Kerr County People magazine by Showcase-Creations Photography & Web Design

People Kerr County

T H E P R E M I E R M AG A Z I N E C E L E B R AT I N G T H E

Kathy Dietert and

Annabelle Lindner The Women Behind Tri County Home Health

COMPLIMENTARY JAN-FEB 2011

P E O P L E & L I F E O F K E R R CO U N T Y

People Kerr County

THE PREMIER MAGAZINE CELEBRATING THE

PEOPLE & LIFE OF KERR COUNTY

Dear Friends & Neighbors, We hope you had a blessed Christmas and are looking forward to a new year ﬁlled with an abundance of all things good. We’re more fortunate, living here in Texas, than many across the land—let us all do as much business here at home as possible—helping our friends and neighbors, thinking of them ﬁrst with our purchasing needs. Keeping as much money here at home as we can will help our entire community. Abundant Blessings,

Look

inside January - February │ 2011

EVENTS 22 KCWC Christmas Luncheon 23 1550 Gallery Anniversary Party 24 Hill Country Market 25 Garden Clubs 26 Nutcracker at the Cailloux

ARTIC LES 5 All in the Family 8 Chocolate Fantasy

COVER

10 Cover Story - Tri County Home Health 15 Chef Dady at the Dietert Center

Kathy Dietert and Annabelle Lindner Tri County Home Health

16 Seeing Red

Photo by Sally Davidson 830.998.1004

19 Title Talk

17 Landscaping & Gardening 18 Home Building 20 Skin 101 30 Automotive Tips 31 Graves Eye Disease 32 Fight Cancer Naturally 33 Hospice Care

Visit us online at kerrcountypeople.com

34 Hip Replacement

Diane Ferrell Editor & Publisher diane@kerrcountypeople.com

38 Peterson RMC Volunteers

830-285-0973 Mark A. Jackson Studio Rio Art Director mark@kerrcountypeople.com

Kerr County People PO Box 291402 Kerrville, TX 78029 KCP reserves the right to edit and/or refuse any submitted materials. The opinions expressed are those of the authors and do not necessarily reflect the opinion of KCP. Ads created for this magazine are copyrighted by Studio Rio and and may not to be used in other publications or print without permission . All Rights Reserved Copyright 2011 Kerr County People Magazine.

37 Home Health Care

D EPARTMENTS 6 The Arts 12 Kerr County Cuties 29 People & Stuff 36 Women's Health

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All in the Family by Doyle Weaver

The

use of generation skipping tax trusts, sometimes referred to as a “dynasty trust,” appears to be on the horizon again as an estate planning tool. Besides its tax advantages, these trusts have other appealing attributes. One of the purposes of a “dynasty trust” is to set aside assets for multi generational beneficiaries, a motive not always favored in law, at least, historically. With these types of trust agreements, a person can set aside assets in trust for the use and enjoyment of beneficiaries, almost perpetually. By the time this article is published, the federal estate tax and the federal generation skipping tax boogie man may be resurrected from the tax grave. For those of you who did not know, there was no applicable federal estate tax or generation skipping tax for the year 2010. If you are reading this article and happen to be wealthy, even moderately, then you may have missed the best opportunity of our lifetimes to die and leave your assets to your children and grandchildren “death tax” free. Pending Congressional intervention, January 1, 2011, will bring the repeal of The Economic Growth and Tax Relief Reconciliation Act of 2001 (EGTRRA). This change in the law will return us to the pre 2002 federal estate tax exemption amount of $1 million. The exemption had risen to $3.5 million in 2009 and was extinguished entirely in 2010. Estates will be subject to an estate, gift and generation skipping tax (GST) rate of up to 55%. For the wealthiest, the rate could go as high as 60%. Specifically, the GST discourages people from gifting their assets to generations other than their children and is intended to thwart the accumulation of family wealth. Not only is there a GST that penalizes wealth

accumulation, there has historically been a common law rule codified into all the various states meant to deter generational wealth creation. The “rule against perpetuities” comes from medieval English common law case, Duke of Norfolk’s Case, 3 Ch. Cas. 1 (1682.) The rule was intended to discourage property owners from creating future interests in property that would not actually transfer to any certain and known person within a certain specified and limited time period. As an example in Virginia, prior law prohibited property transfers to a future interested party or parties beyond the life of an actual being alive at the effective date of the instrument creating the interest, plus 21 years and 10 months. In Texas, a similar rule is found in the Texas Property Code §112.036. In the last few years, a dozen or so states have repealed or modified their statutes governing the rule against perpetuities, including Virginia. The result is a trust now may be established for the benefit of near perpetual generations allowing for the creation of future and potentially staggering family wealth trusts. Unfortunately, Texas is not one of those states. A “dynasty trust” can be set up to maximize the rule against perpetuities in Texas, but, the statutes in a few other states, like Virginia, can be put to better use to extend these trusts almost perpetually. Under certain statutory conditions these

trusts, for instance in Virginia, can be utilized by Texas and other non-residents of Virginia. These trust instruments appeal to people who want to keep family businesses and possible family farms and ranches “in the family” without having to legally split up and distribute the interest among the then living heirs. If the trust is properly drafted, limiting the estate tax and GST tax consequences, the estate taxes and GST may be locked in at the current value while the principal and income can accumulate without further estate tax consequences. Most likely, the “death tax” and GST is with us again. For this reason and others as discussed in this article, a “dynasty trust” or other similar instrument drafted for the same purpose in mind may be a solution. These documents can become key estate planning tools for those with the desire and need to preserve assets for future generations; but, requires extensive planning and consultation with a properly qualiﬁed attorney.

Doyle Weaver earned his JD from Regent University School of Law in 1990; was licensed to practice law in Virginia, 1991 and in Texas, 1997. Doyle is the host of Hill Country Lawyer, aired weekly on local KVHC television.

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843 Sidney Baker St., Suite 101 • Kerrville, Texas 78028 KCP │ Jan-Feb 2011 │5

art...

the gift that lasts forever.

Gallery - Framing - Printing 832 Water St. Kerrville, TX 830.895.5184 riversedgegallery.net riversedgegallery@gmail.com

Landscape Oils, Jewelr y and Other Original Ar tworks Looking for a new hobby or ever wondered if you could spin a pot?

Learn the art of pottery making on the potter’s wheel. Master potter Mark Jackson will guide you through the basics, from centering to shaping clay into beautiful pieces of art work.

Classes held Monday and Wednesday evenings, January through March. Register now to reserve your potter’s wheel. Contact The Hill Country Arts Foundation’s Visual Arts Department for details. 830-367-5120

the arts index

Chocolate Fantasy

Weekend

presents

February 12 & 13, 2011

Wine Seminars and Cooking Demos Delectable Desires Food and Wine Tasting Event

KERR ARTS AND CULTURAL CENTER

Gallery Hours: Tues. - Sat. 10–4, Sun. 1–4 228 Earl Garrett - Downtown Kerrville 830-895-2911 www.kacckerrville.com

Chocolate Extravaganza

All The Chocolate You Can Eat Silent & Live Auctions

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Feb. 11-26

Fri.-Sat. at 7:30 p.m., Sun. at 2 p.m.

Alma Hobson Jan. 21-Feb. 26

Reception - Feb. 11, 6-7:30 p.m. Gallery Hours: Tuesday-Saturday 10-4 p.m.

by John Cariani

& CUT by Ed Monk

THE GALLERY AT THE POINT

CUT By Ed Monk

SAVE STONEHENGE II Help us move Stonehenge II to the Hill Country Arts Foundation. Contact Rosanne at 830-367-5121 to make your tax deductible donation.

