Our physical health plays a huge role in how we age. Good health is often associated with higher quality of life. When we feel good physically, we feel better mentally. Life is just easier when we feel better. Chronic health issues often include pain and lifestyle limitations. We don’t feel well, so getting out is harder to do. We skip lunch with friends. We don’t visit the grandkids. Long car rides can be painful or cumbersome. Pain management can become the focus of the day rather than enjoying the hobbies we once loved: gardening, sports, cooking, socializing and even working. For many, the idea that pain or chronic health issues are simply part of aging is a normal belief. We have seen images of older adults with myriad health issues, and this image has become the norm. We even begin expecting to feel sick, tired or achy as we age. But this expectation doesn’t have to be a reality, and even when we face chronic health issues, there are often answers and solutions we aren’t aware Amongof.
AUGUST 2022 - 1 ASK THE EXPERT: MEDICALERT AWARENESS FEATURE: OPTIMUM HEALTH: WHAT YOU NEED TO KNOW ABOUT PELVIC FLOOR FAMILYDYSFUNCTIONHISTORY & STORYTELLING: USING GENOGRAMS FeatureCONTENTSIntro:A U G U S T 2 0 2 2 continued page 6 Optimum Health: What You Need to Know About Pelvic Floor Dysfunction
health issues often untreated, pelvic floor issues affect large numbers of older adults. According to the National Institutes of Health, the frequency of pelvic floor disorders increases with age, and affect as much as 50% of women between the ages of 60 and 80. This means nearly half of all women struggle with pelvic floor issues, many of them untreated and ongoing. It’s not just women who struggle with pelvic floor symptoms. Men often have pelvic floor problems as well. No matter the gender of the patient, treatments are available and information is key.
AUGUST 2022 - 2 EDITORTHEFROMLETTER
Perhaps the most accurate description of these August days comes from Natalie Babbit’s children’s book, Tuck Everlasting:
Finally, we begin a monthly series on personal storytelling and family history, which will continue throughout the rest of 2022. This month, we begin with the concept of a genogram, the basis for exploring much of our family history and providing a framework for not only creating memoir but also better understanding our family dynamics.
“The first week of August hangs at the very top of the summer, the top of the live-long year, like the highest seat of a Ferris wheel when it pauses in its turning.
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August brings with it the final dog days of summer. As a matter of fact, August 11th is the last of these days, which began July 3rd. We are winding down from the high temperatures and peak humidity. At least that’s the idea. I’m not so sure, as I sit post-storm in what can only be described as clinging humidity, that the dog days won’t last a bit longer. Something tells me August 11th won’t usher in cooler temperatures and drier air, but I remain ever hopeful that fall is, indeed, around the Thisbend.month we explore Pelvic Floor Dysfunction (PFD) in our feature. We are lucky to gain insight and advice in an interview with Dr. Sara Morrison, PT, DBT. Dr. Morrison, a physical therapist with a practice based in Lillington, explains what PFD is, what the symptoms are and how it can be treated for better quality of life. You’ll want to read this for yourself and your loved ones, many of whom suffer in silence. In this month’s Ask the Expert, AOS Care Management Associate Ashley Seace answers a reader’s question about MedicAlert bracelets including what they are, who should consider wearing one and why they’re important for safety, security and independence.
The weeks that come before are only a climb from balmy spring, and those that follow a drop to the chill of autumn, but the first week of August is motionless, and hot. It is curiously silent, too, with blank white dawns and glaring noons, and sunsets smeared with too much color. Often at night there is lightning, but it quivers all alone. There is no thunder, no relieving rain. These are strange and breathless days, the dog days, when people are led to do things they are sure to be sorry for after.” Here’s hoping for cooler temperatures and no regrets!
