’ x 4’ but can be easily trimmed to maintain a smaller size.

The Knock-Out comes in pink, red, yellow, and white varieties and requires at least six hours of sun. Remember to never put a sun-loving plant in the shade. If it is shaded too heavily, it will not be able to produce enough flowers, and as a result, will stretch out to the sun, producing a leggy plant, rather than the dense foliage and cluster of beautiful blossoms you are looking for.

Another favorite for lasting color is the Encore Azalea. It is a re-blooming azalea; producing blossoms in the spring and then again in the fall, giving you twice the bloom time of the traditional azalea. This fantastic evergreen is perfect for a small space, with an average growth of 4’ x 4’. When planting the Encore Azalea, be sure to mound it and allow for good drainage; and most importantly, remember that it requires more sun than the traditional azalea.

A new discovery to this area is the Camellia. It was originally grown in the South, but new “cold hardy” Camellias are now more readily available and in demand! The Camellia is an evergreen with beautiful, shiny leaves. Camellias can be used in the landscape as a hedge, specimen, foundation or even a container plant, as long as they are protected from the drying winter winds. There are great dwarf Camellias for pots, as well as large Camellias that grow to the size of small trees, and the various plants produce blossoms in a host of colors, sizes and shapes. It is this blossom that makes the Camellia my favorite, because it is in bloom when most others plants are not.

There are varieties that flower from September to November, November to January, or February to April. By planting several varieties, as you would perennials, you will achieve long-lasting color. I love to cut the Camellias and display them in a vase or floating in a bowl of water.

Cover Story

S

pring is just around the corner and a great time to plan for your harvests, colors and fragrances! Let’s start with some of my personal favorites. Each plant I have selected provides a unique feature that makes it stand out in the landscape. This feature could be long-lasting color, fragrance, night interest, winter interest or a tasty food to harvest.

If you don’t like blueberries, there are many other old and brand new varieties of fruits and vegetables for your home garden. If you don’t have room for a garden, try gardening in a large pot with herbs and the new dwarf varieties of vegetables.

My summer is not complete without tomatoes and basil!

Another great feature that plants provide is fragrance. The Jubilation Gardenia is a hardy gardenia, a re-blooming and evergreen shrub. It re-blooms fragrantly through the summer and fall with double white blossoms. It is compact, about 3’ x 3’, takes full sun to part shade, but like the Camilla it also needs protection from the winter winds.

A great plant for a shadier yard is the Hydrangea. The new Endless Summer Collection includes: The Original, Blushing Bride, the Twist-n-Shout, and the Bella Ann, that bloom on old and new growth. You will have blossoms from summer through fall, and you can trim them, without losing the flower, the following year. They can take sun, but prefer to be protected from the harsh afternoon rays. The Hydrangea is an easy plant to fit into your landscape, since the many varieties give you a range of dwarf sizes to large shrubs.

Finally, there is the outdoor room, which has become a trend in the gardening world. We are fortunate to be able to enjoy many days of comfortable, outdoor weather on Delmarva.

Decks, kitchens, landscaping, and water features all create the atmosphere for a tranquil outdoor experience! Pots filled with tropical plants can transport you to your own home paradise.

I enjoy adding plants that provide nighttime interest. The nightblooming Jasmine provides a beautiful evening fragrance; the Moon Vine climbs and opens its beautiful flowers each evening.

So, when your gardening is finished for the day, sit back, relax, and enjoy your harvests, the color, and the fragrances you have selectively grown. GLM Valerie Cordrey is a professional gardner with the East Coast Garden Center, Millsboro.

Every landscape should include a plant that provides food. It is just plain fun to go outside and harvest in your own backyard! For this reason and more, I choose the blueberry – it is delicious and easy to grow! It is also a beautiful plant. Blueberries have wonderful white/cream blossoms in the spring, delicious berries in the summer, beautiful fall-foliage color, and great looking bark in the winter. www.grandlivingmag.com

Grand Living Magazine

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The Grand Life

Green Remodeling

by Polly Elliott

Green Remodeling requires a new approach to the home improvement process. It requires more up-front planning to take advantage of opportunities that might otherwise be missed with a conventional approach. This includes expanding your list of objectives, as well as the way you compare the value of products and services, with an eye on long-term value. It also requires a time and energy investment to find solutions that best fit your needs. Finally, a green remodel requires that you approach home improvement tasks with health and safety as priorities. Advance planning will pay large dividends in terms of long-term satisfaction with your project and cost containment. Speak with knowledgeable professionals for a better understanding of the growing variety of “green” opportunities for your home. – Seattle Green Initiative Collaboration is the key element. If you’re hiring out the design and construction, as most homeowners do, the ideal green remodel requires a committed, educated and involved homeowner, a design professional with the skills and willingness to capture your vision in a design, a contractor with the experience and abilities to make that design a reality, and even more important, the ability for all three to work together as a team. Reduce the stress of construction by allowing sufficient time to plan. One year is usually ideal for coordinating a major remodel. Once these elements are in place, you’ll be well on your way to a successful green remodel!

As a general remodeling rule, extensive projects translate into expensive projects–both economically and ecologically.

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You will spend less if you try to keep existing walls, cabinetry, plumbing and electrical layouts. You’ll also use fewer resources, and create less waste. Beyond the environmental and financial benefits, this approach also helps minimize disruption caused by a remodel–an especially pertinent concern when you’re trying to live in a space under construction.

Focus on long-term savings, ease of maintenance and conservation. A higher purchase price can mean a better deal in the long run. For example, you can actually reduce the cost of living in your home by choosing resource-efficient fixtures (lowering monthly utility bills) and durable materials (requiring less frequent replacement). A low purchase price may simply mean a good deal. Or it may signify a lack of quality, or even show

that some environmental or health costs are not reflected on the price tag. Don’t forget the possibilities of government tax benefits. You may spend a bit more upfront, but you will reap the rewards not only on your utility bills for years to come, but on your tax returns too.

Research will help you ask the right questions with retailers, your designer and/or contractor, and it also will avoid costly mistakes if you are doing some of the work yourself. Look for design ideas and businesses that carry the “green” products you like. Keep a file of contact names and businesses, as well as magazine clippings. Knowing enough to discuss the pros and cons of a design or material will increase your participation in the remodel, and enhance your ownership in both the process and final product.

There are many “green” options on the market today. With the growing number, be sure to explore “green” options for all updates you make to your home. Solar, Geothermal and Wind Energy often top the list for updating home heating and air, but you can go “green” with a kitchen remodel or even a new home theater system. You will not only benefit the environment when you go “green,” your health and well-being often gain as well. GLM Polly Elliott is a freelance writer and native of the Eastern Shore. This is the first in a series on the Green Home. Look for Part 2 in the May/June Issue of Grand Living Magazine.

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9

Your teeth play a vital part in your overall health, especially as we age.

Shouldn’t you have outstanding dental care?

INVEST IN YOURSELF AND YOUR COMMUNITY WITH NO CONTRACTS This year, invest in yourself as well as your community.

At the Y, we exist to strengthen community. Together with people like you, we nurture the potential of kids, help people understand and improve their health, and provide opportunities to give back and support neighbors.

So join our cause. And create meaningful change not just for you, but also for your community.