120 Point Theatre Rd. South • Ingram • 830-367-5121 • hcaf.com

ARSENIC KING and Old Lace A Broadway Experience In Your Home Town ARTHUR CHRONICLES THE noises CRUCIBLE Much Ado About Nothing THE MUSIC MAN

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Chocolate Fantasy Weekend

What hat could be sweeter than a Chocolate Fantasy Weekend? The new, re-imagined Chocolate Fantasy Weekend at Kerr Arts and Cultural Center, February 12th and 13th promises to be a fanciful gala with tantalizing additions of cooking demonstrations, wine seminars, and a wonderful food and wine pairing event on Saturday. On Sunday, the Chocolate Fantasy will repeat its annual favorite happening with a decadent all-you-care-to-eat chocolate buﬀet. Guests will have the option of purchasing tickets ala cart or for the full fantasy—an all-inclusive passport—good for every event. Those wanting a dreamy Valentine’s Day weekend ﬁlled with entertaining, educational, and delectable culinary delights, will not want to miss this Chocolate Fantasy Weekend. Call 895-2911, visit www.kacckerrville.com or come by 228 Earl Garrett Street in Kerrville, Tuesday – Saturday 10 – 4 or Sunday 1 – 4.

Chocolate Extravaganza All The Chocolate You Desire Silent & Live Auctions

8 │ KCP │ Jan-Feb 2011

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cover story

A R AY O F S U N S H I N E

No Place Like Home

by Skye Alexander

It’s a team effort An elderly man can’t manage his medications and diet by himself. A new mother needs help dealing with her baby’s medical issues. A person who’s just been released from the hospital requires assistance with bathing, wound care, and personal hygiene. These are only a few of the many temporary and long-term problems handled by the nurses and aides of Tri County Home Health and Alternative Health Care. By providing skilled medical care and custodial services to all generations, home healthcare professionals enable local people to stay in their own homes instead of going to nursing homes or assisted living facilities. “People get better faster at home,” co-owner Annabelle Lindner, RHIT points out. “There’s no place like home.” Co-owner Kathy Dietert, RN, BSN explains that most people turn to home healthcare because 10 │ KCP │ Jan-Feb 2011

they’ve experienced a change in their life situations––a new illness, an accident, release from the hospital, or the loss of a personal caregiver. They don’t need to be institutionalized, but they can’t function entirely on their own either. A few hours of professional care daily or several times a week can allow them to safely remain in the comfort of their homes. As our population ages, providing quality healthcare in the most aﬀordable manner has become a growing concern for our country– –particularly in retirement communities like Kerrville. According to a report issued by the AARP Public Policy Institute in 2009, three people can be cared for in the home for what it costs to keep one person in a nursing home.

at Tri Count y “People get better faster at home.” A Passion for Excellence “Healthcare is my life,” says Annabelle, a third-generation Comfort resident who has worked in the healthcare field since 1964. Kathy, a twenty-year resident of Kerrville, was an operating room nurse for thirteen years in San Antonio before shifting to home healthcare. These two “hometown girls” joined forces while working together for another home health agency. After two years, Kathy recalls, “we decided if we were going to work this hard we were going to have our own agency.” In 1997, they launched Tri County Home Health and Alternative Health Care, located at 117 Hugo Street in Kerrville. Fourteen years later, the agency has expanded beyond the three counties it initially covered. Now eighteen nurses and sixty aides provide a wide range of services to patients in Kerr, Gillespie, Bandera, Bexar, Edwards, Kendall, Kimble, Medina, and Real counties, and a nurse is available ’round the clock. All nurses have at least five years of experience working in operating rooms, hospitals, or home healthcare. Aides have many years of experience, too, and some have worked with the agencies since 1997. Tri County Home Health also has an inhouse physical therapy department and contracts with physical, occupational, and speech therapists, social workers, and other professionals as necessary. James Young, MD, serves as Medical Director to make sure patients receive the best possible care. Recently added telemonitoring technology lets nurses monitor patients’ vital signs via the Internet and catch minor changes before they become major concerns. Each morning, this information is downloaded and reviewed. All nurses carry laptops and can download information at anytime to check on patients. As Kathy explains, “It’s a team effort. We’re the eyes and ears and voice of the patient for the doctor.”

The Human Touch When people become ill, injured, disabled, or diagnosed with terminal conditions, they feel vulnerable and angry. Often the children of elderly patients live far away or can’t cope with the responsibilities of their parents’ ailments. Sometimes an older couple may have managed well enough together, but when one passes the other can’t function alone. Home healthcare personnel must deal with the emotional and psychological ramifications of a patient’s situation as well as the physical aspects. Both Kathy and Annabelle agree, home healthcare is the hardest nursing job there is. “You’ve got to have a passion for it,” says Kathy, who describes herself as a people person. “I love it. I can’t imagine doing anything else.” Consistency is a major issue for patients receiving home healthcare. Once they’ve opened up the most intimate parts of their lives to a caregiver and come to trust that individual, they don’t want to have to start all over again with someone new. Because Tri County Home Health has a low personnel turnover, elderly as well as long-term pediatric patients can enjoy working with the same caregiver over a period of time. But home healthcare nurses and aides don’t just look after their patients, they also care for the families, friends, and animals. It’s not unusual for a member of Tri County Home Health’s staff to feed and water livestock as well as the household pets. One nurse even delivered a baby goat en route to visiting her rancher patient. “Not only do you have to be skilled and seasoned to be a homecare nurse, you’ve got to be fluid in your thinking,” Kathy points out. “Things are constantly changing. You have to deal with all the different personalities in order to make a cohesive living environment.” Caregivers also tend to their patients’ homes. Most homes require some adjustments when a person’s health and mobility decline, in order to ensure his or her safety. Personal

LVNs Sandy Trainum and Brandy Lanell with Cody Holmes

hygiene and meal preparation are two areas that present potentially dangerous challenges. Often minor updates, such as installing handrails beside the bathtub and toilet, can enable that individual to handle the mundane aspects of life. Home care aides shop for groceries, prepare meals, tidy residences, and assist patients with dressing and grooming themselves. Both Annabelle and Kathy say they love working with the elderly. “They all have fascinating stories to tell,” says Kathy. “It’s like listening to history live.” Annabelle agrees. “They’re the most fabulous people. They’ve given us our love of country, our work ethic. They deserve to be treated with dignity.” In order to help the community stay informed, Kathy and Annabelle write a home healthcare-related article in each issue of this magazine; see page 37 or logon to www. kerrcountypeople.com to read previous articles. Tri County Home Health and Alternative Health Care are licensed by the Texas Department of Aging and Disability Services. Tri County Home Health is certiﬁed by Medicare and Medicaid, and is a Blue Cross/ Blue Shield provider. They are also a member of the Texas Association of Home Care and Hospice. 117 Hugo Street, Kerrville. 830-8953100 or 800-506-5557. Skye Alexander is the author of more than two dozen books. She teaches an ongoing writing class at the Dietert Center. For more information, call 830-896-1275. KCP │ Jan-Feb 2011 │11

kerr county

Ava Grace DeMasco 8 months Submitted by grandmother Kathy McGehee

c u t i e s

Sydney Thies 6 month submitted by mom Liz Thies

Degan Cade Booth, 6 months old submitted by parents Micah & Danielle Booth

Tenley Grace Lybarger, 6 months submitted by grandmother Fay Faure

Madison Elizabeth Garza 2-1/2 months submitted by mother Patricia Garza

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CHEF JASON DADY RETURNS TO DIETERT CENTER FOR PASSPORT TO WORLD CUISINE’ Chef Jason Dady by Tina Woods Do you love great food and a great time? Then join us at Dietert Center’s “Passport to World Cuisine!” Chef Jason Dady, a well-known restaurateur, returns for two events at the Center in March. He’s the owner/operator of San Antonio’s most successful and innovative restaurants: The Lodge Restaurant of Castle Hills Bin 555 Restaurant and Wine Bar Tre Trattoria Two Bros. BBQ Market Restaurant Insignia We’re thrilled that Chef Dady will be returning for our Passport fundraiser – both events sold out last year and the food was fantastic! It’s a great way to enjoy world-class cuisine and help our seniors at the same time. Chef Dady will teach a three-course Cooking

