HLN November 2014

Your Monthly Guide to Healthy Lifestyles

He lthy Li ing News November 2014 • FREE

Also available at hlntoledo.com

The gift of joyful sound!

• Look your best this fall • Healthy eating for the holidays • Beat diabetes with education • Senior Living Guide • The dangers of mental health denial

On Thanksgiving...

Smoke the Turkey

Photo courtesy of Ferguson Photography

Also in this issue:

Smaller incisions. Quicker recovery. Easier decisions.

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A Catholic healthcare ministry serving Ohio and Kentucky

Look your best this fall!

V

ery few individuals realize that 80% of their facial appearance with aging is due to sun exposure and subsequent skin damage. All the brown spots (“age spots”), broken blood vessels on the face, fine lines, and sagging skin are caused almost entirely by sun! What about the “worry lines” between your eyes, deep smile lines, upper lip lines (lipstick runs uphill), and your sagging jowls and neck?

These unfortunate changes caused by prior sun exposure can be improved dramatically with painfree, non-invasive cosmetic procedures performed by Dr. Handler.

The NEW Thermage CPT Deep Tip procedure painlessly heats damaged collagen under your skin to tighten and lift the sagging areas of the neck, upper arms, abdomen, and jowls. The NEW Thermage CPT Deep Tip procedure utilizes radiofrequency energy (not laser) to uniformly heat the dermis (deeper layer) while the epidermis (top layer) is cooled and protected.

This heating of the dermis causes immediate collagen contraction and tightening followed by new collagen production over a period of time. This procedure also encourages a natural repair process that results in further tightening, lifting, and younger-looking skin.

With only one treatment, results are seen before leaving the office. Continued tightening and lifting of sagging skin occurs over a 6-month time period with results lasting 3-4 years! There is NO downtime and NO pain!

Is your dermatologist a dermatologist and is he/she board certified?

Individuals seeking diagnosis and treatment of skin cancer and other skin conditions should determine if their dermatologists are indeed dermatologists and board certified by the American Board of Dermatology. Not surprisingly, individuals seeking care of their skin conditions may receive care by physicians, nurse practioners, and physician assistants who may call themselves “skin specialists” and dermatologists. These physicians and others may do so without completing a formal dermatology residency. Many physicians who are board certified in fields unrelated to dermatology may be practicing dermatology. Now there are training programs being developed to permit nurse practioners to receive a doctorate of nursing and call themselves “Doctor” as would a PhD in a specialized field. These nurse practioners (NPs) are NOT doctors of medicine as is a board-certified dermatologist. Certification by the American Board of Dermatology is the consummate title addressed to a dermatologist based on their education and experience. If you see a “skin specialist,” it is your responsibility to ask of their credentials. Remember; a board-certified dermatologist is a medical doctor who has completed a minimum of twelve (12) years of training (four years of college, four years of medical school, and four more years in an internship and a formal dermatology residency program) to even become eligible to take the testing for board certification by the American Board of Dermatology.

Individuals seeking diagnosis and proper treatment of their skin disease can depend on board-certified dermatologists for their care.

The NEW Thermage CPT Deep Tip system has been utilized by Dr. Handler for many years with excellent results and very satisfied patients.

For lines between the eyes (worry lines), crow’s feet, and the “sleepy and tired look with droopy eyelids,” the use of Botox or Dysport works well to improve these areas.

The results are diminished lines and a more “wide awake” and less tired appearance.

These products are also fantastic to reduce anxiety-induced underarm sweating for months after injections. This is also performed entirely by Dr. Handler with minimal pain with results lasting 5-7 months and longer.

The use of fillers, such as Restylane, Perlane, Juvederm, Radiesse, and others, to “fill” deep smile lines and the marionette (sad) lines from the corners of the mouth produces immediate results lasting 12-15 months!

Don’t look tired or sad! These products are also very useful for producing a more full but normal appearance to lips that thin as we age. Since these products are combined with a numbing agent, the pain is minimal.

For fine lines, large pores, and brown (age) spots, the Clear and Brilliant laser produces awesome visual results after 3-5 treatments. This is a painless procedure whereby Dr. Handler utilizes a laser to produce thousands of small columns of empty space in your dermis, which your body fills with its own collagen.

This results in softer, smoother, and diminished facial lines and smaller pores. There is NO downtime with this procedure. When the Clear and Brilliant laser is combined with Thermage CPT Deep Tip, the results are ideal for patients who desire no downtime or pain and predictable results of lifting sagging skin and smoothing fine lines. Dr. Handler is the only dermatologist performing this procedure in Northwest Ohio.

Dr. Handler has performed these procedures for many years with very gratifying results and very satisfied patients. All of these cosmetic enhancements are performed entirely by Dr. Handler.

To view before-and-after photographs of patients who have had these procedures performed

by Dr. Handler, visit Dr. Handler ’s website at drharveyhandler.com. For more information about the above-mentioned procedures or products, please call Dr. Handler’s office at 419-885-3400.

Be sure to ask about specials available on many cosmetic procedures and products to diminish the signs of aging.

Also, please remember to have a yearly Full Body Exam for evaluation of moles and other growths we all develop as we age. Be certain you have no lesions that are pre-cancerous or cancer.

Full Body Exams are best performed and evaluated by a board-certified dermatologist.

Hair loss in men and women

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re you losing hair from surgery, anaesthesia, illnesses, pregnancy and delivery, medications, genetics, or “normal” hair loss secondary to aging or low blood levels of nutrients?

There are many causes of hair loss in men and women. Most are not simply due to age, and many are frequently treatable. Now these problems of hair loss can be evaluated and there is hope for reducing your hair loss and stimulating new growth.

Dr. Harvey Handler, board-certified dermatologist of Sylvania, Ohio, has a medical treatment for increasing blood flow to the hair follicle, thereby decreasing hair loss and increasing growth in many patients!

After appropriate examination of your scalp hair and blood testing is performed by Dr. Handler to rule out treatable medical causes, Dr. Handler will discuss a product to decrease hair loss, increase growth, and cause the hair you have be fuller and thicker. This is not a product that is forever, but for months only. This new treatment works with or without Rogaine (minoxidil, which is forever) for reducing loss and promoting growth.

Call Dr. Handler’s office to set up an appointment for a thorough evaluation and discussion of your particular hair loss and the therapy that may be individualized for you. Don’t assume because it “runs in the family” that you can do nothing to slow your hair loss. Most patients notice a decrease in loss in 30-60 days! ❦

www.drharveyhandler.com

Reduce lines, fade sun spots Smoother, tighter, younger-looking skin on face, arms, and chest

clear + brilliant

ADULT, PEDIATRIC, & COSMETIC DERMATOLOGY HAIR & NAILS

No surgery.

No injections.

No downtime.

Harvey L. Handler, m.d.

Fellow American Academy of Dermatology • Board Certified in Dermatology

5300 Harroun Rd., Suite 126 (in the Medical Office Building on the campus of Flower Hospital)

419.885.3400

e lthy l ng ews

Gopinath R. Upamaka, MD, FACC ProMedica Physicians

November 2014 • Vol. 19, Issue 11

Your Monthly Guide to Healthy Living

HEALTH & BEAUTY

TAKING CARE OF YOUR LIFE

2 Look your best this fall!

6 Smoking avoidance still the best defense against lung cancer 10 Hospice provides comfort, compassion, and dignity at end of life’s journey 20 Education is the best defense against diabetes 24 Senior Living Guide 25 The Academy Corner Benefits of the bicycle

by Julia Roberts 26 The changing face of arthritis: a focus on rheumatoid arthritis, by Bashar Kahaleh, MD 31 Early intervention is key to effective Alzheimer’s care 34 I hate my daddy! by Douglas A. Schwan, DC, Dipl AC 37 Spiritually Speaking Reaping soul, by Sister Mary Thill 46 Avoidance and denial aggravate mental health problems, by Linda L. Smith, MA, LPC 48 Sound Advice from Northwest Ohio Hearing Clinic

by Randa Mansour-Shousher, AuD, CCC-A

5 Smoke the Turkey this Thanksgiving 14 Health Crossword, by Myles Mellor 18 Medicaid expansion and marketplace insurance

by Julie Grasson 28 A Walk in the Park Watch for animals on the road

by LeMoyne Mercer 38 Nobody’s Perfect It started with a curb cut

by Sister Karen Zielinski, OSF 41 Winter running tips, by Amanda Manthey 42 The unwritten value, by Mark S. Faber USPTA Elite Professional

FOOD & NUTRITION 7 Heartland Rehab’s tips for healthy holiday eating 9 Hosting the Thanksgiving feast? Think HoneyBaked 11 Healthy eating for the holidays, by Jihyun Park, BSPS, and Michelle Mangan, PharmD, BCACP, CDE 43 Eating Well Get cooking to stop diabetes!

by Laurie Syring, RD/LD

Dear Readers, Thank you for picking up the November issue of Healthy Living News. The little boy on this month’s cover is just one of nearly 400 people in Jordan refugee camps who were recently given the gift of hearing by a team of area audiologists and volunteers, including regular HLN contributor Dr. Randa Mansour-Shousher of Northwest Ohio Hearing Clinic. Check out the full inspirational story on page 4.

The inset graphic on the cover highlights our annual sponsorship of the Rick Gomez Memorial Smoke the Turkey 5K (p. 5), to be held at 9:00 a.m. on Thanksgiving Day at the St. James Club. This burgeoning family friendly event is expected to attract around 3,000 participants and is the perfect way to offset any holiday overindulgence that

OUR COMMUNITY 4 Local volunteers bring gift of hearing to Jordan refugee camps 15 Is assisted living the right choice for you or your loved one?

16 Keep Calm and Breathe Easy: A lunch and learn education event about sleep apnea 22 It pays to be picky about joint-replacement rehab 32 Hospice to offer free grief workshop 33 Kingston focused on best chance for stroke recovery 40 Seniors, it’s your move—make it with confidence!

44 Harbor and ProMedica to partner to meet growing community mental health needs 45 Laurels nurse navigators help keep patients out of hospital and on road to recovery 49 Sylvania Franciscans honored at gala

Connect with Friends who Like Healthy Living News!

might take place later in the day.

Also in this issue, Janeen Shipp and Lisa Shipley of ProMedica Hospice share their insights on hospice care at end-of-life (p. 10); Jeannie Wagner, Clinical Coordinator for Diabetes Education for Mercy, discusses the diabetes epidemic and the importance of education in the prevention and management of this insidious disease (p. 20); Dr. Charu Trivedi of The Toledo Clinic Cancer Centers emphasizes that smoking avoidance remains the best defense against lung cancer, the leading cause of cancer deaths in the US (p. 6); and Dr. Bashar Kahaleh of the UTMC Rheumatology Clinic sheds some light on the disease process and treatment of rheumatoid arthritis (p. 26). And that’s just scratching the surface of the diverse

Focused.

Determined.

Ready.

24/7. /HLNToledo

@HLNToledo

content you’ll find in this jam-packed, 52-page issue.

Last month, we debuted our Senior Living Guide, which lists all the senior living properties that regularly support HLN through their advertising. We’re thrilled that the feedback we’ve received from the new guide thus far has been overwhelmingly positive! If you or someone you love is exploring the various options for senior living in our area, this invaluable resource (p. 24) is sure to simplify your search. As you tour these different communities, learn about the amenities and services they provide, and meet the staff, be sure to let them know you read about them in Healthy Living News.

Happy Thanksgiving to all, and until next month, stay safe, active, and healthy!

You never know when a heart attack can occur.

Which is why the ER at ProMedica Toledo Hospital is committed to provide a cardiologist on duty 24/7.

It allows us to give you a more accurate and quicker diagnosis for treatment.

We’re ready. Are you?

Take our quiz and find out.

Visit promedica.org/heart.

800-PPG-DOCS © 2014 ProMedica

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Healthy Living News is published the first of each month. The opinions expressed by contributing writers do not necessarily reflect the opinions of the publisher. Distribution of this publication does not constitute an endorsement of any kind. While HLN makes every attempt to present accurate, timely information, the publication and its publisher and/or advertisers will not be held responsible for misinformation, typographical errors, omissions, etc.

Contacts Business office:

To advertise: Healthy Living News, 3758 Rose Glenn Drive, Toledo, OH 43615.

Phone: (419) 841-8202 or email Kevin O’Connell at sfstennis76@bex.net.

Ad reservation deadline is the 15th of the month preceding publication.

HLN reserves the right to refuse advertising for any reason and does not accept advertising promoting the use of tobacco.

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team of 10 volunteers, which Audiology Systems (Tom is a vendor, included Dr. Randa Man- Wendy an audiologist). Representsour-Shousher of Northwest Ohio ing Indiana were audiologists Ken Hearing Clinic and four other audi- and Nora Stuart (originally from ologists from Michigan and Indiana, Toledo, now living in Fort Wayne) of recently spent a week in Jordan fitting HearCare Connection, Sandy Riley hearing-impaired and Anna Bogdon (both staffers refugees with at HearCare Connection), and volunteer Soha Abbasi. hearing aids— making it possible The team visited camps in for many of them the cities of Zarka, Jerrash, and to hear the voices Irbid. Two of the camps are popof loved ones for ulated primarily with Palestinian the very first time. refugees, many of whom have In addition had family residing there for well over half a century—since to Dr. Mansour-Shousher as far back as the 1948 and 1967 and her husband wars. The third camp is new Hussien Shoushand located close to the Syrian er, the Toledo contingent consisted of Northwest Ohio Hearing Clinic receptionist Jamele Shousher and Westgate Family Pharmacy volunteer Rene Ahmed.

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Editorial office: Deadline for editorial submissions is the 10th of the month preceding publication. Send submissions to: Editor, Healthy Living News, 1619 Circular Dr., Toledo, OH 43614. Phone: 419-754-1339, fax 888-506-5790; email: editorhln@bex.net.

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Sales: Robin Buckey Print Designer: Jan Sharkey Web Designer: Strategically Digital LLC Social Media: Miranda Hassen Distribution: Jim Welsh • Alison Foster Dominion Distribution Distributech–Toledo Copyright © 2014 Healthy Living News Reproduction in whole or part without written permission is prohibited. Healthy Living News is published for the purpose of disseminating health-related information for the well being of the general public and its subscribers. The information published in Healthy Living News is not intended to diagnose or prescribe.

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border to receive refugees from the current conflict there.

“If you saw how these people live, you would be appalled,” Dr. Mansour-Shousher remarks. “We were able to serve close to 400 people, but the need is so great that many were left whom we couldn’t help.

Such large numbers of needy were waiting for us that by the end of the day, we had to turn away adults and treat only children. From morning to evening, we literally never stopped.

It was very fulfilling, but also frustrating knowing we couldn’t help all of them. We’re planning to go back to Jordan in April and then to Africa, where the need is also very great, possibly in May.” The mission trip to Jordan, organized in partnership with HearCare Connection and Life USA, was made possible by over $32,000 in donations raised through fundraising dinners and email blasts. Dr. Mansour-Shousher notes one donor, a woman whose daughter is writing a book about refugees around the world, contributed $5,000 to the cause without even being asked.

Several hearing aid distributors did their part by supplying the team with many of the hearing aids they needed at no cost.

In Jordan, the team members contributed in whatever manner they were able, with the audiologists doing the exams and fitting the hearing aids and other volunteers (including Dr. Mansour-Shousher’s husband, Hussien ) putting together the earmolds and prepping the hearing aids. Jamele showed the parents how to put the hearing aids in their children’s ears, clean them, and take proper care of them. She also did a lot of interpreting, which gave her the opportunity to refresh her Arabic.

Like Dr. Mansour-Shousher, Jamele was both inspired by the people the team was able to help and saddened because they had to refuse so many.

“It was very heartwarming to see the

1601 W. Sylvania (Located Off Sylvania between Jackman & Lewis) 419-470-0700 ✚ Fax 419-470-0702 HOURS: M-F 9:30-7:00, Sat. 10:00-3:00, Closed Sunday

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and have another open up as well.

The doctors and other volunteers who went on this trip have formed a great bond and are planning what to do next. It’s like having a second family. I would encourage anyone with the opportunity to do something like this to try it out. Giving something back to humanity gives you a true sense of purpose, a way to pay it forward,” she says. ❦

Smoke the Turkey this Thanksgiving

J

oin the St. James Club in the annual Rick Gomez Memorial Smoke the Turkey 5K Run/Walk to benefit Hospice of Northwest Ohio. This year’s race, which starts and finishes at the St. James Club, located at 7337 W. Bancroft Street in Toledo, will take place at 9:00 a.m. on Thanksgiving Day, Thursday, November 27, 2014.

Participants can run or walk as this course winds its way in and around the beautiful St. James Woods neighborhood. The free Kids Fun Run for ages six and under starts at 8:30 a.m.

Register in person at the St. James Club or print an application online at stjamesclub.net, race360.com, davesrunning.com, or eliteendeavors. com. Mail registration and check payable to “Rick Gomez Memorial Fund” to the St. James Club.

Parking is available at West Side Montessori School, located just east of the St. James Club, and there is additional parking at SunBridge Schools, located on the west side of McCord Rd. just south of Bancroft Street.

Create or continue a new family tradition and enjoy fantastic door prizes, delicious post-race refreshments, and a morning of Thanksgiving fun! The top men and women in each age group will take home a free Schmucker’s pie. Don’t forget about the special prizes for best dressed Buckeye and Wolverine fans, best dressed turkey costume, and the Chicken Chucking Contest!

For more information, email us at turkey2014@stjamesclub.net or call 419-841-5597. ❦

Care that lasts a lifetime.

Life is about making connections. Parents, siblings, friends, a spouse, and, yes, even a health system.

That is, if that health system is ProMedica. Because when you choose ProMedica, you’re choosing to be a part of the most connected health system in the region. Doctors, nurses, specialists, labs, pharmacies ... all linked and all working together on your behalf.

