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One step at a time

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• RU N NI N Spring 2015

Exact Fitness

offers alternative to corporate gyms ...page 24

Sticking point

Acupuncture therapy ...page 8

Yoga with Grace Grace Walker’s 14-year story

...page 12

County kicks off

Relay for Life season ...page 16

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Be... Spring 2015

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Be… Informed In this issue of BE magazine, you can learn about new exercise routines ranging from yoga to dancing and medical procedures from acupuncture to vein repair.

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Acupuncture offers healthcare alternative

Yoga with Grace

Ballroom dancing couple instructs at HRH

Acupuncture may not be the first thing you think of when seeking treatment, but it has been known to help with a variety of ailments and may be both an ancient form of treatment as well as the wave of the future.

Yoga is both an exercise and a relaxation technique. Again, this is a concept that other countries have been practicing for many years, but it continues to grow in popularity here with more and more studios and fitness centers offering classes.

And if neither of those interest you, maybe you’ll just want to put on your dancing shoes and waltz your way to wellness.

The Community Health Assessment highlighted in this issue will point out what areas Hendricks County needs to work on as well as the areas where we’re excelling.

Our expert columnists give tips on what to do in the event of a fire, how to stop smoking, the latest exercise options, and more.

While it may be freezing outside, many Hendricks County residents are already gearing up for the spring thaw and the annual Relay for Life events.

Features

Columns

Fit

Health survey targets county needs 4

Have a plan when fire breaks out 6

County kicks off Relay for Life season 16

We encourage you to think warm thoughts, remember that spring is just around the corner, and enjoy this issue of BE magazine.

Varicose veins erased 28

Help babies breathe easier 11

It is certainly possible 23

To submit story ideas for future issues of BE magazine, contact Editor Kathy Linton by emailing to Kathy.linton@ flyergroup.com.

New study assesses hospice 30

Hospital mistakes kill too many 26

Exact Fitness offers gym alternative 24

Publisher Harold Allen harold.allen@flyergroup.com

Production Director/Design Terry Ballard

Sales Director David Johnson david.johnson@flyergroup.com

8109 Kingston Street, Suite 500 Avon, IN 46123 1-800-359-3747 (317) 272-5800 FAX (317) 272-5887

www.flyergroup.com

Editor Kathy Linton kathy.linton@flyergroup.com

terry.ballard@flyergroup.com

Layout: Autumn Ricketts, Phil Miller, Kaylee Harden

TheHCFlyer

4 Be... AWARE

HEALTHY community Health survey targets county needs

By Steven Penn Hendricks County Flyer

HEALTH ASSESSMENT: The Community Health Assessment is currently online.

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he Community Health Assessment, which is taking place now, is a vital tool in identifying the areas of needs pertaining to the health of the county.

Rachel Buckman, health educator for the Hendricks County Health Department and coordinator for the Hendricks County Health Partnership, said the survey was created through collaboration of the partnership, which includes Indiana University Health West Hospital, Hendricks Regional Health, Franciscan St. Francis, Community Health Network, and St. Vincent Hospital. The survey will be live until May 1.

“The data that we’re gathering from the survey will be used to actually create our next Community Health Assessment,” Buckman said. “Back in 2010,

the Hendricks County Health Partnership and the Hendricks County Health Department worked to gather similar responses with a different survey to create the Hendricks County 2011 Community Health Assessment.”

However, a new assessment needs to be done every three to five years.

“What we’re doing is we’re gathering new information so that we can update the Community Health Assessment, which then we take and use that information to help plan out health activities for the future,” Buckman said.

The four priority areas that were designated in the previous assessment were tobacco use, physical activity and nutrition, mental health, and affordable

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“This is really a community health improvement effort. It’s not just the health department doing it, it’s not just one of the hospitals doing it, this is really trying to combine all of our public and private agencies and businesses to work on these issues as a county … in the name of partnering together to tackle these issues because a lot of them are too big to tackle just as one entity.”

— Rachel Buckman medical care.

“The partnership has been working to actually improve each priority area, which has its own goal,” Buckman said. “Whether it’s getting more people to exercise and eat a balanced diet or reducing tobacco use rates, increasing awareness of mental health facilities and resources in the county or helping people gain access to affordable medical care, that’s what the partnership’s been working on and all of that comes out of the community health assessment.”

The main goal of the assessment is for the community to be able to pinpoint what they feel needs to improve and it also allows the county health entities to work together.

“This is really a community health improvement effort,” Buckman said. “It’s not just the health department doing it, it’s not just one of the hospitals doing it, this is really trying to combine all of our public and private agencies and businesses to work on these issues as a county … in the name of partnering together to tackle these issues because a lot of them are too big to tackle just as one entity.”

IU Health West Hospital officials take the opportunity to partner with other community organizations seriously.

“IU Health West is proud to partner with a broad spectrum of community organizations doing important work to serve the people of Hendricks County,” Cathy Stoll, marketing and community outreach director at IU Health West Hospital, said. “Our partnerships and community engagement activities are aligned with the priorities identified in the community health risk assessment and by outcomes that ladder

Be... Spring 2015

up to the hospital’s mission to improve the health of the community.”

As for the questions, Buckman said they are an amalgam from the health department, as well as the systems of IU Health, St. Francis, Community Health Network and St. Vincent.

“We partnered with them on the survey, because the first half of the survey is theirs and the second half is our questions because those four hospital systems are working on their community health needs assessments across the entire state,” she said.

Buckman said the hope is to get 2,400 responses from Hendricks County.

The survey isn’t the only way the health department gathers data, Buckman said.

“We have another survey specifically for agencies and businesses to answer on how well our local public health system is working to meet the needs of the community,” she said. “We’re also going to have focus groups and town hall meetings in each of the towns around the county in the spring. We’re working on getting those planned now so people can provide input that way.”

To take the survey, visit the website at www.surveymonkey.com/s/inhealthneedssurvey.

For more information about the partnership, visit the website at http://hendrickshealthpartnership.org.

For more information about the Hendricks County Health Department, visit the website at www.co.hendricks.in.us/health.html.

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Have a plan when fire breaks out You and your family are at greater risk for a home fire during the winter months than at any other time of the year based on information from the United States Fire Administration.

The highest percentage of fatalities were located in the bedrooms of residences, which makes sense as the majority of residential fires occurred between the hours of 11 p.m. and 7 a.m. That information comes from National Fire Incident Reporting System for the years 2010-12.

Cooking was found to be the leading cause for residential fires resulting in injuries.

Clothes dryer fires are also quite common.

The adage “predictable is preventable” comes to mind regarding fire prevention in the home. Practice good housekeeping and keep all combustibles away from heat sources.

Have family members practice the “stop, drop and roll” routine.

An exit plan needs to be part of your fire safety preparedness in the home.

Spend some time working with EDITH! (Exit Drills In The Home).

