July 2012 MHL

MHL

JULY 2012 FREE PUBLICATION

Est 1992

MODERN HEALTH AND LIVING

A new outlook

ON RETIREMENT LIVING

Skin Care

AND AGING

COOL THE RISING SUMMER HEAT THE PATH TO EMPOWERMENT

Healthy

SNACKING RULES

Sleep

AND CHILDREN KEEPING YOUR BRAIN YOUNG

A GUIDE TO HEALTHY LIVING FOR MEN, WOMEN, CHILDREN AND SENIORS

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MHL JULY 2012

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Editor’s Note Summer is here! I just love the time of year when everybody makes a mad dash to the garden centers.

I do believe plants nourish us in so many different ways. Herbs in particular are a favorite of mine.

I find their medicinal purposes fascinating and I appreciate the flavors they bring to cooking. I’ve also been noticing more people taking advantage of the local parks. Getting in shape can be as simple as taking your dog for a walk, playing with your children or taking a walk with your neighbor.

Be sure to properly supervise those who handle fireworks as well.

I have been trying to enjoy the beautiful weather and needless to say my kids could not be happier with this weather. My daughter, every morning, wakes up and feeds her favorite yellow finches.

My summer routine is getting up at 6am every morning for a run then a 20 minute workout. Our lives can become chaotic but it is still important to remain active not only for physical fitness but to keep our minds healthy as well. This is why I had to slow down this summer with my excessive work schedule and really enjoy life. I’ve been traveling, it seems, almost every weekend to my favorite summer spots. The horse track for a wine tasting in Arlington. The Union patio at Madison. Coming up Great America, Key Lime Cove...I love it. Even the local events are great. Summer Sounds in Cedarburg, Jazz in the Park, Beerfest at Bayshore mall.

This has truly been a great summer and my family and I are just enjoying it.With the weather this hot it’s important to keep cool and hydrated. I’ve been spending a lot of time at the Cedarburg pool with my SPF 50.

To our senior readers, I have put a special health and independence feature for you. I encourage you to get out and go to all the great music venues.

I would like to thank all the professionals who have contributed to this issue and YOU, our readers for staying in touch with us. Have a safe and healthy July!

-Amanda Lewis

MHL

MODERN HEALTH AND

July Edition 2012

JULY 2012 FREE PUBLICATION

Est 1992

LIVING

A new outlook ON RETIREMENT LIVING

Skin Care

AND AGING

COOL THE RISING SUMMER HEAT THE PATH TO EMPOWERMENT

Healthy SNACKING RULES

Sleep

AND CHILDREN

contributers

A GUIDE TO HEALTHY LIVING FOR MEN, WOME N, CHILDREN AND SENIO RS

Berkeley Wellness Letter, John Hopkins Medical Letter, Environmental Nutrition, Nutrition Action Health Letter, Columbia/St. Mary’s, Wheaton Fransician, Milwaukee Eye Care, Eye Care Specialists, Aurora, NorthShore Chiropractic, National Pedorthic Services, Lifesteps Wellness Clinic, Advance Physical Therapy, Elite Fitness and Racquet Club, Alexian Brothers Village, Transformations, NIH, Jensen Health and Energy, Foot Solutions, Allergy and Asthma Centers, Lakeshore Medical, The Ommani Center, Active Care Rehab, Interfaith Older Adult Services, Jewish Family Services, Laureate Group, Alzheimer Association, Tudor Oaks, Luther Haven, HealthWise Chiropractic, Greensquare Center for the Healing Arts, Midwest Audiology Integrative Family Wellness Center Social Security Offices and American Camp Association

contact

Lewis Media Group Amanda Lewis Malberry Media Marlys Lewis Jerry Kornowski Marlys Metzger Barry Lewis

For information on advertising or to submit articles call, fax or email 414-659-6705 or 608-2376000, email: info@lewismediagroup.com.

Subscriptions are $20 per year. Thanks for reading HealthWisc.

disclaimer

publishers editor graphic design advertising distribution manager travel editor founder

KEEPING YOUR BRAIN YOUNG

HealthWisc is published on the first of each month . The articles in this publication are in no way intended to replace the knowledge or diagnosis of your doctor. We advise seeing a physician whenever a health problem arises requiring an expert’s care.

thanks

staff

MHL Staff

Special Thanks! To all the local professionals that provide us with articles containing new information and keeping all our readers informed of the latest in healthy living.

Lewis Media Group | Malberry Media | www.modernhealthandliving.com JULY 2012 MHL

Skin Care and Aging

Your skin changes with age. It becomes thinner, loses fat, and no longer looks as plump and smooth as it once did.

Cynthia had always been proud of her skin, especially her summer tan.

But as she grew older, she saw she was getting more fine lines and wrinkles.

She began to worry about what other skin problems she may have. What were those brown spots on her hands and arms?

Your skin changes with age. It becomes thinner, loses fat, and no longer looks as plump and smooth as it once did. Your veins and bones can be seen more easily. Scratches, cuts, or bumps can take longer to heal. Years of sun tanning or being out in the sunlight for a long time may lead to wrinkles, dryness, age spots, and even cancer. But there are things you can do to protect your skin and to make it feel and look better.

Dry Skin And ItchingMany older people suffer from dry skin, often on their lower legs, elbows, and lower arms. Dry skin feels rough and scaly.

There are many possible reasons for dry skin, such as: •Not drinking enough liquids •Staying out in the sun •Being in very dry air •Smoking •Feeling stress •Losing sweat and oil glands (common with age) Dry skin also can be caused by health problems, such as diabetes or kidney disease. Using too much soap, antiperspirant, or perfume and taking hot baths will make dry skin worse.

Because older people have thinner skin, scratching can cause bleeding that may lead to infection. Some medicines make the skin itchier. If your skin is very dry and itchy, see your doctor.

Moisturizers like lotions, creams, or ointments can soothe dry, itchy skin.

They should be used every day. Try taking fewer baths and using milder soap to help your dry skin. Warm water is less drying than hot water. Don’t add bath oil to your water -- it will make the tub too slippery. Some people find that a humidifier (an appliance that adds moisture to a room) helps.

BruisesOlder people may bruise more easily than younger people. And, it can take longer for the bruises to heal. Some medicines or illnesses may cause bruising. If you see bruises and you don’t know how you got them, especially on parts of your body usually covered by clothing, see your doctor.

WrinklesOver time, skin begins to wrinkle. Things in the environment, like ultraviolet (UV) light from the sun, make the skin less elastic. Gravity can cause skin to sag and wrinkle.

Certain habits also can wrinkle the skin. Some of these habits are easier to change than others. You may not be able to change your facial expressions, but you can quit smoking.

A lot of claims are made about how to make wrinkles go away. Not all of them work. Some can be painful or even dangerous, and many must be done by a doctor. Talk with a doctor specially trained in skin problems (a dermatologist) or your regular doctor if you are worried about wrinkles.

Age Spots And Skin TagsAge spots, once called “liver spots,” are flat, brown spots often caused by years in the sun. They are bigger than freckles, and many times show up on areas like the face, hands, arms, back, and feet.

Age spots are harmless, but if they bother you, talk to a dermatologist about removing them. Also, a sunscreen or sunblock may prevent more sun damage.

Skin tags are small, usually flesh-colored growths of skin that have a raised surface. They are a common occurrence as people age, especially for women. They are most often found on the eyelids, neck, and body folds such as the arm pit, chest, and groin. Skin tags are harmless, but they can become irritated. A doctor can remove them if they bother you.

JULY 2012 MHL

Lipotherapy A NON-SURGICAL ALTERNATIVE TO LIPOSUCTION

262-240-0997 MHL JULY 2012

What is Lipotherapy? Lipo-therapy is a chemically induced, non-surgical alternative to liposuction. This therapy has been used for many years in Europe and South America founded by Dr Patricia Rittas, Brazil and Dr. LeCoz, Paris., and is finally being used more commonly in the United States, for the loss of localized fat areas.

How is Lipotherapy different from liposuction? Lipo-therapy differs from liposuction in that it is completely non surgical and is done by injecting a chemical called phosphatidyl choline into the area to kill the fat cells, after which the body then flushes these dead fat cells through the body through feces and urine resulting in the targeted areas being depleted of the unwanted fat.

Is lipotherapy painful, and what are the side-effects? Lipotherapy is done with the use of injections so there is a minimal discomfort, as well as swelling and tenderness in the area of injection. In order to know that the treatment is working, the swelling is exactly what we like to see, and should subside along with the tenderness in 24-48 hours.

Is lipotherapy expensive? Lipotherapy is very inexpensive in comparison with liposuction it typically runs $250-500 per area per treatment, some people needing more than one treatment.

Who should have lipotherapy done? Anyone who’s body mass index is less than 30 is a candidate for this therapy, this is not a weight loss alternative but should be used to sculpt the body for individuals who do exercise and have that one area that no matter what they do they simply can not lose it, this is ideal for those people.

How long does it take? The procedure for lipotherapy itself takes only about 15 minutes however the process continues to work over the course of 30 days with the patient typically noticing a significant difference after about a week.

For more information contact Solaris Medical Spa at 262-240-0997.

Editor’s pick Men’s Road Bike REVENIO 3.0 - Raleigh www.raleighusa.com Take to the roads on the Raleigh Revenio 3.0 road bike and put those miles behind you with surprising comfort and efficiency, thanks to a responsive frame and dependable Shimano components.

•Hydroformed and butted aluminum frame utilizes a geometry that blends comfort and performance for a sporty ride with good handling and power transfer •Carbon fork with aluminum steer tube helps reduce weight and damp road vibration •Decked out with reliable Shimano 105 shifters and derailleurs, which offer reach-adjustable levers, precise shifting and good ergonomics •Shimano compact crankset and 12-30 cassette offer 20 gears to handle challenging grades and speedy pursuits •Dual-pivot caliper brakes facilitate sure speed management •Vittoria Zaffiro Pro tires feature a supple 60 TPI casing and puncture-resistant belting to deter ride-deflating flats •Specs on the Raleigh Revenio 3.0 road bike are subject to change

THE BIG DOG ON THE BLOCK Craig Thompson is the Executive Director of the Transportation Development Association of Wisconsin

Wisconsin accounts for about 20% of the entire U.S. cycling industry. Some of these Wisconsin companies include: Gear Grinder (Glendale), Hayes Brakes (Mequon), Mt. Borah (Coon Valley), Olympic Supply Company (Milwaukee), Pacific Cycle (Madison), Planet Bike (Madison), Saris Cycling Group (Fitchburg) and Waterford Precision Cycles (Waterford). In all, there are over 200 bicycle-related companies in Wisconsin.

In addition to Wisconsin being a behemoth in the cycling industry, we are a big dog when it comes to cycling destinations as well.

There are unbelievable trails and bike friendly local communities throughout this state. And while it may not be the first thing that comes to mind when we think of Wisconsin’s economic drivers, it doesn’t go unnoticed by bicycle crazed enthusiasts across the country or the world for that matter. Bicycling brings in more than $535 million a year from out-of-state tourists alone. That’s a lot of people coming to the state looking for food, lodging, entertainment, shopping, and other activity.

[2013] INTERVAL ELITE Mens Diamond Back www.diamondback.com

Looking to give your first tri event a shot but not really looking to break the bank? Interested in the sport but don’t feel comfortable on a race ready road bike? Here at Diamondback we hear you loud and clear and have just the rig to get you off training and competing.

Enter the all new Interval Elite. Taking all of the features that you know and love about your standard performance hybrid and integrating an aero position clip-on bar for maximum aero dynamics and comfortable position options. Add that to the Interval Elite butted 7005 alloy performance hybrid geometry frame with formed top tube, integrated head tube, and DBR AERO Performance Carbon fork and you’ve got yourself one fast machine.

Shimano Tiagra 10spd shifters, 105 derailleurs and cassette plus an FSA VERO Compact N10 crankset with 50 & 34t rings give you a standup drivetrain that is worthy of any competition. Equation 700c aero deep dish rims laced to 20 and 24 hole alloy hubs add a sleek, lightweight and aerodynamic wheelset to the mix. Tektro Rx5 Mini V brakes w/cartridge pads are controlled by Tektro ML730 2 finger brake levers with reach adjust for maximum stopping power.

A DB Performance soft nose, hybrid gel saddle mounted to an alloy micro adjust 27.2mm post offers an exceptionally comfortable yet performance base for riding. A DBR oversized flat bar road and 3D forged stem are a great start to the cockpit… and the cockpit is where things really start to spice up.

Unique to Interval is the aero position clip-on bar. Found more often on high end tri bikes, the aero bars offer you numerous riding positions allowing you to streamline your body position on a bike. Not a fan of the bars on casual rides, take them right off. One bolt… it’s that simple.

The Diamondback Interval Elite Men’s is grey and comes in 4 unique sizes: SM (15”), M (17”), LG (19”), XL (21”). If you love riding your performance hybrid but would love to give a local tri event a go sometime… check out Diamondbacks Interval Elite.

JULY 2012 MHL

Modern Living...

Gotta Have It’s!

