Health Guide Spring 2016
TRANSPLANT
DONATION saves one local man’s life p. 6 GET OUT & PLAY with The B.U.R.G. p. 30
CHIROPRACTICS: A non-traditional health practice p. 18
A publication of
Standard Fredericksburg Radio Post
Article Index Good Samaritan Center .................................. 4 Organ transplants ............................................. 6 Dental health...................................................... 9 Exercising on a budget ................................... 13 Orthopedic Journey ....................................... 16 Chiropractic care ............................................ 18 Eye health ......................................................... 20 Sunscreens and skin health ......................... 24 Heart health ..................................................... 26 Living with Alzheimer’s ................................ 28 Pre-diabetes ..................................................... 29 The B.U.R.G. .................................................... 30
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Healthy, at work and out of the hospital With Good Samaritan Center’s Medication Assistance Program By John Willome Executive Director
Have you ever been sitting and watching TV when an ad comes on for a prescription medication? After the requisite benefits and dangers of the medication are listed, you might hear the words, “If you cannot afford your medications, (insert pharmaceutical company name here) may be able to help.” A lot of people hear those words and think that they aren’t for them. Guess what. If you make around two times the federal poverty level (e.g. a family of four making less than $48,700 per year) and have no insurance, then most of the pharmaceutical companies offer many of their medications to you at no cost. The catch is, there is a lot of paperwork to fill out. That’s where The Good Samaritan Center’s Medications Assistance Program (MAP) comes in. We currently help around 540 patients get over $1 million worth of medications through MAP. There can be a lot of paperwork, and if a patient is on three or four chronic medications, that can mean three or four different companies and three or four different sets of paperwork. That would be too much for most of us to do on our own. We have an incredible staff member, Tatiana Neri, and three generous volunteers, Barbara Birchfield, Sherri Major and Esther Shaffer, who get it done for the patients. We just charge a $5 per 90-day supply that the patients pick up as an administrative fee. The center doesn’t only provide this service for its own patients, but any patient who has a Gillespie County doctor. Why punish people for using a doctor of their choice?
On your mark, Get Set,
Tatiana Neri, with the help of three volunteers, assists patients in getting their medications through The Good Samaritan Center’s Medications Assistance Program. — Submitted photo
We didn’t want to tell someone that they have to be our patient to take advantage of this program. If they are happy with their physician, then Tatiana will work with them to get them what they need. It’s about helping people in financial need to be as healthy as possible. More and more patients are in need of medications for chronic ailments such as diabetes, hypertension and asthma. Being able to affordably obtain and take these medications can mean the difference between living a full, healthy life and missing work and ending up in the hospital. While the clinic does charge patients a small administrative charge for the service, the fees do not cover costs to operate the program.
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We spend about $25,000 per year in direct costs to provide this program, but we only receive about $9,000 in patient fees. The rest is covered through donations that come from the general public. This year, we were able to raise most of that through a special push we did through The Big Give SA on May 3. The Good Samaritan Center is a charitable medical, dental and mental health counseling clinic that helps low-income individuals and families that are uninsured. If you think you might qualify for medication assistance from pharmaceutical companies, want to apply to be a medical/dental patient at the center, or would like to make a donation, call 830-990-8651 or visit it online at www.goodsamfbg.org.
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Transplants: Lifesaving solutions By Sandra Lane
Only a couple of years ago, Fredericksburg resident Ross Bigelow felt he was near death. “I was as sick as sick could be. My heart had started a downward slide, and I felt that I was within a few days of dying,” he said. “I had a lot of fluid buildup because my heart was not working well, and I had an ashen color.” He said that he was confined to a hospital in San Antonio and was put at the top of a list to find a new heart. “I was in intensive care for five weeks,” he said. “Looking back, I probably didn’t realize how bad it was.” Bigelow said he had experienced three heart attacks before his final collapse. The first one occurred when he was working in the U.S. Foreign Service in Cairo, Egypt, in 1998. The second happened in 2008 when he was playing tennis in Fredericksburg, and the third was in 2013 while he was attending church. After that, Bigelow said his health continued to decline until he finally wound up in intensive care in the summer of 2014. After spending five weeks in intensive care, he said he had almost given up hope, when one day, a doctor came into his room and said, “We have a heart. We’re 90 percent sure it’s the right one, and we’re running tests,” This seemed like a miracle to Bigelow. “Everything has to happen quickly in doing transplants,” he said. “It’s a major accomplishment to do the matching up. You only have a few hours between the time the donor passes and the time the recipient is on the operating table. It takes a large team of people you don’t even know to work behind the scenes.” Bigelow’s transplant occurred on July 24, 2014, and only took two hours. Though there were issues
Ross Bigelow is back on the tennis courts taking part in the sport he loves after receiving a lifesaving heart transplant in 2014. — Standard-Radio Post/Yvonne Hartmann