Grand Living Magazine

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When I left my home in Aberdeen, Maryland to move to Brandywine Assisted Living at Fenwick Island, I had many friends. Truthfully, that was the hardest part of the move... leaving my friends, and knowing that I wouldn’t be back so frequently. I can’t replace my old friends, but I have made many friends here. Some people here are just like me, and those are the ladies I gravitate to. Marie and Jane are good friends to me. We play bingo and I eat all of my meals with them. I know all about their families and they know all about mine. We are about the same age, and we have so much in common based on life experiences. I used to hate Bingo because I always thought it was a dumb game. Now I like Bingo, not because of the game as much, but because my friends go and we get silly and laugh. It is not about the bingo game, it’s about having fun with friends.

I’m not the “new kid” anymore...so many people have moved in. I feel more in the position to welcome them, try to make friends, and make them feel comfortable. I know how it feels to be new. We chit chat, compare our lives, where we are from, etc. We always seem to have something in common.

Everyday I meet someone that I’ve seen around but don’t yet really know. That’s what I’ve enjoyed most; getting together and making new friends. I wasn’t sure what to expect in the “friendship” category, but I have made wonderful friends. It’s better than what I had expected. Some people picture, in their head, a nursing-home atmosphere and it’s not like that here at all. I feel society hasn’t gotten use to what assisted living is.

In the past, I wasn’t so tolerant of people I perceived as sicker than me or needier than me, but now I realize I was wrong. I meet people of all needs and make friends with them. I even have made friends with some of the men from the men’s club.

Andy is an excellent entertainer, and I love listening to him sing karaoke. He’s such a comedian. Andy could be a show all by himself, he makes everyone laugh and come together. It’s people like him that make a difference and make me appreciate them as friends. Andy even makes the bus trips fun.

Speaking of bus trips, I love going to the casino in Harrington. I don’t gamble a lot, but I like the Harrington Casino trip for the bus ride and the adventure. It’s always an activity that builds relationships. We have so much fun on the bus. We talk and laugh and sometimes we sing. It’s a lively group. It’s easy to be friends here because everyone is so nice.

The bus outings to Assateague are my favorite. When I look at the activities calendar I first look for the outings. The experience is so much fun, with our group. I enjoy sightseeing and the nature. It’s all very special.

When I’m not out and about, I visit the fitness center. I use all the equipment in there. I used to have a treadmill at my old home in the basement. It is just wonderful to be able to walk down to the fitness room and exercise. It makes me feel good.

The treadmill and the bike are my favorites, and I love the exercise classes too. I feel so accomplished when I get done.

Sometimes I go to the chair exercise classes and amazingly, I feel great when I leave there too.

My Life

Betty’s New Friends

My overall health has certainly improved since moving to Brandywine. When I was home, I was sick more often. I have developed relationships with my new physicians here. I am happy the bus will take me to all of my appointments. My one daughter works and my other daughter is about to go back to work full time, so having the bus transport available makes it easier for everyone. I’m eating three well-balanced regular meals a day, and not a lot of snacks, like I would do around my house. My daughters don’t worry anymore. Eating healthier, taking advantage of the fitness center and the exercise programs have really helped me live healthier and happier, and I feel great. I keep thinking about trying water aerobics, but I have two swimsuits that no longer fit! I need to buy a swimsuit the next time my daughter takes me shopping.

How many places have a nice pool like this? I need to take better advantage of it. Good health makes you happier. If you have good health, you have a lot to be happy about. I am healthier than I was, and I am living life again. There is more to look forward to here than at my old home, everyday.

You would be surprised how busy it gets in the beauty salon.

Oh, and how friendly they are! I have made friends just from going there. I go early so I can sit and talk with everyone. The men come in for hair cuts too! The groups aren’t cliquey. You know it’s not easy to make friends when you are older and if I left here, I would really miss my new friends. During life, you make friends with other moms, your kids’ friends and families, etc. Older people are reluctant to make new friends because there isn’t as much in common, or so I thought. I’ve found everyone here is in the same boat, so they are anxious to make new friends. My daughter Karen said “I don’t worry about you anymore. I know you are over there having a good time. I only worry that one day when I call to ask you if you want to do something, that you will say that you are too busy!”

I’m living life again and loving every minute of it! GLM This story was compiled by Kathy Jacobs, Director of Community Relations, Brandywine Assisted Living at Fenwick Island, as dictated by Betty.

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Grand Living Magazine

11

Paychecks stop.

Life goes on.

Retirement can include a steady income.

Let us help you put a more confident retirement within reach.

Call Today!

Christopher D. Hoen, CRPC® Financial Advisor Chartered Retirement Planning Counselor TM 9928 Old Ocean City Blvd, Suite 5, Berlin, MD (410) 629-0947 / (877) 589-4284 christopher.d.hoen@ampf.com CA License #0e09592

Take 5 Minutes to Lighten Your Load!

by Lou Ann Hill If you have five minutes, pick a task, any task. These “mini” chores will give you the buzz of accomplishment, while making the most of sudden (and fleeting) “extra” time.

Ready…Set…GO! • Pitch three old items from the frig.

• Clean off the top of the frig.

• Tidy up the freezer.

• Get rid of one pair of shoes that kill your feet.

• Shred something…anything!

• Throw out expired coupons.

• Check your stack of magazines and eliminate half!

Grand Living is a keeper!

• Refold your sweaters and stack them by color.

• Test pens or markers, and toss the ones that don’t work.

• Sweep or Swiffer the kitchen floor.

• Toss worn out towels from your linen closet.

• Charge your portable, electronic devices.

Look for more tips next issue!

GRAND TIP

Scan your medicine cabinet and throw out any expired prescriptions, sunscreens, and vitamins.

Brokerage, Investment and Financial Advisory services are made available through Ameriprise Financial Services, Inc. Member FINRA and SIPC. Some products and services may not be available in all jurisdictions or to all clients. © Ameriprise Financial, Inc. All rights reserved.

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Grand Living Magazine

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Lou Ann Hill is the President of Lighten Your Load Solutions, LLC. Offices are located in Annapolis and Tilghman Island, MD.

Christopher D. Hoen, CRPC Americans now know that income tax rates are not going up (at the Federal level) this year. In fact, most people will temporarily pay less Federal tax than was the case previously.

The tax savings may create an opportunity for you to consider putting more money to work toward your key financial goals.

Here is a rundown of what’s been put in place effective in 2011 (or in some cases, in 2010): Extension of 2010 tax rates Federal income tax rates, established in 2001 and scheduled to expire at the end of last year, are now in place through 2012.

Tax brackets start at 10 percent and peak at 35 percent.

Temporary Employee Payroll Tax Holiday For 2011 only, the 6.2 percent Social Security tax deducted from your paycheck (up to the first $106,800 of Social Security wages in 2011) will be reduced to 4.2 percent. That means an extra $200 for every $10,000 of Social Security wages you earn (up to the Social Security wage limit). Note that this reduction does not apply to the employer’s contribution to Social Security, and the payroll tax related to Medicare for both employers and employees remains unchanged. A similar reduction also applies for self-employment tax.

Extension of capital gain and dividend tax rates Like income tax rates, existing rates on long-term capital gains and qualifying dividends were scheduled to increase at the end of 2010. However, the rates that existed in 2010 have been extended through 2012. The highest applicable tax rate on most long-term capital gains and qualifying dividends is 15 percent and for lower-income taxpayers can be as low as 0 percent.

