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2020 Health & Medical Guide
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Lions Den is a fit destination
Photo by BRADLEY KREITZER
The Lions Den offers members the latest in exercise equipment.
By Bradley Kreitzer
MCALISTERVILLE—Sometimes for those who want to get in shape or stay in shape, it’s not the motivation to go to the gym that is the dificulty, but rather finding a suitable facility to do so. For the residents of eastern Juniata County and neighboring Snyder and Perry counties that search is easy. The Fayette Area Lion’s Den, located in McAlisterville, is a fitness and recreational facility with a variety of programs and classes that can accommodate people of any
fitness level or fitness focus. The Lion’s Den has a free weight room for those wishing to ‘pump iron’ to build muscle mass, burn body fat strengthen bones and increase overall strength. The facility also has a room with weight machines each designed to target specific muscles of the body. The Lion’s Den has a room with variety of cycles, treadmills and step machines for those looking to do a cardio workout. There is also two aerobics rooms where the Lion’s Den holds a variety of different group fitness classes. The classes held at the See Lions Den / Page 4
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Encompass Health Rehabilitation Hospital of Nittany Valley...................................Page 2 Heimer Eye Care Associates..................Page 5 Greenway Pharmacy..............................Page 7 Mifflin County OBGYN............................Page 8 Nadyaʼs Massage...................................Page 9 Valley View Retirement...........................Page 9 In Home Services of Central Pa ...........Page 10 Paul A Kline Erie Insurance Co. ...........Page 10
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Juniata Valley YMCA ............................Page 11 Primary Health Network .......................Page 13 Country View Dry Goods......................Page 14 Uhring's Hearing and Balance..............Page 15 Altoona Center for Clinical Research ...Page 17 Lewistown Health & Fitness .................Page 19 Bohn Furniture & Mattress ...................Page 21 DaVita Dialysis .....................................Page 24
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Photo by BRADLEY KREITZER
Free weights at The Lions Den.
Lions Den Continued from Page 3
certain fitness goals and vary in levels of intensity and types of movements. They range from the slow paced, low impact classes such as yoga and Tai chi to the faster, high intensity classes like Tabata, Body Blast and Cycle & Sculpt. Tai chi involves slow, focused series of movements that is accompanied with deep breathing. Studies have shown tai chi improves muscular strength, flexibility, fitness, improves immunity, relieves pain and improves quality of life. Muscle strength is important for supporting and protecting joints. Flexibility exercises like tai chi enable people to move more easily, and facilitate circulation of body fluid and blood, which enhance healing. Yoga is a discipline which incorporates controled breath-synchronized movement, simple meditation and the adoption of spePage 4
cific bodily postures. Yoga is widely practiced for health and relaxation. The yoga class offered at Lion’s Den combines two styles of yoga — Hatha and Vinyasa. This is to make the class more manageable for participants with varying levels of fitness. Hatha yoga is typically a slow paced and gentle and is a good introduction to basic yoga poses. Vinyasa yoga tends to be more of a vigorous style based on the Sun Salutrations series of poses performed in a sequence to create a flow of movement. Each pose coordinates with your breathing. Inhale to extend and exhale to bend. Sun Salutations build heat in the body and are often used as warm-up sequences for a yoga practice. The Lion’s Den does supply blocks, pillows, blankets, mats and straps to use during the class. However these supplies are limited so participants are encouraged to bring their own. Some of the more intense workouts offered at the Lion’s Den includes high inten-
2020 Health & Medical Guide
See Lions Den / Page 6
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The Lions Den offers numerous class and training options.
Lions Den Continued from Page 4
cardiovascular exercise with alternating short periods of intense anaerobic exercise with recovery periods of less intense exercise. This training allows participants to give 100% effort through quick bursts, raises heart rate and keeps it up. HIIT also burns more fat in less time. Another is another high intensity interval training workout offered at Lion’s Den is Tabata. This class is strucutred with intense workout for 20 seconds and rest for ten and is completed in eight rounds. The Lion’s Den class has a 10 minute warmup before the 20-30 minute Tabata training and finishes with abs and full body stretch. The Cardio Core class incorporates elements from both HIIT and Tabata along with plyometrics and cardio step. The class is designed to increase aerobic capacity and burn fat while engaging core muscles for maximum strength. The Lion’s Den facility also houses the McAlisterville Senior Citizens Center and has a variety or exercise programs available for senior citizens including Silver Sneakers Page 6
Photo by BRADLEY KREITZER
and Silver Sneakers EnerChi. The Silver Sneakers class focuses on strengthening muscles and increasing range of movement for daily activities. Hand-held weights and Silver Sneaker balls are available for use and often chairs are used for seated exercises or standing support. Silver Sneakers EnerchChi combines tai chi forms with elements of qichong, a system of coordinated physical postures, movement, breathing techniques and meditation. This class is designed to improve well-being through mindful movement. While learning and practicing form, attension is given to transferring weight smoothly, maintaining postural control and focused breathing. Some of the benefits of Silver Sneakers EnerChi include muscular endurance, improved balance recovery and a calm mind. These classes and a variety of others are offered at different times throughout the year. Please check the Fayette Lion’s Den monthly calendar for classes and schedules. Hours of opperation and aerobics schedule can be found on the Lion’s Den website at www.fayettelionsden.org. For more information contact the Fayette Lion’s Den at (717) 463-3300 or directo@fayettelionsden.org.
