October 2016 mhl

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OCTOBER 2016

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

Are You Tired of Sleeping with This?

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Sleep apnea is more than noisy, it can be bad for your health. Chronic, loud snoring is a sign that you could be suffering from sleep apnea, a condition that causes you to actually stop breathing, often hundreds of times a night! This can lead to chronic fatigue, memory problems, high blood pressure, strokes, and more.

We treat sleep apnea with a custom designed oral appliance. Many of our patients report feeling better and more rested after just one night of using the device.

Call us today at (414) 208-4539 or visit www.SnoringisntSexy.com to stop the noise and start resting.

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Evans Chiropractic & Pain Relief Laser Clinic 262-785-5515

ARE YOU TIRED OF BEING IN PAIN? HAVE YOU STOPPED DOING THINGS YOU ENJOY? KNEE PAIN, NEUROPATHY, BACK PAIN, MIGRAINES? Evans Chiropractic & Pain Relief Laser Clinic, is pleased to announce that they are now offering a revolutionary new Pain Relief Treatment Program which was designed by Dr. Evans, DC Board Certified in Orthopedics and Board Certified in Physical Rehabilitation, Ms. Elizabeth Brink, Board Certified Acupuncture physician and Board Certified Massage Therapist and Miss Casey Hamill-Barth, Board Certified Athletic Trainer to treat difficult acute and chronic pain syndromes.

We have used the Pain Relief Treatment Program on patients’ of all ages and athletic abilities. The most amazing results so far have been that all of our patients with NEUROPATHY have gotten better. This was always the most difficult condition to resolve for our patient’s, finally we have discovered the treatment program that really helps these people, it’s been very rewarding to see patient’s recover from this debilitating syndrome! Clearly it is the combination of natural, non-invasive anti-inflammatory therapies all under onE Roof with providers who are taking a hands-on team approach to patient care.

Together the treatment team brings more than 50 years of clinical experience to each patient’s case.

If you or a loved one are suffering, Call today to see how our Pain Relief Treatment Program can help!!

Ms. Elizabeth Brink is Board Certified in Acupuncture and Chinese Medicine. She is a 2010, Magna Cum Laude Master degree graduate candidate from the Midwest College of Oriental Medicine.

Elizabeth completed her Internship training at Guangzhou University in China where she was exposed to a wide variety of Acupuncture procedures that she was not exposed to in her training here in the states. She is proficient in Electro-Acupunture, Needle Trigger Point Therapy, Cupping, Guasha, and Reiki. Elizabeth’s compassion for her patient’s is really what sets her apart from her peers. Elizabeth is also a board certified Massage Therapist and incorporates many different massage techniques into her patient care with patient comfort being paramount.

ElizabETh bRink, licensed acupuncturist

Dr. Evans Specializes in the management and treatment of complicated chronic pain syndromes.

Additionally, Dr. Evans brings more than 30 years of clinical expertise and training to each and every case thereby ensuring your best outcome. Dr. Evans and her experienced, certified team deliver personalized care to each and every patient and look forward to helping you recover and feel better! Dr. Evans and Elizabeth work closely in the management and successful treatment of the many chronic pain conditions treated successfully every day at Evans Chiropractic & Pain Relief Laser Clinic.

DR. EliESha EVanS

COMPLIMENTARY PAIN RELIEF TREATMENT PROGRAM CONSULTATION CALL 262-785-5515 TO SCHEDULE TODAY! ExPIRES IN 30 DAYS

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OCTOBER 2016 MHL

JAMES “My stay at ManorCare Health Services – Pewaukee was great. I came in for rehabilitation after a traumatic injury. The staff was well trained, organized and worked hard to attend to my needs – both physically and mentally. They understood my needs and provided the care necessary while maintaining my dignity. The facility was clean and the entire staff was accommodating 24-hours a day. The rehabilitation staff gave me the necessary ‘push’ to attain improvement of my injuries.

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My physical injuries have improved from rehabilitation and I feel I’m back to normal since graduating from ManorCare. I would recommend ManorCare to anyone needing rehabilitation of any kind.” www.hcr-manorcare.com

(;3(&7 025( )URP <RXU 'HQWLVW Note from the Editor October is back! The weather is beginning to change into a beautiful, cooler, calmer, climate. With the weather changing I decided to do some rebooting in my life as well. I am attempting to become more mindful and removing opinions and debating out of my life for the month of October. Not during the election? YES! Mindfulness is something I think we all tend to forget about from time to time. Being present with everything we do is a tough feat, but so great for the soul. So I welcome you all to join me in cleansing your mind, its easier than a diet!

The rain has taken over these last few weeks, but I am still finding time to get outside and exercise in between the rainfall.

Halloween is fast approaching.

My family loves halloween. Every year we carve pumpkins and bake the seeds. Maybe this year you should try to incorporate a pumpkin recipe for dinner. When thinking of trick or treating I am definately more of a treater. So, have a night off from all the dieting and enjoy the sweets and scares.

Happy Halloween Everyone!

-Amanda Lewis

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Mindful & Happy

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

contributers

Livestrong.com, Environmental Nutrition, Nutrition Action Health Letter, Columbia/St. Maryâ&#x20AC;&#x2122;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, Interfaith Older Adult Services, Laureate Group, Tudor Oaks, Luther Haven, Greensquare Center for the Healing Arts, Midwest Audiology Integrative Family Wellness Center Social Security Offices, American Camp Association, Home Instead, Manor Care, Tops, Dr Zhou, Oak Creek Pediatrics and MCFI

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Lewis Media Group Amanda Lewis Malberry Media Abigail Carpenter 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.

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MHL 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 expertâ&#x20AC;&#x2122;s care.

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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 OCTOBER 2016 MHL

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Local MDs Provide Perspective on International Eye Research Results

By Cheryl L. Dejewski Cataract Removal Shown to Improve Sleep and Cognitive Function For years, researchers have known about the link between vision quality and mood/cognition. But, additional studies are beginning to show a new development—patients who have cataract surgery also experience improvement in sleep quality. One new study of 934 individuals by Kimie Miyata from the Nara Medical University School of Medicine in Japan confirmed these findings.

“Cataracts are a clouding of the natural lens inside the eye. Advanced cataracts can reduce the amount of light that reaches the retina in the back of the eye, thus having the potential to cause an abnormal circadian rhythm that affects sleep.

Removing cataracts allows light to enter the eyes again, which may help to reset the body’s circadian rhythm and bring sleep quality back to normal,” explains Mark Freedman, MD, senior partner at Eye Care Specialists, a leading ophthalmology practice in Wisconsin.

In the study, participants who had cataract surgery showed significantly higher sleep efficiency and shorter wake after sleep onset than those who did not have surgery, even after adjustment for age, gender, body mass index, smoking sta-

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West Allis Wauwatosa Milwaukee 10150 W. National Ave. 2323 N. Mayfair Rd. 735 W. Wisconsin Ave. 414-321-7520 414-258-4550 414-298-0099

By Cheryl L. Dejewski Cataract Removal Shown to Improve Sleep and Cognitive Function For years, researchers have known about the link between vision quality and mood/cognition. But, additional studies are beginning to show a new development—patients who have cataract surgery also experience improvement in sleep quality. One new study of 934 individuals by Kimie Miyata from the Nara Medical University School of Medicine in Japan confirmed these findings.

“Cataracts are a clouding of the natural lens inside the eye. Advanced cataracts can reduce the amount of light that reaches the retina in the back of the eye, thus having the potential to cause an abnormal circadian rhythm that affects sleep. Removing cataracts allows light to enter the eyes again, which may help to reset the body’s circadian rhythm and bring sleep quality back to normal,” explains Mark Freedman, MD, senior partner at Eye Care Specialists, a leading ophthalmology practice in Wisconsin.

In the study, participants who had cataract surgery showed significantly higher sleep efficiency and shorter wake after sleep onset than those who did not have surgery, even after adjustment for age, gender, body mass index, smoking status, alcohol consumption, hypertension, diabetes, sleep medication, bedtime, rising time, physical activity, daytime and nighttime light exposure, and urinary 6sulfatoxymelatonin excretion.

Besides improved sleep efficiency, patients in the study also had a 33 percent lower chance of being diagnosed with cognitive impairment. According to the researchers, people who have disturbed sleep patterns are more likely to be cognitively impaired.

Brett Rhode, MD, Head of Ophthalmology at Aurora Sinai Medical Center and a practicing partner at Eye Care Specialists, observes, “While the connection between melatonin and cataracts is far from proven, a separate study by the American Academy of Ophthalmology found that when cataracts were removed from Alzheimer’s patients, their levels of sleep-regulating melatonin become normalized. The study also corroborated the Japanese study results, which found that mood, cognitive ability, and sleep patterns improved following cataract surgery.”

“This research further demonstrates how a relatively simple procedure with a high success rate can have positive lifechanging benefits that extend beyond just enhancing vision to actually improving quality of life in terms of mood, cognition, and sleep disturbance patterns,” notes Daniel Ferguson, MD, a cataract surgeon who utilizes both conventional and advanced technology (multifocal, extended-range-of-vision and astigmatism-correcting) lens implants.

Smoking Speeds Onset of AMD A study of 275 patients with a known age at onset of neovascular (“wet”)

AMD revealed that past smokers and current smokers developed wet AMD on average 4.9 and 7.7 years earlier, respectively, than people who never smoked.

Based on their results, the Netherlands researchers concluded: “Individuals at risk for AMD could be identified at an early age if and when preventive or therapeutic options become available. Insight into individual risk profiles might influence patients’ consideration of interventions to increase their chance of avoiding vision loss from AMD.” Daniel Paskowitz, MD, PhD, an ophthalmologist with credentials from Harvard and Johns Hopkins, concludes, “Not only does smoking speed the onset of AMD, it also increases the overall risk of developing the disease by two to five times. If there is one controllable factor patients and the public need to know for preventing this devastating condition, it is: DON’T SMOKE.” Diet Rich in Vitamin C Cuts Risk of Cataract Progression by a Third

A study published in Ophthalmology reported that eating foods high in vitamin C could reduce the risk of cataract progression by a third. The research is also the first to show that diet and lifestyle may play a greater role than genetics in cataract development and severity.

Researchers at King’s College London examined data from more than 1,000 pairs of female twins from the United Kingdom. Participants answered a food questionnaire to track the intake of vitamin C and other nutrients, including vitamins A, B, D, E, copper, manganese and zinc. To measure the progression of cataracts, digital imaging was used to check the opacity of their lenses at around age 60. Follow-up measurement on 324 pairs of the twins was done about 10 years later.

At baseline measurement, diets rich in vitamin C were associated with a 20 percent risk reduction for cataract. After 10 years, researchers found that women who reported consuming more vitamin

C-rich foods had a 33 percent risk reduction of cataract progression.

Genetic factors accounted for 35 percent of the difference in cataract progression. Environmental factors, such as diet, accounted for 65 percent. These results make the study the first to suggest that genetic factors may be less important in cataract progression than previously thought.

“Vitamin C’s ability to inhibit cataract progression may have to do with antioxidant capabilities. The fluid inside the eye is normally high in vitamin C, which helps prevent oxidation that clouds the lens (cataract formation). Increasing vitamin C intake may increase the amount present in the fluid around the lens, providing extra protection. The findings in this study only pertained to consuming vitamin C through food and not supplements,” explains Michael Raciti, MD, a cataract surgeon who volunteers time teaching doctor-in-training.