And when we’re all connected to each other, we can better share our common goal of living happier, healthier lives. Begin your connection today at promedica.org/wellconnected. © 2014 ProMedica

Healthy Living News offers the residents of northwest Ohio and southeast Michigan a monthly guide to news and information about healthy life styles, health care, sports and fitness, and other issues related to physical, mental and emotional quality of life. The publication promises to be an attractive, interesting and entertaining source of valuable information for all ages, especially those 35 to 50. Healthy Living News is locally owned, committed to quality, and dedicated to serving our great community.

children’s eyes light up,” she recalls.

“Some of them had never even heard their own voice or their mother ’s voice before. It just does something to you when you’re able to make a difference for people who don’t have the same choices and opportunities we have here. But it was really sad that we had to turn so many people away. There were so many lined up at each camp that we had to ration the hearing aids to make sure we had enough for the next stop.”

Kathy Chase was similarly inspired, noting “The mission trip was one way I could share with others what has been given to me. The smile of a child hearing his or her family for the first time is priceless. We were very blessed in the process of helping many hear. It’s even more special that my company, WidexUSA, was able to support this cause along with me.”

Dr. Mansour-Shousher emphasizes that needy people requiring hearing aids aren’t just in far-away, war-torn nations, but right here at home, as well. Her goal going forward is to partner with one of the local healthcare systems to establish a fund that will help provide hearing aids to needy people both locally and internationally. “The concept is, when our patients donate used hearing aids, the healthcare system will either match the donation or give a certain amount for each hearing aid donated. The funds raised would then go to purchase brand new hearing aids for needy people here, and the used ones would be sent overseas, where they will definitely be welcome, she says.”

Nora Stuart of HearCare Connection is honored that her organization is part of this vital initiative, stating, “My husband and I view the opportunity to provide hearing healthcare to people who otherwise do not have access to it on their own as our responsibility and our privilege.

We have been able to maximize our philanthropic efforts by leveraging our established relationships in our industry. It is very encouraging to see so many people come alongside our efforts. Currently we are partnering with other like-minded audiologists around the country through Entheos Audiology Cooperative to expand our reach. Together we can really create a positive impact.”

For her part, Jamele is looking forward to future volunteer opportunities and urges others to get involved. “It’s funny how you can open one door

Photo courtesy of Ferguson Photography

Mission Statement

Local volunteers bring gift of hearing to Jordan refugee camps

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CANCER CENTERS

Smoking avoidance still the best defense against lung cancer

WE HAVE MOVED! A

Toledo Clinic Cancer Centers 4126 N. Holland Sylvania Road, Suite 105 Toledo, OH 43623 GET DIRECTIONS TO HERE Scan the QR code and use Google Maps to get directions to this location.

or call 419-479-5605 Toledo Clinic Cancer Centers have moved to better serve our patients and families.

Located on N. Holland Sylvania Road, we have laboratory, MRI and other specialty services conveniently located on the premises.

Why area doctors trust us the most…

• Area’s most experienced cancer care team • Enrolling more patients in clinical trials than any other cancer care provider in the region • Largest number of referred patients • NW Ohio’s first QOPI Certified Cancer Center Dr. David Brown Dr. Mark Burton Dr. Shaili Desai

Dr. Tim Kasunic Dr. Rex Mowat Dr. Richard Phinney

6 November 2014 | Healthy Living News

Dr. Howard Ritter Dr. Bradley Sachs Dr. Charu Trivedi

s we recognize Lung Cancer appetite, and weight loss. ExperiAwareness Month, there’s both encing other symptoms in addition good and bad news with respect to to the baseline symptom, cough in this disease. The good news is, the smokers, is cause for concern,” says rate of new lung cancer cases is on Dr. Trivedi. the decline, largely because more If caught in stage 1, the median and more people are getting the survival rate for lung cancer (nonmessage about the serious health small-cell) is 56 months. By stage 4, the risks associated with smoking. The outlook becomes much bleaker—less bad news is, too many people contin- than six months. Even for patients ue to lose their lives to lung cancer, with stage 1 lung cancer there is a which remains the leading cause of high risk of relapse.

There are two main classes of lung cancer death in the US. Despite this sobering fact, the vast cancer, small-cell and non-small-cell majority of lung cancer cases could (named for the size of the cancer cells be prevented through one lifestyle when viewed under a microscope, and choice: smoking avoidance. In fact, this differentiation is also based on according to Charu Trivedi, MD, of morphological, clinical, therapeutic, The Toledo Clinic Cancer Centers, and prognostic parameters). Nonapproximately 90% of all lung can- small-cell lung cancer has various other cer cases diagnosed are subtypes: adenocarcinoassociated with tobacco ma, squamous cell, large smoking and even seccell, carcinoid etc., and ondhand, or passive, exadenocarcinoma is the posure to tobacco smoke most frequent subtype puts people at risk. of non-small-cell lung Other known lung cancer. cancer risk factors inAccording to Dr. clude exposure to asTrivedi, the majority of bestos, radon, or heavy cases diagnosed—about metals; other environ65%—are non-smallmental or occupational cell and about 13% are exposures; chronic scarsmall-cell. It’s important ring of the lung tissue for doctors to differenfrom prior infections; tiate between the two Dr. Charu Trivedi pulmonary fibrosis; HIV; because the histology, and prior radiation to staging, clinical course the chest area (breast cancer or Hod- and treatment, and prognosis can be gkin’s lymphoma). There may also different in both kinds. For example, be a genetic predisposition of lung only around 1% of patients with cancer, but this has not been conclu- small-cell lung cancer are candidates sively proven. for surgery because this form is priIn common with so many dead- marily treated with chemotherapy ly diseases, lung cancer typically and radiation therapy. causes no symptoms in the earliest, The appropriate treatment for nonmost treatable stages. “It’s usually small-cell-lung cancer also varies by diagnosed in later stages or caught stage. In the first two stages, surgery incidentally at early stage during is usually the standard treatment with chest x-ray for a different health the exception of patients who aren’t complaint. In later stages, symptoms good surgical candidates, such as may include a persistent or worsen- those with a bad heart, severe COPD, ing cough, hoarseness, shortness of etc., and they are usually treated breath, coughing up blood, bone with radiation or newer radiological pain, mental status change, loss of or surgical procedures (cryosurgery, We love feedback. Like us on Facebook. Follow us on Twitter.

radiosurgery, cyberknife, etc). Surgery may also be used to treat stage 3, but the usual choice at that point is a combination of chemotherapy and radiation. In stage 4, most care is palliative, which means it’s based on managing symptoms with chemotherapy, radiotherapy, symptomatic medications, and supportive care, and hospice is also an option for frail patients who cannot tolerate chemotherapy or radiation.

Dr. Trivedi also points out that more and more targeted therapies are becoming available for lung cancer treatment. “For example, we now test tumors for certain molecular markers, such as EGFR and EML4-ALK, and if they test positive for a particular marker, we know they can respond very well to specific drugs based on these molecular markers. More molecular profiling of lung cancer cells is being done to pick appropriate targeted treatments, which may be the future of oncologic systemic treatment for most cancer, including lung cancer, and it may change how we will treat lung cancer in future,” she says.

Some exciting new surgical technologies are now available for treating lung cancer that have not become standard treatments. These include

cryosurgery and stereotactic radiotherapy. Plus, more and more procedures can be done locally. For example, tumors in the bronchi (the airways of the lungs) can be excised and the doctor can then insert a bronchial stent to keep the airway open and help with breathing—much like the stents used to open narrowed arteries.

There have also been some positive developments in the area of lung cancer screening. An August 2011 study published in the New England Journal of Medicine showed that screening reduced mortality among a select population of highrisk individuals who were all between the ages of 55 and 74 with at least 30 pack years of smoking (a pack year is the equivalent of having smoked one pack of cigarettes per day for a year) and who quit within the last 15 years. The study participants, who were screened with a low-dose CT once a year for three years, showed a reduction in mortality of about 20 percent specific to lung cancer.

With respect to lung cancer prevention, as noted above, the best thing people can do is never take up smoking, quit smoking as soon as possible if they’ve already established the habit, and avoid exposure

Kenneth E. Endicott, Prosthodontics, Inc.

to secondhand smoke. Those who work in environments that put them at risk of exposure to asbestos, radon, heavy metals, or other potentially harmful materials should also take all necessary measures to protect themselves on the job. “Of course, the more we educate people about lung cancer and its risk factors, the better,” says Dr. Trivedi. ❦ Toledo Clinic Cancer Centers, located at 4126 N. Holland Sylvania Road, Suite 105, has nine board-certified

hematologists/oncologists and ten nurse practitioners on staff and can provide imaging and laboratory diagnostic services, chemotherapy services, and IV services. TCCC’s satellite centers in Maumee, Bowling Green, Oregon, Adrian, and Monroe remain open for the convenience of the patient, and many TCCC patients are enrolled in the latest cancer research and studies in our region through the Toledo Community Oncology Program (TCOP). For more information, please call the Toledo Clinic Cancer Centers at 419-479-5605.

Heartland Rehab’s holiday survival guide

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ost of us have plenty to be grateful for this holiday season. We look forward to the family get-togethers and holiday parties, anticipating the special foods and drinks that tempt us. We tell ourselves that special-occasion foods don’t have calories, or we’ll just have a taste, but going forward past the holiday celebrations, we find ourselves not

so thankful for the extra pounds we have picked up at the buffet table and the dessert bar. We resolve again to start the new year by eating less, a resolution that often fades before February.

So, here’s a suggestion: plan now how to navigate through the cookies, potatoes, and eggnog concoctions.

Promise yourself you will do what

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it takes to maintain your pre-holiday weight. There are plenty of simple ways to come away from the holiday table without having to loosen your belt.

Thanksgiving comes first, and with it bigger and better food offerings.

We know there will be potato dishes, baskets of breads or rolls, gravy, and “come hither” snacks. The solution: plan ahead.

• If you know the meal will be a big one, plan to eat smaller meals in the days before and after Turkey Day. • Eat the better foods (salads, fruits, vegetables) at those preand post-Thanksgiving meals.

• If you are a guest, bring a tasty, tempting, but healthy food to share.

• Eat good breakfasts so your appetite doesn’t overcome your common sense at the dinner table.

• Try one of each snack and savor the flavors of each; there’s no need to fill up on those foods.

Remember your mother’s advice, “You’ll spoil your dinner,” and save your taste buds and real appreciation for

the holiday meal.

Keep in mind that the average Thanksgiving meal contains 3,000 calories, which we usually consume after having a good share of the crackers and cheese, chips and dip, and holiday cookies. It takes a four-hour moderately paced run, a five-hour swim session, or a 30-mile walk to burn off those 3,000 calories. How much better it would be to walk the 10 steps away from the table and how proud we will be when we aren’t swimming in self-pity because our clothes are tight in January!

In the weeks between Thanksgiving and Christmas, you can arm yourself with even more strategies to maintain your weight:

Eat good breakfasts so your appetite doesn’t overcome your common sense at the dinner table.

• Keep the scale handy; two weigh-ins a week will reassure you that your efforts are paying off.

• Maintain your exercise schedule.

Visit the gym as you always have, walk a bit further, go dancing. Keep busy—to burn off any extra calories and to give you something to do that is better than sampling the holiday cookies hidden in the back of the freezer.

• Keep your portion sizes reasonable. Some diet gurus suggest taking no bit of food that is bigger than a deck of cards or your hand.

• Eat regular meals, especially breakfast. Don’t plan to skip meals all day so you can fill up at the party; you are sure to overeat. Consider drinking water and have a bit of protein (cheese, nuts) before you leave for the party. You won’t feel hungry, and you will be less inclined to listen to your stomach begging for more chocolate or rich casserole.

Odds are, you will be doing holiday shopping this season. Use that task as an exercise session: • Take the stairs instead of the escalator or elevator.

• Park far away from the front of the store so you are forced to take those extra steps.

• Bring a water bottle to take the edge off your hunger and keep yourself from overdoing your stop at the food court.

• Go shopping with a friend who can be your guardian angel or your conscience.

• Resist the urge to slow down; keep your metabolism moving by keeping your body busy.

January will come soon enough, but it doesn’t have to bring extra weight to your bathroom scale. Plan ahead, and you’ll be in good shape for the new year (and the temptations waiting in the wings for Valentine’s Day, St. Patrick’s Day, Easter…). ❦

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A

funny thing happens when you host the family Thanksgiving feast—with so much of your attention focused on meal preparation, you tend to miss out on all the things that make family get-togethers so special and important. While everyone else is enjoying each other’s company, reminiscing about old times, and renewing emotional bonds, you’re stuck in the kitchen. Sure, you catch snatches of conversation and laughter every time you bring out a dish, drink, or platter, but by evening’s end, you can’t help thinking you’ve missed another precious opportunity to be close to the ones you love.

This Thanksgiving, why not begin a new tradition that frees you from food preparation so you can take part in the party and feel like family again? Why not put a HoneyBaked meal on your Thanksgiving table?

As Thanksgiving dinner host—especially if this is your first time—one of your greatest anxieties is that the main course won’t turn out as hoped. What if your guests aren’t enthused about your choice of seasonings? What if the glaze you’re experimenting with falls flat? What if that centerpiece ham or turkey ends up overdone and dry—or, worse, undercooked and unsafe to eat?

HoneyBaked gets it right every time, so when you choose their products, you can be confident in the quality of your meal. Each HoneyBaked ham is hand selected for leanness, smoked up to 24 hours, and then spiral sliced to the bone so each tender, juicy slice is easy to serve. And who can forget that signature crunchy, sweet glaze?

HoneyBaked boneless turkey breasts are gently roasted, sweetly glazed, and irresistibly savory.

And the HoneyBaked product line isn’t limited to their signature sliced hams and boneless turkey breasts. They offer something for every taste—including whole turkeys (smoked, browned and roasted, or Cajun), barbecued ribs, barbecued pork roast, pork or beef roast with gravy, and thick-sliced bacon.

Some families choose a HoneyBaked product for their main course and then surround it with their favorite homemade side dishes. But you have the option of leaving all the cooking to HoneyBaked if you prefer. In addition to their savory main courses, they offer a wide variety of home-style side dishes, such as macaroni and cheese, garlic mashed potatoes, potatoes au gratin, sweet potato casserole, cinnamon apples, herbed stuffing, broccoli rice casserole, and, of course, green bean casserole. They’ve even got you covered when it comes to rich, satisfying desserts!

T h i n k HoneyBaked hams and turkeys are strictly for the Thanksgiving table? Think again! If you’re lucky enough to have leftovers (you may have to discreetly set some aside or else it will end up going home with your guests), rest assured there are myriad ways to incorporate delicious HoneyBaked products into your day-to-day cooking, including soups, salads, sandwiches, pastas, entrees, and brunch dishes.

Be sure to visit honeybaked toledo.com for recipe ideas (under Entertaining) as well as a complete HoneyBaked menu, catering information, gift ideas, store locations, monthly specials, and much more.

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Hospice provides

comfort, compassion, and dignity

In your home or ours.

at end of life’s journey

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When you hear a loved one needs hospice care, it can be overwhelming. What matters most is maintaining a life of quality and dignity with comfort.

At ProMedica Hospice, we can help you and your loved one on this journey by providing expert support and guidance.

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very journey must ultimately come to an end—including the journey of life. As life’s final stage approaches, the type of care we’re given can make a tremendous difference in our level of comfort, dignity, and family connectedness. Terminally ill people who choose hospice care when curative measures are no longer viable find that they and their families receive all the physical, emotional, spiritual, and social support they need to transition with grace through this profound phase.

Janeen Shipp, Social Services and Bereavement Manager for ProMedica Hospice, defines hospice as expert, compassionate care that’s focused on the individual and their family at end of life so they can have a dignified and comfortable passing. Anyone with a life-limiting illness who is expected to live for six months or less, assuming the disease follows its natural course, is eligible for hospice care. Exceeding this six-month life expectancy does not mean hospice care automatically ends, however. Eligibility continues as long as the patient’s health status continues to decline.

Lisa Shipley, RN, Manager of the ProMedica Ebeid Hospice Residence on the campus of ProMedica Flower Hospital, notes, “Hospice is not a place; it’s a philosophy of care that is offered wherever the patient calls home, whether it’s the patient’s actual home, a skilled nursing facility, or a free-standing hospice center such as Ebeid.” She further explains that patients who come to a hospice facility typically require more intensive nursing care for symptoms that loved ones or nursing home staff can’t manage, such as pain, shortness of breath, or the symptoms associated with imminent death.

Because the emphasis of hospice is not curative care, but palliative care, which has the goal of alleviating discomfort and stress; providing emotional, spiritual, and social support; and maximizing quality of life, there is a common misconception that initiating hospice care means giving up on the patient and accelerating the dying process. However, nothing could be further from the truth. “I

don’t view choosing hospice care as giving up, but as a way to empower patients and their families to spend those final moments together more meaningfully. End of life can be a wonderful opportunity for families to come together,” Shipp says.

With respect to the perception that hospice hastens death, an Institute of Medicine report titled “Dying in America” indicates otherwise.

According to the report, there is actually evidence to suggest that “hospice patients may live longer

than similarly ill patients who do not receive such care.”

The ProMedica Hospice team, which consists of RNs, home health aides, social workers, massage therapists, chaplains, bereavement counselors, volunteers, and a medical director, provides holistic support not just to terminally ill patients, but also to their family members, who often serve as 24-hour caregivers. Taking on that caregiver role while trying to manage all of life’s other obligations puts them at high risk of burnout and can lead to unwanted feelings of resentment toward their ill loved one. Shipley remarks, “When we take over the role of caregiver, one of the conversations we have with family members is that it’s okay for them to go back to being the wife, daughter, son, or sibling they were before—to just be there, hold their loved one’s hand, and reminisce.”

Shipp adds, “The biggest advantage of hospice care is the additional support patients and their families receive from all our team members.