2020 Health & Medical Guide
The Sentinel
Injury prevention, treatment is about listening to your body By Brian Cox
Physical activity can have many health benefits. The benefits, however, come with the potential for injury. Whether something as simple as walking or running or something more challenging like weightlifting or playing a sport, the risk for getting hurt comes with any physical activity. But by listening to your body, and taking the proper precautions, many injuries can be prevented and those you do suffer can have their recovery time reduced, says Zach Kavo, the head athletic trainer for Mifflin County High School. Warming up Kavo says no matter what you’re doing or
what type of shape you’re in, getting the body properly warmed up is a crucial piece of the injury prevention puzzle. “The warmup is huge,” Kavo says. “You want to slowly increase your activity and movement, whether that’s light jogging, doing lunges, squatting. And you want to tailor your warmup to whatever activity you’re doing that day.” For example, if weighlifting, Kavo says to start with lighter-weight exercises for whichever muscle groups you plan to work out. If jogging or running, start by walking and slowly increase your speed to how fast you plan to run. And Kavo says those who are older See Prevention / Page 8
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JEFFREY BONJO, RPh Page 7
Prevention Continued from Page 7
need to take longer to warm up. Those who are just starting out must also avoid falling into a common trap that can lead to injury — trying to do more than you’re capable of. “It can be intimidating just starting out,” Kavo says. “Don’t try to match what other people may be doing, just do what you can. Remember, it’s better that you’re doing something than nothing at all.” Treating sprains Among the most common injuries is the joint sprain. And no matter what joint may be injured, the tried-and-true method for treatment still reigns supreme, according to Kavo. “We use the ‘R.I.C.E.’ method,” Kavo says. “That stands for rest, ice, compression and elevation. We also mix in some limited movement. For ankle sprains, we’ll have them do something we call ‘ankle pumps’ which is kind of like pushing a gas pedal. We want to do some early movement, but not too much where it hurts because moving gets the body to heal faster.” Kavo also recommends avoiding heat over the first two to three days after suffering a sprain, even though some may recommend the opposite. “Some people actually say you should use heat right away and the thought there is that getting that blood flowing will help heal that damaged tissue,” he says. “But I like using ice. Ice won’t reduce swelling but it will prevent it from swelling further and I think that really helps with not only healing but with pain management as well.” Joint sprains can last a couple days when fairly mild or up to several weeks when more severe, Kavo says. Pulled muscles Another fairly common injury resulting from physical activity is the dreaded pulled muscle, which can sometimes be tricky to treat, as Kavo says you have to strike the balance between resting and keeping the muscle active while it heals. “For, let’s say, a pulled hamstring, we’ll Page 8
go back to the ‘R.I.C.E.’ method and add in some movement to sort of keep them active,” Kavo says. “We will encourage our athletes at the high school to do some light stretching. We don’t want them doing too much to where it hurts or we’re risking making the injury worse, but you have to listen to your body. Our athletes are always asking us how much they can do. We always try to go by the rule ‘if it doesn’t hurt, then it’s OK to do it.’” More serious injuries Kavo says the most important thing anyone can do is be honest about their feelings. “We’re always saying and the coaches are always saying to our athletes ‘take care of the little things and the big things will take care of themselves.’” Kavo says. “We try to apply that to injuries. We want them to say something when they have a little muscle tightness or something like that so we can do something about it before it gets worse and becomes a full-on strain or worse.” See Prevention / Page 9
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Prevention If the injury is significant enough that a doctor visit is needed, Kavo says to not hesitate. “If you do suffer an injury and you think you need to see a doctor, go,” he says. “In this day and age, a lot of people don’t want to go to the doctor unless they’re really sick or something, but if you think you might
need to see a doctor, go. For most injuries, we recommend physical therapy and not surgery and physical therapy can make a big difference. It can help a lot.” The key to any physical activity, Kavo says, is to just take it slow, but make sure you’re doing something. “Whether that’s just walking or jogging for 30 minutes or joining a gym, if you can engage in physical activity for 30 minutes every day, it will have a positive impact on your health,” he says.
