Your Monthly Guide to Healthy Lifestyles
ng ews
e lthy l November 2013 • FREE
Also available at hlntoledo.com
Get set to
Smoke the Turkey
◆◆Look your best for the holidays ◆◆Research studies bring healthy returns ◆◆YMCA promotes diabetes prevention ◆◆The low-down on lumbar spinal stenosis ◆◆Fried turkey safety tips
Here for
Photos courtesy of Ferguson Photography
Also in this issue:
◆◆Nobody's Perfect ◆◆Health Crossword ◆◆Spiritually Speaking
◆◆Eating Well ◆◆A Walk in the Park ◆◆And more...
24 hours a day, in Perrysburg. MERCY EMERGENCY
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Look your best for the holidays! 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 from prior sun exposure can be improved dramatically with pain-free, non-invasive cosmetic procedures performed by Dr. Handler. The Thermage CPT procedure painlessly heats damaged collagen under your skin to tighten and lift the sagging skin on the neck, upper arms, abdomen, and jowls. The Thermage CPT procedure utilizes radiofrequency energy (not laser) to uniformly heat the dermis while the epidermis is cooled and protected. This heating of the dermis causes immediate collagen contraction followed by new collagen production over a period of time. The procedure also encourages a natural repair process that results in further tightening, lifting, and younger-looking skin. With only one treatment, 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! The Thermage CPT system has been utilized by Dr. Handler for many years with excellent results and very satisfied patients. For lines between the eyes (worry lines), crows’ feet, and the “sleepy look with droopy eyelids,” the use of Botox or Dysport works well to improve these areas with resultant diminished lines and a more “wide awake” and less tired appearance. 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.
2 November 2013 / Healthy Living News
This is also performed with minimal pain with results lasting 5-7 months and longer. The use of fillers, such as Restylane, Perlane, Juveder m, 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 in which Dr. Handler utilizes a laser to produce thousands of small columns of empty space in your dermis that 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, 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. Dr. Handler’s office now has available a new camouflage makeup that is excellent to cover red or blue veins on the face or anywhere else on the body. It is also very helpful to camouflage and cover blue, red, or yellow bruises from prior cosmetic procedures, and especially useful for facial, neck, and
Before
After
chest redness secondary to the diagnosis of rosacea. Remember; this fall and winter is the perfect time for eliminating unwanted hair of men or women on the face, chest, underarm, back, bikini, and leg areas with a special laser for hair removal. This is done exclusively by Dr. Handler with little pain and NO downtime or restrictions following the procedures. ❦
For more information about the above-mentioned procedures or products to reduce the signs of aging, please call Dr. Handler’s office at 419-885-3400. His staff will be able to address your questions or concerns regarding these procedures. Also, please visit Dr. Handler’s web site at drharveyhandler.com to view many before and after photographs of patients who have had these procedures performed. And speak with his office staff to inquire about specials on many cosmetic procedures and products to diminish the signs of aging.
www. drh a rv e y h a n d l e r . c o m
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,
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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
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Mission Statement 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. 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 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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To submit an article or announce an event: Editor, Healthy Living News, 1619 Circular Dr., Toledo, OH 43614. Phone: 419-754-1339, fax 888-506-5790; email: editorhln@bex.net. Deadline for editorial submissions is the 10th of the month preceding publication.
Publisher Kevin O’Connell Editor Jeff Kurtz Travel Editor LeMoyne Mercer Sales Robin Buckey Layout and Design Jan Sharkey Distribution Jim Welsh • Alison Foster Dominion Distribution Distributech - Toledo Copyright © 2013 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. Please consult your physician or health care professional before undertaking any form of medical treatment and/or adopting any exercise program or dietary guidelines.
e lthy l ng ews
November 2013 • Vol. 18, Issue 11
Your Monthly Guide to Healthy Living
HEALTH & BEAUTY
CHILDREN & PARENTING
2 Look your best for the holidays! 7 Understanding carcinoid cancer 10 Research studies give hope while advancing the science of healing 16 Spiritually Speaking Bless us, O Lord… by Sister Mary Thill 23 Nobody’s Perfect Feeling under the weather? by Sister Karen Zielinski 25 Sound Advice from Northwest Ohio Hearing Clinic by Randa Mansour-Shousher, AuD, CCC-A 28 Alzheimer’s and other dementias on the rise as population ages 30 GERD is nothing to lose sleep over! 31 How well do you know your medical team? by Stephanie Aldrich 36 Hearing loss linked to dementia by Dianna Randolph, AuD, CCC-A 37 The low-down on lumbar spinal stenosis 48 Refractive errors and the eye by Bennett Romanoff, MD
11 Large sibling groups in need of loving adoptive families
TAKING CARE OF YOUR LIFE 5 Winter running tips, by Amanda Manthey 15 Sports acupuncture and chiropractic by Douglas Schwan, DC, Dipl ac 17 Healthy holiday tips from Heartland Rehabilitation 22 Health Crossword, by Myles Mellor 32 A Walk in the Park Maybe we shouldn't complain about gravel roads, by LeMoyne Mercer 38 Seven suggestions for safe raking 47 A late-autumn gardening to-do list
FOOD & NUTRITION 21 Eating Well Let’s take a stand against diabetes, by Laurie Syring, RD/LD 42 Dreaming of a deep-fried Thanksgiving turkey? Heed these safety tips! Dear Readers, Thank you for picking up the November issue of Healthy Living News. This month’s cover features the Rick Gomez Memorial Smoke the Turkey 5K Run/Walk, a fun, professionally organized event that HLN is once again proud to help sponsor. This family-friendly 5K, which takes participants on an attractive course through St. James Woods, will benefit Hospice of Northwest Ohio and is a great way to offset any Thanksgiving overindulgence later in the day. See page 5 for full details. This issue also features expert insights on lumbar spinal stenosis from Toledo Clinic orthopedic surgeon Dr. Kraig Kristof (p. 37), an in-depth look at the growing problem of Alzheimer’s and other forms of dementia courtesy of ProMedica Goerlich
OUR COMMUNITY 5 Smoke the Turkey this Thanksgiving 8 Laurels of Toledo puts high priority on fall prevention 14 YMCA offers diabetes prevention program by Christine A. Holliday 18 Honor your father and mother, by Jessica Derkis 26 Mercy to open region’s first free-standing, fullservice emergency and diagnostic center 27 Water for Ishmael helps children of immigrants achieve success 40 Expanded Franciscan Care Center broadens options and services for area seniors 41 Body Works Wellness Studio, the stuff of dreams— and hard work 43 News from Otterbein Free “Medicare Check-up” events coming to Otterbein North Shore and Portage Valley 44 Free mobile app helps people recognize stroke “F.A.S.T.” 45 SouthernCare Hospice does “Whatever it Takes” to comfort and support patients and their families 46 Roller to Lead Toledo’s Swan Creek Retirement Village
AROUND TOWN Elizabeth Scott administrator earns
one of Ohio's first assisted living certification, 13; Local church reaches out to those unable to attend church, 13; Holidays sparkle at the Toledo Zoo, 20; Tennis, the “lifetime sport” by Mark S. Faber, USPTA P-1, 33; Area Office on Aging brochure best in nation, 34; Dr. Bryant Ittiara joins CC4PM, 35; Research participants needed for knee arthritis study, 44.
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Center Administrator Tara O’Rourke (p. 28), and profiles of SouthernCare Hospice and the new Mercy Emergency Services—Perrysburg, our region’s first free-standing, full-service emergency and diagnostic center (pgs. 45 and 26). As long-time readers know, HLN is a strong proponent of clinical research studies. These trials ultimately provide medical practitioners with the most advanced therapies and techniques to help combat disease and improve patients’ quality of life. Unfortunately, many people are reluctant to participate in these studies, largely owing to certain persistent misconceptions about them. We hope the article on page 10 will help put these myths to rest and encourage anyone who might benefit from involvement in a clinical trial to explore this option. Even if patients don’t benefit directly from participating in a
/HLNToledo
@HLNToledo
research study, they’re still contributing to the important body of scientific knowledge that may eventually yield a cure and make life better for future generations. On a personal note, I’m honored that I was recently asked to join the Community Advisory Board for the new YMCA Diabetes Prevention Program. To learn more about this vital initiative, please be sure to read the article on page 14, authored by freelance writer and long-time HLN contributor Chris Holliday. If you or someone you love is at risk of developing type 2 diabetes—a disease that impacts the lives of millions of Americans—we strongly urge you to consider participating in this program. Until next month, stay safe, active, and healthy!
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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. ❦
Smoke the Turkey this Thanksgiving
J
oin the St. James Club and over 2,000 participants in the annual Rick Gomez Memorial Smoke the Turkey 5K Run/Walk to benefit Hospice of Northwest Ohio. Last year, the race generated a donation of over $30,000 for Hospice. This year, the race will take place at 9:00 a.m. on Thanksgiving Day, Thursday, November 28, 2013. The free Kids Fun Run for ages six and under starts at 8:30 a.m. Registration is now open, and T-shirts are guaranteed to the first 1,500 registrants. Applications and race info are available at www.stjamesclub.net,
Amanda Manthey is a former collegiate runner at Eastern Michigan University. She writes about running and fitness for Dave’s Running Shop. Photo courtesy of Ferguson Photography
and online registration is available at www.imathlete.com. 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 prizes for best dressed Buckeye and Wolverine fans, best dressed turkey costume, and the “chuck the chicken” contest! For more information, email us at turkey2013@stjamesclub.net or call 419-841-5597.
Don’t miss Dave’s races! Runners, get ready to “take your mark” in these exciting community events sponsored by Dave’s Performance Footgear. For more information on any event, please visit davesrunning.com. Get it Glowing 5K Run/Walk—Friday, November 1, 2013, 8:30 p.m. at 3100 Main St. in Maumee, Ohio. Kids’ 1-mile fun run begins at 8:00 p.m. Get it Glowing is a fun, family friendly event that benefits the American Cancer Society and Relay For Life of Greater Lucas County. The event takes place at night, and participants light up the course with t-shirts and glow bands. After
Winter running tips
the race, participants are treated to a post-race party with food, a DJ, and raffles and prizes. For more information, email Staceystoneware@yahoo. com. Reindeer Run—Saturday, November 2, 2013 at 521 Glenwood Ave. in Napoleon, Ohio. Kids Fun Run starts at 8:45 a.m. 5K starts at 9:00 a.m. Virtual Run starts at 8:00 a.m. The Reindeer Run is a 5K and 1 Mile Fun Run that is in addition to the Annual Symphony of Trees fundraising event conducted in Napoleon, Ohio. Funds will be used to care for children of domestic violence and sexual assault through the Henry County Hospital, the Center for Child and Family Advocacy, and the Henry County Court Appointed Special Advocates Program. For more information, email reindeer.run.sot@ gmail.com. The Mud Dog Challenge—Saturday, November 2, 2013, 9:00 a.m. at 10631 Airport Hwy. in Swanton, Ohio. A 3-mile, 20+ obstacle course that is set to challenge your strength, stamina, and courage. This event is benefiting The Wounded Warrior Project! Get a team together and register! Have fun with this and give back! Dress up in those Halloween costumes. Like us on Facebook to see what the course looks like. For more information, email
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
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Ar una 5K Run/Walk—Saturday, November 9, 2013, 10:00 a.m. at the Bowen-Thompson Student Union in Bowling Green, Ohio. For one hour, one morning, we will gather for one thing—freedom. Freedom for Kavitha, freedom for Reshma, freedom for the thousands upon thousands who are sold and trapped in Commercial Sexual Exploitation (CSE) in one of South Asia’s largest red-light areas. We will run/walk to give them a voice, to give them hope, and give them freedom. Join us, one hour, one morning, one thing—freedom, one life at a time. For more information, email kards2003@ gmail.com. The Kellen Keiser Memorial Run—Saturday, November 9, 2013 at 400 E. Gamble Rd. in Fayette, Ohio. Half Marathon, 5K Run/Walk, and Kids’ Fun Run begin at 9:00 a.m. Course is a Half Marathon (13.1 miles) and 5k (3.1 miles) on country roads. Approximately 3+ miles for team Half Marathon legs. Runners, walkers, strollers, wagons, and wheelchairs are welcome. For more information, email rachelkinsman2@gmail.com. Churchill’s Half Marathon—Saturday November 9, 2013, 9:00 a.m. at 13385 Roachton Rd. in Perrysburg, Ohio. A scenic point-to-point course starting at Perrysburg High School. The course travels over rolling hills along the Maumee River, taking you through Perrysburg, Waterville, and Maumee and finishing at The Shops at Fallen Timbers. Bus service will be available to get you from Fallen Timbers to Perrysburg High School for the start. No busing will be provided back to Perrysburg High School after you finish the race. Bag-drop service will be available. For more information, email tbg28@ yahoo.com. After the PKs 5K Road and 10K Trail Run—Sunday, November 10, 2013, 2:00 p.m. at 12829 St. Rte. 613 in Van Buren, Ohio. The After the PKs 5K is held every year on the Sunday after the high school soccer state finals and takes place at the Van Buren Sports Complex and Allen Twp House. The race includes a 5k road run/walk and a 10k trail run through Van Buren State Park. All proceeds benefit the Van Buren High School Boys Soccer Team. For more information, email swaz11@ woh.rr.com. Monroe Half Marathon, 5K, and Friendship Relay—Sunday, November 10, 2013 at 2800 State Park Road in Monroe, Michigan. All proceeds will go to benefit Monroe County Special Olympics. The half marathon will begin at 8:00 a.m. with the 5K and relay beginning
at 8:30 a.m.This event will begin and end at Sterling State Park. For more information, email monroehalfmarathon@gmail.com. Girls on the Run of Northwest Ohio Fall 2013 5K—Saturday, November 16, 2013, 9:00 a.m. at 3100 Main Street, Maumee, Ohio. Our Fall 5k, to be held at Fallen Timbers Mall, will be the culmination of our Girls on the Run of Northwest Ohio Fall season. All participants will be completing the 5k along with their family and friends. The community is encouraged to join in the fun as well! For more information, email diller sarah@gmail.com. Toledo Roadrunner Turkey Trot Prediction Run—Sunday, November 24, 2013, 10:00 a.m. at Ottawa Park, Kenwood Blvd. in Toledo. 3.2K and 6.3K prediction run. For more information, email jeff.taylor@davesrunning.com. Smoke the Turkey 5K Run/Walk—Thursday, November 28, 2013 at 7337 W. Bancroft St. in Toledo. The 5k starts at 9:00 a.m. sharp and finishes at the St. James Club on Bancroft Street. Kids’ Fun Run and Chicken Chucking Contest at 8:30 a.m. The run is festive and full of family fun! Families gather together on this morning to run, blessed to be together, and then, of course, to justify all the Thanksgiving calories! One can run or walk as this course winds its way in and around the beautiful St. James Woods neighborhood. Buckeye/Wolverine Challenge: best face/costume prizes. This event will benefit Hospice of NW Ohio and is in memory of Rick Gomez, past General Manager of the St. James Club. For more information, email feltrider@buckeye-express.com. WRC Turkey Trot 5K—Thursday, November 28, 2013, 9:00 a.m. at 750 Bright Rd. in Findlay, Ohio. This Thanksgiving Day 5k (Walk, Run/Race, or Crawl) is a blast for the entire family no matter the age. Race is staged at the St. Michael Church (East) Auditorium and winds through the scenic Country Club Estates neighborhood. We are featuring a chip timing system for precise timing and quick results so you can go home and celebrate the Thanksgiving holiday afterward. For more information, email joed@nwoortho.com. Holiday Hustle 5K—Saturday, November 30, 2013, 5:15 p.m. at the Maumee Indoor Theater, 601 Conant St., Maumee, Ohio. Both the 5K Run and the 1.5-Mile Fun Walk start and finish at the theater. The last 1/4 mile of both events is over the Maumee Holiday Parade route with thousands of cheering spectators. A free movie pass to every runner who beats Santa Claus (he’s in the
We love comments and feedback. Like us on Facebook. Follow us on Twitter.
race) and to all women runners who beat Mrs. Claus (she is also in the race).
For more information, email maumee seniorcenter@gmail.com. ❦
Cancer Center
Understanding carcinoid cancer
T
he neuroendocrine cells perform hypertension, and heart problems. a very important function in the Cushing syndrome is caused by an body. Essentially, they integrate the excess of the hormone cortisol, pronervous and endocrine systems by duced by certain carcinoma tumors, receiving neural signals and, in reand is characterized by weight gain, sponse, secreting hormones or other rounding of the face, skin changes, biologically active substances, such increased body hair, fatigue, and a as histamine, serotonin, insulin, and host of other signs and symptoms. cortisol, into the bloodstream. In The definitive treatment for carsome individuals, something goes cinoid cancer is surgical removal in awry with the DNA of neuroendoearly stages, and the survival rate is crine cells, causing them to become relatively high. As Dr. Trivedi points cancerous and begin forming soout, if the tumor is small and localized, called carcinoid tumors that have the survival rate at five years is betthe tendency to spread ter than 80%. If the canto other organs. cer is locally advanced According to Charu (meaning it has spread Trivedi, MD, of The Toto nearby tissue but has ledo Clinic Cancer Cennot yet metastasized), ters, carcinoid cancer is the rate drops to 47%. a rare, slow-growing Once carcinoid cancer form of cancer that has metastasized—or is diagnosed in only spread from the primary 11,000 to 12,000 people site to other organs or per year in the United parts of the body—the States. “There are both survival rate at five years malignant and benign is closer to 18%. forms, and the tumors Late stages of carcimost commonly originoid cancers are treated Dr. Charu Trivedi nate in the gastrointeswith medications to tinal tract, especially the midgut, control the symptoms caused by appendix, and rectum, as well as the excess hormones, and commonly lungs, or rarely the pancreas or other used drugs include sandostatin, anorgans. However, nobody knows the tihistamines, etc. Rarely, other palliacause, there’s no screening test for it, tive procedures are used to control and there’s no known way to prevent advanced cancer, including cryoablait,” she explains. tion, radiofrequency ablation, hepatic As with many forms of cancer, artery occlusion, palliative surgery, carcinoid tumors usually cause no radiation, or even chemotherapy. symptoms in the early stages. Most Though the cause of carcinoid cases are discovered incidentally cancer is unknown, certain risk facwhen patients are being evaluated tors for the disease have been idenand tested for other complaints or tified. One is having a history of a incidentally during surgery. Sympcondition that causes changes in toms that do arise—typically in later stomach acidity, such as gastritis or stages of carcinoid tumors—depend pernicious anemia. Also, women on the location of the tumor. Local are at higher risk than men, African symptoms can include cough, chest Americans are at greater risk than pain, and wheezing in lung carcinoid, Caucasians, and risk increases with and diarrhea, abdominal pain, or older age. There are also certain gecramps in the digestive tract. These netic syndromes that elevate risk, tumors can also cause hormonesuch as multiple endocrine neoplasia related symptoms, which can be in type 1 and neurofibromatosis type 1. the form of carcinoid syndrome or One of the challenges doctors Cushing syndrome. face in diagnosing carcinoid cancer is A small percentage of patients that the symptoms tend to be vague with malignant carcinoid cancer exand can often be attributed to more perience a constellation of symptoms common complaints. As a result, known as carcinoid syndrome. The diagnosis can be delayed for a signifimost common symptoms associated cant period, even years, while other with this condition include wheezpotential causes are being explored ing, flushing (redness and/or a feeland ruled out. Of course, the more ing of warmth), persistent diarrhea, time that passes before the cancer is Have questions about an advertiser? Click their email or web address in our online issue at www.hlntoledo.com.
7
diagnosed and treated, the less favorable the outcome. “If you experience any of these symptoms and there seems to be no good explanation for it, or if you have risk factors for carcinoid tumors or have symptoms related to carcinoid syndrome or Cushing syndrome, it’s important to go see your doctor for an evaluation and diagnosis,” Dr. Trivedi advises. When facing a diagnosis of cancer, more and more patients are choosing The Toledo Clinic Cancer Centers. With nine board-certified hematologists/oncologists and ten nurse practitioners on staff, The Toledo Clinic Cancer Centers can provide imaging and laboratory diagnostic services, chemotherapy services, and IV services. Also, there are several offices (including the main location at 4235 Secor Road and satellite centers in Maumee, Bowling Green, Oregon, Adrian, and Monroe) for the convenience of the patient. Many Toledo Clinic Cancer Centers 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 419479-5605.