NETGEAR - N900 DUAL BAND WIRELESS-N ROUTER WWW.NETGEAR.COM It’s easy to set up and works great. We noticed improved range and performance over the old wireless G router. Plus, it has two USB ports to hook up other devices such as an external hard drive. It has four LAN and one WAN connection.

Great range and no line droppage are its best features.

LINT LIZARD WWW.LINTLIZARD.COM Nifty little device that allows you to get into the hard to reach area of the dryer’s lint trap. Most vacuums are too big to fit into the lint trap and this helps to prevent lint buildup that can shorten the lie of the dryer. The lint lizard attaches to the wand on the vacuum.

MHL JULY 2012

SONY GOOGLE TV BLU-RAY DISC PLAYER - NSZ-GT1 WWW.SONY.COM The perfect device for the person who wants to watch tv and have access to the internet all at once. The Sony Google TV hooks to the TV through HDMI and can either be looped through the cable box or a separate HDMI connetion. You will either have to have an internet connection or a wireless router to provide internet connectivity. You can surf the internet without limitation on the same screen you are watching TV. The keyboard is a little small and takes a little getting used to, but the learning curve is quick and many people are already used to surfing the net on their cell phones which are much smaller. All in all, the concept is great because it allows one station or TV viewing and internet surfing.

LaceWing

Where to Get Gardening Help?

Knowledge is a gardener’s best tool.

With knowledge and good resources that cover all aspects of your yard and garden, you can troubleshoot problems and come up with great solutions. Luckily we live in the information age. Thanks to the Internet, TV, radio, and books, we have more access to more free information than ever before, but with so many resources available, how do you recognize the best gardening authorities and the most reliable sources of information?

No matter how long you’ve been gardening, sooner or later you’re going to run into a problem that you can’t figure out alone. Where do you turn for help?

Here are some great sources of gardening information — beyond traditional books and TV shows — that can help to turn a potentially disastrous problem into a successful solution.

Web Sites — We live in the Internet age and information is just one google search away. It s important to find Web sites that offer accurate, accessible information. For example, the National Gardening Association (NGA) Web site features articles, pest and weed libraries, plant finders, calculators, how-to projects, regional gardening information, and more. Developed with decades of gardening experience, it s a one-stop

location for a wealth of gardening information.

Online Forums — Online forums, uch as Dave’s Garden, are another great source of information. At Dave’s Garden you can “meet” gardeners with similar interests and problems and chat with them about their experiences. Of course, many users of online forums are amateurs, and their suggestions may be very personal and site specific, but these sites offer a good way to network, find links to other information sources, and build a community of gardeners.

Blogs — Other gardeners are a great source of gardening-specific information. If your neighbor isn’t a gardener, try finding one on the Internet and reading their blog. Try googling for gardening blogs in your region. Read through a few to see which you like best. Some offer more than just gardening how-tos.

For example, The Garden Rant features gardening information as well as political and social commentary about gardening, health, social issues, the environment, and more. It’s a fun read and informative.

Video — People have less time than ever before to sit and read information.

Perhaps that’s why Internet videos have become so popular. Plus, gardening is

such a hands-on, show-me hobby that seeing something is often the best way to understand it. Look for videos on your favorite gardening Web sites or Youtube. com. Be sure to check out Charlie Nardozzi’s how-to videos at the NGA Web site. The best are usually short, to the point, and have good production quality so you can really see what’s happening.

In Person — Yes, people still talk to each other to get information! In this age of iPods, iPhones, and near-universal computer access, it’s sometimes hard to believe this, but the best information still comes from real, live people. Seek out a family member, friend, or neighbor who’s particularly good at gardening for help with your problem. Organizations, such as your state’s Master Gardener Program, can also help , as can local garden clubs, and employees of garden centers. Master Gardeners are trained professionals who volunteer to help other gardeners.

So, don’t be shy if you have a gardening problem. Reach out and find help, either in-person or via the Internet. Throughout history, one thing has always remained true: Gardeners are a friendly bunch, and enjoy helping out a fellow plant lover in distress

Gardening & Consulting Services Home based in NW Milwaukee

Garden Consultation Instruction Design Wildflowers & Woodland Gardens Organic Lawn Care Landscape Maintenance Environmentally sustainable landscapes practice in all area/havitats.

Creating Habitat gardens that attract humming-birds,butterflies and pollinators Including ponds, prairies and rain gardens.

Remember, Life begins in the garden!

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414.793.3652 Winter Services

Landscape Design Thinning & Renewal Pruning Garden Talks to Groups on Various Organic Garden Topics & Lifestyle.

Creating Habitats for over 15 years

JULY 2012 MHL

Breathing . . . It’s a good thing.

Allergies • Asthma • Sinus Disease • Obstructive Lung Disease

We are the Experts at keeping you breathing.

Board Certified in Pediatric and Adult Allergy and Immunology “Top Doc” in Milwaukee Magazine 1996, 2000, 2004 & 2008

Steven H. Cohen, M.D. 11121 W. Oklahoma Avenue • West Allis • www.allergicdiseases.com

414 - 545 - 1111

GET MORE

Vegetables IN YOUR DIET

Whether you’re trying to lose weight or just maintain a healthy lifestyle, it’s important to include a variety of vegetables in meal planning. The health benefits of eating vegetables are many and include reducing the risk of stroke, type 2 diabetes, coronary heart disease, and certain cancers, such as mouth, stomach, and colon cancer.

It can be a challenge to include a sufficient amount of this tasty and beneficial food group to menus. These tips from TOPS Club, Inc. (Take Off Pounds Sensibly), the nonprofit weight-loss support organization, offer some creative ways to eat more vegetables: 1. Make a “pasta” dish with spaghetti squash instead of noodles.

2. Puree cooked vegetables and add them to stews, gravies, and soups.

3. Add raw spinach leaves and an extra-ripe banana to a fruit smoothie. It may sound strange, but the sweetness of the banana masks the taste of the spinach.

4. Baking? Add shredded carrots to muffins or bread.

5. Instead of cheese and meat, pile your morning omelet with onions, mushrooms, and red and green peppers. Chop vegetables the night before to save time in the morning.

6. Add chopped spinach to meat when preparing meatballs or hamburgers.

7. Try mashed cauliflower instead of mashed potatoes. Experiment with different flavorings such as garlic, a dab of butter, and Parmesan cheese.

8. Add salsa to a breakfast burrito, pile it on a veggie burger, or use it in place of high-fat, creamy vegetable dips.

9. Puree pasta sauce with vegetables such as winter squash or chopped broccoli.

10. Add chopped carrots to casseroles or meat loaf.

Visitors are welcome to attend their first TOPS meeting free of charge. To find a local chapter, visit www.tops.org or call (800) 932-8677.

10 MHL JULY 2012

THE SCOOP ON POOP

Zoonoses are infections or diseases that can be passed from an animal to a human

By Deanna Majkowski Keys-check. Wallet-check. Fluffy-check. Bag of poop? Yes, a bag of poop. It sounds odd but other than Fluffy a stool sample is the most important thing you can bring to your pets annual exam. It is also odd that this gross subject is near and dear to my heart. So why is something people don’t want to talk about worthy of an article? The answer can be summed up in two words; zoonoses and compliance.

Zoonoses are infections or diseases that can be passed from an animal to a human.

Yikes!!! Furry family members can pass intestinal parasites to non-furry ones with a pretty serious list of potential consequences for both pets and people; including diarrhea (with or without blood in stool), vomiting, fever, lung, liver, and brain tissue damage, blindness and even death. Our critters can pick up intestinal parasites by coming in contact with a contaminated environment or animal (even inthere own back yards), ingesting feces or urine (including that of wild animals), eating under cooked or raw food, or drinking non-purified water. Unfortunately our indoor cats are not in the clear since 30% of all potting soils contain round worm eggs and tapeworms are the result of swallowing flea eggs. Humans can pick up parasites in all of the same ways, even when the parasites/eggs are too small to see. Children are at greater risk not only because their immune system is less developed but also because they are more likely to kiss their pets, share food with animals, and touch contaminated items and then their mouths without washing their hands.

The second word that makes poop so important is compliance. Compliance boils down to the number of people who are actually following the recommendations of veterinary professionals. Having worked at the Forest Home Animal Clinic I not only could add poop expert to my resume but can also testify that the compliance in this area is shockingly low.

Don’t take my word for it, the Center for Disease Control and Prevention refers to intestinal parasites as “a potential public health hazard”. The danger increases with every pet that is not given a monthly preventative or is not treated when they have intestinal parasites. Only two of the

four most common parasites can be seen with the naked eye so it is possible a pet can be harboring a serious threat without their family being aware. The only way to know for sure if your pet has parasites and get them the treatment they need is to have a fecal screening at your veterinarian. According to a study done by the Companion Animal Parasites Council, 6% of cats had evidence of intestinal parasites in their feces versus 2.9% of dogs. Cats are at higher risk for intestinal parasites due to the low number of feline patients on products like Heartgard which is traditionally given to prevent heartworm disease but also contains ingredients to kill many types of worms pets may have picked up.

So by now you have a pretty clear knowledge of the risks that intestinal parasites pose to us, our children, and our furry friends but what to do with it? How do you protect your family? How do you comply? Don’t panic with eight simple rules of thumb you can minimize the risks to your entire household.

• Do a fecal exam at least 1-2 times a year so parasites can be detected and treated. Make sure to have a stool sample retested in about a month to make sure the issue is completely cleared up-worms can be pretty stubborn.

• Do not skip annual exam. Veterinarians will sometimes become aware of an intestinal issue by feeling a pets stomach.

• Give a monthly wide spectrum preventative such as Heartgard all year.

• Pick up stool as soon as possible • Institute strict hand washing rules for every member of your family.

• Never allow your pet to eat raw or under cooked or raw food.

• Keep your critters out of your plants.

• Make an appointment with your veterinarian as soon as possible if your pet develops diarrhea (with or without blood in stool), vomiting, fever, or if their belly is swollen or tender to the touch. Remember to bring a stool sample that is less than eight hours old and not frozen.

So there you have it, all you ever wanted to know about poop and then some. As a mother of two boys, a dog owner, and veterinary professional, I cannot encourage people enough to take this subject seriously. Have regular fecal screenings done, keep your pets on preventatives all year, institute good sanitary and hygiene practices and embrace your happy healthy pet.

For more information contact the Forest Home Animal Clinic 11222 West Forest Home Avenue Franklin, WI 53132 (414)425-2340 www.foresthomeanimalclinic.com

JULY 2012 MHL 11

DO YOU SEE WHAT I SEE?

A VISIT TO AN EYE CARE SPECIALIST MAY SAVE MORE THAN YOUR SIGHT

Eye Mds’ Detective Skills May Reveal Cancer, Diabetes, Blocked Arteries

Most of us are born with near-perfect vision. But, that sometimes changes with disease or age. As state leaders in eye care, we help countless people each week to see like a kid again with Comprehensive Eye Exams; Diagnostic Laser Scans; and State-of-the-Art Cataract, Glaucoma, Diabetes, Macular Degeneration, Pediatric, & Laser Vision Correction Care. And, we’re affordable—accepting Medicare and most insurances. Call today and see for yourself why we are:

Trusted by more than 121,000 doctors & patients “Top Doctors”— Milwaukee Magazine

Call 414-321-7035 or visit www.eyecarespecialists.net for free brochures on any eye concern

T EYE CARE

SPECIALISTS Norman Cohen, MD Mark Freedman, MD Daniel Ferguson, MD

Robert Sucher, MD Brett Rhode, MD David Scheidt, OD

West Allis

10150 W. National Av. 414-321-7520

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2323 N. Mayfair Rd. 414-258-4550

Milwaukee

735 W. Wisconsin Av. 414-298-0099

Attention:

Patients with Peripheral Neuropathy for non-invasive, FDA approved treatment.

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• Pain, balance and sensation status is evaluated before and after treatment.

• All Major Insurances Accepted Including Medicare and Medicaid • CALL 414-228-7900 to schedule an appointment

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12 MHL JULY 2012

“I consider myself an ophthalmic ‘detective,’” says Dr. Mark Freedman, a leading laser surgeon and ophthalmologist at Eye Care Specialists in Milwaukee. He explains, “The eye is like a transparent looking glass into the vascular, neural and connective tissues of the body. It is the only part of the body that gives us a unique opportunity to look in and actually see certain diseases and conditions, rather than to infer their presence from signs and symptoms. . . . As a result, a visit to the eye doctor can not only lead to the detection and treatment of ocular diseases, it may also turn up clues of serious non-eye-related conditions affecting the rest of your body which present clues of their existence through minor changes in the appearance of the inside of the eye.”

For example, it may come as a surprise to some people, but a visit to an eye care specialist may uncover signs of a blocked artery in the neck. How is this possible?

“Blockage in the carotid artery can break into smaller pieces that travel through the bloodstream and appear as yellow fatty deposits in the arteries in the back of the eye.

These send up a red flag that the patient should have an evaluation of their carotid arteries and heart.”

Although what Freedman and his partners find is not always the best news, it often gives patients the opportunity to seek prompt medical treatment before they would have noticed anything was wrong. “For example, if a tumor or clogged arteries are caught early enough, less invasive and less costly procedures may be able to be used to not only prevent the spread of the problem, but to even save a person’s life,” notes Dr. Norman Cohen, Eye Care Specialists cofounder and an ophthalmologist with 37 years of experience.