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AUGUST 2022 - 4 AWARENESSMEDICALERTEXPERT:THEASK 136 mode rd., west end, nc 27376 go2sandhills.com 910-673-2251 MyQuestion:mom’s neighbor has a MedicAlert bracelet, and my mom is asking me if she should get one. Can you explain more about the benefits of using a MedicAlert bracelet? What are they used for; who should wear one, and what do I need to know to give my mom an educated answer? GreatAnswer:questions!
Wearing a medical alert bracelet can also give your mom confidence to remain at home and to remain independent. Living alone can increase anxiety; a medical alert bracelet can help ease some of the worry of living alone.
ashleys@aoscaremanagement.com|AssociateManagementCareSeace,Ashley
Wearing these bracelets allows for medical professionals to know what medical conditions, medications, or allergies someone might have. This information can lead to fewer medical errors, which can be fatal. The idea for a medical alert bracelet came about in 1953 when a 14-year-old girl went for a routine test at the hospital, then went into anaphylactic shock. This gave her and her family the idea to create a bracelet with a medical symbol on one side, then the instructions on the other side. The MedicAlert foundation was started in 1956, going on to create a widespread database of medical records for people and now provides information that can be be worn around your neck or wrist. They communicate health information in the event of an emergency through connection to an online health
MedicAlertlifesaving.tagscan
record. It is accessible 24/7 through an emergency response service. When there is an emergency, the service calls emergency medical personnel. The benefit to having a medical alert bracelet is access to medical personnel 24 hours a day, 7 days a week in the event of an emergency. This gives both you and your family peace of mind that your medical conditions will be recognized and understood. Your family will know that regardless of where they are, their loved ones will remain safe and medical professionals treating your loved one will have updated information for best treatment outcomes.
August is MedicAlert Awareness month, so this question comes at just the right time. Medical alert bracelets are a great resource for those living alone and those who have life-threatening health conditions.
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If you have one or more health conditions, allergies, medications, or medical instructions that would be needed in an emergency, then you should consider wearing a medical alert bracelet. They are strongly recommended if you have conditions such as asthma, diabetes, epilepsy, down syndrome, cardiovascular problems, and seizure disorders. They are also strongly recommended if you have allergies such as a peanut allergy, shellfish allergy, and penicillin allergy. If you take certain medications (like a blood thinner or use an EpiPen) you should also consider wearing a medical alert ID and always wear it; you never know when an emergency will happen. First responders are trained to look for medical alert identification. Knowing your medical conditions is important to prevent misdiagnosis or unwanted drug interactions and treatments. Medical alert bracelets or necklaces should be updated as your medical needs change. If you have a significant change in your health, you need to have a medical alert ID that reflects that Regardlesschange. of the condition, allergy, or medication you may be wearing one of these IDs for, they can save someone’s life. If you cannot speak for yourself and do not have someone available that you trust to relay this information, then a medical alert ID can speak for you. A crisis does not wait for anyone, so it is important to prepare early and keep these items updated to best reflect your health. Living Memory Care Memory Certified 612 www.openarmsretirement.com910-875-3949
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Optimum Health: What You Need to Know About Pelvic Floor Dysfunction
AUGUST 2022 - 6
ONC spoke with physical therapist Dr. Sara Morrison about what pelvic floor issues are, how they show up in the body and how to treat them effectively for better overall quality of life. This interview has been edited for length. ONC: Can you explain a little bit about how and why someone might come to you for pelvic floor therapy? What are the symptoms of a pelvic floor issue or problem? Sara Morrison: There are many symptoms that your pelvic floor is not working correctly. It’s important to remember that these are just symptoms. Just like when you have a cold, you do not treat the runny nose or watery eyes. You treat the cold. The same goes for pelvic floor symptoms. If you experience any of these symptoms that are listed, it signifies that you may have pelvic floor issues. Many of them are more commonly known, while others are not so well known. Symptoms can include, but are certainly not limited to: Pelvic or lower back pain, groin pain, leaking urine or stool at unwanted times (this may be a large amount or only a few drops). Often this is with coughing, sneezing, laughing or lifting. Having a sense of urgency when you need to use the rest room. Feeling you have not fully emptied your bowel or bladder after using the toilet. Having difficulty starting or stopping bladder or bowels.