8 November 2013 / Healthy Living News
Laurels of Toledo puts high priority on fall prevention
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ccording to the US Centers for Disease Control and Prevention, one-third of Americans aged 65 and older experience a fall each year. The CDC also reports that falls are the leading cause of fatal injury and the most common cause of nonfatal trauma-related hospital admissions among older adults. Recognizing that fall prevention and independent living go hand in hand for seniors, the therapy team at The Laurels of Toledo, a skilled nursing and rehabilitation center located at 1011 Byrne Road, offers a wide range of occupational therapy
services to reduce fall risk for both inpatient and outpatient guests. “Occupational therapy plays a very unique role in preventing falls in the home and other environments,” states Kristin Roberts, OTD, OTR/L, an occupational therapist for The Laurels of Toledo. “Through patient education, environmental modification, and neuromuscular re-education, we can help remedy identified deficits—whether physical or environmental—that increase fall risk and threaten our guests’ independence.” To understand the unique role of occupational therapy in preventing falls, it’s necessary to first understand what occupational therapy actually is. In this context, the term “occupation” is not to be confused with “vocation,” or what one does to earn a living. Rather, it refers to any everyday activity. That could mean something one does every day on the job—but also any other activity of daily living such as cooking, cleaning, using the bathroom, climbing stairs, walking the dog, etc. As Roberts explains, occupational therapists, or OTs, “use the occupa-
tion as the medium for therapy.” For example, if someone has fallen in the bathroom, the OT would, in addition to addressing any physical deficits (such as balance problems) that might have contributed to the fall, suggest modifications to the bathroom environment to make it safer, such as adding grab bars, a transfer bench, a toilet riser, and non-skid surface in the tub or shower. In fact, many seniors fear using the bathtub and may avoid bathing or showering because they hear so much in the media and from loved ones about the risk of falling there. An OT can modify the bathroom to mitigate this risk and allow the senior adult to function safely, independently, and without fear in this environment. Roberts identifies rushing to get to the bathroom or to answer the phone as the two scenarios that most commonly cause falls in the home. Again, an OT can recommend simple home modifications that reduce fall risk under these circumstances, for example, removing carpets or throw rugs that present a tripping hazard or that might catch a walker or cane,
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or removing cords that extend across walkways. “Here at The Laurels, we offer home evaluations, during which we go to the person’s home and observe them as they go through a normal day to assess what modifications would make the environment safer and to recommend any assistive devices that might be appropriate. It’s also very helpful to have family and caregivers involved in the evaluation process so they understand what’s needed and can help to make sure any necessary modifications are done correctly,” Roberts says. Oftentimes, guests who have transitioned home come back to take advantage of the Laurels’ state-ofthe-art therapy gym to fine-tune their balance and strength and for additional fall-prevention education. The facility also offers transitional stays for guests and their caregivers. This program, which is ideal for husband and wife teams, provides an opportunity for the caregiver to stay with the guest and provide all necessary care in a home-like environment with a professional therapy team close at hand in case a problem or question should arise. Sometimes, the Laurels therapy team has to get a bit creative to help guests reduce their fall risk. For instance, one guest’s main goal following knee replacement was to be able to walk her dog without the
risk of falling—particularly when going up and down stairs. So, the team brought her in along with her dog and a dog trainer to work on the problem. First, one of the therapists walked her dog to get a sense of the movements involved so the team could address any physical deficits that might increase her fall risk. Then, the dog trainer worked with her on the cues and commands she should use with the dog in order to eliminate any confusion on the dog’s part that might contribute to a fall. Involving a guest’s hobbies and interests in fall-prevention therapy is also key. “For example, we often have older female guests who enjoy sharing a special recipe with us. So, we open up our kitchen and use this particular interest as therapy—again, using the occupation as the medium
A simple test can assess fall risk. of therapy. In the process of preparing that favorite recipe, they’re working on balance and safety when they’re cooking, moving around the kitchen, and reaching for items. For guests who have balance issues, the therapy team can utilize various neuromuscular re-education (essentially balance and position training) techniques to reduce fall risk. First, standardized testing is performed to get a baseline score for the guest. Several different tests may be utilized and correlated. The test that Roberts uses most frequently is the Functional Reach Test. With this test, the guest stands without an assistive device next to a wall, which has a horizontal yardstick affixed to it at shoulder height. The guest raises his or her arm to the level of the yardstick and then leans forward as far as possible without losing balance or taking a step, keeping the arm extended and parallel to the yardstick. The distance between the starting and ending position of the guest’s hand provides an objective score of his or her fall risk. “From there, we can do specific vestibular exercises. For instance, we can have the guest stand on a special foam mat and perform certain movements, such as lifting the arms up and down, raising and lowering the head, or marching on the mat—first with eyes open and later, as therapy progresses, with eyes closed. This all ties in to fall prevention because the objective is to make the guest strong enough and stable enough to return home safely,” Roberts explains. In addition to occupational therapy, The Laurels’ outpatient services include physical therapy and speech therapy. Guests can utilize one or any combination of these services, depending on their individual needs. Also, the therapy team offers education on fall-recovery techniques— how to get up from the floor safely should a fall occur—both for guests and their family. ❦ 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.
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Research studies give hope while advancing the science of healing
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linical research studies can provide a host of benefits, not only to the people who choose to participate in them, but also to medical practitioners, who often gain powerful new tools to combat disease and improve their patients’ quality of life, as well as to future patients afflicted with the same disease or disorder. However, owing to certain persistent myths, patients are sometimes reluctant to volunteer for research studies. For example, they may fear they’ll be treated like an experimental “guinea pig,” they’ll be given a placebo in place of an effective therapy, or they won’t be able to leave the study once it begins. But the facts surrounding clinical research studies tell a very different story.
Voluntary participation According to Melanie Wheeler, RN, BSN, MBA, CCRC, Corporate Director for ProMedica Research, participation in clinical trials is always voluntary. Participants are free to
change their minds and leave the study at any point and for any reason—without putting their ongoing treatment in jeopardy.
Increased contact with practitioners While every study is different, trial participants usually have much more frequent contact with practitioners and undergo more testing and lab work than non-participants with the same illness or condition. “That means their health status and the progress of their condition are monitored very closely. Even patients who get standard treatment or placebo do better in a research study because of the frequent follow-up care they receive,” Wheeler says. Because study coordinators facilitate, and often complete, the follow-up visits with the patients, ProMedica Research believes it’s vital that they, too, bring clinical expertise to the role. In fact, Wheeler prefers to hire nurses for this position. What’s
more, all ProMedica Research coordinators are expected to achieve the credential of Certified Clinical Research Coordinator (CCRC).
Informed consent Before beginning participation in a research study, patients are provided informed consent documentation that explains the purpose of the trial, what the treatment will entail, their rights as a participant, potential risks and benefits, alternative therapies, etc. Signing the document provides the participant’s consent, but does not mean they’ve given up any legal rights or are obligated to remain in the study for its duration. Informed consent is an ongoing process; patients will receive updates and explanations throughout the study so they can make educated decisions
regarding their continued participation.
The “guinea pig” myth Research study participants are never subjected to any treatment or test that wasn’t fully disclosed and discussed in the informed consent process. As with any medical therapy, there may be a risk of potential side effects to the study treatment, some of which aren’t known to the research team. However, the phasing of clinical research studies is designed to help minimize this risk. As Wheeler explains, phase 1 involves healthy volunteers and is focused not on proving that the treatment is effective but strictly on identifying side effects and proving safety. Phase 2 involves a small population of patients who actually have the disease. In this phase, the researchers are still proving safety, but now also looking for efficacy. In phase 3, much larger patient groups are brought into the study to confirm the treatment’s efficacy and continue monitoring safety. Phase 4 begins after the FDA approves the treatment with the stipulation of a post-marketing trial, which evaluates
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10 November 2013 / Healthy Living News
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how it affects the patient population in the real world.
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The placebo myth While placebos are often used in clinical trials, they are never used in studies of therapies for specific diagnoses. For example, if a study is being conducted to evaluate a new cancer drug, participants will be randomized to receive either the experimental drug or the “gold standard” drug currently in use—not a placebo. The same applies to medical devices, such as artificial heart valves. Under certain circumstances, if a patient taking an experimental medication benefits from it, he or she may be able to continue taking it after the study has concluded.
Cost coverage and convenience Patients often worry that getting involved in a research study will add significantly to their medical bills. On the contrary, many clinical trials cover the cost of study medications, lab work, and other testing, and compensation is often provided for time and travel. The ProMedica Research Team strives to work with the patient so there are no surprises surrounding payment issues. If distance is prohibitive for prospective participants, ProMedica Research will even make arrangements to travel to their location. “We fully appreciate that it’s not always easy for residents of Defiance, Findlay, Fremont, or other towns and cities in our region to drive to Toledo, so we try to make it as convenient as
individualized holistic care possible for them to participate,” says Wheeler. Recognizing that patients are more inclined to participate in research studies if their doctor is involved, ProMedica Research is also working hard to establish relationships with area physicians’ offices to get them engaged and make studies more accessible.
A healthy legacy Even if study participants don’t benefit directly from the experimental treatment being evaluated, they are still making a significant, vital contribution to research that may someday yield a cure for the disease or make the quality of life much better for those afflicted with it. That knowledge can give participants a great sense of empowerment over their disease. “I think many patients are inspired to participate by the humanitarian aspect—the thought that ‘It may not help me, but it might help others, maybe my future generations.’ There’s a pride in contributing to the science that might be taking us one step closer to developing treatment for very serious diseases, or at least, improving quality of life,” Wheeler says. ❦
life journeys
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Large sibling groups in need of loving adoptive families
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s we commemorate National Adoption Month, the child-welfare advocates at Lucas County Children Services (LCCS) are urging members of the community to make room in their hearts for sibling groups in need of a permanent, loving, supportive family. And right now, this need is great. Among the 51 kids LCCS is currently trying to place in “forever homes,” there are 16 different sibling groups, ranging in size from two to seven
children. The agency strives to keep these kids together whenever possible. However, unless families in the community are willing to adopt multiple siblings, the only option is to split them up and place them in different homes. For example, one sibling group of seven is currently separated among four different foster homes, a group of five siblings is divided between two homes, and a group of three siblings is split among three different homes. The agency hopes to reunite each of these groups in single adop-
November is National Adoption Month. Consider adopting a sibling group from Lucas County Children Services. To learn how, call 419-213-3336 or visit www.lucaskids.net. Register now for upcoming foster care and adoption training classes: • Tuesdays/Thursdays, 6-9 p.m., January 7 – February 13, 2014 • Saturdays, 9 a.m. - 4 p.m., February 8 – March 15, 2014
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tive placements. “Siblings entering our care really sustain each other,” explains Julie Malkin, Public Information Officer for LCCS. “They’ve all been through
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the same traumatic experiences, and very often, they have only each other to turn to. That’s why we’re so determined to keep sibling groups intact and why it’s so important for families to step up and make the commitment to adopt them together.” Maintaining the bond between brothers and sisters provides inestimable benefits to children who have already experienced the disruption of a significant family relationship. Not only does keeping sibling groups together enhance their sense of safety, security, and support as they transition into a new family, but it also helps them maintain their mutual history, identity, and sense of belonging. In contrast, when sibling groups are separated, they often experience additional feelings of loss, grief, and anxiety. They worry about their other sibling’s well being and may feel traumatized or victimized all over again or that they’re somehow being punished for something they did. “Kids coming into our care, especially those who are school aged or older, usually know why they had to be removed from their parents. But they don’t understand why they have to be separated from their siblings,” Malkin remarks. Despite the benefits of keeping siblings together, prospective adoptive families are often reluctant to make this commitment, owing to certain perceived obstacles. As LCCS
Recruitment Specialist Celine Woods points out, “Many families are worried that they can’t meet the longterm financial obligations of caring for a larger sibling group, or they may be daunted by the broad age
range of a group. Another hurdle to overcome is that some families don’t feel equipped to handle siblings who have behavioral challenges or have experienced trauma. But we provide a broad range of support services to adoptive families, including financial subsidies, medical, training sessions to learn how to manage issues related to behavior or trauma, counseling, therapy, and casework support until age 18.” To help prospective adoptive families get to know some of the sibling groups in need of loving homes, LCCS will be photographing nine of these groups and featuring them on their website, lucaskids.net. One
MY MOM IS BATTLING CANCER. I NEED TO WORK FULL TI
of the featured groups consists of Cay’Ron, Cay’Lah, Ty’Wonne, and Ter’Raya (born in 2005, 2007, 2009, and 2011 respectively). They enjoy playing with Legos, dolls, or just with each other, and they all share a fondness for pancakes and pizza. Cay’Ron dreams of being president when he grows up, Cay’Lah hopes to be a teacher, Ty’Wonne wants to be Batman, and Ter’Raya wants to be Minnie Mouse. All they ask for is a family that will “love us, take us swimming, and have a puppy and lots of toys.” Adoptive parents must be at least 18 years old and have income sufficient to meet the needs of their household. They must also undergo a home study and background check to ensure they can provide a safe, appropriate home environment for children. It does not matter whether they rent or own their home or whether they have children of their own, and cultural factors such as race, marital status, sexual orientation, ethnicity, and religious affiliation are not considered. Each adopted child must be provided his or her own bed, though bunk beds are perfectly acceptable and same-gender children can share a room. “Anyone interested in learning more is encouraged to attend one of the training classes offered for free here at Lucas County Children Services, located at 705 Adams Street in downtown Toledo. The next session begins in January, and the training schedule for 2014 will be posted on our website, lucaskids. net. You can register online or by calling 419-213-3336, and you can find us on Facebook at facebook. com/LucasCountyChildrenServices,” says woods. Malkin adds, “Many of our foster families ultimately decide to move forward and adopt due to the relationship they build with the kids and with us, so right now we’re licensing for both foster and adoptive parents to keep that option open. The training curriculum is the same for both.” ❦
ME. I WANT TO BE THERE EVERY DAY. HOW CAN I DO IT ALL? y mom is battling cancer. “I could never have done it on my own need to workCANCER. fullI NEED time. MY MOM IS BATTLING TO WORK FULL TIME. without Hospice of Northwest Ohio.” want to be there every day. How can I do it all? “I wasn’t familiar with watching somebody you love pass MOM ISEVERY BATTLING cancer. y mom isBE battling cancer. I WANTMY TO THERE DAY. HOW CAN I DO IT ALL? MY away. I felt a weight had been lifted off my shoulders when need to work full time. want to be there every Hospice of Northwest Ohio got involved because I had no IS BATTLING CANCER. I NEED TO WORK FULL TIME. I day. MOM How can I do it all? idea what I was doing, and they explained everything to me.” I need FULL TIME. to work y mom is battling cancer. WANTto TO BEwork THERE EVERYfull DAY. HOW CAN I DO IT ALL? MY – April, daughter of a Hospice of Northwest Ohio patient need time. want to be there every We are the area’s largest and most experienced provider of Answers to crossword from page 22 day. MOM How canCANCER. I do it TOall? IS BATTLING I NEED WORK FULL TIME. I I WANT EVERY DAY. hospice care, a nonprofit organization solely dedicated to y mom is TO battling cancer. be full there need to work time. providing the best possible end-of-life experience for our WANT TO THERE there EVERY DAY. HOW CAN I DO IT ALL? MY want toBE be every patients and their families. day. How can I do it all? HOW CAN I do y mom battling cancer. MOM IS is BATTLING CANCER. I NEED WORK FULL TIME. I Ask for us by name. The sooner you do, the more we can help. itTOall? need to work full time. want TO to be there every Answers for Living the Last Months of Life DAY. HOW CAN I DO IT ALL? MY day.WANT HowBE THERE canEVERY I do it all? y mom is battling cancer. MOMto IS BATTLING CANCER. I NEED TO WORK FULL TIME. I need work full time. want to be there every y. How can doDAY. it HOW all? BE THEREIEVERY CANMy I DO IT ALL? MY momWANT isTObattling cancer. I eed 12to work full time. I November 2013 / Healthy Living News We love comments and feedback. Like us on Facebook. Follow us on Twitter. 1
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Elizabeth Scott administrator earns one of Ohio’s first assisted living certifications
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att Bucher, Director of Marketand ideas I learned. Those ideas will ing for the Elizabeth Scott Comultimately lead to better quality care munity in Maumee, has successfully for our residents.” completed the first training program Bucher says the most important and examination for assisted living part of the training was the abilexecutives in Ohio. ity to hear from a variety Bucher completed the of individuals who are new Certified Executive experts in their fields of for Assisted Living (CEAL) work. “In one session, certification program, ofwe heard from a demenfered through the Ohio tia expert; in another, we Centers for Assisted Livlearned about Fire Safety ing (OCAL). OCAL is and Disaster Planning an affiliate of the Ohio from a different expert. Health Care Association. Being exposed to a broad He then took, and passed, range of experts was a the National Association key part of the training. I of Long Term Care Adalso believe the hands-on Matt Bucher ministrator Boards (NAB) training we received at Residential Care/Assisted Living Ada residential care facility was very ministrators Examination to earn the valuable.” CEAL designation. Ohio does not currently require CEAL is a comprehensive certificacertification for assisted living adtion program designed to elevate the ministrators, but CEAL has aligned skills and professionalism of assisted its program with the NAB Residential living administrators in Ohio by proCare/Assisted Living Administraviding a national certification along tors Licensing Examination so crewith Ohio’s most comprehensive dentialed assisted living executives state-specific training. The four-day in Ohio meet national competency CEAL Training Course is a combinastandards. tion of interactive classroom trainThe Elizabeth Scott Community, ing, guided self-study, and hands-on located at 2720 Albon Road in Mauclinical learning. The Ohio CEAL mee, offers Independent Living, Asis awarded to candidates based on sisted Living, and Skilled Nursing 100% class participation, including care to area residents. It has been completion of in-class quizzes, testfamily owned and operated since ing, and successful passage of the 1949, and Bucher is a fourth-generNAB examination. ation family member involved in the “The CEAL certification program day-to-day operations of the facilwas very challenging,” says Bucher. ity. For more information about the “But it was worth it, because our Elizabeth Scott Community, contact residents will benefit when we impleMatt Bucher, Director of Marketing, ment the programming concepts at 419-724-5021. ❦
Local church reaches out to those unable to attend church on Sunday
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astor Robert Fry of Heritage Church of God in Maumee, Ohio has had many visions over the years for his ministry. In March 2013, he fulfilled one of these visions with the launch of “Thursday Church.” Thursday Church is not a supplement to Sunday or a watered-down version of a church service, but rather, a way for those who cannot attend Sunday services to have that experience on a different day. Thursday Church starts at 7:00 p.m., and whether you’re a nurse, police officer, server, retail worker, minister, or maybe just looking to
attend a second service in your week, Heritage Church of God welcomes you and your family. There are classes for youth of all ages during Thursday’s service. Heritage Church of God is located at 3520 Strayer Road—it’s that other church on Strayer. There is no membership, as the church maintains that a salvation experience makes you a member. For more information, please visit their website at www.heritagechurchofgod.org, and tune into Proclaim FM 102.3 each night at 11:30 p.m. for Pastor Robert Fry’s radio program, “God is Real.”