Study author Christopher Hammond,

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Still Striding Towards a Cure

Traditionally, when we think of the colors of October, our minds go to the rich oranges and reds of fall, but thanks to the enormous success of breast cancer awareness If you own a small business and canâ&#x20AC;&#x2122;t afford advertising, organizations over the past 30 years or so, we now often also think pink. we have a solution for you. We are looking for people to deliver MHL Organizations like Susan G. Komen, and local and global womenâ&#x20AC;&#x2122;s health initiato 10-15 places once a month in exchange for advertising space in tives, have raised billions of dollars annually for breast cancer research, inspired this paper. It takes approximately 1-2 hours to make these drop offs countless women to get screened early and often, and transformed something that and we will select the distribution points to be in your area.

Call for details. 414-659-6705 was once discussed in hushed tones to an international conversation.

But weâ&#x20AC;&#x2122;re not there yet. More than 40,000 U.S. women still die every year from breast cancer and, according to this article, despite all that money being raised, strategies for preventing the disease have received inadequate attention and funding.

While the so-called Pinktober is a great thing, itâ&#x20AC;&#x2122;s also important to keep brushing up on the facts about breast cancer and focus on a 2020 deadline for a cure. Or, as Fran Visco, president of the National Breast Cancer Coalition, puts it, â&#x20AC;&#x153;We have to stop celebrating breast cancer awareness months and begin pushing for the end.â&#x20AC;?

For more information about caring for yourself so you can better care for others, please call Home Instead Senior Care of Milwaukee at 414-882-5464. ) ! * + ! , - . . /

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HEALTHY AGING COMING IN NOVEMBER 2016 2013 NOVEMBER ATION

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LASIK

Marc Hirsch,M.D In many instances, the laser can eliminate the need to wear glasses. The use of lasers for this treatment has been in existence since the 1980â&#x20AC;&#x2122;s. Initially, the only procedure available was a called PRK(Photorefractive Keratectomy).

In this procedure, the surface of the outermost layer of the eye is removed and then the laser treatment is applied.

Over the next few days, the surface would heal. Once the surface healed the effects of the laser could be appreciated.

PRK is an excellent procedure and is still used today in certain situations.

However, it has largely been replace by LASIK (laser-in-situ keratomileusis).

What is the difference? In LASIK, the surface layer is not removed. Instead a flap is created and reflected prior to the application of the laser. Once the laser is applied the flap is repositioned.

This allows for faster healing with significantly less discomfort compared to PRK. In addition, most patients can undergo the procedure on both eyes in the same day.

Many people have heard of LASIK and are aware that a laser is involved in the procedure. However, most people did not realize that until recently the only option for creating the initial flap was by using a rapid-oscillating metal blade. The use of a metal blade to create the initial flap is a tested and safe method for flap creation. However, the few complications that can occur during the procedure are usually related to a complication in the flap creation.

A recent improvement in safety has been the development of a laser to create the initial flap. The laser is an infrared beam that separates the tissue by using

One Of The Greatest Advances In Eyecare Has Been The Use Of Lasers To Reduce The Dependence On Glasses. a process called photodisruption. Light pulses as short as one-quadrillionth of a second are used to divide material at the molecular level without any impact to the surrounding tissue. This laser is called a femtosecond laser and is made by a company called Intralase. This is a completely different laser than the laser used for vision correction, which is called an excimer laser.

The major advancement in the femtosecond laser over the metal blade is safety. During a flap creation with a metal blade, the blade runs across the surface of the eye. This leads to the potential of inadvertently causing a corneal abrasion. In addition, there is possibility that the metal blade may cause an uneven cut across the cornea, the outer layer of the eye.

The femtosecond laser addresses these potential safety issues by creating the flap in a different manner. Rather than moving across the surface of the eye, the femtosecond laser is applied from directly above the eye. This method removes the potential of creating a corneal abrasion during flap creation. As mentioned this is a major safety improvement over the conventional oscillating metal blades.

A second improvement is the accuracy of the depth of the flap. The laser is programmed to apply the laser spots at a specific depth. This fixed depth aids in calculating the amount of treatment that is safe for a particular eye. The conventional metal blades are not quite as accurate as the femtosecond laser. This means that often the actual depth of the flap made by a mechanical blade may be different than the intended depth. While this translates into small micrometer changes in the flap thickness, it may be important to a patient who has a cornea that may be too thin for their necessary treatment. In addition, it becomes quite important for the occasional retreatment that may need to be performed. The Intralase removes the variability in the flap thickness and improves the ability for delivering a safer treatment.

Some of the most devastating, but rare, complications occur when the metal blade does not perform a smooth flap creation. These complications in flap creation are contraindications for continuing the surgery, and may cause loss of vision. Certain anatomic features of the eye are felt to increase the risk of LASIK>>page 39

OCTOBER 2016 MHL

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OVERCOMING WEIGHT-LOSS PLATEAUS

As weight-loss warriors climb to the mountaintop of fitness and better health, they will inevitably cross a plateau or two in their journey.

According to Nicholas “Dr. Nick” Yphantides, M.D., M.P.H., medical spokesperson f (Take Off Pounds Sensibly), the nonprofit weight-loss support organization, “There are inevitable periods of plateau. You feel like you have changed nothing, yet the body fat no longer disappears and your weight loss seems to be stuck in neutral.

The real dilemma is that the plateau can be a huge motivation killer.”

The harm, he says, is that some people give up during a plateau and fall back into poor eating and exercise habits out of discouragement.

On a positive note, since it’s best to lose weight slowly, steadily, and sensibly, plateaus can often be a body’s balancing act. A plateau also can signal that a body has less fat left to lose.

Dr. Nick points out that real plateaus, when weight loss does in fact stall, are different from perceived plateaus, when a person is in denial and doesn’t believe they are doing anything differently, yet the weight is not coming off.

“Honesty and accuracy are such core ingredients to healthy living for members that I have to mention them, as I frequently discover what I call a ‘perceived plateau’ upon deeper interaction and conversations with people who are frustrated with their weight loss,” he says.

One cause of a true plateau is that the body is trying to achieve equilibrium, or homeostasis. In this state, the body wants to retain the status quo and not lose weight.

WEIGHT<<page 39 TREATING ALL AGES WITH A WHOLE BODY PERSPECTIVE

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ATTENTION ATHLETES AND WEEKEND WARRIORS! AT EVANS CHIROPRACTIC & PAIN RELIEF LASER CLINIC WE GET ATHLETES OF ALL SKILL LEVELS BACK IN THEIR SPORT FASTER THAN ANY OTHER CLINIC

THANKS TO OUR REVOLUTIONARY NEW PAIN RELIEF THERAPY PROGRAM We are the ONLY clinic in the region that has the combination of therapies that are critical for your most rapid recovery. First and foremost we offer the most powerful and effective Class 4 MLS Robotic Laser Therapy in the area and we have been using it extensively since 2012.

Additionally, we couple the powerful Class 4 MLS Robotic Laser Therapy with a multitude of other therapies (as indicated for each patient) which have been tried and tested in our facility for validity, reliability and effectiveness over that past 3 years. If you have had enough of your ACHING, NAGGING, STABBING that no other therapy has been able to eradicate, come on in for your Complimentary Consultation with Dr. Evans to see if our program will work for you. At Evans Chiropractic & Pain Relief Laser Clinic all of the staff is %RDUG &HUWL¿HG in their chosen specialty.

Early in her career, Dr. Evans worked as a Trainer with a professional football team and since has dedicated her career to helping athletes of ALL skill levels achieve their performance goals.

“Our patients appreciate being able to get the care they need all under one roof, it saves them so much time. And in a lot of ways. Too many people go from one therapy to another hoping for relief,” Evans said. In my experience, combining therapies increases the effectiveness of all the therapies.

To fully understand and diagnose your condition, Evans Chiropractic & Pain Relief Laser Clinic uses several approaches including:

-MLS Class IV Laser Robotic Therapy - A complete physical examination - An orthopedic examination - A neurological examination - A complete gait analysis - Acupuncture Therapy evaluation After identifying the source of your pain, Evans Chiropractic & Pain Relief Laser Clinic is proud to offer a comprehensive therapy program all under one roof! With a customized approach, patients receive a combination of the necessary treatments, which can include: - Chiropractic care - Rehabilitation exercises and therapy - Trigger Point Therapy - Electro-acupuncture

- Massage therapy including swedish, deep tissue and therapeutic - Sound Wave Therapy - Complete Nutritional Program

FAST EFFICIENT NATURAL SOLUTION TO YOUR PAIN. CALL TODAY AND STOP LIVING IN PAIN! (OL]DEHWK LV D ERDUG FHUWL¿HG PDVVDJH WKHUDSLVW ZKR JUDGXDWHG IURP /DNHVLGH 6FKRRO RI 0DVVDJH 7KHUDS\ (OL]DEHWK KDV KDG RYHU \HDUV RI experience working in spas, physical therapy clinics and private practice. Elizabeth specializes in therapeutic and deep tissue massage with the goal of decreasing client’s pain and muscle tension. It is through massage that Elizabeth became interested in acupuncture, wanting to be able to do more for her clients. Elizabeth graduated magna cum laude from Midwest College of Oriental Medicine in 2010 with a Masters of Science in Oriental Medicine and a Bachelors of Science in Nutrition. While in school Elizabeth completed an internship at Guangzhou University in China.

(OL]DEHWK KDV FRPSOHWHG OHYHO WKUHH WUDLQLQJ LQ 5LHNL DQG KDV IRXQG FRPELQLQJ WKH WZR PRGDOLWLHV H[WUHPHO\ EHQH¿FLDO LQ EDODQFLQJ KHU SDWLHQWV Qi and alleviating pain. Elizabeth has had great success decreasing patient pain with the use of electo-acupuncture. While majority of Elizabeth’s patients come to her for pain relief, she regularly treats allergies, anxiety, digestion problems, gynecological problem, insomnia, headaches and migraines.

Dr. Eliesha Evans specializes in the management and treatment of complicated chronic pain syndromes. Additionally, Dr. Evans brings more than 25 years of clinical expertise and training to each and every case thereby ensuring your best outcome. Dr. Evans and her experienced, board FHUWL¿HG VWDII XVH D ³ZKROH SHUVRQ DSSURDFK´ 7KLV DSSURDFK WR ZHOOQHVV PHDQV ORRNLQJ IRU XQGHUO\LQJ FDXVHV RI DQ\ GLVWXUEDQFH RU GLVUXSWLRQ (which may or may not be causing symptoms at the time) and make whatever interventions and lifestyle adjustments that would optimize the conditions for normal function. Using this unique approach, Dr. Evans is able to help you accelerate and/or maintain a journey to good health.

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How we carry ourselves and our posture says a lot about who we are. How hard we work, our level of security or happiness or how stressed we are. Poor posture is now noticeable in women of all ages. With all the demands women have and the list of tasks to be completed in a day, it’s no wonder why you would feel like you just ran a marathon. It feels like every muscle in your body aches and you feel drained of energy. It’s no surprise that so many of us are no longer aware of our posture and are starting to hunch already at a young age. Whether you are an executive spending long hours at the office staring at a computer screen, a salesperson spending hours on the road or a stay at home mom taking care of the home and family, these daily activities take a toll on our bodies. The primary target is the upper body, especially the back where the stress can really strike hard. Working at a computer for too long without a break to stretch once in a while can stiffen the back and neck fairly quickly.

Long hours of driving will have the same affect and also fatigues the legs muscles as well. Constantly bending to lift children or all the household tasks stress the entire back. Imbalance also occurs when placing too much weight on one side more than the other while either carrying groceries or toting around a heavy purse or laptop.