Eye Care Specialists’ team frequently conducts continuing education programs for optometrists, physicians and nursing staffs on the subject of detecting diseases through eye exams. They also teach the subject during in-office sessions with doctors-in-training from local medical programs. “It’s important for all health care professionals to know the signs of eye conditions, such as cataracts and glaucoma, as well as non-eye-related conditions, such as blocked arteries or tumors, that may appear in the eyes,” says Dr. Brett Rhode, Head of Ophthalmology at Aurora Sinai Medical Center and a private practitioner in downtown Milwaukee and West Allis.

One area of special interest to Rhode is detection and treatment of a condition that can affect both the body and the eyes— diabetes. “As the life span of diabetics has increased, so has the incidence of general circulatory problems which can develop www.activecarerehabwi.com

over time due to the disease. The most common eye-related complication of diabetes is diabetic retinopathy, which is caused by deterioration of the small blood vessels that nourish the retina in the back of the eye. Sometimes an eye exam reveals telltale signs of weakened vessels leaking blood or fluid before a patient is even aware that they have diabetes. Fortunately, if the diabetes is caught early enough, we can use Avastin injection and/or laser treatment to stop or slow future loss of vision. And, we can refer the patient to their primary care physician or a specialist to ensure that they receive proper testing, nutrition guidance and medication to control or prevent other diabetes-related problems.”

Although discovering underlying diseases is a fascinating part of an eye care specialist’s work, most of the day is filled with performing surgery and examining patients for eye conditions.

“As with any good detective, you begin by interviewing the people involved.

That’s why it is important to listen to patients and pick up on clues when they explain their health and vision history. What is the real cause for an older adult cutting back on driving, a person having difficulty ‘hearing’ the TV, someone suffering frequent falls, or a child not doing well in school? These symptoms are often clues pointing to the need to test for cataracts, macular degeneration, dyslexia or other conditions,” explains Eye Care Specialists co-founder Dr. Robert Sucher.

A thorough examination of the parts and workings of the eye includes evaluating: the external surface (for infections and inflammations); the internal pressure, lens, optic nerve and retina (for diseases like cataracts, diabetes, glaucoma, macular degeneration, etc.); accommodation capability (ability to switch focus between near and far); pupil reflexes (ability to adjust from light to dark); muscle motility (ability to look to the sides and keep the eyes in alignment); visual acuity (ability to see objects clearly near and far); and visual field (ability to see objects off to the side).

One advanced piece of equipment that Eye Care Specialists has added to its detective arsenal is an Optical Coherence Tomographer (OCT machine) for diagnosing and tracking glaucoma, diabetic retinopathy, macular degeneration, and other conditions. “This highly specialized machine uses laser scanning technology to create a 3-D image that enables us to detect changes in microscopic tissue structures before they could be noticed through visual inspection, retinal photography or visual field tests. Armed with this insight, we can prevent future loss of vision by promptly starting or adjusting medications or performing laser therapy or surgery,” explains ophthalmologist and cornea and glaucoma surgeon Dr. Daniel Ferguson.

How do the “detectives” feel about their role? Dr. David Scheidt, past president of the Milwaukee Optometric Society, concludes, “Patients come with questions, and we like to have them leave with answers. We strive to provide the most thorough examination possible to detect and treat eye conditions. To achieve that goal, however, patients must remember that it is their responsibility to provide accurate information, ask questions, and follow treatment suggestions. That way, we can work as partners mapping out the best possible vision for your future.”

When was your last eye exam? To schedule a comprehensive vision checkup or to order FREE booklets on cataracts, diabetic eye disease, glaucoma or macular degeneration, call 414-321-7035.

The physicians quoted in this article are partners at Eye Care Specialists. Since 1985, Eye Care Specialists has provided medical, surgical and laser services to more than 121,000 Wisconsinites. They have received special certification from the American Board of Eye Surgeons and are listed among Milwaukee Magazine’s “Top Doctors.” Drs. Cohen, Sucher, Freedman, Rhode, Ferguson and Scheidt accept Medicare assignment and most insurances at offices in West Allis (102nd & National), Wauwatosa (Mayfair Rd. across from the mall), and downtown Milwaukee (7th & Wisconsin Ave.—across from the Central Library). You can also learn more information about their credentials and detection and treatment of various eye conditions at www.eyecarespecialists.net

Summer Travels...

EDITOR’S PICK

Arlington Park 2200 West Euclid Avenue Arlington Heights, IL 60006 847.385.7500 www.arlingtonpark.com

Holiday Inn Express 2120 South Arlington Heights Rd. Arlington Heights, IL 60005 (847) 593-9400 www.hiexpress.com

Clarion Suites 2110 Rimrock Road Madison, WI 53713 (608) 284-1234 www.clarionhotel.com

Memorial Union 800 Langdon St. Madison, WI 53706 608.265.3000 www.union.wisc.edu

Beer Lovers Fest at the Bayshore Town Center In Glendale, WI welcometoglendale.com

COA 5750 North Port Washington Rd. Glendale, WI 53217 (414) 967-1451 www.getcoa.com

JULY 2012 MHL 13

Well-Being 14 MHL JULY 2012

Editor’s Pick

Exploring Cerra.com Cerra.com offers multiple ways to be aware, act and reflect through three main areas: Moments, Community, and the Boutique.

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Renew your body, mind, and spirit.

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Packed family schedules, demanding work deadlines and unexpected life twists make it challenging for many people to take a moment and focus on their own personal needs. According to a 2010 American Time Use Survey, on an average day, 84 percent of women spent an average 2.6 hours on household management activities on top of time devoted to raising children or working full or part-time. Cerra.com launches today offering support to individuals seeking a happier, more balanced life.

The website offers interactive online experiences, a product boutique and a supportive web community.

Together, these elements are designed to guide community members to grow to be their best selves. “Research shows that being mindful aids in greater overall wellbeing and happiness,â€? said Dr. John Weaver, Psy.D. and guiding partner for Cerra™. “The Cerra™ website encourages mindfulness by providing tools and practices for people to be more aware of their feelings and how they affect actions. It’s a positive approach to learn more about themselves and inspire personal growth.â€?

Cerra™ helps its community members experience balance from within by following three intuitive steps: Be Aware, Act, Reflect™. At Cerra.com, visitors can find ways to slow down in an effort to be aware of thoughts and feelings, act with thoughtful intention, and reflect on experiences. “As a new venture of SC Johnson family of brands, Cerra™ truly embodies our goal of delivering innovations that make families’ lives better,â€? said Kelly M. Semrau, SC Johnson Senior Vice President – Global Corporate Affairs, Communication and Sustainability. “Together with our renowned partners, ranging from licensed clinical psychologists and life coaches to counselors and relevant product advisors, Cerra™ aims to deliver the thing that most of us strive for – a happier, more balanced life.â€?

Cerra™ experiences begin at Cerra.com. From guided breathing exercises and suggested stretches, to sharing a personal journey with the community and a boutique of products that take experiences offline, Cerra.com offers a breadth of mindful tools to integrate into a personal growth journey.

These mindful tools and experiences can also be explored through the Cerra™ Seven Intentions, also described as universal human virtues, like Gratitude and Loving Kindness, which become stepping stones on personal journeys. Each intention assists individuals with shifting moods and inspires internal positive change. Visitors can experiment and explore through Cerra™ affirmations, inspirations, fragrances and tastes, which help people discover new insights and create customized personal growth rituals. Cerra™ Seven Intentions are: Grounded, Creative Energy, Gratitude, Loving Kindness, Courage, Wisdom and Inspiration.

Take a Moment A much-needed break from the day can be found in the Moments section of Cerra. com where visitors can reflect on thoughts and emotions via quick exercises designed to increase self-awareness and help achieve balance. The Moments collection consists of short activities including breathing exercises, meditations, stretches and more to help visitors refocus and recharge.

Enhance Offline Experiences Available for purchase exclusively on the Cerra.com website, Cerra™ products including teas, sensory oils, candles, keepsake and dissolving notes, soaps, music, lotions and more provide opportunities for awareness and reflection. All products are carefully designed to enhance the Cerra™ experience both on and offline.

Fragrance plays a large part in many Cerra™ product experiences. It is said that the sense of smell is the most evocative. The nerves involved in smelling are closely linked to the emotional center of the brain so scent can be a powerful trigger for emotions and memories. The Cerra™ signature fragrances create a natural link between the concept of each intention and its scent.

Cerra™ SERRV, a nonprofit fair trade organization working in partnership with low-income artisans worldwide, and Girls, Inc., a national nonprofit youth organization dedicated to inspiring girls to be strong, smart and bold.

For more information, please visit www.cerra.com.

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Enhance your life, your health and your well-being

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Victoria Shanta Retelny, R.D., L.D.N., Environmental Nutrition The snacking habit has gone mainstream—surveys find that most children and adults in America snack every day. In fact, the Journal of Nutrition (2010) reported that snacking makes up 25% of our total daily calories.

“Since snacking is an integral part of most peoples’ diets, make it count,” advises Christine Gerbstadt, M.D., R.D., spokesperson for the Academy of Nutrition and Dietetics. Just as nutritious meals are important to fueling your body, so are healthful snacks. Snacks should furnish you with servings of whole, minimally processed foods that provide essential nutrients, such as whole grains, lean meat, poultry, fish, low-fat dairy products, nuts, seeds, fruits and vegetables. Whole food, nutrient-rich snacks can include tuna salad with crackers, cottage cheese and fruit, and turkey slices with flatbread.

Snacking on benefits. Evidence shows that eating frequently throughout the day gives your body an even energy stream and staves off excessive calorie loading. This is especially helpful at night, when hunger can hit if you skimp on calories earlier in the day, prompting you to take in excess calories that can lead to weight gain. In fact, a 2009 study published in the British Journal of Nutrition found that eating a high-protein (22 grams), moderate-calorie (200 calories), cheese snack one hour before lunch led participants to eat less at the next meal and throughout the rest of the day, thus, showing that sensible, calorie-controlled snacks—particularly protein-rich ones—can help in weight management.

Regular snackers also tend to eat better overall, according to research findings published in the Journal of the Academy of Nutrition and Dietetics in February 2012.

Researchers examined how snacks affected the overall diet quality of 11,209 adults aged 20 years and older who participated in the 1999-2004 National Health and Nutrition Examination Survey. Using the Healthy Eating Index-2005, a questionnaire used to measure how people’s diets compare to the federal dietary guidelines, the researchers scored the snack food intake of the participants and found that conscious, regular snacking made a ppositive impact on health because it increased the consumption of nutrient-rich foods like fruit, whole grains, milk, nuts and seeds.

How much should you snack? That’s a tricky question, as there are not yet any science-based dietary recommendations regarding the frequency of snacking.

However, nutrition experts advise that the ideal amount of calories you need from daily snacks depends on how many calories your body burns to maintain your normal weight and activity levels. Keep in mind, the more energy you exert, the more calories are needed for energy balance, according to a 2009 position paper by the Academy of Nutrition and Dietetics. “If you are eating three meals a day, eat small snacks that are about 100 calories each, otherwise you will gain weight if you don’t increase your activity,” suggests Gerbstadt. “The best bet is to eat two to three snacks a day that fall within your daily calorie expenditure. Ideally, snacks should supply some important vitamins, minerals, fiber, healthy fat and protein to fortify an overall healthy diet.”

Creating a Healthy Snack. The best snacks should be made up of real foods like chopped fresh vegetables; fresh, canned or dried fruits; low-fat yogurt, nuts, low-fat cheese, lean poultry, and beans. Balance the nutrients by combining a small amount of protein, healthy fat, and minimally processed carbs in each snack. For example, try hummus, peanut butter or a handful of nuts for a supply of protein and healthy fats with a few whole grain crackers, fruit, or veggies like bell peppers, snap peas or baby carrots for a source of healthy carbs. In addition to making the best choices, eating snack at consistent times every day will keep your metabolism humming along, as well as stave off cravings for convenient, less nutritious foods.

Don’t fool yourself into thinking that any old snack will make a healthful contribution to your day. Avoid snacking on highly processed foods, such as sugarfilled granola and cereal bars, salty chips, and crackers, cookies and muffins made of refined flour and sugars—these choices offer you little more than calories, sugar, fat, and sodium.

Reprinted with permission from Environmental Nutrition, 52 Riverside Dr., Suite 15-A, New York, NY 10024.

Retreat your Body and Mind!

love your life

A spa retreat is one the best day-time, or week/weekend relaxation time that one can ever take. By the end of the retreat one feels rejuvenated and more at peace than ever before.

The nice part is you don’t need cell phones, tv or any other distraction of your busy life to have a good time. Instead enjoy a relaxing retreat away from the everyday chatter and problem solving.

If it is calm socialization you need, you can certainly bring friends or family along to enjoy the peace and harmony a retreat has to offer It might be a great way to reconnect with each other.

Solo or not, a retreat can provide ample opportunity for self-renewal, allowing you to return to your daily routine recharged and ready to tackle whatever comes your way.

Treat yourself and go on one of the the many day spa retreats around the country now.

JULY 2012 MHL 17

FOOT PAIN?