7 The family of the late Jacob Krebs stands by his floragraph, which appeared in the Rose Parade in Pasadena, California. The portrait was placed on the Donate Life float that appeared in the 2015 New Year’s Day parade. Pictured from left are sister, Julie, and parents William and Mary Krebs. — Standard-Radio Post file photo
Krebs was found unconscious in issues from the incision and the swimming pool at Hill Country that required them to replace GET ON BOARD Memorial Wellness Center a few some of his blood, he neverTo sign up for the organ donation program, go to years ago while training to be a theless survived. Today, he www.donatelifetexas.org or sign up when renewing drivers’ licenses. To speak with someone about this proNavy SEAL. After a few days on has resumed a normal life. gram, call TOSA at 866-685-0277. life support, he was declared brain Although he will have to dead and died on April 1, 2013. An take anti-rejection drugs for outstanding student, athlete and the rest of his life, he said that Eagle Scout, Krebs was scheduled does not concern him. to graduate from high school in a few weeks. Bigelow is active and enjoys physical activities. Friends said that Jacob always seemed to be wise beyond his years. “Recently, I participated in the Wildflower 5K and 10K Run/Walk at When he obtained his driver’s license at 16, he had designated that he Marktplatz, and I also play tennis,” he said. wanted to be an organ donor. Upon his death, that decision had already Bigelow, who has a Ph.D. in geography, is also teaching classes at the been made, and his parents asked that his organs and tissues be donated Hill Country University Center in Fredericksburg. to military veterans. Eventually, he learned about the person who gave him his new heart. The gift and distribution of the organs was also handled by the Texas He learned that the man who gave him another chance at life was 37 Organ Sharing Alliance in San Antonio. years old and had died in a military hospital in San Antonio. Many people today are aware of this valuable gift and have indicated “Doctors look not only for similar blood types, but also for someone on their drivers’ licenses that upon their deaths, they would like their with similar size and height,” he said. “When they find a donor with organs to be used for transplants. similar genetics, transplants are successful.” Residents of Gillespie County have already been involved in this giftBigelow praises his medical team and the Texas Organ Sharing Allisharing, and statistics show that 47 percent of Gillespie County resiance (TOSA) in San Antonio, one of 58 federally designated organ procurement organizations in the United States. This group provides organ dents have indicated that choice on their drivers’ licenses. Although more than eight million people have registered with Donate donation and recovery services to families wishing to donate and those Life Texas, more people are needed because TOSA staff members say waiting for a life-saving organ transplant. there are 13,000 people waiting for life-saving transplants. Most people in Fredericksburg remember when 18-year-old Jacob
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Joseph M. Cohn, M.D. Agility Orthopaedics & Sports Medicine Specializing in Shoulders, Elbows, Knees & Ankles
Joint Replacement Orthopaedic Surgery Plasma Rich Protein (PRP) Therapy Serving Fredericksburg, Brady & Kerrville
1305 North Milam • Fredericksburg • 830-266-5576 Call for an appointment Office Hours: Monday - Thursday 8:30am to 5pm (Closed daily from 12 to 1 for lunch) Friday 8:00am to 12pm
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“Because Life Requires Motion”
Checkups help preserve dental health Having a nice smile goes a long way. Healthy teeth makes it easy to smile, while some whose teeth could use some work might be reluctant to smile. The teeth are like other parts of the body: to keep them, they must be maintained and properly cared for. If they aren’t, the result can be either expensive visits to the dentist or transitioning to dentures. Will Stehling, DDS, a dentist in Fredericksburg, offers his seven top dental care tips. 1. Brush and floss regularly. Regular brushing and flossing helps to remove food debris and bacteria (plaque) from the teeth and gums. This helps to prevent decay (cavities) and gum disease. “It also has the added benefit of freshening your breath,” Stehling said. 2. Limit intake of sugary and acidic foods and beverages. The bacteria that cause cavities eat sugar and break it down into acids that erode away tooth enamel. Acidic foods and drinks also erode tooth enamel. Carbonated soft drinks and sugary sports See DENTAL TIPS ▶ 10
With his dental assistant, Mandie Cook, local dentist Will Stehling, DDS, gives a patient a
checkup. He recommends regular dental visits. — Standard-Radio Post/Richard Zowie
LEIGH ANNE BAINS, M.D. GENERAL NEuRoLoGy Movement Disorders Specialist • Parkinson’s Disease & Related Disorders • Tremors • Restless Leg Syndrome • Headaches/Migraines • Dizziness • Peripheral Neuropathies • Seizure Disorders • Muscular Disorders
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For Appointment call 830-997-3283
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DENTAL TIPS
Cont. from 9
drinks make matters worse since they contain both sugar and acid. Many of the popular sour candies available also contain this dangerous combination of sugar and acid. 3. Visit the dentist regularly. Every six months is recommended. The dental hygienist will remove plaque buildup (tartar or calculus) that cannot be brushed or flossed away. Fluoride may also be applied to help strengthen teeth. “You will be checked for dental decay, gum disease, oral cancer and signs of wear from tooth grinding, also known as bruxism,” Stehling said. 4. Children should visit the dentist within six months of their first tooth erupting. Starting regular visits at an early age will help the child become comfortable with visiting the dentist. It also gives the dentist an opportunity to discuss the child’s habits such as pacifiers, thumb sucking, sippy cup use, and diet with the parents.