Emotional stress can physically change a body’s posture as the sympathetic nervous system, the fight or flight response engages, we stiffen up our muscles in defense and depending on the situation, we can stay locked in this compromising posture for years. Of course we can’t stop living or moving but how we choose to maintain our bodies is the key. Massage therapy can change the way you look and feel.

There are many postural imbalances that massage therapy can correct. Proper posture is shoulders relaxed, brought back so that they are in a straight line with the ears and hips. There are natural curves to the back but some are exaggerated due to imbalance. Too much of an upper back curve is referred to as hyperkyphosis and hyperlordosis for the lower back. An effective massage treatment will first address the muscle group primarily causing the dysfunction. In the case of low back pain, the center quardricep or thigh muscles, can be too tight. These are specifically postural muscles that help us to stand up straight. Once these muscles are smoothed out and relax, they start to lengthen and shift the body to a more upright position, therefore relaxing the overstretched low back muscles. Upper back pain can be due to tight pectoral or chest muscles which cause the back to roll inwards creating that hunch. This also can pull the neck and head forward as well. The neck muscles are loosened to bring the head back. The shortened pectoral muscles are treated to relax and lengthen them which brings the shoulders back. Now the back itself is treated to smooth out the knots and any remaining restricted tissue is released.

Just one massage therapy session can make you feel taller, not to mention boosting your confidence, making you feel younger, stronger and a bit lighter and happier.

For more infomation contact Active Body Wellness at 414-727-6942.

OCTOBER 2016 MHL 13

Redifning Health I’M FINE

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By Kalpana (Rose) M. Kumar, M.D. “FINE” - a four letter word that covers up feeling. This is what we say when someone asks us how we are. This is what we expect someone to say when we ask them how they are.

When someone asks me these days how I am and I don’t say ‘I’m fine’, there is visible discomfort, disorientation, confusion, and anxious laughter. (My mother died suddenly and unexpectedly, nearly five months ago). After I share that I am grieving the loss of my mother, many have asked, “still?”

All of these comments and body language are symptoms of our discomfort with pain. In fact, the basic drive that people function from is moving towards pleasure and away from pain. In Buddhism, this is seen as one of the root causes of suffering. I agree with this. Our mind naturally wants pleasure and avoids pain, but this never leads to a sense of fulfillment. These cravings are the root causes of addictions and unfulfilled feelings. Both pleasure and pain are fleeting and impermanent. In fact, when we seek to medicate our pain, particularly emotional pain, we can cover or manage it only temporarily with alcohol, shopping, television, sex, sugar, food, work, socializing, or even pharmaceutical medications. Materialism is a symptom of this drive. In fact, most of our socio-economic infrastructure is dependent upon us seeking pleasure and avoiding pain.

What would happen if we just leaned into pain rather than avoided it? What would happen if when asked how we were, rather than saying, ‘I’m fine’, we actually spoke about how we truly felt, what we were struggling with, longing for, or seeking?

Would we actually be able to hold space for one another? Would we be able to bear witness to whatever the other was feeling? What would society look like if we could do this, if we actually did this? Bearing witness to another requires courage, strength, an open heart, and a special kind of fearlessness. It requires us to do what feels counterintuitive – to not avoid pain.

Every day, when I see patients in my practice I ask them how they are. At first they say they are fine, but then, the stories of how they really are pour out of them.

People working for corporations today are not feeling ‘fine’. They are feeling undervalued, squeezed, undermined, and disregarded. They feel stressed, depressed, anxious, restless, sad, tired, and weary. They are becoming chronically ill due to the feelings they are carrying. Teachers, returning back to school from summer break are anxious, stressed (1), exhausted, and losing sleep. It’s not because they don’t want to return to teaching, but because the corporate structure of education no longer allows them to teach creatively or from a place of heart. Physicians (2) practicing medicine in corporate health care have a 100 to 400 times greater suicide rate than the general public. The incidence of alcoholism and depression (3) amongst corporate lawyers is at an all-time high. Today’s veterans are more depressed with suicide rates(4) higher than ever before.

And then we have our children. Our country’s rate of depression and anxiety in children is at an all-time high. ADD, ADHD (5), and learning disabilities are diagnosed in epidemic proportions. Our adult and child obesity rates (6) have sky-rocketed in the last decade leading to chronic diseases in unprecedented numbers. The medical system is medicating and managing these symptoms in record numbers. This is costly, and grossly ineffective. Although it is good for the Gross Domestic Product, it is awful for our individual and collective health and well-being.

So, in answer to how are we doing? - We are really not ‘fine’. We are a hurting culture.

February 2011 Note

staff

Measuring our success from a monetary standard perpetuates illusion. In fact, it is a short sighted and adolescent perspective towards life. Money has now taken over as the greatest drug we use to bring us pleasure and avoid pain. Paradoxically it has caused us more pain than ever and it has not healed our suffering. It has actually deepened it.

So, in answer to how are we doing? - We are really not ‘fine’. We are a hurting culture. We are sicker, more depressed, more stressed, and lonelier than we have ever been.

What can we do to heal this? What if the answer to healing this “dis-ease” is to This month I wanted to start things off with new and modern changes. speak the truth about how we really feel, knowing that we can count on each other Starting with the QR code. Get your cell phones out and scan the code on the to bear witness to ourenjoy suffering? if wewebsite. chooseIftoyou grow thehave courage to leanthat into front and our newWhat updated don’t the phone our pain and stop running towards pleasure?

What if we begin to practice being more scans, no problem, just go to www.modernhealthandliving.com as find even authentic about our feelingsabout towards ourselves more information healthy living. and each other? What if we decide to live from aIplace of meaning and commit ourselves topracticing love and am very pleased that you’ve decided to join us this month. healthy This is our BIG communication?

Health Awareness issue. We have packed so much up-to-date information into I believe,these if we can that make part of our spiritual wehave can something allow ourfor sufpages thisthis issue is just bursting withpractice, health! We fering to transform us and become a more heart-centered country.

I believe we will men and women of all ages. We contact local health professionals every month be happier,and healthier, and more authentic.

I believe that our authenticity can serve are thankful that many have contributed to this issue. They are keenlyas a role model for world.concerns for this region (very important). We stay in touch aware the of health And howwith amthem I doing?

I am I am with grieving hardfind forsomething the loss of so they cannot stayfine. in touch you. deep I thinkand you’ll my motherhere withthat no can endhelp in sight.

I am leaning into my process, my feelings, and my you lead a healthier life. We hope that you share this special profound sense of loss.

I have chosen to be transformed and deepened by my grief issue with friends and family, too. and will allowSpmyself the time it takes to be with it.

For those of you who can eaking of family, I try to keep mine active throughout these cold monthbear s.

My children are grateful. taking a Tae 4 times a week.

I encourage youthe witness to this, I am truly ForKwon thoseDo of class you who can’t, I urge you to find courage to to dotry so.to find something to keep your children active and social. Wheather its dance, sport or aroundyour in circles, staying active keeps I promisegymnastics, you, bearing witness to just painrunning will deepen compassion and empathy the body mind healthy developing. and make you moreand trustworthy as and a fellow traveler through life. I promise you, it To us adults with Super Sunday and myself hosting You the may monthly will deepen your sense of meaning andBowl heal your feeling of loneliness. even Bunco get together this equals food, food It’s and so important find yourself growing in wisdom and being ableand to even love more morefood. deeply authentito keep ourself active, so it might be time to get that gym membership or start cally. walking malls again.

StayM.active!!! youCEO have and a wonderful ©October 2016 the Kalpana (Rose) KumarI hope M.D., MedicalFebruary Director and willCenter touch base again in March of The Ommani for Integrative Medicine, Pewaukee, WI. Website: www.

-Amanda Lewisof Becoming Real: Reclaiming Your Health in Midlife. ommanicenter.com Author 2011, 2014 Medial Press (1)New study on teacher stress & burnout http://tmhome.com/benefits/study-onteacher-stress-and-teacher-burnout/ (2)Physician & Medical Student Depression & Suicide Prevention https://afsp. org/our-work/education/physician-medical-studentdepressionsuicide-prevention/ February 2011 EDITION (3)High rates of alcohol abuse, depression among US attorneys, study says http:// www.chicagotribune.com/business/ (4)Suicide rate of US veterans rose one third since 2001: study http://www.reuters. com/article/us-usa-veterans-suicidesidUSKCN10E2RN (5)Attention-Deficit/Hyperactivity Disorder-New Data http://www.cdc.gov/ ncbddd/adhd/data.html Lewis Media Group publishers (6)Childhood Obesity Facts http://www.cdc.gov/obesity/data/childhood.html editor graphic design

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

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Located directly on quiet shores of western Geneva Lake, The Abbey Resort’s convenient proximity to water activities has made it a long-time favorite for family getaways. Its convenient access to the variety of downtown Lake Geneva amenities, while also providing its guests some peace, quiet and respite has also made it a favorite for couples looking to retreat away together. But now with recent renovations completed on the resort’s four on-site restaurants, as well as its on-site and full-service Avani Spa, The Abbey Resort is now an ideal Midwestern getaway for groups of all kinds – from book clubs and work retreats to the more classic couple and family getaways – to enjoy any time of the year.

The adults-only indoor sunlit Atrium Pool and whirlpool at Avani, which was reopened earlier this year after renovations, provides a warm and relaxing environment to enjoy natural sunlight year-round. And its sizeable 35,000 square feet of useable space makes Avani Spa one of the largest and most complete spas in the Midwest.

Additionally, with 17 private treatment rooms, Avani Spa can easily accommodate larger groups such as bachelorette parties, book clubs or even a family reunion.

Avani Spa prides itself on offering highly customizable packages to accommodate both the type and number of attending guests, allowing groups to choose from a variety of spa experiences. For example, a mom and daughter package might include a selection of the available teen services such as a facial designed just for the teen’s sensitive skin. The Girlfriend’s Getaway package offers discounts not only on spa services, but also in the spa retail shop, the resort gift shop and even in the restaurants. A couple celebrating an anniversary or even a honeymoon could enjoy a couples’ massage as well as services designed just for gentlemen, such as a deep tissue massage or the gentleman’s facial.

A mom-to-be, visiting with either her partner on a babymoon or with a group of girls as part of a baby shower, could be truly pampered from head-to-toe with a maternity massage on a table designed to accommodate her growing belly, and a pedicure for those hard-to-reach toes.

From unique one-time gatherings to the more traditional and frequent getaways enjoyed by couples and families, The Abbey Resort and Avani Spa on Geneva Lake truly has something for guests and groups of all kinds. To learn more about the resort and spa and the amenities and services available, please visit www.theabbeyresort. com/spa.

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Warm Up to

Nutty Sunflower Seeds Lori Zanteson, Environmental Nutrition The folklore. For thousands of years, Native Americans used sunflower seeds, which originated in Mexico and Peru, for food and oil, and used the plant’s roots, stem, and flowers for medicines and dye pigment. One of the first plants cultivated in the U.S., the sunflower provides one of our favorite snacks.

The facts. Spiraled artistically inside the large flowering head of the sunflower (Helianthus annus), the many small, tubular flowers become sunflower seeds. Each plant can grow up to twelve feet with a flower diameter of one foot, and produces an average of 800 to 2,000 seeds. Thin shells of black, gray, or gray and white stripes encase gray-green or black seeds. All are edible, though black seeds are generally pressed into sunflower oil, which is rich in linoleic acid. One ounce of seeds has nearly half of the daily requirement for heart healthy vitamin E, as well as rich supplies of fiber, protein, thiamin, niacin, vitamin B6, folate, magnesium, phosphorus, copper, manganese, and selenium.