Class on Thursday, March 3rd, and prepare a lavish ﬁve-course Gala Dinner on Saturday, March 5th. Each course represents a signature dish from one of his restaurants and will be paired with wine. Featured items from last year’s menus included Jumbo Lump Crab Napoleons with Spanish Piquillo Peppers, Mango, Avocado and Cilantro/Jalapeno Sorbet; Proscuittowrapped Lamb with Minted Cucumber Slaw, Orange and Fennel Aioli; Tuscan-marinated New York Strip with Yukon Gold Pave, Red Wine Braised Wild Mushrooms and Rosemary-Thyme Jus. Tickets to the Cooking Class are $75 each; the Gala Dinner is $125 each. Proceeds beneﬁt the Center’s operating fund.

the lives of the elderly. More than 57,000 “Meals On Wheels” are delivered annually, and 20,000 lunches are served in the main dining room, availably by donation for those who qualify. There’s also a wide variety of educational and recreational activities, and rewarding volunteer opportunities. The Center also assists less-active seniors with services that help them maintain their independence. Tina Woods is the Dietert Center’s Executive Director. Contact her for ticket or sponsorship information at (830) 792-4044, ext. 247, or visit the Center’s website: www.dietertcenter. org. The Dietert Center is located at 451 Guadalupe Street in Kerrville.

For more than 40 years, the Dietert Center has been the only non-proﬁt organization in Kerr County dedicated exclusively to enriching

Flattering Your Face Shape by Katie Kleespies

Round - characterized by a round chin. Because they lack the length of the oval face, the cut should create the illusion of length in the face—creating height on top of the head and minimizing face width by keeping sides ﬂat.

Rectangular - long and narrow with square

Several things need to be considered when choosing a hairstyle; one of the most important is what ﬂatters your face shape. A few tips: Oval - considered the ideal shape. Mathematically, it’s 1.5 times as long as its width; the forehead is slightly wider than the jaw. Ovals can wear most styles and lengths.

chin and jaw. The ideal cut creates width at the sides, disguising the narrowness. Fringe can shorten the face, and a side part will help to reduce the square appearance.

Pear - a narrow forehead and wide jaw line, with a round chin. The objective of a suitable style is to give the illusion of an oval face by creating width at the forehead and temples. Heart-shaped - widest at the temples and narrowest at the jaw line. Usually the chin is small and delicate. The objective is to create an oval by adding width at the jaw line. Diamond-shaped - widest at the cheek

bones and narrow in the forehead and chin. By creating width at the forehead and minimizing it at the cheekbones, the illusion of an oval face can be achieved.

Square - a square jaw line and hairline at the forehead. Jaw and brow are nearly the same width. They are too short, so a suitable style seeks to create height, elongating the face. Layer around the face to soften the jaw line. Hair should wisp around face to reduce squareness. While it’s not uncommon for someone to walk into a salon and say, “Give me a Jennifer Aniston,” the key to a ﬂattering style is choosing one that works with your face shape, not against it. $25 oﬀ chemical services (new clients). Katie is a nail technician and hairdresser. Call Katie at 370-4945, the Tin Star Salon, 319 Earl Garrett, Kerrville. www.hairbykatiek.com. KCP │ Jan-Feb 2011 │15

Seeing

RED

custom picture fr aming

by Kevin & Linda Pillow

e are very fortunate to live in Cardinal Country. Here in the Texas hills you will see the Northern Cardinal in great abundance. This beautiful bird is appropriately named after a high-ranking member of the Roman Catholic Church. They were named after the clergy member’s ceremonial scarlet robes and high, pointed hat. Seems like a perfect match considering the males red plumage and crest.

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The Northern Cardinal is known by many names—including common cardinal, cardinal grosbeak and Virginia nightingale. The most common “other” name is redbird. The Northern Cardinal is part of a three species songbird genus. The other two are the pyrrhuloxia and the vermilion cardinal. The pyrrhuloxia can be seen here in the Hill Country and is often referred to as the desert cardinal. The vermilion cardinal hangs out in the Caribbean. Cardinals are a favorite among backyard bird watchers. For one, they stay here year round and frequent backyard feeders. They are most likely the first ones at your feeders in the morning and the last ones there at dusk. Another fun reason to watch the cardinal is their courtship rituals. While looking for a mate in the early spring, the male twists towards the female, showing off his breast and spreading his wings. The females fall for it every time! Another interesting courtship ritual is the male feeding the female. We like to refer to this as a dinner date. Most people believe that cardinals mate for life. Not really true. In fact, they really aren’t all that “faithful” either. Studies suggest that between nine and thirty five percent of young result from a female mating with a male other than her assumed mate. It is also widely suggested that if one mate dies the other will go on, eventually finding another mate. Invite cardinals to your yard with an array of foods. They love safflower seeds, suet, and fruit. You will just gaze with amazement at these wonderful creatures.

Happy Birding! Kevin & Linda Pillow are the proud owners of Wilds Birds Unlimited Nature Shop located at 855 Junction Hwy in Kerrville. Each staﬀ member is a Certiﬁed Bird Feeding Specialist and can help you discover a refuge in your own backyard. 830-895-7393. wbu.com/Kerrville.

LANDSCAPING AND GARDENING by Zack Derese

The Outdoor Guy

Landscaping Resolutions for two thousand eleven What a year 2010 has been!

We have been blessed to work on some of the ﬁnest homes and commercial projects in the Hill Country. I am very thankful to live in one of the greatest places on God’s green earth. I hope your Thanksgiving and Christmas holidays were wonderful and you are ready to take on the New Year. Or maybe you only want to sneak into January 1st and hope it doesn’t notice you! Whatever the case, it is the time for New Year’s Resolutions and we wouldn’t want to disappoint you.

 

I will only water my lawn in the early mornings to conserve water and prevent lawn disease. Watering

late in the evening can promote fungus and disease. Watering in the middle of the day in the heat of summer just donates moisture to the atmosphere in the form of evaporation.

I will not cut my grass too short. When you adjust your lawn mower to a shorter setting, you’re robbing your lawn of its ability to produce sugar from photosynthesis, exposing sensitive root systems to excess sunlight, and allowing weeds to capture more sunlight and grow themselves. The grass must race to produce new blades using additional sugar reserves. Letting the grass grow long, then cutting it short can shock your lawn system. The clippings will be too thick to leave on your lawn, removing nutrients from the system. Dramatic cutting removes more of the leaf, leaving mostly bare stock. Thus, the plant is unable to produce extra shoots and brown patches are often the result. This, in turn, leads homeowners to think their lawns need more watering, a dangerous course of action for a lawn already weakened by shortened blades.