Less known symptoms include:
ONC: What are some of the conditions a patient might have that pelvic floor (PF) therapy can help address?
Once we improve the way you breath, your upper back, chest, abdominal muscles, diaphragm, and pelvic floor are allowed to function better. We also get the core muscles strong and make sure they work in a coordinated manner. When we do this, there will no longer be excess strain on the pelvic floor. Amazingly, this improves leaking, the ability to fully empty your bowels/bladder, gastrointestinal symptoms, pain and more. As a bonus, when you are getting more air into your body you will notice more energy, feel stronger and have less fatigue.
ONC: What are the main myths or misconceptions people have about pelvic floor issues?
SM: Physical Therapy is a great way to improve these embarrassing symptoms and get back to “normal.” Surprisingly, the pelvic floor affects many functions throughout your body. When you get it working right you will be amazed at how good you feel and how much energy you have! Pelvic Floor Physical Therapy uses EXTERNAL exercises, stretching and massage. Nothing is put inside of you. Surprisingly, the first step of fixing your pelvic floor is working on your breathing. Most people are not breathing properly.
ONC: How does physical therapy help resolve this issue?
SM: I can think of five primary myths related to pelvic floor disfunction, including:
SM: During pregnancy or after having a baby, PF Physical therapy can greatly prevent and treat issues with weakness, pain or posture that are commonly associated with these conditions. If you had a more traumatic delivery that required episiotomy, forceps, vacuum or other emergency procedure, Pelvic Floor Physical Therapy is often needed to correct the short term and long-term conditions that you may experience. It is very important to remember that these problems can show up or worsen many years after having your Itbaby.isalso helpful with chronic back or pelvic pain, erectile dysfunction, hernia, Gastrointestinal issues (acid reflux, IBS, chronic constipation/diarrhea, etc.) or Nurse’s bladder. Nurse’s bladder is a term used for people that do not have the ability or time to use the bathroom regularly. Due to the constant “holding” of their bowel or bladder, the pelvic floor muscles can become extremely tight. When this continues for a prolonged time it can often cause pain or leaking of urine or stool. As the name suggests, this condition is common in nurses, but also in many other professions. One profession that is often overlooked is our military. When deployed, our military members often do not have a safe place to use the toilet. The constant “holding it” can cause significant issues that are often undiagnosed.
Also, pelvic floor dysfunction (PFD) is very common with hormonal changes. It can often occur at puberty, pregnancy, post-partum, menopause or with surgery involving any reproductive organ.
2. Men do not have pelvic floors and do not need pelvic floor PT. FALSE! Men benefit greatly from PF PT. It’s a great way to improve gastrointestinal issues, Nurse’s bladder, prostate problems, or erectile dysfunction.
• After Prostate surgery
AUGUST 2022 - 7 • Acid Reflux • Chronic Constipation/Diarrhea • Diastasis Recti (abdominal separation commonly seen after pregnancy) • Erectile dysfunction • Hernia
1. Leaking after having a baby or as we age is normal. FALSE! It is common and happens to many people, but it is not normal. And there are easy ways to fix it
ONC: Pelvic floor issues are often associated with women, but men can also have problems. Can you talk more about how men present with pelvic floor issues and how they are treated?
AUGUST 2022 - 8
procedures suffer leakage of bowel and/or bladder. The leakage experienced after this is often much more severe than seen in women. This often causes men to be afraid or embarrassed to leave the house.
5. Pelvic Floor Therapy sounds expensive. FALSE! It is covered under your regular health insurance. Most insurances (including all forms of Medicare) do not even require an order from your doctor to be seen!
3. I don’t want anyone to touch my groin, so I cannot get pelvic floor PT. FALSE! Pelvic Floor PT can be done externally… with your clothes on… without anyone touching your groin.