They, as patients or caregivers, no longer feel like they’re out there alone, whether from a medical, emotional, spiritual, or social standpoint. Hospice

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9/18/12 9:52 AM

addresses all of those aspects.”

Despite the many benefits hospice care offers patients and caregivers, many people fail to make plans and communicate to loved ones their desires related to end-of-life care.

In fact, according to the Institute of Medicine report, “More than a quarter of all adults have given little or no thought to their endof-life wishes.”

Both Shipp and Shipley recommend having this discussion with loved ones sooner rather than later, noting that a medical crisis can arise at any time. “If that conversation has already taken place, decisions about your end-of-life care may not be any easier for your loved ones to make, but they can make them more confidently knowing they’re honoring your wishes. That can save them a lot of unnecessary guilt and doubt down the road,” Shipley states.

The decision of when it’s appropriate to halt attempts at curative treatments and initiate hospice care can be a difficult one, but there comes a time when another emergency room visit, hospitalization, or round of

chemotherapy becomes counterproductive and actually interferes with the patient’s ability to spend those remaining days surrounded by love ones without the burden of pain, anxiety, or treatment side effects. While it’s a very personal, tough choice to make, the sooner hospice care is initiated, the sooner the patients and their families can benefit from the added support, education, and symptom management.

“Hospice care gives them that remaining time to spend with one another rather than sitting in a doctor’s office, running from specialist to specialist, or driving for hours to get treatment,” Shipp says. “Once we’re able to control patients’ symptoms, it’s amazing how much fulfillment they can get from this stage of life.”

Shipley adds, “We just want to improve quality of life for our patients, no matter how much time they have left.” ❦ To learn more about ProMedica Hospice, call 419-824-7400 or visit www. promedica.org/hospice.

Healthy eating for the holidays

Call for Help!

Medicare Plan Members have from October 15th to December 7th to choose a new plan for 2015.

Our authorized licenced agents have years of experience and represent many plans.

Let us help you find the right plan for your needs.

Call (419) 897-1001 today and ask to speak with Dave Holman or Dave Sickles

by Jihyun Park, BSPS, and Michelle Mangan, PharmD, BCACP, CDE

I

t’s November. The leaves are changing colors, and a chilly breeze is in the air. Soon it will be the holiday season. At this time of year, everyone is looking forward to celebrating with family and friends and a feast of delicious food. However, since most people indulge in meals during the holidays, it is also a time for overeating and weight gain.

According to a study conducted by the National Institutes of Health (NIH), holiday eating can result in an extra pound or two gained every year, causing the extra weight to

accumulate through the years and to be a major contributing factor to obesity later in life.1 The holidays don’t have to mean weight gain, though. If you focus on a healthy balance of food, activity, and fun, you can stay healthy through the holiday season.

1 National Institutes of health. http://www. nih.gov/news/pr/mar2000/nichd-22.htm

Dave Holman

Dave Sickles

1645 Indian Wood Circle Suite 203 Maumee, OH 46537

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Connect with our advertisers via our online issue at www.hlntoledo.com | Healthy Living News | November 2014

11

Constipation Frustration?

Is your child suffering from constipation?

If your child is: •

Between 6-17 years of age

•

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Suffers from constipation

Your child may be eligible to participate in a research study.

As we prepare for the upcoming holidays, these tips will help you to enjoy yourself without packing on the pounds: Don’t arrive on an empty stomach.

Skipping breakfast or lunch may cause you to overeat and consume more calories than you would if you had eaten something beforehand.2 Therefore, before leaving for a party, eat a light snack like raw vegetables, a piece of fruit, a bowl of cereal, or a handful of nuts to curb your appetite. You will be less tempted to overindulge.3

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The study requires only 6 clinic visits and 2 phone calls.

By participating, you and your child may help other children find relief from constipation.

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12 November 2014 | Healthy Living News

mindless calories into your mouth.4 Therefore, focus on chewing your food well and enjoying the smell, taste, and texture of each item. Of course, conversation at the table cannot be missing in the party, but try to set your food down until you’re finished chatting so you are more aware of what you’re taking in.4 Eat slowly. Take time and enjoy the taste of your meal. Take small bites, and chew slowly. It usually takes about 20 minutes for your brain to signal to your stomach that you’re full.2 According to a study, people reported feeling fuller when they ate slowly, and they also ended up consuming about 10 percent fewer calories when they ate at a slow pace, and presumably chewed slower, as opposed to when they were rushing.5

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Leave the table when you are done.

Eat the best-for-you offerings first.

For example, eating a salad or hot soup (broth-based, not cream-based) as a first course can help you avoid eating too much during the main course.4

Choose these foods more often:

Turkey breast, chicken breast, mineral water, plain potatoes, tossed salad, steamed vegetables, fresh fruit, and plain rice.2 Choose these foods less often: Beef prime rib, pie, cake, gravy, bread pudding, candy, eggnog, stuffing, sugar-sweetened beverages, and high-calorie alcoholic beverages.2 Be careful with beverages. Save your calories for the main meal. Alcohol provides many calories without nutrients.2 Also, alcohol can reduce inhibitions and induce overeating.

Non-alcoholic beverages can also be full of calories and sugar.3 Select small portions. Moderation is the key. Selecting small portions allows you to control your calorie intake as well as enjoy all the different items offered. If you really crave a high-calorie item, go ahead and treat yourself to a small serving.2

Concentrate on your meal while you’re eating it. Research shows that

If you linger at the table, you may be tempted to continue eating even if you are not hungry.2 Stay long enough to enjoy the meal, but leave the table when you are done. Try playing games, going on a walking tour of decorated homes, or helping with dishes.

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Don’t restrict yourself from enjoying your favorite holiday foods. You can enjoy the holidays the healthy way with balance and moderation. Your body will thank you for it later. ❦

Jihyun Park is a sixth-year doctor of pharmacy student at the University of Toledo College of Pharmacy and Pharmaceutical Sciences. Dr. Michelle Mangan is a clinical assistant professor of pharmacy practice at UT and is currently the program director of the outpatient diabetes education program.

with contrast

both breasts

abdominal

*SOURCE: Averages derived from newchoicehealth.com as of 03/05/2014

Call today! Local: 419.479.5935 Toll Free: 800.444.3561 Or visit us online at www.toledoclinic.com/radiology

The information presented in this column is intended for your general knowledge only and does not aim to replace medical advice or treatment for specific medical conditions. If you have any specific questions about any medical matter, you should consult your doctor or other professional healthcare provider.

5 Andrade AM, Greene GW, and Melanson KJ. Eating slowly led to decreases in energy intake within meals within meals in healthy women. J Am Diet Assoc. 2008 Jul;108(7):118691.

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mealtime multitasking (whether at home or at a party) can make you pop 2 The University of California. http://www. dining.ucla.edu/housing_site/dining/SNAC_ pdf/GiftOfGoodHealth.pd 3 California Pacific Medical Center. http:// www.cpmc.org/about/e-health/11-05%20 healthy-holidays.html 4 Real Simple. http://www.realsimple.com/ health/nutrition-diet/healthy-eating/eathealthy-during-holidays

A simple squeeze of lemon or lime juice and a sprinkling of salt and black pepper is all you need to bring out the fresh flavor of steamed vegetables.

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For more information on our service visit www.toledoclinic.com/healthcare-services Main Campus: 4235 Secor Road, Toledo, Ohio 43623 • 419.473.3561 • 800.444.3561 Connect with our advertisers via our online issue at www.hlntoledo.com | Healthy Living News | November 2014

13

by Myles Mellor

ilovecrosswords.com

Crossword by Myles Mellor

Across 1 Getting some exercise 5 Sources for sugar 8 X-ray machine product 9 Pink leaves used in pies 10 Gym fixture 14 Small pouch 15 Italian hello 16 ___ acid

Across

18 Reputation 19 Hawaiian fish 21 Hot winter drink 22 They make healthy liquid “meals” 23 Emotional condition 24 Thai and Japanese are two 27 They cool down a drink (2 words)

Answers on page 21

28 Mark of healing on the skin Down 1 Wrist, elbow and ankle connections 2 Fruit from a vine 3 It might be put on a sprain 4 Seasoning bulb that is reported to help with a

1 Getting some exercise 5 Sources for sugar

8 X-ray machine product

cold 5 French wine designation 6 Gets closer 7 Skin glands that secrete an oily or waxy substance to lubricate the skin 1

2

3

4

8

20 22 25 26

Seafood dish Unit of energy Knight’s title Copper symbol

5

6

13

14

7

9

10

11

12 15

Life getting you down?

9 Pink leaves used in pies

10 Gym fixture Low Testosterone? Hormone Imbalance?

If14 youSmall suffer pouch from fatigue, low sex drive,

11 Tooth related 12 Gloss target 13 Containing the most fat 17 Pathogenic bacterium 19 From the sea

16

17

18

19

20 21

22

weight gain or depression

15 Italian hello

WE CAN HELP!

16 ___ acid

18 Reputation 734-847-4700

23

24

25

26 27

28

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19 Hawaiian fish 21 Hot winter drink 22 They make healthy liquid "meals" 23 Emotional condition 24 Thai and Japanese are two 27 They cool down a drink (2 words)

20 Seafood dish 22 Unit of energy 25 Knight's title 26 Copper symbol

Is assisted living the right choice for you or your loved one?

A

ccording to Carrie McGlothlin, Regional Director of Marketing for Franciscan Living Communities, this is the time of year when assisted-living facilities, such as St. Clare Commons in Perrysburg, begin to receive the highest volume of inquiries from area seniors and their adult children.

For seniors, the motivation to look into assisted living may be the realization that, despite being relatively healthy and independent, they need more and more help with activities of daily living. This can really come to a head when considering the daunting prospect of another fall raking leaves, the memory of digging out from last winter’s record snowfall, or the stress of keeping up with burdensome household projects and chores.

For the adult children of seniors, the realization that it’s time to explore the option of assisted living often occurs when they’re visiting their parents’ home around the holidays and notice certain warning signs, for example neglected housecleaning or personal hygiene, laundry piling up,

spoiled food left in the refrigerator, bills left unpaid, evidence that he or she isn’t taking prescription medications properly, and so on.

“This is also the point at which we tend to see the first split between seniors and their adult children when it comes to making decisions that affect the parents’ lives,” McGlothlin notes. “Complicating the decision is the fact that most seniors have been conditioned to tell their children, ‘Don’t ever put me in the home!’ But this thinking is based on some very outdated perceptions. Assisted living today is nothing like it

was decades ago. In fact, at St. Clare Commons, the atmosphere on our campus is more like a resort. After people move into our community, we often hear comments like, ‘If I’d known assisted living was going to be like this, I would have made the decision a long time ago.’”

McGlothlin emphasizes that in assisted living, residents still have their own private, secure apartment or suite, but help is always just a few steps away.

And the residents can arrange for as much or as little help as they need. For instance, one person might just need a little assistance getting out of bed in the morning, while another might need some help with organizing

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14 November 2014 | Healthy Living News

and taking multiple daily medications.

The care is individualized according to the resident’s specific needs. “In addition, we provide three meals, housekeeping, and laundry. Each apartment has a full kitchen, so you can prepare your own meals if you prefer, or you can have chef-prepared meals delivered to your suite. We can also arrange transportation, and, of course, there’s no more leaf raking or snow shoveling,” she adds.

The social advantages of assisted living can be tremendous, as well.

Oftentimes seniors who are beginning to experience some health deterioration, such as impaired vision or loss of mobility, tend to become more withdrawn, avoid activities, and spend less time visiting with friends. However, the amenities at St. Clare Commons—which include an on-site Starbucks, restaurant-style dining, piano bar, Happy Hour every Thursday from 4:00 to 6:00, and much more—make it very easy for residents to stay connected and enjoy themselves with family and friends, and they’re free to participate in as many or as few community activities

Now offering home health and personal care services.

Sponsored by the Sisters of St. Francis of Sylvania, Ohio

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*Some restrictions apply.

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15

and field trips as they wish.

Residents also appreciate the fact that their spiritual needs are given high priority at St. Clare Commons, with the facility featuring a serene on-site chapel and having many connections to St. John XXIII Catholic Parish. For those who can’t get to the chapel, mass and other religious services are aired on the in-house television channel. In addition, Sr.

Joy Barker and Sr. Diana Lynn Eckel work hard to ensure that the three core values of St. Clare Commons’ mission—service, stewardship, and reverence—are integrated into all aspects of the care and services the staff provides.

Assisted living also makes it possible for couples to age in place together.

McGlothlin points out that, “Many times couples don’t age simultane-

For more information, contact:

Clinical Research Source, Inc.

419-873-1532 VERSION 1 - 27/APR/2012

ously—one usually needs more care than the other. Here, the caregiver spouse gets all the support he or she needs so they can stay together longer. And if there’s an acute setback, such as a broken hip, where one spouse needs to go into skilled nursing for a short time, the other can stay right on campus without having to worry about driving back and forth every day.”

Of course, not all assisted-living communities are created equal.

McGlothlin recommends taking the following steps to make sure a facility is the right choice for you or your loved one: Evaluate the atmosphere. Note the level of cleanliness and maintenance throughout the facility. Your nose can often give you a pretty good sense of whether the staff places a high priority on keeping things clean and fresh.

Check the staff’s attitude. Your observations of staff interaction with the current residents should give you confidence that you or your loved one will be cared for by positive, friendly people and that the ratio of staffers to residents is adequate.

Try the food. Food is important to all of us, not just for its nutritional value, but also as a source of comfort and a focal point around which to gather and socialize. Make sure the food lives up to expectation, and inquire about the meal services provided to verify that they’ll fit your lifestyle.

Tour the common spaces.

Remember, the private apartment you or your love one will occupy is just one part of the facility’s overall

living space. As you tour, carefully assess any outdoor spaces, activity rooms, and other common areas. Are they clean, inviting, well-maintained, safe, and secure? Also, consider the quality and safety of the neighborhood surrounding the facility.

Participate in an activity. Just as it’s important to try the food, it’s a good idea to participate in one of the activities the community offers to get a sense of whether they’re thoughtfully planned, well attended, and enjoyable.

Rate the level of safety. When you visit, note the safety, security, and accessibility features that are in place in apartments and common areas and inquire about emergency preparedness policies and procedures.

“Most importantly, don’t postpone making this vital decision. Too many people wait and wait, and then it becomes a reactive decision. It’s better to plan ahead and be proactive by taking the time to tour different facilities to find the one that best fits your needs, preferences, and lifestyle,” McGlothlin says. ❦

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Keep Calm and Breathe Easy oin pulmonologist Dr. James Tita as he hosts a free Lunch and Learn on November 18 at noon at Heartland of Waterville, 8885 Browning Drive, Waterville.

Dr. Tita will provide an overview of sleep apnea and discuss ways to identify and manage this condition.

Sleep apnea is a common disorder in which you have one or more pauses in breathing or shallow breaths while you sleep. As a result, the quality of your sleep is poor, which makes you tired during the day.

Sleep apnea can also be related to more serious

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Winter Special: 419.442.0474 Veterans Pinning Ceremony November 11 • 12:30 p.m.

The French Medal of Knight of the Legion of Honor was awarded to West Park Place residents Erro (Mike) Michelson and Eugene Meyer. West Park Place along with Great Lakes Caring will be having a pinning ceremony on Veterans Day.

A lunch and learn education event about sleep apnea

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419-843-6106.

We all remember too well the cold and snow of last winter and the travel difficulty and confinement that accompanied it.

Join us as we honor and pay respect to our American veterans.

West Park Place Invites You to Attend.

Call 419.442.0474 to attend these free events! Limited Seating!

Live Well with Walgreens November 25 • 3:00 p.m.

November is Chronic obstructive pulmonary disease (COPD) Awareness month. It is the 3rd leading cause of death in the United States.

Learn about COPD, the risk factors, symptoms, and treatment at Wagreen’s informative presentation.

3501 Executive Parkway Toledo, OH 43606 seniorstar.com

Dr. James Tita

16 November 2014 | Healthy Living News

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17

medical conditions.

Anyone affected by sleep apnea, including spouses and caregivers, is welcome to attend. Complimentary lunch is provided. For more information, call Heartland of Waterville at 419-878-8523.

Dr. James Tita is the medical director of the Heartland of Waterville’s Respiratory Care Program. He has held many leadership positions at St. Vincent Mercy Medical Center, including Chief of Staff, and is currently the medical director of the Mercy St. Vincent Medical Center Intensive Care Unit and Department of Respiratory Care. After graduating from Midwestern University College of Osteopathic Medicine, he completed a residency in Internal Medicine and Fellowship in Pulmonary Disease, both at Cleveland Clinic. He is board certified in Internal Medicine, Pulmonary Disease, Critical Care, and Sleep Disorders Medicine.

Heartland of Waterville is a skilled and post-hospital care facility that offers tenured respiratory rehabilitation and acute respiratory care.

Heartland of Waterville also operates a ventilator care and rehab unit, caring for some of the region’s most medically complex patients. ❦

Medicaid expansion and marketplace insurance

by Julie Grasson

I

n October 2013, we saw the first open enrollment for insurance through the federal Marketplace. Later that year in December, the state of Ohio expanded Medicaid in connection with the Affordable Care Act (ACA), which went into effect on January 1, 2014. Despite several road bumps with www. healthcare.gov, more than 143,959 insurance plans were purchased during open enrollment. However, in Lucas County alone, only 4,759 out of the 22,715 uninsured individuals (based on the 2012 US Census) actually purchased a plan.

In Ohio, 507,837 individuals (based on the 2012 US Census) became eligible for Medicaid expansion beginning January 2014. Through the end of July, 68.8% had enrolled, due in large part to the aid provided

by Federal Navigators and CACs

(Certified Application Counselors). Within Lucas County, the rate is slightly higher; of the roughly 22,174 individuals eligible, 72% (15,989) had enrolled through the end of July 2014.