Renewal of Education Tax Credit and Other EducationRelated Provisions The enhancements made to the Hope Scholarship Credit (American Opportunity Tax Credit), which provided for a $2,500 maximum tax credit, per student, for the cost of tuition and related expenses paid during a taxable year in 2009 and 2010, is extended to 2011 and 2012. Qualification for the credit is subject to income limits. The credit is phased out for single taxpayers with income over $80,000 and married couples filing a joint return, with income over $160,000.

Also extended for 2011 and 2012 is the ability of certain individuals to deduct up to $2,500 in interest on qualified higher education loans from their income taxes. The deduction phases out for individuals earning more than $60,000 and married couples filing a joint return with income above $120,000.

Families can continue to invest up to $2,000 per year in Coverdell Education Savings Accounts in 2011 and 2012.

Dollars can grow on a tax-advantaged basis and be used to pay elementary, secondary and higher education expenses.

Financial Strength

New Tax Rates Could Create New Opportunities

Estate Tax Is Back But Affects Fewer People The estate tax has been in flux for several years. In 2009, a perperson exclusion of $3.5 million was in place. Taxable estates valued beyond that amount were subject to a tax of 45 percent.

In 2010, the estate tax was scheduled to be repealed, but only for that year. Under the new law, the estate tax is retroactively reinstated for 2010 (but with an elect-out provision), with an exclusion amount set at $5 million per person, so potentially $10 million per couple – with a tax rate of 35 percent applying to estates larger than that. The higher exclusion amount and lower rate apply for 2011 and 2012.

What to Consider Now That Rates Are Set Strategies that may be suitable will depend on your circumstances, but here are some specific ideas to consider, in light of the recent tax legislation: • Make sure that the amount being withheld from your paycheck is appropriate. Now that you know income tax rates aren’t going up this year or next, you are better off avoiding having too much withheld and ending up with a large tax refund every year. This is money that could be put to better use each month, specifically toward your key financial goals.

• Consider taking the two percent savings from the temporary payroll tax holiday and putting it to work toward your retirement, by increasing the amount directed to your workplace savings plan, or making a regular contribution to an IRA. • Determine if you should adjust your investment strategies to take advantage of the ongoing favorable rates for long-term capital gains and qualifying dividends.

• Review your estate plan to determine if any changes are needed in light of the new estate tax laws. Make sure any trusts and wills are up-to-date and consistent with the law, especially since the most recent change is only effective through 2012.

• Stay prepared for future changes. By the end of 2012, at the latest, Congress is likely to have to address many of these same tax issues again. A regular review of your financial and tax situation should be part of your routine.

• Consult with your financial and tax advisors for more information before making any critical decisions that could have a tax impact.

Christopher D. Hoen is a financial advisor with Ameriprise Financial in Berlin, MD. He can be reached at (410) 629-0947. Advisor is licensed/registered to do business with U.S. residents only in the states of MD, DE, VA, CA, SC, FL, NJ, CO, TX, KY and NJ. Brokerage, investment and financial advisory services are made available through Ameriprise Financial Services, Inc. Member FINRA and SIPC. Some products and services may not be available in all jurisdictions or to all clients. All guarantees are based on the continuing claims paying ability of the issuing company, and do not apply to the performance of the variable subaccounts, which will vary with market conditions. Withdrawals that do not qualify for a waiver may be subject to a withdrawal charge.

Withdrawals are subject to income taxes, and withdrawals before age 50 ½, may incur an IRS 10% early-withdrawal penalty. © 2010 Ameriprise Financial, Inc. All rights reserved.

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Grand Living Magazine

13

Beef Tenderloin with Spicy Crab Salad Ingredients:

For the surf: 1 pint lump crabmeat 1/2 cup mayonnaise 1 tablespoon hot chile paste 2 tablespoons chopped fresh cilantro leaves 1 lime, juiced Kosher salt and freshly ground black pepper For the turf: 4 center-cut beef tenderloin steaks, each about 2 inches thick Kosher salt and freshly ground black pepper For service: 1 bunch arugula 1/4 cup extra-virgin olive oil, plus more for drizzling 1 tablespoon lemon juice

Directions:

For the surf: In a medium bowl, stir the crabmeat together with the mayonnaise, chili paste, cilantro, and lime juice, and season with salt and pepper. Cover with plastic wrap and set aside in the refrigerator.

For the turf: Preheat the grill. Sprinkle the beef all over with salt and pepper and grill until desired temperature has been reached. For service: Wash the arugula and toss it in a bowl with olive oil and lemon juice. Season with a few turns of freshly ground black pepper. To serve, arrange the steaks on a serving plate. Spoon the crab salad over the meat and drizzle with olive oil. Serve with a small tangle of dressed arugula and a glass of rose wine.

Grilled Pineapple with Mascarpone Cream Ingredients: 1 tablespoon chopped hazelnuts 1 lemon, juiced and zested 8 ounces of mascarpone cheese 3 tablespoons honey 8 slices of peeled fresh pineapple, 1/2-inch thick Directions: 1.Preheat the grill for medium heat, and lightly oil the grate.

2.Place the hazelnuts into a small saucepan over medium heat, and shake the pan until the nuts turn golden and fragrant, about 3 minutes. Remove from heat, and set aside.

3.Mix the lemon juice, lemon zest, mascarpone cheese, and honey in a bowl until well combined.

4.Grill the pineapple slices on the preheated grill until the slices show brown grill marks and the fruit is hot and juicy, about 3 minutes per side.

5.Serve 2 slices per plate with a generous dollop of sweetened mascarpone cheese and a sprinkling of toasted hazelnuts on each serving.

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LASIK Changed My Life

by Emerson Que, M.D. Frequently Asked Questions About Refractive Surgery

S

tacey Weisner, of The Salisbury Zoological Park, is a “regular” at Salisbury Area Chamber of Commerce events as a way to network with people who can help her help raise funds for the “Renew the Zoo” campaign. So, the irony was not lost as she fumbled for her glasses while checking in at a BusinessAfter-Hours event at Azar Eye Institute (AEI) that the door prize was free LASIK surgery.

“When I heard that one of the door prizes was free LASIK surgery at AEI, I knew I would be one of the first in line for a chance to win,” said Stacey, now an AEI patient. “One of the first people I met at the event that evening was Dr. Emerson Que. Little did I know he would be the doctor performing my LASIK surgery when my business card was picked as a winner.”

Weisner has worn glasses since she was 7 years old. Without them, she can’t see her own fingers in front of her face or a road sign off in the distance. Her prescription is so strong, she purposely pays extra for thin lenses to avoid having to wear thick bottle cap glasses.

“I knew it was bad when I was younger and couldn’t even see the eye chart, let alone the symbols on it,” said Stacey. “I tried contacts, but they were very uncomfortable. I later found out I couldn’t wear them because I had astigmatism.”

LASIK surgery, a form of refractive surgery, usually takes less than 30 minutes. Using a laser, Dr. Que created a flap on the surface of each of Stacey’s corneas and then used a second laser to reshape each cornea. The flap is then returned to its original position. LASIK can be used to correct many types of issues including nearsightedness, farsightedness, and astigmatism.

Stacey looked into having LASIK surgery in 2004 but was told she wasn’t a candidate because her cornea was too thin.