I will begin a master landscape plan. Even if it is only feasible to landscape in three, four, or even ten phases, having an ultimate goal will help you prioritize and keep you from “getting lost along the way.”

   

I will convert some of my problematic lawn space into xeriscaped shrub beds. Xeriscaped does not necessarily mean white gravel and 3 cacti. Xeriscaping can be very lush; it is simply the rational and intelligent use of watering, utilizing native and well adapted plants.

I will re-mulch my shrub beds. Not only does new mulch look nice, it conserves water by preventing evaporation, creates nutrients for the plants as it decomposes, and retards weed growth, which saves herbicide use and/or trips to the chiropractor! I will plant a well adapted tree with a long life span. Trees can save on utility bills by shading a home, save on watering by shading the lawn, and add value to your home in years to come. Some examples are: Monterrey Oak, Chinese Pistache, Live Oak, Mexican Sycamore, and Bald Cypress.

I will call Kerrville Landscaping to help me with these daunting tasks! Ok, ok, maybe I snuck up on you with that one. I know that most people can mow their own lawns or plant a few shrubs, but professional help should be called for with any major project—even if only for consultation. I know I have harped on it before, but planning and a working knowledge of plants, our climate, destructive animals, etc., are essential to a beautiful, functional landscape. We hope to be able to help with yours.

Happy New Year! Zack Derese has deep roots in Kerrville. As owner of Kerrville Landscaping, Inc., he has been in the landscape business for over 15 years. He is a Landscape Designer, holds an Irrigation License (LI#9453), a Backﬂow Prevention License (BPAT #10754), is NCMA certiﬁed for Segmental Retaining Walls, and is a Water Feature Specialist. You can reach K e r r v i l l e him at zack@kerrvillelandscaping. L a n d s c a p i n g . I n c com or call him at 830-377-4861. KCP │ Jan-Feb 2011 │17

home building by Derek Meier & John Merritt

High Efﬁciency Remodeling

ith America’s economy struggling, many homeowners are shifting gears in the way they think. Instead of selling the older home and buying a new one, they are upgrading or remodeling their existing home. This behavior brings up the same question again and again—can I remodel my home in such a way that it becomes energy efficient? Absolutely! From a financial perspective, there are numerous federal and state tax benefits in the form of rebates and tax credits. There are also home improvement loans based on energy efficient improvements. Due to all the benefits available, it actually pays to improve your home in an energy efficient manner versus conventional methods.

From a construction perspective, using energy efficient methods and materials creates long-term savings. There are numerous ways to incorporate energy efficient techniques when remodeling. From windows, doors, and insulation to appliances and energy efficient practices, we actually teach homeowners as we go through the building or remodeling process. They learn that their home is an interrelated system. The end result is happy clients with a new look to an older home, all done in a cost-effective and highly efficient manner. Whether building a new home, remodeling or adding on to an existing home, it pays to make informed decisions—talk with a building contractor who is high efficiency

certified and experienced to maximize your investment now and in the long run. HCMM Homes is owned by Derek Meier, whose family came to the Kerrville area in the mid-1800s. John Merritt is the company’s Project Manager. The two have almost fifty years combined experience in the construction trade. As members of the National Association of Homebuilders, they are certified as Design and Build Professionals and also as Green Building Professionals. For more information visit them at www. hcmmhomes.com or call 830.370.1558.

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Title Talk by Diane Green

A Positive Forecast

here is no time like a new year to reﬂect on events of the past and to look to a future full of opportunity and promise. We should all feel fortunate to live in Texas. We live in a state that has created an additional 174,900 jobs since last year. We live in a state that has weathered the economic downturn better than most. A recent Brookings Institute report stated that Texas cities rank among the highest U.S. in recession recovery. Our state’s unemployment rate is 1.5% lower than the nation as well.

As a title company professional, I am proud to protect the dream of homeownership in a state where we can boast a relatively strong economy. I recently read an article by real estate columnist Ron Schildknecht. His words inspire me. Ron states, “I believe now is the time to invest in your future and buy a home. Why would I advocate buying a home today when California recently had approximately 68,000 homes in the foreclosure process? Because we don’t live in California. By comparison, Texas had less than 15,000 homes posted for foreclosure during the same period. Texas home sales have remained a strong investment. Why would I recommend buying a home today when the media is still full of stories about the sub-prime lending debacle? Because home mortgage money is cheap and readily available for people with good credit who pay their bills and can afford the homes they are shopping for. Today, a typical home mortgage can be obtained with less than 4.5% interest. In the late 1970s people were applying for mortgages at 17%. For a $200,000, 30 year fixed-rate loan, today’s loan payment would cost $1,800 less now than in the 1970s. Homeownership has traditionally driven our economy and, I believe, it is the answer to our current economic woes.” Here’s wishing each of you a new year filled with opportunity, promise, and hope.

Sterling & 18k Earrings $140.00

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Merchants in America Since 1733

Visit Our Custom Design Center Diane Green moved to Kerrville in 1972 with husband, Bob, and immediately began her title insurance career at Kerr County Abstract & Title Co. This is Diane’s 38th year in the title business. She owns Kerr County Abstract. To learn more, call 257-5151 or visit www.kerrtitle.com.

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211 Earl Garrett  830-257-3373  Kerrville, Texas KCP │ Jan-Feb 2011 │19

Skin 1O1 by Emily Russ, LA, LMT

The

In order for your skin to look its best you must do your part. That means washing, exfoliating and hydrating it every day.

minute we take our first breath, the aging process begins. The speed at which we age relies on genetics, natural order, and the environment that we expose our skin to. As the influence of aging begins to take part on our skin, the science behind it is simple, our skin cells’ metabolism, like the rest of our body slows down. When we are born our skin cell turnover regenerates and sloughs off allowing for smooth skin to surface. As time marches on skin cells tend to collect on the surface of our epidermis, resulting in a thick layer of dead skin that can makes a once youthful appearance uneven and dull. The epidermis becomes thinner, drier, and even transparent due to the slowed production of keratin. As we age our hormones change and along with that the amount of oil production that once left our skin dewy, now leaves it dehydrated and thirsty. Aging slowly depletes our elastin and collagen proteins, breaking down the tightness in the skin. Environmental exposure is one of the top factors in aging—such as lathering on baby oil and submitting young, beautiful skin to sun exposure. This extrinsic influence generates free radical damage, destroying essential nutrition that is required for healthy skin cell production, not to mention the mutations that may have occurred in the process. The tan was gorgeous at the time, but just another sign of the damage that occurred. Sun damage is not alone in the contributing factors to environmental damage—smoking, lack of sleep, poor nutrition, neglecting skin care needs, and the list goes on. This information may leave one feeling as though it may be a little too late to do the right thing now; however, we have good news!