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Chiropractic EFFECTIVE CARE FROM HEAD TO TOE Chiropractic is a drugless, non-surgical whole-body form of health care

People often seek out a chiropractor for some type of back pain. Most commonly for low back pain. Recent surveys state that 57% of American females and 53% of American males will suffer at least one bad backache this year. Of those, 70 million people will have back pain severe enough to seek professional treatment. Low back pain accounts for one quarter of Americans lost work days and cost us between 15-20 billion dollars per year in lost earnings and doctor bills.

Who’s at Risk? Everyone! However, those who sit, bend, or twist a lot are at greater risk. Those who may not like their current job or who may have problems at home also place one at a higher risk. Another, added factor is not being in shape, especially in your back and abdominal muscles. Proper nutritional habits also help decrease the possibility of back pain. Those who maintain a healthy lifestyle are more prone to eat right, exercise on a regular basis and have a generally higher self image.

What is Chiropractic?

Chiropractic is based on the scientific fact that your nervous system controls the function of every cell, tissue, organ and system of your body. Chiropractic is a drugless, non-surgical whole-body form of health care. With the vision, to see the human body, having an innate natural ability to adapt to changes in its external environments, and maintain itself in a state of health. Chiropractic has proven to be an effective treatment for those experiencing back pain. Chiropractors are considered the experts in the care of spinal misalignments consisting of the bones, muscles and nerves. They focus on adjustments to correct misalignments (or subluxations) within the human body in order to remove interference to the Central Nervous System, the spinal cord and the muscles and organs they innervate.

There are many different ways to adjust the spine. Many doctor’s use there hands or specially designed instruments to deliver a highly-accurate thrust. After a thorough history, orthopedic examination and possible radiographic evaluation, the doctor presents a treatment plan and care that is specifically designed for each patient. Depending on the patient’s age, size and unique spinal or extremity problem the doctor will tailor each chiropractic adjustment. The adjustments are so safe, that even newborns and children can receive adjustments to repair problems caused from the birth process, learning to walk, or other childhood trauma.

Did you know that chiropractors can also treat problems such as: headaches, carpal tunnel syndrome, tennis elbow, sprains/ strains, whiplash, scoliosis, sciatica and problems associated in infancy and childhood?

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Holistic Alternatives

DEEP TISSUE, SWEDISH, HOT STONE, ASIAN BODYWORK THERAPY

Redefining Health THE PATH TO EMPOWERMENT

By Kalpana (Rose) M. Kumar, M.D. Have you ever heard people say “Life is unfair�? It’s a phrase that can easily become a part of our script. Indeed it is the script of many people today. The script comes from many years of conditioned thinking and from the part of us that may feel victimized. If we have been wronged, treated unfairly or dominated as children, we may carry this script with us throughout our life and play it out unconsciously. Since the ‘law of attraction’ is always operating in our lives, we materialize what we believe, which includes the scripts we play in our head from moment to moment.

Some scripts are imprinted in us from our families of origin. Others are learned from our peers and from the larger culture through media, advertising and the collective consciousness. Some of these scripts are empowering, such as, “I can accomplish anything�, “I deserve to be happy� or “I am abundant�. Others are disempowering such as, “life is unfair�, “I am powerless�, “ I am not good enough�. The disempowering scripts disempower through activating the ‘Victim’ archetype in our psyches. Archetypes were described by Carl Jung as universal forms in the psyche that channel experiences and emotions resulting in patterns of behavior with certain probable outcomes. The Victim is an archetype that is activated when we see life as unfair, or feel like the victim of another’s behavior long after the behavior occurred.

This archetype causes us to lose our power and makes us vulnerable to domination and abuse. On its flip side, it can activate feelings of entitlement, lack of self-responsibility, blame and persecution. If we look deep enough into the history of a person who persecutes others, we will find the Victim archetype driving the behavior.

I see this as one of the underlying archetypes beneath emotional eating, lack of self-care and depression. When people get stuck in the Victim archetype, behaviors that can be healthy and restorative are replaced with behaviors that reinforce the victim. When one gains weight through ‘emotional eating’ and feels shame due to lack of self-control, one feels victimized by these behaviors and their outcomes. This creates an endless loop that is disempowering. This can be healed by understanding the power the Victim archetype has over our behaviors. One can change the script that activates this. This can even change one’s conditioned negative perceptions about life replacing self-abuse and disassociation with self-care and self-responsibility. Consequently, one is able to be fully present to participate in life with courage and presence. Often it takes the right health-care practitioner, friend or family member to support this process. The process itself awakens a deeper understanding of life. Joy and health are some positive by-products of this shift.

As I supported this process for my patients, I witnessed the transformation and recovery of their lives, health, self-esteem and self-respect. I have witnessed diabetes, heart disease, irritable bowel disease, depression and anxiety heal. The process itself is powerful and restorative. It offers wisdom and a deepening experience of well-being for all involved. I invite you to explore this dimension of health as part of your reclamation process.

Kalpana (Rose) M. Kumar M.D. CEO and Medical Director of The Ommani Center for Integrative Medicine Pewaukee, WI www.ommanicenter.com Author of Becoming Real: Harnessing the Power of Menopause for Health and Success, 2011, Medial Press JULY 2012 MHL 19

REPETITIVE STRESS COMES IN MANY DIFFERENT FORMS AND FROM MANY DIFFERENT ACTIONS

REPETITIVE STRESS INJURY PREVENTION Every day we do repetitive activities, but with a little effort, you can help reduce your risk of Repetitive stress injuries. Repetitive stress comes in many different forms and from many different actions, but in all cases, repetitive stress injuries occur from an action you do over and over again. These actions can range from sleeping positions, computer work, sports, carrying heavy or bulky items, poor posture, or a sedative lifestyle. This stress can take months or years to develop enough biomechanical stress to create symptoms in musculoskeletal areas. The more awkward or exertional of the action, the quicker it can create an injury. Injuries are usually variations of tendonitis, which can cause muscle pain, joint pain, radiating pain, swelling, trigger points, muscle contractures such as trigger finger, and muscle fatigue. These symptoms are usually worse with activity and decrease with rest.

A repetitive stress injury can occur quickly in the instance of someone recovering from a broken foot. As the foot is healing, the person needs to limp often for weeks or months. This quick change in a person’s gait starts to create stress in other joints, specifically the low back, hips and knee. Most of the time, the person will never return back to their proper gait on their own. They often continue leaning onto the uninjured leg and eventually get repetitive stress injuries in the other foot as well.

A slower forming repetitive stress injury is when someone is a stomach sleeper and always has their head turned to the side. When the body is at rest, but not in a neutral position, muscle stay contracted and the body starts to adapt posturally to this position that it is in for several hours every night. Over time, this person gets trigger points, tension headaches or neck pain as well as pain and muscle tension that can occur in other areas of the body.

So what can you do to prevent yourself from getting a repetitive stress injury?

What I frequently tell my patients is that no matter what the repetitive activities that they have to do during the day, find a way to stretch your body in the opposite direction at the end of the repetitive activity. In the person how is a stomach sleeper and has their head turned to the side, when you wake up in the morning stretch the neck out to the opposite side. Try to do every activity being conscious of your body position and be focused on doing actions in good posture and with the best body mechanics possible. Learn to do actions differently and not always using your dominant side. If there is lingering muscle tension, exercise or activate the opposite muscle in the body. For every muscle that does an action, there is another muscle that does the opposite action. Biceps and triceps are opposite muscles. When you use the bicep, the triceps has to relax for you to lift an object with the bicep. So if you have a trigger point in your bicep, doing triceps exercises will tell the bicep to relax. This is why it is great to work with a health care provider that is knowledgeable about biomechanics and the musculoskeletal system to help you avoid a repetitive stress injury. These injuries can be debilitating and hard to treat especially if you still have to do the action that was causing the injury in the first place. Working with health care providers such as chiropractors, physical therapists, occupational therapist, personal trainers and massage therapists can help keep our bodies strong and balanced and help you recover from your repetitive stress injury.

Dr. Angela English DC CACCP www.ifwcenter.com

20 MHL JULY 2012

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THE RISING SUMMER HEAT

In Ayurveda, the ancient holistic healing system from India, maintaining good health throughout the year requires living in harmony with the natural cycles of the seasons. This is because your outer environment influences your inner world.

Each season has specific characteristics and factors which can affect your wellbeing. Knowing how to adjust to the changes in the outer environment through the food you eat, the type and amount of exercise you do, even the clothes you wear is vital to enjoying good health.

Here in Wisconsin, we have fully entered into the season of summer which is dominated by heat and is characterized by the qualities of hot, bright and sharp. If you already have a heated bodytype or constitution, it won’t take much of the summer sun and heat to aggravate your body and mind. Luckily, when you get an excess of this heat, your body will begin to tell you about the imbalance through signs and symptoms. When you pay attention and understand what those signs mean, you can then take action to remedy them.

Signs that your heat is rising: • Acid indigestion, reflux and heartburn have increased or have begun giving you grief. • You’re skin feels like it is raw and on fire plus you are experiencing acne, rashes or hot and irritated skin conditions. • You’ve come down with an infection that spikes a fever. • Your find yourself having temper outbursts over minor aggravations or often feel frustrated and irritable. • You are suddenly waking up in the very early hours of the morning and then find it difficult to get back to sleep. • Your thirst has increased significantly and you are hot the majority of the time.

To keep your body and mind in balance this summer, you need to make a few simple seasonal adjustments. While this may sound like a new concept, you actually are likely already doing just that! As the temperatures heat up, you naturally begin to shift from eating hot soups to cooler salads. The sweaters go on the shelf while the shorts, sundresses, and sunglasses come out. You begin to exercise in the cooler parts of the day and are more attracted to water activities that cool off the body.

Seasonal transitions mark a great opportunity to recalibrate your body and increase your awareness about what YOU need to stay in balance. As an individual, you have a unique biochemistry different than anyone else and will be affected by the season in different ways. In addition to this, your current state of health, what health conditions and symptoms you’re already experiencing, also need to be considered.

In summer, the general countermeasure to the heat is fairly obvious - stay cool -- both physically and emotionally. To find out exactly what you need to maintain balance through the summer heat, contact Jamie Durner of Ayurveda Wellness @ 262-389-5835 to schedule your professional Ayurvedic assessment or find out more information at www.ayurvedawellness.org. Š2012, Jamie Durner, Ayurvedic Natural Health Practitioner and Wellness Educator. For more informattion contact Jamie at 262-389-5835.

JULY 2012 MHL 21

Children’s Health and Living

2012

Summer fun is just around the corner at Elite Sports Clubs!

22 MHL JULY 2012

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Children’s

BEHAVIORAL HEALTH CLINIC

One in every five children in the United States is living with a behavioral or emotional health condition, according to a 2010 study by the National Academy of Sciences. Although that statistic is alarming, children’s behavioral health issues are treatable, especially when identified early, said Gary Kendziorski, Ph.D., a clinical psychologist with the Milwaukee Center for Independence and its affiliate, Transitional Living Services, Inc. “Even very young children, especially those who have experienced trauma and environmental stress, can exhibit symptoms of behavioral and emotional health disorders,” Kendziorski said.

Whether the child has a serious behavioral health problem or he is responding to a particularly challenging situation, symptoms need to be addressed as quickly as possible. Those symptoms may include: • Acting out in school • Inability cope with routine activities and daily challenges • Constant complaints about physical problems • Changes in eating or sleeping habits • Persistent nightmares • Loss of friends and increasing isolation

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• A tendency to defy authority • Stealing or damaging physical property • Frequent angry outbursts and temper tantrums • Dramatic changes in academic performance • Excessive anxiety • Hyperactivity

When symptoms go untreated, they can interfere with a child’s ability to learn, damage self-esteem and negatively affect relationships within the family, at school and in the community. Kendziorski said the earlier the issue is addressed, the better the opportunity for the child to recover and move on to a healthy and productive future. Often, however, parents may not know how to begin to get help for their children.

Kendziorski advised that parents talk to their pediatrician about any concerns regarding the behavior of a very young child. If the child is in school, parents can talk to a teacher to share concerns and identify resources that are available in the community.

“Usually, a useful next step is to call the insurance company and find out what providers are available,” Kendziorski said.

To begin treatment, the psychologist will collect some information from the parents and from the child, he said. A standardized evaluation may be used as well. The psychologist will analyze the information and sit down with parents to discuss the child’s strengths, needs and goals and to work together on developing a treatment plan.

“That could include individual treatment for the child and family therapy as well as consultation with the child’s school and collaboration with medical providers and any other community agencies that might be helping the child,” Kendziorski said.

Treatment is reviewed with the family on a regular basis, with the first review usually scheduled for about three months after treatment has begun. Measures of successful treatment include a decrease in behavior problems or emotional distress and an increase in coping skills and overall functioning as a child, Kendziorski said.

Dr. Gary Kendziorski is a clinical psychologist with MCFI Children’s Behavioral Health Resources, which provides behavioral health assessments for children up to age 12, individualized behavioral health treatment plans, 12:58 PM Page 1 confidential therapy and counseling services and professional consultation services for charter, choice and public schools. For more information, call (414) 937-2030.

lIfe. CHANGING. MCFI Children’s Programs

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we believe in what children can do. That’s why all of our programs and services for children with special needs are focused on one goal: helping kids reach their highest levels of achievement. For a lifetime.