New technology, including the all laser LASIK procedure, gave her another chance at the surgery.

“When I found out I was a candidate, it was like a dream come true,” said Stacey. “The first thing I thought of was being able to swim in my pool with my grandchildren without worrying about wearing glasses.”

Before LASIK surgery, Stacey had 20/1150 vision. Just three months after the procedure, her vision was measured at 20/20.

“It has truly changed my life,” said Stacey. “My vision is actually better now than it was when I had my glasses on. I now see life like I’ve never seen it before.”

Q: How does the doctor determine if I am a candidate?

A: An appointment for an evaluation is scheduled. A series of measurements and tests are completed such as corneal measurements, refractions (glasses prescriptions), and a dilated exam.

The doctor will review the results of all of the testing and determine if the patient is a candidate.

Q: What factors prevent me from being considered a candidate?

A: There are a few factors which prevent a patient from having refractive surgery. Most of these include pre-existing conditions; however, not all conditions are a contraindication. If a patient’s corneas are too thin, it will prevent them from being a surgery candidate.

Q: If I had surgery on my eyes for other problems, does that mean that I will not be a candidate?

A: Other types of surgery are not necessarily a contraindication for refractive surgery. It all depends on the type of surgery performed.

Q: Are there different kinds of refractive surgery?

A: There are many different kinds of refractive surgery. The most common is LASIK, where a flap is made on the surface of the cornea and laser is used to reshape the cornea. The flap is then returned to its original position. Another type is PRK, which is very similar to LASIK. The biggest difference is that a flap is not made on the cornea.

Q: Will I still need glasses at all?

A: In many cases, the need for distance glasses is completely resolved. Patients who have “over-40 eyes” may still need reading glasses, but monovision (one eye corrected to see well in the distance, and one eye corrected to see well near) is possible.

Q: What is the recovery time?

A: Recovery time varies from patient to patient, depending upon their rate of healing and tolerance. IN MOST CASES, people are able to return to work the next day following LASIK. Q: Does insurance cover refractive surgery?

A: Currently most insurance companies DO NOT cover refractive surgery. It is considered a “cosmetic” procedure. There are some vision-specific plans that do offer discounts. GLM Dr. Emerson Que is a board certified Ophthalmologist in practice at the Azar Eye Institute, Salisbury, M.D.

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Grand Living Magazine

15

by Zaaira Ahmad, MD,

A Clearer Understanding of

Macular Degeneration What is Macular Degeneration?

To understand age-related macular degeneration (ARMD), you need a basic understanding of the anatomy of the eye.

Think of the eye as a hollow ball. The inside back wall of the eye is lined by the retina, which is the part of the eye that converts light into signals which the brain can recognize as images. The macula is the center of the retina and is the area

16

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responsible for your best vision. It is this area that is damaged in macular degeneration.

There are two types of macular degeneration; a “wet” or exudative type, and a “dry” or non-exudative type. Dry macular degeneration is caused by damage to the retina and underlying tissue. There may be deposits of material under the retina that are called drusen. Patients may have difficulty adjusting to changes in light (i.e. entering a dark room) or problems with night vision, early in the disease.

As the disease progresses, area of atrophy or thinning can develop causing further vision loss. Dry macular degeneration typically progresses very slowly. However, dry macular degeneration can turn into wet macular degeneration in a small percentage (10-20%) of patients.

In wet macular degeneration, new blood vessels grow under the retina. These vessels are abnormal and leak fluid and blood under the retina, which causes vision problems, including areas of blurry vision, distortion (i.e. straight lines look wavy), blind spots (areas in the center of vision where things are blurry or dark), or overall decreases in vision.

Some patients may develop a fibrous scar, causing severe vision loss. Typically, wet macular degeneration progresses quickly with increasing vision loss unless treated. The earlier treatment is initiated, the better the results tend to be.

Who gets Macular Degeneration?

Macular degeneration is typically seen in patients over the age of 50, and the incidence increases with age. It is the leading cause of permanent blindness in the world for patients over age 65. Fair skin, smoking, and family history are also risk factors.

How do I know if I have Macular Degeneration?

The earliest symptoms of the disease are often blurry central vision or distortion of vision (straight lines look wavy). A quick

and easy test is to check an “Amsler” grid. These are often readily available at your ophthalmologist’s office at no charge. If you do not have an Amsler grid, you can do a very crude test by looking at any surface which has straight lines (i.e. fence, striped shirt, etc.) to determine if there is any distortion. However, early in the disease, there may be no symptoms at all.

Who should be tested?

Anyone over the age of 50 should have, at a minimum, a baseline eye exam with pupils dilated and a good examination of the retina. This is especially important in patients with a family history of the disease.

How is Macular Degeneration treated?

Prevention is always more effective than treatment. A healthy diet with a lot of green leafy vegetables and fish shows some promise in reducing the risk of macular degeneration, and preventing vision loss in those who have the disease. If you smoke, the importance of quitting for your ocular health cannot be overstated.

The Age Related Eye Disease Study (AREDS) showed that high dose vitamins can reduce the risk of vision loss in patients with moderate to severe dry macular degeneration. Recommended AREDS vitamin doses are Beta-Carotene 25,000IU, Vitamin C 500mg, Vitamin E 400IU, Zinc 80mg and Copper 2mg daily.

Many brands of vitamins with AREDS doses can be found over the counter at your local drugstore. Patients who smoke or have a recent history of smoking should avoid formulations with beta-carotene as it has been shown to increase the risk of developing lung cancer.

Wet macular degeneration is treated in a number of ways. The newest and most effective treatment is with injections into the eye. There are two medications currently in use for this purpose; Avastin and

Lucentis. They are both very similar and administered in the same way. These are anti-VEGF agents; they block Vascular Endothelial Growth Factor (VEGF), which is found in large quantities in eyes with wet macular degeneration. The medication causes the abnormal blood vessels found in wet macular degeneration, to stop leaking fluid and blood, thus improving or stabilizing vision. Up to 40% of patients improve vision and 95% maintain stable vision. The procedure is performed in the office. The eye is numbed and then a very tiny needle is used to inject a small amount of medication directly into the eye. The procedure is typically painless and takes only a few minutes.

Injections may need to be repeated every four to six weeks, for an extended period of time, as the effect of the drugs is frequently transient.

Other treatments used for wet macular degeneration include PDT (photodynamic therapy). In PDT, a light-sensitive dye (Verteporfin) is injected into a vein in the arm, and then a special low-energy laser is used to treat the area of abnormal blood vessels under the retina. Occasionally, wet macular degeneration may be treated using thermal laser treatment. GLM Zaaira Ahmad, MD, is a board certified Ophthalmologist in practice at Retina Consultants of Delmarva.

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17

by David T. Walker, MD

Early Detection: Best Protection Against Breast Cancer E

arly detection is the key against fighting breast cancer. Numerous studies prove that early detection is a vital component in the successful treatment of breast cancer, and good screening leads to early detection. Mammograms play a central part because they can detect changes in the breast, which may be early signs of cancer, but are too small or subtle to be felt.

Breast cancer is the second leading cause of cancer death among women, exceeded only by lung cancer. Statistics demonstrate that one in eight women will develop breast cancer sometime in her life. The stage at which breast cancer is detected influences a woman’s survival, and if detected early, the five-year survival rate is over 90%.