Your skin can benefit from nourishing facials using papaya enzymes, microdermabrasion, salicylic or glycolic peels, even laser rejuvenation and tightening may be just the thing to refresh and renew your skin, evening out its overall pigment and refining the appearance of pores and fine lines. At any age, it is vital to take proper care of your skin. Some say that teens are too young to start worrying about aging, but in my opinion, it’s the perfect time to teach them how to prevent damage from occurring by protecting their skin with the appropriate

Environmental exposure is one of the top factors in aging. products including sunscreen and antioxidant serums. As for the rest of us it is never too late to change our daily skin care regimen and ﬁx the damage that occurred over the years. It is crucial to satisfy the skin’s needs through clinical skincare treatments in order to nourish and heal the deterioration that has occurred over time. In order for your skin to look its best you must do your part. That means washing, exfoliating and hydrating it every day. Whether you are high maintenance with 12 products on your nightstand or a soap and water kind of girl, you will notice beautiful changes in your skin by adding four products to your daily and weekly routines: Vitamin C, sunscreen, Vitamin A (retinol, renova,

etc.) and Glycolic Acid. Don’t be misled by over-the-counter products containing these anti-aging ingredients. Only physician-grade, available in doctors’ offices, has the efficacy needed to produce real results. Vitamin C (serums) assists in repair of skin damage and is a powerful antioxidant that prevents free radical damage. Free radicals are mutated skin cells that cause signs of aging, the culprit for lines, wrinkles, hyperpigmentation and breakouts. Glycolic Acid (a wash or cream) is a natural fruit acid that breaks down dead skin cell build up, helps minimize the appearance of fine lines, wrinkles and can assist in fading sun damage (those liver spots). Vitamin A (retinol) promotes collagen production, speeds up skin cell metabolism, and minimizes pores and redness, resulting in more supple skin. Lastly, sunscreen—especially ones containing Zinc and Titanium Dioxide help reflect and block the sun’s rays. Zinc is anti-inflammatory and less likely to irritate your skin. The key to sunscreens are ingredients and reapplication, when out in the sun reapply every 2 or 3 hours. Emily has been an aesthetician for five years and is a licensed massage therapist. Certified in microdermabrasion and dermaplaning, she stays abreast of the latest scientific advances in skincare. Call Bella Luz at 792-3552 to schedule a free skincare consultation. 1411 Water Street, Kerrville.

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1411 water street (corner of water and e street) • kerrville, texas • www.bellaluzkerrville.com

who

Kerr County Women’s Chamber

what

Annual Christmas Luncheon

when December 1, 2010 where Y.O. Ranch Hotel Amy Wooten, Psy.D, Carol Clark, PHD

Anissa Reagor, Rachel Davidson

Anita Shackelford, Kari Potter

Cortney Hawkins, Scott Gross

Ellen Reilly, Faye Carroll

Penny Lord, Angie Nava

Karol Potter, Carol Kolb

Vanessa Silva, Trina Rodriguez

KC WC Joan Miller, Vicki Roark Martha Milting

Jacque Rudman, Melissa Nunn, Linda Tatsch

Linda Elkins, Kitty Ocker, Karen Fair

Kerr County

Christmas

Women’s Chamber 22│ KCP │ Jan-Feb 2011

Luncheon 2010

who

1550 Gallery

what

9th Anniversary Party

hometown events Evelyn Hickey & Lynda Ables

where 1550 Gallery when

1550 Gallery

December 11, 2010

David Tabaka & Karen Wilkinson Frank & Luciana Lima

Lois & BB Browning

Maria Walters & Marcel van Hasz

Krispen Spencer & Susan K. Boyle

Music provided by Junior Pruneda

Richeanne, Sarah Rodriquez, Anita Rollo

KCP â&#x201D;&#x201A; Jan-Feb 2011 â&#x201D;&#x201A;23

what why when where

2nd Annual Hill Country Market Beneﬁting Hill Country Cares November 18-20, 2010 YO Resort Hotel, Kerrville

hometown events

Stephanie Miller, Judy Wilson

Michael & Bernice Fischer

Carol Schreiner, Sudie Burditt Kathryn Loeffler, Jan Lynch, Jo Wilkinson

Patrice Doerries, Patia Sandifer Marilyn Polzin, Hilton Farris

Mary Slabbbaert, Cindy Kastner

Chastity Dunn, Judy Saxton, Rose Jackson

Paula Barron, Rene Crosthwait Charlene Stacey

Jackie Woerner, Virginia Smith

Jaylynn Perkins, Kimberly Stewart Judy Sullivan

Andy Magee, Nancy Cockrill, Dorothy Schmidt

Christy Garrison, Betty Martens

Barbara & David Zwald 24 │ KCP │ Jan-Feb 2011

Chris Bynum, Cheryl Howard

Louise & Tony Larson, Bea Bode

who

Anne Foster, Ann McDaniel & Shirley

A Sea of Decorations

Kerrville, Hunt, Ingram, & Medina Rose Garden Clubs what Annual Christmas Decorations Workshop for Kerrville State Hospital when November 30, 2010

Evelyn Hill & Ginger Roan Mildred Coggin Louise Laj & Joan Borges

Glenda Koch & Jane Carbone

Sandy Martin & Judy Schmitt

GARDEN b Clubs

Elva Perez, Caryn Talarico, Linda Seymour & Jaye George

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hometown events Tchaikovsky ’s

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Chase Wiginton, Cecile Desprez, Hayley Fair, Samantha Kemp 26 │ KCP │ Jan-Feb 2011

Area students, including many from Nursel Conrad’s Kerrville School of Dance, had the privilege of performing with the San Diego Ballet in The Nutcracker at the Cailloux Theater in December.

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KCP │ Jan-Feb 2011 │27

Kerr County People Magazine, our Advertisers and Rose Radio have collaborated to bring you great stuﬀ.

Want To Win Great Stuff? How can you win great stuff? Just follow these easy steps: 1. Have your current KCP or access it on our website, KerrCountyPeople.com. 2. Tune in to Harley’s show at 99.9 or listen online at roseradio999.com, Wednesday mornings between 8 and 9. 3. Listen for Harley’s question that can only be answered with your magazine and be the first to call him with the correct answer at 830-890-5229. And, bam!—you’ve won great stuff. 4. Remember what your mama taught you—don’t be selfish—so tell your friends so they’ll have a chance to win great stuff, too!

“Harley in the Morning!”

Peterson RMC Volunteer Awards Banquet On December 9th, PRMC honored its volunteers with an awards banquet at Inn of the Hills. The hospital auxilliary, lay chaplains and hospice volunteers received recognition for a combined total of almost a quarter of a million volunteer hours! Pictured: Keynote speaker Randy Beamer, WOAI news co-anchor; Liz Murray; PRMC CEO Pat Murray; PRMC Auxilliary Coordinator Martha Kies.

28│ KCP │ Jan-Feb 2011

Harley 830-890-5229

People

Wild Birds Unlimited is spreading their wings Where in Kerrville can you go to bird watch and shop at the same time? Wild Birds Unlimited at 855 Junction Highway is just the place. Kevin and Linda Pillow expanded their delightful nature shop in River Oaks Shopping Center to include an outdoor area for bird feeding stations and a water feature. Customers can browse the now over-twice-as-large anchor store as well as stroll through a flower-full garden planted to attract all sorts of avian traffic. Advice on bird feeding as well as quality seed, binoculars, habitats, garden accessories, and unique gift items are available. Videos play on screens in the store to demonstrate squirrel-and-doveproof feeders that work, and to show how mounted bird cameras can film the feathered friends who visit your feeders. Linda adds, “The most important things for bird seed are its high oil content and its freshness. Bargain stores offer seed heavy with milo,

and

having no oil, and barley, something the birds do not eat. Wild Birds Unlimited sells only quality seeds, with no waste—for edible bird feed, just one of our 20 pound bags equals four of the discounted bags.” Be a wise shopper and support our local bird population with help from Wild Birds Unlimited. 895-7393. The Pillows want your experience at Wild Birds Unlimited to be enjoyable… both fun and functional. Questions are always welcome and solutions abound at this amazing store. This is the coldest season of the year and particularly stressful for birds who need extra protein just to stay warm. Wild Birds Unlimited recommends keeping feeders full, oﬀering fresh water daily, and providing shelter (housing and roosting).