The findings. Vitamin E, an important antioxidant, protects against the oxidation of cholesterol, which can initiate atherosclerosis and lead to blocked arteries, stroke or heart attack. In fact, some studies suggest that this important nutrient may help or prevent the onset of coronary heart disease. But when it comes to vitamin E, evidence suggests that you’re better off getting it naturally in foods, such as sunflower seeds, than in supplements. Sunflower seeds are also rich in phytosterols, compounds similar to cholesterol that block the absorption of cholesterol in the intestines. This, according to the November 2009 American Journal of Clinical Nutrition, lowers LDL cholesterol levels in humans. Tiny as they are, sunflower seeds are rated among the highest sources of phytosterols, compared to other commonly consumed nuts and seeds, according to a study in the November 2005 Journal of Agriculture and Food Chemistry.

The finer points. Raw or roasted, shelled or unshelled, the sunflower seed has a huge following of snackers and cooks alike. The freshest, unshelled seeds have firm shells that aren’t broken or dirty. Avoid shelled seeds that are yellow or smell “off.”

High in oil, they are prone to rancidity, so refrigerate or freeze them in an airtight container. An easy and satisfying snack on its own, the mildly nutty sunflower seed partners well with every food group, while kicking up the nutrition. Sauté with veggies, sprinkle atop fresh fruit, fold into an omelet, or mix into ground meats, bread and cookie batters.

Free Advertising If you own a small business and can’t afford advertising, we have a solution for you. We are looking for people to deliver MHL to 10-15 places once a month in exchange for advertising space in this paper. It takes approximately 1-2 hours to make these drop offs and we will select the distribution points to be in your area.

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EN’S Own Sunflower Omelet 4 large eggs, beaten 1 tsp sunflower oil 2 Tbsp raw sunflower seed kernels ¼ cup onion, sliced ¼ cup arugula ¼ cup tomato, diced ¼ cup mushrooms, sliced 2 Tbsp basil, chopped 2 Tbsp feta cheese, crumbled Heat sunflower oil in sauté pan over medium heat, add sunflower seeds, stirring and toasting for 3 minutes. Add onions and cook 1-2 minutes longer.

Lower heat and pour in eggs, cooking until firm. Add arugula, tomato, mushrooms, and half of basil and feta cheese to one half of pan. Cook for 3-4 minutes, fold omelet in half, slide onto a plate, and garnish with basil and feta. Serves 2.

Nutrition information per serving: 251 calories, 15 grams (g) protein, 4 g carbohydrates, 19 g fat, 252 milligrams sodium, 1 g dietary fiber.

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

OCTOBER 2016 MHL 17

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With the help of two young patients with a unique neurological disorder, an initial study by scientists at the National Institutes of Health suggests that a gene called PIEZO2 controls specific aspects of human touch and proprioception, a â&#x20AC;&#x153;sixth senseâ&#x20AC;? describing awareness of oneâ&#x20AC;&#x2122;s body in space. Mutations in the gene caused the two to have movement and balance problems and the loss of some forms of touch. Despite their difficulties, they both appeared to cope with these challenges by relying heavily on vision and other senses. â&#x20AC;&#x153;Our study highlights the critical importance of PIEZO2 and the senses it controls in our daily lives,â&#x20AC;? said Carsten G. BĂśnnemann, M.D., senior investigator at the NIHâ&#x20AC;&#x2122;s National Institute of Neurological Disorders and Stroke (NINDS) and a coleader of the study published in The New England Journal of Medicine. â&#x20AC;&#x153;The results establish that PIEZO2 is a touch and proprioception gene in humans. Understanding its role in these senses may provide clues to a variety of neurological disorders.â&#x20AC;?

Dr. BĂśnnemannâ&#x20AC;&#x2122;s team uses cutting edge genetic techniques to help diagnose children around the world who have disorders that are difficult to characterize. The two patients in this study are unrelated, one nine and the other 19 years old. They have difficulties walking; hip, finger and foot deformities; and abnormally curved spines diagnosed as progressive scoliosis.

Working with the laboratory of Alexander T. Chesler, Ph.D., investigator at NIHâ&#x20AC;&#x2122;s National Center for Complementary and Integrative Health (NCCIH), the researchers discovered that the patients have mutations in the PIEZO2 gene that appear to block the normal production or activity of Piezo2 proteins in their cells. Piezo2 is what scientists call a mechanosensitive protein because it generates electrical nerve signals in response to changes in cell shape, such as when skin cells and neurons of the hand are pressed against a table. Studies in mice suggest that Piezo2 is found in the neurons that control touch and proprioception. â&#x20AC;&#x153;As someone who studies Piezo2 in mice, working with these patients was humbling,â&#x20AC;? said Dr. Chesler. â&#x20AC;&#x153;Our results suggest they are touch-blind. The patientâ&#x20AC;&#x2122;s version of Piezo2 may not work, so their neurons cannot detect touch or limb movements.â&#x20AC;?

Further examinations at the NIH Clinical Center suggested the young patients lack body awareness. Blindfolding them made walking extremely difficult, causing them to stagger and stumble from side to side while assistants prevented them from falling.

When the researchers compared the two patients with unaffected volunteers, they found that blindfolding the young patients made it harder for them to reliably reach for an object in front of their faces than it was for the volunteers. Without looking, the patients could not guess the direction their joints were being moved as well as the control subjects could.

The patients were also less sensitive to certain forms of touch. They could not feel vibrations from a buzzing tuning fork as well as the control subjects could. Nor could they tell the difference between one or two small ends of a caliper pressed firmly against their palms. Brain scans of one patient showed no response when the palm of her hand was brushed.

Nevertheless, the patients could feel other forms of touch. Stroking or brushing hairy skin is normally perceived as pleasant. Although they both felt the brushing of hairy skin, one claimed it felt prickly instead of the pleasant sensation reported by unaffected volunteers. Brain scans showed different activity patterns in response to SENSE<<page 39

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Autism diagnoses are increasIS YOUR CHILD AT RISK?

By Tracey Sparrow The Centers for Disease Control and Prevention estimates that one in every 88 children will be diagnosed with autism.

That 2012 estimate is a 23 percent increase from the CDC’s last previous calculation, when it reported that one in every 110 children would be diagnosed with the complex neurological disorder that affects boys four times more often than girls.

The reasons for the increase are not fully known, but CDC researchers believe it is due in part by a broader definition of autism, which is a spectrum of developmental disabilities, and greater efforts and skill in making a diagnosis.

“We can definitely say that 50 percent

of this increase can be accounted for by awareness,” said Mallory Walsh, the manager of field development for Autism Speaks in Wisconsin. “Pediatricians know how to look for it. But the other 50 percent, we have no idea.”

It’s a diagnosis that understandably strikes fear in the hearts of parents, as autism begins during early childhood – the average age of diagnosis is 4 -- and lasts a lifetime.

Yet parents play an integral role in ensuring a correct diagnosis is made so early intervention strategies can be employed, said Emily Levine, executive director of the Autism Society of Southeastern Wisconsin.

Walsh said parents can look for symptoms early on, even though not every child will exhibit the same symptoms.

“The key signs of autism are a delay in communication, a delay in social skills and repetitive behavior,” she said.

“The big hallmark with autism is language delay,” Levine agreed. “Even in an infant, there are red flags.”

Levine said those warning signs in-

clude an infant not meeting a parent’s gaze, or not responding to familiar voices or faces. “The big one we see is not responding to their name,” she said.

For toddlers, another symptom may be that the child won’t imitate a gesture or, instead of playing with toys, will line them up in a repetitive pattern.

“We know we can make a reliable diagnosis at 18 months,” Levine said. “By the time they’re two, if the child doesn’t make short sentences like, ‘Throw ball,’ that’s a red flag. Any time a toddler loses skills – that’s a big red flag.”

Early diagnosis is critical, both Walsh and Levine said, as intervention strategies can greatly improve the prognosis.

“We know early intervention can pay big dividends,” said Levine. “All kids learn and make progress. Our kids learn in a different way. They may need more repetition.”

Said Walsh: “When the child is still young, the brain is a sponge. Skills can be taught.”

Levine said younger children can learn to build skills in Birth to Three

programs, while older ones can receive speech and occupational therapy through their school.

Also, the Children’s Long-Term Support Waivers, offered through the state Department of Health Services, provide funding for eligible families to receive intensive in-home therapy to reduce challenging behaviors and teach new skills.

But again, early diagnosis is crucial, and Levine said parents have to be their child’s advocate.

“Moms have to be pretty assertive,” she said, as many parents who present autism symptoms to pediatricians are still told to “wait and see.” “That’s time you don’t get back.”

Tracey Sparrow is the vice president of Children’s Programs for the Milwaukee Center for Independence, serving people of all ages with special needs since 1938. For more information about MCFI’s Children’s Programs, visit www. mcfi.net or contact Tracey Sparrow at 414-937-3990 or tracey.sparrow@mcfi. net.

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OCTOBER 2016 MHL 21

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MOVING INTO A SENIOR COMMUNITY SOONER THAN LATER

Many people delay the decision to move to a retirement community due to misconceptions or fear. They often regret not making the decision to move sooner; when they were healthier, more involved, or did not realize how lonely they were and the reasons go on and on. Regret is undesirable in all times of life; retirement decisions are no different.

The many activities and daily interactions with friends and neighbors offer a dynamic and stimulating environment.

Residents freely share their thoughts about retirement living in general and the choices available to them. As you read through this article, look for the comfort, freedom and peace of mind that come from making informed choices.

“Statistics show that retirement community residents live healthier and longer lives than those living alone.” That doesn’t sound like rocket science; we need people. A resident commented, “If I knew how many of my friends lived here, I would have moved in years ago.” As one resident says, “I have to admit, it was lonely sometimes at home, now there is always something enjoyable to do.” Whether

you want to participate in all of the social activities and outings or read a good book in the quiet of your apartment, the choice is yours.

“I love telling stories and reminiscing but it’s not always easy when they’re thirty years younger than me,” remarks a resident.

A retirement community, by its very nature, allows people to interact with people their own age affording greater empathy and identification. Memories and recollections are complimented when two people can truly share the depth and breathe of events.

Somewhat tongue-in-cheek yet true, is the adage that retirement communities provide a “constant reservoir of friends.” “I never have to worry about home upkeep or shoveling again,” said a smiling resident. Now you can choose what you would like to spend time doing: cooking in your apartment, patio gardening, traveling, learning to paint or play the piano; all of the things you never felt you had time to do before. The choice is yours.

Keeping the mind, body and spirit healthy is the goal of many retirement communities. “When I moved here, it was very impressive to see how many care about my wellbeing,” a resident reported. Your choice of personal wellness goals are supported by a retirement community’s team who are all rooting for you. “Wellness programs” are growing initiatives in retirement communities to ensure balance, increased strength and awareness of changes.

Many retirement communities provide a spiritual component through pastoral visits or Sunday services that keep your hope and faith strong through all times of life.

Retirement communities offer various forms of financial protections like “life care” or “endowments” that protect your financial future regardless of your health.

A “life care” type contract also provides the potential for tax deductions for prepaid medical expenses. If you don’t feel the need for long term health care coverage, many communities offer rental programs, so again the choice is yours as to which option works best for you.

“When my wife had her stroke, it was so convenient to visit her several times a day. I couldn’t do that if I had to drive each way,” commented a resident. Should a care need arise, retirement communities can provide professional and caring services, all in the comfort of your “community.”