MCFI, a nonprofit agency, has been assisting people with special needs and their families since 1938, and is known for innovation in disability treatment.

MCFI Children’s Programs and Services include: SmartBaby �

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Focused on healthy birth outcomes Prenatal care coordination Support for healthy parenting Mommy Mentors

Pediatric Special Care Unit �

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Birth to age 20 with special health care needs Skilled day nursing care and complete medical monitoring Child care licensed, Medicaid certified Accredited by the Joint Commission

Birth to Three program �

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Serving families and children with diagnosed and suspected developmental delays Evaluation and treatment at your home In-home therapies

School for Early Development & Achievement (SEDA) �

Individualized education programs

2020 West Wells St., Milwaukee, WI 53233

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414.937.2020

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For students K3-2nd grade, with and without special needs A public school, chartered through UWM Centered on the needs of the child and family

Children’s Behavioral Health Resources �

Comprehensive therapy and counseling services for children with behavioral and emotional health challenges, up to age 12

Let’s talk about what your child can do!

Call 414.937.2020 or visit us at www.mcfi.net

TTY: 414.937.2022

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www.mcfi.net

JULY 2012 MHL 23

CHILDREN &

Sleep

Sleep, like diet and exercise, is important for our minds and bodies to function normally.

Sleep Is a Basic Human Need Sleep is a natural part of everybody’s life, but many people know very little about how important it is, and some even try to get by with little sleep. Sleep is something our bodies need to do; it is not an option. Even though the exact reasons for sleep remain a mystery, we do know that during sleep many of the body’s major organ and regulatory systems continue to work actively. Some parts of the brain actually increase their activity dramatically, and the body produces more of certain hormones.

Sleep, like diet and exercise, is important for our minds and bodies to function normally. In fact, sleep appears to be required for survival. Rats deprived of sleep die within two to three weeks, a time frame similar to death due to starvation.

An internal biological clock regulates the timing for sleep. It programs each person to feel sleepy during the nighttime hours and to be active during the daylight hours. Light is the cue that synchronizes the biological clock to the 24-hour cycle of day and night.

DinoAd9x6 6/6/12 10:22 AM Page 1

24 MHL JULY 2012

Problem Sleepiness Has Serious Consequences Sleepiness due to chronic lack of adequate sleep is a big problem in the United States and affects many children as well as adults. Children and even adolescents need at least 9 hours of sleep each night to do their best. Most adults need approximately 8 hours of sleep each night.

When we get less sleep (even one hour less) than we need each night, we develop a “sleep debt.” If the sleep debt becomes too great, it can lead to problem sleepiness – sleepiness that occurs when you should be awake and alert, that interferes with daily routine and activities, and reduces your ability to function.

Even if you do not feel sleepy, the sleep debt can have a powerful negative effect on your daytime performance, thinking, and mood, and cause you to fall asleep at inappropriate and even dangerous times.

Problem sleepiness has serious consequences – it puts adolescents and adults at risk for drowsy driving or workplace accidents. In children, it increases the risk of accidents and injuries. In addition, lack of sleep can have a negative effect on children’s performance in school, on the playground, in extracurricular activities, and in social relationships.

Inadequate sleep can cause decreases in: Performance Concentration Reaction Times Consolidation of Information Learning Inadequate sleep can cause increases in: Memory Lapses Accidents and Injuries Behavior Problems Mood Problems Signs of Sleep Disorders

Editor’s Pick Rainbow Play Systems invites you to come play on our swing sets So your family wants a swing set. Before we go any further, we need to clear up a major misconception. You and your children will not see the same things when you look at Rainbow Play Systems swing set models. You see a spiral slide and climbing rope where they visualize a time travel capsule and swinging jungle vine. While you consider the merits of a lower-level playhouse versus an upper-level cabin, your child is mentally sending invitations to her girls-only tea party or planning the quickest escape route should his fort come under attack. Hmm, tough call.

To help you make the best choices, we encourage you to load up the family and visit one of our Rainbow Play Systems swing set showrooms where you and your children can see, touch and most importantly, play on our display swing sets. While the kids are playing, pay attention to the swing sets they’re attracted to and which accessories capture their interest.

This valuable information will make designing your family’s dream swing set a snap.

Rainbow of Southern Wisconsin W. 229 N1416 Westwood Dr Waukesha, WI 53186 (262)650-1837 waukeshasales@rainbowisc.com swingsetsmilwaukee.com

Why I recommend Rainbow’s Play Systems

Rainbow Play System swing sets are an environmentally responsible choice you can feel good about having in your backyard. They build safe, durable swing sets with strong, sturdy lumber, America’s greatest renewable resource. The Sunshine, Rainbow, Monster and King Kong swing sets are constructed exclusively of North American timber and are covered by our unprecedented Lifetime Warranty.

The installation takes about 3 hours but the installers were friendly and very helpful picking out were we wanted the system. They also made sure I was happy before they left. It is very sturdy and even held up in a hail storm.

The kids play on it all the daily, several times a day. The system that we chose was the in the Sunshine Series model 50A. It is there most popular model and I can see why. Nice slide, 2 regular swings, 1 tire swing and 1 disc swing. It also comes with rope climb and rope ladder. The kids use the club house as their main hangout spot. I highly recommend.

A child who has not obtained adequate nighttime sleep is at high risk for symptoms of physical and/or mental impairment. The child may fall asleep in school, have difficulty concentrating in school and other activities, and/or exhibit behavioral problems. Some children who are sleepy become agitated rather than lethargic and may be misdiagnosed as hyperactive. Not getting enough sleep is one cause of problem sleepiness. Undiagnosed/untreated sleep disorders can also cause problem sleepiness. Children as well as adults can suffer from sleep disorders. Parents should talk to their pediatrician about a possible sleep disorder if their child has any of the following: Snoring Breathing Pauses During Sleep Problems with Sleeping at Night Difficulty Staying Awake During the Day Unexplained Decrease in Daytime Performance

JULY 2012 MHL 25

26 MHL JULY 2012

Senior Healthy And Living

Independent Living for Seniors

Capri SENIOR

COMMUNITIES

“It’s not just your apartment, It’s your home!”

UNDERSTANDING YOUR CHOICES IN RETIREMENT FACILITIES AND HOMES As we age, many of us are faced with the prospect of revising our living arrangements. While it can be a stressful topic, planning ahead can give you more choices and improve your level of independence and quality of life. If you feel overwhelmed by home upkeep, need help with certain services, or simply want more transport and social amenities, an independent living facility may be a good option. These guidelines can help you choose a residence that’s right for you.

Understanding your choices in independent living

Independent living is simply any housing arrangement designed exclusively for seniors, generally those aged 55 and over. Housing varies widely, from apartmentstyle living to freestanding homes. In general, the housing is friendlier to older adults, often being more compact, with easier navigation and assistance in yard maintenance if there is a yard. You may also hear the terms retirement communities, retirement homes, senior housing, and senior apartments applied to independent living.

The key difference between independent living and other housing options is the level of assistance offered for daily living activities. Just as with regular housing, you can hire in-home help to assist you in an independent living facility. However, if you or a loved one requires round-the-clock help with eating, dressing, and using the toilet, or requires regular medical assistance, other housing options such as assisted living facilities or nursing homes may be a better fit.

Types of independent living facilities

There are many types of independent living facilities, from apartment complexes to separate houses. They come in a range of costs, including subsidized housing for low income older adults. Continuing care retirement facilities provide independent living as well as other housing with more services at the same facility.

Subsidized senior housing. In the U.S., there are senior housing complexes, subsidized by the U.S. Department of Housing and Urban Development (HUD), for low income seniors. Keep in mind that depending on the area, waiting lists can take years, so it’s a good idea to plan well in advance for this option.

Senior apartments. Senior apartments are apartment complexes restricted by age, usually 55+. Rent may include community services such as recreational programs, transportation services, and meals served in a communal dining room.

Retirement communities. Retirement communities are groups of housing units for those aged 55+. These housing units can be single family homes, duplexes, mobile homes, townhouses, or condominiums. If you decide to buy a unit, additional monthly fees may cover services such as outside maintenance, recreation centers, or clubhouses.

Continuing Care Retirement Communities (CCRCs). CCRCs offer service and housing packages that allow access to independent living, assisted living, and skilled nursing facilities in one community. If residents begin to need help with activities of daily living, for example, they can transfer to an assisted living or skilled nursing facility on the same site.

Is independent living the right choice for me or a loved one?

Thinking about giving up the familiar for a new living arrangement is a big decision. Here are some considerations to assist you in the process:

Start by considering emotional roadblocks

You may be excited to plan this new phase of your life. However, it can also be difficult emotionally to consider a move.

CHOICES>>see page 29

Independent & Assisted Living Communities Germantown

The Gables of Germantown 262-345-1000

Kenosha

St. Catherine Commons 262-654-6080

Milwaukee - South Wilson Commons 414-281-2450

Milwaukee

Three Oaks Circle 414-321-0320

Milwaukee - East Hedwig House 414-321-0320

Sturtevant

Killarney Kourt 262-321-0802

Waukesha

Summit Woods 262-521-1388

West Allis

The Landmark of West Allis 414-302-1700

West Allis

Carnegie Place 414-302-1700

Whitewater

Mulberry Glen 262-473-4515

Call today

to find out more about the Capri Community in your area!

262.798.1224 www.CapriCommunities.com JULY 2012 MHL 27

CHOICES<<page 27

AMeNItIes you’ll love

fantastic Germantown location patio or balcony kitchen pantry 24-hour emergency maintenance

oNe & tWo BedrooM AffordABle APArtMeNts for seNIors 55 & Better!

Patio

Living Room

Bedroom

Dining

Closet Closet

You may be reluctant to leave a home filled with memories, even if the home is difficult to maintain or just feels too big.

It may be getting harder and harder to get out and meet up with friends, but it may feel easier to just accept that as part of getting older.

Realize that some anxiety and stress is normal in considering such a big decision.

The more information you have, the easier it is to make informed choices about the future.

If the anxiety feels too overwhelming, reach out for help. Talk to family, friends, or your health care professional. Try Helpguide’s free toolkit for more help managing your emotions.

Ease of keeping up your current home Maintaining a home may be a longstanding source of pride for you, but it can also become a burden as you age. Perhaps your home has a large yard which requires constant maintenance, or maybe it’s becoming more and more difficult to clean those extra rooms that are rarely used now your children are gone. If your home is difficult to access, such as on a steep hill or up several flights of stairs, it may be harder and harder for you to leave your home as often you’d like, leading to more isolation.

Sometimes these challenges can be partially remedied by hiring outside help, remodeling parts of your home, or by other family members lending assistance. However, it’s worthwhile to take a look at your current living situation and see if an alternative to remaining at home may give you more freedom and flexibility in the long run.

Kitchen welcome Entry

Closet

Call about our

CurreNt sPeCIAls!

262.532.0974

W168 N11374 Western Ave, Germantown, WI 53022 PrairieMeadowsApts.com

Transportation

Transportation is a key issue. You may live in an area where you must drive to attend social activities, visit friends, and shop. If you find yourself less comfortable with driving, you may find yourself relying more and more on family and friends to get out and about. It may be harder to visit others, go to activities you enjoy, or keep doctors’ appointments. Independent living usually offers opportunities to socialize on-site with peers and may also offer some transportation options to outside activities.

Socialization

Are you finding it harder and harder to connect with others? Maybe you have a difficult time getting out of the house, perhaps due to trouble driving or increased mobility issues. Neighbors may be busy with other work and family commitments, or the neighborhood may not be easy to get around. While the phone and computer can help, you need human connection as well. The more isolated you are, the greater your risk for depression and other mental health problems. Independent living facilities can give you a built-in social network of peers, while some even provide structured activities such as a recreation center, clubhouse, or field trips.

The health of you or your spouse

Take a look at your current state of health. While no one can predict the future with certainty, if you have a health condition that makes it difficult to stay active and will most likely worsen with time, it’s good to consider your options carefully. It’s also important to consider the health of your spouse if you are married. Are you already helping your spouse with daily activities? If you are shouldering a significant amount of care already, moving to a facility where some of the burden can be lifted could help both of you stay independent longer.

What should I look for in independent living facilities?

What you need from independent living depends on your own unique situation.

Where would you be most comfortable? Here are a few things to keep in mind:

It’s all about the people

No matter what type of independent living facility you consider, you want to make sure you connect with peers and feel comfortable in the community. When you visit the area, talk with some of the residents. Are they people you’d like to know better? Are some of your favorite hobbies or activities available? Are support services timely, with staff friendly and accessible?

Size and location of community

There is no set size for an independent living community, so it’s really your preference. Do you prefer a smaller size community, or a busier place with more people and opportunities for socialization? Are you comfortable with more compact apartment-style living, or is having a detached home with easy access the ultimate goal?

Be sure to visit several communities to get a sense of what is comfortable to you.