Practice setting your smoke alarms off at random times — even while the fam-

Lisé Crouch Lisé Crouch, AEM, PEM, is coordinator of Hendricks County Emergency Management

Photo: MetroCreativeConnection.com

ily is sleeping.

All family members need to know how to exit every room in your home.

Everyone should know and practice the low crawl to stay under the smoke as the smoke can be toxic.

You and your family should have a prearranged meeting location not far from the residence but enough distance that all are safe and out of the way of the fire department response. Time your drills until you and your family can get them under two minutes.

Make sure every member of your family knows how to call 911 and give the proper information to dispatch.

Do not re-enter the residence if a fire is present.

Once you are safe, don’t make yourself a victim.

Having a fire extinguisher in the home is always a great idea but does little good if not used properly and often is not enough to fully extinguish the source. According to NFIRS 2010-12 reports, 35 percent of fire injuries in the home were the result of trying to control a fire. Always call 911 and get the people who have trained to fight the fire there as quickly as possible.

For more information on fire safety, go to the website http://in.gov/dhs/getprepared.htm.

Be... Spring 2015

By Melissa Gibson Hendricks County Flyer

8 Be... AWARE

Sticking

POINT

BODY PATHWAYS: Acupuncturists say there are literally thousands of meridians or points on the body that allow access to natural healing.

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uffering from arthritis, inflammation, migraines and other painful conditions often result in frequent trips to the doctor, a list of referrals and most extreme — to the surgeon.

When surgery doesn’t work or patients are inundated with harsh medications, they sometimes start looking for answers.

“What that leaves you with is a pool of patients of last resort,” said Dr. James Keating of Avon. “Most patients don’t feel strongly enough about it to go with acupuncture first. They first go to surgery; the surgery didn’t work and things are much worse than they were, but the acupuncture is still successful.”

Doctors specializing in alternative therapy such as chiropractic, dietary and acupuncture believe the health system should consider another option outside of the typical healthcare hierarchy.

The practice is ancient — at least several thousand years old — according to studies where researchers

have found pointed rocks and knives of varying shape and size, all pointing to physicians using tools to poke one or multiple patients with.

As needles developed, the autoclave process was accepted and now, single use, sterile needles are used.

“Infection is minuscule,” Keating said. “It’s a super safe procedure now.”

Despite the history of acupuncture involving steady medical discoveries and developments, it wasn’t until President Richard Nixon’s visit to China in the late 1970s that he stumbled upon the practice and suggested the United States adopt some or all of its benefits.

“The trials they used to disprove acupuncture accidently proved that it does work,” Keating said. “So, to this day, you’ll find six studies that say it works and six that say it doesn’t.”

Most patients willing to try are surprised if not fascinated by the results.

Janet Krebs has been receiving acupuncture treatment for years.

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AILING RELIEF: Dr. Steven Mangas applies acupuncture needles to Krebs’ face, relieving pressure in her sinus.

“The surprise about acupuncture is that it uses your own body to heal,” she said. “It seems to supercharge even other treatment protocols.”

For those remaining skeptical, Keating says evidence is building.

“Now we can document things like brain chemistry,” he said.

And patients are becoming increasingly open about sharing their experiences and success stories.

“I think the public feels hungry for alternatives, especially as health care versus sick care gets debated,” Krebs said. “Traditional medicine will always have a place, but the public is sick and tired of being handed another drug as the only treatment, especially when the side effect lists are often scarier than the ailment itself.”

Many think acupuncture looks ‘scary’ or painful, but in fact, little to no pain is involved in the treatment.

Ever hear someone say, “You’re messing with my chi (CHEE)”?

Traditional Chinese medicine explains acupuncture as a technique for balancing the flow of energy or life force — known as Qi or Chi — believed to flow through pathways in the body.

Dr. Steven Mangas of Indianapolis saw a need for alternative options early on. Even as a chiropractor, Mangas says adjusting the spine “still wasn’t accomplishing everything we wanted to do.”

Acupuncture points, Magas says, are “basically like outlets that come to the skin. The needle provides stimuli and we can suppress or boost a response based on the goal.”

Mangas gives an example: “If I step on your toe,

Be... Spring 2015

10 Be... AWARE you immediately have a reaction — stimulation. The longer I step on your toe, eventually it becomes numb. That’s sedation.”

The super thin needles are not medicated. Five acupuncture needles can fit in a regular hypodermic needle and the needles are so sharp they literally push the cells apart.

What patients are finding impressive is the wide range of treatment acupuncture has the ability to treat.

Keating references four pillars of modern medicine: anti-inflammatory, pain management, muscle relaxer and antibiotic.

One of the more controversial parts of acupuncture is treating inflammation.

“Acupuncture treats arthritis in the way it approaches the body,” Keating said.

“It brings down inflammation because there’s a hormonal intervention where the brain can even dial down.”

Pain management or pills can be extremely dangerous for the patient, but through acupuncture, studies have shown the brain chemistry changes, allowing for a decreased level of pain.

Keating argues that the benefit of acupuncture in lieu of a muscle relaxer is the practice that allows the muscle to relax to normal tone and tension. Many suffer from the option of taking a pill and being ‘knocked out’ for the night or enduring the pain.

“You can also have a muscle that is going soft and we can use acupuncture to wake that one up,” Keating said.

While mainstream medicine is fighting arguments of over-medicating or creating super bugs as a result of patients developing immunity to antibiotics, acupuncture can also be used to stimulate the immune system.

Regardless of the healthcare system’s current stance on acupuncture, there is promise of the treatment helping patients in more ways than the four modern pillars.

Patients can take a combination of

both acupuncture and medication as the process does not conflict with medication.

Due to a change in brain chemistry with acupuncture, the process can also affect the mood of the individual.

It’s been known to help chemotherapy patients — not to cure the cancer, but to provide support in pushing through the nausea or pain.

Acupuncture can also be used to dial down the craving process, potentially helping patients with the desire to quit smoking, over eating, or taking drugs.

“It’s not a reflex, you are still in control of the decision,” Keating warns. “It’s just meant to support your goals.

“Acupuncture continues to outperform my expectations on a regular basis.”

Positive changes can be seen on the horizon. Although the process is fairly affordable, some insurance companies have begun accepting it, in particular in support of veterans.

“They’re starting to realize that all of these medications are not working,” Keating said.

About 3.1 million American adults have used acupuncture, and the numbers are growing, according to the National Center for Complementary and Alternative Medicine (NCCAM).

Next in line to the development and addition of an alternative treatment is acceptance.

Acupuncture theories today are based on extensive laboratory research, and have become widely known and accepted. In addition, controlled studies have shown evidence of the effectiveness of acupuncture for specific conditions.

At present in the United States, about 3,500 physicians and 11,000 to 12,000 non-physician acupuncturists use this medical art. About 40 acupuncture schools train non-physicians and about 500 to 600 physicians, according to the American Academy of Medical Acupuncture.

Keating feels that surgeons would make the referral pre-surgery if they had solid evidence.