Mills & Associates Physical Therapy Frank Mills, PT Owner Melinda Mills, PT Owner Autumn Holland, PTA Carol Johnson, PT Kay Wright, Office Manager Roger Trinkle, Office Coordinator
5. Seal out decay. Permanent molars start erupting around the age of six. A sealant is a protective coating applied to the chewing surfaces of the molars. Sealants help prevent decay in the pits and fissures of these teeth. 6. Many medications can cause a dry mouth. Saliva naturally helps to cleanse the teeth and buffers (neutralizes) and acids that may be present. “If you have a dry mouth, using sugar free gums or mints sweetened with xylitol can lessen your symptoms,” the dentist said. “There are also saliva substitutes and oral moisturizers that your dentist may recommend.” 7. Avoid tobacco. Tobacco use not only stains the teeth, it significantly increases a person’s risk of gum disease and oral cancer. A person who’s considering quitting can get appropriate resources from their dentist. One such resource is The American Lung Association: www.lungusa.org
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Comprehensive Orthopaedic Care • Hand Surgery • Total Joint Replacement • Arthritis Treatment • Sport Medicine Surgery
J. Steven Hoerster, M.D. P. Charles Romanick, M.D. Clint R. Beicker, M.D. Board Certified/Eligible by The American Board of Orthopaedic Surgery
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Working out without breaking the bank Trainers, cardio machines, and gym memberships may come to mind when the term work out gets tossed around; however, a health conscious person doesn’t have to break the bank to promote long-term health. Here are five exercises a person can do on the cheap at home or in the office. Quick exercise routine Do three sets of 15 to start 1. Partial-body push-ups (with knees on the floor). 2. Modified jumping jacks. Rather than moving arms over the head, press the palms of the hands together at chest level, holding elbows out to make a straight line. 2. Chair crunches. Sit on a chair with hands under the behind, arms straight, and fingers facing inward toward one another. Contract the pelvis and lower abs, and, keeping knees bent at a 90-degree angle, lift feet off the floor and tuck knees in toward the chest while bending upper body slightly toward the knees. 3. Chair dips. Place hands on the side of the chair and wrap fingers around the edge. Scoot forward until the bottom is on the edge of the chair and arms are fully extended. Keep feet three inches apart with legs extended, so the knees are at a 150 degree angle with the heels grounded. With elbows pointed back and tucked in tight alongside the, lower the body and hold for three seconds down and one second up. Keep the chest up and shoulders back. Use household items to substitute for fitness equipment. Soup cans and milk jugs can be used as weights. Paper plates can be used as body sculpting equipment. Use the plates to help the body slide on a carpet for sliding lunges (put the paper plate under one foot and lunge forward); skating (attach the plates to the feet with rubber bands) or chest workouts, on all fours, place plates under the hands and work the chest by sliding arms back and forth. Pantyhose can be used for resistance bands. Any exercise can be done with a resistance band. Fredericksburg workout options Anytime Fitness – $36 per month, 18-month membership; 1420 E. Main St., Fredericksburg, 830-992-3713 See WORKING OUT ▶ 15
Fredericksburg features plenty of places and options for those who want to work out but are doing so on a budget.
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MID-TEXAS HEALTH CARE FAMILY MEDICINE DaviD Cantu, M.D. Yvonne Haug, M.D.
Accepting New Patients • child & adult • urgent sick visits wellness • family planning • immunizations • hospital & nursing • newborn care home care
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The Paige House Ron Rickerhauser, PhD Dr. Rickerhauser is a Licensed Professional Counselor - Intern supervision provided by Eric Cardwell, LPC-S
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3021 S. State Hwy 16, Suite 105 Fredericksburg, TX, 78624
Luxury Retirement Living
Fredericksburg’s premier Retirement/Assisted Living community. We provide the perfect venue for living well. For some it’s music or gardening, faith or pets. For others it’s relaxing or entertaining in their private suites, or celebrating connections with family & friends in the community common areas. At The Paige House you’ll discover life enhancing programs in tune with your interests and lifelong passions. If assistance or enhanced care is desired, it will be provided with compassion and expertise.
Services offered include:
Three meals a day served in a common dining area or room service, weekly housekeeping, scheduled transportation, 24-hour personal assistance, personal laundry, social and recreational programs & other services tailored to your needs.
We welcome the opportunity to serve you and your loved ones. For more information, please call 830-997-4613 or come by 2230 N. Llano for a tour. thepaigehouse@gmail.com
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WORKING OUT
Cont. from 13
Crossfit830 – $125 a month with discounts for teachers, students, police, fire, military 733 Brehmer Lane, 830-285-8007 CrossfitFBG – 1316 Texas 16 South, Suite B www.crossfitfbg.com FISD Community Ed Exercise Class – $35 per month; Fredericksburg Elementary School 900 Gym; Contact Carol Reeh at 830-997-7182 for a list
of all exercise classes HCM Wellness Center – $10 day passes; $60 monthly and annual options. 1006 Texas 16 South, Suite B 830-997-1355; wellness@hillcountrymemorial.org Lizard Dreaming Yoga – $15 drop-in class and $100 for 10 classes; 724 Mustang St., 830-992-8840;
info@lizarddreamingyoga.com FACTOIDS: A 2013 study from Centers for Disease Control and Prevention estimated that 80 percent of American adults do not get the recommended amounts of exercise each week. The World Health Organization recommends that adults from 18 to 64 get at least 150 minutes of moderate-intensity aerobic activity each week, or at least 75 minutes of vigorous-intensity aerobic activity each week.
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Choosing the best orthopedic journey By Lindsey Bertrand
It may start as a twinge or an ache. It may come from an old sports injury or from arthritis. Whatever the kind or cause of joint pain, it doesn’t have to limit your life. Instead, it can be treated with a range of options. “Everyone’s experience with joint pain is different,” says Marilyn Berry, RN. Berry, the coordinator for Hill Country Memorial’s Restore joint replacement program, lived with knee pain for many years before she had knee replacement surgery in 2007. If joint pain severely limits your daily activities, she recommends working with an orthopedist, a physician specifically trained in caring for the bones, muscles, ligaments, tendons and joints. “It’s important to let your doctor know if you’re in pain so that you can work together to determine some possibilities for treatment,” Berry said. Those treatments cover a spectrum of options. Hill Country Memorial physical therapist Angela Austin assists a patient with balance and strengthening exercises. — Submitted photo
BRINGING BACK TO FULL FUNCTION.