Location is another consideration. Some popular retirement/independent living areas are in warmer states such as Arizona, California, and Florida. However, consider carefully if you are prepared to move a considerable distance. It does mean develCHOICES>>see page 30 JULY 2012 MHL 29

CHOICES<< page 29 oping a new support network if you don’t have family and friends close by, as well as finding new medical care.

Accessibility

Take a look at how accessible the community is, both inside and outside. Do you feel safe coming and going at different hours of the day? Are facilities outside of the community within walking distance, or do you need transportation like a car or cart to get around? How easy is it to get to services such as a common dining hall or recreation center?

In your potential housing unit, get a feel for future adaptability. Are there any stairs inside the unit or outside? Can ramps be added if necessary? Check to see if adaptive devices like grab bars can be easily installed in bathrooms.

Community Resources and Support

With so much variation in services, think about which are most important to you in an independent living facility. Also, consider services that you may find useful in the future. For example, if you value exercise, consider a community with an exercise area, pool, or fitness classes. You may like cooking your meals now but want the option for communal meals in the future. Prioritizing the services you want also helps you budget appropriately, since the more services a community offers, the higher the cost may be.

Costs of Independent Living

There are a range of costs associated with independent living, ranging from subsidized housing for low-income seniors to comprehensive service facilities with other options for long-term care. As you consider independent living, prepare a budget to estimate costs you feel comfortable with, taking into account other considerations such as medical bills. There are several websites in the Resources section below that offer examples on preparing a budget and making the decision that’s right for you.

If you are considering subsidized housing, remember that waiting lists can be quite long, often several years. You may want to begin the process as soon as possible.

When considering costs, make sure you are able to comfortably handle both the initial investment and monthly fees. These could range from homeowners association fees to fees you pay for services on site. How many services are included, and how much does it cost to add on services if you need them later?

If you or your spouse are relatively healthy now, but anticipate significant health problems down the line, you may want to consider a Continuing Care Retirement Community (CCRC). These facilities offer a spectrum of care from independent living to nursing home care at the same site and normally require a one-time entrance fee and monthly service fees thereafter.

Reprinted with permission from Helpguide.org © 2001-2010. All rights reserved.

For more articles in this series, visit www.Helpguide.org.

LIFE. CHANGING. Maintain your independence with reliable in-home assistance from NHS Home Care. NHS Home Care provides personal care and help with daily tasks to help you stay in control of your well-being, your household, and your future.

Let s talk about the resources available to you today!

(414) 937-2030 www.mcfi.net

30 MHL JULY 2012

A New Outlook MOVING AND CHOOSING A SENIOR COMMUNITY

A senior’s residence is a place of security. Moving out of the home you spent many years creating memories can be difficult emotionally. But you might want to look at moving into a senior community as a positive move.

When we are young we can’t wait to explore new things and get away from the same old – same old. We want to start making memories and planting our roots. Why not think the same way.

Look at a Senior Community as an adventure, something that might bring back the great memories from when you were young and getting back into the world out there. A senior community can be a great change. You can meet new people, get rid of all the hassles of house work, and have a easier retirement life.

There are several types of residential senior communities to choose from, so you need to explore and find what is right for you.

How does one determine which senior community would fit best with their needs?

Temporary vs long term care: A senior’s needs are more practical by planning to move into a situation that is most likely to remain for many years to come.

Independence: Can you and would you want to live on your own? Or would it be best to find a more service oriented residential facility?

Needs for personal care: How much and what kinds of personal or “custodial care” are needed or desired? There are online needs assessment questionnaires to help determine this and then match the care needs with the right type of housing.

Needs for medical care: If the senior has a chronic illness that necessitates special medical care, or ongoing services of medical professionals, independent living and even assisted living may not be suitable.

Costs: Learn about the financial aspects of senior housing to determine what options are affordable for you.

Walk through senior communities that seem suitable. Make a checklist of what each has to offer.

Then make your own checklist of your needs and wants. Look over each list with a friend or family member they might have some helpful input to give.

Seek guidance from professionals who are experts in senior communities. They can help with the process of identifying your goals and values, assessing your needs, determining what your financial situation will allow and suggesting what facility might be right for you.

Seniors have so many choices to make when the search for senior communities.

With so many senior housing options available, it’s easy to feel overwhelmed by all the different kinds of communities. It’s important to learn the differences between the many options and to assess your needs to make the right decision.

JULY 2012 MHL 31

Older Adult Day Centers Not too many years ago, nursing homes seemed to be the only choice for older adults who were not able to fully care for themselves on a daily basis. But today there are many options for older adults who need assistance to remain living in their neighborhoods and at their highest levels of independence.

Increasingly, families of older adults who are challenged by chronic illness, Alzheimer’s disease or other dementias, or who are recovering from strokes, are turning to older adult day centers to provide a safe, nurturing and stimulating daytime environment. Many family members who are caring for an elderly or frail parent are finding that older adult day centers can be the best choice for everyone concerned.

Older adult day centers are open during daytime hours, so that family members can continue to work or tend to other necessary tasks without worrying about leaving their loved ones at home alone. Older adults can attend the program every weekday, or just a few days each week.

The best programs not only help older adults maintain their quality of life, but are aimed at improving physical and mental health. Look for an older adult day center that provides: • A focus on wellness, with regularly scheduled exercise sessions and activities designed to stimulate memory and cognitive function. Personal wellness plans should be developed to set practical goals for improvement.

• Access to clinical therapies (occupational, physical and speech) as well as expressive arts therapies, such as music and art therapies.

• Meaningful experiences for older adults, such as community outings, activities that encourage interaction with peers, and programming choices based on personal needs and interests.

• Personal care services, such as therapeutic whirlpool baths as well as hot, nutritious lunches and healthy snacks.

QUALITY...INNOVATION...EXPERIENCE...

• An on-site Registered Nurse to provide medical monitoring and health FOR MORE THAN 40 YEARS, NPS HAS BEEN DEDICATED TO PROVIDING THE HIGHEST education services.

QUALITY PRESCRIPTION FOOTWEAR FOR YOU AND YOUR PATIENTS. • Intergenerational experiences, to encourage positive interactions between Chronic Disease—Diabetes Chronic Disease—Arthritis ERVICES NCLUDE older adults and children and young Congenital Conditions Muscular Sclerosis people.

Cerebral Palsey Sports Injuries OMFORT HOE • Services that are sensitive to the Rehabilitation Overuse current and changing needs and abilities THLETIC OOTWEAR of participants and their families.

Work Injury Stroke OOT RTHOTICS • Timely communication with family Trauma Aging members.

RACES Older adult day centers are licensed by the state and some also have received national certifications and accreditations.

An excellent resource for those who are interested in learning more about older adult day centers is the Wisconsin Adult Day Services Association (WADSA) at www.wadsa.org.

NATIONAL PEDORTHIC SERVICES, INC. This article was provided by the Milwaukee Center for Independence MILWAUKEE AREA - 2745 W. LAYTON AVE. STE. 103, MILWAUKEE WI 53221 TEL: (414)282-8888 (MCFI) Older Adult Day Center, 2020 BROOKFIELD - 2475 N. 124TH STREET, BROOKFIELD WI 53005 TEL: (262)754-2440 W. Wells St., Milwaukee. For more MADISON - 1825 S. PARK STREET, MADISON WI 53713 TEL: (608)225-3500 information on the MCFI Older Adult FOND DU LAC - 885 WESTERN AVE, FOND DU LAC WI 54935 TEL: (920)907-1060 Day Center or to schedule a tour, call

NO ONE CAN OFFER BETTER PEDORTHIC CARE THAN NPS!

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There’s Something About MUSIC

Music can lift you up. It can bring tears to your eyes. It can help you relax or make you get up and dance. You probably hear it several times a day—on the radio or TV, in the supermarket, at the gym or hummed by a passerby. Music’s been with us since ancient times, and it’s part of every known culture.

Music strikes a chord with all of us.

“There’s something about music and engaging in musical activities that appears to be very stimulating for the brain and body,” says neuroscientist Dr. Petr Janata of the University of California, Davis. Singing favorite songs with family and friends, playing in a band or dancing to music can also help you bond with others. “It’s a way of synchronizing groups of people and engaging in a common activity that everyone can do at the same time,” Janata adds.

NIH-funded scientists are exploring the different ways music can influence our bodies and minds. Their research may also shed light on creative processes. Ultimately, scientists hope to harness the power of music to develop new treatments for people with stroke, autism and many other conditions.

Several well-controlled studies have found that listening to music can alleviate pain or reduce the need for pain medications. Other research suggests that music can benefit heart disease patients by reducing their blood pressure, heart rate and anxiety.

Music therapy has also been shown to lift the spirits of patients with depression.

Making music yourself—either playing instruments or singing—can have therapeutic effects as well.

Scientists have long known that when music and other sounds enter the ear, they’re converted to electrical signals. The signals travel up the auditory nerve to the brain’s auditory cortex, which processes sound. From there, the brain’s responses to music become much more complex.

Over the past decade, new brain imaging techniques have shown that music activates many unexpected brain regions. It can turn on areas involved in emotion and memory. It can also activate the brain’s motor regions, which prepare for and coordinate physical movement.

One brain area that’s drawn interest in recent years is the medial prefrontal cortex, located just behind the eyes. In a recent study, Janata showed that this region seems to be a central hub linking music, memories and emotion. He used an imaging technique called fMRI to look at the brains of young adults while they listened to snippets of songs from their childhoods. When they heard familiar songs, the medial prefrontal cortex lit up. Activation was strongest when the song evoked a specific memory or emotion.

“It turns out that the medial prefrontal cortex is also one of the last brain regions to deteriorate in Alzheimer’s disease,” Janata says. This may help explain why many Alzheimer’s patients can remember and sing along to tunes from their youth when other memories are lost. Janata hopes to conduct studies of older adults—including some with mild thinking impairments—to see how the brain processes nostalgic songs.

The medial prefrontal cortex also seems to play a role in the creative expression of music. Dr. Allen Braun, a scientist at NIH’s National Institute on Deafness and Other Communication Disorders (NIDCD), and Dr. Charles Limb of Johns Hopkins University asked jazz musicians to play music on a keyboard inside an MRI scanner.

When improvising, the musicians’ medial prefrontal cortex turned on. But the region wasn’t activated when they were playing memorized scales.

Meanwhile, a different brain area that’s involved in self-monitoring shut down during improv. “The musicians were letting go and not watching themselves as much while improvising,” says Braun.

“When you make music, it engages many different areas of the brain, including visual, auditory and motor areas,” says Schlaug. “That’s why music-making is also of potential interest in treating neurologic disorders.”

Schlaug’s been exploring how music making may help adults regain their ability to speak after a stroke. When stroke damages the speaking area of the brain, some people can still sing words but not speak them. With an experimental technique called music intonation therapy, patients learn to sing and mimic the rhythms of simple songs. Gradually, different regions of the brain may take over some speaking functions.

Scientists continue to explore the relationship between music and health. While they search, try turning on the radio or grabbing your guitar. Enjoy whatever music brings your way.

FRee Summer Concert Series!

7:00 - 8:00 p.m.

Sarah Chudnow Community

JuNe 5 – L’il Rev: Ukulele Music, Blues, Folk, Jewish & Yiddish Folksongs, and Originals.

JuNe 19 – Nadine Borngraeber: Accomplished Opera soprano delights us with the classics.

JuLy 3 – Cantor Jeremy and Amanda Stein: Marital harmony leads to musical harmony on guitar and clarinet.

JuLy 17 – William Florescu of the Florentine Opera discusses Carmen. This educational musical event is part of our Summer Concert Series, but in respect for the solemn days leading up to Tisha B’Av, there will be no actual concert.

JuLy 31 – Aaron Hetzel Trio: Rick Aaron and Mike Hetzel Sr. and Jr. perform traditional Jewish tunes, Jazz, the standards and more.

AuguST 14 – easy Days Barbershop Quartet: Award-winning quartet uses a breezy style for a fun presentation.

AuguST 28 – Carmen Nickerson and Kostia: Beautiful vocals and amazing piano talent!

Sponsored by the Gilbert Meisel Music Fund of the Jewish Home and Care Center Foundation.

10995 N. Market St., Mequon, WI 53092 262-478-1506 LLadin@JewishSeniorLiving.org SarahChudnow.org Like us on Facebook Follow us on Twitter @sarahshouse JULY 2012 MHL 33

Senior Housing COMING A LONG WAY OVER THE YEARS

By Jan Rupnick .Starting approximately 30 years ago, this industry saw new options develop to meet the demands of a growing senior population. Initially limited in its offerings, there is now a plethora of senior housing options available.

With more and more baby boomers getting ready to retire, the senior housing market is growing with new senior housing developments. Some baby boomers are looking into senior housing options for themselves, while others are looking for communities that can help care for their aging parents. Finding the right option comes down to knowing what’s available and understanding the needs of the person who is going to be living in the community. Below are descriptions of the various senior housing options available and the segments of the senior population that they serve.

Independent Senior Housing For seniors who are tired of maintaining their own home or looking to down-size, independent senior housing is ideal. Those looking to move into an independent senior living community have two choices. One is to purchase a senior condominium and the second is to rent a senior living apartment. Both provide independent, active seniors with the freedom they enjoy, but without all of the burdens of home ownership like mowing the lawn, shoveling the snow, or making home repairs. Some independent senior communities have also adapted a lifestyle approach, including such amenities as a salon and spa, golf course, on-site restaurants, on-site shopping, housekeeping and more.