The choice is yours regarding your lifestyle and many elements need to be considered in making your decision. Should you decide that a retirement community is right for you, there are many elements, such as the ones listed here, that need to be considered and weighed, so that you can feel confident about your choice.

OCTOBER 2016 MHL 23

24 MHL OCTOBER 2016

HOW TO CHOOSE A LONG-TERM CARE SOLUTION So how do you go about the search intelligently?

Think about it before you need it!

Marlene Heller When I was young, people talked about being packed off to the “old folk’s home” or sent to a “nursing home” when they were too old and frail to live on their own.

Terminology isn’t all that has changed since then. Technology, regulations, and the education of our professionals have all contributed to our ability to care for aging parents and resulted in a variety of choices in the older adult market.

Complicating the choice of a skilled nursing facility, or SNF, can be the need to do so on short notice. Quite often, trauma is the finger pointing the way to a decision.

It is accompanied by stress, and leaves behind clarity and careful planning. Families or an aging spouse who have to make a decision in a hurry are usually under the pressure of expediency and more likely to make a decision based on insurance and location alone, not knowing what other things they should be looking for at such an important juncture.

So how do you go about the search intelligently? Think about it before you need it! When you move into a new neighborhood, you look for schools and hospitals. You should do a similar assessment of the eldercare facilities and rehabs before your family needs them. Take a “just in case” tour of the ones that look the most interesting to you as your family begins to age, and take note of the things that matter most to you; the smells and the aesthetics, the friendliness of the staff and the way you were greeted at the door, etc.

Ask to see an activity calendar, and observe some of the activities if you can. Are there engaged staff and, perhaps, volunteers assisting the residents at the activity?

Are the activities diverse and interesting, or is it the same old bingo and current events every day? Do residents get to do hands-on projects or just listen?

The clinical details, of course, are the most important. You want to know who is in charge. Is there a medical director on staff? What is that person’s specialty? You want to know that the residents are being cared for by caring and compassionate staff with proven tenure and engagement. Will your loved ones have registered nurses taking care of them, or LPNs, who collect data and then need to wait for an RN to do the assessments?

At the Jewish Home and Care Center in Milwaukee, a gerontologist is the medical director and he can be reached 24/7. Seasoned CNAs and RNs staff all the floors and many have impressive specialties, making their ability to care for residents with critical needs unique.

Some residences mix their rehab or post-acute patients (who are there to continue their recovery after a hospital stay) in amongst their long-term residents. Others, such as the Jewish Home and Care Center in Milwaukee have dedicated floors to short-term rehab. At the Sarah Chudnow Community in Mequon, short-term rehab is a separate area, with its own dining space, nursing station and lounge areas.

You will also want to know a little bit about the organization’s philosophies towards care. Are they “person centered?” Do they care about research and education for their staff and their residents? Is there research going on within the organization that will benefit the residents? Is there a continuing quality assurance plan in place?

Do they enhance the lives of residents through meaningful activities and events in a warm, safe and pleasing environment?

Once you are armed with information about the skilled nursing residences that appeal to you, you will be ready to make a decision more quickly and appropriately when the time arises. At that time, the questions will revolve around “who takes our insurance?” and “who has an available bed?” You most likely won’t have the time to worry about all the other details.

Go forth with the confidence of knowing what you’re dealing with.

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OCTOBER 2016 MHL 25

SAD AFFECTS MANY PEOPLE IN NORTHERN LATITUDES IN FALL & WINTER

SEASONAL AFFECTIVE DISORDER “SAD may be the first psychiatric disorder in which a physiological marker correlates with symptom severity before, and in the course of, treatment in the same patients,” Most Seasonal Affective Disorder (SAD) symptoms stem from daily body rhythms that have gone out-of-sync with the sun, a NIMH-funded study has found.

The researchers propose that most patients will respond best to a low dose of the light-sensitive hormone melatonin in the afternoon in addition to bright light in the morning. Rhythms that have lost their bearings due to winter’s late dawn and early dusk accounted for 65 percent of SAD symptoms; re-aligning them explained 35 percent of melatonin’s antidepressant effect in patients with delayed rhythms, the most common form of SAD, report NIMH grantee Alfred Lewy, M.D., Ph.D., and colleagues at the Oregon Health & Science University, online, April 28, 2006, in the

Proceedings of the National Academy of Sciences.

SAD affects many people in northern latitudes in winter, especially young women, and is usually treated with bright light in the morning. The pineal gland, located in the middle of the brain, responds to darkness by secreting melatonin, which re-sets the brain’s central clock and helps the light/dark cycle re-set the sleep/wake cycle and other daily rhythms. Lewy and colleagues pinpointed how rhythms go astray in SAD and how they can be re-set by taking melatonin supplements at the right time of day. The findings strengthen the case for daily rhythm mismatches as the cause of SAD. The researchers tracked sleep, activity levels, melatonin rhythms and depression symptoms of 68 SAD patients who took either low doses of melatonin or a placebo in the morning or afternoon for a winter month when they were most symptomatic.

They had determined from healthy subjects that a person’s rhythms are synchronized when the interval between the time the pineal gland begins secreting melatonin and the middle of sleep is about 6 hours.

Seventy-one percent of the SAD patients had intervals shorter than 6 hours, indicating that their rhythms were delayed due to the later winter dawn. Taking melatonin capsules in the afternoon lengthened their intervals, bringing their rhythms back toward normal. The closer their intervals approached the ideal 6 hours, the more their mood improved on depression rating scales, supporting the hypothesized link between out-of-sync rhythms and SAD. “SAD may be the first psychiatric disorder in which a physiological marker correlates with symptom severity before, and in the course of, treatment in the same patients,” explained Lewy, referring to patients’ rhythm shifts towards the 6 hour interval in response to melatonin.

Taking melatonin at the correct time of day — afternoon for patients with short intervals and morning for the 29 percent of patients with long intervals — more than doubled their improvement in depression scores, compared to taking a placebo or the hormone at the incorrect time. While the study was not designed to test the efficacy of melatonin treatment, the researchers suggest that its clinical benefit “appears to be substantial, although not as robust as light treatment.” They propose that the 6-hour interval index may be useful for analyzing the circadian components of non-seasonal depression and other sleep and psychiatric disorders.

Also participating in the study were: Bryan Lefler, Jonathan Emens, Oregon Health and Science University, and Vance Bauer, Kaiser Permanente Northwest Center for Health Research.

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By Cheryl L. Dejewski and Carolyn Vescio There are two things 76 year-old Mary Ann Snedigar never misses—her appointments with Dr. Brett Rhode at Eye Care Specialists and her grandson’s basketball games. Snedigar, who was diagnosed 15 years ago with wet macular degeneration in her left eye, was one of Rhode’s first patients to receive injection treatments starting in 2007.

“Age-related macular degeneration, or AMD, is a condition in which the macula, a tiny (about the size of this “O”), highly sensitive area of the retina responsible for central and detail vision, is damaged. There are two forms of AMD. Both cause loss of central or straight-ahead vision (as needed for driving, reading, and recognizing faces) but, fortunately, not side vision,” explains Rhode, who is also Head of Ophthalmology at Aurora Sinai Medical Center. “’Dry’ AMD is more common (90% of cases), progresses slowly, and is caused by a thinning of macular tissue. Many dry AMD patients retain good sight throughout life; others may need to use magnifiers and aids.

‘Wet’ AMD is less common, can progress quickly, and is marked by the growth of abnormal new blood vessels under the macula, which can leak fluid and blood.

This leakage can create scar tissue which causes blind spots and profound loss of central vision. The earlier it is detected, the better the chances of preserving vision.

Without treatment, about 70% of wet AMD patients become legally blind within two years.”

Ophthalmologist Daniel Ferguson, MD, a partner at Eye Care Specialists, where thousands of AMD patients are diagnosed and treated each year, explains, “If we detect dry AMD, we often recommend vitamin supplements, healthy omega fatty acid intake, sun protection, and avoidance of smoking, as measures to prevent or slow progression. If wet AMD is diagnosed, we review the risks, benefits and candidacy for injections of special medications (Avastin, Eyelea or Lucentis) that inhibit growth of the abnormal blood vessels that cause wet AMD.” He adds, “Although there are NO guarantees, we have seen remarkable results. With regular injections (about every

4-8 weeks), we are able to stop the progression of wet AMD in 90% of our patients and even have up to 30% gain improvement in vision.” (Injections are also used to treat diabetes-related vision damage.)

“I always go 32-36 days between injections. If I wait longer, my vision starts slipping,” reports Snedigar, who says she usually notices improved vision within one to two days after treatment. Her strict appointment schedule has paid off over the years, as she maintains visual acuity near 20/40 .

There are two things 76 year-old Mary Ann Snedigar never misses—her appointments with Dr. Brett Rhode at Eye Care Specialists and her grandson’s basketball games. Snedigar, who was diagnosed 15 years ago with wet macular degeneration in her left eye, was one of Rhode’s first patients to receive injection treatments starting in 2007.

“Age-related macular degeneration, or AMD, is a condition in which the macula, a tiny (about the size of this “O”), highly sensitive area of the retina responsible for central and detail vision, is damaged. There are two forms of AMD. Both cause loss of central or straight-ahead vision (as needed for driving, reading, and recognizing faces) but, fortunately, not side vision,” explains Rhode, who is also Head of Ophthalmology at Aurora Sinai Medical Center. “’Dry’ AMD is more common (90% of cases), progresses slowly, and is caused by a thinning of macular tissue. Many dry AMD patients retain good sight throughout life; others may need to use magnifiers and aids. ‘Wet’ AMD is less common, can progress quickly, and is marked by the growth of abnormal new blood vessels under the macula, which can leak fluid and blood. This leakage can create scar tissue which causes blind spots and profound loss of central vision. The earlier it is detected, the better the chances of preserving vision. Without treatment, about 70% of wet AMD patients become legally blind within two years.”

Ophthalmologist Daniel Ferguson, MD, a partner at Eye Care Specialists, where thousands of AMD patients are diagnosed and treated each year, explains, “If we detect dry AMD, we often recommend vitamin supplements, healthy omega fatty acid intake, sun protection, and avoidance of smoking, as measures to prevent or slow progression. If wet AMD is diagnosed, we review the risks, benefits and candidacy for injections of special medications (Avastin, Eyelea or Lucentis) that inhibit growth of the abnormal blood vessels that cause wet AMD.” He adds, “Although there are NO guarantees, we have seen remarkable results. With regular injections (about every 4-8 weeks), we are able to stop the progression of wet AMD in 90% of our patients and even have up to 30% gain improvement in vision.”

(Injections are also used to treat diabetes-related vision damage.)

“I always go 32-36 days between injections. If I wait longer, my vision starts slipping,” reports Snedigar, who says she usually notices improved vision within one to two days after treatment. Her strict appointment schedule has paid off over the years, as she maintains visual acuity near 20/40 in her left eye, despite the AMD. “I’m also very careful,” explains Snedigar. “My husband of 57 years and I own a lake cottage, and I always wear a hat with a visor and sunglasses.”

“Although the exact cause of AMD is unknown, aging and genetics are the main culprits. Other factors include: being female; being white; sun exposure; smoking (raises risk 3-4 times); circulatory problems; light eye color; and a diet high in fat and low in vitamins, minerals and antioxidants,” explains Mark Freedman, MD, a leading local eye surgeon, continuing education lecturer, and partner at Eye Care Specialists.