CITY OF TOLEDO Winter Sports Programs Boys & Girls youth BasketBall
team Fee: $150.00 per team ages: 10 & under, 12 & under, 14 & under registration Dates: 2012-2013 Returning Teams: Tuesday, October 15th - Friday, October 25th New Teams: Monday, October 28th - Friday, November 8th season starts: Saturday, December 7th, 2013
youth Girls VolleyBall
team Fee: $150.00 per team ages: 10 & under, 12 & under, 14 & under registration Dates: October 14th - November 8th, 2013 season starts: December 3rd, 2013
aDult Women’s & CoeD VolleyBall
team: $150.00 per team registration Dates: October 14th - November 8th, 2013 season start: January 6th, 2014
ottaWa Park iCe rink oPen skatinG General admission: $4.00 per person Children 3 and under: No Charge senior Citizen: $2.00 per person Please call 419-245-3388 for times and days.
rent the rink For holiDay Parties, BirthDay Parties, PraCtiCes anD Games. rink rental: $150.00 per hour
aDult DroP-in iCe hoCkey $5.00 per player 4 on 4 aDult iCe hoCkey leaGue team Fee: $250.00 per team registration Dates: October 14th - November 8th, 2013 season starts: Monday, December 16th, 2013 Division of Parks, recreation & Forestry 2201 Ottawa Parkway, Toledo, Ohio 43606
419-936-2877 For daily ice conditions, call 419-936-2997 For more information on programming and ice rental, call
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419-245-3388
13
YMCA offers
diabetes prevention program by Christine A. Holliday
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With our VA contract, we can accept veterans who are not well enough to go home after their hospital stay. We also have long-term beds available, should the need arise. Your benefits may cover: Room • Meals • Skilled nursing care • Physical, speech, and occupational therapy Respiratory therapy • Medical and nursing supplies • Oral medications Most items of durable medical equipment • Routine laboratory tests • Routine physician visits We suggest contacting Veteran’s Services Commission Office in your county for assistance with veteran’s benefit questions and to verify skilled nursing benefits.
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iabetes. It’s a disease that impacts will receive a food and activity tracker the lives of millions of Ameriand a fat gram counter and will be cans and is waiting to touch the lives weighed weekly. Ruff notes, “We will of many more who aren’t aware that be keeping track of every single thing they have the disease or are in danthey eat and the amount of physical ger of developing it. It is the seventh activity, with the goal of a 7% weight leading cause of death in the United reduction and an increase in physical States, the leading cause of activity to 150 minutes per new cases of blindness in week. That sounds like a people aged 20-74, and the lot of exercise to someone cause of medical expenses Diabetes is who isn’t even a little ac2.3 times greater for those tive, but he doesn’t have the seventh to do all the exercise at one who have it than those who don’t. leading cause time. He can do it in small The local YMCA is joinsegments—walk the dog a of death in couple of times each day, ing the National Y’s efforts to educate people about for example—and the minthe US. diabetes and how to live utes add up.” with it. Susan Ruff, the After the 16 weeks, Diabetes Prevention Prothe group will meet for gram Coordinator, explains that the monthly maintenance meetings for disease is a serious threat to health. the remainder of a calendar year, “There are probably 75 million people where facilitators will take in-depth who are pre-diabetic, but only 11% looks at diabetes-related topics. As are aware of their situation. They the number of participants increases, don’t know that being pre-diabetic Ruff expects to have several sessions increases the risk of type 2 diabetes, running at the same time, with plans heart disease, and stroke. They don’t to meet at various Y locations and know about the serious complications workplaces during lunch breaks. of the disease, including high blood Scholarships will be available to help pressure, stroke, blindness, and heart cover the costs of the program, and disease. The purpose of our program participants will receive a Y memberis to give information and support ship when they enroll. to those who have diabetes or are in The Y reports that research danger of developing it.” funded by the National Institutes The program, which had its first of Health shows that the program meeting October 28 (people are welreduces the risk of developing type come to join up to the third week of 2 diabetes by as much as 58%, with the program) at the Morse Center a 71% reduction in adults 60 years of on the campus of the University age and older. of Toledo Medical Center, targets Ruff invites inquiries about the African-Americans and Latinas, who program at 419-725-7844. Participants are at higher risk of developing do not need a referral from a doctor the disease, but is open to anyor insurance. They can take body over age 18. At the first the risk assessment online at of 16 weekly hour-long seswww.ymcatoledo.org or on sions, participants are given the YMCA’s Facebook page. a risk assessment to identify She also encourages spouses those conditions that might to come together to learn make them likely to become about how to cook healthy diabetic. Those conditions meals for both. include having a parent “Diabetes is really a who had diabetes, living a health emergency waitsedentary life, being a feing to happen,” she says. male who delivered a baby “We hope to give people weighing nine pounds or the information they more, being overweight, need to minimize or having a body mass its effects on their index of 25 or more. lives.” ❦ During those classes, each participant will have a lifestyle coach to Chris Holliday is a freelance help as he examines his own nutriwriter and regular contributor to tion and physical activity habits. Each Healthy Living News. We love comments and feedback. Like us on Facebook. Follow us on Twitter.
Sports acupuncture and chiropractic by Douglas Schwan, DC, Dipl ac
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remember a few years ago, a young man came into our office with a bad hip and back injury. He said he was practicing for an upcoming trackand-field sports event and injured himself jumping hurdles. He wanted to know if I could “fix” him enough to compete in an upcoming sports event the next weekend, which, he said, was important to him. I took a look at him and figured out he had badly sprained his hip and twisted a vertebra in his lower back out of place. From my initial evaluation, I figured better safe than sorry and told him that competing that soon was really iffy. I treated him with chiropractic adjustments to restore normal alignment in his lower back and hip. I also performed acupuncture to reduce swelling and inflammation. I instructed him to return each day for the next three days and told him there may be a chance he could compete in some events by the weekend, but I made no promises. The next day on the front page of the Toledo Blade sports section was a picture of my smiling patient surrounded by his family with the caption, “Specialist opinions that Star Athlete might be able to compete in National Championship despite injury!” This kid, James, and his parents had been concerned but were so low key about their son's achievements that I had no idea he was slated to go to the National Championship event! When he came in the next day, I went to work on him—asking him exactly what events he was competing in and working those muscle groups most aggressively to limit the inflammation and pain from his injury. While we worked, James told me that I was his “little secret” and that his coach and medical consultants felt he could not compete at all by the weekend. His mom told me that our office was kind of a last-ditch effort to get him up and competitive by the weekend. All James’ hopes and dreams had centered on winning
complaints, and defensive linemen have lower-back and neck issues. As for James, he did make it to his National meet and placed second in two events. He was able to compete in all but one of his events. He returned to the office the following Monday, and I now have a picture
Nationals, and here he was, just a few days before the event, limping around my office! Very frustrating for all concerned. On the third day of treatment, James brought in his coach with him. He had improved so dramatically in the last two days that the coach, Bob, had to see for himself what was going on. I demonstrated how the chiropractic adjustments brought the body into proper alignment so that it released the stress on his injury, allowing it to heal at the maximum possible rate. I also demonstrated how we combined ancient healing and modern healing by using acupuncture in combination with computer-controlled micostimulation techniques, stimulating through the needles to increase healing and decrease pain and inflammation. These procedures are designed to increase blood flow, relax tight and spastic muscles, and accelerate healing by concentrating energy within damaged tissues. I’ve treated a great many local athletes over the years, both at the high school and college level. It got to be kind of a challenge to guess what sport and position a player played based on their complaints: For example, baseball pitchers complain of elbow and shoulder pain, receivers tend to go down on their legs and shoulders, baseball catchers have knee and ankle
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of all of us standing with his medals. I think we both won that day. ❦ Dr. Schwan is available to speak at your group functions on a wide variety of Alternative Medicine topics, including chiropractic, acupuncture, herbal medicine, nutrition, vitamins, etc. He is
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a graduate of the International Academy of Medical Acupuncture and Palmer College of Chiropractic. He maintains a practice in Toledo, Ohio. He is an
Do you have type 2 diabetes that is difficult to control? Have you had a heart attack or stroke in the past 2 years?
BySister Mary Thill
Spiritually Speaking
The GRAND-306 Study is looking at whether an investigational medication (a new medication) that is under development is safe and effective in people with type 2 diabetes, who have difficulty in controlling their blood sugar levels, and have experienced heart problems or have risk factors for heart disease. You may be eligible to participate in the GRAND-306 Study if you: • • •
are 18 years of age or older have been diagnosed with type 2 diabetes have had heart problems or stroke, or have risk factors for heart disease, such as being a smoker, having high cholesterol, or high blood pressure.
If you decide to join the GRAND-306 Study, you will continue taking your current diabetes treatment as usual and will be given the investigational medication, or placebo (which looks the same as the investigational medication but contains no actual medication). to take as well. The GRAND-306 Study will last about 6 years, and will require approximately 23 visits to the study center and scheduled telephone calls. The study will include a screening period to confirm that the study is suitable for you, a study medication closing period, and a follow-up visit.
For more information, please contact:
Clinical Research Source, Inc.
419-873-1532
grand
306
a type 2 diabetes clinical study
GRAND-306 Study. Patient Flyer [V01 USA(EN)01]
Special Events Brought to You By:
BRUNCH BUNCH • TUESDAY, NOVEMBER 19 Breakfast served at 9:30 am • Presentation at 10 am Health Care Fraud Prevention
Join Us to Learn from Mike Winslow of the FBI the Answers to These Questions: • What should you look for? • How does it affect you? • What should you do if you suspect it? Cost: $5 at the door. Please RSVP Carleen at 419-878-1807.
FALL AND WINTER COOKING CLASSES TUESDAYS: OCT. 29, NOV. 12, 26 and DEC. 10 from 6-8 pm $20 per class/$75 for all 4 classes Join Us for Chef Bill Kolhoff
Learn how to make variations of old time favorites like chili, mac & cheese and casseroles. Plus, you will learn new recipes for holiday beverages, appetizers, deserts and much more. Please RSVP Carleen at 419-878-1807 Seating is limited, so don’t wait 8883 Browning Dr. • Waterville, OH 419-878-4055 • www.browningmasoniccommunity.org 16 November 2013 / Healthy Living News
author, lecturer, and one-time standup comedian. For more information on Alternative Medicine, please visit our website at www.acupuncturetoledo.com.
Bless us, O Lord… “Bless us, O Lord, and these thy gifts…” I was so hungry for these words; It was like a cool breeze, a polite thank-you note to God, the silky magnetic energy of gratitude. I still love that line. —Anne Lamott I’ve come to the conclusion that gratitude is not a function of either abundance or scarcity. Rather, it is an approach to living. The grateful bring light into the world. —Bob Short
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ast November, Anne Lamott had an article in the Sunday Parade magazine (Nov. 11, 2012) in which she shared her love of the blessingat-meals prayer said by her Catholic friend. No one prayed at meals in her family (her parents were atheists), but she secretly believed in God and felt the need to be grateful to God for the many things she had, including the food on the table. No matter if the prayer or grace said was short or long, Anne felt it important that we thanked God because in doing so, “We’re acknowledging that this food didn’t just appear. Someone grew it, ground it, bought it, baked it, WOW.” What a great reminder of our need to be grateful for the bounty on our tables, in our homes, in our schools, in our places of worship, and just about all around us. We set aside a day on which to be grateful during this month, and I think it might be helpful to reflect on what we’re grateful for and why. I, for one, am grateful for good health care provided by doctors who seem to want me to be as active and healthy as I can be at this stage of my life. I’m grateful for private health insurance and Medicare that help pay the bills. I’m grateful for family and friends and co-workers who add so much to my life by their care and compassion, their challenges and encouragements, and their love and concern in the good times and the difficult times. I’m grateful for my housemates,
the three Sisters I live with at Greccio, who keep me on my toes, join in my laughter, share my tears, listen to my stories, and continue to be faithful companions on the journey as we live religious life in the 21st century. I’m grateful for my vision and that I can still read and enjoy the beauties of the earth. I’m grateful for my hearing, which has decreased over the years, but I can still hear my favorite music, listen to my friends’ stories, and enjoy the sounds of nature that surround me on our beautiful campus in Sylvania and elsewhere. I’m grateful for being able to be grateful and having a loving God
who is present to me in so many ways each day. I hope that as you take time to reflect on what you are grateful for this Thanksgiving Day, you will realize that “gratitude is not a function of either abundance or scarcity [but] it is an approach to living.” Would that we could approach our world, our life, our work, everything that we do, and everything that happens to us with such an approach. I do believe then that “The grateful [will] bring light into the world.” And our world needs light, does it not? Happy Thanksgiving, and GO BLUE! ❦ 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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Healthy holiday tips from Heartland Rehabilitation
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he weather is turning cooler, and stores are putting up holiday decorations, so we know the holiday season has begun. This month’s article focuses on your health and wellness during this time of year. November and December are months when we typically have more events to plan or attend and we feel more stress and fatigue. What can we do to make the holiday season a little more healthy and fun with friends and family, not a time of stress? Here are some tips to reduce holiday stress from the website www.acqyr.com:
and bustle by planning ahead, ordering online, or making personalized gifts. Don’t let the stress of others rub off on you.
Let go
Be jolly
This is not the season of conflict. Trying to win small battles may cost you health, happiness, and peace of mind. Grudges, arguments, and fights waste energy and magnify stress. Instead, let go and seek peace in your heart.
This is the season to be jolly! Don’t perpetuate anxiety or fear. Instead, spread joy and happiness. Embrace each moment—good or bad—with a smile. Live, love, and laugh! All else will fall into place!
Eat, sleep, and be merry This is the season to be healthy. Bring good tidings to your body, mind, and stomach by managing your diet and sleep. Good health starts with healthy food and quality rest. Otherwise you’ll feel bloated, tired, or cranky, and that just might rub off on others.
In addition to these few simple steps, it is never too late to start a home exercise Program. Doing simple exercises (back to the basics) of squats, lunges, push-ups (wall, knee, or regular), rows, and deadlifts (hinging movement at the waist, touching your shins, and then up) for 15 to 20 minutes at least three times a week
RETURN TO PLAY SAFELY Heartland Rehabilitation Post Concussion Return to Play Program
Do what you can This is not the season of excess. At least it should not be. Having too much on your plate, whether literally or figuratively, can overwhelm. Be aware of the commitments you make for yourself and your schedule. Don’t overbook yourself or stretch yourself too thin.
Count your blessings This is the season to celebrate. What do you have to celebrate? More than you think. Concentrate on what you do have, not what you wish you did.
Expect the time crunch, not perfection This is the season of the time crunch. With so much expected of you—family, work, social events, and more— it’s just not possible to meet every demand. Unreasonable expectations will lead to great disappointments. Manage what you can with the time you have. There’s no use in stressing yourself out.
Beat the procrastination bug This is the season of much to do. Your mind may drift onto your long to-do list, but don’t let that distract you from the task at hand. Get everything out of your head and onto paper. Once you do, stop worrying. Trust that things will get done in time.
Heartland Rehabilitation offers a comprehensive return to play program for anyone who has been diagnosed with a concussion.
Benefits of Heartland’s RTP Program • Athlete will undergo a 5-step protocol that is required for all highschool athletes • Athlete is under the direct care of an educated, properly trained, andlicensed health care professional • Athlete will be in a controlled environment to eliminate outside influences and potential setbacks in the rehabilitation program • Athlete will return to play timely and safely • Heartland has convenient locations • Parents will have peace of mind knowing their child’s head injury isbeing taken care of appropriately Arrowhead: 897-9822 Oregon: 697-8000 Perrsyburg: 874-2657
Beat the shopping rush This is the season of busy malls and parking lots with long line-ups and stress filling the air. Avoid the hustle
Therapy for Today, Wellness for Lifesm
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Westgate: 536-8030 Bedford: 734-856-6737 17
will help with all the holiday bustle, lifting, carrying, and bending. Adding cardio (walking, marching in place, dancing, etc.) three days a week to the resistance program you started is a must. ❦ Heartland Rehabilitation has five locations in the Toledo and Bedford, MI areas with knowledgeable staff to assist
with your physical and occupational therapy needs. Plus, Heartland offers wellness opportunities, including gym memberships, personal training, pilates, and SilverSneakers®. In addition, Heartland has a Balance and Dizziness Program; Healthy Lifestyle Management Program; and Return to Play Concussion Management Program.
Honor your father and mother by Jessica Derkis Honor your father and your mother, that you may have a long life in the land the LORD your God is giving you. —Exodus 20:12 NAB
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here is no better way to honor your parents than with your time and presence. Instead of eating out, plan smaller gatherings at home during the holidays. Instead of getting your parents a gift certificate for housekeeping, help strip the bed, catch up on laundry, and prepare the house for the coming cold weather. By working alongside them, you may learn more than a full-service dinner and a glass of wine would produce. For instance, when you help recre-
Free Whitening for new patients
ate Mom’s signature dishes, does she have difficulty chopping vegetables? Maybe those joints ache more and there might be ways to alleviate that pain. Are pots and pans that have always been in the same cupboard moved? It could be as simple as craving a new perspective, but it could be a sign of memory slipping. You may find that clearing out long-held sports trophies, old band uniforms, and dorm room decor is beneficial for both of you. It is a great responsibility to be the keeper of the stuff. These things can take up a lot of valuable real estate. Taking pictures or portions of some of these items to create wall hangings,
quilts, and other keepsakes might trigger “remember when” without clogging closets. Family stories are just as important, but far less tangible, mementos. Even though you have heard the same stories over and over and over again, those will be stories you share with your children. You may groan internally at every telling now, but the time may come when you will cherish those stories. Flexibility is key as the dashing through the snow begins. Most everything from traveling to opening presents can take longer as you get older. It helps to build in time to go off the plan. This will be especially appreciated if you or your loved one becomes overwhelmed and exhausted by festivities and expectations. The holidays by themselves can be a stressful time. Remember to take care of yourself. Eat well, stay as well rested as possible,
Kenneth Endicott D.D.S., M.S. Prosthodontics
Chun-Yu Liu
D.M.D.
General Dentistry
and find joy in even the little annoyances that always happen. Feel good about your triumphs. Expect—but don’t beat yourself up over—the occasional frustration. Learn ways to help your parents stay safe at home. Join the St. Rose Parish Fab50+ Club on Thursday, December 5, at 11:30 am at St. Rose. The first Thursday of every month, there is an opportunity to learn new ideas and skills with the Fab50+Club that meets at St. Rose Parish. Also, join St. Clare Commons for the Christmas Open House on Sunday, December 15 from 11:00 am until 3:00 pm. Please RSVP to 419931-0050 by December 9. The first phase of St. Clare Commons is now open! Reser vations are available for in- and outpatient rehabilitation, assisted living apartments, a secure area featuring efficiency suites specializing in dementia care, and beautifully ap-
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Affordable Root Canals TMJ Dysfunction Free 2nd Opinions Dental Crowns & Bridges Complete & Partial Dentures Implants, Full-Mouth Rehabilitation Fillings, Cleanings, Teeth Whitening We are pleased to announce the addition of Dr. Chun-Yu Liu to the practice. He and his family reside in the Toledo area. He is a graduate of the University of Pennsylvania. Dr. Liu is a member of the ADA, the ODA and the Toledo Dental Society.
419-882-8388
Dr. Endicott graduated from Ohio State University College of Dentistry in 1970 and received his Master of Science in Prosthodontics in 1974. He is on staff at The Toledo Hospital and has been serving the Northwest Ohio and Southwest Michigan area for years.
4352 Sylvania Avenue • Forum Building, Suite G • Toledo, Ohio 43623 18 November 2013 / Healthy Living News
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F R A NC I S CA N C A R E C E N T E R A
F R A N C I S C A N
L I V I N G
C O M M U N I T Y
Franciscan Care Center’s rehabilitation and therapy center is now open. With new private suites in a beautifully designed setting, the short stay at Franciscan Care Center is the perfect stepping stone from hospital to home. For admission information call 419.882.6582.
rehab renew Rosary Care Center Our Lady of Grace Sylvania, Ohio
St. Clare Commons Perrysburg, Ohio
St. Leonard
Centerville, Ohio
Madonna Manor Villa Hills, Kentucky
Providence Care Centers Sandusky, Ohio
Franciscan Care Center Toledo, Ohio
ASSISTED LIVING INDEPENDENT LIVING MEMORY CARE REHABILITATION SKILLED NURSING HOMECARE SERVICES 567.455.0414 • flcsylvania.org Sponsored by the Sisters of St. Francis of Sylvania, Ohio
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At St. Francis de Sales High School we want you to "Be who you are" through academics, Christian service, athletics and more! See what we mean at our Open House. Meet the faculty, coaches and counselors.
pointed short-term-nursing-care suites. Other amenities you will find in the new 136,000-square-foot healthcare building include a stateof-the-art therapy lab, fountains, a rooftop terrace, a piano lounge, community education space, a chapel, and many connections to Blessed John XXIII Parish. St. Clare Commons is a member organization of Franciscan Living Communities (FLC). FLC is a division of Sylvania Franciscan Health, sponsored by the Sisters of St. Francis of Sylvania, Ohio. FLC is a mission-
driven, industry-leading provider of senior-living services throughout Ohio and Kentucky. The organization offers continuum-of-care options, including independent living, assisted living, skilled nursing, rehabilitation, memory care, senior housing, and home health services. May your Christmas season be richly blessed with honored family, friends, food, festivities, and fellowship. ❦ Jessica Derkis is the Marketing Director for St. Clare Commons.