Acupuncturists agree with those fighting to secure the modern or conventional healthcare system.

“Sometimes surgery is needed, and sooner or later I’m going to recommend it,” Keating said. “I just think we need to be included in the hierarchy of medicine.”

He warns, like most procedures, there are limitations.

“If you have bone on bone, taking the inflammation down isn’t going to change that fact,” he said. “When you get up to walk, you still have bone on bone.”

Still, the practice of acupuncture can stop the process of erasing the cartilage once the problem has been diagnosed.

“I really don’t try and change people’s minds,” Krebs said. Personal choice is important, but I am living proof that they really have nothing to lose. There is no stress on the liver, no added drugs and why not shoot for a permanent fix than a band aid solution?

“We trust our doctors sometime without question. Similarly, alternative medicine protocols delivered by a quality clinician can be life changing.

I am prescription free and have saved thousands of dollars in treatments over the past 10 years. Most importantly, I feel much more in control of my own health by choosing alternatives that make sense.”

The Avon Chiropractic Clinic with Dr. James Keating is at 10080 E. U.S. 36, Ste. B, Avon. For more information on Keating’s practice visit the website at http://avonchiropracticclinic.com/ chiropractic/ or call 600-3070.

Mangas Chiropractic with Dr. Steve Mangas is at 6699 Rockville Road, Indianapolis. For more information, visit the website at http://www.mangaschiropractic. com or call 247-1717.

Be... Spring 2015

Be... HEALTHY 11

Help babies breathe easier There has been a lot of talk recently around the state about Indiana’s high infant mortality rate.

In 2013, the state reported an infant mortality rate of 6.7 infant deaths per 1,000 live births, a rate significantly higher than the national rate of 6.1 infant deaths per 1,000 live births.

The Centers for Disease Control and Prevention (CDC) states that the top three causes of infant death in the United States are congenital malformations, low birth weight, and sudden infant death syndrome (SIDS). One of the biggest risk factors for each of these causes of death is smoking during pregnancy.

Hendricks County has a smoking rate among pregnant women of about 10 percent, or about one in every 10 pregnant women in Hendricks County smokes at some point during her pregnancy.

According to a study published in Human Reproduction Update, babies born to mothers who smoked had roughly 20 percent to 30 percent higher odds of having shortened or missing arms and legs, cleft lips and cleft palates, and abnormally shaped heads or faces compared to babies born to nonsmoking mothers.

The CDC adds that smoking during pregnancy can cause a baby to be born too early or to have low birth weight, making it more likely the baby will be sick and have to stay in the hospital longer.

Smoking can also increase the chances of a child dying from SIDS because secondhand smoke deprives infants of oxygen, stunts brain growth, and blocks nasal passages, which is particularly harmful

because, often times, babies breathe solely through their nose.

Quitting and being smoke-free during pregnancy is one of the most important things a parent can do for the health of their baby because babies get more oxygen, have less risk of being born premature, are less likely to have cleft lip or cleft palate, and are at less risk of dying from SIDS when they are not exposed to tobacco smoke.

Pregnant women and their families are not alone when trying to quit smoking. The Indiana Tobacco Quitline is available to all Indiana residents over age 13 and provides free quit counseling over the phone, online, or by text message.

Pregnant women receive 10 free sessions with a certified quit counselor, while their family members receive four free sessions.

Residents can enroll in the Indiana Tobacco Quitline by calling 1-800-QUIT-NOW or visiting the website at www.quitnowindiana. com for more information.

In fall 2014, the Hendricks County Health Department launched BABY & ME – Tobacco Free™, a national cessation program for pregnant women and their support partners funded in Indiana by the Indiana State Department of Health and Anthem Blue Cross/Blue Shield. The Health Department hosts one of the 12 program sites across the state to help pregnant women quit smoking during pregnancy and stay quit after giving birth.

BABY & ME – Tobacco Free™ provides four in-person smoking cessation sessions with a trained facilitator during pregnancy and

refers participants to the Indiana Tobacco Quitline for additional support.

During the sessions, participants learn the health benefits of quitting, how to protect themselves and their newborn from secondhand smoke, where to go for support in living smoke-free, and how to stay smoke-free after delivery.

This program continues to provide support after the baby is born, and participants earn a $25 voucher for each month they are smoke-free for up to 12 months.

This program is open to any pregnant woman and her support partner who are current daily smokers or were daily smokers within three months of becoming pregnant. There are no income or age requirements, and no fees to participate. Participants must quit during their pregnancy to receive the vouchers.

For more information about enrolling in BABY & ME – Tobacco Free™, call the Hendricks County Health Department Nursing Division at 745-9222.

Creating a community that promotes smoke-free pregnancies is just as important as helping pregnant women and their families lead smoke-free lives.

Tobacco Free Hendricks County is a local coalition of agencies and businesses that work toward a healthier community through tobacco prevention and cessation promotion.

For more information about tobacco prevention and cessation resources in Hendricks County, call Michael McDonald, coalition coordinator, at 828-9248.

Cathy Blume Cathy Blume is a member of the Tobacco Free Hendricks County Coalition.

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Yoga with

By Devan Strebing Hendricks County Flyer

GRACE

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race Walker, 46, has been teaching aerobics for more than 28 years. That includes step, muscle conditioning, spinning and kick-boxing. She has taught yoga for more than 14 years. ways been a big part of my “Fitness has always life, starting with school sports and teaching group fitness as a second career,” she said. “I had a bad d car accident in ‘99, and have had back issues sues since then. Some of my physical therapy py exercises resembled yoga, and as I started arted to gain more interest in yoga, I started with DVDs, some classes, and eventually wanted anted to pursue more training to become a yoga teacher.”

Walker and her husband Eric have been married for 13 years and live with their dog and cat.

She earned a degree in dietetics/nutrition from Indiana University in 1991 and a BSN in nursing from IU in ’97. She is certified with AFAA (Aerobics & Fitness Association of America) and RYT-200 (Registered Yoga Teacher).

Walker is a minister’s daughter, so the family moved around a lot while she was growing up here in Indiana.

She’s been an RN at IU Health Methodist for 17 years and currently works in the Resource Department.

She’s been teaching at National Institute for Fitness & Sport (NIFS) since 1992 and at her church, Chapel Hill United Methodist.

Walker said she called to find out if any

yoga classes were offered at IU Health Methodist for employees and was told they were looking for an instructor, so she started a yoga class there

INSTRUCTOR GRACE WALKER has been teaching yoga for more than 14 years.

about 10 years ago.

She currently teaches yoga and full body workout (muscle conditioning) with three classes at Methodist and two classes at IU Health West.

“I am so proud to be a part of an organization that supports health and fitness and offers on-site classes for both employees and community members,” she said. “Yoga is my favorite class to teach. It’s this wonderful gift you have for yourself and sharing it with others is truly a blessing.”

Her full body workout utilizes conditioning of the entire body.