Most experts agree on screening recommendations, which include monthly breast self examination, yearly clinical breast examination by a healthcare professional, and yearly mammography. Breast Self Examination (BSE) is simply to check your own breasts on a monthly basis. It is easy to learn and takes less than five minutes and instructions are available from your doctor or any local breast care center. If you find a lump, nipple discharge or other abnormality, or any change in your breast from the previous monthly self breast exam, notify your doctor. Your doctor will advise you and schedule you for the appropriate testing to determine what the abnormality is. A Clinical Breast Exam (CBE) should be performed annually by your OB/GYN, primary care physician, or at a local breast care center.

Annual mammograms start at age 40 and have been proven to reduce the mortality from breast cancer. Screening recommendations change for those women who are at an increased risk for developing breast cancer. For example, screening exams and mammograms should start 10 years prior to the age that any first-degree relative (mother or sister) was diagnosed 18

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with breast cancer. This means that if your mother was diagnosed with breast cancer at age 40, your screening, including mammograms, should start at age 30 (but screening does not need to start before age 25).

What happens if something abnormal is detected on a mammogram? Additional tests such as Breast Ultrasounds and/or MRI may be utilized to determine what type of abnormality is within your breast. These tests cannot replace mammography but can yield valuable information. An abnormality may require you to have a biopsy to prove if cancer is present. Breast biopsies obtain a tissue sample to be examined under a microscope, and are usually minimally invasive. Biopsies are performed with a needle, which can be guided to the area of concern using mammography (called a stereotactic biopsy), Ultrasound Directed Biopsy or MRI guided biopsy. The tissue obtained is sent to a pathologist to be examined under a microscope. The result of the biopsy is generally available in 3 to 5 days and most abnormalities are not cancer (85-90% of biopsies are benign).

But what if, after a biopsy, you hear those two words - Breast Cancer? Know that with modern treatment, the majority of patients with breast cancer are cured. The best cure rates are due to diligent screening which results in early detection. Remember, early detection has a five-year survival rate of over 90% and “breast cancer survivor” are the words you want to hear.

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Guidelines and early warning signs Warning Signs • A lump or thickening in or near the breast or in the underarm area.

• A change in the size or shape of the breast.

• A discharge from the nipple or a change in color or feel of the skin of the breast, areola or nipple.

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Detection/Screening Guidelines • 20 + Years of Age: -Monthly breast self-examination.

• 20 – 40 Years of Age: - Monthly breast self-examination.

- Clinical breast examination every 3 years.

- An initial mammogram by age 40.

• 40 + Years of Age: - Monthly breast self-examination.

- Clinical breast examination annually.

- Mammogram annually.

Remember, an annual mammogram is one of your best defenses against breast cancer.

It is recommended that annual mammograms should start at age 40, however that varies depending on your family history and increased risk indicators. It’s important to speak with your physician to find out what’s best for you. GLM David T. Walker, MD is the Medical Director of Breast Center at Peninsula Regional Medical Center

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19

Use Your Senses ~ Be Good To Yourself

by Therese H. Ganster, LCSW, MPM If you close your eyes when listening to John Denver’s Annie’s Song, You fill up my senses Like a night in a forest Like a mountain in springtime Like a walk in the rain Like a storm in the desert Like a sleepy blue ocean... you are left with some beautiful images and music that enraptures you...

When discussing stress management or relaxation techniques, this is called imagery.

If you add a simple breathing technique of slowly breathing in, and then slowly breathing out, you can now feel your muscles, as well as your mind begin to relax. A relaxation CD or instructor could also assist you in learning to tense varied muscle groups as you breathe in, and relax them as you breathe out. After going through a series of muscle groups, you will be able to identify what your body feels like as you relax (known as “progressive relaxation”). These simple foundations are meant to help you understand how simplistic these daily routines can be in your life, and they can easily lead you to varied forms of yoga, meditation and relaxation... with huge rewards!

Research has shown that following these simplistic routines with regularity, may assist in reducing high blood pressure, cardiac disease, diabetes management, fibromyalgia and cancer-related symptoms. People with these diagnoses relayed better control over stress (daily and /or due to their diagnoses) which then had a positive effect over their physical, emotional and spiritual well being.

Does it work? Everyone needs to decide that for themselves. But I can share a few instances with you where it had positive impacts. When initially trained in relaxation techniques, I immediately was able to experience that nice, warm fuzzy state one does before drifting to sleep. What made me uncertain was being able to bring my “image” (e.g. being on a boat and feeling the warmth of the sun on my face) to convey that relaxation response . I had to speak in front of 100 people 20

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within a week of relaxation training and practice. As soon as I saw the audience, I tensed. But then I geared up to “get on that boat”… and guess what? My body immediately relaxed. I’ve been a believer ever since.

During that time, I was part of an outpatient cardiac rehabilitation team. When I initially introduced this concept and process to the patients, I was met with healthy skepticism. We would take our pulse rate prior to the exercise and then following the exercise. The rate, as well as the blood pressure rate, typically dropped. Most would practice in the evening after dinner or before bedtime. Most believed it helped them relax considerably. Many did not use imagery with the relaxation response, but just let their minds wander, even thinking of positive times in their lives.

Soon after, Mom was diagnosed with colon cancer. Patients using guided imagery when getting their chemotherapy was just being researched with positive outcomes. Once relaxed, they were to imagine the little Pac Men gobbling up their cancer cells. I told my mom about this exercise. Whether it was to humor her child, a willingness to try anything to rid her of the nasty cells invading her body, or give her the opportunity to relax, she and I would follow the relaxation response and then follow through with the guided imagery. Mom also said it made her feel that she had some control in a frightening world she did not understand. She also became a believer then and years after.

You’ve got nothing to lose and much to gain…use your senses.

The results may surprise you.

Here are some CDs and a workbook that may get you started: Deep Stress Relief: When You Need a Long Vacation, but Only Have a Short Time: Total Relaxation and Guided Relaxation by Kelly Howell • Relaxation Healing by Peggy Huddleston • Total Relaxation/How to Manage Stress Easily by Bob Griswold • Relaxation & Stress Reduction Workbook by Martha Davis, Matthew McKay, Elizabeth R. Eshelman. GLM •

Therese H. Ganster, LCSW, MPM, is the Branch Director of Peninsula Home Care, Salisbury, Maryland.

F

inding the right health care provider can be a difficult decision. It is important that you do the homework in choosing the individual that best fits you. We spend many hours in search of the perfect car, using many different resources, but when it is time to choose a healthcare provider, it can be a challenging task.

The role of your primary care physician is to provide comprehensive healthcare, focusing on disease prevention and health promotion. It is important to find a compatible provider to entrust with your healthcare needs.

There are many resources available like local magazines, Vitals.com, Top Doc surveys, and others, but one of the best sources of information is people from your community.

An easy way to assess physicians in the area is to talk to family, friends, and locals. Questions to ask include: • Do you feel comfortable with your physician?

• Does the physician answer your questions clearly?

• Are you able to access help after hours and on week

ends?

• Are you able to obtain an appointment in a reason

able amount of time when you are sick?

After identifying a potential physician, contact the office and ask several basic, but important, questions including: • Is the provider taking new patients?

• Does the physician have an active license?

• Is the provider board certified? This means he or she has received the appropriate training in a specialty and has passed certification requirements.

• What are the office hours?

