Healthy U — May 2018 by Times Record

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HAPPINESS IN SIMPLICITY: Fort Smith patient, doctor share secrets

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HEALTHYU Contents VOLUME 2, EDITION 4 | May 2018

KNEE, HIP PAIN TREATMENT EVOLVING

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Sparks doctors discuss joint replacement, other options

RETIRED TO REJUVENATED

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Mercy Fitness Center’s SilverSneakers just the right ﬁt

HAPPINESS IN SIMPLICITY

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St. Scholastica sister, Mercy doctor reﬂect on ‘aging well’

MEDICAL DIRECTORY

22-23

Access to the area’s leading medical providers by category so readers can easily ﬁnd contacts for their areas of need.

about HEALTHYU

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Healthy U is a monthly publication of the Times Record, focusing on issues of health and wellness for the River Valley area. It publishes the third Saturday of every month. For more information: ccosta@swtimes.com

Publisher Crystal Costa Editor Mardi Taylor Photographers Brian Sanderford, Jamie Mitchell Production Manager Christy Morrison Contributing Writer Carole Medlock ADVERTISING Sales Manager Julie Newman

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MAY 2018

Why you shouldn’t wait to treat hearing loss Brandpoint

Hearing loss is often referred to as a silent disease. It doesn’t hurt and it often occurs so gradually over time that you barely notice the insidious damage it does. As a result, hard-of-hearing people often delay seeking treatment for their hearing loss. Here are seven reasons you shouldn’t make that mistake. 1. Hearing loss can be a sign of a more serious illness.

While in most cases hearing loss is a result of aging and excessive noise exposure, it can also be a symptom of a 4

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serious underlying medical condition. Some of these include tumors, cardiovascular disorders and diabetes. As such, hearing loss should never be dismissed. 2. Untreated hearing loss hurts your career and earning potential.

Thinking about hiding your hearing loss at work because it makes you look incompetent and old? Think again! Misunderstanding instructions and asking people to repeat themselves all the time makes others question your ability to do your job. Minimizing communication breakdowns at work by wearing hearing aids will

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ensure that hearing loss doesn’t become a roadblock for your career. 3. Untreated hearing loss hurts your relationships with loved ones.

Did your hearing loss cause you to miss out on a private joke with your pals? Or did you inadvertently hurt your grandchild’s feelings because you didn’t hear them calling you? Since good communication is vital to any close relationship, hearing loss can be hardest on the ones we love the most. Left unresolved, mounting resentment and frustration eventually strains your most cherished relationships.

4. Untreated hearing loss leads to rise in fall risk.

Did you know that (along with vision) good hearing also helps you maintain spatial orientation and balance? This is why research has shown that those with even a mild untreated hearing loss are nearly three times more likely to have a history of falling than people with good hearing. 5. Untreated hearing loss has been linked to increased risk for cognitive decline and dementia.

There is a growing body of evidence linking untreated hearing loss to physical changes in the brain, accelerated

rate of cognitive decline, and cognitive disorders like dementia and Alzheimer’s disease. On the other hand, at least one long-term study shows wearing hearing aids reduces cognitive decline. Why would you take chances? 6. Untreated hearing loss can cause social isolation and depression.

When you have a hard time hearing, social activities with friends and family start to become more embarrassing than fun. Your natural recourse may be slowly withdrawing from these activities that you once enjoyed. No wonder, then, that

untreated hearing loss frequently leads to social isolation and even depression. 7. Treating hearing loss is easy and painless.

Given all these reasons why untreated hearing loss is bad, here’s one piece of good news: Getting treated for hearing loss is easy! Unlike other serious medical conditions that may require surgeries or painful treatments, having your hearing loss evaluated and treated with hearing aids is easy and painless. In fact, most people who finally start to wear hearing aids regret that they didn’t seek treatment earlier.

Study: Smoking impacts stroke risk for men For those under 50, the more cigarettes smoked, the higher the stroke risk

By American Heart Association News

Men under 50 years old who smoke are 88 percent more likely to have a stroke than men who never smoked — and the number of cigarettes a day can move that risk up or down, according to new research. The study, published April 19 in the American Heart Association’s journal Stroke, involved 1,145 men ages 15 to 49, including 615 men who had had a stroke. When the numbers were broken down by cigarettes smoked, those who had less than 11 cigarettes a day were 46 percent more likely to have had a stroke. Men with a twopack-a-day habit had nearly five times — or 466 percent — higher risk for a stroke than people who never smoked. “There was a clear-cut relationship between the number of cigarettes the men were smoking and their risk for stroke,” said Janina Markidan, the study’s lead author and a thirdyear medical student at the University of Maryland School of Medicine. “For each subgroup, the risk went up. The more you smoke, the more you stroke.” The study was a look at a snapshot in time and didn’t record how long the study participants had a smoking habit. But it showed that former smokers — people who had more than 100 cigarettes in their lifetime but had not smoked for the 30 days leading up to the study — had made

gains. Their risk was 42 percent, less than half that of current smokers. “There’s hope,” she said. “Our number one takeaway is the best you can do for yourself is to never smoke, but if you quit now there are benefits you will see soon after quitting. So, it’s worth it to quit, even if it’s something you’ve been doing for a long time.” The research didn’t include information on vaping, said Dr. John Cole, a study co-author and associate professor of neurology at the University of Maryland and Baltimore Veterans Affairs Medical Center.

“But it is reasonable to consider the inhalation of a variety of chemicals through vaping to also be toxic,” he said. “I urge individuals to not vape, as the health risks associated with vaping are unknown. Further research regarding vaping and stroke risk is required.” Dr. Karen Furie, chair of neurology at Brown University’s Alpert Medical School, said the research strengthens the scientific argument about smoking and stroke.