“Sight-robbing conditions, like AMD, often develop gradually and painlessly, and good vision in one eye can mask problems in the other. As AMD progresses, however, signs may become obvious. If you notice a problem with your vision (especially straight lines appearing wavy; blind or dark spots; and/or blurriness of faces, clocks and printed words) don’t ignore it. Call your eye care specialist immediately,” explains Daniel Paskowitz, MD, PhD, an ophthalmologist with credentials from Harvard and Johns Hopkins. “Don’t assume you simply need new glasses and then wait to make an appointment. A professional eye exam is the only way to accurately detect eye diseases. People age 40-64 should have a thorough dilated eye exam every 2-4 years and every 1-2 years after age 65 to check for AMD and other conditions.”

In addition to maintaining an exemplary eye and health regimen, Snedigar, is very focused about spending time with her three children and five grandchildren. “I have a grandson who plays basketball for Concordia University, and I never miss his games. I even plan my injection treatments around his games!”

Snedigar’s outlook on life is inspiring—whether you have AMD or not. She counsels, “There are worse things than macular degeneration. You have to learn to deal with what you’re given, and you have to be positive about everything in your life. It’s nothing to be depressed about.”

Free educational booklets & information Eye Care Specialists’ doctors are dedicated to the diagnosis and treatment of AMD, glaucoma, diabetic eye disease, and cataracts. They frequently lecture to the public and fellow physicians and have written their own series of booklets on these conditions. Call 414-321-7035 for FREE copies or to schedule an appointment for a thorough eye screening (usually covered by insurance or Medicare) at their offices on 7th & Wisconsin Avenue, Mayfair Road across from the mall, or 102nd & National Ave. They also offer information at www.eyecarespecialists.net.

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REDUCING DISEASE AND DISABILITY About 79 percent of people age 70 and older have at least one of these seven potentially disabling chronic conditions—arthritis, hypertension, heart disease, diabetes, respiratory diseases, stroke, and cancer.9 Other chronic conditions can compromise the health and quality of life of older Americans, as well; for example, a recent study found that 11 percent of U.S. men and 10.2 percent of U.S. women over age 65, and fully 20 percent of Americans over age 85, have anemia. This condition, while usually treatable, is often under-diagnosed and can be associated with a number of adverse health outcomes.10 The burden of such chronic conditions is felt not only by individuals, but also by families, employers, and the health care system. Research to improve understanding of the risk and protective factors for chronic disease and disability can lead to the development of effective prevention strategies.

Treatment and Prevention of Disease An Asthma Drug Improves Heart Function and Prevents Further Damage in Rats With Heart Disease. The β-adrenoreceptors (β-ARs) receive and react to nerve impulses in certain tissues throughout the body. In the heart, there are at least three types of β-AR, each found primarily in a different type of cardiac tissue and each causing different effects when activated. Suppression of β1-adrenoreceptors through the use of “beta blockers” is a standard treatment for congestive heart failure, which currently affects around five million Americans,11 while drugs that stimulate β2ARs act as vasodilators and are commonly used in asthma inhalers. In addition, laboratory studies have shown that continuous stimulation of β2-ARs protects heart cells from premature death.

NIH researchers have achieved promising results using a β2-AR stimulator in a rat model of heart disease. After inducing heart attacks in rats, they treated one group with a beta blocker, metaprolol, while additional groups received continuous treatment with one of two β2-AR stimulators, either fenoterol or zinterol. A final (control) group received no treatment. After six weeks, the rats’ heart function was assessed and heart tissue was examined. The researchers found that the β2-AR stimulators were more effective than metaprolol in preventing further cell damage and death.

In addition, treatment with fenoterol or zinterol, unlike metaprolol, was actually associated with improved heart function in the diseased rats. These results suggest that β2-AR stimulators, already widely in use for the treatment of pulmonary disease, may also be effective in the treatment of congestive heart failure.

Extended Outpatient Rehabilitation improves independence after hip fracture. Hip fractures are common in the elderly and can have a devastating impact on the ability of older patients to remain independent. Despite standard rehabilitation, up to threefourths of patients with hip fractures fail to regain their walking ability or functional status within six to twelve months of surgery. To determine whether additional rehabilitation would improve function following hip fracture in frail elders, researchers conducted a randomized controlled trial comparing extended outpatient rehabilitation that included resistance training, to the usual program of low intensity home exercise following surgery to repair a hip fracture. Men and women 65 years or older with a recent hip fracture (within 16 weeks of repair) were randomly assigned to either supervised physical therapy with whole-body progressive resistance exercise training or to a control group doing home exercise focusing primarily on flexibility.

The outcome measures included physical performance tests, measures of functional 30 MHL OCTOBER 2016

status, and activities of daily living (ADL) over six months. Changes in physical performance and functional status over time were significantly better for the intervention group compared to the control group: patients in the intervention group showed greater improvements in muscle strength, walking speed, and balance than patients in the control group. These results indicate that extended outpatient rehabilitation with progressive resistance training improves physical function and mobility among frail elderly hip fracture patients. Compared to usual care for this patient population, this program promotes better return to prefracture function, reduces disability, and improves quality of life.

Early-Life Determinants of Late-Life Health A number of studies have investigated early-life determinants of later life health.

For example, researchers have investigated the association of high blood pressure (BP) and hippocampal atrophy (HA) among Japanese-American men participating in the longitudinal community-based Honolulu Asia Aging Study (HAAS). The hippocampus is an area of the brain that is critical to learning and memory, and is vulnerable to vascular damage. The investigators found that men who had had high midlife BP, but had never been treated, had an increased risk for Elevated Levels of later HA compared with never treated men with normal midlife BP. In another study, Homocysteine May be researchers studying a cohort of young and an Important but middle-aged adults from a semirural black and community in BoModifiable Risk Factor white galusa, Louisiana, examined the association between carotid wall for Osteoporosis. thickness and traditional cardiovascular risk factors measured since childhood. Increased arterial stiffness is a known predictor of cardiovascular-related diseases and death at middle and older ages, and carotid artery wall thickness is associated with cardiovascular risk factors and predicts atherosclerosis in middle- and older aged adults. They found that measures of LDL (“bad”) cholesterol and relative weight in childhood predicted carotid wall thickness in the adults, and that childhood blood pressure was a consistent predictor of arterial stiffness in adulthood. Recent research has pointed to a number of early life conditions that have far-reaching associations with a range of chronic conditions, including exposure to adverse conditions in utero, infectious diseases and environmental toxins, nutritional deficits, childhood poverty and stressful family conditions.

Earlier identification of risk factors that are associated with diseases that manifest later in life could lead to the development of earlier and better preventive strategies.

Elevated Levels of Homocysteine May be an Important but Modifiable Risk Factor for Osteoporosis. To test the hypothesis that increased blood homocysteine levels may be a risk factor for osteoporosis, the relationship between circulating homocysteine levels and later hip fractures was evaluated in 825 men and 1174 women, ranging in age from 59 to 91 years, from whom blood samples had been obtained years earlier.

After a followup of 12.3 years for men and 15.0 years for women, there was a significantly greater risk of hip fracture for both men and women with high homocysteine compared to those with low levels—risk was increased in men and women by a factor of 4 and 1.9 respectively. Because homocysteine levels can be modified by diets or vitamin supplements with sufficient levels of vitamins such as folic acid, B6 and B12, such dietary strategies could re-

duce the burden of hip fractures in older individuals.

Importance of Walking for Maintaining Mobility. In a recent study of community-dwelling women enrolled in the Women’s Health and Aging Study, investigators found that functionally limited women ages 65 and older, who walked at least eight blocks per week outside their homes, were better able to maintain their functional capacity and walking ability than women who walked less or did not get out the door at all. This effect is independent of initial functional capacity, disease profile, health-related behaviors, and psychological and social-demographic factors. These results provide strong evidence that even a small amount of regular walking can help to maintain mobility.

Appetite and the Immune System: A New Model. Loss of appetite and decreased food intake are common among the seriously ill. Appetite regulation is complex and involves a number of factors; for example, appetite is suppressed by leptin, a protein found in fat cells, but stimulated by ghrelin, a recently identified hormone produced by stomach cells. There is also increasing evidence that the immune system is involved, with immune-based proteins known as inflammatory cytokines acting on the nervous system to control appetite. NIH researchers have recently found that, in addition to stomach cells, ghrelin is produced in certain immune cells, along with its receptor protein, GHS-R. When ghrelin binds to GHS-R, the result is inhibition of inflammatory cytokines associated with appetite loss. They further found that leptin increases cytokine activity, while also spurring increased expression of GHS-R by Tlymphocytes, a different type of immune cell. These findings provide a model of how ghrelin and leptin work together to control immune cell activation and inflammation with regard to the appetite, and also suggest that drugs that stimulate ghrelin/GHS-R may be useful in the management of wasting associated with chronic disease. v1_new health ad 4.75x3.qxp

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AEROBIC ROUTINES FOR HEALTHY LIVING Most doctors recommend trying to get about 30 minutes of physical activity five times a week.

Getting regular exercise is one of the keys to staying healthy, and cardiovascular fitness is especially important because it can help prevent heart disease. Regular aerobic exercise is vital for everyone, including seniors – the National Institute on Aging noted that regular exercise can improve balance, delay or prevent osteoporosis and diabetes and improve mental health. Most doctors recommend trying to get about 30 minutes of physical activity five times a week. Read on for exercise tips and examples of great aerobic routines for seniors: Speak to your doctor and start slow Before you get started breaking a sweat, meet with your health care professional and ask about starting a new exercise regimen. Your doctor may suggest that you start slowly, perhaps by doing a five-minute cardio workout each day. From there, you’ll be able to work your way up to 30-minute routines.

Make aerobic exercise fun You’ll be more likely to stick with a new routine if you genuinely enjoy it. Thankfully, there are many ways to exercise that don’t involve going to the gym. For example, you could go for a brisk walk around the neighborhood or in a local park.

During the hot summer months, you can even head to the local mall and take a few laps in the air conditioning. Now is also a great time to pick up activities you’ve en-

joyed previously such as swimming or tennis. Swimming, for instance, is easier on your joints yet works out almost every muscle in your body and can really get your heart pumping! Tennis and other low-impact sports are fun to play with your friends, which will keep you more engaged with the activity.

Take a class If you’d rather work out with a group and get assistance from a professional at the same time, consider taking a class a your local gym or community center. LiveStrong recommended finding a water aerobics class near you because it can have a strong physical impact. Avid cyclists might consider a spin class. Those who prefer one-onone support might benefit from enlisting the help of a personal trainer at the gym. If you’re undecided, try out a few classes to see what you like – you might be surprised by how much fun exercising can actually be!

No matter what form of exercise you decide on, always remember to warm up and cool down. In a class, this will be part of the structure. On your own, you can jog a bit to warm up, walk to cool down and stretch to stay limber and avoid painful aches.

Check in with your doctor to make sure you’re on track with your fitness goals and exercising safely.

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WHAT CAN I DO TO PREVENT HEART DISEASE? There are a lot of steps you can take to keep your heart healthy.

Try to be more physically active. Talk with your doctor about the type of activities that would be best for you. If possible, aim to get at least 30 minutes of moderate-intensity activity on most or all days of the week. Every day is best. It doesn’t have to be done all at once—10-minute periods will do. Start by doing activities you enjoy—brisk walking, dancing, bowling, bicycling, or gardening, for example. See For More Information to find out how to contact Go4Life®, an exercise and physical activity campaign from the National Institute on Aging (NIA) at NIH. Go4Life is designed to help you fit exercise and physical activity into your daily life.

If you smoke, quit. Smoking adds to the damage to artery walls. It’s never too late to get some benefit from quitting smoking. Quitting, even in later life, can over time, lower your risk of heart disease and cancer.