Despite the relatively large number of individuals enrolled in Medicaid and Marketplace insurance, it is estimated that over 24,000 Lucas County residents and more than 619,700 Ohioans still remain uninsured. While there is no deadline to apply for Medicaid, the next open enrollment for insurance through the Marketplace is November 15, 2014 through February 15, 2015.

The Ohio Association of FoodBanks was awarded $2.18 million in Federal Navigator Grant funds from HHS in September 2014. Toledo/ Lucas County CareNet is proud to be a part of the FoodBanks’ consortium for a second year and will once again be placing federally certified

Medicaid Annual Household Income Guidelines

Marketplace Annual Household Income Guidelines for Insurance Tax Credits

1

Up to $16,104

$16,104–$46,680

2

Up to $21,707

$21,707–$62,920

3

Up to $27,310

$27,310–$79,160

# of people in household Heartland of Waterville Presents

“Keep Calm and Breathe Easy” Tuesday, November 18, 2014 12:00 Noon – 1:00 PM*

navigators throughout 19 counties in Northwest Ohio. Navigators will assist individuals with Medicaid and Marketplace applications, provide education on the variances between bronze, silver, gold and platinum plans; and help individuals research which plans include their existing physicians and current medications. These services are provided at no cost to the individual seeking assistance, and all education is fair and unbiased.

Based on the chart below, uninsured individuals can have a good indication if they may qualify for Medicaid expansion or insurance through the Marketplace with tax credits to help reduce monthly premiums.

It is important for individuals to know that if they are without insurance in 2015 for more than three months, they can be assessed a fee when filing their 2015 taxes, which can be either 2% of their income or $325 for each adult in the household and $162.50 for each child in the household, whichever is higher.

Anyone who would like assistance from a Certified and Licensed Navigator can call 1-800-648-1176 or visit www.ohioforhealth.org to find a nearby navigator and to schedule an appointment. ❦

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• Prescription drug coverage • 24-hour nurse advice line • Rewards for healthy choices • Maximum annual out-of-pocket protection • Preventive coverage • Doctor’s office visits and hospital coverage • Convenient mail-order prescription coverage • Emergency coverage at home and when you travel • Fitness program - gym membership at no additional cost • Dental, Vision and Hearing coverage • Over-the-counter medication benefit Get the benefits you need and the extras you want. One plan, one price. Simple.

Make the switch in just one call.

1-855-808-1727 (TTY: 711)

Join pulmonologist Dr. James Tita as he hosts a complimentary Lunch and Learn. Dr. Tita will provide an overview of sleep apnea and will discuss ways to identify and manage this condition.

Call a licensed sales agent seven days a week, 5 a.m. – 8 p.m.

Sleep apnea is a common disorder in which you have one or more pauses in breathing or shallow breaths while you sleep. This can be related to more serious medical conditions. Anyone affected by sleep apnea, including spouses and caregivers, are welcome to attend.

Dr. James Tita is the Medical Director of Heartland of Waterville’s Respiratory Care Program. He is currently the Medical Director of the Mercy St. Vincent Medical Intensive Care unit and the Department of Respiratory Care. He is board certified in internal medicine, pulmonary disease, critical care and sleep disorders medicine.

Humana is a Medicare Advantage organization with a Medicare contract. Enrollment in a Humana plan depends on contract renewal.

The benefit information provided is a brief summary, not a complete description of benefits. For more information contact the plan.

Limitations, copayments and restrictions may apply. Benefits, premium and member cost share may change on January 1 of each year.

You must continue to pay your Medicare Part B premium. For accommodation of persons with special needs at sales meetings call 1-855-808-1727 (TTY: 711), 5 a.m. – 8 p.m., 7 days a week. Applicable to Humana Gold Plus H8953-010 (HMO).

Complimentary lunch is provided. *Presentation time is approximate.

Register by calling 419.878.8523 or myndi.milliken@hcr-manorcare.com

Heartland of Waterville 8885 Browning Drive Waterville, OH 43566

18 November 2014 | Healthy Living News

Y0040_GHHHXCNENTE_2 Approved We love feedback. Like us on Facebook. Follow us on Twitter.

HUNO3071v3.indd 1 10/16/14 10:2119 AM Connect with our advertisers via our online issue at www.hlntoledo.com | Healthy Living News | November 2014

HUNO3071 – 10” x 12” – 4C – November Issue Healthy Living News

CUDDLE ON

Education is the best defense against diabetes



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Allergy testing and treatment with allergy shots or allergy drops.

W

e frequently hear news reports stating that the rate of diabetes in the United States has reached epidemic proportions. While such claims may seem like journalistic sensationalism, data indicate that they’re actually right on the mark.

According to Jeannie Wagner, MS, RD, LD, CDE, BC-ADM, Clinical Coordinator for Diabetes Education for Mercy, an estimated 29 million Americans—about 9% of the population—currently have diabetes, and approximately 86 million Americans are in the state known as pre-diabetes, which means their blood sugar levels are higher than normal but not yet high enough for a diagnosis of diabetes. “Even more frightening, if people don’t start paying attention to this problem and making changes at or before the pre-diabetes stage, it’s estimated that by the year 2050, one in three Americans will have diabetes,” Wagner warns.

What’s more, type 2 diabetes, the form associated with lifestyle and once termed “adult-onset diabetes,” is becoming more and more prevalent among younger people, which will have profound implications for their long-term health.

How is diabetes diagnosed?

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Healthcare practitioners can diagnose diabetes or pre-diabetes with three different techniques: the fasting blood sugar test, oral glucose tolerance test, or the Hemoglobin A1c (A1C) test.

With the fasting blood sugar test (which is performed after at least 8 hours without food or caloric beverages), a result less than or equal to 100 mg/dl is considered normal, any value between 100 and 125 mg/dl is pre-diabetes, and 126 mg/dl or higher is diabetes.

The oral glucose tolerance test involves having the patient drink a special sweetened beverage to see how the body processes the sugar.

With this test, a result of 140 mg/dl or lower is normal, 140 to 199 mg/dl is pre-diabetes, and a value of 200 mg/ dl or higher is considered diabetes.

The A1C test determines the pa-

tient’s average blood sugar level over the course of several months.

A normal A1C result is less than or equal to 5.6%, pre-diabetes is in the range of 5.7 to 6.4%, and diabetes is diagnosed at 6.5% or higher.

The earlier diabetes is identified, the better As with so many chronic diseases, the sooner diabetes is diagnosed—and treatment and lifestyle changes are initiated—the lower the patient’s risk of developing serious complications, such as heart disease, stroke, kidney disease, eye problems, peripheral neuropathy, and others. “The sooner you control diabetes, the less vascular damage will be done,” Wagner notes.

“That’s extremely important because people with diabetes are twice as likely to die of heart disease or stroke as those without the disease.”

Wagner also points out that, in addition to avoiding smoking, closely monitoring the “ABCs”—an acronym for A1C, blood pressure, and cholesterol—is the best way for people diagnosed with diabetes to avoid developing complications.

Strive for the D5 According to Wagner, Mercy physicians also promote a set of five treatment goals, called the D5, which represent the gold standard for diabetes management. When reached together, the D5 significantly reduce the risk factors for complications of diabetes. They include aspirin use (as appropriate), smoking cessation or avoidance, LDL cholesterol (the “bad” cholesterol) below 100 mg/dl, A1C below 8%, and blood pressure below 140/90.

Know the symptoms The onset of diabetes can cause a variety of physical symptoms, among them: • Significantly increased thirst • Increased frequency of urination (often waking in the middle of the night) • Fatigue

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• Blurred vision • Poor wound healing • Potentially, changes in body weight (typically weight loss) “However, in pre-diabetes, most people don’t report feeling any different at all. Even at the level of diabetes, for every one person diagnosed, there is another walking around with no obvious symptoms to indicate that he or she has the disease,” Wagner says.

Diabetes education makes a difference To help patients learn to successfully manage their diabetes, Mercy currently offers a diabetes education program at Mercy St. Vincent Medical Center.

The program, which is recognized by the American Diabetes Association (ADA) and coordinated by Wagner, who is also a registered dietitian, and Rita Sowinski, RN, BSN, CDE, the Nurse Educator, is for adult patients age 18 and older (there is also a pediatric program at the hospital) and consists of four group classes or one-on-one sessions.

“We see everyone individually first for a general assessment and then channel them into group or individual classes, depending on what is appropriate for the patient.

After the classes are finished, we have a follow-up meeting at three months to check how patients are doing with the goals they have set, review results of their recent A1C tests, and assess any medication changes and further education needs. Thereafter, we have a twohour visit on an annual basis. We also offer Medical Nutrition Therapy (MNT) for patients needing individualized meal planning/ carbohydrate counting, which is done by a registered dietitian,” Wagner explains.

The content of the classes is based on the AADE7™, which are seven Answers to crossword from page 14 1

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as a podiatrist and pharmacist, are brought in to share their perspectives as well. “The focus of the classes isn’t on lecturing, however. We facilitate the topics, but we let the participants lead the discussion so they learn from one another as well as from us,” says Wagner.

Though the diabetes education classes are currently available only at Mercy St. Vincent Hospital, the ADA has approved expansion of the program to other sites for patient convenience, including Mercy Family Practice at the Gandy Health Center and Mercy St. Charles Hospital.

Wagner notes that another important resource available to the community is the CDC-led National Diabetes Prevention Program, offered locally by the YMCA. “Seeing prediabetes on the rise, the YMCA is stepping up to do its part by offering this grant-funded, evidence-based program to help area residents prevent type 2 diabetes through education, physical activity, and healthy eating,” she says. ❦ Mercy’s diabetes education program is available by doctor referral. For more information, please call 419-251-4505.

NEED SOME TIME TO MEND? Sunset Village offers comfortable, home-like private rooms for short or long term nursing/rehab care so you can focus on getting back to your best self – and safely back home. Call today to see how Sunset Village can help you spread your wings.

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self-care behaviors identified by the American Association of Diabetes Educators as most effective in bringing about the desired outcomes of diabetes education. They include healthy eating, being physically active, monitoring blood sugar, taking prescribed medications, problem solving, risk reduction, and healthy coping.

Among the topics discussed in class are carb counting, food label reading, eating out, developing a meal plan, medications, preventing complications, holiday eating, and many others. Guest speakers, such

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It pays to be picky about joint-replacement rehab

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ehabilitation plays a critical role in recovery following joint replacement surgery, and the quality of the rehab environment chosen can have a significant impact on patients’ ability to achieve their therapy goals and return safely to their lives and daily activities. At The Manor at Perrysburg, Bowling Green Manor, and The Bowling Green Care Center (all HCF Management facilities), the rehabilitation teams understand that an individualized, person-centered approach to joint-replacement rehab consistently yields the most successful outcomes.

Because joint replacements are usually elective, patients undergoing these procedures often have the opportunity to select a rehab facility ahead of time—an option that Barbara Mullholand, Director of Market Development for The Manor at Perrysburg, urges patients to consider. “Quite frequently, people know exactly when they’re going to have that surgery. Oftentimes, they’ve scheduled it with the orthopedic surgeon a few weeks or more in advance. During that time, we strongly encourage patients and their families to come in and tour our facility, meet the therapists and nursing staff, look at the rooms available, and make a reservation for the type of room they’d prefer to have,” she says.

Erica Sage, Director of Rehabilitation at The Manor at Perrysburg, concurs, adding, “It’s better to decide where to go ahead of time rather than when you’re in crisis, not just for your own sake, but also for the

sake of your family. Knowing exactly where they’ll be taking you after surgery relieves them of a lot of stress. They can even bring in some of your clothing and other personal items before surgery so your room feels more like home when you arrive.”

The period prior to surgery is also a good time for patients to bring their insurance card, advance directives, and any other pertinent medical documentation to their chosen rehab facility so they complete the necessary paperwork in advance, allowing them to focus completely on recovery when they arrive after surgery.

For Patricia (Jaeger) Herman, touring The Manor at Perrysburg prior to undergoing a partial knee replacement last November helped ease the anxiety of entering an unfamiliar environment. This surgery was the second performed on her right knee, so she knew what to expect from the standpoint of physical recovery. But she also wanted to familiarize herself with the staff she’d be working with in rehab. “It’s the fear of the unknown that causes apprehension and anxiety. Having been here, seen everything, and met the therapists and nurses ahead of time made the adjustment so much easier for me,” she remarks.

Mrs. (Jaeger) Herman also appreciated the warm, welcoming, home-like atmosphere of the Manor at Perrysburg, a family owned facility that was fully remodeled—complete with a brand-new therapy wing—in 2012. The facility’s unique, innova-

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cupational therapy is often necessary to help joint-replacement patients manage regular daily activities such as bathing and dressing. The OTs can also teach them to work with special adaptive equipment designed to make daily activities easier for people with functional limitations, such as reachers, sock aids, and long-handled sponges.

Prior to discharge, and with the patient’s approval, the therapists can also perform a home evaluation to ensure it’s safe and appropriate for the patient to return. The purpose of the evaluation is to determine whether it might be advisable for the patient to add safety or accessibility features, such as grab bars, a shower chair, and a raised toilet seat in the bathroom, as well as to check for potential hazards, such as loose throw rugs, electrical cords, or clutter that could cause a trip-and-fall accident.

“I had my home evaluated before my surgery, and my grandson came over to put in grab bars, which was a big

help,” says Mrs. (Jaeger) Herman.

During her rehab stay at The Manor at Perrysburg, Mrs. (Jaeger) Herman enjoyed support not only from the staff and other residents, but also from her then boyfriend of four years, Chuck Herman. Shortly after Patricia finished her joint-replacement rehab at The Manor at Perrysburg, the two were married at Sacred Heart Catholic Church in

East Toledo. Since then, they started married life together in a brand new home—and with one brand new knee. ❦ For more information about The Manor at Perrysburg, please contact Barbara Mullholand at 419-874-0306, and for Bowling Green Manor and The Bowling Green Care Center, please contact Jeff Miller at 419-351-6514.

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Sage explains that when joint-replacement patients arrive at an HCF facility post surgery, the goal is to perform an evaluation as soon as pos734-847-4700 sible and then get them started with www.DrMarkNeumann.com rehab. The physical therapists focus on improving the strength, function, and range of motion of the particular joint in question.

In addition, they can utilize different state-of-the-art From hospital to home, our goal is to make your transition modalities such as seamless, and get you back to the lifestyle you deserve. electrical stimulation (or e-stim), ultraComplete Your Paperwork sound, and shortBEFORE Don’t wait to fill out forms. Begin early and we’ll help you fill out wave diathermy to the necessary paperwork during your pre-surgery registration.

After her short-term therapy stay AFTER speed recovery, deat The Manor at Perrysburg, crease pain, increase Discuss Insurance Coverage Patricia independently walked down the aisle at her wedding. range of motion, Insurance coverage can be complicated. Meet with the and stimulate tisappropriate member of our team to review your benefits and sue healing in many covered treatments and services. joint-replacement patients.

Tour the Facilities If ordered by Comfort comes from feeling good about your surroundings, so their doctor, knee-rewe’ll give you a tour of the facility and let you know where each 250 Manor Drive, Perrysburg, OH 43551 placement patients phase of your care will take place.

419.874.0306 might also use a Meet Our Team CPM (continuous It’s nice to know who will be taking care of you. So we passive motion) maencourage you to meet with our staff and establish a chine in the comrelationship before you begin your treatment.

1021 West Poe Road, Bowling Green, OH 43402 fort of their room to 419.352.4694 gradually increase Share Your Thoughts their range of moAlthough we will receive your treatment orders upon transfer, tion and improve Pre-surgery Registration is the perfect time to share any upon the gains concerns or questions you may have about your care and they’ve achieved 850 West Poe Road, Bowling Green, OH 43402 treatment. during therapy ses419.352.7558 sions.

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Benefits of the bicycle

by Julia Roberts

Spring Meadows Senior Community 1125 Clarion Ave. Holland, OH 43528 419-866-6124 www.springmeadowsecf.com

Aspen Grove Assisted Living Residence 7515 Secor Rd. Lambertville, MI 48144 734-856-4400 www.aspengrovefamily.com

Senior Living Guide Choosing a senior living community that’s right for you or a loved one is among the most important—and challenging— decisions you’ll make in your lifetime. We’re fortunate here in Northwest Ohio and Southeast Michigan to have a wide variety of high-quality senior living options, including independent living, assisted living, continuing-care, and subsidized low-income housing communities.

To make your decision a bit easier, we’ve assembled this guide to all the senior living properties that regularly support Healthy Living News through advertising. In addition to referencing this page for each organization’s contact information, we urge you to see their ads in the pages of this issue, check out their websites, and give them a call to schedule a tour if you are interested in hearing more about all the services and amenities they offer.

Senior Star at West Park Place

St. Clare Commons 12469 Five Point Road Perrysburg, OH 43551 419-931-0050

3501 Executive Parkway Toledo, OH 43606 419-972-2280

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Sunset House 4030 Indian Rd. Ottawa Hills, OH 43606 419-536-4645 www.sunset-communities.org

The Woodlands 4030 Indian Rd. Ottawa Hills, OH 43606 419-724-1220 www.sunset-communities.org

4121 King Road Sylvania, OH 43560 419-517-8200 www.kingstonhealthcare.com

Pelham Manor 2700 Pelham Rd Toledo, OH 43606 419-537-1515 www.jewishtoledo.org

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Otterbein Skilled Nursing and Rehab Neighborhoods Monclova/Perrysburg 3529 Rivers Edge Drive Perrysburg, OH 43551 Joy Riedl • 419-308-0585 jriedl@otterbein.org

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The Laurels of Toledo

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T

he simple act of riding a bicycle can have boundless positive impacts on an individual and the community at large. First, there are obvious financial benefits. On an individual level, people can cut down on the significant portion of their budget that is allocated to transportation by riding a bicycle. On a community level, roads designated for bicycles are cheaper to establish and maintain.