In light of concerns about COVID-19, various health organizations have issued specific instructions on how to maintain personal safety and cleanliness. The Environmental Protection Agency states that coronaviruses are some of the easiest types of viruses to kill because they have an envelope around them that enables them to merge with other cells and infect them. HOT WATER AND SOAP - The reason
hand-washing is at the top of the list of sanitizing methods is because it is so effective at washing away viruses and bacteria. HYDROGEN PEROXIDE - The CDC says household hydrogen peroxide at 3 percent concentration can deactivate viruses. Natural items can be used for general cleaning. White vinegar, baking soda pastes and citrus oils and juices can be used. •••
Continued from Page 8
How to clean when faced with a shortage of supplies
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Make an exercise plan first
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LEWISTOWN — There’s no question that exercise benefits everyone. But what’s best for you? If you have a personal trainer, he or she can certainly map out an individual plan. That’s not realistic for all of us, though. So we asked a gym teacher — in this case, a veteran physical education instructor and longtime coach in the Mifflin County School District and elsewhere. George Miskinis offered this advice based on a general approach; again, individual needs may very based on goals and overall health. “The first thing before beginning any exercise program is to make sure you are medically cleared by your primary care physician. They will also point out any limitations you may have with exercising,” he said. “The next thing that needs to be con-
sider is your resting heart rate. This is best acquired when you wake up in the morning and before getting up and moving about. This allows a person to work toward their target heart rate.” Miskinis points to a calculation on the Centers for Disease Control website, found at https://www.cdc.gov/physicalactivity/basics/measuring/heartrate.htm. One example on that site is for moderateintensity physical activity. Your target heart rate should be between 64% and 76% of your maximum heart rate, which you can estimate based on your age. To estimate your maximum age-related heart rate, subtract your age from 220. For example, for a 50year-old person, the estimated maximum age-related heart rate would be calculated as 220 – 50 years = 170 beats per minute (bpm). The 64% and 76% levels would be
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Monitors help track fitness goals
ARGENTA, Ill. (AP) — Doctors suggest 60 minutes a day of moderate to vigorous exercise is optimal for good health for kids. At Argenta-Oreana Middle School, physical education class is 40 minutes a day and some of that time is spent changing, warming up and cooling down, so teacher Abby Schoolman estimates the students get only about 20 minutes of actual exercise at school, which means the rest is up to them to do on their own. To help train the kids to monitor their own fitness level and exertion, she applied to the Illinois Association for Health, Physical Education, Recreation and Dance (IAHPERD) for a grant to buy heart monitors for the students to use during PE class. “I had been teaching elementary PE so I was kind of excited to come to the middle school and try out some of the theories I’d learned,” Schoolman said. She and co-teacher Kaleb Renfro wanted to get 40 heart monitors and an iPad so the
students could track their heart rates in real time. The grant covered about two-thirds of the cost and the district covered the rest, she said. “We wanted enough for our biggest class, so every kid in the class can have one,” she said. The zones are color-coded for easy identification and kids can see if they’re working hard enough to get the most benefit from the workout and the most useful thing about it, she said, is that kids are striving for their own best level instead of being compared to each other. For example, the athletes who compete on the school’s teams have a different level of fitness than the more sedentary kids, and it takes much more work for them to reach a higher heart rate. One student, Schoolman said, can reach his optimum heart rate and get the most cardiovascular benefit doing fewer laps See Monitors / Page 12
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109 bpm and 129 bpm. Barring any restrictions, Miskinis said walking and simple stretching are the top two exercises for all ages. “The next would be strength maintenance,” he said. “Safety considerations for these exercises includes walking in a safe area — if walking on the highway always walk facing traffic — and never stretch a cold muscle, which increases muscle soreness.” And, he said, “always have a workout partner when doing any type of exercise.” Miskinis said people can workout daily if they vary their exercises or the distances and time spent exercising. The minium amount of time is 20 to 30 minutes daily, but some execise is better than none. “Recovery time for strenuous exercise will be longer than moderate or limited exercise. Individuals create their own barriers for exercising — no time, no place, no partners, no equipment, etc.,” he said. The Sentinel
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Monitors