• Do they take your health insurance plan? Are there other payment options?

• Are same day appointments available?

After you gather this information and are satisfied with the responses, make an appointment with the physician. During the appointment, do

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FINDING A PHYSICIAN THAT’S RIGHT FOR YOU

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not be afraid to ask questions. The physician/patient relationship needs to be honest and connected, so it is important to have an open discussion.

Common questions include: • What is your after-hours and weekend cover age plan?

• What is your out-of-office coverage plan?

• Are you affiliated with any hospitals?

• Do you provide care in the hospital?

Be sure to have all of your questions answered by either the provider or the office staff. Most importantly, you need to feel comfortable with the health care provider.

Finding the right specialist is equally challenging. First, discuss with your primary care provider who he/she recommends. Next, use the same approach as if you are trying to find a primary care physician. Talk to community members, family, and friends, especially ones who have seen the specialist. In addition to the questions above, be sure to ask about complication rates, recovery care, and his/her second-opinion policy. There are many online resources that can guide you and provide additional questions for physicians, specific treatments and procedures for the area of expertise you may need.

Your health should be your number one priority. Take the time and effort to find the health care professional that will provide you the quality of care you deserve.

For more information on health care providers in western Sussex County, call 1-877- 4NHS-Docs. GLM Dr. Joseph Kim is a family practice physician located in Laurel, Delaware. Dr. Kim is a member of the Nanticoke Physician Network and is the President-Elect for Nanticoke Memorial Hospital’s Medical Staff.

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21

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Asparagus Quiche Ingredients:

• 1/2 pound asparagus, trimmed, chopped • 2 tablespoons butter • 4 green onions, with green, thinly sliced • 1 small tomato, peeled, seeded, diced • 1 1/2 cups shredded Swiss, about 6 ounces • 4 large eggs • 1 1/2 cups half-and-half or whole milk • 1/2 teaspoon salt • 1/8 teaspoon ground black pepper • pie pastry dough Preparation: In a saucepan, cover asparagus with water. Bring to a boil over high heat; reduce heat, cover, and cook for 5 minutes. Drain and set aside.

In a skillet, heat butter over medium-low heat; add green onions and cook for 1 minute.

Line a 9-inch pie plate with pastry; bake at 375° for 8 minutes. Remove from oven and reduce oven temperature to 350°.

Arrange vegetables and shredded cheese in pie pastry.

Whisk together the eggs and half-and-half; add salt, and pepper. Pour egg mixture over the vegetables.

Place the filled pie shell on a large cookie sheet and place in the oven and cook for 45 to 55 minutes, or until a knife inserted in the center comes out clean.

Serves 6 to 8 22

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Fare

Baked Stuffed Tomatoes Ingredients:

• 4 large ripe tomatoes • 1 can cream of mushroom soup • Salt, pepper to taste • Stuffing (see below) • Buttered cracker crumbs • 1 onion • 1/2 green pepper, chopped • 2 celery stalks, chopped • 2 tablespoons margarine • 2 to 3 cups bread crumbs or cooked rice • chopped tomato centers Preparation: Cut slices from stem ends of tomatoes, scoop out centers. Chop and save centers for stuffing. Pour soup into a shallow baking dish; set tomatoes in soup. Sprinkle tomato cavities with salt and pepper. Stuff (stuffing directions below), sprinkle with buttered bread crumbs, and bake at 350° for about 30 minutes.

Stuffing: Cook chopped onion, green pepper, and celery in the margarine for 5 minutes, or until tender, stirring occasionally. Stir in chopped tomato centers. Add 2 to 3 cups bread crumbs, cooked rice. For variation, try cooked ground beef or other vegetables as stuffing.

Serves 4

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23

Rabies Facts

Fact: American Veterinary Association recommends, and Maryland law requires, that cats, dogs and ferrets have a rabies vaccination as early as 4 months of age, and again at one year. Thereafter, the frequency is determined by the type of vaccine used, usually one to three years. It’s even more important to be sure your pet has the booster shot that offers multi year protection, because protection gradually declines over time. The second shot, given at one year, boosts that protection higher, so decline is stretched over a longer time period. Should your pet be exposed, veterinary professionals recommend and Maryland law requires, another booster, so that the pet’s ability to fight the infection remains high.

Lesser known fact: In some counties, if you are feeding a transient animal, for as little as two weeks, you are responsible for that animals rabies protection. The law is a little different in each county. Contact your local health department for more in your area or simply don’t feed the cute little kitty that comes around the porch if you don’t want to be its legal guardian.

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Delmarva Unleashed

9

home and family that it simply invited itself in via the doggie door. Sadly, that healthy looking cat was infected. It not only exposed the family pets and indoor kitties, but the humans as well. Since all the pets were vaccinated, only boosters were required, and the humans can now say they’ve had their shots.

But this situation could have been much more grim without vaccinations. Particularly since the kitty was apparently in and out many times during the night without anyone aware. It was caught in the house simply by chance.

Like so many poorly understood diseases in our world, we can live healthy lives in a rabies-infected area, but protection is key.

What can you do?

Get your pet vaccinated. Your vet will make this part of your pet’s routine medical care. If you are looking to save a few dollars, visit one of the local rabies clinics. The vaccinations there are less expensive because they are subsidized by the counties in which they are offered. Here you can stretch your tax dollars a little further. Remember, the booster shots are very important, be sure to go back and get those additional vaccines at the recommended times. Many rabies clinics offer magnetic reminders that will keep you on track, and easily adhere to your refrigerator, so your pets maintain as much protection as possible throughout it’s life.

Reduce the possibility of exposure.

Don’t feed the wildlife! Don’t leave your garbage out for transient animals looking for a quick meal. Feed pets indoors, but if you must feed outdoors, do not leave food out overnight, and clean up any spillage. Infected animals can appear quite healthy in the early stages, but are capable of transmitting the disease and exposing your pets and family during that time.

If you see an animal acting strangely, call your local county Animal Control or law enforcement so they can investigate. Be sure to make the call if a person or pet is bitten, or if contact or an attack is probable, so the offending animal can be evaluated and obtained for rabies testing, if necessary. Again, if your pet is current on shots, it may just be a formality. Your responsibility is to protect your family... furry members too!

Every day your pet is not vaccinated to protect it from rabies could be the day they are exposed, to that otherwise healthy looking animal that is not yet showing outward signs of the disease, then what?

With the growing number or rabies cases on the shore, Delmarva Unleashed will offer this series over the next four issues. There is much to learn about this disease. Please share this material with your friends and family. We don’t want you or your pets to become a statistic.

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Unintended

Consequences First in a four part series.

by Sandy Phillips

D

id you know that the Mid-Atlantic states were free from raccoon rabies until the late 1970’s, when a small group of coon hunters unknowingly brought the virus to West Virginia? They simply thought they were relocating, what appeared to be healthy animals, to increase the number of raccoons to hunt. The disease then spread east and southward, and it arrived on the Eastern Shore in the late 1980’s and early 1990’s, where it has remained.

Rabies is now endemic here on the Eastern Shore, and epidemic in some counties. It is a disease of the brain and spinal cord that is caused by a virus, and it’s nearly always fatal. Rabies in humans is very rare in the United States, but rabies in certain animals, especially wildlife, is common in many parts of the country. In 2010, 354 cases were confirmed in the state of Maryland; 217 of those cases were identified in raccoons, 83 on Maryland’s Eastern Shore. Those masked bandits are not the only threat to your pets. Cases have been confirmed in fox, skunks, groundhogs, cows and in 17 cats in 2010.