Mark Ball, MSPT Clinic Director
Certified Kinesio Taping Practitioner®
Kristin McKinnon, MPT Alice Hahn, P.T., DPT
• Orthopedic Care • Sports Medicine • Hand Therapy • Cancer Related Fatigue • Vestibular Rehabilitation • Therapeutic Massage
1425 E. Main St., Suite 600 • Fredericksburg, TX 78624
Tel. 830-391-8009 • Fax 830-990-9088 www.fredericksburgpt.com
Hours: Mon. - Thurs., 7-6, Fri., 8-5
17 Lifestyle changes that focus on managing your weight and maintaining a healthy level of physical activity can go a long way to easing pain. Losing even a few pounds and walking three times a week can be beneficial in reducing pain and preserving flexibility. Physical therapy can also help, says Clay Holland, director of physical therapy at the HCM Rehab Center. “Having a specific set of exercises designed by a physical therapist for you can make a huge difference in maintaining your mobility,” he says. “And the therapist is there to work with you when you have questions or need help.” The HCM Rehab Center’s therapists can also recommend low-impact exercises to be done in the HCM Wellness Center’s heated therapy pool. These “hydrotherapy” exercises can be done individually or with the Wellness Center’s Arthritis Therapy class three times a week.
Many clients enjoy the supportive and encouraging atmosphere of the group class, Holland said. An orthopedist may also recommend injections of steroid medication for pain management. Such injections are administered as needed by an orthopedist in his or her office. They are intended to reduce pain and restore function. If your joint has deteriorated significantly and your pain is not managed well with other treatments, you may be a candidate for surgery. If so, you still have options. An arthroscopic surgery is a less invasive pro-
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cedure designed to repair or remove damaged tissue. With advances in surgical technique and post-operative pain management, patients who choose total joint replacement surgery can often go home within two to three days of surgery. Wherever you are on the orthopedic journey, there are options. “You don’t have to live with pain, but you do have to take action,” Berry said. “Most importantly, talk with your orthopedist to determine the right course of action for you.”
For those who may be candidates for joint replacement surgery, HCM offers a pre-operative education class every Monday at 1 p.m. at the hospital. To learn more, call the Restore coordinator at 830-990-6134.
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Neal Cobb, D.C., moved to Fredericksburg two years ago and opened his chiropractic clinic here after practicing in the Houston area. At his clinic, he offers some of the latest non-traditional treaments. — StandardRadio Post file photo
Chiropractic care a health option By Sandra Lane
Many people today are turning to non-traditional health practices to improve their health. Chiropractic treatments are becoming more popular because they offer non-surgical and drug-free solutions for many health challenges. One of the most recent chiropractors to establish a practice in Fredericksburg is Neal Cobb, D.C., who moved to Fredericksburg two years ago after practicing in the Houston area. His clinic offers some of the latest non-traditional treatments. “We’re into whole body wellness,” Cobb said. “It’s not only about getting rid of pain, it’s about functionality, too. We get our patients not only out of pain, but back to doing things they want to do again.” “I use all sorts of treatments, depending on the patient,” he said. “There is a recent method for treating disc herniations called non-surgical spinal decompression. This treatment actually takes the pressure off of the disc and reduces the herniations.” He said that MRIs taken after treatment show that the herniation has been reduced or is completely gone. “There is so much you can do besides surgery,” he said. “Patients who thought that was their only option, found out there were other
methods.” Another tool Cobb uses is the Graston technique. “This is a tool that will break up scar tissue and realign the tissue,” he said. “After the treatment, we can do kinesiology taping, which helps the muscles to heal faster.” Cobb said he treats a lot of sports injuries, including back or spine injuries, as well as shoulder injuries, tennis elbows and nerve and soft tissue injuries. Before moving to Fredericksburg, he treated athletes at Rice University in Houston. In addition to several chiropractic techniques, Cobb also recommends some nutritional formulas to support healing and well-being. He also gives counseling on installing pure water systems in the home. Another chiropractor who has seen some remarkable recoveries among his patients is David Hardison, PT, D.C., a long-time Fredericksburg resident who has been in practice here for more than 20 years. He said that before becoming a chiropractor, he oversaw the physical therapy department at the Hill Country Memorial Hospital. “I did that for 10 years before going to chiropractic school,” he said. “An aspect of our work is that we try to help the body heal itself,” he said. “We believe that the power that made the body heals the body if it’s in the right position and gets energy at the right time.”
19 According to Hardison, he uses several different adjusting techniques to fit the problem or the patient’s tolerance and desires. He does several soft tissue techniques besides manual adjusting. “I treat the whole body,” he said. “Just because someone has a problem that appears to be in one area, that doesn’t mean there are no other areas affected. That’s why I treat the whole body.” Nutrition is also a large part of Hardison’s practice because he said that if the body is not fed well, it can’t feel well. “When you put junk in your system, your performance is not what it should be,” he said. “The body requires certain nutrients for us to do all kinds of activities.” He said eating convenience foods in America helps to decrease the ability of the body to function properly. This includes eating simple carbohydrates such as white rice, potatoes, breads and biscuits, all of which he said have too much sugar. Hardison tells of a female patient in her early 50s who had a rash over much of her body. She also was somewhat overweight. “With changing her diet and getting her on supplements to help restore her body’s functions, that all went away,” he said. Hardison said he also did adjustments so that “the energy of the body would be balanced and go to the right place at the right time.” Within six weeks, there was a considerable change in this lady’s health and appearance, he said. Hardison added that coffee, tea, alcohol and sodas are not healthy. “They are somewhat of a diuretic,” he said. “When we get dehydrated, we get toxic and then our muscles and joints don’t work properly, and we have more pain and discomfort.”