There are also obvious environmental benefits. If the average American’s commute (which is less than three miles) were done by bicycle, not car, there would be impressively less greenhouse gas emissions, noise pollution, and overcrowding of the roads and parking lots. The myriad of benefits continues, but what most people don’t know about are the remarkable and not-so-obvious health benefits.

It is difficult to do justice to the positive impact of cycling on one’s health in just one article. Its effects on physical and mental health are well-documented, and it decreases risk of stroke, heart attack, some cancers (including breast cancer), depression, diabetes, obesity, and arthritis. Cycling has also been shown to decrease many of the risk factors for the number one cause of death in the country (cardiovascular disease), lowering “bad cholesterol” and increasing “good cholesterol.”

Compared to other forms of exercise, riding a bicycle puts less stress and impact on the joints and results in a more balanced tone of the muscles, working not only the legs, but also the core and arms. Though everyone rides at difference intensity levels, most will burn hundreds of calories in one bike ride and may

burn up to 1,000 calories per hour.

By commuting to work just twice a week, one can easily lose a pound of weight a month. Cycling has also been shown to decrease fatigue and increase energy levels, related to the massive dopamine release associated with long bicycle rides.

The benefits are not just in the bones and muscles, but the brain as well. Riding a bicycle has been shown to increase blood flow to the brain and promote brain development in the hippocampus, an area involved in memory. Besides the well-documented physical benefits, the mental health benefits also abound. I have often heard people refer to cycling as their form of meditation—it connects you to the environment and quiets the mind.

Research has shown that those who commute with bicycles versus motor vehicles throughout a work week report significantly lower stress and depression levels.

On a personal note, riding a bicycle has changed my life—what is exercise (normally a word I grudg-

ingly associated with anything and everything unpleasant) has become one of the most enjoyable things I do in a week. I have lost weight, gained stamina and energy, become more in tune with my environment and body, and connected with a whole community of individuals who enjoy riding as well.

Ultimately, one of the ways to a safer, healthier society and individuals is riding a bike. It is clear that this is becoming more recognized nationally and locally through policy and infrastructure changes, but there is a long way to go. For example, many people still don’t realize that a bicycle is considered, by law, a vehicle. Thus it belongs on the road and is subject to the same traffic laws as cars are.

Sharing the road has more benefits than one, and the more awareness is raised about it, the safer and healthier our community—and you—can be.❦ Julia Roberts, MPH, UTCOM MS4, submitted on behalf of The Academy of Medicine of Toledo and Lucas County, www.toledoacademyofmedicine.org.

Did you know about Toledo’s best kept secret?

Did Did you know about Toledo’s best kept Did you you know know about Toledo’s best keptsecret? secret?

Swan Creek Retirement Village Creek Retirement Village Did you knowaSwan about Toledo’s best kept secret?

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24 November 2014 | Healthy Living News

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25

The changing face of arthritis

The University of Toledo Medical Center

Rheumatology Physicians

A focus on rheumatoid arthritis

are accepting new patients

by Bashar Kahaleh, MD

utmc.utoledo.edu

R Rheumatology physicians provide diagnostic and therapeutic evaluation for adults and children with acute and chronic rheumatic diseases. We commonly see patients with: • Rheumatoid arthritis

Dr. Nezam Altorok

• Chronic arthritis • Systemic lupus • Polymyositis • Vasculitis • Autoimmune diseases The University of Toledo Medical Center Ruppert Health Center, Suite H

Dr. M. Bashar Kahaleh

For more information or to schedule an appointment please call 419.383.DOCS (3627)

A Higher Degree of Healing

Recovery to Home...

Dr. Vivek Nagaraja

One patient at a time

Lutheran Home at Toledo (East Toledo/Oregon) 419-724-1841 Lutheran Home at Napoleon (Napoleon) 419-592-1688 Lutheran Memorial Home (Sandusky) 419-502-5706 Lutheran Homes Society 2021 N. McCord Road Toledo, OH 43615 www.LHSOH.org

Our rehab services include: y Inpatient and outpatient therapy

y Physical, occupational and speech therapy y Skilled nursing care y IV therapy y Complex wound care y Tracheostomy care y Home assessments y And much more

26 November 2014 | Healthy Living News

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5.

01 , 2 nd 15 a ry l t h . ua ea ts br h en Fe ood om gh g m l. ou w e’s el 4 thr er ho of lif e w 201 cov all Liv 15, dis joy e. er to en lif mb 77 ou ur ve -08 lp y yo s No 413 he It’s ent i (800) d can llm at in ro s f m en ll u e o Ca eac p

Lutheran Village at Wolf Creek (West Toledo/Holland) 419-861-5634

en

Lutheran Homes Society has four therapy centers to serve you.

Op

Lutheran Homes Society’s rehabilitation services focus on the needs of the patient. Do you want a private room for your recovery?

We have that. Looking for individualized care? We have that, too. Our care plans are designed to restore function, reduce pain, prevent further injury, and, most importantly, get you back home.

ecent advances in the under- therapies—Enbrel, Humira, Remstanding of arthritis resulted in icade, Orencia, etc. are just a few the introduction of new treatment medications manufactured through approaches that changed the course biological process and are quite difand outcome of many forms of ar- ferent from chemically synthesized thritis. Currently, a person with in- medications—has been heralded as flammatory arthritis, who is treated one of the most dramatic changes in early and appropriately, the outlook for RA patients. should expect prevention These drugs effectively of joint damage, maincontrol the symptoms (like tenance of employment, pain and joint stiffness) and and enjoyment of good signs (such as joint swelling) quality of life. of RA, even in patients who Rheumatoid arthritis, are in the advanced stages commonly called RA, is of the disease. Particularly the most common form important, they substanof inflammatory arthritis. tially retard and frequently It has been long feared halt joint damage.

Control of RA in its early as one of the most disabling types of arthritis. stages is associated with RA is an autoimmune long-term financial savings, Dr. Bashar Kahaleh disease that is triggered such as the diminished need and maintained by a for in-patient rehabilitation faulty immune system (the body’s or orthopedic surgery on damaged defense system). At least 1.3 million joints, and continued employment.

US adults have RA; of these, about Furthermore, rapid and effective 75 percent are women. In fact, 1 to control of inflammation will minimize 3 percent of women may get RA in the incidence of premature heart disease and stroke. their lifetime.

The disease most often begins The best treatment of RA involves between the fourth and sixth decades more than medicines alone. Patient of life. However, RA can start at any education, such as how to cope with age. It causes pain, stiffness, swelling, RA, is also important. Proper care and limited motion and function requires the expertise of a team of of many joints. It can affect many providers, including rheumatologists organs as well, for instance the eyes, and physical and occupational therlungs, or heart. Serious collateral apists. Patients will need frequent damage takes the form of premature visits throughout the year with the atherosclerosis (hardening of the rheumatologist. These checkups let arteries), which accounts for much of your doctor track the course of your the reduced lifespan of patients with disease and check for any side effects severe RA as a consequence of heart of your medications. attacks and strokes. Up to a third of The UTMC Rheumatology Clinic patients with rheumatoid arthritis provides patients with all types of stop working within two years of inflammatory arthritis rapid access onset as a result of joint damage. to rheumatologists for a comprehenThe good news is that the out- sive assessment and an appropriate look has greatly improved for many treatment at the early stage of their people with newly diagnosed RA. arthritis. We are committed to applying Treatment advances have made it early comprehensive evaluation and possible to stop, or at least slow, the therapy to patients with joint sympprogression of joint damage. We now toms. Patients will now be able to see have many new treatments that target a rheumatologist within one week the inflammation that is caused by of requesting an appointment. Our RA. We also now understand better physicians are currently accepting when and how to use treatments to new patients. Call 419-383-3627 for an appointment today! ❦ get the best effects.

The introduction of biological

MedMutual.com/YourHealth

© 2014 Medical Mutual of Ohio

Connect with our advertisers via our online issue at www.hlntoledo.com | Healthy Living News | November 2014

27

A Walk in the Park LeMoyne Mercer

Watch for animals on the road

O

ur guidebook for the Alaska Highway offered some helpful advice: “Watch for animals on the road northbound.” How, I wondered, do they train the animals to stay in the northbound lane? Can you just ignore them if you are southbound? I’m sure our stalwart HLN editor would have just removed “northbound” and eliminated the ambiguity.

But, dear reader, that is merely a pedantic quibble. Whether or not

you are “northbound,” travelers should always watch for animals on the road.

People who know that Shirley and I travel a lot sometimes ask, “Did you see any animals?” They don’t mean farm animals. Or squirrels or raccoons or ‘possums. They mean “real” animals. You know, the big ones. Elk, moose, bison. Mostly, they mean bears. Even my sister, after all these years, still seems impressed

that, well yes, we do see bears.

Regular readers of this column may have gotten the impression that bears in the West and Great North are as common as squirrels in South Toledo. That is an impression I have worked hard to cultivate. Partly because it is true. Partly because it fits our personae as fearless explorers in the exciting world of ferocious beasts.

Please forgive a digression. (My ADD is working overtime today.)

Shirley and I took a little walk in the woods to visit a “historic town site” in Alaska. Along the way, she spotted some steaming fresh bear scat in the trail. Knowledgeable hikers can tell two important things from fresh bear scat: what he has eaten recently; who he is likely to eat next.

We moved at a deliberate pace right on out of there.

Seeing animals on the road is easier than you might think. Perhaps even easier than seeing them in the woods. Bison, for example, are really, really common in Grand Teton National Park. Even so, we visited several times back in the ‘80s without seeing any at all. Trailheads and visitor services are mostly along the park road that runs close to the base of the mountains. It has numerous

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28 November 2014 | Healthy Living News

pullouts and a low speed limit designed for gawkers. Motorists who are more interested in speed than in sightseeing typically take the parallel Rt. 191 (and grow irate with drivers who dawdle). Ironically, hundreds of bison, as well as quite a few pronghorns, are to be found along Rt. 191, just a short distance from where the tourists are complaining that they haven’t seen any.

Stone sheep, like many animals, come down to lick salt on the road. The lamb stuck very close to mama.

had an important engagement in Whitehorse. He swerved around the vehicles parked (illegally) in the road and almost ran over one of the rams as he sped away.

Stopping for photos along the road in wild places can be problematic. Often, there is no safe place for drivers to pull over. There may be no shoulder or you might come upon the animals just over the crest of a hill or, like the bighorn sheep, right around a curve. Smart drivers obey the law and don’t stop unless they can get safely off the road.

A little farther up the road, we met a half dozen Stone’s sheep, a subspecies of Dall’s sheep that is named for Allen Stone. They live in northern British Columbia where they

had come down to lick the salt on the Alaska Highway. Dall sheep, on the other hand, are named for William Healey Dall who…oh, never mind.

Both species are somewhat smaller than bighorn sheep and have much less impressive head gear.

None of the above should be confused with the mountain goat—which, technically speaking, is not a goat but a relative of the chamois. Now, here’s the fun part. (Don’t you just love biology?) The easiest way to tell bighorn sheep from mountain goats is that sheep are brown but goats are white. Except in the far north where

the Dall’s sheep are white and the… oh, never mind again.

And another thing: You should

Bighorn sheep are brown. Mountain goats are white. Watch for either where they may come to supervise road construction projects.

EAT HEALTHY, SLEEP MORE, DRINK WATER AND GET MOVING! This pronghorn, feeding near the road, was still wearing her winter coat in early June.

That is never an issue in Yellowstone. First-time visitors tend to screech to a halt if they spot a lone bison lying in a meadow a half mile away. After two or three hours, though, they are cursing all the bison for blocking the road and making them late for the scheduled eruption of Old Faithful.

Adapting quickly to a plethora of wildlife is a common phenomenon.

On the one hand, visitors to wild and scenic places look forward to encounters with wildlife. At some point, though, our wildlife receptors just get saturated and we are no longer as impressed—or as patient—as when we saw a (fill in the blank) for the very first time.

Mercy Children’s Hospital and Kohl’s Cares believe that fostering positive behaviors in health and nutrition will help children be healthier and happier.

We’ve teamed up to offer parents and other caregivers’ practical advice on raising healthy children. Kohl’s Kids in Action is focused on four valuable steps that are important to better health: good nutrition, increased physical activity, proper water intake and good sleep habits.

Attention Elementary Educators and Administrators Are you looking for programs that meet the National Health Education Standards*? Do you lack funding for extended Health Education? Let us help.

Mercy Children’s Hospital and Kohl’s Cares believe that fostering positive behaviors in health and nutrition will help children be healthier and happier.

We’ve teamed up to offer area elementary school students practical advice on keeping themselves healthy. The Kohl’s Kids in Action community outreach program delivers four key messages: get enough sleep, drink plenty of water, eat a variety of healthy foods and get at least 60 minutes of physical activity every day. We offer these lively lessons using fun activities, discussions and role playing exercises. We can teach one classroom at a time, or larger groups, depending on the needs of your school.

We are currently taking reservations for the end of this year, summer health fairs, and for the 2012-13 school year. For more information, call Kohl’s Kids in Action at 419-251-1246 or visit kohlskidsinaction.org.

“

*These lessons correlate with the following National Health Education Standards:

We are committed to our mission of

1. Students will comprehend concepts related to health promotion and disease prevention to enhance health.

Providing Service With Our

Hearts

and

Hands”

and as such, our employees take the extra measures to create the comforts of home during a critical time.

"Watch for sheep on the road" should be taken literally in the Yukon.

In the Yukon, we saw a sign: “Watch for Mountain Sheep on the Road.”

We went around a curve and there they were, just as advertised. Traffic was stopped. Including a tour bus loaded with people who all wanted pictures. A couple of the rams were butting heads right there on the shoulder. Most of us thought it was fairly impressive. But one fellow

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2. Students will demonstrate the ability to use decision-making skills to enhance health.

3. Students will demonstrate the ability to practice healthenhancing behaviors and avoid or reduce health risks.

Connect with our advertisers via our online issue at www.hlntoledo.com | Healthy Living News | November 2014

29

never confuse the wood bison of Canada with the plains bison of the US. The wood bison is also called the wood buffalo or the mountain buffalo or the American bison. Because it lives in Canada. Get it? Now, stick with me. There will be a quiz on Friday.

The plains bison is sometimes called the American buffalo. But there are no buffalo species in America. So, just to simplify and hammer home the point, taxonomists gave them a redundant scientific name: Bison bison.

Sometimes people have trouble distinguishing members of the deer family. Visit enough national parks and you get to overhear lots of interesting conversations. You might be surprised by the number of times we have heard Daddy tell Junior that the mule deer is an elk or the elk is

Look! It's a wolf! Nah. It's just a coyote. Well, I don't know for sure but I think that's a fox.

Sometimes moose take off through the woods at really amazing speeds. Sometimes they just stand in the road posing for pictures.

a moose or the moose is a caribou or the caribou is a pronghorn. We won’t even bother telling you about the fox that was a coyote that was a wolf. A fellow in our First and Still the Best National Park told me that such distinctions are “just technicalities.”

He’s probably right.

Shirley and I have seen quite a few actual moose from the road. We have probably seen even more in campgrounds. At least, I’m almost certain they were moose.

But people get really worked up when they see a bear. Especially when they suddenly stumble into one on a hike. Ideally, what you want is a potentially fatal encounter experienced in absolute safety. We have met a number of bears while we were just

walking around in the woods. Sometimes they were in the campground checking to see if someone left out a picnic basket or cooler. It is probably better for everyone involved if the bear is feeding quietly near the road and can be viewed from the safety of a vehicle. Whatever you do, don’t get out to shove your camera or iPhone in his face. (We have seen quite a few people who apparently have no idea what “zoom” means.)

Unlike members of the deer family, almost everyone can recognize a bear. But is it a black bear or a grizzly bear? Veteran hikers say if the bear chases you up a tree, it is a black bear.

If the bear shakes the tree until you fall out, it is a grizzly bear. But that

Black bears are not always black, but they are increasingly common in all parts of the country.

Early intervention is key to effective Alzheimer’s care

T Grizzly bears are sometimes confused with the Terminator because of their huge shoulders and reputation for ferocity.

is just a technical distinction with no difference as far as your edibility is concerned. If you carry pepper spray for the bears, the seasoning just makes you even more delicious.

The odds are far greater that any bear you happen to see is a black bear.

Their range, which now includes a lot of suburban backyards, is extensive and getting bigger every year. But black bears are not necessarily black, so the Daddy who can’t tell an elk from a moose can be forgiven for not knowing that a bear that is brown might still be a black bear. (Naturally, the taxonomists call him Bear bear.)

Grizzlies live in the western moun

hough there is no cure for Alzheimer ’s disease, medications can slow its progression, preserve memory, and help individuals with the disease live better day-to-day lives—and the earlier Alzheimer’s is diagnosed and treated, the better the quality of life for those affected.

Alzheimer’s disease—one of many forms of dementia—is a progressive, degenerative, ultimately fatal neurological disorder that affects memory, cognition, and the ability to function.

According to the Alzheimer’s Association, more than 5 million Americans are living with Alzheimer’s disease and it’s currently the sixth leading cause of death in our nation. In fact, one out of every three seniors dies

—Continues on page 49.

Open House

with the disease or another form of dementia. What’s more, as the “Silver Tsunami” of baby boomers entering retirement age progresses, these statistics are likely to get worse.

A recent Lucas County Health Needs Assessment revealed that in the state of Ohio alone, 210,000 residents have Alzheimer’s, but that number is anticipated to increase by 19% to 250,000 in 2025.

Recognizing that early intervention is key to leading the best possible life with Alzheimer’s disease, ProMedica Goerlich Center, on the campus of ProMedica Flower Hospital, is offering free memory screenings on Tuesday, November 18, 2014, from 9:00 a.m. to 4:00 p.m. in commemoration of National Memory Screening Day. Tara O’Rourke, Administrator/ Dementia Trainer for the ProMedica Goerlich Center for Alzheimer’s and Dementia Care, notes that the memory screenings are by appointment only and take about a half hour.