Take a tour of the school. Check out the latest classroom technology. We’ll also answer your questions about tuition assistance and scholarships. Open House
Sun., November 17th, 1p.m. - 4 p.m.
Placement Test Prep
Sat., November 23rd, 8:30 a.m. - 11a.m.
Holidays sparkle at the Toledo Zoo
High School Placement Test Sat., December 7th, 8 a.m. - 12 p.m.
Be sure to join us! For more information, please call 419.531.1618 or visit sfstoledo.org
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o one makes holidays sparkle like your Toledo Zoo; it’s the area’s destination for family memories. The fun starts early and lasts all winter long! Visit the Zoo’s website, toledozoo.org, for more information about these and other upcoming events: All month long: holiday parties— With exotic venues and award-winning catering options, your holiday party at the Zoo is tailor-made to suit your needs. Add a million-plus twinkling lights, carolers, and everything else that makes the Zoo the area’s premier holiday destination, and you have a party like none other! Ask about the new Festive Feast packages that start in December; learn more at toledozoo. org/holidayparties.
Nov. 9–10: Live from Little People Place!™—Little People friends are allnew, and they can’t wait to meet you in this live, interactive show. The FisherPrice® Little People™ holiday show is sponsored by Fisher-Price®. 11:00 a.m., 1:00 p.m., and 3:00 p.m. Free with regular Zoo admission. Nov. 15: Tree-lighting ceremony— Join friends and family at 6:00 p.m. as the Zoo lights its 85-foot Norway spruce with more than 35,000 LED lights (it’s ranked as one of the top holiday trees!). Learn more at toledozoo.org/lights. Free with regular Zoo admission. Presented by KeyBank. Nov. 15–Dec. 31: Lights Before 20 November 2013 / Healthy Living News
Christmas—New this year is an outdoor ice rink (bring your own skates or rent them on site), and back by popular demand is the giant snow globe, both sponsored by Yark Automotive Family. Enjoy more than a million lights, plus family activities, carolers, and icecarving demonstrations on selected evenings. Ride on the Safari Railway and African Animal Carousel, make a gift for your family’s animal friend at Santa Paws Workshop, or just enjoy the sights. The Zoo is your Santa Claus destination, too, as the jolly old elf will hear children’s wishes in the Museum through Dec. 23. Learn more at toledozoo.org/lights. Starts at 3:00 p.m. Closing times vary. Lights Before Christmas is sponsored by KeyBank. Nov. 20: Walleye Night at the Zoo’s ice rink—Join Toledo’s own Walleye hockey team from 5:00 to 7:00 p.m. on the Zoo’s new outdoor ice rink at Lights Before Christmas! Uniformed team members will be skating and signing autographs. Free with regular Zoo admission (bring your own skates or rent them on site). Nov. 29: Open for holiday shopping— Start your holiday shopping with remarkable gifts you won’t find anywhere else. The Zoo offers gifts the animal lovers on your list will cherish, from one-ofa-kind jewelry and apparel to animal sponsorships, Zoo memberships and special event tickets. Free with regular Zoo admission. 10:00 a.m. to 4:00 p.m.
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Eating Well by Laurie Syring, RD/LD
Let's take a stand against diabetes
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ovember is American Diabetes Month, a health observance designed to bring attention to the programs, efforts, and issues surrounding diabetes in America. One of these efforts, STOP Diabetes®, is a movement by the American Diabetes Association (ADA) to raise awareness and understanding of the disease and its consequences as well as management and prevention of type 2 diabetes. Individuals are urged to take a public stand via social media and other online venues in support of this movement. Also, in 2012, the ADA launched a social-focus initiative called A Day in a Life, which demonstrates the impact diabetes has on families and communities across the country. Diabetes-awareness efforts such as these could not be more timely, considering the fact that: • 26 million children and adults
• •
• •
in the US have diabetes and 79 million Americans are at risk for developing type 2 diabetes or have prediabetes. 2 out of 3 people with diabetes die from heart disease or stroke. Diabetes is the leading cause of kidney disease and the leading cause of blindness among adults. The cost of diabetes for diagnosed children and adults in the US is $245 billion. 1 in 10 healthcare dollars is spent treating diabetes and its complications.
Diabetes 101 There’s considerable confusion over what diabetes is and what distinguishes type 1 from type 2. Simply stated, you have diabetes if your fasting blood sugar is higher than 125. If it is higher than 100, you have
prediabetes. Type 1 diabetes comes on quickly, usually between the ages of 1 and 25 years. It used to be referred to as juvenile-onset diabetes. With this form, blood sugars are very high and insulin is needed to lower the level on a continuous, daily basis. There is no cure. Type 1 is due to the pancreas’ inability to produce insulin—the hormone that allows the blood sugar into cells where it can be stored or burned for fuel. Research is showing that this is an autoimmune response, possibly to 5 different viruses. Type 1 diabetics must take insulin for the rest of their lives. Type 2 usually develops later in life—after age 35—and is typically related to lifestyle. The vast majority—90%—of diabetics have type 2. Being overweight, being out of shape, and making poor food choices all contribute to the risk of developing this form. Type 2 is characterized by elevated blood sugars caused by impaired insulin sensitivity and insufficient insulin production by the pancreas. Most patients can control type 2 diabetes with oral medication, but some may also need to take insulin. Healthy life-
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style changes, such as losing weight, eating right, and exercising, greatly help in controlling type 2 diabetes and can even reverse it.
Is sugar toxic? You’ve probably seen this headline, or some version of it, quite a few times over the past few years in magazines and newspapers. I don’t know that I’d describe sugar as “toxic,” but there’s no question it’s troubling! Sugars, such as table sugar, high-fructose corn syrup, and honey, have all raised the alarm. In lab studies it’s clear that these sugars are metabolized into fat if too much is consumed. Other research showed that those who consumed the most sugary drinks each day had a 26% higher chance of developing diabetes.
The blood sugar bottom line The best way to dodge type 2 diabetes is to lose or avoid gaining extra pounds and to limit sweets, especially sugar-sweetened beverages—even those containing naturally occurring sugars, such as 100% fruit juice. Also: • Eat leafy greens, whole grains,
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beans, and nuts to boost your magnesium. • Get the RDA for Vitamin D (600 IU a day and up to 800 IU if you are over 70) from supplements or foods fortified with vitamin D. • Do at least 30 minutes of brisk walking or other aerobic exercise every day. • Aim for 2-3 days of strengthtraining sessions a week. Each should include 8-12 repetitions of 8-10 exercises. For now, there is no way to prevent type 1 diabetes, but there is
promising research out there, and perhaps in our lifetime, we will develop a cure. For those with the disease, diabetes doesn’t stop; it is there every day, 24/7, 365 days a year. This I know from personal experience. When my son was told he has type 1 diabetes, I’ll never forget him asking me, “Is there a cure?” It was all I could do to hold back the tears and say, “No—but we can treat it and you can live a long and healthy life.” ❦ For more information, please visit diabetesstopshere.org, american diabetesassociation.org, or JDRF.org.
by Myles Mellor
ilovecrosswords.com 21 Straight, at the bar 23 Wine included in beef bourguignon 24 East Coast state, for short 25 Tuna type 26 Protein building block (2 words) 29 Chicken pot pie ingredient 30 Wrap up 31 Sweet wine used in chicken a la king 32 Japanese specialty
Across 1 Protein substance that remains when starch is removed from cereal grains 4 Disease that is a reaction to eating 1 across 9 Cook on hot coals 10 It’s used a lot in Mediterranean diets (2 words) 11 Sour to the taste 14 Fizzless, of a drink 15 Delectable mushroom 17 She becomes mutton when cooked 19 Piquant 1
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Answers on page 12 2 Japanese category of taste 3 Dine 5 _____ parmesan 6 Refreshing cold drink 7 Cake flavor 8 Not usable now 12 Very cold 13 This, in French 16 Fruits and veggies 18 Weight, for short 20 Anchovy 22 Pizza topping 24 Kitchen cleaners 25 Includes, in a recipe 27 Your and my 28 Popular
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nobody’s perfect Sister Karen Zielinski, OSF
Feeling under the weather?
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omorrow, expect an unseasonably warm day for January—a high of 65!” When the local weather person gushed that out, I wanted to “shoot the (proverbial) messenger,” and I am not a violent person (unless it is humid out). Don’t these people know that for many of us, sudden temperature changes wreak havoc on our bodies?
Under the weather? We have all heard people say things like, “I think it is going to snow, since my hip replacement really hurts today.” Older relatives may complain that their rheumatism acts up whenever it rains. Sometimes windy weather blows a bundle of allergens (things that bring on the allergic sneezes, coughs, etc.) our way. But is there any scientific truth to
these comments? People always talk about the weather and often add that they feel sleepy or their back hurts and their hands get numb. Some heart patients feel more fatigued at changes of temperature. But do our bodies respond to weather? Here in the Great Lakes region, we take high humidity and rainy days for granted. Does this weather affect our health? We in the 21st century are not the only weather-sensitive people. Health writer Richard Leviton tells of some famous people who believed weather affected their health. In his later years, the Nineteenth-Century poet Johann Wolfgang von Goethe took to carrying a barometer with him to foresee what “indispositions” he risked from each day’s weather. One of Goethe’s contemporaries, French philosopher Maine de Biran, wrote, “There is no atmospheric
change, no matter how slight, which escapes my sensitive system.” Hippocrates, the Greek father of medicine, in his pre-Christian era book On Airs, Waters, and Places, described the links between human health and weather. That advice to physicians might have laid the foundation for a future scientific field: Biometeorology. Although research is a bit scarce, there does seem to be a case for studying weather and what it does to our bodies. Our bodies tell us that there is a link between our physical well being and what’s in the air.
History of Biometeorology The motivation for forming the International Society of Biometeorology (ISB) was to bring together scientists from around the world who were working in the field of Biometeorology to exchange information and ideas. The ISB was founded on August 29, 1956, at the UNESCO headquarters in Paris, France. The foundation was initiated by geologist Dr. S.W. Tromp (The Netherlands), meteorologist Dr. H. Ungeheuer (Germany), and several human physiologists, of which Dr. F. Sargent II (USA) became the
first president. The Society defines Biometeorology as an interdisciplinary science studying the interactions between atmospheric processes and living organisms—plants, animals, and humans. The most important question that Biometeorology answers is, how does weather and climate impact the well-being of all living creatures? A related organization, the Climate and Health Commission (CHC), delves further into the relationship between weather and human health: “The relationship between human health and climate has become an important topic all over the world in the last decades. Climate and also weather influence human beings since the moment they are born until the end of their days. Climatic conditions can affect our health in a positive or a negative way. Some topics related to climate, weather and health, such as climate change (global warming), weather extreme events (tsunamis, flooding), and spreading epidemics (avian flu), are generating a global concern in this sense.” The main aims of the ISB Climate and Health Commission (ISB-
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CHC) are to identify the interaction between atmospheric variables (air temperature, wind, air humidity, radiation fluxes, rainfall, lightning, etc.) and human health; clarify the way in which these interactions lead to human health disorders; develop and promote health guidelines for the prevention of health impacts of climate change and weather extreme events; and discuss scientific research on bioweather forecasting and related services. “Practically all physiological processes in a person change during the
different months of the year,” said the late S.W. Tromp, MD, a pioneer in the field and the author of Biometeorology, one of the first weather/body classics. Dr. Tromp based his studies on apparent effects that meteorological factors, such as wind, air pressure, temperature, and humidity, have on a person’s physical and mental health. Alfred Wehner, DDS, former president of the American Institute of Medical Climatology in Philadelphia, says, “There’s a clear connection between certain weather
conditions and some human diseases. Wehner’s group of over 100 members has grown largely because they have seen significant changes on such body aspects as blood volume in different types of weather. “Your blood vessels constrict in cool weather and expand in warm weather,” states Stephen Rosen, PhD, author of Weathering: How the Atmosphere Conditions Your Body, Your Mind, Your Moods—and Your Health. “These changes alter the oxygen supply to your cells and change your blood pressure and composition.”
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The benefits. For more information contact the The benefit information provided isisa abrief Thebenefit benefitinformation informationprovided providedis briefsummary, summary,not nota acomplete completedescription descriptionofof benefits. For more information contact the plan. Limitations, copayments and restrictions may apply. Benefits, formulary, pharmacy network, provider network, premium plan. plan.Limitations, Limitations,copayments copaymentsand and restrictions may apply. Benefits, formulary, pharmacy network, provider network, premium and/or will bebe present with information and and/or copayments/coinsurance may and/orcopayments/coinsurance copayments/coinsurancemay maychange changeon onJanuary January1 1ofofeach eachyear. year.A Asales salesperson person will present with information and applications. For accommodation of persons with special needs at sales meetings, call 419-897-1001 (TTY: 711). Aetna applications. applications.For Foraccommodation accommodationofof persons with special needs at sales meetings, call 419-897-1001 (TTY: 711). Aetna Medicare depends Medicare an HMO/PPO plan with onon contract renewal. Plans areare Medicareisisisan anHMO/PPO HMO/PPOplan planwith witha aMedicare Medicarecontract. contract.Enrollment EnrollmentininAetna AetnaMedicare Medicare depends contract renewal. Plans offered may offered by Aetna Life Insurance Company vary byby location and areare subject to to offeredby byAetna AetnaLife LifeInsurance InsuranceCompany Companyand anditsitsaffiliates. affiliates.Plan Planfeatures featuresand andavailability availability may vary location and subject change toto 88 p.m., change each year. For additional assistance, seven days a week. changeeach eachyear. year.For Foradditional additionalassistance, assistance,call call1-800-832-2640 1-800-832-2640(TTY: (TTY:711), 711),8 8a.m. a.m. p.m., seven days a week.
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What we know Although no one has written a unified theory about weather and its effects on health, we know some trends. Cold fronts are associated with increased heart attacks, almost doubling their incidence. Wind can also have an effect on health. From the Santa Ana in California to the Chinook of the Rocky Mountains, wind can make people feel ill or out of sorts. Biometeorologists say an overabundance of positive ions (electrically charged oxygen molecules in the atmosphere) can cause physical weakness, irritability, headaches, anxiety, insomnia, nightmares, nausea, apathy, depression, and a tendency to quarrel. Negative ions, on the other hand, seem to produce a calming effect. The ions theoretically link with serotonin, a brain neurotransmitter and mood-altering substance that instructs brain cells to relax the body and induce drowsiness. Temperature itself can affect people’s health. Dr. Tromp’s research shows that patterns of warm and cold weather can also help predict other serious illnesses. According to his research, multiple sclerosis occurs more frequently in cooler climates—and so does arthritis, though researchers still do not understand why. Neurologist Peter Zangara says, “Years ago, doctors used heat in the form of hot tub immersion to make diagnoses of multiple sclerosis. Having raised the patients’ core temperature, they would examine the patient and often find signs not previously apparent. This is the reason MS patients try to avoid core heat exposure.” Local MS patients say, “I wish it would just get cold.” Tina, a nurse at a neurological clinic, says that neurologists at the office saw many MS patients this unseasonably warm fall, adding, “There were lots of problems in September and October with fatigue, numbness, and a general feeling of weakness.” Along with seasonal illnesses comes a large group of illnesses associated with a change of seasons. Those who suffer from rheumatic diseases may react in pain to the first chill signaling summer’s end. Changing weather fronts—the briefer fluctuations marked by sudden clouds, building barometric pressure, or an unexpected blast of warm winds heralding the arrival of a new season— can wreak havoc on a rheumatic’s health when a new weather front arrives. “Weather changes may depress your immune system or reduce your resistance to infection, which can leave you vulnerable to flare-ups
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of latent ailments,” Rosen says. What does this mean for all of us? Noticing when our symptoms worsen with the weather can be helpful if we plan accordingly. And in the new millennium, meteorologists may be giving us temperature, ion count, and wind conditions so that we can make adjustments to our lifestyles, home environment, and even attitude. So, there probably is a lot of
truth when we say we’re “under the weather.” ❦
Q
Hearing aids promoted at insanely discounted prices must have a catch, and you need to be aware. It’s prompted us to take a step back and really explain the quality difference between a $300 hearing aid and the fully digital hearing aids provided here at Northwest Ohio Hearing Clinic and other audiology practices.
: I saw an ad in the local newspaper for a pair of hearing aids for only $700. Why are they so much cheaper than the ones your practice offers?
A
: We know you’ve seen these ads; we’ve seen them too. But remember, cheaper is not better.
Sister Karen Zielinski is the Director of Canticle Studio, which is an overall advancement effort and with the mission of being a creative center where artists generate works, products, and services in harmony with the Mission of the Sisters St. Francis. Sister Karen can be reached at kzielins@sistersosf.org or 419-824-3543.
Northwest Ohio Hearing Clinic offers patients hearings aids of the highest quality and newest technology. Our main purpose is not the business of selling hearing aids, however. We aim to provide diagnostic and comprehensive hearing health care. This includes audiological assessments, tinnitus treatments, and our specialty dizzy clinic. We also offer hearing protection to patients who are recreational hunters, musicians, and workers exposed to excessive ambient noise, along with protection for the sensitive middle ear, which requires different types of swim plugs. When a patient is diagnosed with a hearing loss, hearing aids may turn out to be the treatment of choice. Only then will we recommend a hearing aid that meets their exact needs and lifestyle. We use the educational and medical model, involving the patient and his or her family in the decision, when it is time to fit a hearing aid. We have access to a wide range of hearing aids and other products from a variety of manufacturers. We are not tied to any brand, and that gives our audiologists flexibility in choosing the perfect customized solution for each individual hearingimpaired patient.
The hearing aids promoted in local ads and big-box stores do not always have the updated technology. In fact, these hearing aids may be using technology from pre-digital and wireless days. The hearing aids are not digital, and the battery life is seriously lacking. They’re not effective in crowds and don’t work in environments with background noise. The hearing aids we provide are fully customized to each individual patient. We have a proven track record and have been trusted for over 30 years for our hearing aid services, including our hearing aid assessments and fittings. So, please be aware that if it sounds too good to be true, it usually is. Make sure you are seen by an audiologist who holds at least a master’s degree. Our practice is fortunate to have all Doctors of Audiology available to service patients and offer them information to make an educated decision for their hearing health care. ❦ 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 (419383-4012) and 1601 Brigham Dr., Suite 160 in Perrysburg (419-873-4327).