For consultations, Neal Cobb, D.C., may be reached at 830-992-3221, and David Hardison, PT, D.C., may be reached at 830-997-7811.
David Hardison, PT, D.C., explains that “an aspect of our work is that we try to help the body heal itself.” Hardison has been in practice in Fredericksburg for more than 20 years. — Standard-Radio Post Photo
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Getting regular vision examinations can help maintain ocular health Many consider it a blessing to have eyesight, even if it means having to wear glasses to correct vision deficiencies and re-align the eyes to 20/20 vision. To maintain eyesight and ensure years of vision, Charles Cohn, M.D., offers seven top eye care tips. Cohn is a local ophthalmologist, along with Martha Walton, M.D., and Anne Pluenneke, M.D. 1. Protect eyes with appropriate safety glasses. This is especially important when doing high risk activities such as yard work, grinding or sawing, or hammering. “Find safety glasses that wrap around and are comfortable — you’ll be more likely to wear them if they feel good on your face and don’t obstruct your vision,” Cohn said. 2. Children need vision screening examinations periodically throughout their visual development years (especially ages four to eight, since kids of this age rarely complain See EYE CARE TIPS ▶ 25
Charles Cohn, M.D., uses a slit lamp to look into the eyes of a patient. The ophthalmologist said regular eye exams are necessary for adults. — Standard-Radio Post/Richard Zowie
Dr. Christa O’Leary, D.O. Hill Country Integrative Medicine Dr. O’Leary offers a personalized approach to many complicated issues including: ● ● ● ● ● ●
Hormone imbalances in men and women Chronic Fatigue and Autoimmune Disorders Food Allergies and Gut Disorders Metabolism & Obesity evaluations Ideal Protein comprehensive ketogenic weight loss program Nutritional DNA testing
Our Nutritional DNA testing allows us to look at your unique genetic makeup and recommend nutrition and lifestyle changes to improve many chronic illnesses and to optimize aging. www.hillcountryintegrativemedicine.com (830)992-3042 Board certified in Family Medicine and Integrative and Holistic Medicine
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Michael Majors, MD
DerMatology Certified by the american Board of Dermatology
753 S Washington St. Fredericksburg, Texas 78624
For Appointment Call 830-992-3396
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TIM BARSCH, D.D.S. WILL STEHLING, D.D.S.
• Family Dentistry • Children’s Dentistry • Dentures • Root Canals • Crowns/Bridges • Cosmetic Dentistry • Oral Surgery Including Wisdom Teeth • Implants • Invisalign Accepting New Patients • Emergencies Welcome! Open Mon-Fri www.fredericksburgsmiles.com
510 S. Adams St. (830) 997-9825
Hill Country Dermatology 95 East Highway Street • Fredericksburg
830-997-0898
Most Insurances Accepted, Including Medicare • New Patients Welcome
Michael Braden, M.D.
Pedernales Medical Group
Certified American Board of Dermatology
Board Certified Internal Medicine & Pediatrics - Office & Hospital Care for the Entire Family!
Cynthia Olfers Clegg, M.D.
NANCY K. THOMPSON, MD
Skin Disease, Skin Cancer
Skin Disease, Skin Cancer, Botox®, Dermal Filler, Microdermabrasion, Chemical Peels
Internal Medicine & Pediatrics
PAMELA D. CANTU, MD
Certified American Board of Dermatology
Internal Medicine
Edward J. Keuer, M.D.
FELICE H. HOWARD, MD
Skin Disease, Skin Cancer, Pediatric Dermatology
Certified American Board of Dermatology Certified American Board of Pediatric Dermatology
John J. Ghidoni, M.D. Skin Disease, Skin Cancer, MOHS Surgery
Certified American Board of Dermatology Fellow American College of MOHS Surgeons
Internal Medicine & Pediatrics
THERESA S. WIGINTON, MD Neurology
830-997-2191
205 W. Windcrest, Suite 310
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Creek Street Dental Ericka T. McBrine, D.D.S
Family & General Dentistry 101 West Creek Street • Fredericksburg 830-990-1178 • www.creekstreetdental.com We offer a wide variety of services including wisdom tooth removal, sedation dentistry and Invisalign®
AWARD-WINNING SERVICE. THE POCKET EDITION. With the Frost App you can deposit checks, transfer funds, find nearby locations and talk to a real person at the bank with a single tap. Now available for iPhone and Android.