“Participants complete standardized cognitive testing, approved by the Alzheimer’s Foundation of America, which involves answering simple yesor-no questions, performing certain tasks, such as drawing a picture, or completing a series of commands to assess your recall,” she explains. “The testing is conducted in a private room with just the assessor and the person being evaluated, and participants get two copies of their results, one to keep and one for their doctor’s

medical records.”

O’Rourke emphasizes that the purpose of the screening is not to diagnose memory loss. Any memory deficits that might be observed during the evaluation should be considered a starting point for follow-up discussion with the participant’s physician.

The Goerlich Center has been offering annual memory screenings since 2008, and in that time, O’Rourke has observed an interesting phenomenon—many of the participants are much younger than anticipated. “We expected most of the people attending to be in their 70s or 80s, but the average age was 51.

In many instances, these people have first-degree relatives with Alzheimer’s, so they’re greatly concerned that any forgetful behavior on their part, such as misplacing their car keys, is a sign that they’re developing the disease.

Many people even come back every year, so if their score does start to drop, they can see their doctor and get the support they need promptly.

We reassure them that coming in for screening is a very positive, proactive step,” she says.

Today ’s Alzheimer ’s medications can maintain the neurotransmitters in the brain and preserve memory longer, but the Goerlich Center can also provide tips on how to take care of the body and heart in order to promote good brain health. Plus, as O’Rourke points out, there are numerous brain-training and neuroplasticity apps online that teach the brain new ways of doing things so there are more possible channels to follow to complete different tasks. Having a “Plan B,” such as using your left hand rather than your right hand

Serious illness raises tough questions.

Let our experts help with what’s weighing on your mind.

Sunday, November 16 12:00 - 4:00 pm Be the best version of OneSelf. centralcatholic.org

ToughQuestionsStraightAnswers.org © 2014 Hospice of Northwest Ohio

30 November 2014 | Healthy Living News

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13-21 BG Health Fall Jan's 2013_Layout 1 10/18/13 11:46 AM Page 22

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(or vice versa) to brush your teeth, can be invaluable if the part of the brain used to complete that task is affected by Alzheimer ’s or a stroke.

In addition to providing a compassionate, safe, and secure residence for patients with Alzheimer’s or other forms of dementia, the Goerlich Center offers adult daycare services as well as short-term dementia-specific rehab, which includes private rooms in a dementia-supported secure environment; expert, dementia-specific physical, occupational, and speech therapy techniques; comprehensive cognitive assessment utilizing the Allen Cognitive Model and the Reality Comprehension Clock Test; an

LPN-to-RN Bridge Program

www.Acadiacareer.com

To schedule an appointment for your free memory screening on Tuesday, November 18 at the Goerlich Center, please call 419824-6448 (select option 3).

Hospice to offer free grief workshop

ENROLLING NOW!

Call 419-833-9100

in-house neurologist, gerontologist, and family practice physician; a quiet, alarm- and restraint-free environment with appropriate socialization and recreational options to promote recovery; and comprehensive planning to assist in returning home successfully with aftercare options. “This program offers a more in-depth assessment and another level of cognitive support for those with memory loss, and they can be paid for by Medicare or private insurance,” O’Rourke says. ❦

17345 McCutcheonville Rd. Pemberville, Ohio 43450 (located NW of Rt. 105 & Rt. 199)

Ask us about our 1-YEAR LPN Programs

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ospice of Northwest Ohio will facilitate a two-hour Facing the Holidays After the Loss of a Loved One workshop for families or individuals dealing with the death of a loved one on Sunday, November 23 from 1:00 to 3:00 p.m.

Being held at the Toledo Hospice Center, the session will enable participants to interact with others their age to share, learn, and support each other through the grieving experience.

For adults Counselors will help attendees explore thoughts and feelings regarding the holidays and learn helpful, creative ways to remember their loved ones, cope with the stress of the holidays, grieve, and rekindle the holiday spirit.

For kids and teens Special activities will encourage

participants to share their personal stories of loss and teach them new ways to cope. They will explore their thoughts and feelings regarding the holidays and learn helpful, creative ways to explore their grief.

Advance registration required Anyone in the community is welcome to attend, whether or not they have any experience with Hospice of Northwest Ohio. Though the workshop is free, registration is required by November 17. To register, call Hospice of Northwest Ohio’s Bereavement Department at 419-661-4001 or 734-568-6801.

Hospice of Northwest Ohio’s Toledo Center is located at 800 South Detroit Avenue, just north of Arlington. For more information about grief and loss or Hospice of Northwest Ohio, visit www. hospicenwo.org.

The Grass is always greener on the Land•Art side

Call for a free lawn care estimate.

419-666-5296 We are committed to quality We use the best exclusive granular turf builders available, and we stand behind their performance.

If needed, additional grandular fertilizer, and liquid weed control will be applied at no extra charge.

We’d like to Thank our valued loyal customers!

32 November 2014 | Healthy Living News

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Kingston focused on best chance for stroke recovery

A

n on-staff medical director a leading cause of disability in the focused on launching the US. The right choice for reharegion’s premier stroke-rebilitation following a stroke habilitation program is just is crucial to attain the best one of the many things that recovery possible. “We curset Kingston Rehabilitation rently achieve a high level of of Perrysburg apart from success with our rehabilitaother skilled-nursing faciltion patient outcomes in both ities in the area. The center our Perrysburg and Sylvania recently opened a dedi- A stroke occurs every 40 campuses,” states Lavonne cated program to support seconds, making it the Elston, physical therapist patients who require stroke leading cause of disability and Regional Director of in the US. recovery between hospital Therapy. “However, we are and home. Stacey Hoffman, committed to continuously MD, a specialist in Physical Medicine advancing our therapy service for and Rehabilitation, joined Kingston stroke patients. We have invested HealthCare to manage a stroke recov- considerable resources to learn from ery program and other specialized some of the best treatment approaches services that will further enhance and programs available. Our specially Kingston’s clinical expertise. trained therapists, along with the Dr. Hoffman is based in the new addition of Dr. Hoffman, make all rehabilitation center located in Per- the difference. Our unique stroke rysburg on East Boundary Street. rehabilitation program is exciting She leads a team of certified nurse for our community.” practitioners and licensed nurses. The Kingston values employees whose facility opened in August 2013 and characters promote our mission of features a warm saltwater pool, private honesty, respectful service, and spacious rooms, and state-of-the-art friendly communication, and we clinical and therapeutic amenities. believe our staff members are our Unlike most other skilled rehabilita- most important asset. We value our tion centers, Kingston offers one-to- professional staff ’s ideas and proone therapy treatments vide leadership, coaching, available seven days a tools, and resources with week, supported by a training for them to do collaborative team of their jobs well. Kingston is physician partners. In special because of our emaddition, the facility ployee-focused culture, holds one of highest and we work together to customer-satisfaction meet resident expectaratings in the state. tions. We hold employee “Kingston is showgatherings where we plan ing true healthcare inour days and encourage novation, not just by each other’s efforts. Check creating an unprecewww.kingstonhealthcare. dented surrounding com for career opportufor recovery, but also nities and to see what by being one of the our employees say about only assisted-living working for Kingston.

Both Sylvania and Perand skilled-nursing companies in the US rysburg campuses offer The right choice for to add a full-time med- rehabilitation following a stroke skilled nursing and rehaical director backed by is crucial to attain the best bilitation for all types of a strong clinical care after-hospital care; howevrecovery possible. model,” said Dr. Hoffer, Kingston Rehabilitation man. “What this means of Perrysburg will house for patients is that Kingston can offer a dedicated environment for stroke stroke patients the best chance for survivors across Northwest Ohio and Michigan. recovery.”

Approximately 795,000 strokes For more information about Kingswill occur this year, one every 40 ton’s stroke program, please call seconds, resulting in stroke being Kingston at 419-873-6100. ❦

When a stroke

unexpectedly pauses life, we help you

press play again.

Introducing Kingston’s On-Site Stroke Recovery Physician With a specialty in physical medicine and

rehabilitation, Stacey Hoffman, M.D.

is the full-time medical director of the

Kingston care staff. She manages a

team of well-qualified licensed nurses

and certified nurse practitioners to

give you the best chance at

stroke recovery.

We understand that stroke isn’t just a neurological disruption; it’s a family disruption that affects both patient and loved ones. Kingston HealthCare is here to set you and your family back in motion through premier stroke care at our state-of-the art facility.

Kingston HealthCare is the region’s best choice for stroke rehabilitation offering:

• Newly constructed skilled nursing and rehabilitation center

• Team of clinical and rehabilitative experts • One-to-one specialized therapy

• Clear and candid facility-to-family communication

• Immediate, ongoing and long-term coping strategies • Private, spacious rooms

rebuild mobility renew strength resume life

Call today to schedule a tour and learn more about our unique stroke program.

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33

I hate my daddy!

N

ot really. My daddy is pretty cool. I became a chiropractor in order to follow in his footsteps.

However, there is one thing that irks me about him; he can put just about anything in his mouth and not gain weight. I remember sitting across from him at the dinner table and watching him wolf down two stacked cheeseburgers, a double helping of potato salad (extra fat please), and a large side of chips. As he is gnawing his way through this gastronomical disaster, he looks at my plate of salad and burger-sans

bun and opines that, “Doug, you are overweight because you lack self-control.” I look for something to throw at him, but he has already pulled the cheesecake out of reach for a second slice. I am sure one of these days I’ll write a “Daddy Dearest” book.

We all know people like my father. People who can eat almost anything and still not gain a pound.

I believe my father has been the perfect weight for his height since he was a teenager and never watched a single calorie he consumed. Un-

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tion alone was not enough. One approach that has seen a lot of success since the 1950’s and a resurgence of interest in recent years is HCG (human Chorionic Gonadotropin) therapy.

Sublingual (under the tongue) HCG therapy with Traditional Chinese Medicine (acupuncture & herbal supplements) along with a strict dietary regime can achieve substantial weight loss of up to one to two pounds per day.

HCG is a hormone found in everyone, but it is found in especially high concentrations in pregnant women. Its purpose is to assist in funneling large quantities of proper nutrients to a developing baby. Its use in weight control dates back to the 1950’s when, in Italy, a Dr. ATW Simeons began using small doses of HCG in obese patients to decrease appetite.

He observed weight loss and decreased inches around hips, thighs, buttocks, and stomachs.

It has continued to gain in popularity as a successful, natural approach to weight loss.

I think those who have been trying for years to lose weight get incredibly tired of hearing self styled experts who suggest that fat people just overindulge or are just too lazy to lose weight. People literally starve themselves to claim a few-pound loss only to see the weight jump back on. Diets are attempted that leave a person dragging and dozing off for afternoon naps in the recliner. In fact, studies have shown that people stuck in these yo-yo dieting cycles end up conditioning their body to store calories more efficiently and end up storing much more fat than they would if they just ate normally!

This phenomenon is termed a “stalled metabolism.” If there were a way to “unstall” your metabolism and start burning calories, most of America would not be obese. This accounts for those people, like my father, who can consume vast quantities of calories without any apparent ill effect while others can walk by a Twinkie wrapper and gain weight!

With this line of thinking, obesity becomes an illness due to an abnormal functioning of some part of the body and every ounce of abnormally accumulated fat is the result of a

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disorder of proper dietary regulation. There should be no doubt that to cure this illness and achieve sustained and lasting weight loss requires a commitment to a permanent lifestyle and diet change.

With our patients, we begin by taking a careful case history to establish any health problems prior to beginning. Then, utilizing acupuncture and herbal supplementation to suppress the appetite, we also incorporate sublingual homeopathic HCG drops, which are taken daily with the idea of triggering the body to utilize stored fat. Once this is established, the patient begins on a carefully monitored calorie-restricted program consisting of 500-1,000 calories per day. HCG releases 1,500 to 4,000 calories from your stored fat.

With the additional calories that you are eating, this is is equal to a 2,000to 4,000-calorie diet, which is why people do not feel hungry while on the HCG Diet.

The literature suggests patients can lose up to one to two pounds per day on average. However, in our office, we have found most patients unofficially average around 20 pounds per month. That’s a little 10x5.9_ES_NurseMaggieAd_HL_414.pdf less than a pound a day.

C

M

Y

CM

MY

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CMY

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©2014 Elizabeth Scott Community

by Douglas A. Schwan, DC, Dipl Ac

fortunately, I did not inherit this trait. Through my college years, I steadily gained weight as I spent inordinate amounts of time in desk chairs struggling to learn the intricate details of the human body. Once I graduated and started private practice, it became a little easier to avoid the weight because my activity level shot up, but the weight I gained stubbornly refused to vacate the premises!

Over time, I had the perfect statistical family. The two-point-three kids, a dog, a cat, a gerbil, the white picket fence, etc. Contentment breeds complacency, and the middle-age spread began to, ah, spread.

I remember one morning stepping out of the shower and noting with disgust that my six-pack abs had turned into a pony keg. As a doctor of chiropractic, I felt disgusted with myself for letting things get so bad. After all, what patient is going to listen to dietary advice from a doctor who can’t even get his own act together?

With expertise in Traditional Chinese Medicine, I began a course of acupuncture and herbal medicine, which led to a slow and steady weight loss. With this program, one loses four to six pounds per month, mainly by appetite suppression. It is slow, steady, and healthy weight loss. The pounds go off just like they came on—a bit at a time. For patients like myself, this was ideal as it didn’t require fancy diets or weird exercise regimes and had the added benefit of balancing the body’s systems overall into a healthy whole.

However, this approach didn’t serve the needs of a large portion of my patients who were used to instant gratification. Many patients were typically like Susan.

They sat on the other side of my desk explaining that they just “had” to lose thirty pounds by the end of the month to fit in their prom dress, wedding dress, bikini, or whatever outfit!

In order to serve these patients’ needs, something more proactive was required. The typical passive appetite suppression characteristic of just acupuncture and herbal supplementa-

Most of my personal weight loss was through acupuncture (with herbal support) and appetite suppression and occurred over several years—just like it came on. By offering this new program, we can cater to those looking for a more intense weight-loss regime.

Today, at age 53, I might not have the six-pack abdominals I had at age twenty but I no longer lug around a pony keg ab either. Some of us do not inherit the perfect “thin” genes from our parents.

There are creative programs that compliment “self control” and help us reach our healthy goals. My daddy loves it now that there is less of me to love! ❦

1

Dr. Schwan is a doctor of chiropractic and a Diplomate of the International Academy of Medical Acupuncture. He is president of Schwan Acupuncture & Chiropractic Clinic in Toledo, Ohio.

He is an author, lecturer, and one-time standup comedian. He is available for questions and lay-lectures. For more information about Chiropractic, TCM, Acupuncture, or Schwan Chiropractic & Acupuncture Center, please visit us at www.AcupunctureToledo.com or email 5/29/14 11:43 AM Dr_Schwan@acupuncturetoledo.com.

ting us Best Thank you for vo at Doctors ro Ear, Nose and Th row! a in s ar two ye In Office

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“ I love the geriatric population. They’re funny, honest… and you can learn a lot from them.”

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Maggie enjoys caring for the elderly. Not just providing medical care, but getting one-on-one time with each resident. She believes the family atmosphere at the Elizabeth Scott Community provides a unique environment.

“The owners are here every day, and they’re definitely available when you need them. It’s a great place to work, and that makes for a nice living arrangement for our residents.”

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Connect with our advertisers via our online issue at www.hlntoledo.com | Healthy Living News | November 2014

35

BySister Mary Thill

Spiritually Speaking Reaping soul If you put food and shelter in the inner city, you will reap survival; if you put art and beauty and values there, you will reap soul.

I

—Sister Joan Chittister, OSB

t being Thanksgiving time and all, I could not resist Sister Joan Chittister’s observation about what we reap when we feed and shelter the body and what we need to do to reap soul. Many families gather to celebrate this feast of thanks and do so around tables full of culturally delicious, if not healthy, food and drink. Some of our local churches offer special dinners at this time of year for those who have no food or no one to share food with. Our homeless shelters and other agencies that care for the homeless offer Thanksgiving dinner to folks for whom there is no other home to go to and celebrate the fruitfulness of the earth and enjoy fellowship with others. It seems to me that the body at least is well taken care of in many circumstances at this time of year. What about the soul?

Sister Joan’s comment about putting art and beauty and values into the lives of those who live in the inner city in order to reap soul gave me some new insights into my own appreciation for art, beauty, and values.

If anyone has visited the campus of the Sylvania Franciscan Sisters, also the home of Lourdes University and Rosary Care Center, you are aware of the many points of beauty that surround you inside and outside the buildings. Mother Adelaide, the foundress of the Sisters, also believed that just being surrounded by art and beauty one could not help but be affected by such surroundings. I grew up in those surroundings and still enjoy them today, and I know from my own experience and that of others that one comes away from the Sylvania campus feeling different, feeling that one’s soul has been

36 November 2014 | Healthy Living News

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fed in a special way by the beauty of nature, art, and architecture that surround you on the campus.

Since I work at a medical center in the inner city, I’m very aware of the many ways in which we feed and shelter the sick and frail bodies and minds of so many people who come here for care. We have a beautiful chapel right within the medical center that serves as a place of prayer, peace, and beauty. It truly feeds the soul and helps cure the mind and body. Our chaplains and many other staff members provide spiritual care to our patients and their families with understanding, compassionate, and caring hearts and hands. Almost constant renovation and remodeling gives us a chance to add to the healing spirit, to “reap soul,” as Sister Joan says. The values that are posted in so many places within the medical center are constant reminders of how we are to approach what it is we each do here for the benefit of our patients and staff.