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10/22/13 3:46 PM
Mercy to open region’s first free-standing, full-service emergency and diagnostic center
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onvenient access to high-quality healthcare services and practitioners is never more critical than during a medical emergency—when timely, expert treatment is of the utmost importance. With Mercy opening the region’s first free-standing, full-service emergency and diagnostic center in Perrysburg, comprehensive, around-the-clock emergency medical services will soon be available in the midst of one of our area’s fastest-growing communities. Mercy Emergency Services—Perrysburg, part of the Mercy Medical Center—Perrysburg complex (located near the corner of Route 25 and Eckel Junction Road, close to Tom’s Tire), serves a wide range of patients, including those who require a higher level of care brought in by emergency medical services providers. The facility was designed by ER professionals to treat patients suffering from strokes, heart attacks, respiratory distress, head injuries, abdominal pain, and sports and orthopedic injuries. In addition to emergency services, Mercy Medical Center—Perrysburg
will also offer imaging and diagnostic services. Patients of all ages—from infant to elderly—will be treated at the Center. The 15,000-square-foot facility features 12 exam rooms, short-term observation beds, immediate access for ambulances, a helipad for Life Flight transport of patients to Mercy St. Vincent Medical Center, an outpatient laboratory, and the area’s only MRI Caring Suite and Mammography SensorySuite with special lighting, interior décor, scenery, and music—all designed to improve the patient’s experience. How does Mercy Emergency Services—Perrysburg differ from the ER at a hospital? According to Chris Goliver, MD, Medical Director of the new Mercy ER in Perrysburg, “This new, state-of-the-art facility will have the same board-certified physicians, staffing, and equipment as an emergency room attached to a hospital. The only difference between Mercy Emergency Services—Perrysburg and a traditional hospital emergency department is that it’s not connected
physically to a hospital. Patients who need to be hospitalized, for example heart-attack patients or those requiring surgery, will be treated, stabilized, and transferred to a hospital with an immediate opening that is best suited to their needs.” Dr. Goliver also emphasizes that Mercy Emergency Services—Perrysburg should not be confused with a traditional urgent-care facility. He explains that urgent-care clinics are more like doctors’ offices with extended hours and are typically staffed by nurse practitioners who are generally not trained in treating critical patients. In fact, patients who go to an urgent-care clinic with a life-threatening injury or illness must be redirected to an emergency department. “In contrast, Mercy Emergency Services—Perrysburg will be staffed with Emergency Medicine physicians, nurses, and technicians
who are trained to treat all forms of emergencies, from life-threatening to minor. Plus, our new facility will be open 24 hours a day, 365 days a year,” he adds. In addition to comprehensive, 24/7 emergency services delivered by board-certified and board-eligible physicians and a team of experienced emergency staff, Mercy Medical Center—Perrysburg will provide an expansive array of imaging services, including MRI scans, CT scans, 3D mammography, digital radiology, ultrasounds, and dexascans. As an added benefit, a radiologist will be on call at all times so images can be read and evaluated immediately and patients can receive their test results during the same visit rather than having to wait several days. One could justifiably say that Mercy Medical Center—Perrysburg is different by design. “The facility was
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designed by professionals working in emergency departments throughout Northwest Ohio to be a place they would want their family and friends to be treated in. Attention to detail, patient comfort, and time to treatment were all given the utmost consideration. Mercy Emergency Services—Perrysburg will strive to make the emergency experience as
comfortable and pleasant as possible,” says Dr. Goliver. ❦ On November 3, from 2:00 to 4:00 p.m., Mercy will be hosting a community open house to introduce Mercy Medical Center—Perrysburg to the public. For more information, please log onto mercyweb.org.
Water for Ishmael helps children of immigrants achieve success
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our-year-old Eduardo and his mother moved to the United States from Brazil last year. They spoke very little English, and they did not understand the American school system. Eduardo’s mother had many concerns about moving here, and education for Eduardo was high on her list. She quickly realized that Eduardo could not attend kindergarten because he missed the age cut-off. Not having Eduardo in school for months was an uncomfortable thought. She was worried about his future. Then she found Water for Ishmael’s (WFI) school. Soon, Eduardo was enrolled and on his way to a brighter future. Taught by educators with more than 100 years combined experience, WFI’s childcare specializes in children who are learning English as a second language (ESL). With a com-
behind and underachieving throughout their school years. On average, it takes a school-aged immigrant child five years to learn academic English. In addition, students who do not read proficiently by third grade are four times less likely to graduate from high school than proficient readers. If you put those statistics together, that puts immigrant children whose first language
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Health Care is complicated But that’s where you come in.
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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. You can supplement your undergraduate degree with training in this field through The University of Toledo’s Graduate Certificate in Patient Advocacy Program. This is a 100 percent online graduate certificate that can be completed in just two semesters. For more information call or e-mail Debra O’Connell – 419.530.5421 or Debra.Oconnell@utoledo.edu.
JHHS 32 0113
prehensive curriculum tailored just for kids like him, Eduardo learned English, how to interact with other children, and school expectations. This year, when Eduardo’s mother dropped him off for his first day at kindergarten, Eduardo confidently walked into his class amidst other crying children. With a wave and a smile, he said “See you later” to his mom. In that moment, his mother recognized something so important to her son’s future: Eduardo has the ability to beat the common trend of immigrant children starting school
is not English at extreme risk. The reality is, if Eduardo did not receive WFI’s specialized English instruction, there is a good possibility that he would have become another statistic of underachievement and missed out on the opportunity to have a better life here in the United States. Along with the children’s program, Water for Ishmael’s school has six levels of English instruction for international women. Alumni of the American School for Women and Children (ASFWC) have gone on to become university students, quality employees, and active community volunteers. The school offers scholarships on a sliding scale, based on the financial need of the family. This allows low-income students access to quality education. Water for Ishmael relies on generous individuals to fund scholarships for these women and children. They are especially grateful for The Toledo Community Foundation, BP, and oth-
27
ers that have financially supported the development of WFI’s programs. This fall, 50 women and 30 children are enrolled at their school. WFI believes that by helping internationals develop skills and sharing the love of God through their programs, their families will develop a true sense of belonging and purpose in America. Their work is widely appreciated by the parents of the students who attend our childcare. A Malaysian mother, speaking about
her daughter, said, “She was so confident on her first day of kindergarten. She learned a lot from wonderful teachers. I will always recommend this school to others.” ❦ To read more stories about lives changed through WFI, or to help a child like Eduardo by contributing to the WFI scholarship fund, visit www. waterforishmael.com or check out their school at facebook.com/ASFWC.
Alzheimer’s and other dementias on the rise as population ages
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ith the U.S. population aging and life expectancy increasing, the impact of Alzheimer’s disease is becoming tremendous in scope. In fact, according to statistics from the Alzheimer ’s Association, Alzheimer ’s is currently the sixth leading cause of death in our nation and one out of every three seniors dies with the disease or another form of dementia. What’s more, as the “Silver Tsunami” of baby boomers entering retirement age progresses, these challenges will only be compounded. Alzheimer ’s compares unfavorably to several other major illnesses with respect to mortality. While deaths from breast cancer, prostate cancer, heart disease, stroke, and HIV are all declining, there has been an enormous increase in the number of deaths associated with Alzheimer’s. To put that trend in perspective, breast cancer deaths have declined by 2% while Alzheimer’s-related deaths have increased by 68%. Alzheimer’s disease is a progressive, degenerative neurological disorder that affects memory, cognition, and the ability to function. Medications can slow the progression of the disease and help maintain the individual’s quality of life, but Alzheimer’s is incurable and ultimately fatal. According to Tara O’Rourke, LNHA, MA, CTRS, CDP, Administrator for the ProMedica Goerlich Center for Alzheimer’s and Dementia Care, the question of what causes Alzheimer’s has not yet been satisfactorily answered. “We know that
people with a certain genetic marker are predisposed to Alzheimer ’s,” she says, “but that doesn’t necessarily mean they’re going to get it. Plus, some people who develop Alzheimer ’s don’t have that genetic marker. It’s thought that an interplay between genetics and environment is at work.” She further explains that people who die of Alzheimer’s are found to have plaques and tangles in the brain that interfere with the transmission of messages between neurons. However, many people who are found to have those plaques and tangles after death never showed signs of dementia in life. Why some people
with these plaques and tangles develop Alzheimer’s while others do not is unknown. Alzheimer’s, while the most common form of dementia, is just one of hundreds of forms. The second most common is vascular dementia, which is caused by breaches of blood supply in the brain due to stroke, aneurism, or other vascular problems. Other examples include Lewy body dementia, Parkinson’s disease, and alcohol-related dementia. As Alzheimer ’s progresses
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Mom or Dad leaving for church, taking several wrong turns, and ending up in a completely different state are all too common—and sometimes the outcome is serious, if not dire. The good news is, ProMedica Flower Hospital currently offers driving assessments that can help families determine whether it’s still safe for their loved one to drive and guide them through that difficult decisionmaking process. While dementia is unquestionably devastating to the sufferer, it also places an absolutely exhausting 24-hour burden on caregivers, particularly if the patient experiences sundowning. When deprived of sleep, the stress of coping with a loved one’s confusion and agitation can be overwhelming for caregivers. “It takes a highly skilled person to manage this situation effectively, calm the person, and assuage those fears,” O’Rourke says. “Here at the Goerlich Center, we use validation therapy, which involves validating the patient’s feelings, gently redirecting their focus, and possibly moving them into reminiscing. For example, if a patient insists they need to leave and pick up their kids, we can reassure them that we’re going to help and possibly suggest that we can get someone else to pick them up. Then we might ask them to tell us about their kids to shift their focus and soothe their anxiety. We enter their reality to help resolve the situation.” To give caregivers a much-needed break so they can rest or attend to other needs, the Goerlich Center, located on the campus of ProMedica Flower Hospital, offers adult day care and night care services to individuals with dementia. This flexible program offers awake-based day, evening, nighttime, and weekend care at a reasonable hourly rate. Caregivers can be confident that their loved one is well cared for in a supportive environment while receiving good nutrition, medication administration, socialization, mental stimulation through recreational activities, and therapy services if needed. And that’s just scratching the surface of the programs, services, and amenities the Goerlich Center offers to dementia patients and their families. Other examples include short-term dementia-specific rehab, which incorporates cognitive test-
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through the various stages, the signs and symptoms change, as well. Having difficulty paying bills or balancing the checkbook independently and becoming forgetful about obligations and appointments are examples of early indicators. Not all forgetfulness indicates the onset of dementia, however. Common memory lapses, such as forgetting the name of someone we just met or where we put the car keys, are usually a result of simple inattention, and it’s normal for these lapses to become more common as we age or as our stressors increase. Another early sign is making poor decisions or exercising poor judgment, for example, being talked into spending thousands of dollars to put a new roof on the house when the old roof was in perfect shape. Oftentimes, early-stage dementia patients can live successfully at home if support is provided and safety measures are in place. “As the disease gets a little further along, you might start to see deficiencies in hygiene, such as a once very tidy and impeccably groomed loved one now having a dirty house, looking disheveled, and wearing dirty clothes. They may also begin to repeat themselves over and over again,” O’Rourke says. In the moderate stages, people with Alzheimer ’s are more prone to issues that can put their health and safety at risk, such as forgetting to take medications, eating expired foods, or wandering outside in the winter without a coat. Also in this stage, approximately 20% of Alzheimer’s patients become more restless, agitated, and confused at night—a condition known as “sundowning.” Later stages bring more and more physical deficits. The patient may need help with various activities of daily living, such as bathing, grooming, and using the toilet. Eventually, functions such as eating and walking are lost. An interesting interrelationship between dementia and depression has also been noted. According to O’Rourke, depression can exacerbate underlying dementia and depression left untreated can be a catalyst for dementia down the road. She also points out that family members of people with dementia often struggle with the question of when it’s appropriate to take away their loved one’s car keys. Stories of
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ing in addition to physical, occupational, and speech therapy; private rooms with special features designed for clients with dementia; secured households and beautiful enclosed outdoor courtyards that allow freedom to roam while assuring safety; dementia-appropriate recreational activities offered through the day and night; nurses and administrators who are trained Certified Dementia Practitioners; and the Namaste end-of-life dementia-care household focusing on therapeutic touch and sensory experiences. In commemoration of the Alzheimer’s Foundation of America’s National Memory Screening Day,
the ProMedica Goerlich Center and ProMedica Lake Park are offering free memory screenings on Tuesday, November 19, 2013 from 9:00 a.m. to 4:00 p.m. “The screenings consist of simple cognitive tests and a Q&A and take approximately 30 minutes. You’ll get the results then and there. The purpose of the screenings is not to diagnose memory loss, but to provide important information that you can share with your physician. To schedule your appointment, call 419-824-6448 and leave your time preference. Then we’ll call back to confirm a specific time and provide complete details,” O’Rourke says. ❦
GERD is nothing to lose sleep over!
“J
osh,” age 45, was just beginning to experience some of the aggravating physical complaints common to middle age. Having packed on more than a few extra pounds, his BMI of 29 placed him well within the ranks of the overweight and right on the cusp of obesity. Oncesimple activities like climbing the stairs left him out of breath, his knee joints ached, and lower-back pain frequently prevented him from getting restful sleep. Josh was also vexed by another problem: Severe heartburn was becoming an almost nightly ritual. Oftentimes, a nagging dry cough would accompany the burning sensation, and he would occasionally awake suddenly with a sour taste in his mouth after having regurgitated a small amount of stomach fluid. On some nights, propping his upper body with several pillows prevented these symptoms, and popping antacid tablets offered temporary relief, but the root problem persisted. A visit to his primary care physician revealed that Josh had gastroesophageal reflux disease, or GERD. GERD is a chronic digestive disor-
der that develops when stomach acid frequently refluxes—or backwashes—into the esophagus (the tube through which food passes to the stomach) and irritates and inflames the esophageal lining. This reflux occurs because the circular band of muscle located at the lower end of the esophagus—called the esophageal sphincter—functions abnormally. When it’s doing its job as it should, the esophageal sphincter remains closed until food or liquid flows down to the stomach. Then, it relaxes just long enough to allow the food or liquid to pass and then closes again. But if this band of muscle relaxes abnormally or becomes weakened, stomach acid, and possibly bile, can travel the wrong way 30 November 2013 / Healthy Living News
and back up into the esophagus, causing heartburn and other unpleasant symptoms. In addition to heartburn, these symptoms might include hoarseness or sore throat, a dry cough, difficulty swallowing or a sensation of swelling in the throat, regurgitation of food or stomach acid, and even chest pain. Over time, this constant acid reflux can also lead to the formation of scar tissue and consequent narrowing of the esophagus, ulceration and bleeding of the esophagus, precancerous changes to the esophageal lining, as well as other complications. Risk factors for GERD include, but aren’t limited to, obesity, asthma and other respiratory diseases, smoking, excessive alcohol consumption, diabetes, hiatal hernia, and pregnancy. As Josh’s doctor explained, his excess body weight was likely a major contributing factor to his problem. Essentially, his abdominal fat was applying pressure to the stomach and diaphragm, causing the lower esophageal sphincter to open when it shouldn’t. Some lifestyle changes were definitely in order for Josh. Under his doctor ’s supervision, he began a weight-loss program based on exercise and nutrition and gradually shed 20 pounds over the course of two and a half months. In the process, he also shed most of his symptoms and began to enjoy much more restful sleep. He still experiences occasional heartburn, but he can usually manage it with over-the-counter medications. As in Josh’s case, GERD can often be diagnosed through a simple history, but various tests are also available to assist in diagnosis when necessary, such as X-ray of the upper digestive system with a barium swallow, endoscopic examination of the esophagus, as well as tests that measure the movement of the esophagus or the acid level in the esophagus. In addition to encouraging Josh to shed excess pounds, his doctor also recommended the following lifestyle modifications to help reduce the frequency of his heartburn symptoms:
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• Eat smaller meals and avoid eating for at least three hours before going to bed. • Avoid foods or beverages that seem to trigger GERD symptoms. Examples of common dietary triggers include fried foods, fatty foods, garlic and onion, tomato sauce, alcohol, and caffeine. • Avoid wearing tight-fitting clothes. • Avoid smoking. • Elevate the head of the bed, either by placing a wedge (available at drug stores and medical supply stores) between the mattress and box springs or by placing wood or cement blocks under the feet of the bed. Certain over-the-counter medications can be helpful in managing heartburn symptoms, as well. In addition to antacids, these include various H-2-receptor blockers and proton pump inhibitors, which reduce or block acid production. Prescriptionstrength versions of these and other drug classes used to fight GERD are also available. But be sure to consult with your physician before taking any medication to ensure it will be both safe and effective for you and won’t have any harmful interactions
with other medications you may be taking. Like Josh, most GERD sufferers find symptom relief with over-thecounter or prescription-strength medications and lifestyle changes.
However, if this conservative approach is not effective, your doctor may recommend one of several different surgical procedures that can be performed to prevent stomach acid from flowing into the esophagus. ❦
How well do you know your medical team? by Stephanie Aldrich
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hen you think of receiving medical care, who do you think of? Doctors, nurses, and receptionists are the most common response, but do you know what each medical team member has to offer? We all know that when we are sick we can see our doctor for advice, medications, testing, and treatment. However, many times you need help from the rest of the team. Here is just some of what they do for you. Your nurses do a great deal for you too. They do much more than just
your initial assessment. The nurse also takes your history, or reason for your visit—so be sure to tell your nurse everything that you need addressed. As your nurse reviews your medications at each visit, make sure you have an accurate list with you each time. Nurses also assist the doctors by calling in your refills or electronically prescribing them. Many nurses triage phone calls for patients who cannot get an appointment for the same day. They can offer advice or take a message
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to give to the physician. Nurses also help with minor issues or anything else that you may need after seeking the advice of your physician. They administer many types of injections and vaccinations, such as the flu shot and allergy shots, as well as perform EKGs, blood pressure checks, ear irrigations, PT/INR for coumadin checks, wound care, and other inhouse services. On top of all of their clinical duties, nurses also fill out forms for prior authorizations, family medical leave, disability, and many other purposes. Your receptionists provide excellent care also. Chances are, nearly every time you have called your doctor’s office, you have talked to a receptionist. Did you know that your receptionist is the first line in your medical care? The role of a receptionist has come a long way over the years. Today’s receptionists are very knowledgeable and can answer many of your questions. At the Oregon Clinic, the front office staff is under the direct supervision of the physicians and has been granted authority to answer many questions. Receptionists do more than just schedule checkups and sick appointments. They are responsible for co-
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ordinating care for different reasons. When patients are discharged from a nursing home or hospital, the receptionists schedule an appointment within seven to 14 days with their doctor. This helps to keep the patient from returning to the inpatient setting. They also coordinate care with other physicians by sending referrals and pertinent information. The front office is the main hub of many offices, and a great deal of information goes in and out of this area. Receptionists field all the calls that come into the office, and then they are handled quickly and efficiently. Your medical team works together seamlessly to ensure the best quality medical care possible. Each team member brings a different level of care to make sure that nothing gets left out. If you haven’t already, get to know the members of your care team! ❦
LeMoyne Mercer
A Walk in the Park
Maybe we shouldn’t complain about gravel roads
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ast month, I told you that Shirley and I enjoy camping in the national forests. The advantages of boondocking include solitude, beautiful scenery, and opportunities to view wildlife. The downside is that unpaved forest roads can be worse than Toledo streets following a hard winter. To be fair, though, washboard mountain roads in Wyoming are not quite as bad. But what constitutes a bad road is a matter of perspective. On our way home from Wyoming in September, we made several stops along the 2,000-mile route the pioneers called the Oregon Trail. Long before European settlers arrived in North America, there was a network of animal migratory routes and In-
32 November 2013 / Healthy Living News
Scotts Bluff was a major landmark that could be seen by travelers for days before they reached it.
dian footpaths in the West. By the early 1800s, the demand for beaver pelts had attracted British, French, and American fur trappers to the Rocky Mountains. After President Jefferson struck a deal with Napoleon for the Louisiana Purchase in 1803, he sent Lewis and Clark with the Corps of Discovery to follow the Missouri River to its headwaters. From there, they made their way down the Columbia River to the Oregon coast. That little trip turned out to be much more arduous than expected. In 1812, though, fur trader Robert Stuart followed an old Indian route across the Continental Divide at a place that is so wide it does not even look like a pass. In addition, it has a long, relatively easy grade. Relatively. This South Pass route became the gateway to the West because it was possible for ox-drawn wagons to reach the Oregon Territory and California. In the 1820s and ’30s, freight wagons carrying supplies to fur trappers followed the Platte River to Wyoming. By 1840, the days of the Mountain Men were over but the tracks of their supply wagons established the main route followed by pioneers. The first emigrant wagon trail left Independence, MO in early 1841. In 1850, the Donation Land Act offered settlers 160 acres of free land in Oregon—and another 160 acres to their wives. There was a land rush—and a wedding rush—to beat the 1854 deadline. In 1869, the Union Pacific and Central Pacific railroads met at Promontory Point, UT and the long, arduous wagon train trek to the West pretty much ended. Sections of the old Oregon Trail survived as local routes. Other parts were eventually paved and became part of our highway system. A century and a half after wagons created the route, you might expect that the effects of time and weather would have erased all indications that 350,000 settlers had passed that way.