frostbank.com 1300 South Main Street | Boerne, TX 78006 (830) 249-6633 MEMBER FDIC
“Assistance When You Need It... Independence When You Want It” * Bathing and Dressing * Medication Management * Transfers * Transportation * Kitchenettes * Restaurant Style Meals & Snacks * Studio, One Bedroom and One Bedroom Suites * Housekeeping & Laundry * Tons of Social Activities
96 Frederick Rd., Fredericksburg, Texas 79624 www.HeritagePlaceOfFredericksburg.com Lic. No. 030089
830-997-9406
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Sunscreen — a second layer of skin Consisting of three primary layers, a human’s skin is key in holding things together and protecting a person’s insides from the exterior environment. Harmful aspects to the outside world include many things, but the sun can be the most damaging to skin. That’s why sunscreen is widely recommended by doctors. “The number one reason to wear sunscreen is that it helps prevent skin cancer, both melanoma and non-melanoma,” Fredericksburg dermatologist Michael Braden, M.D., said. “The second is to prevent premature photo-aging, like wrinkles, skin spots and stuff like that.” Sunscreen is measured in SPF, or sun protection factor. Braden recommends getting sunscreen that has a minimum SPF of 30. “SPF measures how strong the sunscreen is, so higher number SPF is more effective,” Braden said. “Also make sure you get broad-spectrum sunscreen that blocks against ultraviolet (UV) A and UVB rays. We suggest putting on the sunscreen at least 20 minutes before going out into the sun. Additionally, use double protectant like wearing a longsleeve shirt and a wide-brimmed hat which will cover your ears and neck versus a cap, which will not.” Sunscreen with SPF over 100 can be over-kill, Braden said, but there are no harmful factors for using sunscreen with a high SPF. The sunscreen should be reapplied throughout the day, Braden said, at least every two hours or after swimming, drying off, or sweating. Additionally, Braden said there is chemical-free sunscreen for those who have sensitive skin. Users should make sure the sunscreen is labeled as broad-spectrum or multi-spectrum, to protect from both types of UV rays. “UVB is probably worse because it’s lower wavelength and it’s carcinogenic (skin cancer causing),” Braden said. “UVA doesn’t cause cancer as much, but it will go deeper and cause aging. Both are bad and both can cause cancer, but UVB is a little worse and is the one that causes sunburn. Furthermore, tanning booths are not recommended as they cause damage to deep parts of the skin.” Additionally, Steven Q. Wang, M.D., director of dermatologic surgery and dermatology at Memorial Sloan-Kettering Cancer Center at Basking Ridge, New Jersey, in an online post, said that sunscreen should include some combination of the following UVA-blocking ingredients: zinc oxide, titanium dioxide, avobenzone, ecamsule and oxybenzone. For more information on skin health and the importance of sunscreen, visit www.skincancer.org. Additional progress John Ghidoni, M.D., a dermatologist at Braden’s office, is an expert in Mohs surgery and has helped bring the process to the Hill Country. Mohs surgery is a precise surgical technique used to treat skin cancer. During Mohs surgery, thin layers of cancer-containing skin are progressively removed and examined until only cancer-free tissue remains. Ghidoni can do the process quicker than before, thanks to the TN-2085 Tanner, a cyrostat machine that examines skin. “With this machine we can do all the work in-house,” Ghidoni said. “It would typically take us up to a week to get results with the old process, but now we can get results within an hour.” The machine is very thorough, Ghidoni said, and helps the doctor achieve results. “We mainly test for Basal cell carcinoma which is the most common type of skin cancer,” Ghidoni said. “But this machine checks the entire
John Ghidoni, M.D., examines the skin on a patient’s forehead during a routine examination at the Hill Country Dermatology office. — Standard-Radio Post/Scott Allen
interface of the skin.” Sunscreen can help protect people from the sun, but those who are worried about their skin, may find solutions with doctors like Braden and Ghidoni.
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TOP EYE CARE TIPS about vision problems). 3. Adults need medical eye examinations, especially as they get older. Conditions like glaucoma, macular degeneration or ocular cancer may be present and cause no symptoms at all — but can be detected by thorough medical evaluation. 4. Those who wear contacts should practice good contact lens care. “Never use a dirty or broken contact lens, and only use contacts under the care of your eye doc-
Cont. from 20
tor,” Cohn said. “Old, broken or dirty contacts increase your risk of scratching your eye or causing an infection. It’s usually best not to sleep in your contacts either, as this increases the risk of infection.” 5. There are certain micronutrients that are important for eye health. Lutein, zeaxanthin, and omega-3 fatty acids have been studied in large trials and found to be beneficial, especially for patients with macular degeneration. Eating a diet
rich in green leafy vegetables is another way to get these micronutrients. 6. Don’t smoke. Smoking increases the risk of cataracts, macular degeneration and other eye problems. 7. Establish care with a local eye doctor, even if there are no current eye problems. “If you get something in your eye on the weekend, you’ll be thankful you have an eye doctor that can help you right away,” Cohn said.
307 S. Washington • Fredericksburg, TX 78624
830-693-8144 Susie Sant’Anna, DPM
Treating all Surgical and Non-Surgical Foot and Ankle Problems Diabetic Food Care • Heel Pain • Bunions Ingrown Nails • Hammertoes • Fungal Nails Flat Feet • Neuroma • Sports Medicine Wounds • Arthritic Joints • Tendonitis MOST INSURANCE ACCEPTED Go to www.hillcountryfoot.com for more information or to request an appointment
We would like to thank Hill Country Memorial as well as the specialists and dentists who help us help the uninsured in our community. You are the living embodiment of the Good Samaritan. For more information about our medical and dental services for uninsured families and individuals, please contact us Monday through Thursday at 830-990-8651, or visit us on the web at www.goodsamfbg.0rg.
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Maintain heart health with these expert tips M Exercise for at least 30 minutes five times a week. M Don’t smoke. M Follow the doctor’s orders when it comes to taking any prescribed medication. (In medical terms, this is called “compliance,” and it can apply to any doctor’s order — taking meds, being active, ceasing unhealthy habits, etc.) M If a person has diabetes, they should make sure to manage it well. (Diabetes puts a person at two to four times higher risk for heart disease.) M Maintain a low-fat, low-sodium diet. — Cardiac rehabilitation nurse, Amy Montgomery, R.N., at Hill Country Memorial Hospital
National Center for Health Statistics statistics on heart disease Heart disease is the No. 1 cause of death for Americans. • Number of adults with diagnosed heart disease: 27.6 million. • Percent of adults with diagnosed heart disease: 11.5 percent. • Number of deaths from heart disease: 611,105. • Deaths per 100,000 population: 193.3.