I personally would like to see more art and beauty around and within the medical center and the neighborhood. I can only imagine what the “inner city” would and could become if everyone within its boundaries focused on what values are needed for people of various cultural and economic backgrounds to live and work together as a model of peace and community in an area of the city where so many harmful and difficult situations presently exist. It would be interesting to see what influence the Toledo Museum of Art has on its neighborhood. Does it “reap soul” as Sister Joan suggests? What about the neighborhood where you live? Are you surviving? Do you reap soul? ❦ Sister Mary Thill is a Sylvania Franciscan Sister. She is Patient Liaison for Mature Health Connections at Mercy St. Vincent Medical Center. She can be reached at 419-251-3600.

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37

nobody’s perfect Sister Karen Zielinski, OSF

It started with a curb cut

B

arb loves her curb cuts.

They make it easy for her to wheel her toddler in a stroller. At the grocery store, she enjoys the wide electronic doors that let her maneuver her daughter’s stroller while carrying some grocery bags—all while her father follows with his walker. The bathrooms at the supermarket where she shops have a couple larger, accessible stalls that include grab bars and are safe and large enough for all to use.

Many of these accessible building designs are part of a much larger movement called universal design. Universal design makes things safer, easier and more convenient for everyone.

It attempts to include all people—it’s universal.

Universal design emerged

from slightly earlier barrier-free

concepts, the broader accessibility movement, and adaptive and assistive technology and also

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different tasks and postures, and, amidst many of the world’s public transit systems, low-floor buses that “kneel” (bring their front end to ground level to eliminate gap) and/or are equipped with ramps rather than on-board lifts.

Universal design, which is related to “inclusive design” and “design for all,” is an approach to the design of products, services, and environments to be usable by as many people as possible regardless of age, ability, or circumstance. It links directly to the political concept of an inclusive society, and its importance has been recognized by governments, business, and industry.

Universal design is a relatively new paradigm that emerged from “barrier-free design” or “accessible design” and “assistive technology.”

Barrier-free design and assistive technology provide a level of accessibility for people with disabilities, but they also often result in separate and stigmatizing solutions, for example, a ramp that leads to a different entry to a building rather than a main stairway. Universal design strives to be a broad-spectrum solution that helps everyone, not just people with disabilities. Moreover, it recognizes the importance of how things look. For example, while built-up handles are a way to make utensils more usable for people with gripping limitations, some companies introduced larger, easy-to-grip and attractive handles as a feature of mass-produced utensils. They appeal to a wide range of consumers.

Universal design involves designing products and spaces so that they can be used by the widest range of people possible. While universal design evolved from accessible design, a

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design process that addresses the needs of people with disabilities, universal design goes further by recognizing that there is a wide spectrum of human abilities. Everyone, even the most able-bodied person, passes through childhood, periods of temporary illness, injury, and old age. By designing for this human diversity, we can create things that will be easier for all people to use.

The term universal design was coined by Ronald L. Mace, founder and former program director of The Center for Universal Design at North Carolina State University. In 1997, Ron Mace collaborated with a group of architects, product designers, engineers, and environmental designers to develop the Seven Principles of Universal Design.

UniversalDesign.com clarifies who and what can be affected by the designs.

Who does universal design benefit?

Everyone.

Universal Design takes into account the full range of human diversity,

including physical, perceptual, and cognitive abilities, as well as different body sizes and shapes. By designing for this diversity, society can create things that are more functional and more user-friendly for everyone.

For instance, curb cuts at sidewalks were initially designed for people who use wheelchairs, but they are now also used by pedestrians with strollers or rolling luggage. Curb cuts have added functionality to sidewalks that all can benefit from.

What can be universally designed?

and spaces that are safer and easier for them to use.

• Universal design can also be applied to the community at large through urban planning and public transportation.

For the general public, universal design will make life much easier in the activities of daily living. It is a framework for the design of places, things, information, communication, and policy to be usable by the widest range of people operating in the widest range of situations without special or separate design. Most

simply, universal design is humancentered design of everything with everyone in mind.

❦ Sister Karen Zielinski is the Director of Canticle Studio. Canticle Studio is a part of the Sisters of St. Francis of Sylvania, OH’s overall advancement effort and has a mission of being a creative center where artists generate works, products, and services in harmony with the Mission of the Sisters St. Francis. She can be reached at kzielins@sistersosf.org or 419-824-3543.

Everything.

• Universal design can apply to anything that can be designed, including products like door handles, kitchen utensils, and smartphones.

• Universal design can be applied to architecture and the built environment, including public and commercial buildings, as well as residential buildings and family homes. Universal design can also help older adults concerned with “aging in place” by designing products

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39

will the timing of the move be?

News From

OTTERBEIN

8. Get touring!—Take tours of homes, condos, senior living communities, and other options for retirees. Ask about finances, activities, healthcare, and security.

Seniors, it’s your move— make it with confidence!

F

or retirees, downsizing and moving to a new home can be overwhelming. Here are eight tips to help you organize your mind and your move and better ensure a new life in a new place:

1. Make up your mind—“Move”

means to “go forward.” Try to think of it this way: The reality is that the house may be too big, too much for your needs. A change to a different, simpler way of life can be exhilarating.

Your attitude will help determine the success of your move!

2. See the big picture—To avoid

being overwhelmed by details it helps to have four strategies: Do a little at a time; keep your eye on the end goal—a simpler and happier life; enlist the help of family, friends, and professionals; and create a timeline.

3. Take a look at your “stuff ” and home—What can you do without? Is your home in good order and ready to be shown? What do you need to know before talking to a realtor.

4. Downsize and de-clutter—Be

ruthless! Pass on items to family. Get some plastic bins and post-it notes.

Get rid of out-of-size and out-of-date clothing! Get help from someone who will be honest and swift with the downsizing.

5. Get your house in order—Put on the glasses of a buyer. Does your house have good curb appeal? Is it light and bright inside? Is there clutter on counters? Can you pack away the majority of personal items?

6. Pick the right realtor—Interview three real estate professionals. Ask them, what is the competition? How

Skilled Nursing Neighborhoods Call Joy Reidl 419-308-0585

40 November 2014 | Healthy Living News

many homes have you sold this year?

What price do you propose that will bring us a buyer in 90 days? How will you market/advertise my home? Based on your research, pick the realtor who will be the best “business” choice and the best relational choice for you. You need someone you can trust!

There are many options in the market for retirees. Making a move can be a tough decision, and change can be difficult. Senior living professionals like Geri Ricker at Otterbein Portage Valley can help you with answers and resources that have been proven successful for many men, women, and couples in our area. Call Otterbein Portage Valley today to book a tour and talk with Geri at 419-833-8917, or check us out on the web at www.otterbein.org. ❦

7. Prepare for your new home—Is your next move “a

plan for life”? Will your move improve your quality of life and lessen the burden on you, family, and friends? Is it the right financial decision? Will it provide you with joy? What

Portage Valley Lifestyle Community Call Lori Stitely 419-833-8917

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Winter running tips

by Amanda Manthey

A

s the winter months approach, running outdoors in cold conditions is not as appealing as the warmer months to many of us. Using these helpful winter running tips will make your workout safer and, hopefully, maintain your desire and commitment.

Cold and icy conditions are the ideal scenario for slipping and injuring a muscle or even breaking a bone.

It’s advisable to warm up indoors before you hit the pavement and to be especially vigilant if the conditions are icy or wet. When running in cold weather, warm up slowly and gently. Your muscles are cold and need a chance to warm up to prevent injury. Most wise runners use the winter season for maintenance runs. You are increasing your risk of injury if you try to do speed work in the severe cold.

Try not to run on icy roads and opt for snow as this surface will provide you with better traction. If you must run in an icy area, think about putting spikes over your running shoes, but make sure you have proper instruction before hitting the pavement.

Choose the proper clothing to keep you warm and comfortable while still maintaining your performance.

Synthetic and breathable fabrics will wick perspiration away from the body to the outer surface of the garment where it can evaporate more easily.

You want to dress in layers with the layer closest to your body being a light-weight wicking fiber. Also, wear a warm hat when running in cold conditions. Approximately 40 percent of body heat is lost from the head, which affects the whole body’s circulation.

Cold weather running can be dehydrating. Make sure you do not reduce the amount of fluids you drink just because you are not sweating as much as in the warmer weather. Cold weather can mean more urination, which, by itself, is a source of fluid loss.

It is imperative that you remember to maintain adequate hydration before and after running in cold weather to ensure your muscles recover. Remember to use moisturizers and sun block to prevent blister formation and redness on your skin and face.

Running in the winter months can be enjoyable if you dress appropriately and use your best judgment on the running conditions. Remember, the winter time is perfect for maintenance runs. Be winter smart this season and, hopefully, you will stay warm and safe. ❦ Amanda Manthey is a former collegiate runner at Eastern Michigan University.

She writes about running and fitness for Dave’s Performance Footgear.

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41

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The unwritten value

Lutheran Village is a whole new direction in retirement living.

by Mark S. Faber, USPTA Elite Professional

It's a neighborhood!

A community where residents can add life to their years.

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T

his month, I am going to take a different approach to my monthly article. I am hoping it will get you thinking about having your kids try tennis, not because of all the stats and reasons I have shared over the past year, but because of the unseen and unspoken value it provides.

Over the past few months, there has been a great deal of negative

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press concerning professional athletes. Heck, when the lead story on many news channels on September 11 is about football player Ray Rice rather than the remembrance of the most horrific day in my lifetime, I ask, have we lost our way? This is going to be my attempt to refocus on the positive of sports and the values outside of the championships that are always talked about when discussing success.

In Northwest Ohio, we have had many great teams win high school state championships. We get to read about the accomplishments of the teams and individuals. What we do not get to hear or see is what becomes of those teams and the teammates after they graduate and move on. Well, I and the publisher of this newspaper have witnessed firsthand the unwritten value of being a member of a team, not because of the championships won, but because of the lifelong relationships established.

The team that I will be referencing as my example is the 2002 St. Francis Tennis Team. This team not only won the former City League Tennis Championships for multiple years, but also had multiple individual top four state finishes, an over 40 match winning streak, and back-to-back OTCA Team State Championships.

Sure, they were fortunate enough to have received press on their accomplishments from various publications.

They received documents from the state government congratulating them on their accomplishments.

Some would say that is awesome and amazing, but the unwritten value is the reason kids should play

team sports.

See, this group never basked in the glory individually. They learned to put each person ahead of their accomplishments on the tennis court.

They loved being around each other, not only on the court, but off. This bond is one that has carried over to today. All ten teammates have stayed in touch, attended weddings together, congratulated one another when kids were born, mourned together over family deaths, and just shared day-to-day conversations.

This is the stuff that doesn’t appear in newspapers. What a true team experience provides is the opportunity for all players to contribute and be part of something bigger than them.

When this happens, the unwritten value occurs, a team becomes a lifetime of memories. You do not have to be on that “championship” team to experience this, and that’s something this group of guys taught their young coach at the time.

Team sports provide kids the opportunities to not only play a sport they love, but also to be part of something special, something that teaches values beyond winning and losing. They learn the meaning of what really is important: friendship and teamwork.

Some might wonder what has happened to this special group of guys. Well, they are doctors, coaches, and successful businessmen throughout the country. On October 30, this special group of guys and their families will be inducted into the St. Francis Hall of Fame. I would like to congratulate Ross Wilson, James O’Connell, Mike O’Connell, Kevin O’Connell, Justin Jordan, Jeff Serpa, David Kubacki, Colin Mohler, Frank Viviano (the self proclaimed best 8th player in the state), Matt Durbin, and Adam Speiker on this recognition.

In closing, I would like to finish with how I started this article. I encourage all of the readers to get their children involved in team sports. In tennis, there is USTA Junior Team Tennis through high school tennis, not for the championships but for the unwritten value. Championships are great, but at the end of the day, it is the lessons learned and friendships created that last a lifetime, and that is what ultimately means the most.

For information on Junior Team Tennis in our area, please contact Amy Beaverson (USTA Northwest Ohio) at 419-265-5478 or your nearest tennis club. ❦

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Eating Well

by Laurie Syring, RD/LD

Get cooking to stop diabetes!

I

’m always excited to write this column for November, National Diabetes Month, as diabetes is a topic near and dear to my heart. My father had type 1 diabetes, and my 14-year-old son has been type 1 for the past 22 months.

In fact, besides these two special people in my life, approximately 30 million children and adults in the US have type 1 or type 2 diabetes. Most of us have a loved one, co-worker, or neighbor that has diabetes. Though this disease can have devastating consequences, people need to know that eating right, exercise, and medication can help prevent the deadly complications.

This month, the American Diabetes Association’s goal is to bring awareness and spread the message of America

Gets Cooking to Stop Diabetes®.

Their mission is to prevent and cure diabetes and to improve the lives of all people affected by diabetes.

The purpose of this initiative is to engage and empower people to get active and make healthy food choices.

Throughout November, Americans are encouraged to take part in weekly activities. Check out the website www. diabetes.org to participate in daily activities—from exercise, cooking, health, and fundraising.

Lose the diet; choose a meal plan!

It has been about 20 years since the American Diabetes Association announced there is no one universal diet for people with diabetes. The word “diet” has even been downplayed

s g i A n

SUe you

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and replaced with “meal plan” or “meal pattern.” A healthy meal plan should include heart-healthy food choices, portion control, and limiting excess fat, sugar, and calories, but that doesn’t mean it should be one-size-fits-all.

Not only is there no single diet for diabetics, but there are actually many suitable eating plans diabetics can choose from. These include the Mediterranean, vegetarian, vegan, DASH, and Consistent Carb diets just to name a few. Most of these meal plans are based on whole grains, fruits and vegetables, and lean protein, with fewer refined foods and less refined sugar.

Finding a meal plan that takes into account the individual’s lifestyle and supports behavior change is key to compliance.

Get comfy with carb counting At the hospital, we teach carb counting. Most patients are allowed three to five carb choices per meal depending on their energy needs. We

teach what a carb choice is and that it depends mainly on portion size.

This approach works well for most people who like to follow a pattern and have a set regime. However, diabetics should always talk with their healthcare provider about whether carb counting should be a part of their plan.

Get help Meeting with a certified diabetes educator can really help this process along. A diabetes educator can create your personal eating plan—your step-by-step action plan—making it as simple or complicated as you need.

Start small All of this can be overwhelming at first, but it doesn’t have to be if you start off with small, manageable changes.

Sometimes just getting a new diabetic to stop drinking regular pop is considered a huge success. Once that first step is achieved, you

—Continues next page

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43

can move on to the next goal in the action plan.

Nothing magic about it!

There is no magic to any eating plan or pattern for diabetics, and anyone with prediabetes, diabetes, or a family history of diabetes can benefit from a diet plan. The best plan is the one that’s individualized to your health goals and comports with your per-

sonal and cultural preferences.

Of course, it’s also important for anyone following a diabetes diet plan to regularly monitor their blood sugars—as that is the real proof of whether what they’re eating is right for them—as well as to get regular exercise and have regular checkups for medication review.

For more great tips, visit www. diabetesforecast.com. And please join the American Diabetes Association’s mission to Stop Diabetes®. ❦ Laurie Syring, RD/LD, is chief clinical dietitian at ProMedica Flower Hospital.

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Laurels nurse navigators help keep patients out of hospital and on road to recovery

Harbor and ProMedica to partner to meet growing community mental health needs

P

roMedica and Harbor recently announced plans to form a joint operating company (JOC), effective in January 2015, to address a growing community need for mental health services in Northwest Ohio.

The JOC will help increase access to much-needed mental healthcare services and enhance care through a more integrated, coordinated healthcare model.

According to the Centers for Disease Control and Prevention, mental illness is a “serious and growing problem” that affects about a quarter of American adults. In Lucas County, nearly 30 percent of adults have a mental health disorder. More than 35 percent of adults in Ohio report their mental health status as poor.

ProMedica offers comprehensive behavioral health services with a key focus on inpatient intensive care.

Harbor offers significant expertise in a wide range of outpatient mental health programs and services.

In July, Behavioral Connections of Wood County, Inc., merged and became part of Harbor. Behavioral Connections also provides treatment for mental health and substance abuse. Together these two agencies will have 23 locations and more than 650 employees in Lucas, Wood, and Defiance counties.

ProMedica and Harbor already collaborate in behavioral pediatrics and autism at Children’s Safe Harbor on the campus of ProMedica Toledo Hospital and the Great Lakes Collaborative for Autism. In the future, the organizations will explore new and innovative ways to treat children and adults. One example is the use of telehealth technology to expand care to patients in rural communities.

“This is a natural evolution of our relationship, and we see a tremendous opportunity to build on existing synergies and strengths,” said Lee Hammerling, MD, chief physician executive and chief medical officer, ProMedica.

“Now area patients will have access to a full spectrum of high-quality,

convenient, and coordinated behavioral healthcare services.”

“The most exciting and beneficial part of the agreement is how much it will benefit our clients and their families. Integration of healthcare services is a major theme in all of healthcare reform as is achieving better outcomes and improving quality of life for all of our patients,” said John Sheehan, Harbor Chief Executive Officer. “This affiliation will make us stronger by providing more resources and service opportunities for our patients than we have ever had before.”

Harbor and ProMedica will focus on clinical integration where appropriate to respond to healthcare reform by implementing standard care protocols, guidelines, and best practices around the management of behavioral health disorders. There will also be increased effort regarding wellness, prevention, and education aimed at reducing the stigma of a behavioral health diagnosis and empowerment of patients through awareness and outreach.

In addition, there will be a focus on increased recruitment of behavioral health specialists to the region.

Research shows a severe shortage of psychiatrists and behavioral health providers in Northwest Ohio and Southeast Michigan. These specialists are also among the hardest to recruit in the nation. According to the US Department of Health and Human Services, 55 percent of the nation’s 3,100 counties have no practicing psychiatrists, psychologists, or social workers.