Assisted Living Assisted living provides a great alternative for seniors who need some additional help with medication, grooming, dressing, eating, etc. Assisted living has two options including; Residential Care Apartment Communities (RCAC), which allows seniors to live in their own apartment, but only offers 28 hours of care, and CommunityBased Residential Care Facility or CBRF. This type of community is an ideal living option for seniors who need more assistance that what can be provided by an RCAC, offering care 24 hours a day, seven days a week. Assisted living communities tend to offer more of a residential, home-like environment, as well as provide meals, social activities, housekeeping and transportation.

Specialized Care Community There are some CBRFs that specialize in caring for one kind of illness. One of the most common is an Alzheimer’s or memory impairment care community. In specialized assisted living communities, the environment, staff and programming is specifically designed to meet the unique needs of those individuals who are living there. Like a non-specialized assisted living community, a specialized care community also provides 24/7 care, social programming, meals, housekeeping and transportation are generally provided.

Nursing Home This is probably the most commonly known, but often confused type of senior living option. It’s also one of the only options that used to be available to seniors.

Nursing homes provide 24-hour skilled nursing services for seniors who need rehabilitation after a surgery, or require care for issues like feeding tubes. The levels of hospitality services in nursing homes vary greatly depending on their targeted clientele.

Whether you’re looking to down-size your home or a community to meet the needs of an aging parent, there is a senior living community to meet your needs.

Being prepared and understanding the options available will help you to choose what type of senior living community is best for you or your loved one.

34 MHL JULY 2012

Keeping Cool!!!

Summer is in full swing and there is nothing that boosts your mood faster than a sunny day. If the sun is a blessing, its heat is the curse. We’ve heard the news reports probably a million times that children and the elderly are more susceptible to heat-related illness and should take extra precautions on hot days.

Even though, a large number of seniors ignore those warnings. In a Kent State University study, 90 percent of those over the age of 65 knew about heat warnings for the elderly, but only 15 percent took them personally. The problem lies in the fact that those delivering the warnings used the word “elderly”. People have different perceptions of what “elderly” means, especially for those over the age of 65.

The study revealed that responders, who ignored the warnings, did so because they did not view themselves as “elderly”. Ignoring the warnings can be very dangerous. It has been estimated that seniors account for nearly half of the heat-related deaths each year.

Regardless of how seniors think of themselves, it is important for any one over the age of 65 to take precautions when the weather is warmer. The Center for Disease Control and Prevention has compiled a list of tips for seniors and their loved ones to help prevent any heat-related illness.

• Stay in air-conditioned buildings as much as possible. Do not rely on a fan as your primary cooling device during an extreme heat event.

• Don’t wait until you’re thirsty to drink and drink more water than usual.

• Check on a friend or neighbor and have someone do the same for you.

• Don’t use the stove or oven to cook—it will make you and your house hotter.

• Wear loose, lightweight, light-colored clothing.

• Take cool showers or baths to cool down.

• Check the local news for health and safety updates.

• Seek medical care immediately if you have, or someone you know has, symptoms of heat-related illness like muscle cramps, headaches, nausea or vomiting.

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The Ongoing Fight against Parkinson Disease

38 MHL JULY 2012

Jonathon Klein, B.S., C.C.R.C. Research Coordinator Regional Parkinson Center, Milwaukee, WI Parkinson disease is a neurological disorder that leads to tremor, lack of coordination, poor mobility, and trouble with walking. Along with these main features, patients also experience problems with swallowing, constipation, excess saliva, rigidity, soft or slow speech, stooped posture, depression, and anxiety. Although there has been much progress in the treatment of Parkinson’s, there are still aspects of the disease that we do not fully understand.

Here are some of the questions we are trying to answer: • For those diagnosed with Parkinson disease (PD), how is the disease going to progress?

• How do we improve on the PD medications that are currently on the market?

• Why is it that no two Parkinson patients look exactly alike with regard to symptoms, progression, and treatment response?

• How can we implement a holistic treatment plan that leads to happier, healthier lives for our patients?

• And most importantly, what is the cause of the disease? And how do we cure it?

At the Regional Parkinson Center in Milwaukee, we are making progress on all of these fronts. Our clinical research department is always testing new and cutting-edge medications that will improve treatment options. The medications currently approved to treat PD are sometimes sporadic in terms of the control they provide and the side effects they may trigger, so to find safer and more effective medications, we have developed one of the most successful Parkinson clinical research departments in the country. At this time we are studying eight new experimental medications that we hope will lead to better control of PD symptoms and significantly change the way we treat the disease.

The Regional Parkinson Center also has a separate research entity.

The Parkinson Research Institute analyzes data and designs studies using information that has been gathered for more than 30 years, and it is home to one of the largest Parkinson disease brain banks in the world. The brain bank allows us to test tissue samples and better understand the pathology of Parkinson disease. By analyzing the information from patient clinic records and tissue samples, we may be able provide answers to important questions: If we can pick out certain variables and predictors from certain groups of patients, then we can figure out what may be the cause or causes of this disease. Also, by analyzing specific variables, we can attempt to categorize patients and group them based on symptom profiles and treatment responses, which will allow for future development of specifically tailored treatment plans that cater to individual patient needs.

Both departments are vital in the ongoing fight against PD. The FDA should soon approve new medications that will improve treatment capabilities.

Researchers systematically gather and share information pertaining to disease progression and categorization. Medical professionals are designing better treatment plans to deal with the physical and psychological affects of PD. Progress is being made all around the world. In the end, we hope that this stepwise progression of research will lead us to a cure for Parkinson’s disease.

Is An Assisted Living Facility Right For You? Having an active social life is vital to your health and happiness.

If you’re trying to decide whether assisted living is right for you, ask yourself the following questions: Do you need more help than family and friends are able to provide? Are the activities of daily living becoming stressful or overwhelming? If family or in-home help is not able to bridge the gap, assisted living is an option.

Do you feel lonely or isolated at home? Having an active social life is vital to your health and happiness. Being alone much of the time is a recipe for depression.

The social aspect of assisted living is a huge benefit. Good facilities offer a range of social and recreational activities. And the community environment also gives the opportunity to make new friends.

Do you worry for your safety? Perhaps your mobility is limited, making it difficult to get out of bed by yourself, for example. Maybe you’re afraid of what might happen if you fell and couldn’t get up, or experience another problem and couldn’t get help.

Are you tired of maintaining a home? There are a lot of responsibilities that come with living in your own home. Assisted living facilities can provide a home-like atmosphere, without the work of cooking, cleaning, shopping for groceries, and doing laundry.

Is transportation an issue? Perhaps you’re having trouble driving or can no longer drive. If public transportation or another alternative isn’t easy and convenient, you may be increasingly housebound. Assisted living facilities offer transportation, so you can get where you need to go without having to rely on friends and family.

Signs that a parent or loved one might need assisted living It’s not always easy to tell when your parent or another family member or loved one needs more help. The following warning signs may indicate that it’s time for a talk about assisted living.

The refrigerator is empty or filled with spoiled food or your parent is losing weight.

These may be signs that he or she isn’t eating well because shopping or cooking is difficult.

You notice frequent bruises, although your parent may try to cover them up. This may be a sign of falling, or mobility and balance problems.

Your parent wears the same clothes over and over again or neglects personal hygiene. This can indicate that doing laundry and bathing is physically challenging.

The house and yard isn’t as clean and tidy as it used to be.

Your parent forgets things, including doctor’s appointments and when to take medication. This may be due to memory loss.

Your parent seems depressed. Depression is common in seniors who are isolated and alone.

You notice strange or inappropriate behavior. For example, your parent may dress inappropriately for the weather. This can be a sign that he or she is experiencing confusion.

Making the decision to leave home: What you may be feeling No matter your situation, moving is always stressful. But when you’re contemplating leaving your home for an assisted living facility, stress is just the tip of the emotional iceberg. You may associate grief with the death of a loved one, but grief is a natural response to any loss. And the loss of your home, neighborhood, and community is a big one.

The thought of leaving everything you know can make you feel very vulnerable.

You may feel like you’re losing your independence or a big part of your identity. It’s ASSISTED>>see page 40 JULY 2012 MHL 39

ASSISTED<<page 39 important to realize that all of these feelings are normal. Take some time to acknowledge these feelings of loss. Sometimes talking to someone who is sympathetic can help. Counseling and therapy can be an option too. Give yourself time to grieve and get used to the change.

Tips for making the transition to assisted living easier Life in an assisted living facility is an undeniable adjustment. In addition to a new living environment, you are meeting new residents and getting used to the staff.

This can feel stressful in the beginning. But there are things you can do to make the transition easier.

Pack well in advance of the move. Don’t add to the stress of the actual move by putting yourself in a position where you’ll need to make hasty decisions about what to take and what to discard.

Know what to expect. Do your homework on the facility. It will be less stressful if you know what to expect. Read all the materials before you move in and make sure all of your questions are answered ahead of time.

Stay busy. You may be tempted to stay in your apartment or living space, but you’ll feel comfortable much quicker if you get out there to meet the residents, participate in activities, and explore the facility.

Go easy on yourself. Everyone adjusts to change differently, so give yourself a break, no matter what you’re feeling. However, if you feel like you’re taking longer than you think you should to adjust, it may help to talk to your family members, the director of the facility, or a trusted friend.

Choosing the right assisted living facility for you There is a huge variation among assisted living facilities. While this can make the process of choosing seem daunting, the plus side is that you have a good chance of finding a facility that is perfectly suited to your preferences and needs.

As you start your search, try not to get overwhelmed by all the options. Remember, amenities matter much less than the residents and staff. It’s the people that truly make any place, including an assisted living facility. You can tell a lot about a facility by the people who live and work there. You want a facility with an active social atmosphere—where the residents are friendly and the staff is caring and warm. Make sure that, overall, you feel the facility is a place where you will fit in and develop new relationships.

Reprinted with permission from Helpguide.org © 2001-2010. All rights reserved.

For more articles in this series, visit www.Helpguide.org.

40 MHL JULY 2012

SOCIAL SECURITY GOES

Country

By Karyl Richson Social Security Public Affairs Specialist in Milwaukee, WI It may seem crazy, but there are 20 country song titles or lyrics in this column (including the one in this sentence). Can you circle all of them?

You probably think of July 4 as Independence Day. Did you know that it is also National Country Music Day? A new holiday? Not by any means. In fact, you might even say it’s been around forever and ever Amen. It was in the 1950s that the Country Music Deejay Association decided to start the holiday. It’s been celebrated every year since.

Social Security’s been around nearly as long as country music — since the 1930s.

Social Security was signed into law during the same depression era that found Gene Autry singing “Take Me Back To My Boots and Saddle.” Since its dustbowl beginnings, Social Security has helped many silver-haired daddies (and mammas who let their babies grow up to be cowboys) get back in the saddle again.

By helping many older Americans stay out of poverty, Social Security is used to being told “I will always love you” and that “you were always on my mind.” Not to mention, “If you’ve got the money, honey, I’ve got the time.”

These days, retirees live longer than ever. Today’s average 65-year old can expect to live another 20 years.

About 55 million Americans will receive $760 billion in Social Security benefits this year; the average monthly benefit for a retired worker in 2012 is $1,229.

But let’s give them something to talk about: Social Security is more than retirement. The agency could cry, “People who say ‘Social Security Retirement’ never even called me by my name.” That’s because Social Security also pays disability and survivors benefits, as well as Supplemental Security Income, or SSI. Whether you’re at the start of your career, working 9 to 5, or well into mid-career, you should give some thought to planning your future retirement. To help you plan, visit our Retirement Estimator at www. socialsecurity.gov/estimator. It’ll help you determine how much you need to save to harvest a comfortable VMP MANOR PARK - EXPIRES 09/30/12 retirement.

PLEASE PRESENT THIS AD TO RECEIVE YOUR CREDIT Are you at the end of a career? Ready to take this job and shove it? There’s no reason to walk the line to your local Social Security office, even if you are king of the road. The easiest way to apply for retirement benefits is online, at www.socialsecurity.gov. Being away from your friends at work may make you so lonesome you could cry, but at least you can count on a monthly Social Security payment. They may even begin to sing about the day of the month “when our old-age pension check comes to our door.” Or, in most cases, by direct deposit to your bank account.

Here’s a word of advice for Lucille and Ruby. You may have picked a fine time to take your love to town, but if you were married for ten years or more, and are

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JULY 2012 MHL 41

Taking Care Of Your Elderly Parents HELPING THEM MAKE THE RIGHT DECISION ON HOUSING

Its always difficult to help your parents find their next living situation.

Many adults find it hard to decide on what the best next move is for their parents.

Here are some helpful questions to help you make the right decisions for your elderly parents care.

Assessing their needs -Does your parent need help with grooming, bathing, or dressing?

-Does your parent need help with housekeeping, shopping, or yard work?

-Does your friend need help planning or preparing meals?

-Is your parent unable to drive or get around on public transportation alone?

-Does your parent need help managing finances and paying bills?