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than, for example, a basketball player, yet that student always felt he wasn’t keeping up with the other kids. With the heart monitors, he can see that he’s working just as hard. “Any time they’re in Zone 3, 4 or 5, they’re accumulating minutes (toward their goal) and making themselves heart-healthier,” Schoolman said. The goal isn’t to reach the maximum heart rate, which is what the kids thought at first, Renfro said. Staying in that top zone too long can actually be harmful. What they want is healthy exertion to strengthen their hearts and increase their endurance. Schoolchildren used to take the annual Presidential Fitness Test which experts now liken to military training exercises rather than overall fitness in children. Kids in middle and high school were expected to do 40 push-ups, 10 pull-ups, a mile run in 6:30 and other benchmarks that were intimidating even for active kids. That test was discontinued in the 201213 academic year and the goal is for kids to
improve their own individual fitness. The Presidential Youth Fitness Program is more about assessing children’s health and is confidential among student, parents and teacher. It measures aerobic capacity, body composition, flexibility, muscle strength and endurance and gives the teacher and student the tools to improve fitness. At Argenta-Oreana, for example, the students look at their results and create goals to improve their fitness, and work on those goals with their teachers’ help. “When I’m in a different zone, it tells me whether to slow down or keep pushing myself,” said Carter Logue, 12, a sixth-grade basketball player. Now that the basketball season is over, he said, he’ll be starting track season and knowing how his body feels at maximum performance will be a help. “You get a lot of information about your heart and how you can increase your endurance and your balance and get stronger, and gives you information about how healthy or not healthy you are,” said 11year-old Sarai Roman. “When you’re doing exercise, and you’re sweating, it’s like a sign that lets your heart monitor know how your heart is getting more energy.”
Tips when to exercise or not if sick
The eDocAmerica Health Tip offers this advice — do not exercise if you have the following symptoms: • Fever, body/muscle aches, or fatigue • Chest congestion, wheezing, or a bad cough • Upset stomach, nausea, vomiting You can exercise if you only have the following symptoms: Runny nose, head or nasal congestion, sneezing, minor sore throat. If you do want to exercise when you are sick, here are some things to consider: • Reduce the intensity and length of your normal work out; maybe go for a walk instead of a run. • Consider doing some indoor exercise, rather than exercising outdoors in winter weather conditions. If the weather is not harsh, the outdoor air might do you some good. • Listen to your body. If you get tired or your muscles start hurting during your workout, you should stop the workout. The next day, try something less strenuous. • If you start coughing or wheezing during a workout, stop the workout. • If you do take a few days off from your regular exercise routine while you are sick, this should not have any adverse effect on your exercise performance. As you start to feel better, gradually get back into your exercise routine. Start at a lower intensity and pace, and gradually increase to your normal routine.
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Glaucoma
Content from Heimer Eye Care
What is glaucoma? Glaucoma is an umbrella term for the eye disease that causes progressive damage to the optic nerve over time. There are different sub-categories of glaucoma such as open angle, closed angle, primary, and secondary, but they all demonstrate some form of optic nerve damage which can cause changes to both the appearance of the nerve as well as its function. The term “primary” means that the patient has no known eye disease or systemic disease causing the damage, while the term “secondary” implies the opposite. “Open” vs “closed” angle has to do with the anatomical structure of the angle of the eye, which is the location where fluid is drained from the front of the eye. It is important to make these distinctions as different types of glaucoma are treated differently. The most common type of glaucoma we encounter is primary open angle glaucoma (POAG), so I will focus the majority of the column on this condition. What causes POAG? The current understanding of POAG is that the fluid (aqueous humor) produced in the front part of the eye has increased resistance to drainage at the angle of the eye, which in turn causes a rise in the intraocular pressure. There is a common misconception that one has to have an elevated intraocular pressure to have glaucoma. Although we generally say that “normal” intraocular pressure is somewhere between 10-21 mm Hg, that is somewhat misleading as there are patients who demonstrate optic nerve damage and visual field changes despite having intraocular pressure in the so-called “normal” range. What this means is that there are other factors at play which we do not yet fully understand, including hereditary/genetic and possibly nutritional/environmental influences. Intraocular pressure is important because it is one of the few risk factors for glaucoma that we can modify with medication, lasers, and surgery. Page 14
How do you test for POAG? When you see your ophthalmologist or optometrist for a glaucoma evaluation, you will likely undergo multiple tests to help make the determination of whether or not you have glaucoma. These include measurements of visual acuity, intraocular pressure, and central corneal thickness. Central Continued on page 15
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corneal thickness is important as thinner corneas have been identified as a risk factor for glaucoma development. Your doctor may also perform gonioscopy, which utilizes a special mirrored lens to look at the anatomy of the angle of the eye. In addition to a slit lamp examination of your optic nerves, your doctor may also use an imaging modality such as optical coherence tomography (OCT) to look for areas of thinning of the nerve fiber layer surrounding the optic nerve. Changes in the nerve appearance or increasing thinning of the nerve fiber layer can be signs of progressive damage to the nerve. Finally, an assessment of your peripheral vision will be performed which is usually referred to as a visual field exam. This test is very important as glaucoma generally tends to affect peripheral vision before if affects central vision. How do you treat POAG? Once the diagnosis of glaucoma is made, your doctor will decide on a treatment that