“Some days we work with weights or resistance tubing or your own body weight for resistance,” she said. “Yoga is more of a mind/ body connection, with focus on strength, balance, and flexibility. Both classes require a mat and water.”

For full body, class participants will need a good pair of athletic shoes and a set of light hand weights (two to three pounds).

Walker says she offers lots of modifica-

Be... Spring 2015

tions for beginners or those who have been out of fitness for a while.

“It’s important to pace yourself and remember that there is no competition, no expectations or judgment,” she said.

“We have a great group of students who just want to be fit and happy, reduce stress and stay accountable for everyone, through encouragement and keeping it fun.”

She says her students are what keep her going.

“They show up every time ready to go, ready to leave the stress of the day behind them and honestly they keep me motivated to keep my classes fresh and new as well as challenging and safe,” she said. “I always remind the class that this is their class ... it’s all about self-care right now, making sure we are healthy and strong to take care of all of those around us who love and depend on us.”

She said she’s heard many success stories from her students.

“Besides the obvious perks of moving more, I’ve had numerous students tell me they just feel better,” she said.

“Yoga is their time to recharge, refresh, re-energize, and reboot. We all can improve on balance, flexibility, and strength.

Classes like yoga will get you there in your own pace and time.”

She says too often many people worry about fitness when a big event comes up; but today is the best day to begin to feel better.

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RACHEL KELTER participates in the yoga class at IU Health West.

14 Be... HEALTHY

“Let’s not worry about the numbers on the scale — focus on the numbers of fruit/veggies you are getting in that day, or the ounces of water you drink, or the minutes of just setting aside that time for fitness, and the number of hours of sleep you get at night,” she said. “Work on less perfection and more consistency — just show up.”

The one bad story she has dealt with includes a woman who was texting in her class.

“She appeared to have some twitching in her right lower arm during Savasana , so being the nurse, of course, I quietly wandered over to her to make sure she was OK, and come to find out she was texting,” she said. “To this day I’d like to think she was texting to all of her friends to try out my yoga class.”

All employees of the hospitals only have to sign a waiver and make a payment through payroll deduction to attend Walker’s class. She also advises anyone interested to check with their doctor beforehand to make sure this is the right class for them.

Some of Walker’s favorite quotes that help her with her fitness routine include “Keep your workouts dirty and your diet clean” by Jillian Michaels and “If your friends don’t work out, get new friends — you be the good example” from Chalene Johnson.

“Find activities you enjoy and you will stick with it, forgive yourself if today was not an active day or a not-so healthy meal day, let it go

MICHELLE SCHWINDLER and Kristen Runyan are students of Walker’s at Indiana University Health West Hospital.

and move on to the next meal, the next workout, the next day,” she said. “Lastly, keep moving forward; plan and prepare ahead, change things up, sign up for class. Though change can bring on challenges or fear, it can also bring some awesome results.”

Walker says she will be teaching for as long as she can.

“It’s just a part of me; it’s awesome to find something you love to do and share it with others,” she said. “Some yoga instructors teach well into their 90s. I hope that will be me.”

For more information on the local classes, contact Bryland Sutton by emailing to bsutton1@iuhealth.org or by calling 962-8104.

Be... Spring 2015

By Steven Penn Hendricks County Flyer

16 Be... FIT

THERE ARE ALWAYS community groups selling food and other items at the Relays, like this one at a past Danville relay.

County kicks off Relay for Life season

A

ll across Hendricks County, residents are getting ready for this year’s versions of Relay for Life.

Each year, more than 4 million people in more than 20 countries participate in Relay for Life, which raises funds for cancer awareness and research. As a campaign, Relay for Life has been around since 1985, making the 2015 season the 30th anniversary.

In Hendricks County alone, there are three relays: Brownsburg, Avon, and Southwest Hendricks County,

which combined the Plainfield and Danville efforts.

Casey Trojnar, a specialist with Relay for Life, said Hendricks County as a whole is one of the best areas when it comes to fundraising.

“I think the fact that we have three relays in the county is pretty amazing,” she said.

This year, Brownsburg’s Relay will be start at 9:30 a.m. May 16 on the Brownsburg Town Hall Green.

Brownsburg Relay officials said they have set lofty goals for the 2015 fundraising efforts.

In each of the last few years, the Brownsburg Relay

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Be... FIT 17

WALKERS at last year’s Brownsburg Relay for Life enjoy themselves.

has nearly doubled its fundraising haul. This year, the goal is to raise more than $90,000.

“In 2013 we raised $45,000 as a Relay and in 2014 we raised about $85,000 as a relay — so about double the size,” Kevin McCluskey, 2015 Brownsburg Relay for Life event chair, said. “Certainly we think we can get near $100,000 this year.”

The Avon Relay for Life event will be from 6 p.m.

May 29 to noon May 30 — an 18-hour event — at Avon Middle School North.

Last year, Avon’s fundraising efforts brought in about $40,000.

The newly combined Plainfield and Danville efforts into the Relay for Life of Southwest Hendricks County will take place from 11 a.m. to 11 p.m. June 13 at the Hendricks County 4-H Fairgrounds.

The 2014 efforts of Danville netted about $35,000, while Plainfield brought in $22,000.

This year, Trojnar said Relay for Life has made a few changes.

“Some of the things that are different is that we don’t have a registration fee,” she said. “I think that’s really important for people to know. The other thing is that we are not doing our traditional team captain meetings.

In the past, we’ve had monthly meetings. We’re not doing that anymore. We have team ambassadors who are really focusing on reaching out to the captains and communicating with them.”

For more information, visit the website at www.relayforlife.org and search for the specific Relay or search on Facebook for each town’s event.

THERE’S MUCH MORE than walking going on at Relays, like this inflatable slide that was at Brownsburg’s event.

The services and care you need to recover, improve, or maintain your ability to live independently.

Choose Brownsburg Health Care Center.

Acute Rehab Medicine Specialists Our advanced rehabilitation (ARMS) Group staff the Rapid program is designed to enable Recovery Program to ensure the patients recovering from a highest level of care for our hospitalization to return home short-term patients. ARMS Group quickly, with the highest level of chooses only the highest quality independence possible. rehabilitation providers for partnership to Our Rapid Recovery Unit has private suites and a state-of-the-art Rehabilitation bring unparalleled care to elderly patients.

Physicians are on-site 3 days per week center equipped with advanced technoloand on call 24/7. Specialists including gies and a highly experienced staff.

Neurology, Pulmonology, Hospitalists and Nephrology are available. Relationships with local hospitals to ensure rapid response to emergencies.

Caring is Our Business.

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1010 Hornaday Road, Brownsburg, IN 46112 317-852-3123 www.brownsburghcc.com

18 Be... HEALTHY

Time to start LIVING HEALTHY

H

ealthy living is a combination of balanced eating and a fitness routine.

What is a balanced fitness routine? It is a routine that incorporates, strength training, cardio and flexibility. Many people struggle to find that balance.