Mothers-to-be Registry Lola Alvarado Jenna Cummings Lacy Dahse Allyson Day Katie Givens Emily Murray Koellner Misty O’Fiel Amber Ruggles Sarah Wernette Stop by Izzi Bear at 227 Earl Garrett in Kerrville to add your name to this list or shop for the soon-to-arrive bundles of joy.

stuff Don’t Hold Your Breath

Yes, it is flu season, but try Reiki instead. This hands-on, non-invasive therapy stimulates the immune system and catalyzes the body’s natural ability to heal itself. Reiki is extremely effective as a stress reducer and can relieve pain, as well. Over 70 hospitals and clinics in the U.S. utilize Reiki in their patient programs. Kerrville Reiki Master Anne Schneider offers free public Reiki talks and demos, as well as private Reiki sessions and training. For more information or to schedule these services, cotact Anne at www.ReikiTexas.info or (830)739-5828. Reiki I training is available at Anne’s Ventana Al Cielo Studio on January 21-22 and February 18-19 (FRI, 6:30-9:30 p.m.) – (SAT, 10 a.m.-5:30 p.m.).

Cell Phones for Soldiers Wayne Este thanks you for the nearly 500 phones and/or accessories you’ve donated to the program. Please keep those unused cell phones coming (it’s ok if they don’t work—parts can be salvaged). For each phone donated, one of our troops gets a sixty-minute calling card. Drop them oﬀ at Texas etc., at Inn of the Hills in Kerrville, visit with Wayne for a while and check out his fabulous American Indian jewelry, art and gift items while you’re there.

KCP │ Jan-Feb 2011 │29

automotive tips by Stephen Roberts

Q & A with Stephen

Dear Stephen: We need a new car, and some dealers are oﬀering really tempting interest rates—like 0.9 percent. Are these for real? Mary S.

Dear Mary: They might not be. Congress blew a chance to beef up consumer protections last summer when the embattled auto industry won an exemption from the new financial reform law. So, although mortgage brokers will be subject to new rules, car dealers—who brokered about 80 percent of U.S. consumers’ $850 billion in auto loans—may keep on making unnecessary profits. If you must borrow, don’t assume dealerships will give you the best loan. There are simply too many ways for them to rip you off or seduce you with easy payments on a longer loan. A better move is to get preapproved for a loan from a local bank or credit union before you set foot on the lot. That can help you set a realistic budget. Car buyers pay an extra $20 billion a year because new car dealers routinely mark up the interest rate of loans they broker. They also pad profits with dealer preparation fees for cleaning your vehicle, high doc fees, and even life insurance to pay off your loan should you die! As always: Buyer beware. 30│ KCP │ Jan-Feb 2011

Money you Shouldn’t give away Also trading in your vehicle can cost you up to 25% of the full value of your trade. Sell your car yourself and save. Sometimes if you have a buyer already for your trade-in, you can bring them to the dealership and still show your vehicle as a trade for what you are selling it for and save on the sales tax. Also, consider buying used to avoid unwanted depreciation on the ﬁrst 2 years of a vehicle’s life. Most of the time you can get a lot more for your money buying used and can even save on car insurance with a used vehicle. The newer the car, the pricier your insurance.

trading in your vehicle can cost you up to 25% of the full value of your trade. You’d be wise to put down at least 20 percent, choose a loan of 4 years or less, and make sure the monthly payment is no more than 10 percent of your gross income per month. A big down payment helps ensure you’ll never owe more on the car than it’s worth. Limiting your loan also makes room for the costs of insurance, maintenance, and fuel. If the dealership oﬀers you better terms, you can always drop the bank loan. But you’ll walk in knowing you have a deal that you can aﬀord.

Stephen Roberts grew up in Kerrville and graduated from Tivy in 1997. He went to Angelo State University, then transferred to Texas Tech University in 1998, graduating with a Bachelors of Accounting and Bachelors of Finance in 2002. He went to work for one of the Big 4 accounting ﬁrms, Ernst & Young. Recruited by a car dealership in Burnet, Texas, Stephen became its Finance Manager and was later given the opportunity to come back to Kerrville to be a Sales Manager for the dealership. He then decided to leave in pursuit of his dream of owning his own business and opened the doors to Roberts Auto Sales and RAS Finance in June 2005. It is currently one of the fastest growing dealerships in the Hill Country.

2410 Memorial Blvd • Kerrville, TX 78028 830-257-0625 • RobertsAuto.us

health by William R Thornton, MD, FACS

Graves’ Eye Disease condition and treatment What is Graves’ eye disease? It is an autoimmune condition, usually associated with hyperthyroidism, where antibodies are formed against the normal cells of the eye muscles, eyelid muscles, connective tissue, and fatty tissues surrounding the eye within the boney orbit. This autoimmune reaction produces varying degrees of inﬂammation, swelling, and scarring. About 25% of people with Graves’ disease will develop the eye problems, even up to one year after treatment for hyperthyroidism, when all thyroid tests are normal!

How does the eye disease progress? There are two distinct phases of Graves’ eye disease. Active Phase – Characterized by inflammation, usually lasting 6 months to 2 years. High dose steroids (Prednisone) are used to control the inflammatory process on a short-term basis. The active eye disease phase parallels the acute hyperthyroidism. Medical specialist management is required to treat a spectrum of conditions, including possible atrial fibrillation, a cardiac arrhythmia. Thyroid ablation with radioactive iodine is the method of choice (in most cases) to reduce the abnormal thyroid hormone production. Chronic Phase – Characterized by a hypothyroid condition requiring maintenance with supplemental thyroid hormone and monitoring of the total body metabolic state. Despite excellent treatment protocols, some degree of scarring (chronic inflammation) of the eye, lid, and orbital

tissues occur. The resulting common eye conditions are: • Severe dry eyes • Eyelid retraction and incomplete closure • Double Vision • Proptosis (bug eyes)

Team approach to treatment.

The medical team is assisted by the eye doctor throughout the active and chronic phases of the abnormal thyroid state (Graves’ disease). Maintenance of the eye exposure with ocular lubricants, monitored by microscopic corneal examinations, will prevent permanent corneal scarring and visual loss. Temporary eyelid procedures can be done to protect the exposed eyes until the acute phase subsides.

What is the Ophthalmic Plastic Surgeon’s role?

Before Surgery

Post Surgery (wearing blue contacts)

For acute orbital congestion, not controlled by steroids, the surgeon may be required to do orbital decompression to prevent vision loss due to increased eye (intraocular) pressure and compressed optic nerve circulation. In the chronic phase, orbital decompression (placing the protruding eye back into the orbit) may be used with eyelid lengthening procedures to aﬀect a more normal appearance while providing better closure of the lids to protect the exposed eyes.

eyelids in people with lesser degrees of abnormal thyroid. Strabismus surgery (cross-eyed muscles) can be very successful at reducing or correcting double vision, which occurs with scarring of the muscles that balance the eyes into position for single binocular vision. Dr. Thornton has a new oﬃce at 244 Wesley Drive in Kerrville. To speak with him directly, call 210-633-6106 or to schedule an appointment call 800-525-7371. Dr. Thornton is a Board Certiﬁed Ophthalmologist and University Fellowship trained in the subspecialty of ophthalmic (eye) plastic and reconstructive surgery.