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But you would be wrong. Wyoming Rt. 28 crosses the Continental Divide at South Pass. You can stand at the pass and look across miles of open prairie and marvel at what the pioneers did and endured. In Southwestern Wyoming, the land is broken up by deep gullies and arroyos. It is hard to believe that an ox-drawn wagon could get across that kind of country. Actually, a lot of early travelers reached the same conclusion and just turned around because going on seemed like pure insanity. Still, many persevered even if, when they made camp after a long day, they were still within sight of where they left that morning. Typically they hauled about a ton and a half of provisions and household goods in a 10-by-4-foot, canvastopped wagon pulled by oxen. And they walked alongside to lighten the
Displayed before the enlisted men's barracks at Fort Laramie are examples of a covered wagon with ox yoke and a Mormon hand cart.
Most of the emigrants who passed Register Cliff came between 1841 and 1869. The earliest authenticated white visitor left his mark in 1797.
load for the animals. No galloping horses driven by mama while papa fired his repeating rifle at attacking savages and wide-eyed children huddled in the otherwise empty bed of the wagon. It was far worse than that. They endured the extremes of drought and floods that made river crossings deadly. Diseases killed many who could rely only on “allnatural“ pharmaceuticals. Bison stampedes. Rattlesnakes. Mosquitoes “so thick it was hard to tell if a man was white or black.“ Winds so fierce they knew they weren’t in Kansas anymore. The necessity to keep going lest winter trap them in the mountains a la the infamous Donner Party. Only on very rare occasions were there encounters with hostile Indians. At Register Cliff, early emigrants,
Tennis, the “lifetime sport” by Mark S. Faber, USPTA P-1
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ast month, I shared the benefits that tennis provides the youth of today. This month, I would like to share with you how tennis can be enjoyed as a lifetime sport. With the fall season upon us, many of you will be watching the MLB playoffs, the start of the NFL season, and/or the start of the NHL season. Although each of these sports appeals to a different population, they all have one thing in common: Involvement in them tends to be short and limited. Now, tennis is a sport that can be enjoyed from age three to 93 and beyond! There are so many great opportunities out there for people to get involved in tennis, and I would love for Healthy Living News readers to give it a shot. Not only is tennis a lifetime sport, but it’s also a sport for the whole family that can give mom, dad, son, daughter, grandma, and grandpa all an opportunity to play
together. I have personally seen this while traveling throughout the country as well as right here in Toledo. Heck, if you want a great local example of how a family can enjoy tennis together, look no further than the family of Healthy Living News publisher Kevin O’Connell. To find various programs offered for all levels, check the local listings of your area tennis clubs (Laurel Hill Swim and Tennis Club, Shadow Valley Tennis Club, Perrysburg Tennis Center, and Belmont Country Club all have indoor programs) or contact your local USTA office.
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evidently proud of having made it that far, carved their names and dates on the rock. Indians also had left their signs there for hundreds of years, but their pictographs and petroglyphs have been obliterated by a flood of white names. Which is a pretty good metaphor for what happened to the Indians themselves. More recent visitors have, in turn, continued to deface the historic site, wiping out the names of some of the real pioneers. Graffiti represents a universal human urge to leave one’s mark on the world.
Speaking of leaving a mark, Shirley and I stopped at Oregon Trail Ruts near the small town of Guernsey, WY. We found it much more fascinating than it sounds. Thousands of wagon wheels cut deep channels in exposed rock. You would swear that it was nearly impossible to drag a loaded wagon up the steep grade and through the yawning holes that passed for a “road.” When you consider that many of the wheels were on hand carts pulled or pushed by Mormons on their way to Salt Lake, it seems even more implausible. Shirley
Area Office on Aging brochure rated best in nation
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he Area Office on Aging (AOoA) brochure can be viewed at www. was chosen as havareaofficeonaging.com/ ing the best brochure for brochure.pdf. older adults in the nation AOoA President/ with its selection as the CEO Mrs. Billie JohnGold National Mature son said, “Sometimes Media Award winner in the smallest things we the brochure category. The do at the Area Office National Mature Media on Aging end up havAwards is the nation’s ing the biggest impact. largest awards program In developing our brothat annually recognizes chure, we just wanted the best marketing, comit to effectively communications, educational municate our story to materials, and programs local older adults and for adults age 50 and older. caregivers. We are About 1,000 entries were pleasantly surprised judged by a panel of to see it have a much mature market experts bigger impact by being from across the country recognized as the best for overall excellence of design, brochure in the nation for older content, creativity, and relevance adults.” to the senior market. The Mature Media Award reThe development of the bro- cipients are found at http://www. chure was a joint effort between s e n i o r a w a r d s . c o m / 2 0 1 3 m m a the AOoA and T. Parker & Co. The 10.25x4_ES_USNewsAd_HL_513.pdf 5/30/13 winners.pdf. 12:28:45 PM
Thousands of wagon wheels cut grooves in solid rock climbing this hill near Guernsey, WY.
said, “I suppose we shouldn’t complain about gravel roads.” Indeed, we should not. Just a few minutes later, traveling in comfort at 60 mph on Rt. 26, we came to Fort Laramie. The fort evolved from an Indian trading post in the 1830s to an army outpost dedicated to the protection of settlers from the Indians. While we were there, a busload of German tourists arrived. One of the German ladies questioned the staff at the Visitor Center about the distinction between “Indians” and “Native Americans.” She felt she understood who the “Indians” were but was having trouble with the concept of “Native American.” She said she was a native German and had met many people she perceived to be “native Americans.” But the native Americans she knew were white whereas the “Indians” were red. It was a puzzlement. The distinction seems to be that if your ancestors ar-
rived in pursuit of mastodons 12,000 years ago, you get to capitalize the “N.” If you were born here within the last 400 years, you qualify for a lower case “n.” Use of the word “Indian” just shows that you are racially insensitive. We always learn something when we travel. What we learned at Fort Laramie is that it doesn’t look at all like the forts you see in Western movies. In 1834, the original Fort William (after mountain man William Sublette) was only 80 by 100 feet with a 15-foot cottonwood palisade. In 1841, the year emigrant trains began arriving, it was replaced by the larger adobewalled Fort John. Then, to protect the emigrants, the army bought it and greatly expanded it as Fort Laramie. Eleven structures have been restored and provided with authentic furnishings. The original wooden structures are long gone, but the walls of some of the original adobe buildings survive. Later buildings from the army era have a decidedly Victorian look. Apparently there were even white picket fences around a number of the buildings but no palisades to fit the stereotype. The post commander’s two-story house, the oldest surviving structure in Wyo-
Officers' quarters at Fort Laramie resembled any middle-class home in the Victorian era.
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Original buildings at Fort Laramie were made of adobe bricks covered with plaster. Lumber didn't grow on trees way out on the prairie, but there was always plenty of dirt.
ming, was furnished like any middleclass residence of the era. It is probably not widely known that most soldiers at Fort Laramie served in the 7th US Infantry, not the much more famous 7th Cavalry led by Custer. But the results were similar in both cases. In 1854, Lt. John Grattan led 29 soldiers to a Lakota Sioux village to arrest an Indian accused of killing and eating an emigrant’s cow. Grattan forced the issue and got himself and all his men killed. The tribes had generally gotten along well with the mountain men and early emigrants. As a rapidly growing number of settlers and gold
seekers invaded their lands, the Indians were pushed onto reservations. Many did not go willingly and resisted strenuously. Fortunately, all the scalping done today is at the casinos owned by their descendants. Continuing along the Platte River (“Too thick to drink, too thin to plow“), we arrived at Scotts Bluff, a major milepost on the Oregon Trail. Settlers could see the 800-foot bluff rising on the prairie horizon for days before they arrived. Today, it just seems to take days to get there with the kids in the back seat asking 87 times an hour, “Are we there yet?” Kids must have been more patient in the 1850s because Scotts Bluff is only
a third of the way to their destination. The only people who could really hurry back then were the Pony Express riders who passed by Scotts Bluff on their way from St. Joseph, MO to Sacramento, CA. Actually, the mail traveled 1,996 miles but the wiry young riders (weight limit 120 lbs) rode relay stretches, changing mounts every 10 to 15 miles. They spent nights in home stations spaced every 75 to 100 miles. There were 80 riders on the trail at any one time—40 headed west and 40 east. The first delivery arrived in only nine days and 23 hours. The record run was
made in seven days and 17 hours, carrying President Lincoln’s inaugural address. The Pony Express is part of the legend of the West, but the service only lasted from April 1860 until November 1861. There were 308 runs in each direction, and the mail failed to get through only once when the rider was killed in a Paiute uprising in Nevada. Winter weather was a much greater hazard than hostile Indians. As we travel, Shirley and I are reminded to keep things in perspective. Does it seem to take forever to get across Nebraska? (A whole
The Physicians of CC4PM are pleased to announce the addition to our newest Pain Medicine Specialist to our staff
Bryant Ittiara, D.O. Off-duty members of the US 7th Infantry were welcomed by the bartender at the post saloon.
Doctor of Osteopathic Medicine; Pain Medicine Fellowship; Member: American Society of Anesthesiology, American Osteopathic Association, and American Medical Association Now accepting new patients in Oregon and Lambertville! CC4PM main phone: 419-843-1370
Dr. Bryant Ittiara joins CC4PM
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omprehensive Centers for Pain Management (CC4PM) is pleased to announce the addition of Bryant Ittiara, DO, to the practice. Dr. Ittiara will devote most of his practice time at CC4PM-Bayside (Oregon, OH) and CC4PM-Aspen Grove (Lambertville, MI). He is accepting new patients and physician referrals. Dr. Ittiara received his BSE in Mechanical Engineering and MSE in Biomedical Engineering at the University of Michigan. He then went on to complete his medical training at the Lake Erie College of Osteopathic Medicine (FL) and the Anesthesiology program and Pain Fellowship program at Detroit Medical Center/ Wayne State University. He also completed Fellowship Courses in Spinal Cord Stimulation and Intrathecal Pain Therapy with Boston Scientific and Medtronic. Dr. Ittiara is a member of the International Association for the Study of Pain, American Society of Anesthesiologists, American Osteopathic Association, and American Medical Association.
“We are very pleased to have Dr. Ittiara joining us, adding new dimensions to our pain medicine practices’ capabilities,” stated CC4PM’s founder and Medical Director, William G. James, Jr., MD. Dr. Ittiara’s focus will be in treating patients suffering from acute and chronic pain symptoms. CC4PM, which opened in Toledo in 2003, offers a novel approach to treating and managing numerous chronic pain conditions and employs a multidisciplinary model that is unique in our region. All of its physicians are accepting new patients. Referrals are normally made by patients’ primary care or specialty physicians, but patient inquiries directly to CC4PM are welcome. Virtually all Ohio insurance coverage is accepted, as well as many Michigan plans. To schedule a consultation, patients and/or their physicians may reach CC4PM at their main number, 419-843-1370, or call toll-free 1-877-44-NO-PAI(N). Also, you may wish to visit their website at www. CC4PM.com. ❦
Toll-free 1-877-446-6724
www.CC4PM.com
MOKE THE TURKEY RICK GOMEZ MEMORIAL 5K Thanksgiving Day—November 28, 2013 All Proceeds Benefit:
Location: St. James Club, 7337 W. Bancroft St. Toledo, Ohio 43615 Time: 8:30 am Kids Fun Run 9:00 am 5k Run / Walk Course: Start and Finish at St. James Club. Course winds through St James Woods Entry Fee: 5k Run/Walk $25 (includes LONG Sleeved Race shirt to first 1500 5k registrants) $30 on race day (Race shirt not guaranteed) Kids Fun Run (6 and under) FREE (must have a signed registration form) FREE FUN CHICKEN CHUCKING CONTEST FOR KIDS AND BIG KIDS TOO!! Register: In person at the St. James Club or online at: www.eliteendeavors.com Printable applications at www.stjamesclub.net, www.davesrunning.com Mail printable applications to: St. James Club 7337 W. Bancroft, Toledo, OH 43615 Checks payable to: “Rick Gomez Memorial 5k” Divisions: Male/Female Overall; Male & Female: 10 & under, 11-14, 15-19, 20-24, 25-29, 30-34, 35-39, 40-44,45-49, 50-54, 55-59, 60-64, 65-69, 70-74, 75 and over. Awards for top 3 in each age category. SCHMUCKERS FAMOUS PIE FOR ALL AGE-GROUP WINNERS!!! BUCKEYE • WOLVERINE DIVISION GREAT PRIZES FOR BEST-DRESSED FANS 2013!!! BEST DRESSED TURKEY OUTFIT SPECIAL PRIZE! Packets: Early packet pick up: Wednesday November 27: 1 pm to 7:30 pm at the St. James Club Race day SIGN UP and Packet pick up: 7:30 am to 8:45am, November 28, 2013 Parking: Westside Montessori School (just east of the St. James Club) and at the St. James Club Certified 5k course by USA Track and Field
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Chip/Bib timing by Gault Race Management
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day compared to a whole month.) Are there too many delays for road repairs? (The road was once literally just wagon ruts.) Feeling scalped by the price of gasoline? (Well, we won’t even go there.) Compared to the challenges once presented by
prairies, mountains, and deserts, cruising along in our RV is just 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.
Hearing loss linked to dementia by Dianna Randolph, AuD, CCC-A
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ot too long ago, I had a gentleman come in to our office with his mother. After testing his mother’s hearing and recommendations, he stated, “My mother’s doctor wants her to get hearing aids because we can’t figure out if the problem she is having with her memory is due to dementia or due to the fact that she doesn’t hear well.” This statement surprised me because I never thought the two were related to each other. But when I thought about it, I realized that there is a relationship between them. We see many patients in our office with some sort of cognitive disability. If these patients would have worn hearing aids sooner, would it have slowed their cognitive decline? This encouraged me do some research,
and I’d like to share with you what I found. In a 2011 study from John Hopkins University, Frank Lin, MD, PhD, looked at ways hearing loss affected cognitive brain function. He, along with his colleagues, used data from the Baltimore Longitudinal Study on Aging. The study focused on 639 people whose hearing and cognitive ability was tested over a 12- to 18-year period. About a quarter of those people had hearing loss, but none of them had dementia. After years of monitoring the patients, 58 of them developed dementia. The study showed that those with mild, moderate, or severe hearing loss were more likely to develop dementia. The risk increased in conjunction with the severity of the hearing loss; the
greater the loss, the higher the likelihood of developing dementia. The next question was, how does hearing loss lead to dementia. Lin suggests four theories. One suggested that hearing loss and cognitive decline have common physiological pathways in the brain, but due to the way the study was done, Lin does not consider this theory very credible. Another theory is that hearing loss and straining to hear stress the brain. According to Arthur Wingfield, who heads the neuroscience program at Brandeis University, “If you put in a lot of effort just to comprehend what you’re hearing, it takes resources that would otherwise be available for encoding [what you hear] in memory.” Wingfield’s lab has documented this effect on a shortterm basis. The big question, he says, is whether years of drawing resources away from brain functions like working memory eventually reduces the brain’s resilience.
A third theory, suggested by Wingfield and Linn, is that hearing loss may affect the brain structure. Looking at images of the brain, it was shown that older adults with hearing loss have less gray matter in the part of the brain that processes speech. Wingfield stated that certain parts of the brain shrink when they don’t get enough stimulation. Getting a clear signal to the brain may allow the brain structures to grow back to their previous size and function. The last theory of how hearing loss could lead to dementia is related to the social isolation that is common in people with hearing loss. When hearing is difficult, people are less likely to socialize. Social isolation is known to be risk factor in dementia development. (AARP, August 8, 2013.) So, knowing all this information, does wearing hearing aids reduce the risk of dementia? Well, the answer is yes and no. Studies did not show a direct benefit of hearing aid use and
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36 November 2013 / Healthy Living News
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decreased dementia risk, but wearing hearing aids can decrease other factors that indirectly increase the risk of dementia. According to a study by the National Council on Aging, hearing impaired adults over the age of 50 who were not wearing amplification were more likely to develop depression, anxiety, and paranoia and were less likely to participate in organized social activities when compared to the same population of people with hearing aids. As mentioned above, this social isolation is known to be a risk factor for the development of dementia. So, with the use of hearing aids, this risk factor is greatly reduced. Unfortunately, only about 15% of people who could benefit from hearing aids are actually using them. We have seen amplification improve our patients’ quality of life. Our patients report being able to participate in activities that were once deemed too
difficult because of their inability to hear and understand speech. Their family members have also reported noticing an increase in confidence and self esteem in their loved one after they received their hearing aids. Having a family member or a loved one with dementia is hard enough, but adding hearing loss on top of it can make communicating with them even more difficult. Taking hearing loss out of the equation by using amplification could make living with dementia a little easier. At Northwest Ohio Hearing Clinic, we will discuss your needs with you and determine the right type of amplification for you or your loved one with dementia. ❦ Dianna Randolph, AuD, CCC-A, is a Doctor of Audiology with Northwest Ohio Hearing Clinic, located at 1125 Hospital Dr., Suite 50 in Toledo (419383-4012) and 1601 Brigham Dr., Suite 160 in Perrysburg (419-873-4327).
The low-down on lumbar spinal stenosis
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ow back pain is among the most common reasons people seek medical attention and a major cause of lost productivity. In fact, a significant majority of the population can expect to experience at least one bout of it in their lifetime. Most episodes of low back pain stem from simple muscle strain and resolve within a relatively short period of time. However, another very common cause of back pain and leg pain is a condition called lumbar spinal stenosis. According to Toledo Clinic orthopedic surgeon Kraig Kristof, MD, lumbar stenosis is typically a degenerative process related to arthritis and degenerative disc disease. Over time, the overgrowth of soft tissue and bone in the lumbar spine—the five vertebrae located between the rib cage and the pelvis—causes narrowing of the spinal canal and the openings through which nerve roots branch out from the spinal cord. As these passageways narrow, the nerve roots can become pinched. Also, degeneration of the vertebral discs can cause them to bulge at the back, causing narrowing of the spinal canal and compression of the nerves. “This pressure on the nerve roots,
called neurogenic claudication, can cause numbness and tingling in the lower extremities and a tight, cramping pain that extends from the low back, through the buttocks, and down the back of the legs,” explains Dr. Kristof. “But the classic symptom of lumbar stenosis is the ‘shopping cart sign.’ When the person goes to the grocery store, the first thing he or she does is grab a cart and lean on it. This posture opens up the spinal canal slightly and improves symptoms. On the other hand, standing up straight and hyperextending worsens the symptoms.” Treatment of lumbar stenosis typically begins with conservative measures to manage symptoms, such as activity modification, physical therapy, medications, and various muscle stimulation techniques (e.g., transcutaneous electrical nerve stimulation, or TENS). If those methods don’t work, the doctor may progress to lumbar epidural steroid injections or possibly facet injections (corticosteroid injections into the facet joints) to reduce inflammation related to the underlying arthritic problem. If conservative management doesn’t
Kraig A. Kristof, M.D. in the specialty of Orthopaedic-Spine
4235 Secor Road, Building 1, Upper Level Toledo, Ohio 43623
419-479-5424
www.toledoclinic.com
About Dr. Kristof The Toledo Clinic is pleased to announce the addition of Dr. Kraig Kristof, establishing a new Orthopaedic-Spine Department, effective August 15, 2013. Dr. Kristof graduated from University of Toledo Medical School. He completed his Residency in Orthopaedic Surgery at The University of Toledo Medical Center and a Fellowship in Spine Surgery at William Beaumont Hospital in Royal Oak, MI. Dr. Kristof is Board Certified in Orthopaedic Surgery and is a member of the American Association of Orthopaedic Surgeons, The Academy of Medicine of Toledo and Lucas County & NASS (North American Spine Society). Dr. Kristof is accepting new patients and referrals.