will best suit your needs as well as your personal preferences. As was mentioned earlier, intraocular pressure is one of the few risk factors that can be modified. The vast majority of POAG is treated by instillation of topical eye drops to lower the intraocular pressure by decreasing fluid production or increasing fluid outflow. There are multiple classes of medications designed to do this, and they include prostaglandin analogs, beta blockers, alpha agonists, and carbonic anhydrase inhibitors. Each class has its own unique side effect profile, and your doctor should discuss the risks and benefits of each medication before starting treatment. The most common initial topical therapy is the prostaglandin analog class secondary to ease of dosing, the fact that they are generally well-tolerated, and are effective in pressure lowering. Some patients will require more than one topical medication for control of their pressure. For patients whose pressure cannot be Continued on page 16
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adequately controlled with topical medications or are intolerant of the side effects, there are the options of laser procedures and surgical procedures. Two of the most common types of lasers include argon laser trabeculoplasty (ALT) and selective laser trabeculoplasty (SLT). Both lasers are generally well-tolerated and can be performed in the office setting. The surgical options for glaucoma have been expanding in recent years, ranging from the traditional trabeculectomy to less invasive procedures commonly referred to as MIGS (minimally invasive glaucoma surgery). It is beyond the scope of this article to go into all of the surgical options in detail, but they generally involve creating a pathway for fluid to drain
from the eye and therefore lower the intraocular pressure. Any surgical discussion should include the risks and benefits of each procedure option. Summary Glaucoma is a disease characterized by progressive damage to the optic nerve. Your doctor will monitor your glaucoma and its potential progression using measurement of intraocular pressure, the appearance of your optic nerves, thickness of the retinal nerve fiber layer (using OCT), and involvement of your peripheral vision (using the visual field test). Once glaucoma is diagnosed or determined to be progressing, your doctor will utilize medical and/or surgical treatment options to try to stabilize your condition and prevent further significant damage.
Where You Go For Rehabilitation Does Make a Difference Richard C. Senelick, M.D.
You or one of your family members are in the hospital and your doctor has just told you that you will need a course of rehabilitation. You may have had a stroke, fallen off your high-tech bicycle or spent time recovering from a major operation that has left you too weak to return home. Dr. Smith has been your family doctor for years, and all of your children have been born at the same hospital, but no one in your family has ever needed rehabilitation. A short time after your doctor leaves your room a case manager enters and gives you three choices. One is an inpaPage 16
tient rehabilitation hospital and two are skilled nursing facilities that provide rehabilitation services. How do you choose? Will your choice influence your ability to improve and reach your maximum potential? Absolutely! What is the difference? We know that dose, function and motivation make a difference. Which facility will
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give you the greatest dose of therapy that performs functional tasks in a setting that motivates you to get better – an inpatient rehabilitation hospital or at a skilled nursing facility (SNF)? You have to ask some questions: Does a stroke patient do as well in a SNF as in an inpatient rehabilitation hospital? Is that patient as likely to be discharged home and back to the care of their loved ones? The answer to both questions is, “definitely not!” I don’t just say this because I work in an inpatient rehabilitation hospital, but because the medical literature supports this position. Evidence-based medicine is the gold standard for clinical decision-making, whether we are deciding what medicine to use or what is the best choice in rehabilitation. Just as you wouldn’t take a pill that had not undergone rigorous testing, you need to follow the evidence when making a decision about rehabilitation. As early as 1997, a major study1 in the Journal of the American Medical Association compared stroke patients who received their rehabilitation at an inpatient rehabilitation hospital (IRF) versus a skilled nursing facility (SNF). Those who received their rehabilitation at an IRF were three times more likely to be discharged home. That’s right, three times more likely to sleep in their own bed, eat with their families and kiss their grandchildren goodnight. Knowing this, where would you want to go if you had a stroke? Noted researcher Pam Duncan, PhD, looked at the same problem of poorer outcomes in patients who went to nursing homes for rehabilitation and determined that the practice of utilizing nursing homes “is now shown to be potentially cost ineffective and detrimental to patient recovery.”2 Not just less effective, but detrimental. The American Heart Association and the American Stroke Association looked at the highest levels of scientific evidence and in 2017 published guidelines that state, "Stroke survivors who qualify for and have access to IRF care should receive treatment in an IRF in preference to a SNF.” Page 18