The JOC will have a six-member board that will include representatives from both ProMedica and Harbor. The Harbor name will remain and it will operate as an affiliate of ProMedica.❦

P

atients entering a rehabilitation program following a surgery, injury, or illness want to regain strength and function—and get back to their normal lives—as quickly and safely as possible. At The Laurels of Toledo, a skilled nursing and rehabilitation center located at 1011 Byrne Road, the clinical team now includes two highly skilled nurse navigators, Ruth Williams, RN, and Ciera Johnson, RN, who work closely with the doctors and other clinical staff to help patients achieve their rehab goals with a significantly lower likelihood

of rehospitalization.

“Our job is to assess patients, stay on top of their care, make sure they’re responding to any medications they're taking, and serve as another set of clinical eyes to ensure we’re not missing anything that might send them back to the hospital,” Williams explains. “One of us is here every day, and we work 10- to 12-hour shifts. We see every new patient for at least the first five days, but we may extend that to seven days or even longer if they’re more critical.”

Doing an effective job as a nurse navigator—so patients can stabilize, heal, and return home—demands a high level of clinical experience and expertise, a close working relationship with the physicians and nursing staff, and strong familiarity with each patient as an individual.

Williams notes that having the

ability to perform certain testing, such as blood work, EKG, and Doppler ultrasound, at The Laurels is tremendously helpful in determining whether a patient can remain on site or needs to be transferred to the hospital. In addition, the nurse navigators have the experience and expertise to understand the significance of the test results as they relate to the individual patient.

“For example, we know that orthopedic patients often have infections, and that will be reflected in their lab results. By monitoring their labs, following them for infection, and making sure they’re responding to their medications, we can usually keep them here. Of course, if we need to send a patient to the hospital for a more critical concern, such as a cardiac issue or respiratory distress, we don’t hesitate to send them,” Williams says.

The Laurels’ nurse navigators must take a holistic, big-picture approach to patient care, factoring in

any co-existing medical conditions.

For instance, a patient coming in following knee-replacement surgery may also have heart disease, diabetes, or another chronic condition that has to be considered when developing a treatment plan. Williams gives the example of a diabetic patient who is taking a steroid to reduce infection.

“In this case, the steroid and the infection itself can cause the patient’s blood sugar values to be all over the place, so we have to monitor those labs closely and make sure they’re taking their medications properly,” she remarks.

Williams and Johnson have developed strong working relationships with the medical director and other physicians at the Laurels, even rounding with the doctors so they can develop a good sense of what questions they ask and what they look for when assessing patients, thus enabling them to become that trusted set of extra eyes on the patient. In fact, Williams credits this relationship with the overall success of the nurse navigator program at The Laurels, which has lowered the facility’s rehospitalization rate to less than half the state average.

“We also work hard to develop

For more information about behavioral health services at ProMedica and Harbor, visit www.promedica.org/mentalhealth and www.harbor.org.

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45

Admittedly, she chose The Laurels because she’d heard that they have the very best food, but it was the staff that impressed her most. “I was here for 30 days, and I didn’t want to go home! Everyone here, from the doctors and nurses to the therapists, aides, housekeeping, and cooks, is excellent. They treat you more like family than a patient. They really care, and they really show that they care,” she says.

Hopkins also appreciated the personal approach of the therapy team, each of whom knew her by name, and the fact that they worked

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with her until she got better without pushing her beyond her capabilities.

Now, if anyone asks her where to go for rehab, her advice is always “Come to The Laurels! You’ll love it!” ❦

Avoidance and denial aggravate mental health problems

by Linda L. Smith, MA, LPC

A

t one time or another, we or someone we know has gotten in serious trouble by ignoring important issues needing attention.

It might be a debt that hasn’t been paid, a car repair that must be made, or a health problem requiring a doctor’s visit. It seems to be a natural human tendency to avoid facing what causes us anxiety or fear. But ignoring problems can have dire consequences if debt collectors begin calling, the car breaks down, or medical issues become critical.

Avoidance and denial can also have negative consequences for mental health problems.

Avoidance and denial can take many forms, not always negative.

For example, avoiding thinking about something beyond our control is a helpful deterrent to anxiety. As the Serenity Prayer so eloquently recommends, “God grant me the serenity to accept the things I cannot change.” Putting such things out of our minds prevents the endless rumination and worry that contribute to depression and anxiety.

However, more often than not, we avoid and deny problems that really do need our attention. While we may feel better in the short run, such problems can become the “elephant in the room” we are working so hard to ignore. Carl Jung wrote, “The foundation of all mental illness is the unwillingness to experience legitimate suffering.” Instead of ignoring our pain and our problems, we need to have the courage to face them head on, even if it causes us suffering to do so. Unfortunately, most of us have more strategies for avoiding the elephant in the room than for facing it.

The mechanism and consequences of avoidance and denial Several defense mechanisms help us ignore problems that need attention.

46 November 2014 | Healthy Living News

The Laurels of Toledo accepts Medicare, Medicaid, and all private commercial insurances. For more information, please call 419-536-7600 or visit www. laurelsoftoledo.com.

lose touch with ourselves. When we spend so much energy repressing or denying painful feelings, we can lose the ability to feel genuine happiness.

And of course, our problems are more likely to become worse rather than better when we ignore them.

In the long run, when we practice avoidance and denial, we lose touch with ourselves and we lose connection to our loved ones. Ultimately, we may become numb and our lives devoid of passion and joy.

How avoidance and denial contribute to specific mental health problems Avoidance and denial play a significant role in many specific mental health problems. For example, they are major contributors in the abuse of alcohol and other substances. Avoidance of negative feelings is often one of the initial attractions to the use of alcohol, as well as so-called “recreational drugs,” such as marijuana.

The euphoric feelings such substances produce are a powerful antidote to the common stresses and anxieties of life. And for many people, substance abuse is a kind of self-medication for other problems such as depression

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good relationships with area hospital staffs, so when we have patients in the hospital, we can call to follow up and see how they’re doing, ask about their plan for discharge, and share what we know about them to ensure they’re getting the best possible care,” says Williams.

Perhaps most importantly, the nurse navigators and all the other staff at The Laurels treat each patient as an individual, not just a condition or set of symptoms—a fact that wasn’t lost on Eileen Hopkins, who recently came there for rehab following a total knee replacement.

or anger-management issues. The desire to avoid painful or traumatic experiences, such as sexual abuse, divorce, or the death of a loved one, can also draw individuals into substance abuse.

Once an individual is physically or psychologically dependent upon such a substance, denial then plays a major part in maintaining the addiction through minimizing, rationalizing, or even blaming others. Other compulsive behaviors—gambling, pornography, gaming, social media, and overeating—have a similar basis in avoidance and denial. Even when the addiction causes major legal, job, financial, or family problems, the use of defense mechanisms can allow those with addictions to continue to deny the elephant in the room.

Attempts to avoid the pain of grief and loss can also result in more serious mental health problems.

Loss is a natural and normal part of the human experience, and most who allow themselves to accept and experience their pain will pass through it and eventually achieve healing. Painful as it may be, peace does eventually come. But trying to avoid such pain can prevent or slow the healing process. Keeping busy

to ignore what has happened can actually backfire, and unresolved grief can bring individuals into the counseling office many years after a loss has occurred.

Avoidance and denial are also destructive forces in romantic relationships and marriage.

Relationships often start out in the bliss of infatuation, when we cannot imagine problems ever developing.

But in the common and natural progression of love, that unrealistic belief is replaced with a less romantic attachment based on connection and commitment rather than passion.

If attention is not paid on a 24/7 basis to nurturing and maintaining the connection between partners, problems will develop and love may fade.

Avoidance and denial of such problems can doom a relationship either to infidelity or to years of loveless discontent. When couples come in for marriage counseling, they almost always admit that the problems were years in the making.

Why did they wait to seek help, often until there was too much anger and resentment to save the marriage?

Once again, it is the tendency to

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In the case of extremely traumatic events, we may actually repress the memory of our experiences so we do not have to face the painful emotions. Similar to repression is denial, when we lie to ourselves so effectively that we do not believe that any problem exists. It may be something painfully obvious to those close to us, but we can be completely blind to it ourselves. Even if such a problem is brought to our attention, we can continue to lie to ourselves by minimizing or rationalizing. We can convince ourselves that others are exaggerating or that they are worrying for no reason. We may even blame or attack others when they try to point out our problem.

We may accuse them of being critical, failing to accept us as we are, or even wanting to hurt us.

Even though denial and avoidance may help us reduce discomfort in the present, in the long run, it is almost always detrimental to our mental health. In severe cases, we may dissociate from our feelings and our memories so completely that we can

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avoid and deny what is difficult or painful that takes a painful toll on human happiness.

Avoidance and denial also play a role in mental health disorders such as post-traumatic stress disorder (PTSD) and various phobias. In such disorders, emotional and physical discomfort caused by a specific event or experience often cause an individual to avoid places, objects, or situations associated with the discomfort. Instead of causing relief, such avoidance actually increases the anxiety and expands what the individual feels compelled to avoid. A common treatment involves gradual exposure to the stimulus that causes the discomfort until avoidance is no longer necessary.

Learning to confront rather than avoid I have discussed here only a few of the problems in life that are aggravated by avoidance and denial.

If nothing else, I hope this shows that life requires courage and that the way to live more happily and more successfully is facing, rather than ignoring, our difficulties and challenges. Acknowledging the elephant in the room is not something that comes naturally to most of us.

But, happily, it is a habit that can be learned with perseverance and determination. ❦ Linda L. Smith, MA, LPC, is a licensed professional counselor at Central Behavioral Healthcare in Toledo, Ohio.

Seek medical care if you experience tinnitus-like symptoms immediately.

This may prevent future misdiagnosis or even delayed diagnosis. Moreover, it helps diminish the possibility of individuals becoming stressed or depressed.

Tinnitus patients commonly have trouble sleeping (insomnia). Lack of sleep can reduce the ability to pay attention. It can also lead to anger, frustration, and other negative emotions. Keep in mind that it’s vital to discuss the side effects of tinnitus on your daily life with your hearing health professional.

For the lucky few, tinnitus may

eventually improve or even go away on its own. For others, tinnitus treatment may be necessary. It’s designed to help manage tinnitus symptoms and allow individuals to go about their day. Hearing aids are another viable option as they not only help treat the tinnitus, but also assist with hearing loss simultaneously. Your best bet is to contact an audiologist who specializes in hearing loss and tinnitus treatment.

However, beware when looking for that magical cure! Studies have proven that advertised products, such as melatonin and gingko biloba, do not improve tinnitus and should

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: I heard there has been new information revealed about tinnitus and its treatment. Would you mind reviewing some of it with me?

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Patient advocates, or professionals who act as liaisons between patients and the health-care provider, are needed now more than ever.

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48 November 2014 | Healthy Living News

: Tinnitus is essentially hearing sounds coming from one or both sides of the head. Individuals describe it as a range of sounds, including a buzzing, wind noise, humming, roaring, or even a type of clicking.

One individual may have the tinnitus consistently all day, while another may only notice it when it’s quiet, like around bed time. Tinnitus also affects each person differently. Some patients don’t pay attention to the buzzing, while others can’t help but take notice. Tinnitus affects their ability to hear conversations. They struggle throughout the day because of the extreme noise, which can lead to high blood pressure, stress, and anxiety.

The American Academy of Otolaryngology describes two types of tinnitus: primary and secondary.

Primary tinnitus has an unknown cause and can be directly related to a hearing loss. Secondary tinnitus has a specific cause. Common

triggers may be impacted earwax, diseases, or pressure behind the eardrum. Secondary tinnitus may be commonly connected to such diseases as Meniere’s or ear nerve conditions. Tinnitus can be caused by more unusual or serious conditions. Some of these rare conditions include tumors, heart problems, or blood vessel problems.

The complaint of tinnitus may affect both genders at any age and in all ethnic groups. It does, however, occur more frequently in males, the elderly, and non-Hispanic whites.

There is also a higher rate of tinnitus among military veterans due to the exposure to ammunition and other high-decibel sounds. The Academy has also cited that it is more likely to occur in people who are overweight or obese or have high blood pressure.

Other risk factors include diabetes, high cholesterol, and anxiety disorder. Tinnitus is linked to long-term noise exposure, which is why we always stress the importance of ear protection. More specifically, onetime or excessive exposure to loud noises, such as firearms or music, is also a risk factor.

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ore than 300 supporters, friends, and family of the Sisters of St. Francis of Sylvania gathered September 27, 2014 at the Franciscan Center to honor and support their work to “embrace the poor and marginalized.” Jim Pope, president and CEO of Sylvania Franciscan Health, Dr. Richard Paat, recipient of the St. Clare Award; received the St. Francis Sister Mary Jon Wagner, congregational minister of award for his exemplary the Sisters of St. Francis of Sylvania; and James Pope, contributions to society. Dr. president and CEO of Sylvania Franciscan Health and Richard Paat, a physician recipient of the St. Francis Award, stand together at of internal medicine and the Franciscan Gala, held September 27, 2014 at the former chief of staff at St. Franciscan Center in Sylvania.

Luke’s Hospital in Maumee, received the St. Clare Award for modeling the Franciscan values in his daily life.

The Franciscan Gala is a once-a-year fundraiser that is held to celebrate the many ways the Sisters of St. Francis live their mission of “joyful servanthood among all people.” Attendees enjoyed food by Stella’s Catering in Perrysburg and entertainment by the KGB Motown Band. The Gala included a silent auction with items ranging from food baskets and oneof-a-kind artwork to a raffle for a gift card tree from local merchants. It also had a raffle with three cash prizes.

More than $100,000 was raised to support the diverse ministries of education, social work, health and human services, religious, parish, retreat, and spiritual direction. The Sylvania Franciscans serve the ever changing needs of people in 11 states and the island country of Haiti.

not be used to treat tinnitus. The Academy further explains that there is not enough evidence to either recommend or discourage using acupuncture.

It’s a good idea to keep up on the topic of tinnitus, and we hope this summary and new information answer your question. As always, please feel free to contact our office for further information. We listen so you can hear! ❦ Randa Mansour-Shousher, AuD, CCC-A, is a Doctor of Audiology with Northwest Ohio Hearing Clinic, located at 1125 Hospital Dr., Suite 50 in Toledo (419-383-4012) and 1601 Brigham Dr., Suite 160 in Perrysburg (419-873-4327).

A Walk in the Park —Continued from page 30.

tains of the US and Canada. Like black bears, they come in a range of colors. Even so, it is easy to tell the blacks from the grizzlies by size and body shape. Think of grizzlies as the Arnold Schwarzeneggers of bears with huge shoulder muscles.

(Ignore what you may have heard about steroid use among grizzlies.

It is far less prevalent than the 60 Minutes story suggested.) Even if it is just a young grizzly and otherwise no bigger than a black bear, its shoulders will tell you what it is.

On our way to Alaska, we saw the first grizzly of the trip at Canyon Campground in Yellowstone. It came ambling past our picnic table and never even turned to look in our direction. As we continued north, we saw more bears, both black and grizzly, right from the road. A natural inclination is to pull over when you see a bear. We noticed, though, that drivers with local plates kept right on going. Eventually, even a grizzly can become ordinary. I suppose.

But maybe it explains that line from the guidebook. Watch for animals northbound because by the time you head southbound you just may not care anymore. I accused Shirley of being jaded because her reaction to one grizzly was, “Poo! He’s just a little one.” Still, seeing even a little grizzly from the safety of your car is even better than when you encounter one on a walk in the park. ❦ LeMoyne Mercer is the travel editor for Healthy Living News and the regular contributor of A Walk in the Park.

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Put an expert to work for You Full service Ad Agency specializing in TV, Radio, Cable, Station Negotiation, and Pre- and Post-Buy Analysis • copywriting • shooting • editing• post production Sam Jacobs 419.867.8520 bci-comms.com

Murawa Painting and Powerwashing Pat Murawa Owner

419-351-5533

Now Accepting Applications for Efficiencies & 1 Bedroom Apartments at the

PLAZA APARTMENTS 2520 Monroe Street

Housing Community for Elderly (62 and older) or Handicapped/Disabled.

Air Conditioning and Appliances Utility allowance. Rent based on income.

Applications by Appointment 419-244-1881

Increase flexibility • Strengthen the body Reduce stress and tension in body and mind

• Hatha yoga classes for adults and children Presence Yoga of all ages and levels of flexibility 3450 W. Central Ave. Suite 320F Toledo 43606 • Specializing in small, personalized classes 419-376-6300 www.presenceyogaltd.com • Affordable pricing with student/senior discounts available Nicole Losie, MOL, RYT

Yoga is truly for every body.

Certified Yoga Instructor Registered with Yoga Alliance

MESSIAH HELPING HANDS, LLC Caring for Individuals with Disabilities

Shawntay L Gregory (CEO)

Agency Provider Level 1, I/O Waiver Certified, and Private Care Day Program, Transportation, Med Pass Personal Care, Respite Care, Recreational Outings

LOOK NO FURTHER! Call or text me for ALL of your Real Estate Needs.

5015 Bennett Rd., Toledo, OH 43612

567.225.3193 Accepting Individuals for Respite September 22nd

50  November 2014  |  Healthy Living News

Carol Venia-Stokes

567-202-7021 We love feedback. Like us on Facebook. Follow us on Twitter.

Connect with our advertisers via our online issue at www.hlntoledo.com   |  Healthy Living News  |  November 2014 

51

Mercy Robotic Surgery Center

SMALLER INCISIONS. QUICKER RECOVERY. EASIER DECISIONS.

I was treated at St. V’s with the most advanced robotic surgery.

Less invasive than traditional surgery.

So I can get back to her faster.

THE REGION’S LEADING SURGEONS AND THE LATEST DA VINCI XI®. ONLY AT MERCY. Facing the choice between

traditional and robotically-assisted surgery? Let us help make your decision easier. More precise, less invasive procedures.

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SmallerIncisions.com A Catholic healthcare ministry serving Ohio and Kentucky