Lifting weights at the gym and going for a run is simple for some, but others may need something different.

Did you know that the Washington Township Avon Fire Department offers free group fitness classes on Monday and Thursday nights to members of the community? Currently, Insanity and PiYo Live are the classes available to the public.

Monday night classes start at 6 p.m. with a 30 minute Insanity workout, followed by a 30 minute PiYo Live class at 6:45p.m. Many class members stay for both classes, totaling a full hour of exercise. The intensity of Insanity paired with PiYo is a perfect combination for balancing cardio, strength, and flexibility. These classes are offered at the Washington Township Park Pavilion Center. As you wind your way down to the Pavilion Center, you’ll enjoy the beautiful scenery of Washington Township Park.

Thursday night’s schedule is slightly different as PiYo Live is the only class offered. Class still starts at 6:00pm, but it is a 45 minute version of PiYo with 2 additional routines added on to Monday night’s routine. Light and

Life Church has been very generous to open their doors to the community to keep classes free. The church address is 8264 County Road 100 S. Avon, IN 46123

strengthening and relaxation. To top it all off, the music is awesome!

Nikki Ford, a current class member enjoys the fact that she can introduce fitness to her children and make fitness a family affair. “The PiYo class is wonderful and it is an amazing opportunity for our community that it is offered for free. Karen is able to reach out to those that want to make their life healthier but may think they can’t because of their budget restrictions. I love that PiYo is low impact but offers big results. Because of the PiYo classes being offered, I have been able to bring my 5th grade daughter and my middle school aged niece along with me and make fitness a family activity for my house.”

What is PiYo LIVE?

What is Insanity LIVE?

Flexibility training is essential, more so as we get older. If traditional exercise bores you, you may need something that keeps you moving and is fluid. Standing still while working out is hard for some to do.

What’s to love about PIYO? It is an athletic workout, which is inspired

by Yoga and Pilates, as well as the principles of stretch, strength training, conditioning and dynamic movement.

It is a pre-designed class that will get your heart rate going as it features various styles of continuous movement and flow from one exercise to another.

PiYo has been described as “yoga for hyper people”, but with the benefits of deep breathing, balance, stretching,

The cardio-based, total-body conditioning program is based on ‘max interval training’. Traditional HIIT (high intensity interval training) workouts, which can burn up to 750 calories in 45 minutes, feature short bursts of maximum intensity with longer periods of rest. But Insanity flips that formula upside-down by combining lengthier periods of high intensity exercise with shorter cool downs.

Developers have taken the principles of the successful Insanity home DVD series and created the ‘ultimate HIIT class’. This class is available at the Washington Township Park Pavilion Center every Monday night at 6pm.

Be... Spring 2015

» COM E JUDGE

for Yourself.

GOLFERS FROM AROUND THE WORLD COME TO CHALLENGE THE JUDGE and the two other golf courses in Prattville at RTJ Capitol Hill. Bring your clubs and come take on Judge hole number 1, voted the favorite hole on the Trail. Complete your day in luxury at the Marriott and enjoy dining, firepits and guest rooms overlooking the Senator golf course. With the Marriott’s 20,000 square feet of meeting space, 96 guest rooms and luxurious Presidential Cottage combined with three world-class golf courses, business and pleasure can definitely interact in Prattville.

THE ROBERT TRENT JONES GOLF TRAIL AT CAPITOL HILL is home of the Yokohama Tire LPGA Classic on the Senator Course September 18 to 24, 2014. The Marriott Prattville is part of the Resort Collection on Alabama’s Robert Trent Jones Golf Trail.

Visit www.rtjgolf.com or call 800.949.4444 to learn more.

20 Be... FIT

One

STEP

at a time Devan Strebing Hendricks County Flyer

Ballroom dancing couple instructs at HRH

C

arlos and Mary Kay Hood have been teaching ballroom dance classes for the past four years at Hendricks Regional Health.

Mary Kay is from Indianapolis and Carlos is from Kentucky. The two met at a dance studio while taking ballroom dance classes. And they’ve been dancing for 27 years.

“We were students for a while and we wanted to get into the other side of the business — teaching,” Mary Kay said. “I always tell people the joke is on us because we got into the business because we liked to dance together MARY KAY AND CARLOS HOOD instruct classes at HRH. but when you get in, you don’t dance with each other, you’re dancing with the students.” recent retirement.

The pair owned and operated the Arthur Mur“While we had the dance studio, I worked ray studio in Lafayette for 13 years. at HRH full time,” she said. “People knew we They taught ball room, which encompasses 12 danced and when they wanted to hold a fitness types of dances including Viennese waltz, boclass, dancing was an opportunity for some lero, samba, hustle, two-step, west coast swing, good exercise and they asked us if we would be cha cha, fox trot, waltz, swing and rumba. interested in teaching it.”

“It’s talked about as a touch dance or couple The Hoods offer a beginner class and an addance because you’re with a partner,” she said. vanced class throughout the week.

“It has brought both of us together.”

The beginner class is generally about six The couple has had hundreds of students of weeks long, and the couples are introduced in various ages. After selling the studio about nine the five dances most often used in social situayears ago, the Hoods were asked to instruct a tions: fox trot, waltz, cha cha, rumba and swing. ballroom dance class at Hendricks Regional “What we hope to achieve at the end of the Health where Mary Kay had worked until her beginner session is for them to know the basic

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The Hoods have more than 27 years of ballroom dancing experience.

Be... FIT 21

“It’s about social interaction — many people would be sitting on the side wishing they could do it, try it and have fun,” he said. “The biggest challenge is that a 45-minute lesson is equivalent to 1.3 miles of jogging. You will use muscles you normally never use. You will use muscle memory — the muscle picks it up instead of you thinking about it.”

— Carlos Hood

steps with a partner,” Mary Kay said. “We encourage them to not go home and practice — it sounds counterintuitive, however if they go home and practice and remember it incorrectly, we have to undo and relearn, which in the long run is harder.”

Classes at HRH are on Mondays with the

Be... Spring 2015

advanced dancers meeting from 7 to 7:45 p.m. and the beginners meeting from 8 to 8:45 p.m.

There are six couples in the advanced class and they all have about four years of experience.

Carlos says the biggest benefit of ballroom dancing has to do with couple “togetherness.”

“It’s about social interaction — many people would be sitting on the side wishing they could do it, try it and have fun,” he said. “The biggest challenge is that a 45-minute lesson is equivalent to 1.3 miles of jogging. You will use muscles you normally never use. You will use muscle memory — the muscle picks it up instead of you thinking about it.”

As for the kind of music that should be played during ballroom dancing, Mary Kay says it doesn’t matter if the music is old or new, as long as it’s a good rhythm for the dance.

“We’ll listen to Doris Day, Dean Martin, to “Blurred Lines” — whatever is good for the dance, we’ll play,” she said.

Dancing shoes for beginners should have a leather sole, the Hoods say.