Cholesterol Cholesterol is a type of fat in some foods. Eating fatty foods can raise the choles-

terol in your blood. High blood cholesterol levels could add to the plaque in your arteries. Your doctor can check the cholesterol in your blood with a blood test. This will tell you your overall or total cholesterol level as well as the LDLs (“bad” cholestrol), HDLs (“healthy” cholesterol), and triglycerides (another type of fat in the blood that puts you at risk for heart problems.)

Follow a heart-healthy diet. Choose low-fat foods and those that are low in salt.

Eat plenty of fruits, vegetables, and foods high in fiber like those made from whole grains. And if you drink alcohol, men should not have more than two drinks a day and women only one. Get more tips in NIA’s booklet, What’s On Your Plate? Smart Food Choices for Healthy Aging. The National Heart, Lung, and Blood Institute (NHLBI) has information on two eating plans— Therapeutic Lifestyle Changes (TLC) and Dietary Approaches to Stop Hypertension (DASH). See For More Information to learn how to contact NIA and NHLBI. Keep a healthy weight. Your healthcare provider will probably check your weight and height to learn your BMI (body mass index). A BMI of 25 or higher means you are at greater risk for heart disease as well as diabetes (high blood sugar) and other health conditions. Extra fat around the middle of your body may increase your risk of heart disease. A man’s risk of heart disease is increased if his waist measures more than 40 inches. A woman’s risk is increased at 35 inches. Following a healthy eating plan and being physically active might help you.

Questions to Ask Your Doctor The National Heart, Lung, and Blood Institute suggests you ask your doctor the following questions to learn more about your risk for heart disease and what to do about it. Be sure to ask what you can do if you are told you are at increased risk or already have a heart problem.

What is my risk for heart disease?

What is my blood pressure?

What are my cholesterol numbers? (These include total cholesterol, LDL, HDL, and triglycerides.)

What are my body mass index (BMI) and waist measurement? Do they mean that I need to lose weight for my health?

What is my blood sugar level, and does it mean that I’m at risk for diabetes?

What other screening tests do I need to help protect my heart?

What can you do to help me quit smoking?

How much physical activity do I need to help protect my heart?

What’s a heart-healthy eating plan for me?

How can I tell if I’m having a heart attack? If I think I’m having one, what should I do?

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ANNOUNCING THE 10TH ANNIVERSARY OF THE CARING FOR THE CAREGIVER CONFERENCE The 10th Annual Caring for the Caregiver Conference, an event dedicated to supporting family and professional caregivers, will be on Dec. 3 from 9 a.m. to 4 p.m. at the Marquette University Alumni Memorial Union.

The event will feature an outstanding keynote from the former Director of the Milwaukee County Department on Aging, Stephanie Sue Stein, titled “Caregiving: Valuing the Invaluable.” In addition to a gourmet lunch, door prizes and a supportive environment with other caregivers, attendees can choose to participate in workshops, ranging in topics from Alzheimer’s disease, mental health, art therapy, senior financial planning and more. Caregivers will also have access to resource specialists, community information booths, and consultation time with experts from the Alzheimer’s Association, Parkinson’s Association, elder law attorneys, and more.

“This year’s event theme, ‘Silver Linings,’ encourages caregivers to always consider the positive impact they have on those they care for, while reminding them that caring for themselves is equally as important,” said Rachel Olson, Interfaith Older Adult Programs’ Director of Family Caregiver Support.

Registration is now open and costs $15 per person. Caregivers can register online at interfaithmilw.org/caregiverconference16, or by calling (414) 220-8600. Scholarships or reimbursement for respite care may be available: please call to learn more.

Sponsorships are also available for the conference. All sponsors who contribute $250 or more will receive a display table and advertising in event materials. Call (414) 220-8600 to learn more about sponsorships.

Interfaith organizes the conference, in collaboration with: the Alzheimer’s Association of Southeastern Wisconsin, Aurora Health Care, Crossroads Care Center, Golden Living – Heritage Square, IndependenceFirst, Marquette University, New Health Services, Seasons Hospice, St. Camillus, the VA Medical Center, VITAS Innovative Hospice, and other legal coordinators.

About Interfaith Older Adult Programs: Since 1975, Interfaith responds to the current physical and social challenges of aging by providing innovative programs, successful solutions, and the often much needed extra helping hand. Learn more at www.interfaithmilw.org.

OCTOBER 2016 MHL 35

PEOPLE AT GENETIC RISK FOR ALZHEIMER’S DISEASE TO TEST PREVENTION DRUGS The two biggest risk factors for late-onset Alzheimer’s disease—age and carrying a risk gene—can’t be changed. But what if people could do something to counteract those risks and possibly tip the balance in their favor? A groundbreaking clinical trial aims to find out if two experimental drugs can prevent or delay dementia in people at high genetic risk for developing the disorder.

The Alzheimer’s Prevention Initiative’s (API) Generation Study is studying cognitively normal older adults with two copies of the APOE ɛ4 gene. People with two copies of this risk-factor gene are more likely than not to develop late-onset Alzheimer’s, the most common form of the brain disorder, which so far has no cure.

A growing number of trials are testing promising therapies that may prevent or delay memory loss and other symptoms of Alzheimer’s in the most vulnerable people. The drugs being tested in A4, DIAN, API’s Autosomal Dominant Alzheimer’s Disease trial and now Generation are designed to attack beta-amyloid, a protein that plays a key role in the brain changes that lead to Alzheimer’s dementia.

Supported by a public-private partnership, with $33.2 million from the National Institute on Aging (NIA), part of the National Institutes of Health, the Generation Study will be conducted at about 90 sites in North America, Europe, and Australia, about half of them in the United States. The research team plans to enroll 1,340 cognitively normal adults, age 60 to 75, who will be randomly assigned to take either a test drug or a placebo for at least 5 years.

The NIA-supported Banner Alzheimer’s Institute (BAI), based in Phoenix, Ariz., is running the trial with Novartis Pharmaceuticals, which is providing the drugs to be tested, CAD106 and CNP520, and Amgen, which helped develop CNP520.

Attacking an early Alzheimer’s culprit The failure of past anti-amyloid drugs to stop Alzheimer’s in people with mild to moderate dementia has led researchers to test some of the same drugs, and new ones, earlier in the disease process, when therapies might be most effective at altering the course of the disease.

In a handful of prevention trials, experimental therapies are being tested in symptom-free people who, because of their age, genes, or amyloid levels in the brain, are most likely to develop Alzheimer’s disease—sooner rather than later.

“The results of this and our other prevention trials will help us learn whether and how anti-amyloid therapies can slow or perhaps prevent cognitive decline in individuals who are most likely to develop Alzheimer’s disease,” said Laurie Ryan, Ph.D., chief of the Dementias of Aging branch at NIA’s Division of Neuroscience.

“We’ll also gain valuable biomarker data that will be shared with the wider scientific community.”

She added, “The ultimate goal is to find a way to block Alzheimer’s damage in the brain at the earliest possible point, long before symptoms appear, and to prevent a disease that burdens more than 5 million Americans and many more around the world.”

Zeroing in on uncommon genetic risk factors The Generation Study seeks people who have inherited two copies of a specific form of the apolipoprotein E (APOE) gene, called APOE ɛ4. APOE, which helps transport cholesterol and other fats in the bloodstream, has three forms. About 25 percent of people carry one copy of the APOE ɛ4 gene, which increases the likelihood of developing late-onset Alzheimer’s and is associated with an earlier age of onset.

About 2 to 3 percent of the world’s population has two copies of APOE ɛ4. Studies show that up to 60 percent of them will develop Alzheimer’s dementia by age 85, compared with 10 to 15 percent of the general population. However, some people with an APOE ε4 allele never get the disease, and others who develop Alzheimer’s do not have any APOE ε4 alleles.

36 MHL OCTOBER 2016

API’s prevention trial in Colombia involves a different genetic risk. It is studying 300 cognitively normal adults who are at high risk of developing a rare, inherited type of early-onset Alzheimer’s that can begin in people in their 30s.

The Generation and Colombia trials share an ambitious goal: to determine whether data collected from brain scans and cerebrospinal fluid measurements can predict clinical benefit. The hope is that these measurements could be used to quickly test prevention therapies in a much larger segment of the population.

“We have to find that sweet spot between starting early enough before Alzheimer’s pathology develops and yet late enough so that there’s enough decline over the next few years to see if the treatments actually work,” said Eric Reiman, M.D., executive director of BAI and one of API’s leaders.

“Our goal is to help individuals at the highest imminent risk in a way that helps everyone at risk for Alzheimer’s, and to do so as soon as possible,” he added.

Thousands of volunteers needed Banner scientists expect to screen about 80,000 people to find enough participants for the Generation Study. “People with a family history of Alzheimer’s are good potential volunteers for this study because they may carry the APOE ε4 gene,” said Jessica Langbaum, Ph.D., a BAI scientist and associate director of API. “We need more people to join to fight this devastating disease.”

To speed the process for this and other studies, Banner started GeneMatch, a registry that will collect genetic information from adults age 55 to 75 living in the United States. GeneMatch’s genetic testing will allow researchers to match potential volunteers with and without the APOE ε4 gene for this and other studies. (See below for more information about GeneMatch.)

Testing two new drugs The two drugs being tested in Generation, CAD106 and CNP520, attack betaamyloid in different ways. If the brain produces too much beta-amyloid or does not clear it fast enough, it clumps together into the plaques found in Alzheimer’s. Over time, these plaques damage and destroy nerve cells throughout the brain, leading to problems with memory, reasoning, and other cognitive functions.

CAD106 is an active immunotherapy designed to trigger the body’s immune system to produce antibodies that attack different forms of amyloid. This secondgeneration drug does not have the brain-inflammation side effect found with some first-generation immunotherapies, said Dr. Pierre Tariot, M.D., one of API’s leaders and director of BAI. CNP520 inhibits beta-secretase, an enzyme that helps turn a normal protein into harmful beta-amyloid. “The idea is to block production of pathological amyloid,” Dr. Tariot said.

Researchers will determine if either of the drugs leads to changes in overall cognition and how long it takes participants to be diagnosed with mild cognitive impairment (a condition that often precedes Alzheimer’s) or dementia. The drugs’ safety and side effects will also be assessed.

In addition, investigators will gather biomarker data to compare to results of cognitive tests. Participants will undergo brain scans to measure the accumulation of amyloid plaques and tau tangles, as well as declines in brain size and energy utilization that are associated with Alzheimer’s. They will also have lumbar punctures to measure Alzheimer’s-related proteins in cerebrospinal fluid.

“The hope is that we will be able to relate biomarkers to treatment benefit,” Dr. Reiman said. “To what extent does a biomarker move in response to treatment? Can we show a biomarker effect at 2 years that will predict [a change in cognition] at 5 years?”

Other Alzheimer’s prevention trials API’s Generation and Colombia trials are among the first Alzheimer’s prevention

trials. Others supported by NIA include: Anti-Amyloid Treatment in Asymptomatic Alzheimer’s Disease (A4 Study)— testing the drug solanezumab in cognitively normal adults age 65 to 85 with elevated brain amyloid levels detected by imaging, who are at risk for late-onset Alzheimer’s Dominantly Inherited Alzheimer Network Trial (DIAN)—testing the drugs gantenerumab and solanezumab in people age 18 to 80 with a genetic mutation for earlyonset Alzheimer’s or who have a parent or sibling with such a mutation To learn more about Generation, visit www.generationstudy.com. For more information about finding and participating in clinical trials, visit the Alzheimer’s Disease Education and Referral (ADEAR) Center, or call 1-800-438-4380.