Comprehensive Spine Specialist from Cervical to Lumbar Spine Utilizing Minimally Invasive and Open Techniques for all Spine Pathology Cervical: Herniated Discs, Radiculopathy, Myelopathy Thoracic and Lumbar: all Degenerative and Deformity cases including Scoliosis, Stenosis, Spondylolisthesis, Herniated Discs, Tumor, Trauma, Infection and Pediatric Scoliosis.
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37
achieve the desired results after apspace to decompress the stenosis, proximately six to 12 weeks, surgical restore disc height, and open up the treatment is the next option. canal. Fusion is also performed along “Surgery can take a variety of the back of the treated vertebrae to forms, depending on the stabilize them. cause,” states Dr. Kristof. Surgery is very safe and “One option is decomeffective. Over 90% of surpressive laminectomy, gery patients report relief which is essentially reof leg symptoms, and fumoving the roof of the sion can be very effective for bone to allow more room improving symptoms of mefor the nerve roots and chanical instability. Potential soft tissue to expand. If risks of these procedures are, scoliosis or mechanical in large part, the same as slippage is involved, futhose associated with any sion can be done in addiother surgical procedure, tion to decompression to such as bleeding, infection, Dr. Kraig Kristof stabilize the spine. There blood clots, and anesthesiaare also both open and minimally related risks. In rare instances, there invasive approaches that can be used, is injury to the nerve, resulting in though not all patients are candidates post-surgical numbness, tingling, and for minimally invasive surgery.” possible weakness. However, there Examples of recent advances in is no risk of complete paralysis folminimally invasive techniques inlowing surgery on the lumbar spine clude using a tubular retractor, which because the spinal cord ends at apinvolves performing decompression proximately the first lumbar vertebra. through a small tube and is typiDr. Kristof emphasizes that the cally used for relatively mild cases. development of bowel or bladder A TLIF, which stands for transfoproblems, such as incontinence, in raminal lumbar interbody fusion, patients with lumbar spine stenosis can be performed open or through a is an absolute indicator of the need small incision and involves removing for surgery. This symptom should be damaged disc material and placing a considered an emergency and must bone graft with a cage into the disc be addressed right away.
“Post-operative recovery typically includes a three-day stay in the hospital and getting the patient walking right away—either that same evening or the following morning. Physical therapy for the next six weeks usually involves just getting up and walking. By six weeks, most patients are feeling pretty well, and they can add therapy later on to build their strength back up,” notes Dr. Kristof. Unfortunately, not much can be done to prevent lumbar spinal stenosis. It’s a degenerative process that stems from both genetics and wear and tear. Plus, as we age, the water content in the discs of the spine naturally diminishes, so the discs no longer provide the same degree of
cushioning and begin to collapse. Weight loss can help improve symptoms, but there’s often a “catch 22” to that approach: Patients need to exercise in order to shed excess pounds, but their back pain makes it very difficult to exercise. The good news is, doctors have a wide range of treatment options available to them to help bring relief to patients with lumbar stenosis, ranging from conservative therapies to open and minimally invasive surgeries. “A lot of patients are fearful about spine surgery, but overall, it’s exceedingly safe. It’s what we’re trained for, we do it on a daily basis, and it usually gets very good results,” Dr. Kristof says. ❦
Seven suggestions for safe raking
T
hough early autumn was warm and mild, cooler days have finally arrived, and our local deciduous trees have begun shedding their leaves. That means it's time for area homeowners to dust off their rakes and get to work. Though raking isn’t as arduous as snow shoveling and doesn’t involve the use of equipment with razor sharp edges or whirling blades, it’s a chore that requires a lot of bending, lifting, and reaching. Thus, it can still lead to injury if it’s done incorrectly. So, before you take rake in hand this fall, consider the following saferaking suggestions:
1 Choose the right tool for the job
#
It may seem insignificant, but using a rake that is inappropriately sized or has missing, loose, or rusty parts can significantly increase your risk of muscle strain or injury because it
will cause you to double your effort. Start out right by making sure your rake is the correct size for your height and strength and is completely intact and functional. Using a model with a padded handle will result in fewer blisters, as well.
2 Use proper body mechanics
#
While raking, maintain proper posture. Position your feet so they form a wide base, and place one hand near the end of the rake handle and the other approximately three-quarters of the way down the handle. Maintain an upright position, and try to keep your back naturally aligned, taking care not to twist your spine. Instead of remaining planted in one position and extending your rake in all directions to reach the leaves, change your position frequently and try to avoid overreaching. Also, avoid overloading your leaf bags or tarp,
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and when picking up leaves, bend at your knees and lift with your leg muscles. To distribute the strain on your muscles evenly and to prevent overuse of the muscles on one side of your body, it’s important to switch sides frequently—raking right-handed for ten minutes and then lefthanded for ten minutes.
3 Rake when leaves are dry
#
Mother Nature—or your city’s leafcollection schedule—may not cooperate in this regard, but try to choose a dry day to rake your leaves. Wet leaves are significantly heavier than
dry leaves and also pose a greater slipping hazard.
4 Dress for leaf-raking success v#
You may feel cool when you start raking, but all that exertion will have you perspiring in no time. Dress in several thin layers so you can shed layers if you start to overheat and add them again if you start to chill. Wear work gloves to protect your hands from blisters and splinters, and make sure your footwear has a good slip-resistant tread so you don’t lose your footing on damp
leaves. Fallen leaves can quickly turn moldy, making life miserable for allergy sufferers.
5 Special considerations for leaf blowers
#
If you use a powered leaf blower instead of a rake, you’ll need to consider several additional safety issues. These devices can produce powerful air currents and move debris at considerable velocity. They also generate a great deal of noise. So, when using a leaf blower, make sure children and pets are removed from the area and that
you protect yourself with goggles, hearing protection, long pants, and a long-sleeved shirt. When using a plug-in electric blower, keep in mind that electricity and water are a dangerous combination. Never operate a plug-in blower when it’s raining or when the ground is wet from rain or dew. Of course, as with raking, proper body mechanics should be employed when using a leaf blower.
6 Break it up
#
Every athlete knows that it’s important to get back in the game slowly after a
ProteCt YoUr CHILD’S SLeeP JUSt AS YoU Do tHeIr SAFetY Sleep problems don’t just effect a child’s nights, they disrupt their days too. Lack of sleep can cause your child to have learning delays and be: • hyperactive • less alert • easily distracted • physically impulsive • injured from increased falls • overweight
How much sleep time do they need?
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.
Infants
14-15 hours
Toddlers
12-14 hours
Preschoolers
11-13 hours
School-age
10-11 hours
Teenagers
9-10 hours
establish a bedtime routine • Turn the TV, cell phone and computer off an hour before bedtime, allowing for quiet play • A warm bath and comfy pajamas will help your child ease into sleep • Take care of all of the “have-to’s” like brushing teeth and going to the bathroom so your child won’t ask after they’re in bed • Read to your child or let them read to you for 10-15 minutes • Give your child a big hug, tell them that you love them, turn off the light, leaving just a night light on, say “goodnight” and leave the room • Children thrive on routine so be consistent even on the weekends
Kohl’s Kids in Action offers free obesity prevention programs to your elementary school or at health fairs. For more information, call Kohl’s Kids in Action at 419-251-1246 or visit us online at kohlskidsinaction.org.
DRINK WATER, EAT hEAlThy, slEEp moRE AND gET movINg! Have questions about an advertiser? Click their email or web address in our online issue at www.hlntoledo.com.
39
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long hiatus. You should take the same approach to raking leaves. After all, it’s likely been a year since you did it last, so your body is unaccustomed to the exertion. Taking frequent rest breaks in between short work sessions will give your muscles a chance to relax and help prevent an overuse injury. Also, don’t be afraid to ask for help. If you have to carry a heavy load of leaves, don’t approach it like a “weekend warrior.” Get someone
to assist you with the burden.
7 Rake for exercise
#
When done right—i.e., using proper body mechanics and not pushing yourself too hard—raking can be good exercise that strengthens your upper body and core. It can also burn up to 240 calories an hour. By heeding these safe-raking tips, you can make the most out of this annual activity, and your body will thank you for it.❦
Expanded Franciscan Care Center broadens options and services for area seniors
BOLD! ✶ BRILLIANT! ✶ BEAUTIFUL! ✶ BLESSED!
Notre Dame Academy & Junior Academy
Grades 7-12 ✶ All Girls ✶ 419-475-9359 ✶ www.nda.org Sponsored by the Sisters of Notre Dame
Playing on a team offers something for everyone regardless of age, gender, cultural background, and physical ability or skill level. Do you want to have fun, enjoy camaraderie and participate in friendly competition? It is as easy as 1-2-3!
1
Call your local USTA League Tennis Coordinator.
2
Register via usta.com and select TennisLink option.
3
Play Tennis and have fun!
ATTENTION USTA League Tennis Players: We would like to thank and congratulate all of our players who participated in the 18 & over, 40 & over and 55 & over leagues this year. A special congratulations to the 3.0 Men’s 18 & over team captained by Chris Cunningham that will be advancing to the National Championships - Good luck!
Congratulations to all of our District Champions! 40 November 2013 / Healthy Living News
NWO USTA League Tennis Coordinator
Amy Beaverson 419-472-1095 nwotaleagues@att.net
W
ork was recently completed on the $6.5 million expansion of Franciscan Care Center. The 25,000-square-foot addition increases the total number of beds from 99 to 109, with 25 private suites reserved exclusively for short-term rehabilitation residents. Sponsored by the Sisters of St. Francis of Sylvania, Ohio, Franciscan Care Center provides services to individuals age 55 and older who need rehabilitation following surgical procedures or hospital stays, as well as those who are in need of long-term nursing care. One of the most distinctive features of the expansion project is the beautifully designed chapel. Centrally located, this lovely sanctuary is constructed of natural materials and was modeled after the Portiuncula in Assisi, Italy, which was rebuilt and restored by St. Francis in 1209. This church subsequently became the center of Francis’ movement. The Portiuncula conjures up sentiments and thoughts linked with having a center, a heart, symbolic of Francis’
heart. “In the design of our chapel, you actually will experience the peace,” says Sylvania Franciscan Sister Jordan Schaffer, Director of Mission Integration and Spiritual Care for the Franciscan Care Center. “No one has walked into the chapel that has not experienced kind of a home and spirited peace and joy and contentment.” The expansive new wing is also home to a new reception and waiting area, offices and conference room, a private dining area for skilled residents, and a state-of-the-art therapy facility with the very latest in rehab equipment. In addition, 15 semiprivate rooms in the current facility are in the process of being transformed into private rooms, bringing the total number of private rooms available to 49. “The expansion has allowed us to offer more options and enhanced services to more seniors,” said Administrator Jill Schlievert. “The addition is the fruition of a long-term plan developed by the Sisters of St. Francis to align the facility for the marketplace,” she reports. “Franciscan Care Center is a stepping stone between the hospital and home for many patients and our goal is to re-
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habilitate people so they can return home. However, we also offer longterm care for those people who are unable to return home and live on their own,” she explains. Residents can receive speech, occupational, and physical therapies either as an in- or out-patient. “We also offer many other services for our short- and long-term patients,” says Laurie Stewart, Director of Admissions/Marketing. Those services include 24-hour nursing care and supervision; restorative nursing program; prescription drug services monitored by a licensed pharmacist; physician, dental, ophthalmology, and podiatry services; laundry; lifeenrichment programs; social-work services; respite care; pastoral care; and a registered dietician who assesses the need for specialized diets. With input from the residents, activities are planned by the Center’s activities department. These include baking, gardening, exercise classes, arts and crafts, discussion groups, coffee hour, bingo, luncheons, and field trips. Residents are also encouraged to participate in the practice of their faith while at Franciscan Care Center. Franciscan Care Center is located at 4111 N. Holland-Sylvania Ave-
nue in Toledo. For more information about the beautiful expansion or any services provided at the campus, please call 419-882-6582. ❦ Franciscan Care Center is a member of Franciscan Living Communities (FLC). FLC is a division of Sylvania Franciscan Health, sponsored by the
Sisters of St. Francis of Sylvania, Ohio. FLC is a mission-driven, industryleading provider of senior-living services throughout Ohio and Kentucky. The organization offers continuum-ofcare options, including independent living, assisted living, skilled nursing, rehabilitation, memory care, senior housing, and home health services.
Body Works Wellness Studio, the stuff of dreams—and hard work
“I
am so excited to open my business, to continue helping people inside and out,” says Leslie Moore about Body Works Wellness Studio, scheduled to open November 4 at Levis Commons in Perrysburg. Moore, a runner and former competitive swimmer, says she’s committed to lifelong learning and wellness. “The more I can do to contribute to health and well-being, the happier I am,” she says. “I’ve been working toward this for a long time.” Moore received her massage therapy license from the State of Ohio Medical Board while working for Serenity Health & Wellness Center as a business manager. She received her
massage therapy education from the Healing Arts Institute in Perrysburg and has an MBA from Tiffin University. “The three years with Serenity really helped me understand client needs and gave me a good foundation for launching my own dream.” She is also a member of the American Massage Therapy Association. Moore specializes in myofascial release, trigger point release, neuromuscular therapy, deep tissue massage, and sinus and migraine treatments. She’s also trained in Swedish massage and can accommodate the needs of pregnant women. And, she’ll offer body wraps and detoxification services, as well.
“This has been my dream for a long time. I really can’t express how excited I am to continue helping people achieve their wellness needs,” Moore says. “Everyone’s been so great helping me get the studio ready. I am really grateful—and ready to get started.” Body Works Wellness Studio opens November 4 and is located at 2160 Preston Parkway in Levis Commons. Hours: Monday through Friday, 10:00 a.m. to 7:00 p.m., Saturdays 10:00 a.m. to 5:00 p.m. To find out more, visit bodyworkswellnesstudio.com, call 567246-9101, or email leslie@body workswellnessstudio.com. ❦
January 1 is the time to explore my health insurance options. Significant changes required by healthcare reform go into effect January 1. That’s why now is the time to consider your options for buying health insurance. Making a decision before the end of the year could save you money. Talk to your insurance advisor or a Medical Mutual representative today. Call 877-325-6664 or visit MedMutual.com/individual.
© 2013 Medical Mutual of Ohio
Have questions about an advertiser? Click their email or web address in our online issue at www.hlntoledo.com. Healthy Living | Time to Explore-Individual | 10.25" x 6.25"
41
Dreaming of a
T
he trend of deep frying the Thanksgiving turkey continues to grow all across our nation, and with good reason. Deep frying the ol’ gobbler seals in flavor and juices so it turns out delightfully tender, succulent, and delicious. What’s more, deep frying cooks the bird in a fraction of the time it takes for conventional oven roasting—only about three to four minutes per pound. But deep-fried turkey also has a potential sinister side. Lowering a turkey into a big vat of scalding-hot oil makes for a highly combustible situation to say the least. Each year around Thanksgiving, news stories about turkeyfryer-related fires, injuries, and even deaths begin to pop up. So, if you intend to deep fry your bird this Thanksgiving—and would prefer to stay out of the headlines—be sure to observe the following safety tips:
deep-fried Thanksgiving turkey? Heed these safety tips! Read the fryer manual While most turkey fryers function in essentially the same way, there are certain differences among the various models. Before attempting to use your new fryer, be sure to read the manual thoroughly to familiarize yourself with all the included components as well as the manufacturer’s safety precautions and recommendations for proper use.
Set up the fryer outdoors Under no circumstances should a turkey fr yer be used inside your home, garage, or any other enclosed area. Instead, set up the fryer outdoors on a flat, level surface that is out of the wind and a good distance from any structure or combustible material, such as dry leaves. The best place to set up frying operations is on dirt or concrete—never on a wooden deck or any other type of wooden platform.
42 November 2013 / Healthy Living News
Have a fire extinguisher handy
going larger. Instead, fry a second bird while the first one is resting.
No turkey frying should take place without a fire extinguisher close at hand—and make sure it’s rated for use on oil fires. If an oil fire should occur, the last thing you’d want to do is try to extinguish it with the garden hose. Small fires can grow into large, unmanageable ones very quickly, so if you have any doubt about your ability to extinguish the fire, call 911.
Don’t overfill the oil
Protect your hands and eyes To protect your hands and arms from spattering oil and the hot surfaces of the frying vat, wear heavy-duty oven mitts. It’s also a good idea to don goggles or other protective eyewear before deep frying the bird.
Smaller birds are better The bigger the bird, the greater the potential for hot oil to overflow and cause a fire or major injury. Not to mention, bigger turkeys tend to burn on the outside before the inside is cooked completely. The USDA recommends a maximum size of 12 pounds for turkeys destined for the deep fryer. If one 12-pound bird won’t feed all your guests, don’t risk
Simply “eyeballing” the oil level before lowering the turkey into the vat often results in an overflow of oil, which can easily ignite if it makes contact with the cooking flame. The best way to determine exactly how much oil you’ll need is to perform a simple water-displacement test. Place the turkey in the empty vat and fill it with water to a few inches above the bird. Then, remove the turkey and measure the depth of the water. That measurement will tell you how high the oil level should be before the turkey is added. Once you’ve made your measurement, drain the water and dry the vat completely.
Prepare the turkey properly Before frying, make sure the turkey is completely thawed and pat it dry—inside and outside—with paper towels. Remember, any moisture will cause the oil to spatter. Also, be sure to remove the neck and bag of giblets from the body cavity as well as any plastic bindings and that plastic button that pops up when the turkey is
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done. Do not stuff the turkey before frying.
Go slow The risk of tipping the frying vat or causing an overflow is greatest when you’re immersing the turkey in the oil and raising it out. Never rush these operations. Even a completely thawed and dried bird will cause some spattering as you lower it into the hot oil. Lower too quickly, and the vat can easily bubble over.
Cook the turkey properly Food safety is just as big a concern when frying a turkey as when oven roasting it. Heat the oil to 350 de-
grees, and cook the turkey until its internal temperature reaches at least 165 degrees in the breast as well as the thickest part of the thigh.
Never leave the fryer unattended From the moment the burner is lit, the turkey fryer must not be left unattended. Also, the frying area should be ruled off limits to children and pets. The oil will remain dangerously hot well after you’re done frying, so this rule must remain in effect for several hours post cooking. Also, don’t attempt to dispose of the oil or store it until it has cooled completely. ❦
News From
OTTERBEIN Free “Medicare Check-up” events coming to Otterbein North Shore and Portage Valley
L
ieutenant Governor and Departbers, and healthcare professionals. ment of Insurance Director Mary Taylor urges Ohioans to call OSHIIP Taylor announced the Department’s at 1-800-686-1578 with their Medicare Ohio Senior Health Insurance Inforquestions and for enrollment assismation Program (OSHIIP) will hold tance. A Medicare Check-up and Ana free Medicare Check-up presentanual Enrollment Toolkit is available at tion at both Otterbein North Shore in www.insurance.ohio.gov. The toolkit Lakeside-Marblehead and Otterbein includes a plan listing, Check-up Portage Valley in Pemberville on Frievents schedule, and more. Ohioans day, November 15th. can also visit OSHIIP on When reviewing Facebook. The presentation will begin at 10:00 a.m. at Taylor said that Medicare options, Otterbein North Shore when reviewing opbe sure your and at 2:00 p.m. at Ottions, people should prescriptions are ensure a plan’s list of terbein Portage Valley. The public is invited included in the plan’s covered drugs includes and encouraged to attheir needed prescriplist of covered drugs. tend. tions and consider the The event is intendconvenience of having ed to help people review Medicare pharmacies in their network near changes and determine coverage for where they live. It’s also important 2014. It coincides with Medicare’s to take into account all out-of-pocket Oct. 15 to Dec. 7 annual enrollment expenses before making a decision. period. OSHIIP helped nearly 40,000 Topics of discussion at the event Ohioans save an OSHIIP record $5.5 include recent changes to Medimillion during last year ’s annual care, such as the new Medicare deenrollment period. So far in 2013, ductibles, co-pay, and co-insurance OSHIIP saved Ohioans with Mediamounts; Medicare Advantage and care $8 million. Part D plan options for 2014; as well “Understanding the many differas available financial-assistance proent types of Medicare coverage can grams. Attendees should bring their be complicated,” Taylor said. “Forlist of prescription drugs with dostunately the Department’s staff can ages and preferred pharmacy, inhelp consumers identify the coverage formation on retirement coverage, that best meets their unique needs.” and Veteran’s Administration (VA) OSHIIP is Medicare’s designated or other medical care benefits they and impartial educational program in receive. Ohio for beneficiaries, family memTaylor cautions Ohioans to watch
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for predatory sales practices and offers that seem too good to be true. If you suspect wrongdoing or have been victimized, call the Department’s fraud and enforcement hotline at 1-800-686-1527.