The rabies virus is typically transmitted to humans or pets via a bite from an infected animal. Less commonly, although very possible, is transmission from contact with infected saliva, which enters an open cut or gets in the eyes, nose or mouth of a person or animal. Vaccination is the best protection for your pet. It’s also required by law.

What if your pet comes in contact with an infected animal?

What if you don’t know it came in contact with that animal?

Do you really know what goes on in your yard while you are at work?

Animal Control, or your local health department can offer many seemingly fantastic tales of pets that have tangled with wildlife traversing the property when their owners aren’t home. A rabid raccoon can scale a chain-link fence in just seconds, and your pet is faced with defending itself. If your pet is protected with a vaccine, maybe only a booster will be required to offer it additional protection from the disease, and a short period of observation. If your pet is not protected, the consequences can be dire.

It is the job of local health agencies to protect the general public.

If a potentially infected animal is loose, there is a greater risk of human contact and infection. The un-vaccinated pet will face a very strict quarantine or even euthanasia. There is no debate...get them vaccinated! Don’t wait for “What if ?”

What about your house cat?

Is the kitty that never goes outside really all that safe in the house? What if kitty is exposed to the dog that was exposed while out in the neighborhood? Again, what if you don’t know the dog was exposed? Do you really know what comes and goes through you pet door? I heard the story of a feral cat that was being fed on the porch. Eventually, it was so comfortable with the www.grandlivingmag.com

Delmarva Unleashed

7

Continued from page 5

Harness Horrors: The second biggest contributing factor causing pulling is a harness. Plain and simple, harness’ are used FOR PULLING, not more control. Throughout history, man has used a harness on cattle, people, and dogs to give them the additional leverage to lean forward… and PULL! So, unless you're training your Bischon, Boxer or Basset for the Iditerod Trail Sled Dog Race, any harness that clips on the back will make your dog pull harder.

Alpha You Ain't: The third and most important element to stopping pulling…is YOU. Do you make excuses for the pulling and jumping? Does the dog yank you out the door? Are you constantly apologizing when guests come and visit? Do you find that walking the dog is more of a dreaded task then an enjoyable bonding experience with your best friend?

Sadly, it's time to look in the mirror and honestly examine if YOU need to refresh your training as well.

Now that we have isolated the three more common elements to pulling, let's examine the tools YOU need to regain your rightful role in the pack as the “Alpha Wolf:” 1. Appropriate equipment, leashes, collars and harnesses 2. Training exercises 3. Proper body positioning 4. Consistency

A four to six foot lead/leash is the perfect distance to control your tiny draft horse dog, and it can be made from natural to synthetic material with all kinds of fancy features, like padded handles, multiple adjustment points, and reflective material. But essentially if you got a piece of old rope lying around... Ta-Da you have a lead! More importantly, you "the Alpha," have a way of controlling and correcting your dog. This is why most basic training classes start with a static fixed lead. Regardless, if it's made of leather, nylon, or a chain, static leads have a pre-determined length. This may seem fairly obvious, but to your dog, it is a psychological set distance he/she knows they can travel. Your pup is cute, but not stupid, and they know when they reach the end of the rope…that's it! So, dig out that old lead, from the back of the coat closet, the one you first used in your new puppy training class, and return to the basics!

Collar Contact: There's a reason why we put collars on dogs, other than identification. The neck of most animals (yourself included) have sensitive nerves and limited muscle strength, and if you have ever been given the Mr. Spock Vulcan Neck pinch, you understand. However, a pulling dog can be so focused on chasing that squirrel or following the next delicious smell, that they mentally ignore or do not acknowledge your corrections. So it's time to power up the signal!

Let's be clear: NO collar alone can train your dog. A properly fitted collar is a tool to use as a Secondary signal supporting your Primary verbal commands, praise, and corrections with training.

When fitted high up on the neck (close to the ears), this signal can be very affective. The best way to enhance your training Leashes/ Leads: corrections is with a cinching mechanism. Instinctively, we refer It's helpful not to think of a leash as a fashion statement, but to these as "choke collars," like we call all facial tissue Kleenex®. more of a electrical power cable, where signals are transmitted But choking is the last thing you want to do. A true choke collar back and forth between dog and owner. Just as with telephone actually has the ability to crush and damage your dog's trachea, wires, certain materials transmit more effectively than others. cut into the skin, and literally choke your dog to death. A choke A lead (often known as a leash) is perhaps one of the most collar should NEVER-EVER be used on puppies! vital and physical tools any dog owner can use to correct pullOn the other hand, cinching mechanisms such as a Martingales, ing. Coupled with a proper collar (see below) you have a very Limited Slip Collars, and Prong Collars are designed to constrict powerful combination. But if you go into any pet store or bouaround your dog's neck but not damage the neck or trachea with tique, and you can easily be overwhelmed by all the different their built-in limiters. Even the freakish Prong Collar, with its types of leads, not to mention all the materials and colors. You impressive arsenal of "spikes," can be safer than a choke collar already know not all of them help with pulling (i.e. retractbecause of a set limiter. Pinch Collars are wonderful for aggresables), so let's take a look at the more effective leash/collar/ sive pullers or dogs with exceptionally thick fur. The "prongs" are harness to give you a physical advantage. able to penetrate though the fur and dense undercoat to transmit your correction to the neck. But not all Prong collars are created equal. Less expenSalisbury’s Premier r ie s a E sive versions have sharper edges or use low There Areh the Dog. Self Service Dog Wash quality materials which may distort, bend or as Ways to W break, and that WILL be painful. So, invest in your pet and buy a good leash...not the cheapest one.

443.736.7441

Stephen Frolich is the owner of “Tails n Tubs” in Salisbury, MD. He will be happy to help you select the correct type of restraint for your dog. Look for Part 2 of “Hold Me Back” in the May/June issue of Delmarva Unleashed.

Proper Vaccination Records Required

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Hold Me Back!

by Stephen Frolich

Bryan & Brittingham, Inc.

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W

e've all seen them walking down the street... that spectacular battle of will between dog and owner.

The dog wants one thing, the owner wants the other. Arms are being wanked out, knees are locked, feet going thump, thump, thump down the pavement, as one teeters on a majorly embarrassing face plant in front of the whole neighborhood.

It's a matter of perspective if you are the “puller or pull-ee.�

Regardless, the fact remains the two of you are not working together on the same team, and YOUR dog is pulling YOU all over.

Pulling is one of the most common behavior problems owners face with their dog. That's why learning how to walk on a leash is one of the first and most basic commands we all learn when we get a dog. It is also one of the first ones we abandon as the weeks turn into months, and months turn into years.

Three big elements can lead to problem pulling: 1.Using the wrong type of lead/leash 2.Harnesses 3.YOU (admit it!)

As your dog's leader, you need to address each one individually, so when collectively used, you can gain the physical and mental advantage.