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OCTOBER 2016 MHL 37

Autumn Offers

LESSONS FOR RETIREMENT

By Karyl Richson Social Security Public Affairs Specialist in Milwaukee, WI In autumn, animals know winter is coming and take the steps to prepare. Bears grow thicker fur and settle in for peaceful hibernation. Squirrels collect and store acorns and other nuts. Birds, favoring warmer weather and having the means to make it possible, fly south for the winter.

When it comes to preparing for retirement, we can learn from the animals -- making sure the transition into the later years of our lives is as smooth and comfortable as possible. The best place to start is a visit to www.socialsecurity.gov.

You can get an instant, personalized estimate of your future Social Security benefits at www.socialsecurity.gov/estimator.

To prepare for a comfortable retirement, you should start saving as early as possible. Social Security is the foundation for a secure retirement, but was never meant to be the sole-source of income for retirees. In addition to Social Security, you also will need savings, investments, pensions or retirement accounts to make sure you have enough money to live comfortably when you retire. Learn about retirement planning and how to save at www.socialsecurity.gov/retire2/other2.htm. But wait, there’s more.

If you decide you’re going to be a “snowbird” when retirement comes, and go to warmer climates during winter weather, make sure that your Social Security payment goes with you. The best way to do that is to use direct deposit. You never have to worry about where your monthly payment will be delivered — it will show up in your bank account whether you’re in the Dakotas or the Florida Keys. Learn all about electronic payments at www.socialsecurity.gov/deposit.

Whether you’re in the spring, summer, or entering the autumn of your life, the best time to start preparing for retirement is always the present. A good place to start is at www.socialsecurity.gov. Even the animals know they can’t wait until the last minute to prepare for a comfortable winter. Take a lesson from our furry and feathered friends and prepare for your own comfortable retirement.

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WEIGHT<<page 11 Weight will resist coming off, even if the number of calories consumed and level of exercise stay the same.

Dr. Nick says that the key is to mix up your routine so the body reacts to changing signals. “Some weight-loss warriors make the mistake of expecting different results with the same routine. It’s easy to get discouraged, but it’s more effective to get creative,” he notes.

His strategies for overcoming a weight-loss plateau include: • Eat the same weekly amount of calories but eat less one day and more the next to make the body react differently. Also, remember to drink water to feel full and avoid problems caused by dehydration.

• Try adding a new activity to an exercise routine. It will activate more muscles and change the way the body is used. For instance, if you typically walk daily, swim or bike instead. Add high-intensity cardio intervals to a low-intensity workout. If there’s a fun, new dance class to try, this is a good time.

• Switch the type of workout. For example, trade an aerobic session for a strength-training or muscle-toning class. This can increase lean muscle mass and jump-start the metabolic rate.

• Spread out daily food intake to fuel metabolism over a longer period of time.

Add a few mini-meals each day, going from three meals to five, without adding calories. Make sure breakfast is a solid meal, because it results in better concentration and higher energy throughout the day.

Use patience and persistence as tools in the journey to overall wellness. Weightloss plateaus will happen along the way - but they can be overcome.

TOPS Club Inc. (Take Off Pounds Sensibly) is the original weight-loss support and wellness education organization. Founded more than 63 years ago, TOPS is the only nonprofit, noncommercial weight-loss organization of its kind. TOPS promotes successful weight management with a “Real People. Real Weight Loss.®” philosophy that combines support from others at weekly chapter meetings, healthy eating, regular exercise, and wellness information. TOPS has about 170,000 members – male and female, age seven and older – in nearly 10,000 chapters throughout the United States and Canada.

Visitors are welcome to attend their first TOPS meeting free of charge. Membership is affordable at just $28 per year, plus nominal chapter fees. To find a local chapter, view www.tops.org or call (800) 932-8677.

Helping people remain safe in their homes by providing:

SENSE<<page 18 brushing between unaffected volunteers and the patient who felt prickliness.

Despite these differences, the patients’ nervous systems appeared to be developing normally. They were able to feel pain, itch, and temperature normally; the nerves in their limbs conducted electricity rapidly; and their brains and cognitive abilities were similar to the control subjects of their age.

“What’s remarkable about these patients is how much their nervous systems compensate for their lack of touch and body awareness,” said Dr. Bönnemann. “It suggests the nervous system may have several alternate pathways that we can tap into when designing new therapies.”

Previous studies found that mutations in PIEZO2 may have various effects on the Piezo2 protein that may result in genetic musculoskeletal disorders, including distal arthrogryposis type 5, Gordon Syndrome, and Marden-Walker Syndrome.

Drs. Bönnemann and Chesler concluded that the scoliosis and joint problems of the patients in this study suggest that Piezo2 is either directly required for the normal growth and alignment of the skeletal system or that touch and proprioception indirectly guide skeletal development.

“Our study demonstrates that bench and bedside research are connected by a twoway street,” said Dr. Chesler. “Results from basic laboratory research guided our examination of the children. Now we can take that knowledge back to the lab and use it to design future experiments investigating the role of PIEZO2 in nervous system and musculoskeletal development.”

This work was supported by the NCCIH and NINDS intramural research programs.

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LASIK<<page 9 these complications, but all eyes are at least a very small risk of these occurrences.

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When patients are deciding whether to undergo laser vision correction, the safety and the accuracy of the procedure are the most important issues to consider. The use of the femtosecond laser is significant safety advancement. in an already extremely safe procedure. Further detailed information can be gained at www.milwaukeelasereye. com

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Did I get your attention? Good. ing aids from. Especially if you are be- It is in your best interest to find an AudiTake 5 minutes out of your day and ing charged the same price! ologist who has experience with several read this article so I can help you purWho makes hearing aids? hearing aid companies so they can select chase hearing aids properly. If you are Hearing Aids are manufactured by 6 which product is most appropriate for As seen in... over the age of 60, you are probably major world-wide manufacturers and your hearing loss and lifestyle. getting several pieces of direct mail several subsidiaries. There are plenty of Hearing Aid Advertising. that advertise the latest and greatest brand names and models but, in general, I oftentimes look at advertising for in hearing aid technology. You prob- most hearing aids that are sold are man- hearing aids. The truth is that the na“New smartphone appsufactured that link are helping people impaired ably also noticed that there are plenty by to onehearing of these 6aids companies. tional franchise thatwith is selling the “latest of advertisements in your local newsThese 6 companies are Widex, Resound, and greatest” is selling the same levelto of hearing to pump up the volume on their devices or to use them as headphones paper for hearing aids. Let me tell you Oticon, Siemens, Starkey, and Phonak. hearing aid technology others are, just videos andbuy music.”

- Reuters why. stream phone calls, YouTube However, you won’t hearing aids under a different name……and at a far I have been an Audiologist for 23 directly from these companies. Hearing higher price. I’m disappointed when I years and have offices in Milwaukee aids are dispensed by local audiologists, hear some of the folks come in and tell and Madison, WI. I hear comments hearing aid dispensers, and large hearing me what they paid for technology that I “The technology melds aids with popular consumer withless. theMy adfrom my patients on a weekly ba- hearing aid franchises. routinelyproducts, sell for $1,000.00 sis about how they are being overWhen you have made the decision to vice is for you to get an estimate of what hopes of lessening the stigma associated with wearing hearing devices.” whelmed by hearing aid advertising. investigate purchasing new hearing aids, it would cost for the hearing aids that are Minneapolis Star Tribune Who- dispenses hearing aids? many folks take advantage of advertised recommended for you, and then compare Hearing aids are sold/dispensed by offers. My intent in writing this article that cost with others. Get the hearing aid two groups of professionals, Audi- is to educate the public on what to look manufacturer name and model number. ologists and Hearing Aid Dispensers. for and how to save you significant time Forget about the $1000.00 coupons, 50% There “Users is a significant difference in the and money. discounts, buy in oneeach get one freeon offers, adjust everything from the volume to the bass and treble ear the training of these 2 groups of profesThere are many tricks and gimmicks phony research studies, and fake evaluReSound Smart app, which means more withfora“new giant device You on sionals. that I have seen no in my years fiddling as an Au- around ation periods technology”.

Audiologists are the- most highly Please ask yourself who you need the final cost and the level of techyour head.”

New Yorkdiologist.

Daily News trained professionals to diagnose and think is paying for the expensive adver- nology that is being recommended to treat hearing loss. Audiologists are tising you are seeing. Is this company in make an accurate comparison. required to have at least a Master’s the paper every day? Do they send you Many audiologists concentrate on didegree in Audiology, and many have direct mail on a weekly basis? You can agnostic skills, hearing aid dispensing Doctoral level credentials. This means bet you will be paying a premium price and patient care. Unfortunately, they do they have extensive graduate level for their hearing aids. not spend as much time as large hearing college training on ear anatomy and Remember, only 6 companies make aid franchises and hearing aid dealers physiology, diagnostics, and hearing the overwhelming majority of hearing that market heavily and aggressively. Let aids. aids. The top level hearing aids from me ask you this question…Are you really The second group of people who each company are all high quality prod- going to spend thousands of dollars on a dispense hearing aids are called Hear- ucts that can be fit successfully on most set of hearing aids when you can get the ing aid dealers/dispensers. They must patients. There is not one hearing aid same technology, fit by an audiologist, pass a state exam to earn their license company that stands out and has “the for a lot less money than what you would to dispense hearing aids. There is no best” hearing aids in my opinion. How- have to spend at a large franchise? formal training, college courses, or ever, there are hearing aid companies that Here is a set of questions you can ask degree required to be a hearing aid do have technology that is “the best” for when purchasing new hearing aids? dealer. You will often pay the same certain hearing losses. This is where the 1) What level of technology is being price for your hearing aids whether skill of an independent audiologist who recommended for you? Why is this level you see and Audiologist or a Hearing works with several of the top hearing being recommended? Who manufactures Aid Dispenser. aid manufacturers is most advantageous. the hearing aid? What model is it?

One would be wise to find the Some companies have hearing aid fea2) How many channels do the hearing most qualified person to obtain hear- tures that other companies do not offer. aids have? Channels allow for greater

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4818 S. 76th Street • Suite 3 Greenfield, WI 53220 www.midwestaudiology.net Doug Kloss, Au.D.

programming and fine tuning ability. The more channels you have, the greater the technology and ability to adjust to your needs. For example, a 16 channel hearing aid is generally more technologically advanced than a 6 channel hearing aid BUT, the prices can be the same. You would want the 16 channel hearing aid, not the 6 channel. Again, a quality hearing aid manufacturer is essential.

3) How long is the warranty, does it include loss and damage, and how much are office visits?

4) Who pays for batteries? Are the hearing aids rechargeable? What accessories are available?

5) How long is the trial period?

If I return my hearing aids during the trial period, how much will it cost me? Some establishments do not offer any refunds, or charge large return fees. If you don’t like your $6000.00 set of new hearing aids, you can get stuck with them.

Feel free to contact me and ask these questions. I’d be happy to evaluate your hearing and provide a free consultation to give you my opinion of your hearing loss.

Dr. Douglas Kloss is an audiologist with over 23 years of experience.

He has locations in the Milwaukee and Madison area.

Midwest Audiology Center, LLC, 4818 S. 76th St., Suite 3, Greenfield, WI 53220. www.midwestaudiology. net 414-281-8300 Wisconsin Hearing Aids, Inc. 1310 Mendota St., Suite 113, Madison, WI 53714. www.wisconsinhearingaids. com 608-244-1221 Dr. Kloss offers a free comprehensive diagnostic audiological exam and free hearing aid consultation for all patients. By appointment only.