Those with questions and in need of Medicare coverage and financial assistance enrollment can call OSHIIP at 1-800-686-1578 or Medicare at 1-800-MEDICARE (1-800-633-4227). See also www.medicare.gov. ❦
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Free mobile app helps people recognize stroke “F.A.S.T.”
T
he American Heart Association/American Stroke Association offers a free mobile app to help people detect a stroke. In addition to detailing an acronym to help people recognize a stroke, with the “Spot a Stroke F.A.S.T.” app, smartphone users can call 9-1-1 directly, locate award-winning hospitals, and view a stroke-warning-signs video that’s part of an American Stroke Association public-service campaign with the Ad Council. The campaign includes multimedia public-service advertisements and online education and outreach. Teaching people how to recognize a stroke and respond quickly is a major goal of the association’s Together to End Stroke initiative, sponsored by global healthcare products company Covidien. Together to End Stroke raises stroke awareness and educates Americans that stroke is largely preventable, treatable, and beatable. “Even if you don’t think you’re at risk for a stroke, it’s important for everyone to know stroke warning signs and what to do in a stroke emergency,” said Allyson France, senior director of the Northwest Ohio Division of the American Heart Association. “When someone recognizes a stroke and acts fast by calling 9-1-
Deep Tissue Laser Therapy™ is an innovative, scientifically based process offering pain relief in as little as 5-15 minute sessions. This non-invasive approach, has long lasting benefits with no side effects!
Deep Tissue Laser Therapy can dramatically reduce the pain associated with: • Low back and neck strain • Bulging, fused or slipped discs • Carpal Tunnel Syndrom (CTS) • Epicondylitis (Tennis Elbow) • Temporomandibular Joint Disorder (TMJ) • Headaches, including migraine and sinus
• Arthritic Conditions (osteoarthtrits and rheumatoid arthritis) • Post surgical recovery • Sports injuries • And many more joint, muscle, circulatory and inflammatory conditions
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44 November 2013 / Healthy Living News
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1, the person has a greater chance of getting to an appropriate hospital quickly and being assessed for a clot-busting drug or other medical devices that may save their life and improve their chances for recovery.”
F.A.S.T. stands for: • Face Drooping: Does one side of the face droop or is it numb? Ask the person to smile. • Arm Weakness: Is one side of the body weak or numb? Ask the person to raise both arms. Does one arm drift downward? • Speech Difficulty: Is speech slurred? Are they unable to speak, or are they hard to understand? Ask the person to repeat a simple sentence like: “The sky is blue.” Is the sentence repeated correctly? • Time to call 9-1-1: If the person shows any of these symptoms, even if the symptoms go away, call 9-1-1 and get them to the hospital immediately. The “Spot a Stroke F.A.S.T.” mobile app is available by searching for “American Stroke Association” at iTunes and Google Play online stores. For a direct link, visit StrokeAssociation.org/WarningSigns. ❦
Research participants needed for knee arthritis study
D
o stiff and painful knees slow you down? Researchers at the University of Toledo are seeking participants for a study on the effects of six weeks of strengthening exercises on pain, muscle strength, and function in people with knee osteoarthritis. All study procedures are conducted by a qualified physical therapist. The study is funded by the University of Toledo, and there is no cost to participate. We are seeking men and women who: • Are 40 years of age or older • Have knee osteoarthritis that affects their regular activities • Are willing to be randomly assigned to either an exercise group that will meet twice weekly for six weeks or a noexercise group that will not change their activity for six weeks. Individuals in this group will be trained in a home-
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exercise program after the sixweek period. Qualified participants who complete the study will receive $50. For
more information, please contact Michael A. Tevald, PT, PhD, at MuscleFunctionLab@utoledo.edu or 419530-4149.
SouthernCare Hospice does “Whatever it Takes” to comfort and support patients and their families
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or patients diagnosed with a lifelimiting illness, there inevitably comes a time when curative treatments are no longer appropriate or even desired by the patient. It’s at that point that SouthernCare Hospice is poised to step in to provide comfort, compassion, and spiritual and emotional support to patients and their families. “We’ve been here in the community for nine years, and it’s our philosophy to do ‘Whatever it Takes’ to make this profound transition as comfortable as possible,” states Anna Vogt, Administrator/Clinical Director for SouthernCare Hospice in Toledo. “We don’t assess patients based on their diagnosis. We look at the whole person and
develop an individualized service plan to give them the best possible quality of life—as defined by them. Doing ‘Whatever it Takes’ also means providing ongoing education and guidance so patients and their families fully understand what to expect during this transition and can make informed decisions regarding care.” With 78 offices in 17 states, Souther nCare Hospice touches many lives across the country. Nonetheless each community-based office is small by design so the team can develop close, personalized relationships with clients. The concept is to bring hospice care to patients and their families wherever they call home—whether it’s actually in their family home, a
long-term-care facility, the hospital, or elsewhere. SouthernCare’s highly qualified, multidisciplinary team of caregivers consists of hospice aides, nutritional counselors, registered nurses, social workers, chaplains, volunteers, medical directors and physician consultants, as well as occupational, physical, and speech therapists. These professionals are trained to focus on the whole person, helping patients live life to the fullest for as long as possible. In addition to regular nurse visits, psychosocial services, and spiritual and emotional support, SouthernCare Hospice offers pain and symptom management, wound care, nutritional supplements, and incontinence supplies for any diagnosis. “We’ll also fulfill any of the patient’s equipment needs, such as wheelchairs, walkers, mattresses, and oxygen, along with any medications related to their diagnosis,” explains George Thompson, SouthernCare’s Community Relations Director. “Furthermore, we’ll provide palliative chemotherapy or radiation treatment if the patient’s doctor assures us it will make them more comfortable. That’s something many hospices are unwilling to do.” Vogt is enthusiastic about South-
ernCare’s Last Wish program, which makes it possible for patients to do something that’s especially meaningful to them one more time. For example, one cancer patient’s wish was to go to the casino with her friends one more time. The state of her health made it impossible to travel, so SouthernCare volunteers brought the casino—slot machines, party hats and all her friends—to her. It’s also SouthernCare’s policy to be right there at the bedside whenever one of their patients passes away, provided the patient and family welcome their presence and they’re notified that the patient has taken a turn. “We firmly believe no one should ever make that transition alone, so we’re going to be there every time the family wants us to be there,” Vogt says. According to criteria established by Medicare, to be eligible for hospice care, a patient must have received a diagnosis that could potentially end his or her life within six months if the
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actually begins.” SouthernCare Hospice’s services are offered 24 hours a day, 7 days a week, and 365 days a year. Patients and their families also appreciate the fact that, in addition to routine hospice care, SouthernCare offers Continuous Time Care (intermittent care up to 24 hours for management of complicated medical or emotional symptoms), Inpatient Care for complex pain and symptom management that can’t be managed in the home, Respite Care (up to 5 days) to allow caregivers time to take care of other daily essentials, and Grief and Bereavement Support. In summing up SouthernCare Hospice’s approach to serving clients, Thompson emphasizes, “What we do here is not about end of life. It’s about quality of life. Our job is to bring compassionate care to patients and their families so they can make the most of their time together during this period of profound transition.”❦
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illness runs its normal course. Factors that might warrant initiating hospice care include needing assistance with 50% or more of daily care, such as bathing, dressing, eating, or walking; making frequent visits to the hospital, emergency room, and/or doctor; and experiencing continued weight loss with treatment, frequent infections, severe shortness of breath, or persistent severe chest pain. Vogt notes that the sooner in the disease process hospice care is begun, the easier the transition for patients and their families and the sooner their symptoms can be alleviated. In fact, experts agree that patients need at least 60 days of hospice care in order to receive optimum symptom management. “Many people, physicians included, don’t understand that two weeks before passing away is not the best time to initiate hospice care,” she says. “The best time is right after receiving the terminal diagnosis, which is when the grieving process
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wan Creek Retirement Village enced leader who is approachable has selected an accomplished and sensible.” executive to lead the Toledo conRoller succeeds Jean Morgan, tinuing care retirement community. who remains with OPRS CommuAnn Roller took over as executive nities as the executive director of director on Wednesday, August Cape May Retirement Village in 28, 2013, and also as the campus’ Wilmington, Ohio. licensed nursing home “Swan Creek has a steladministrator. lar reputation in the ToRoller brings 15 years ledo area, and I’m ready of long-term-care expeto serve my residents and rience to Swan Creek staff. My door always is Retirement Village. She open,” says Roller. "Part completed an internship of the master plan for this with OPRS Communities, campus includes an upwhich owns and operdated health-care center ates Swan Creek, while and assisted-living area, earning her license as a and I’m excited to guide Ann Roller nursing home administhese future enhancetrator. She served as the ments.” administrator for OPRS CommuRoller has served as LeadingAge nities’ Dorothy Love Retirement Ohio’s west regional director and Community for seven years and was a past nominating committee was promoted to executive direc- member for Altrusa International. tor in 2006. She’s also been on the Business and At Swan Creek, she’s responsible Industry Board for the Miami Valley for day-to-day operations, resident Career Center in Piqua, Ohio. communications, growth and deRoller is a native of Piqua. She velopment, budgets, quality assur- and her husband, Ted, have two ance, outreach, board relations, and children, Cameron and Benjamin, staffing. The campus includes villa and now call Ottawa Hills, Ohio, and apartment homes, assisted- home. living apartments, a rehabilitation She can be reached at Swan center, and a health-care center. Creek Retirement Village, 5916 “I am delighted Ann accepted Cresthaven Ln., Toledo, Ohio, the position in Toledo,” says OPRS 43614, 419-865-4445 or aroller@ Communities President Daniel J. swancreek.oprs.org. O’Connor. “She’s a solid, experiWe love comments and feedback. Like us on Facebook. Follow us on Twitter.
A late-autumn gardening to-do list Consider what you’re I composting t’s time once again to bid a fond farewell to the growing season and put our gardens and landscapes to bed until spring. Along with cool temperatures and reduced daylight, late fall brings its own set of gardening chores to be tackled before winter’s snow begins to fly. Gardener’s need to tidy up borders and beds, wrap up any remaining fall planting, provide winter protection for tender plants, and properly clean and store their tools and equipment.
Prep your perennials Once the first hard frost hits and the foliage on your herbaceous perennials has completely withered, it’s time to cut them back to the ground. However, hold off cutting back any plants that still have green leaves, since they are still performing photosynthesis and transporting energy to their roots to be stored until spring. If you’d like your garden or landscape to provide a little winter interest, you might choose to avoid cutting back any plants that have attractive seed heads or stems or fruits or seeds that will attract foraging, winter-weary birds.
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If you compost, your garden debris can be added directly to the pile with the exception of diseased or pest-infested plants or foliage. Never allow these to overwinter in your compost pile or planting beds or the disease/pest will likely return for an encore in your garden next spring.
Keep on planting It’s getting late in the season for fall planting, but there’s still time. As long as the soil is workable, you can plant many varieties of trees, shrubs, hardy perennials, and spring-flowering bulbs. They won’t have much time to establish a good root system before winter sets in, so be sure to water them well right up until the ground freezes and give them a nice insulating blanket of mulch. Keep in mind, however, that some plants will overwinter poorly if planted too late in fall and are, therefore, best left until spring. These include broadleaf evergreens, such as rhododendrons, azaleas, hollies, and boxwoods; tree roses; and tender perennials (those that naturally
occur in warmer climates). In contrast to deciduous trees and shrubs (those that shed their leaves in autumn), broadleaf evergreens continue to lose moisture through their foliage all winter long and tend to dry out easily. Couple that with the fact that late-planted specimens don’t have much time to develop a good root system, and you can see why their odds of winter survival are shaky.
Make the most of markdowns This is also a great time to take advantage of marked-down nursery stock to fill in those empty spaces in your garden or landscape. In late fall, garden centers commonly offer good, viable plant material at half or 25 percent of its original cost. The plants may not look like much in the pot, but they’ll come back in spring just as well. If you’re not too particular about
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the variety or color of spring-flowering bulbs, you can often get terrific deals on large quantities of “mystery bulbs”—those that fall out of the bulk bins as customers rummage through them or bagged bulbs that have lost their labels. You can still distinguish a tulip from a hyacinth or a crocus from a narcissus, but the colors and blooming periods will be anyone’s guess. If you’re looking to naturalize a remote corner of your garden on a low budget, mystery bulbs may be a good solution.
Put winter protection in place As alluded earlier, mulch will be your biggest ally in preventing winter casualties. All plants benefit from its insulating and moisture-retaining characteristics, so apply it liberally around the base of each plant. With grafted roses, be sure to mulch over the bud union (the point where the plant has been grafted to the rootstock), which is very sensitive to
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freezing. If the bud union is left exposed, the rose could die back past the graft, and you may end up with a rose of an entirely different color growing up from the roots in spring. If you choose to protect your roses with Styrofoam rose cones, keep in mind that they allow no air circulation, so mold can quickly result if the air temperature climbs too high. Be prepared to remove them during unexpected warm spells. Burlap is also very useful for winter protection. Use it with stakes to build a wind block around tender plants in exposed areas. A burlap frame combined with the use of an anti-desiccant spray (applied in strict
accordance with label directions) will give broadleaf evergreens a good level of protection against winter damage.
Keep on watering! Water is perhaps the most commonly overlooked garden-winterizing tool. Until the ground freezes, plants keep expanding their roots, and water helps insulate them against the elements. So, if Mother Nature doesn’t oblige with regular rain showers, keep on watering until the ground is frozen. This is especially critical for perennials planted in the fall, such as chrysanthemums.
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If you decide to join the GRAND-306 Study, you will continue taking your current diabetes treatment as usual and will be given the investigational medication, or placebo (which looks the same as the investigational medication but contains no actual medication). to take as well. The GRAND-306 Study will last about 6 years, and will require approximately 23 visits to the study center and scheduled telephone calls. The study will include a screening period to confirm that the study is suitable for you, a study medication closing period, and a follow-up visit.
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W
hat are refractive errors? Light rays go through the tear film, the cornea, and the lens in order to reach the retina of the eye to see clearly. The process of bending the light to reach the retina is referred to as the refraction of the light. In order to see clearly, the light must be refracted to perfect focus on the retina. Refractive errors occur when the light focuses either in front of or behind the retina or when the shape of the cornea, the window of the eye, is misshaped and the light is distorted in the back of the eye. Fortunately glasses are able to easily correct refractive errors.
What is myopia? Myopia, nearsightedness, typically occurs when the eyeball is too long and, thus, the light rays are refracted
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48 November 2013 / Healthy Living News
An investment in the future This may seem like a substantial to-do list—especially when you thought you were done with gardening for the season—but if you tackle these chores now, you’ll be prepared to hit the ground running next spring with far fewer plant losses. ❦
by Bennett Romanoff, MD
The GRAND-306 Study is looking at whether an investigational medication (a new medication) that is under development is safe and effective in people with type 2 diabetes, who have difficulty in controlling their blood sugar levels, and have experienced heart problems or have risk factors for heart disease.
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Last but certainly not least, it’s time to clean up and prepare your trusty gardening tools for a long winter’s nap. Fill a large bucket with sand, and mix in some light motor oil. After removing as much dirt and debris as you can from your tools, dip the business end of each repeatedly into this mixture. The sand will scour off any remaining dirt, and the oil will provide a rust-protective coating. If some tools are already rusted, sand off the rust before dipping. Prepare your gas-powered tools for winter storage by either run-
ning them dry or adding a fuel stabilizer to the fuel tank. This will make starting a snap next season. Late autumn is also a good time to take power tools in for any necessary repairs, adjustments, or sharpening. Don’t postpone repairs until next spring when the shops will be inundated
Refractive errors and the eye
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in front of the retina. Myopia causes clear vision up close and blurry vision far away. Other symptoms are halos around lights, squinting, and eye strain. Myopia is often inherited; however, it can occur spontaneously. If one or both parents have myopia, the likelihood that their children will have it is greatly increased. Fortunately, myopia is easily diagnosed and treated with eyeglasses.
What is hyperopia? Hyperopia, farsightedness, typically occurs when the eyeball is too short and the light rays are refracted “behind” the retina. Often it is inherited; however, most children are born slightly hyperopic. Usually children outgrow it as the eyeball grows. Until middle age, hyperopia is not usually a problem since the human lens is
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very flexible and can refocus the light rays back on the retina. By the time bifocals are necessary, usually between 40 and 45 years of age, the human lens is no longer as flexible and, therefore, farsighted glasses with a bifocal are necessary.
What is astigmatism? Astigmatism typically occurs when the cornea is more football shaped than basketball shaped. When this occurs, light is refracted in different areas, thus distorting the way we see. Both near and far objects appear distorted. Symptoms include objects that look thinner, wider, or taller than they really are. This, in turn, causes glare and eye strain if not treated with glasses. Astigmatism may occur concurrently with either myopia or hyperopia. Glasses easily correct this condition.
What is presbyopia? Presbyopia, aging of the eyes, happens to everyone and usually occurs in the early 40s. When we are young, the human lens is very flexible. When we use our eyes up close, as in reading, it is necessary to flex the human lens to focus up close. By the time we reach the 40s, the human lens is much less flexible, so we no longer can focus up close. Fortunately, bifocals or reading glasses are an easy solution to this aging condition. Everyone eventually needs bifocals or reading glasses to see up close.
Can wearing glasses correct or worsen one’s vision? The answer is no. Glasses serve only one purpose, and that is to correct the refractive error and to see clearly. Correctly prescribed glasses do not help the eye to get better, and they do not make the refractive error get worse. Refractive errors are more or less genetically predetermined.
Can glasses do more than correct refractive errors? The answer is yes. Ultraviolet light is very harmful to the eye. It is a major
cause of cataracts and is implicated as a cause of macular degeneration. In my practice, the vast majority of my patients wear Transitions lenses, which are 100% UV protective. Polarized sun glasses are also virtually 100% protective. To avoid sports or work injuries, polycarbonate plastic, which is very impact resistant, is recommended. I give polycarbonate plastic to all children 18 and under since they are more likely to play sports and are more active than adults. Anti-reflective coating is recommended since it reduces glare and reflections that often occur with lights at night time. I recommend it to all my patients when they start driving a car. It also helps with glare that occurs with the illumination of computer monitors and televisions.
Are glasses the only way to correct refractive errors?
Northwest Ohio Chapter
Contact lenses and LASIK are other options to correct refractive errors. Since both of these choices involve risk, it is best to consult with an ophthalmologist before deciding if either of these options is a good choice.
Are refractive errors the only cause of blurred vision, glare, halos, and eye strain? No. Many ocular and systemic conditions, such as glaucoma, cataracts, macular degeneration, diabetes, migraines, and brain tumors, just to name a few, can cause the same symptoms. I recommend eye exams with an ophthalmologist every two years starting at the age of four until 60 and then every year thereafter. Approximately one-third of all systemic disease is potentially diagnosed through a comprehensive eye exam. If at any time there is a change in one’s visual status, it is very important to consult an ophthalmologist. An ounce of protection is worth a pound of cure. � Dr. Bennett Romanoff is Chief of Ophthalmology at Flower Hospital, a Clinical Assistant Professor of Ophthalmology at the University of Toledo College of Medicine, and an instructor of Ophthalmology in the Family Practice residencies with Flower and Toledo Hospitals. Since setting up his practice in 1978, Dr. Romanoff has helped thousands of patients in Northwest Ohio achieve better quality of vision with up-to-date treatments and solutions.
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