Blepharoplasty, combined with eyelid lengthening procedures can improve the comfort and appearance of the eyes and KCP │ Jan-Feb 2011 │31

health awareness

Fighting

by Dr. John Bilderback, Chiropractor

CANCERNaturally According to the American Cancer Society, cancer causes one in four deaths in the United States. In 2010, we saw more than 1.5 million new cancer cases and more than half a million deaths from cancer in this country. Cancer has been around as long as humankind, but only recently has the number of cancer cases burgeoned. Although this is partly due to increased longevity, our diets and lifestyles contribute to the cancer explosion. Today we’re exposed to toxins and pollutants our ancestors never experienced, along with high-stress lifestyles, junk food and food full of pesticides, high amounts of sugars and artiﬁcial sweeteners, irradiated and genetically modiﬁed pathogens, electromagnetic stress––and myriad other things that didn’t exist 200 years ago. All this weakens the immune system and alters the body’s internal environment so it’s conducive to the growth of cancer cells. Cancer cells are always being created in your body. To deal with this, parts of your immune system seek out and destroy cancer cells.

Cancer tumors occur when more cancerous cells are created than the overworked, depleted immune system can destroy. The good news is, you can do quite a few things to fight cancer. Lifestyle change is one of the easiest and most effective ways to combat cancer. Cancer thrives on sugar and refined grains. Reduce these as well as popular artificial sweeteners––switch to healthier sweeteners such as stevia, xylitol, and lacnato. Too much animal protein can also promote cancer––add more vegetables and fruits, nuts, beans/legumes, and soy products to your diet. Because understanding cancer and cancer prevention is such a broad topic, I plan to write several articles during the coming months in which I will discuss cancer causes and remedies. Mention this article to receive your initial consultation free. Dr. Bilderback received his degree from Western States Chiropractic College in Portland, Oregon in 1985. He has chosen to serve the folks of Kerr County and surrounding area for more than twenty years. 1416 Sidney Baker, Kerrville. 257-2323.

Just What The Doctor Ordered We have everything you need when it comes to comfort and discretion with a personal touch. • Prescription Services • Most Prescription Plans • Serving All Area Nursing Homes • City-Wide Delivery • Competitive Pricing • Respiratory Medications • Oxygen • Nebulizers • Hospital Beds • Wheelchairs • Bathroom Safety • Mobility Products • Mastectomy Products • Diabetic Products & Shoes • CPAP/BIPAP • Respiratory Therapist

“We take it personally” (830) 895-2803 1331 Bandera Hwy. Ste. 5 (Mon – Fri: 7:30-5:30) 212 Wesley Dr. (Mon – Thurs: 7:30-4:00, Fri: 7:30-1:00,Sat: 8:00-1200)

“Together Meeting Your Health Care Needs”

errville Drug Co.

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32│ KCP │ Nov-Dec 2011

Customer Driven Committed to Quality Patient Care with Respect, Conﬁdentially, and Accountability Servicing Kerr, Gillespie, and Bandera counties for nearly 20 years

Why CPL? • Friendly, relaxed atmosphere with patient wait times 15 minutes or less at all locations. • We ﬁle all Primary and Secondary Insurances on patient’s behalf. • 20% patient discount at time of service or on-line at

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No Appointment Necessary

hospice care

DECISIONS DECISIONS...DECISIONS

by Dr. Michael Schlabach

We make many choices during our lifetime. Shouldn’t we also have a choice when it comes to the end of life?

Every day

we are confronted with countless choices. Each one must be considered and decisions made. Should it be corn flakes or bran? Maybe fruit today? Should I wear the blue shirt or the white one? Is this a good time to apply for that new position at work? Can I afford that new car or should I wait? So it goes…choices, big and small, and frequently some decisions are put off only to be reconsidered, yet again tomorrow. In most situations, we insist on making our own decisions and choices. As children, we attempted to make choices even if we knew our parents were the final decision-makers. As young adults, we considered choices and made decisions about college, our first job, moving away from home, getting married…even now, choice and decisionmaking occupy much of our time. Life is, indeed, all about the choices we make. Interestingly, however, one of the most important of life’s decisions is often made for us—leaving us with little or no opportunity for choice. Choices at the end of life are, all too often, deferred to others—especially when it comes to making choices regarding our medical options, including hospice. It’s safe to say that most people would probably choose not to need a hospice program at all. But the choice of having or not having a life-limiting illness is seldom in our power. When confronted with a decision about hospice, many will defer to others who are all too willing to make the decision for us. Unfortunately, their choices are often based not on our wishes or goals, but on their preferences and conveniences, no matter how well intentioned they may be. Perhaps we’re more comfortable letting someone else make the decision because it seems less “real” that way? Or, maybe we feel less vulnerable when we don’t have to make the decision. However, the choice of how we wish to live out our lives can only

be ours. So, too, is the choice of which hospice we want to help us meet our life goals and to protect our vulnerability while facing life’s ﬁnal reality— only ours. We make many choices during our lifetime. Shouldn’t we also have a choice when it comes to the end of life? If hospice becomes the most appropriate medical option for us, we must make our own choices.

Life is, indeed, all about the choices we make—one of the most important of life’s decisions is often made for us. And if we choose hospice, ﬁnding the right hospice requires us to make informed decisions, using at the very least, the same sensible approach we would when deciding to take a new job or buy a new car. To make an informed decision, it’s important to compare hospice programs and services that are available to us. We must decide for ourselves which hospice is best suited to care for us and help us achieve our goals at the end of our lives. Michael Schlabach, MD, MPH, is Medical Director for VistaCare Hospice of Kerrville. He is certiﬁed by The American Board of Internal Medicine in both Internal Medicine and Hospice and Palliative Medicine. He also has a Masters of Public Health in General and Preventive Medicine and Public Health. Dr. Schlabach has practiced Internal Medicine in Kerrville since 2006. VistaCare, 1001 Water Street, Suite B-100, Kerrville. 830-792-6200. www.vistacare.com. KCP │ Jan-Feb 2011 │33

health and wellness by Robert Mitchell, MD Orthopedic Surgeon

What You Should Know About Hip Replacement most hip replacement patients are between 60 and 80 years old.

Severe hip pain

can come from several causes such as osteoarthritis, rheumatoid arthritis, injuries, or bone tumors. If you suffer from hip pain that just won’t quit, despite medication you may want to think about hip-replacement surgery. The surgery to replace your damaged or injured hip joint with an artificial joint is much more common than it use to be. Most people, when thinking about hip replacement candidates imagine older patients whose hips have caused increasing pain over many years. The fact is most hip replacement patients are between 60 and 80 years old but there are many younger patients who receive the surgery as well. Younger patients tend to either have a family history of arthritis or have suffered a sports or accident injury. It’s also interesting to note that older adults aren’t waiting as long to get hip replacements than in years past. They want to be as active as possible and aren’t willing to suffer many years of pain before they consider the surgery. The success of a hip replacement surgery is dependant on several key factors. The first is the surgeon. It’s important that your surgeon know about your lifestyle, your history and your expectations. We have excellent orthopedic surgeons in Kerrville and have seen patients come here from all over the country specifically for orthopedic surgery and recovery. The second important factor is the health and participation of the patient. Before any joint replacement surgery, the patient should quit smoking. Smoking can cause complications, which can negatively affect the recovery process. Another important way the patient

34│ KCP │Jan-Feb 2011

can participate is to consider their weight. Excess pounds can make recovery more diﬃcult. Over-weight patients who lose as few as 5-10 pounds can make a positive diﬀerence in their recovery.