“You need something that will move on the floor,” Mary Kay Hood said. “But if you get into this and want to continue, we recommend you buy dance shoes with suede on the bottom, so

22 Be... AWARE

Mary Kay and Carlos Hood instruct classes at HRH.

you can feel the floor as you’re dancing.”

The Hoods encourage everyone to try out this fun, minimum risk activity.

“You can come into a safe environment, learn the basics, be introduced to basic steps, and everybody learns at a different rate,” Mary Kay said. “We’ll work with you as much as we can to get you up to where everybody is. One of the good things about this is that you not only get

the man’s perspective, but also the woman’s. We teach as a couple. Come out and give it a shot.

Classes are offered in the basement of building 3 at HRH, 100 Hospital Lane, Danville. Cost is $72 per couple.

To register or for more information, contact Jill Woodward by calling 718-8160 or emailing to jawoodw@hendricks.org.

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Be... AWARE 23

It is certainly possible As we dive in a bit deeper into a new year, we need to talk about getting to that edge, and noticing what happens as we begin to cross over, outside of that “safe” comfort zone. As mentioned before, a shakiness, an uncomfortable feeling of not knowing that specific territory begins to set in.

Why did I use quotations with “safe?” Well, we often think of where we are at in a current job, relationship, economic status, weight, etc. as “safe” because nothing can happen to us at that moment. Our job is stable, our relationship is strong, our weight is consistent etc. But although these appear “safe” nothing truly is; there is downsizing, divorce and separation, and health issues that can drastically change what appears safe. The point I’m trying to make isn’t one in which to scare you, but more to open your eyes to your view on playing it safe. In other words, everything is risky, it’s just figuring out which risks are worth taking.

As Jennifer DeLucy questions above, what happens if one reason that we haven’t achieved something so close to our grasp is in all actuality fearing that it’s truly possible? As strange as it may sound, it happens all the time. We self sabotage our close success because we begin to truly feel the pull of possibility, and then all of our new fears of fitting into that sought after success becomes downright overwhelming!

Clearly, fear becomes the bad guy again. Thinking too much of what our vision of success might require can be daunting. But, like with most things, we tend to over exaggerate our fears, making them out to be so much larger than what that success may actually be.

After working with clients over the years, it’s amazing to witness the shift that occurs once she begins to see that she is the only one standing in between where she wants to be and where she currently is.

Remember there is a line in between your comfort zone (your current state) and your desire (your future state) … and NOW is the time to cross it. And, yes, it does involve a leap of faith in doing so.

Visualization time Imagine yourself across that line. What does it feel like? What does achieving and living in your desire actually feel like?

Your immediate reaction might be: “Meg, I don’t know … I’m not there yet?”

And this, my friend, is where the true beauty lies … you (yes YOU) have the power within your mind of cre-

Be... Spring 2015

ating what that specific desire feels like.

As Tony Robbins always says, «what you desire is actually attached to a feeling.» What you really want is the feeling that is associated with whatever your desire is. Now is the time to dig a little bit deeper and truly get to the root of that feeling.

This week (the sooner the better) take time, and visualize what you will feel like once you conquer your fears by taking that leap of faith over your fear threshold, and start basking in your desire’s light. There are no rules; this is your vision and your desire.

Clearly paint that picture in your mind. You can’t see clearly through a window if the glass is dirty, so clean up your focus and create that clarity as best as you can. Yes, it takes a bit of time, but don’t let that stop you. Taking the time now will save you from repeating this same “resolution» in 2016. We don’t do the typical ‹week long resolutions› here, we manifest our desires this 2015! Have the Best FUEL-filled day ever!

Megan Church Megan Church is CEO of MangoFuel LLC. Contact her at mangofuel3@gmail. com

24 Be... FIT

KYLE SCHLICHTER coaches gym member Bruce Whitley of Brownsburg on some planks.

Communityminded

By Steven Penn Hendricks County Flyer

BRUCE WHITLEY works his chest.

W

hen it comes to a place to work out, Exact Fitness coowner Kyle Schlichter said there’s one difference between his gym and a big corporate one: “We care.”

Schlichter and his partner Rachel Younger have been operating Exact Fitness at 1551 N. Green St., Ste. P,

Exact Fitness offers alternative to corporate gyms Brownsburg.

Both said they have history working in more corporate gyms that have no ties the community.

Schlichter said he’s been working in fitness for more than a decade and has managed several gyms and has even worked for an assisting living facility, running their exercise classes.

Younger said she’s always been drawn to fitness.

“I was always very active when I was younger and I always played sports,” Younger said. “That’s kind of how I ended up in fitness.”

For Schlichter, when he saw a corporate gym up and move from the community, he knew it was time to change his approach.

Be... Spring 2015

Be... FIT 25 “That really inspired me to stop working for these corporate gyms that have no investment in the community,” he said.

Younger said that’s what makes a family-owned, community-minded gym like theirs different.

“I get that they care about money and it’s important, but they don’t care about their members,” she said. “They don’t know what goes on here. That’s where we’re different.

That’s how we stand out from different people. We actually care about our members. We listen to what they have to say.”

As for the equipment, Schlichter said he did plenty of research and settled on Star Trac machines. He found that a lot of professional and college sports teams are using the equipment, which was previously more known for its cardio machines.

“It’s iso-lateral equipment,” he said.

“That’s one thing that’s different about our equipment … your right side and your left side work independently whereas most machines you sit down and it’s just (both arms).”

That helps create more of a balance between your extremities you are working, Schlichter said.

He added that there are also plenty of free-weights at his gym and they are still working to add more equipment.

“We still haven’t gotten 100 percent of all our stuff yet,” Schlichter said. “We’re still missing one piece. We’re always trying to figure out what we need. We’ll add things as time goes on and we’ve had a couple requests for some things.”

Both Schlichter and Younger are certified personal trainers and offer their services to their members.

Taking the input of their members is something Younger said makes their gym stand out.

“If people have suggestions or Be... Spring 2015

RACHEL YOUNGER wipes down a machine. Younger and Schlichter both know the importance of running a clean gym.

THERE IS A GOOD MIX of both free-weights and machines at Exact Fitness.

they want something, we actually will listen and try as hard as we can to accommodate their needs,” she said.

They have also understood the growing trend of gyms being open 24/7 and offer that at their place.

“That was my biggest complaint when I went to a local gym in town that’s not 24 hours,” Schlichter said.

“If I go to church on Sunday, maybe I don’t get out of there until 1 p.m. and it closes at 3 or 4 p.m. I don’t think we get a lot in the middle of the night, but weekends are important too.”

Younger agreed.

“It’s nice that they don’t have to go by our schedule,” she said.

They also understand most people don’t like to be tied to a long contract that’s why their memberships are month to month.

Following the trend of being tied to the community, Schlichter said they commissioned all the work they could for their gym to local businesses.

“Everything that we could do, we did locally,” he said. “Our mirrors are done in Brownsburg, our flooring is from Brownsburg, and our contractors. Everybody was people from this community that we could.”