4. I exercise a lot and am very strong. I don’t need pelvic floor PT.
FALSE! Pelvic Floor PT regulates the pressure in our body. It has to do a lot with balancing the body. Just because you are very strong does not mean your muscles are balanced or working in a coordinated manner. You can still benefit from Pelvic Floor PT if you have any of the symptoms.
ONC: Why do you think pelvic floor therapy is often overlooked? Why do patients fail to seek treatment?
SM: Men have pelvic floor muscles too! Like women, these issues can severely impact a man’s lifestyle. Pelvic floor issues experienced by men include back, pelvic or groin pain; erectile dysfunction, and leaking of the bowel or bladder. Many times, men have the feeling that they cannot completely empty their bladder. Sometimes the urine stream is hard to begin, or they feel they must go again shortly after they urinate. Because the prostate is so closely connected to the urinary systems, many men that undergo prostate
Pelvic floor exercise is very effective for all these issues. No matter what the cause of your pelvic floor dysfunction, pelvic floor PT shows amazing results! For example, erectile dysfunction has many different causes other than pelvic floor muscle weakness (such as diabetes, high blood pressure, stress, etc.).
Exercising the muscles in the pelvic floor will not only strengthen the pelvic floor, but it also causes an increase in blood flow to the area. This will allow more blood to nourish the tissues which can in turn provide more muscular support and more blood flow to achieve or sustain erection. No matter what the main cause of ED is, exercise is beneficial. Exercise is also a great treatment for many other factors that cause erectile dysfunction. This means it will not only improve the ED, but also the issue causing ED. Talk about a win-win situation! In fact, pelvic floor PT is so beneficial for ED that many doctors are now prescribing exercise before medication. They then use medication only if needed after initiating exercise. (And remember, no one needs to touch your groin to do this)
AUGUST 2022 - 9
SM: I think there are several reasons. Some of them
SM: I have seen amazing results in people’s lives after pelvic floor PT. The biggest change is that people are no longer embarrassed to leave their house. They are now “free” to go places without worrying about leaking in public. They no longer worry about needing to locate the bathrooms every place they enter. It gives them back their freedom. With many people, especially in men, there is a feeling that they are no longer a “real man” because they have problems with their male organs. Pelvic Floor dysfunction is very closely tied to depression in men. Once we improve the pelvic floor, their feeling of self-confidence can be restored.
SM: I was most surprised at how many people suffer from pelvic floor dysfunction. Millions of Americans are silently suffering from PFD. I am also amazed at how many issues in your body can be traced back to your pelvic floor not functioning correctly. I also had no idea how many issues in your body can occur with prolonged issues with your pelvic floor. The good news is once we improve your pelvic floor functioning, many of these issues improve!
3. Lastly, I think people, including health care providers, do not fully understand the pelvic floor. The pelvic floor is made up of 9 different muscles. Just like any other muscle they need to be strong, need to have the ability to move and need to be able to do its job. If it does not do its job right, it can cause problems. It just happens that the job of these muscles is to hold up your organs and release your bowel and bladder. That often leads to embarrassment. There is nothing embarrassing about having pain in a neck muscle, or a neck muscle not working properly. In the same manner, we need to not be embarrassed about a pelvic floor muscle that is not working correctly. Especially when it is so easy to fix!
ONC: As a physical therapist treating pelvic floor dysfunction, what has surprised you most in this work?
1.include:Ithink the main reason PF PT is overlooked is that people think leaking is normal. They think as we get older leaking is a normal part of aging. They think it is normal if you have had a baby. This is simply not accurate. It is not a normal part of aging and is easily fixed.
ONC: How can pelvic floor therapy help improve quality of life in patients, both male and female?