-Does your parent need help making legal and other important decisions?

-Does your parent have trouble functioning at home? Would modifications help?

-Does your parent have trouble with hearing, vision, or memory?

Get permission -financial power of attorney to make financial decisions and pay bills -living will to make life-support decisions -medical power of attorney to make health care decisions -durable power of attorney to make legal decisions -access to safe deposit box -may choose to be added to deeds and mortgages -may need to be added to automobile insurance

-know the person's wishes (medical treatments, funeral, finances, etc.)

Information to have on hand -insurance (Medicare / Medicaid number, supplement, other policies) -doctors (names, phone numbers, and other contact information) -medical history (medications, allergies, conditions, procedures) -identification (social security, military ID, driver's license numbers) address list (friends, neighbors, family) -service providers (attorney, financial advisor, clergy, accountant) -financial (account numbers, checkbook, investments, tax records) -legal (wills, powers of attorney, health care directive) -deeds (house, other property, car title, boat title) -insurance (life, medical, auto, homeowner's) -household (mortgage, apartment lease, property tax records)

-vital records (birth certificate, marriage license, divorce decree) -final wishes (organ donation, burial, property distribution) Make sure that you -respect your parent's independence, even while taking care of them -allow your parent to make as many decisions as appropriate -have reasonable expectations of what your parent can do independently -talk regularly with your parent about their concerns, desires, and frustrations -make informed decisions that are in the best interest of your parent's needs -show compassion while you are trying to be efficient and responsible Content provided by OnlineOrganizing. com -- offering “a world of organizing solutions!” Visit www.onlineorganizing. com for organizing products, free tips, a speakers bureau, get a referral for a Professional Organizer near you, or get some help starting and running your own organizing business.

Assisted Living and Memory Care Communities Walk through the doors of one of our Senior Living Communities and you will immediately sense the home-like and friendly atmosphere.

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Keeping Your Brain Young Allis Care Center Aging leads to a certain amount of brain cell loss, which can affect the ability to remember. As we age, our brains produce less of certain chemicals which help the brain function to its best ability. This “slowing down” of mental function is normal, but it also can be countered, improving your brain’s natural function and reducing memory loss. You can improve your brain function with games, exercise, good nutrition and socializing. Making the right choices for your lifestyle can directly influence your brain function today and in the future.

Five Healthy Tips for Keeping Your Brain Young Physical Exercise A professor from the University of Illinois has conducted studies to prove people who exercise and live an active lifestyle have sharper brains then those who are inactive. These studies even showed those people who were in physical decline were able to sharpen their brain after starting an exercise program.

Mental Exercise Researchers encourage older adults to play bridge, chess and poker. Also, crossword puzzles are a great way to stimulate your brain. Try to mix up your brain exercise games by not playing the same games or puzzles over and over again.

Good Nutrition According to the Alzheimer’s Association, a diet rich in dark vegetables and fruits and low in fat may help to protect brain cells. A good rule of thumb for your diet is making your plate as colorful as possible.

Laugh More Laughter has multiple benefits including stress relief, lowering blood pressure and improving brain function. Laughing stimulates both sides of the brain to enhance learning and ease muscle tension. Rent a funny movie or stay in and watch old “I Love Lucy” re-runs.

Socialize Studies have shown that staying socially active with friends can improve brain function and reduce dementia. Engage with others verbally by picking up the phone and conversing for 15 minutes. Join bridge clubs, take dance lessons or go to dinner with a group of friends.

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JULY 2012 MHL 43

Understanding Medicare: KNOW YOUR RISKS. KNOW YOUR OPTIONS.

Planning a Secure Retirement is not Simple- but it is important The first step in planning a secure retirement is understanding the risks you face in retirement.

One of the most complicated and confusing issues youâ&#x20AC;&#x2122;ll face as you plan for retirement is understanding what Medicare does and does not cover.

Failure to protect against expenses that are not cover by Medicare can have a dramatic impact on your financial security.

An insurance service organization specializes in helping you understand your needs for life and health insurance in retirement.

This article will help you understand what Medicare covers and does not cover.

This article, together with an assessment of your individual needs, will help you be informed, be smart, and be secure.

Understanding the Medicare Insurance Program

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While Medicare helps cover healthcare costs, It doesnâ&#x20AC;&#x2122;t cover all medical expenses or the cost of most long-term care. The program has four basic parts: PART A Medicare Part A (Hospital Insurance) Part A help pay for inpatient hospital care, and other services.

PART B Medicare Part B (Medical Insurance) Part B helps pay for doctorsâ&#x20AC;&#x2122; fee, outpatient hospital visits and other medical services and supplies not covered by Part A. PART C Medicare Part C (Private Medicare Advantage) Part C allow you to choose to receive all of your healthcare services through a private organization.. (You must have both Parts A and B to enroll in C.) PART D Medicare Part D (Prescription Drug Insurance) Part D helps pay for some of the cost of medications that help your healthcare professionals prescribe.

Understanding Supplemental Health Insurance Because Medicare does not cover all your medical costs, you may decide to obtain additional protection through supplemental health insurance policies. These policies are sold by private companies and are not part of Medicare.

Having the right insurance protection in place can provide the peace of mind and protect you from high out-of pocket medical expenses. Having Medicare alone can expose you to many thousands of dollars in out-of- pocket expenses.

You may want to consider insurance coverage for some or all of the flowing expenses: The deductibles , coinsurance and exclusions in Medicare coverage The high cost of prescription medications The costs of skilled, nursing, assisted living, nursing home and home health care The cost of final expense The additional cost that go alone with critical illnesses like the cost of travel and lodging when receiving care way from home.

Medicare Does Not Eliminate Your Financial Responsibilities The number-one misperception most people have about Medicare is that it covers all of your medial expenses. It does not. In many cases you could be responsible for thousands of dollars of care.

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AND REHABILITATION FACILITIES When you no longer need the amount of care provided in the hospital, the hospital will begin a process to discharge you.

Most people hope to go directly home from the hospital after surgery or being ill.

However, even if you and your doctor planned for you to go home, your recovery may be slower than expected. As a result, you may need to be transferred to a skilled nursing or rehabilitation facility.

Skilled nursing facilities provide care for people who are not yet able to care for themselves at home. The goal is for you to return home and care for yourself.

Plan AheadIf your surgery is planned, you should talk about this issue with your doctors and nurses in the weeks beforehand. They can advise you about whether going directly home will be good for you.

If your stay in the hospital is not planned, you or your family should discuss discharge planning with your health care provider as you begin to recover.

Planning ahead of time where you would like to go helps ensure you can go to a place that provides high-quality care and is located where you would like it to be. â&#x20AC;˘Have more than one choice. If there is no bed available in the skilled facility that is your first choice, the hospital still needs to transfer you to another qualified facility. â&#x20AC;˘Always make sure the hospital knows about the places you have chosen.

Choosing the Right Facility for You It is always a good idea to check out different skilled nursing facilities that you would like to go to. Visit two or three facilities and choose more than one facility at which you would be comfortable.

Important factors in the facilities you choose will include where the facility is located, how well it is decorated and maintained, and what the meals are like, along with many others.

You should also remember, your most important goal is to get safely back in your home. The quality of care you will receive at this facility plays the biggest role in getting you home.

Therefore, when looking into the facilities that are near you or those suggested to you by friends or the hospital, find out more about them.

Do they take care of many people with your medical problem? â&#x20AC;˘For example, if you had a hip replacement or stroke, ask how many patients with your problem they have cared for. â&#x20AC;˘A good facility should be able to show you data that shows they provide good quality care. â&#x20AC;˘Do they have a pathway, or protocol, for taking care of patients after hip replacement or stroke?

Other questions to ask are: â&#x20AC;˘Ask whether they have physical therapists that work at the skilled nursing facility. Make sure the therapists have experience helping people with your problem.

Ask whether you will see the same one or two therapists most days. â&#x20AC;˘Do they provide therapy every day, including Saturday and Sunday? How long do the therapy sessions last? â&#x20AC;˘If your primary care doctor or your surgeon does not visit the facility, will there be a doctor in charge of your care? â&#x20AC;˘A good facility will take the time to train you and your family or caregivers about care you will need in the home when you leave the facility.

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Surgery After Stroke CORRECTS DEFORMITIES & RESTORES MOBILITY About 65% of people recovering from a stroke develop spasticity—involuntary muscle contractions that can cause pain and disfigurement

The Johns Hopkins Medical Letter About 65% of people recovering from a stroke develop spasticity—involuntary muscle contractions that can cause pain and disfigurement. When medications and physical therapy don’t fix the problem, many patients believe they’ve run out of options.

Fortunately, another treatment can help: Evidence has shown that orthopedic surgery can dramatically improve many of the muscular abnormalities that result from damage to the brain.

Muscle control after a stroke

final 1/2 pg bridgeway healthwise ad_Layout 1 3/23/12 11:18 AM Page 1

Whenever we move, an area of the brain called the motor cortex sends messages through the spinal cord to nerves in the muscles that “tell” the body what to do. The left brain directs muscles on the right side of the body, while the right brain generally controls the left side of the body.

“If a stroke damages areas of the brain that inhibit reflexes—like the leg moving in response to a tap on the knee—reflexes can become exaggerated and muscles may start to contract unnecessarily,” explains Richard Zorowitz, M.D., Chairman of the Department of Physical Medicine and Rehabilitation at Johns Hopkins Bayview

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Medical Center. “This condition is known as spasticity. In some patients, it manifests as an immobile knee or a curved foot. It can also look like a tight fist, a bent arm, or a shoulder that won’t rotate.”

Long-term contractions can eventually deform the joints and affect the coordination required to walk, eat, or get dressed. Painful spasms are common, and walking on stiff, curled toes leads to blistering. Spasticity may also cause the arms, fingers, or legs to jerk uncontrollably.

Conservative care first

Physical rehabilitation immediately after a stroke may prevent spasticity from setting in. Your physiatrist (a medical doctor who specializes in physical medicine and rehabilitation) will recommend exercises focused on activating weakened areas of the body and maintaining range of motion in your joints.

If your muscles still stiffen, additional physical and occupational therapy is enough, in some cases, to correct the problem. “Splints, electrical stimulation of muscles, muscle-relaxant medications, or botulinum toxin (Botox) and phenol injections also can help considerably,” adds Dr. Zorowitz.

The next step

With these conservative methods, most improvements take place within the first six months. After that, it’s much more difficult to regain muscle control, and some patients may benefit from orthopedic surgery.

To determine if surgery may help, your doctor will conduct a physical examination, along with a nerve test known as electromyography (EMG). During EMG, a needle with an electrode is inserted into a muscle. The electrode measures whether the muscle is over-or under stimulated. This reveals which muscles and nerves are contributing most to spasticity.

It is normal to experience some pain during the test (which lasts approximately 30 minutes). Any bruises left by the needles should disappear within a few days.

The benefits of surgery

Some orthopedic operations can be performed under local anesthesia. Because this dramatically reduces surgical risk, even patients with other serious health conditions, like heart disease, are candidates for surgery.

The long-term goals and benefits of these procedures vary. “The patients most likely to experience dramatic improvements are those with foot and ankle spasticity, which causes the foot to point or curve inward (equinovarus),” says Dr. Zorowitz.

“For these patients, a procedure that lengthens contracted tendons may restore the ability to walk.”

Doctors may also reroute part of the tendon to the heel in a procedure called a split anterior tibial transfer (SPLATT), which may improve muscular balance and restore the foot’s normal position.

“Patients with spastic bent knees also commonly have surgery,” Dr. Zorowitz adds. In this case, however, mobility may not return right away. While surgery can lengthen spastic hamstrings to increase knee extension, the muscles may be weakened after a stroke; that means vigorous physical training after surgery will be necessary to improve your gait.

The goals of upper-body operations are usually more modest. If the internal rotator muscles in the shoulder stiffen, causing the arm to rotate inward and cross over the chest, operating won’t help you move your shoulder again on your own. But surgery can re-establish normal appearance and reduce pain.

Similarly, operating to open a clenched fist doesn’t restore grasp for most patients, but it will make the hand easier to clean.

Active recovery

Recovering from surgery generally takes two to three weeks. It is essential to get moving as soon as possible—waiting decreases your muscle strength (and may make the steps necessary for rehabilitation seem more daunting).

Your physiatrist will continue to recommend exercises to build muscle strength and maximize the range of motion in your affected joints.

When you are ready to leave the hospital, your doctor may refer you to an occupational therapist, a specialist who can help you make adjustments to your home that will maximize your independence.

Seek treatment right away if you develop in-grown toenails, bowel or bladder problems, or pressure sores, and avoid tight clothing, which all can over stimulate the nerves.

A permanent fix?

To maintain surgical improvements in the long term, many patients require splints and medications. “Remember, surgery is not an exclusive cure for joint deformities,” Dr. Zorowitz explains. “It’s one step in a multidisciplinary approach to stroke recovery. Recontracture is possible—but with diligent follow-up, another operation usually isn’t necessary.”

Reprinted permission of the Johns Hopkins Medical Letter Health After 50, copyright MedLetter Associates, 2009. To order a one-year subscription, call 386447-6313.

JULY 2012 MHL 47

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