People are beings sent to skilled nursing facilities to save insurance companies money, but the price in what it means in outcomes is being paid by the patient. What we know Intensity of rehabilitation drives success: The evidence is clear that success with rehabilitation is dose-related. The intense therapy provided in a Rehabilitation Hospital is superior to the less intense setting of a skilled nursing facility. Functional focus of rehabilitation is crucial: Animal and human research demonstrates that it takes functional tasks to “rewire” the brain and restore function. Most skilled nursing facilities do not have access to the latest technological advances that promote repair of the nervous system. Even modest functional improvement affects the future of the severely impaired: Too often, healthcare providers assume that severely affected patients are not candidates for an inpatient rehabilitation hospital. This is not true. If these people are provided proper rehabilitation, the majority of patients are returned to their homes and families. Rehabilitation hospitals are superior to nursing homes for achieving greater gains and going home: The data speaks for itself. Patients who go to an inpatient rehabilitation hospital achieve higher functional gains and are more likely to go home than those who go to a skilled nursing facility, or nursing home. Hopefully, you are now a better informed consumer and will insist on the best care for you and your loved one. For more information about Encompass Health Rehabilitation Hospital of Nittany Valley, visit encompasshealth.com/nittanyvalleyrehab. Dr. Richard Senelick is a physician specializing in both neurology and neurorehabilitation. For 30 years, Dr. Senelick served as the medical director of Encompass Health Rehabilitation Hospital of San Antonio, Texas. 1 http://www.ncbi.nlm.nih.gov/pubmed/9214526 2 http://www.ncbi.nlm.nih.gov/pubmed/11779907
2020 Health & Medical Guide
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Dr. Kivitz Joins Panel as Expert Rheumatologist in New York City
Dr. Alan Kivitz, founder and president of the Altoona Arthritis & Osteoporosis Center and the Altoona Center for Clinical Research traveled to New York City to join a panel discussing the importance of personalized therapy and shared decision making in patients with knee osteoarthritis. Dr. Kivitz was the expert rheumatologist on this panel and was joined by Dr. David Jevsevar, Associate Professor of Orthopedics and Department Chair of Orthopedics at Geisel School of Medicine at Dartmouth College, and by Dr. Andrew Spitzer, Professor of Orthopedic Surgery and Co-Director of the Joint Replacement Program at Cedars-Sinai Medical Center. Shared Decision Making (SDM) was the main focus of this recorded panel discussion that took place on February 7, 2020 in New York City. SDM is the collaboration between patients and their health care provider that is based on available evidence from medical tests, any adverse events and treatment options available as well as patient values, capabilities and preferences in their treatment. By patients and their health care providers working together in selecting an appropriate therapy for the OA treatment there is a greater potential of seeing improvement in patient outcomes. Drs. Kivitz and Spitzer presented three different cases in which the individuals being treated worked with their health care providers to choose the best treatment option available that also lined up in being beneficial based on test results and the patients unique situation. As the expert rheumatologist on the panel, Dr. Kivitz, was able to firsthand discuss the benefits in utilizing medical The Sentinel
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testing, especial imaging tests such as X-Ray and MRI, in finding a best treatment option for patients with knee OA that also works best for the patients’ capabilities and preferences. As a practicing physician, Dr. Kivitz has more than 38 years of experience treating patients with arthritis and rheumatic disorders. He received his medical degree from Albany Medical College in Albany, New York. He completed training in internal medicine at the North Shore University Hospital in Manhasset, New York, and Memorial Sloan Kettering Cancer Center in New York City. Dr. Kivitz then completed his fellowship training in rheumatology at Albany Medical College. He is board certified in internal medicine as well as the subspecialty of rheumatology. Dr. Kivitz has authored and co-authored more than 500 research articles, abstracts, and studies on subjects covering osteoarthritis, osteoporosis, rheumatoid arthritis, and pain management. In addition, his studies have been published in several prestigious medical journals including The New England Journal of Medicine, Pain Medicine, Journal of the
American Medical Association, Arthritis & Rheumatology, and Journal of Clinical Rheumatology. Dr. Kivitz has served as a consultant on numerous osteoarthritis and rheumatoid arthritis clinical trials. Dr. Kivitz is an active member of the Pennsylvania Medical Society and the American Medical Association. He holds certifications in Human Subjects Protection and HIPAA Research Training and is classified as a Certified Principal Investigator by the Association of Clinical Research Professionals. His research work has focused on the development of newer strategies for treating patients with arthritis and rheumatic disorders. He has served as Principal Investigator or Sub-investigator in more than 1000 clinical trials.