2. Another reason I believe this is overlooked is that pelvic floor issues are often embarrassing. Surprisingly many people will not even mention these issues to their doctor. I have asked several primary care providers how often their patients discuss leaking of bowel/bladder with them. Most of them said they are never asked about leaking by their patients! Wow! If we never talk about this, how do we expect it to be fixed?
editor@outreachnc.com}ChiefinEditorPhariss,Amy
AUGUST 2022 - 10 GENOGRAMSUSINGSTORYTELLING:&HISTORYFAMILY
A few months ago, as part of a counseling training, I completed a genogram. Before this training, I’d only vaguely heard of genograms as part of my education, but I’d never engaged in completing one. It was one of those murky topics that sounded useful…if I had any clue what it was or how to use it properly. I filed the term genogram in the back of my mind and figured one day it might be relevant. That day came (as they always do), and I was forced to explore the genogram not only from a clinical perspective but with my own family history. I thought: no big deal. I’m a counselor and writer. I’ve helped many people tell their stories, both verbally and in writing. I listen to family histories on all fronts, all day long. So, my own family history should be easy. I reached out to my parents and asked for a few details regarding birth dates and other relevant facts to fill in the family tree. What I got back was stunning. A genogram is a visual representation of a family’s history and structure. It’s often created like a family tree, but a genogram traces much more than births and deaths. For example, a genogram might be created to trace a family’s medical history. Starting with one generation, a genogram might trace three or four more generations, marking the cause of death for each person or major medical issues experienced by family members. We can trace medical histories and see patterns within families that otherwise may go unnoticed. A genogram may also trace mental health diagnosis or even fertility issues. What seems confusing when we try to collect data in our heads becomes clear when we map it out in a visual way, and many times, counseling clients and social workers are able to identify relationship patterns, habits, illness or socio-economic growth through a genogram. Genograms are used in many fields including counseling, psychology, medicine, genealogy and education. In a non-clinical sense, genograms
www.myheritage.comwww.ancestry.com/genogramwww.genopro.com
a genogram is a great place to start when you’re trying to create a family history. It allows families to clarify issues and clear up misconceptions. It lets us explore deeper into our family’s past and better understand how that past affects the present. We are able to see how our family constellation is connected in an organized matter. Counselors use this as a first-step in assessment during family counseling, creating a snapshot of the family to begin work. But genograms aren’t only useful in the clinical sense. We can all benefit from exploring our past and family histories in an organized manner.
AUGUST 2022 - 11 can give a basic framework for exploring family history using a pre-set structure and symbols to represent links and connections between family Essentially,members.
The point is to begin, which is exactly what I did several months ago when I texted a very simple request to my parents for the dates of my grandparents’ and great-grandparents’ births and deaths. This led to conversations between family members yielding untold stories, discovered truths, and gaps in knowledge (we do not know, for example, how or when my uncle died).
Most importantly, exploring our family history led to some surprising healing. What my mother learned about her mother helped my mom better understand and accept her childhood. As my mother said, “It makes sense now.” For my mother, who is 67 years old, having peace about her childhood after her mother’s death is a blessing. We are never too old for healing, understanding and peace. For more information about genograms and to get started in exploring, visit these sites:
For many who wish to write family stories or memoirs, the task can seem overwhelming. Where do we start? Who do we talk to? What memories should be included? Who is related to whom, and how? A genogram is a way to start the process, dipping one’s toe into the deep pool of information, stories and memories that make up the collective history of a family.
Starting a genogram can be as simple as grabbing a sheet of paper and writing your name and then filling in branches for your parents, siblings and grandparents. From there, the branches can keep going back as many generations as you can find information or as you wish to explore. You might include cousins, nieces and nephews or even nontraditional family members (those people who act as family but are not blood-related). You can start by simply adding birth dates and, if applicable, dates of death. You can then fill in gender, profession, health issues (mental and physical), marriages, children, etc.