For more information about Exact Fitness, visit the website at www.ex actfitnessclub.com or call 456-4944.

26 Be... AWARE

Hospital mistakes kill too many Few people go to the hospital expecting their hospital stay to kill them. But sometimes it does.

No one is sure of the precise number of people who die because of mistakes made in hospitals, but it’s not small. Every patient is potentially at risk.

Even though hospitals don’t intentionally harm people in their care, they have not faced any bottom-line penalties when they do. That’s now changing.

In 1999 when the Institute of Medicine (IOM) issued its landmark report, “To Err is Human,” it estimated as many as 98,000 people died each year because of hospital errors.

In 2010 the Office of the Inspector General for the Department of Health and Human Services found that bad hospital care contributed to the deaths of some 180,000 Medicare patients in a given year.

And in 2013, John James, a NASA toxicologist, found that as many as 440,000 patients suffer preventable harm in hospitals every year. His report was published in the Journal of Patient Safety.

Why are so many Americans still dying from preventable mistakes 16 years after the IOM called attention to the problem?

I explored this question and others recently with Dr. Ashish Jha, professor of health policy at the Harvard School of Public Health and one of the country’s leading experts on patient safety.

Jha told me no one really knows why hospitals have not reduced the harm caused by

mistakes.

“While we have clearly made some progress in a few areas, there has been little progress in other important areas of patient safety,” he said.

Rates for surgical site infections and central line infections are down 40 to 50 percent nationally. (Central lines are catheters inserted in the chest or neck veins to administer fluids and medicines to critically ill patients.) But Jha said studies show little to no progress on reducing catheter-related urinary infections, which can be fatal.

“The latest data from the Centers for Disease Control and Prevention says these rates are just not meaningfully getting better.”

He added that blood clots continue to be a problem even though “‘we generally know how to prevent them.” Blood thinners and special boots that keep blood from stagnating can be helpful, but not all hospitals are using them.

If we know how to prevent these problems, why aren’t we doing that?

“To be frank it really isn’t anyone’s top priority — except maybe the patient,” Jha told me.

Hospital CEOs generally don’t get fired because of the hospital’s infection rates. Salaries are tied to things like fund raising and having high-tech equipment. “There’s no evidence that having a high infection rate or a high mortality rate has any effect on CEO salaries,” Jha said.

But hospitals could soon see their bottom lines suffer. In December Medicare announced

it was penalizing 721 hospitals across the country that it determined have high rates of exactly the kinds of errors Jha talks about. These include central-line infections, catheter- associated urinary infections and serious complications based on injuries including blood clots, bed sores and falls.

Hospitals penalized for these complications lose 1 percent of each Medicare payment made to them over the year.

This means the loss of tens of thousands or even hundreds of thousands of dollars.

I looked at Medicare data for hospitals in the four states participating in the Rural Health News Service and yep, there were penalties assessed — some against well-known hospitals.

One-third of all eligible hospitals in Colorado and almost onethird of those in Nebraska were penalized. In Indiana and South Dakota, fewer than 20 percent were. Some hospitals like small critical access hospitals and children’s hospitals are exempt.

So you see, even the big wellknown hospitals can pose safety risks to patients. Since most errors are caused by systemic failures, what can patients on their own do? You can examine data for hospitals in your state using the government’s Hospital Compare site http://www. medicare.gov/hospitalcompare/ search.html, and check the http://patientsafetyamerica. com/ website of Patient Safety America. You should speak up if you think something isn’t right.

Trudy Lieberman Trudy Lieberman is with the Rural Health News Service. The organization is funded by a grant from The Commonwealth Fund and distributed through the Nebraska Press Association Foundation, the Colorado Press Association, the South Dakota Newspaper Association and the Hoosier (IN) State Press Association.

Be... Spring 2015

HI, I’M JOE TAYLOR. Overton, Texas. What keeps me coming back to the Trail? It’s just absolutely sensational.

I have people tell me what they’ve spent playing one round at Pebble Beach and a night at the hotel, or going to Pinehurst for a couple rounds. We do the entire week, travel, hotel, green fees, good meals and everything for the price of one day at these places. And it’s absolutely a sensational place to come.

TO PLAN YOUR VISIT to Alabama’s Robert Trent Jones Golf Trail, visit rtjresorts.com or call 1.800.949.4444 today. facebook.com/rtjgolf twitter.com/rtjgolf

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28 Be... AWARE

By Melissa Gibson

Varicose veins erased with less painful procedure

A

s patients get older, some find themselves covering up their veins. Men and women refuse to wear shorts, are embarrassed at the gym or avoid public outings.

Many are afflicted with spider veins, varicose veins or other unsightly vein issues. But when does cosmetic become a health issue?

Not only are patients beginning to notice their veins and asking questions, but technology is also improving for interventional radiologists like Francis Marshallek and director of the department at Indiana University Health West Hospital Dr. Robert King.

Marshallek There are several diagnoses concerning vein health, including atherosclerosis, Buerger’s disease, chronic venous insufficiency, deep vein thrombosis (DVT), Raynaud’s phenomenon and thrombophlebitis.

Varicose veins and spider veins are perhaps the most common.

Varicose veins occur when the blood flow has changed in the vein causing it to swell.

Most leg vein problems begin when the vein valves that prevent the blood from flowing in the wrong direction become weak or malfunction. This causes blood to pool in the veins, forcing them to protrude from the skin becoming tortuous or rope-like.

“Typically, blood flows toward your heart,” Marshallek said.

PAINLESS PROCESS: The process of endovenous ablation is painless and recovery time is much quicker than past procedures.

“When that process reverses, we call [the vein] incompetent.”

Marshallek said up to 25 percent of females and 15 percent of males are affected by incompetent or insufficient veins.

The least evasive treatment is the use of compression stockings.

Unfortunately, patients often find stockings uncomfortable and stop wearing them, causing further damage to the vein.

“Venous insufficiency occurs when the valves of the leg veins do not function properly. This may occur for many reasons, most commonly it is hereditary,” King said. “The first stage is the appearance of varicose veins that occur commonly in the legs. In this stage, there are no symptoms associated with the abnormal veins.

Many people with varicose veins never progress beyond this first stage.”

The difference is when veins progress from unsightly to painful.

The majority of patients that undergo treatment seek a doctor’s opinion due to symptoms: pain,

restlessness and aching at night.

The issues are very common post pregnancy, with the use of birth control pills or hormone replacement therapies, a lack of exercise, prolonged sitting and standing, and aging.

“I am frequently asked by patients who want to know if these veins should be treated or even what the treatment options are, King said.

When varicose veins are present in the absence of other signs or symptoms, we generally do not recommend treatment. That is not to say, I haven’t treated veins in this stage, I have. However, in the absence of other signs or symptoms, treatment is considered a purely cosmetic procedure.”

Regardless of the reason, those seeking treatment are now experiencing a less evasive, less painful alternative to the previous answer to vein correction.