Variable Variations: Oh! That wonderful retractable lead/ leash with the comfy handle, poop-bag holder and flashlight sure do make YOUR life convenient, but it is probably one of the three biggest elements leading to your pulling problem. Retractable leads, expandable leads, and bungi leads encourage the bad habit of pulling, because the dog is always trying to gain one more inch, then another, and one more after that. With a variable lead, they never learn to STOP pulling. In addition, retractable leads eliminates your ability for instantaneous correction. Proper training requires quick verbal and physical correction for when your dog is pulling or jumping. But with a variable lead, much of your energy is lost through the tiny 1/8 inch line or as that elastic cord stretches.

Leads that E -X -P -A -N -D are designed to absorb energy when the dog pulls, but the same occurs when you pull, too. Not to mention it is practically impossible to grab that teeny tiny black cord with your free hand for additional leverage.

Continued page 6

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Peninsula Animal Hospital & Orthopedics

by Sandy Phillips

T

Lexi, gets an x-ray of her knee for a better evaluation of a limp.

here was such a time on the lower shore, when you had to travel to the western shore or Wilmington for veterinary orthopedic care. The recovery from a leg or hip fracture meant many trips and sometimes an overnight hotel stay, if reconstructive surgery for your pet required them a hospital stay.

Times have changed, Delmarva now has the technology and talent to treat most orthopedic challenges right here at home.

Dr. Frances Haberstroh, M.S. V.M.D., Diplomate of the American Board of Veterinary Practitioners,1997 graduate of the University of Pennsylvania School of Veterinary Medicine and an Eastern Shore native, has focused her continuing education on the orthopedic specialty for the last fourteen years. Now owner of Peninsula Animal Hospital and

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Orthopedics in Delmar, Dr. Haberstroh focuses her practice on orthopedic procedures in additiona to general veterinary medicine and surgical care. Having been limited in the past to simple procedures, technology has opened many doors to cats and dogs for fractures of many kinds. New diagnostic equipment and surgical tools have made it possible for even some car accident victims to regain a better quality of life post surgery.

“There have been so many advancements in veterinary medicine. We can do so much more for our pets in today’s world”, says Haberstroh. “I have completed almost 100 tibial tuberosity advancements, a procedure that repairs a torn ACL, since 2007, and have seen great improvement in many dogs. Often the older version of the repair left the dogs with large blocky arthritic knees. With today’s procedure, I see much less arthritis and the dogs regain better activity levels with excellent long term results.”

There are now metal plates that can be used for the repair of pelvic fractures and other complicated breaks. Stem cell therapy is also available for dogs that are not surgical candidates for a variety of reasons.

Broken bones can be life changing for both humans and animals. It’s comforting to know that we have such advanced capabilities here on the shore and that there are options for better outcomes when tragedy strikes. Keep in mind that orthopedics are not just for trauma, but can often improve the quality of life when congenital structural problems, like hip dysplasia and patella luxations are discovered.

Put A Smile Back On That Face John Maniatty, V.M.D.

S

o many times as a vet, I here that Fluffy is starting to eat less, staying away and we think she has some type of disease.

Many times that disease is dental disease. The majority of dogs, (80%), and cats, (70%), are diagnosed with some type of periodontal disease by 2 years of age. Periodontal disease entails infections that attack the gums, the fibers that attach the tooth to the gums, the fibers that attach the tooth to the bone, and in the most severe cases, the bone itself. Early periodontal disease detection often lacks outward clinical signs since it is not too painful. As the infection continues to grow, it penetrates further into the tissue, around the tooth, and possibly the tooth itself. As this occurs, we start to see outward clinical signs due to the discomfort, such as not eating hard food or treats, bad breath, pawing at the mouth or rubbing face against the floor or furniture.

Other signs include hiding, not playing with favorite toys or not chewing on chew toys, and not drinking cold water. If you see one of these signs, then you should have your pet seen by your local veterinarian.

Your veterinarian will do a complete physical exam. The oral exam portion of the physical may allow them to probe the teeth and pinpoint the damaged tooth/teeth. Further diagnostics may be needed, such as dental radiographs. By doing this, your vet can help determine how progressive the disease is and which teeth may need to be removed, and if other specialty treatments to save the teeth can be done. Sometimes you may be refered to a dental veterinary specialist for these treatments. Dental veterinary specialist do things such as root canals, cap teeth, and make implants to move the teeth to more desired positions.

Besides the teeth being affected by this bacterial infection, there are strong indicators that this infection can become systemic and affect the kidneys, liver, heart and lungs. The physical exam will check the heart and lungs, but prior to any dentistry, it is strongly recommended to have preoperative blood work done to assess the liver and kidney functions.

Any dentistry is best performed under general anesthesia. If your dog is exceptionally good and has a medical condition that may preclude them from being able to go under anesthesia, then hand scaling awake may be attempted even though this is not the best medicine. Once under general anesthesia, each tooth is probed checking for loose teeth or pockets. If necessary, any teeth that are bad are removed. This can be quite difficult because some are multirooted and one root could be abscessed, but the other roots are fine. The tooth can be cut with a dental drill and each root removed using a dental elevator. The sockets are then flushed and flaps are made from the gingiva to close over the socket, which is now filled with a blood clot to aid in the healing process. Once the extractions are done, the remaining teeth have the calculus/tartar chipped off, and hand scaling below the gum line is preformed. An ultrasonic scaler is used to remove the remaining calculus on the teeth and then the teeth are polished. The patient is monitored through recovery and sent home with pain medication and follow-up antibiotics if needed.

In post dentistry, brushing the teeth, if possible, is recommended. If not there is water additives that will help prevent or at least slow calculus build up. When choosing a water additive, consult your regular veterinarian because many are on the market but few have been actually clinically tested and proven.

They can help you choose the right one for you. Also, dental chew treats can be used to help clean the teeth, and some even have chlorhexidine in them, which will help fight oral bacteria.

It is preferable these chews not be swallowed, as raw hide can upset a pet’s stomach or become an obstruction. Once the chew is soft, take it and replace it with a hard one. The soft one can be left to dry and will reharden, and able to be used again.

As the old adage goes, “Prevention is the best medicine.� If you take care of the teeth before it becomes a problem, your pet can be saved a lot of discomfort. People are always amazed at how much better their pet feels post dentistry. They never realized how miserable their mouth made them feel, and they are so happy to have their furry friend smiling again.

Dr. John Maniatty is a board-certified veterinarian in practice at the Ocean City Animal Hospital, Ocean City, MD.

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contents

Delmarva Unleashed A Supplement of Grand Living Magazine

Vol. 3 Issue 2- March/April 2011

3

Put A Smile Back On That Face

4

Peninsula Animal Hospital & Orthopedics

5

Hold Me Back

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Unintended Consequences

Publisher Sandy Phillips Associate Publisher Farin Phillips Editor Lou Ann Hill Creative Sandy Phillips Farin Phillips Contributing Writers Stephen Frolich John Maniatty, V.M.D. Grand Living Main Office Advertising Info: (410)726-7334 Cover Satin, the loveable companion of Betsy Varble of Whitesville, MD., loves flowers.

10 Delmarva Pets

Over the Rainbow Bridge.....

Chance Nov. 12,1998 Jan. 2, 2011 Family Dog Protector Child Entertainer Faithful Companion Muddy Paws Tennis Balls Frisbees Total Fetchaholic Arby’s Roast Beef Fries GLM Family Member Sadly Missed 2

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Unleashed Delmarva

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Hold Me Back!

Put A Smile Back On That Face

Unintended Consequences