It is rewarding to see a patient just a few months after surgery and hear them say, “Hey, I played golf last week.” The third key factor is the quality of recovery and rehab facilities. Today we want patients up and moving around much sooner than in years past and a knowledgeable rehab team makes all the difference in the recovery process. The Acute Rehab unit at Peterson is a great example of what a recovery facility should be. You need a qualified and highly trained team of therapists to work closely with the surgeon and other physicians in order to have the best patient outcome. Each individual’s situation, surgery and recovery process is going to be different. There does seem to be some differences between men and women hip replacement patients. Men usually have the surgery

younger—whereas women wait longer before they are ready for the surgery. Women tend to recover more quickly and seem to do better with their rehab than men. Hip replacement surgery is not as daunting as it once was. The incisions are smaller, the replacement joints are better and the recovery time is much shorter than in years past. Patients are becoming more knowledgeable and savvy about their expectations and are more of a partner in their surgery and taking more responsibility for their recovery. It is rewarding to see a patient just a few months after surgery and hear them say, “Hey, I played golf last week.” or “I didn’t realize how much I was missing before my new hip”. Many new patients come to us because of seeing the quality of life that’s been given back to someone they know who had hip replacement surgery.

Dr. Mitchell is a practicing orthopedic surgeon and an active member of medical staﬀ at Peterson Regional Medical Center. His oﬃce is located at 695 Hill Country Drive, Suite B in Kerrville. 257-2880.

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women’s health by Niessa Meier, RN, CNM

What is your weight doing to your health? If the numbers on your bathroom scale have been going up and up, you’re not alone. According to the World Health Organization (WHO) there are 1.6 billion overweight adults worldwide, and that number is expected to climb. The benefits of weight loss are profound, and here are just a few ways that losing a few pounds can make a big difference. Cardiovascular Disease - The number one killer in America, cardiovascular problems, such as heart attack, congestive heart failure, sudden cardiac death, angina, and abnormal heart rhythm, are higher in people who are overweight or obese. Losing just 10-15% of your body weight can dramatically decrease your risk of early death. Diabetes - Gaining as little as 18 pounds can double your risk for type II diabetes compared to someone who maintains a healthy weight. In people who are at high risk for diabetes a small weight loss of 5-7% can cut their risk in half! Cancer - Research shows that overweight and obesity are associated with an increased risk for some types of cancer. These include endometrial, colon, gallbladder, prostate, kidney, and postmenopausal breast cancers. Also, women who gain more than 20 pounds between age 18 and midlife double their risk of postmenopausal breast cancer, compared to women who do not gain weight. Being overweight can cause many bothersome symptoms that, while they may not kill you, can dramatically affect the quality of your life. Arthritis and other types of joint and muscle pains can often be reduced by weight loss. Obesity can contribute to irregular and heavy menstrual bleeding, as well as certain types of infertility. Urinary frequency and incontinence may be improved with weight loss of 10-20 pounds in those who are overweight or obese. Talk with your doctor, midwife or nurse-practitioner about developing a plan to get healthy and stay healthy! Niessa Meier is an RN and Certified Nurse Midwife. She is the mother of three and has worked in women’s health for 10 years as a labor and delivery nurse, childbirth educator and lactation counselor. 36│ KCP │Jan-Feb 2011

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New Rules & Regulations for Physicians and Home Health Agencies There is a new requirement that will aﬀect physicians that order, and the patients that they refer, for Medicare home health services.

n accord with the Patient Protection Affordable Care Act, CMS issued a Final Regulation that goes into effect January 1, 2011 any patients referred to home health agencies must have a face-toface physician visit with the physician that certifies the home health plan of care 90 days prior to, or 30 days of, the start of home health services. The primary reason for home health services must be addressed during this visit. Physicians that work in collaboration with a nurse practitioner or a clinical nurse specialist, or supervise a physician’s assistant may allow one of these professionals to make the face-to-face visit and document their findings and communicate such to the physician. However, only a physician may order home health services, certify that a face-toface encounter occurred, and certify that other eligibility criteria are met (medical necessity and homebound status).

The face-to-face encounter (physician visit) must be: • • •

Made by the physician responsible for overseeing the patient’s plan of care. The physician visit must be related to the primary reason the patient requires home health services. The physician visit must be within 90 days prior to admission to a home health agency, or within 30 days after admission to home health services.

The encounter (physician visit) must be documented. Documentation of the face-to-face visit must include: • • • • •

The date of the visit (when the physician sees the patient) The physician visit must be related to the primary reason for home health services. The physician must describe how his clinical ﬁndings support the need for skilled nursing or therapy services in the home. The physician must describe why his/hers ﬁndings support that the patient is homebound. The physician must sign and date the form and maintain in the patient’s medical chart.

The home health industry is currently preparing a Guide Form for physicians to use in order to meet this new regulation. It is important that patients exercise their rights to receive home health services and make every eﬀort to assist the physicians and home health agencies in this new process. If you would like additional information, speak with your local home health agency. Tri County Home Health has been serving our friends and neighbors in Kerr and surrounding counties since 1994. Kathy Dietert, RN, BSN, is Director of Health Services and Annabelle Lindner, RHIT, is the Administrator.

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PRMC

volunteers receive awards Ronnie Woods 500 hours

by Martha Kies Volunteer Auxiliary Coordinator Peterson Regional Medical Center

The volunteers pictured here are among the many honored at the December 9th Volunteers’ Christmas Award Celebration. Those in attendance include PRMC CEO Pat Murray, members of the board of directors and special guest speaker, Randy Beamer, Channel 4 WOAI news co-anchor. We enter the new year with many volunteering opportunities—such as golf cart drivers, ﬁling, information desk attendees, and in the gift shop. We’ll be cross-training so that those who like variety in their work can help out in diﬀerent areas.

Bob Hokanson, 4,000 hours; Doris Hokanson, 4,500 hours

Please feel free to stop by and talk about enriching your new year by joining our great team of volunteers. Martha Kies, Volunteer Auxiliary Coordinator for Peterson Regional Medical Center, brings to PRMC her love of helping people, as well as expertise in volunteer coordination from serving 11 years as Asst. Volunteer Coordinator of Community Relations with Kerrville State Hospital. You may call Martha at 258-7495 or email her at mkies@petersonrmc.com.

Doris Stallings, 500 hours

Billie Bryant, 100 hours

Florentine Martinez, 2,000 hours

Ann Livengood, 20,000 hours

Bettie Rankin, 11,500 hours

Oran & Gerrian Harrison 500 hours each

38│ KCP │ Jan-Feb 2011

Mary Tomlinson, 100 hours; Sue Fullerton, 100 hours

Carole Salvas, 2,000 hours; Ila Geyer, 1,000 hours

J Amason, 7,000 hours; EJ Amason, 3,500 hours

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