information (feedback) about your body (bio)
Hill Country Inner Works Karen Robertson Biofeedback Provider Helping Others Help Themselves 1603 E. Main St., Suite A Fredericksburg, TX 78624 830-992-5918 hillcountryinnerworks@gmail.com
functions, such as your heart rate and breath
. Biofeedback uses technology to help you consciously infuence your body’s
DARIN W. HOLMES, D.D.S. General Dentistry Implants Cosmetic
830-997-9505 707 South Adams Fredericksburg
ing. Biofeedback technology uses sensors to help you receive and measure
C. LANCE LOVE, MD
BOARD CERTIFIED AMERICAN BOARD OF SURGERY • Laparoscopy and Minimally Invasive Surgery • Colon, Stomach & Intestinal Surgery • Hernia Repair • Parathyroid & Thyroid Surgery • Gallbladder Surgery • Colonoscopy and Endoscopy • Thoracic Surgery • Breast Surgery • Skin Cancer & Skin Grafting
(830) 997-6000
820 Reuben Street, Suite A • Fredericksburg, Texas
Hill Country Vision Center 508 S. Adams Fredericksburg, TX 78624
O D
Shelly Blaker O.D. and W. Steve Kroeger O.D. Therapeutic Optometrists Optometric Glaucoma Specialists
Tel: 830-997-2504 1-800-997-2504 Fax: 830-997-5155
O D
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STOP THE SNORE! Comprehensive Treatments for: v Sleep Apnea v Snoring v Daytime Sleepiness v Restless Leg Syndrome v CPAP acclimation v Insomnia Now offering Telemedicine throughout Texas!
Kathy Wilson, MD Board Certified in Sleep Medicine
www.Texassleepdocs.com 830-792-1132 - Kerrville • 512-381-4555 - Austin
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Neal Cobb, D.C.
Reduces pain & inflammation Increases nerve regeneration Improves cellular healing
Cobb Chiropractic
412 S. Adams St., Fredericksburg TX www.cobbchiropractictx.com
Call Today! (830) 992-3221
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Friendship Lane
Center for Cancer Care
753 South Washington Street Fredericksburg, Texas 78624
Dr. Michele Nedelka 830-990-4800
Dr. Michele Nedelka Radiation Oncologist
Friendship Lane Center for Cancer Care
N
Global One
Street (Hwy. 87)
Highway Washington St.
The Friendship Lane Center for Cancer Care believes in educating the patient and their family while offering the latest cancer treatments once only found in larger cities.
Communications
South Church
Friendship
Lane
Tips for living with Alzheimer’s If you are reading this article, it is possible that you are living with someone or know of someone who has Alzheimer’s. It is difficult to maintain a normal life with someone who is living with this disease. In the coming weeks, we will give you some tools to deal with individuals living with Alzheimer’s. These tools will stop a problem from escalating and bring peace to the home, allowing you to keep that person at home as long as possible.
Stork
On the second Tuesday of every month, we have our Alzheimer’s Support Group meeting at 2 p.m. at the Brune Professional Building, 808 Reuben Street, Fredericksburg. We discuss these and other tools that can help friends and family deal with loved ones who are living with this disease. Bring your loved one who you are caring for and your friends. Refreshments will be served. { The first tool is to not argue. Instead agree. No one likes to be told they are wrong, especially someone who has dementia or Alzheimer’s. You are not going to convince them they are wrong and will only anger them. Would you argue politics with a child? I hope we would just agree that Abe Lincoln was the first president and let it go. Just let them feel good about themselves if it will not immediately bring them harm. { Another good tool is never reason. Just redirect. Our reasoning is sometimes lost with this disease. Explaining why something is dangerous will not work. Instead, redirect their attention. If they want to cook, do not keep saying no or reason with them why it is not safe. Just change the subject. Most of the time their attention span is very short so this tool works well. { Do not shame a person. Instead, distract them. You do not need to make them feel worse about themselves. Depending on the stage of their disease, they may be struggling with knowing they are losing control and do not need to be shamed by anyone. If the disease is progressed to a point of them not knowing this emotion, it makes you feel terrible after it is over, and will definitely do no good to change the behavior. { Do not lecture. Instead, reassure. Everyone likes to be assured everything is going to be all right. This is never going to change. From my experience, lecturing my teenagers had little effect, and lecturing someone who has Alzheimer’s or dementia has less chance of working. Reassuring them will calm the situation for whatever poor choice they have made. I hope to see you and your family to discuss these and other tools helping our local families understand and deal with someone who has Alzheimer’s or dementia. If you have any questions, call me. Michael Stork is owner of Morning Star Memory Care of Fredericksburg. Reach him at 903-399-5472 or email storkmichael@hotmail.com.
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‘Pre-diabetes’ a warning sign By Lindsey Bertrand
A flashing yellow light. A blaring siren. These are the warning signs we experience every day that tell us, “Watch out!” Your body does the same thing. You just have to pay attention. One of the most important warning signs for your health is called “pre-diabetes.” “Pre-diabetes is like an alert,” says Kim Thornton, a registered dietitian and certified diabetes educator at Hill Country Memorial. “In this pre-diabetic stage, your blood sugar levels are higher than normal, and your body is telling you now is the time to act.” If untreated, pre-diabetes can lead to diabetes and heart disease, she added. To learn more about how these diseases affect the community, Hill Country Memorial completed a “Community Health Needs Assessment” in 2013. For three months, HCM leaders gathered information, including public health and hospital reports, phone and online surveys, and personal feedback from a focus group and local leaders to determine the community’s most important health needs. “As a result, diabetes was identified as a priority issue,” said Maureen Polivka, HCM Chief Nursing Officer. According to the assessment, the incidence of diabetes in Gillespie County — those aged 20 and older diagnosed with the disease — is 11 percent, significantly higher than the statewide average of nine percent. That means nearly 2,800 people in Gillespie County are affected by diabetes. Since 2013, Hill Country Memorial has worked to educate residents on their potential risk for diabetes by offering classes and free blood sugar screenings. “If people get screened, they then know their potential risk and
“What Is Pre-Diabetes?” Class Schedule
Kim Thornton administers the A1c test that provides information about a person’s average level of blood sugar and potential risk for diabetes. — Submitted photo
can take action to improve their health,” Polivka said. In fact, there are many ways to learn about your potential risk for diabetes. In addition to a blood sugar screening, you can participate in the ongoing “What Is Pre-Diabetes?” class at the HCM Wellness Center. All classes are free and open to interested individuals and family members. Participants learn about risk factors for pre-diabetes and diabetes and receive an assessment tool to evaluate their level of risk. Most importantly, be sure to review your overall health with your doctor, eat right, stay active and pay attention to your body’s warning signs.