AUGUST 2022 - 12 RCC service is available for individuals who have hearing loss or speech disability to actively participate in teleconference calls or webinars by reading live captions on their laptop, mobile device or tablet. To inquire, contact kim.m.calabretta@t-mobile.com or visit relaync.com/rcc Accessible Communication with Captions! Relay Conference Captioning of a Senior Living Community. Retire Your Perception A Life Plan Community offered by Liberty Senior Living © 2022 Quail Haven Village Call 910.537.6812 to schedule a visit and discover all that Quail Haven Village has to offer. QUAIL HAVEN VILLAGE OFFERS A picturesque location conveniently close to the Village of Pinehurst Newly renovated garden apartment homes Our INSPIRE wellness program that helps promote an active lifestyle Preferable Rental model that requires no large, up front fee Continuing care on-site to provide peace of mind SCAN HERE 1 55 BLAKE BLVD., PINEHURST, NC 28374 QUAILHAVENVILLAGE.COM Limited Availability - Call Today! 122098 quail haven retire your perception planting ad-outreach nc.indd 1 6/14/22 5:01 PM HOMEALZHEIMER’STHERAPY CONTACT US TODAY FOR A FREE CONSULTATION 779-ALZ-HOPE KSZUCH@ALZHOMETHERAPY.COM(259-4673)WWW.ALZHOMETHERAPY.COM Our unique therapy improves emotional well-being and physical functioning while slowing mental decline. SensoryPhysicalCOMPONENTS:THERAPEUTICActivityTherapyBrainGames
AUGUST 2022 - 13 GRAY MATTER GAMES ACROSS 1. Dried coconut meat 6. Alliance that includes Ukr. 9. "Beat it!" 14. Bailiwicks 15. "___ to Billie Joe" 16. Fragrant resin 17.Type of insect reproduction 20. Buttonhole, e.g. 21. Burning 22. Assistant 23. Kama ___ 25. Bread maker 27. Log cutter 29. Grand Canyon transport 31. Aloof 32. ___-guided 34. Raised to the third power 38. Obvious (hyphenated) 41. Association of Southeast Asian Nations (acronym) 42. Drunk, in slang 43. "___ Ng" (They Might Be Giants song) 44. Affirm 46. Adjusted 48. ___ fly 51. Alleviated 52. Bookbinding leather 53. Blatant 56. Steals 59. Government income (2 62.wd).01 of rupee 63. Dumfries denial 64. American symbol 65. Artist Max 66. Armageddon 67. Big Bertha's birthplace DOWN 1. Beanies 2. Face-to-face exam 3. Court enclosed by columns 4. House rodent genus 5. ___ Wednesday 6. Kind of line 7. "American ___" 8. ___ lily 9. Clinton, e.g.: Abbr. 10. Leave (2 wds) 11. Gum 12. OrganiccontainingcompoundCONH2 radical 13. Moliere comedy, with "The" 18. Swab target 19. The America's Cup trophy, e.g. 24. Gifts 26. Amusement park features 27. Galileo's birthplace 28. Frosts, as a cake 29. Contradict 30. ___-Altaic languages 33. Advance, slangily 35. Embarkments 36. Coastal raptor 37. Pair 39. Color Retention 40. Cancel 45. Long, long time 47. Lover of Dido, in myth 48. Balderdash 49. Navigational aid 50. Dine at home (2 wds) 51. Blew it 54. Barn topper 55. Brio 57. Stubborn beast 58. Caught in the act 60. Backstabber 61. Certain intersection
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AUGUST 2022 - 16 At Fox Hollow Senior Living, our residents have the opportunity to do everything they’ve always loved. With Five Star Dining, days filled with friends and adventures, you can be yourself again – while we take care of the rest. Make Every Day Five Star FOX HOLLOW SENIOR LIVING COMMUNITY 190 Fox Hollow Road • Pinehurst, NC 28374 910-695-0011 • www.FoxHollowSeniorLiving.com ASSISTED LIVING • MEMORY CARE RESPITE/SHORT-TERM STAYS ©2021 Five Star Senior Living Call to visit and explore community.our