The Truth About Cataracts by Jay Fiore MD Heimer Eye Care Associates, P.C.
A cataract is a clouding of the crystalline lens of the eye and a reversible cause of blindness. The lens of the eye rests behind the pupil and is responsible for helping to focus light on the back the eye (the retina). Cataracts can affect anyone, of any age, but is more common in the aged population. As cataracts develop, they block the passage of light through the eye and cause light to be scattered as it enters the eye. This loss of quantity and focus of light leads to decreased quality of vision and visual acuity. Early signs of cataracts include seeing “halos” and glare from lights at night as well as the inability to read road signs at the same Page 20
distance one was once used to. Eventually, cataracts lead to overall decrease in visual function leading to a decreased ability to read and perform activities of daily living. Cataracts can cause frequent eyeglass prescription changes, double vision, and a fading of colors. A typical cataract of aging will cast a yellowish hue to one’s vision, a process that happens so slowly that its effect typically isn’t noticed until the cataract is removed. Cataracts most commonly are the result of the process of aging but can also be derived from other causes. Children can be born with congenital cataracts and require surgery before 6 weeks of age. Secondary cataracts can develop from diabetes,
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radiation, corticosteroid use, and previous intraocular surgery, just to name a few. Blunt force trauma to the eye can also trigger cataract formation. Lastly, certain lifestyle choices can lead to early cataract formation, such as smoking, alcohol use, and prolonged sun exposure. Fortunately, in the western world, going blind from cataracts is almost a thing of the past due to the many highly trained Ophthalmologists performing state of the art surgery. Cataract surgery has progressed from a procedure known as Couching, where the cataract was pushed to the back of the eye and Coke-bottle glasses were worn afterwards, to today, where a cataract can be removed through a microscopic self-sealing incision with Phacoemulsification and a lens can be inserted into the eye to not only correct for one’s eyeglass prescription, but in certain circumstances, eliminate glasses entirely. A main fallacy with cataracts is that it “has to be ripe” before it can be removed.
While it is true that Medicare and insurance companies won’t pay for clear lenses to be removed just so an intraocular lens can be placed, one does not have to be blind in the eye in order to qualify for surgery. Typically, a visual acuity of 20/40 or less under normal lighting or glare testing, in a patient with cataract related visual complaints, is reason enough to remove the cataract. Cataract surgery in today’s world has moved from being a purely therapeutic procedure to a refractive procedure. Not only is the visual obstruction to vision removed, but a lens is placed in the eye that can compensate for one’s eyeglass prescription. For those willing to pay a premium, lenses are available that can correct both distance and near vision or astigmatism. While not perfect, these technologies are great for the right patient. If you or someone you know feels their vision is being affected by a cataract, our staff at Heimer Eye Care would be happy to assist you.
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Are you at risk for diabetes? Content from Primary Health Network
Diabetes is becoming more prevalent in the United States each year - by the end of 2020, 1 in 3 Americans may have Type 2 diabetes. This prediction is alarming, especially considering the many health complications that can be caused by diabetes. This number also applies to Americans of all ages; anyone can be at risk for Type 2 diabetes, from children to seniors. Primary Health Network physician, Dr. Yekalo Beyene has done extensive research on diabetes management and prevention and places importance on managing the risk factors that you can control. There are three main risk factors for Type 2 diabetes: • Being overweight • Eating an unhealthy diet • Not getting enough exercise Fortunately, most people can control all three of these factors. Weight management is
important to prevent many diseases, not just diabetes. If you are overweight, losing just 10% of your body weight can make a difference. When it comes to your diet, try increasing the amount of vegetables and whole grains you eat, and reduce the amount of sugar you consume. Exercising increases your production of insulin and lowers your blood sugar, and can also contribute to weight loss. In addition to these factors, genetics may play a part in your risk of getting Type 2 diabetes. If your doctor believes that you might have a higher risk of Type 2 diabetes due to your family history, you may need to start getting screened sooner. Talk to your doctor at your next appointment about your risk and about making lifestyle changes to lower your risk. For those that have Type 2 diabetes, management and communication are vital to staying healthy. Dr. Beyene emphasizes a few essential pieces to diabetic management which include, "carefully monitoring feet for injuries, proper diet and exercise, scheduling an annual eye exam, proper medication management, and keeping your doctor well informed on any complications that may arise." For more information on Dr. Beyene or to schedule an appointment, please either visit primary-health.net or call 717-447-0340.