Free Screenings
• June 23 at noon. • Aug. 18 at 5:30 p.m. • Oct. 27 at noon. • Dec. 8 at 5:30 p.m. Classes are held at the HCM Wellness Center. For more information and to register, call 830-997-1355.
The HCM Wellness Center offers free blood sugar (A1c) screenings. • Mondays from 4-5:30 p.m. by appointment. • Fasting is not required. • With a small finger stick, results are ready in less than 10 minutes. Those who have a family history of
diabetes, are overweight, have high blood pressure, lead a sedentary lifestyle, or have had gestational diabetes are at higher risk of diabetes and may especially benefit from knowing their A1c. For more information and to schedule a blood sugar screening, call 830997-1355.
“Home Town care and compassion, Big city quality urgent care.”
1426 E. Main St., Ste. 300 Fredericksburg, TX 78624 • 830-997-9995 OPEN 7 Days a week. Monday-Friday 8-8, Saturday 8-6, Sunday 10-6. Most major insurances accepted. We see all ages. On site x-ray, EKG, labs. Occupational Medicine. www.mainstreeturgentcaretx.com
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‘Get out and play’ with The B.U.R.G. Encouraging adults ticipants’ kids “get out and play” in are watching and Fredericksburg is just cheering on their one of the missions of parents. Some are The B.U.R.G. even bat boys and The organization, girls for the softthe brainchild of ball teams. Justin Hill, offers the “They are chance to do just that watching you,” through activities such Hill said. “They coed softball, 5-on-5 are going to act basketball, coed flag like you act. If you football, coed soccer, have a bad attikickball, dodgeball tude they will see tournaments. and that. We’re setmore. ting an example “Basically, the goal by showing them of The B.U.R.G. is to how to play.” build up and unify the Not only does To learn more about The B.U.R.G, for community through The B.U.R.G. proregistration information, sponsorships recreational activivide participants and more, visit www.theburgfbg.com or ties,” Hill said. with a chance call Justin Hill at 469-316-3488. Another goal, to gather with The process to list The B.U.R.G as a according to Hill, is friends or become 501(c)3 non-profit is underway. a sports complex/ involved and recreational center for meet new people, The B.U.R.G. sponsors dodgeball tournaments with proceeds benefitting the Boys Fredericksburg. but it also has and Girls Club in Fredericksburg. — Standard-Radio Post file photo The B.U.R.G. was health benefits, as soccer this summer along with kickball in formed almost a year well. the fall. ago, and Hill is making plans for a one-year “There is a difference between playing and There is a nominal fee to participate. anniversary celebration. working out,” Hill said. “Whenever you are The neat thing about the teams, Hill said, is Currently, there are 15 teams playing coed working out, your goal is gains. When you are the range of ages from high school and up. softball on Sunday afternoons at Lady Bird playing, your goal is fun.” And, some of the participants are long-time Johnson Municipal Park and Oak Crest Park “And with The B.U.R.G. you’re gaining fun,” residents of Fredericksburg while others are while the seven teams playing 5-on-5 bashe said. new to the community. ketball meet on Tuesday nights at the First Health-wise, he said, participants can Hill said that the only requirement to play Baptist Church gymnasium. relieve stress, work on their conditioning, in a league sponsored by The B.U.R.G. is to Both of the current softball and basketball breathing, critical thinking and more. “play well with others. We don’t like bad sessions began in March and will end in a “When you compete, it does something attitudes.” couple of weeks. The leagues will resume in to your mind. It pushes you to do better and “Sportsmanship is huge,” Hill said. the fall. shows you a little about yourself,” Hill said. “It He pointed out that many times, the parHill is planning coed flag football and coed makes you feel alive.”
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ANN BARSCH, MS Audiologist, CCC-A
Fellow American Academy of Audiology Board Certified American Board of Audiology Celebrating my 32nd year of professional hearing care in Fredericksburg.
Professional Hearing Care For All Ages Diagnostic Audiological Evaluation State of the Art Digital Hearing Aid Technology in a variety of styles, features and price ranges to meet individual communication and lifestyle needs.
COMPREHENSIVE COMPASSIONATE COMPETENT AUDIOLOGICAL CARE 510 South Adams Street Fredericksburg, Texas 78624 830-997-5006
Monarch Physical Therapy, LLC Transformation into Wellness
Physical Therapists and Massage Therapists trained in John F. Barnes Myofascial Release to decrease pain, improve function and align posture. Commercial Insurance, Medicare and Self-Pay accepted. Physical Therapy - Massage Therapy Biomat (in house or available for rental)
830.995.3508 203 Hwy. 87, Suite 208 Comfort TX 78013 www.monarchpt.com