Previously, treating insufficient veins required a procedure called ‘surgical stripping.’.

“Surgical stripping involves the superficial veins of the skin, Marshallek said. “Surgeons used to remove the vein — the same vein they use for a heart bypass, so it’s not really needed.

“The procedure would keep the patient in the hospital for a couple of days and then in bed for a couple of weeks. In the end, the patient would have a big scar.”

Today, standard of care is called endovenous, a procedure in which the interventional radiologist causes the vein to collapse.

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Be... AWARE 29

“The endovenous is an in-office procedure,” Marshallek said. “The patient lies down on the table; we introduce a small laser in the vein and in essence, burn the vein.”

He said the procedure is effective more than 98 percent of the time, the patient wears stockings for two weeks to ensure success of the procedure, and they have a band aid on one little incision.

Marshallek said the most painful part is the local anesthesia used to numb the leg. Burning the vein is not painful at all.

Spider veins are small blood vessels on the surface of the skin. They often appear small, web-like and are red or purple in color.

A common procedure to treat spider veins, called sclerotherapy or “injection therapy” is a mild chemical solution injected in the incompetent vein or capillary. The sclerosing agent irritates the walls of the vessel, causing it to collapse.

The blood can then reroute to healthier veins. Spider veins will dissolve and disappear over a period of about four to six weeks after treatment.

Patients can have both varicose and spider veins and both are a reflection of insufficient veins.

In fact, the new procedures have sparked patient interest with the promise of less painful options.

“There is now a large body of scientific data that shows patients who undergo percutaneous venous ablation have a faster recovery time, less post-operative pain, less recurrence compared to surgical ligation,” King adds. “Most of my patients are back to work the day after their procedure and are exercising again by day two or three. Patients like this and seek

Be... Spring 2015

COMPROMISED VEINS: A typical varicose vein appears on the leg as blood pools at the calves and feet.

“There is now a large body of scientific data that shows patients who undergo percutaneous venous ablation have a faster recovery time, less post-operative pain, less recurrence compared to surgical ligation.”

—Dr. Robert King this treatment option out because of it.”

Insurance pays for those situations that have progressed to painful or have become a hindrance to the patient’s daily life.

“A patient experiencing leg pain and/or swelling and having varicose veins should consult with an interventional radiologist to see if they are a candidate for treatment,” said King.

How serious can vein insufficiency get?

King says there is a broad spec-

trum from painless varicose veins to venous stasis ulcers.

“Lower leg ulceration is the end result of long standing untreated venous insufficiency. These ulcers are difficult to treat with wound care alone. The underlying problem must be addressed in this stage or the patient will suffer with non-healing ulcers for years,” King said.

“Fortunately, there are minimally invasive techniques available to aid in wound healing. I see a lot of these patients in my clinic. However, with the proper management and treatment we can prevent the vast majority of cases from advancing to this stage.”

Unfortunately, there is no direct way of avoiding varicose or other vein insufficiencies. Marshallek suggests using stockings before the patient presents symptoms.

For instance, those working on their feet frequently — nurses, teachers, waiters and stock brokers — are at risk as are those sitting for extensive periods of time, such as truck drivers, postal workers and those working at desk jobs.

Doctors recommend those knowingly at risk should wear stockings before they begin suffering from symptoms.

Marshallek adds, “Weight-loss is always recommended,” and steps may or may not avoid vein issues.

“The problem is, with stockings, once they are off, the veins swell back up again, so it’s just a temporary fix.”

Patients suffering from vein insufficiency or curious about cosmetic vein correction should consult their Interventional radiologist.

30 Be... HEALTHY

New study assesses hospice s hospice for nursing home patients grows dramatically, a new study from the Regenstrief Institute and the Indiana University Center for Aging Research compares the characteristics of hospice patients in nursing homes with hospice patients living in the community.

The study also provides details on how hospice patients move in Nationally, and out of these an estimated two settings.

40 percent Longer lengths of Medicare of hospice care, recipients die rising costs and with hospice. concerns over possible duplication of services have led to increased scrutiny by policymakers of hospice patients living in nursing homes. Nursing home patients have longer hospice stays compared to individuals living in the community.

The researchers, led by Regenstrief Institute investigator and IU Center for Aging Research scientist Kathleen Unroe, M.D., MHA found that nursing home hospice patients were older, more likely to be women, more likely to be on both Medicare and Medicaid, and more likely to have dementia than individuals receiving hospice services outside a nursing home.

Nationally, an estimated 40 percent of Medicare recipients die with hospice.

In the study, one in three Medicare recipients died with hospice.

Cancer was the leading primary diagnosis for all hospice patients,

A

although nursing home hospice patients were as likely to have a dementia diagnosis as a cancer diagnosis both nationally and in the study.

“Hospice is a poor fit for many people in nursing homes due to the way eligibility criteria currently are configured,” Unroe said. “Yet nearly a third of hospice patients in the United States live in nursing homes, and the number is growing. Our goal is to understand more about who uses hospice and where they live so that policymakers can make informed decisions as they contemplate redesign of the hospice benefit.”

Using 11 years of data, the researchers initially planned to contrast only the two groups: those who received hospice care in nursing homes and those who received hospice care in the community.

But Unroe said it became apparent that that there were four groups that needed to be studied: • Patients receiving hospice care only in nursing homes; • Individuals who received hospice services only in non-nursinghome settings; • Crossover patients who used hospice in both settings; and • A transition group who received hospice care within 30 days of transition in or out of a nursing home.

Medicare spending on crossover and transition hospice patients was higher than Medicare costs for hospice patients in nursing home or in the community, according to the new study.

While nursing home patients have longer hospice stays compared to individuals living in the community,

the number of days on hospice was significantly higher for the crossover group than for any other group.

Nearly a third of crossover patients had hospice stays greater than six months.

Overall, for the four groups, 28 percent of patients had a hospice stay of less than one week.

“Policymakers need to look at all four groups and consider potential consequences of regulatory decisions for these patients,” Unroe said.

The 3,771 patients in this study were identified through Eskenazi Health (Wishard Health Services at that time), one of the largest safetynet health systems in the country.

Data from Medicare, Indiana Medicaid and other sources capturing use of hospice services inside and outside Eskenazi Health was evaluated.

“Hospice Use Among Nursing Home and Non-Nursing Home Patients” appears online in advance of publication in a future print issue of the Journal of General Internal Medicine.

Study authors, in addition to Unroe, are Regenstrief Institute investigator Greg A. Sachs, M.D.; M.E. Dennis, B.A.; Susan E. Hickman, Ph.D., of the IU School of Nursing; Timothy E. Stump, M.A.; and Regenstrief Institute investigators Wanzhu Tu, Ph.D., and Christopher M. Callahan, M.D. Dr. Callahan is the founding director of the IU Center for Aging Research.

The study was supported by grants from the National Palliative Care Research Center and the National Institute on Aging.

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