MEDICAL AND HEALTHY LIFESTYLE DIRECTORY OF SERVICES
BEHAVIORAL HEALTH Primary Health Network Theresa Fry, LCSW 106 Derry Hts Blvd, Lewistown, PA 17044 • 717-447-0340 www.primary-health.net
DENTAL Primary Health Network Lewistown Dental Center 106 Derry Hts Blvd, Lewistown, PA 17044 • 717-248-9900 www.primary-health.net Page 22
DIALYSIS DaVita Dialysis 611 Electric Ave, Lewistown, PA 17044 • (866) 544-6741 www.davita.com EYE CARE Heimer Eye Care 1700 Old Gatesburg Rd #300, State College, PA 16803 (814) 234-1002 www.heimereye.com
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MEDICAL AND HEALTHY LIFESTYLE DIRECTORY OF SERVICES
FAMILY MEDICINE Primary Health Network Yekalo Beyene, MD 106 Derry Hts Blvd, Lewistown, PA 17044 717-447-0340 www.primary-health.net
GOUT RESEARCH STUDY Altoona Center for Clinical Research (800) 924-7790 www.altoonaarthritis.com
HEALTHY LIVING/FITNESS & EXERCISE Juniata Valley YMCA 105 1st Ave, Burnham, PA 17009 (717) 248-5019 www.jvymca.org
REHABILITATION Encompass Health Rehabilitation Hospital of Nittany Valley 550 W College Ave, Pleasant Gap, PA 16823 www.encompasshealth.com/ nittanyvalleyrehab Valley View Rehab 4702 E Main St, Belleville, PA 17004 (717) 935-2105 www.vvrconline.org
RETIREMENT COMMUNITY Valley View Retirement Community 4702 E Main St, Belleville, PA 17004 (717) 935-2105 www.vvrconline.org
Lewistown Health & Fitness 109 S Plaza Dr, Lewistown, PA 17044 (717) 248-6995 www.lewistownfitness.com
HEARING Uhring’s Hearing & Balance 1130 West 4th Street Ste. 2, Lewistown, PA 17044 (814) 641-4327 www.uhrings.com
HOME CARE AGENCY In Home Services of Central PA 3 West Monument Square Suite 304, Lewistown, PA 17044 (888) 881-2046 www.inhomeservicesofcentralpa.com INSURANCE Paul A Kline Insurance Agency 31 S Main St, Reedsville, PA 17084 (717) 667-3994
MASSAGE THERAPY/WELLNESS Nadya’s Massage 129 Nolan Dr. Lewistown, PA 17044 814-933-9379 www.nadyasmassage.com The Sentinel
PHARMACIES Greenway Pharmacy 310 S Main St, Yeagertown, PA 17099 (717) 953-9534 www.greenwaypharmacy.com
TELEPSYCHIATRY SERVICES Primary Health Network 106 Derry Hts Blvd, Lewistown, PA 17044 717-447-0340 www.primary-health.net
VITAMINS/ESSENTIAL OILS Country View Dry Goods 85 Wengerd Ln., Belleville, PA 17004 1.5 miles west of Belleville on Rt 305
WOMEN’S HEALTH Mifflin County OB/GYN Stephen Solomon, MD 130 Highland Ave Ext, Lewistown, PA 17044 (717) 247-7918 www.mifflinobgyn.com
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Kidney Smart Is the Smart Start Kidney SmartSM Classes
: : Kidney Disease Education : : Expert Educators : : No Cost : : In class, you will learn: :: How kidneys function and the causes of chronic kidney disease :: How medications, diet and nutrition work together to keep you healthy :: How to continue educating yourself and what treatment choices are available Join us for an upcoming class in your area:
2nd. Thursday of every month at 10:00 AM All classes held at Davita Lewistown Dialysis, 611 Electric Avenue, Lewistown, PA 17044 Sign up today at KidneySmart.org/Class or call 717-248-2344 Page 24
2020 Health & Medical Guide
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