“Unfortunately, younger populations, particularly those who might not be medically sophisticated don’t perceive the same degree of risk,” said Furie, who was not part of the research. She is chair of the AHA’s Stroke Council, which promotes research and education. “It may be that they believe their youth will be protective. Stroke in younger people is unusual but can occur. This study demonstrates that risky behaviors early in life do increase risk.”

Smoking, of course, is commonly known as a major risk factor for cardiovascular disease. But Markidan said the study’s findings connecting the number of cigarettes to stroke risk is as important as ever. In a span of about a decade, smoking rates for men and women who have been hospitalized for stroke increased from 5 percent to 16 percent, a 2017 study found. In the United States, among adults 18 and older, 16.7 percent of men and 13.6 percent of women are current smokers, according to the Centers for Disease Control and Prevention. New smokers 18 to 25 years old increased from about 600,000 in 2002 to 1.05 million in 2015. University of Maryland researchers have worked on other smoking studies, and their work a few years ago showed young women had the same increased risk for stroke, depending on how many cigarettes they smoked. “This shows the risk is not sex-specific,” Furie said. “So, for people providing care for young adults, the message should be the same for both men and women, to stop smoking as soon as possible.” Cole said while smoking is a well-established risk factor for stroke, it’s a unique one. “It is fully under the individual’s control,” he said. “While for many individuals quitting can be challenging, they do have the ability to do so, and hence directly reduce their own stroke risk. Despite our dose-response findings, in the end, it is best to completely stop or never start in the first place.” HEALTHYU

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KNEE, HIP PAIN TREATMENT EVOLVING

MAY 2018

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Sparks doctor discusses joint replacement, other options By Mardi Taylor Times Record

Long-term, unmanageable pain is the only reason to seek out a total knee or hip replacement, one Sparks doctor said recently. Dr. Stephen Heim, MD, orthopedic surgeon at Sparks Healthy System in Fort Smith, says people tolerate pain differently, and only when knee and hip pain become unmanageable through other means will he consider Dr. Stephen Heim doing a replacement. “The only reason to X-rays; we treat people.” have surgery is pain,” Dr. Dr. Heim said when Heim said. “I don’t really pain continues following care what your X-ray other treatment options looks like. You could such as losing weight or have the worst X-ray in taking cortisone shots, that’s the time to discuss the world, and if you’re a total joint replacement. not having hip pain, “If your pain is unacknee pain, you’re getceptable, if it’s affectting around fine, you’re ing your life, that’s not taking narcotics (for when you need to pain) ... the only reason consider it,” he said. (for surgery) is pain. Many of Dr. Heim’s “We don’t treat

patients come to him for a joint replacement because of arthritis pain. Natalie Bohannan, DPT, joint care coordinator at Sparks Orthopedic and Spine Center in Fort Smith, said arthritis is the most common cause of diability in the U.S. “Cartilage is on every bone in your body,” she said. “You’re born with so much cartilage; once you lose it, it can only regenerate through exercise and nutrition. And it damages very easily.” Bohannan describes arthritis as inflammation of the joint — pain, swelling, loss of motion. Symptoms of arthritis include pain, swelling and stiffness. Arthritis pain can have a great impact on a person’s lifestyle, she said. Treatment for arthritis patients include exercise (like walking, swimming and bicycling), modifying daily activity

QA &

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How do I know if I need hearing aids? Only a comprehensive hearing screening performed by a licensed hearing care professional, audiologist or medical doctor can tell you if you need hearing aids. Often, people think they need hearing aids, but they really don’t. ,Q‫ٻ‬ K]T\a PMIZQVO KIV [\MU from excess ear wax, an infection, or a physical irregularity, such as a perforated ear drum. These issues can be corrected medically, without the need for hearing aids. A simple hearing quiz can tell you if your hearing should be checked.

Orthopedic doctors at Sparks Health System include Dr. Eric Heim, MD, from left; Dr. Michael Wolfe, MD; Dr. Stephen Heim, MD; Dr. Jeff Evans, MD; and Dr. John Harp, MD.

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hearing screening. A proper hearing exam uses sounds, tones and speech to test your hearing. It must be performed in the right environment and analysed correctly. Your results, which are plotted on an audiogram, will indicate whether or not you are a candidate for hearing aids. Call today to schedule an appointment for a free hearing test.

[PHOTO COURTESY SPARKS HEALTH SYSTEM]

HEALTHYU

MAY 2018

and using things like knee braces, walkers and analgesic creams. Applying heat and ice can also help, Bohannan said. But for those who have tried pain management options and aren’t getting enough relief, a total hip or knee replacement may be the answer. Dr. Heim recently discussed how far the procedures have come in recent years. “Things have changed a lot,” he said. “It used to be, you came to the hospital the day before, you had a joint done, you stayed in the hospital a week or two. I discharged a lady today after 18 hours. She was from Searcy, and she went home 18 hours after total replacement, walking. We have people walking the day of surgery.” Replacing a knee or hip is not a one-size-fits-all procedure, Dr. Heim said, and neither is the recovery process. Instead, the procedure is tailored to fit each patient’s needs. “We’re trying to get people to realize that, you’re not really sick; you’re in the hospital because you need to be, but you’re not sick,” he said. “You’re there for an elective procedure; we want you in an out, basically as smoothly and cleanly as possible.” How long it takes to get back to normal — whether it’s returning to work or driving — varies for each patient. “People ask me, ‘When can I drive? How long will I be in therapy?’ Dr. Heim said. “Well, you’re going to drive when you can, and you’ll be in therapy as long as you need it. It’s silly for me to say, ‘You’re going to have 32 therapy visits,’ or ‘You’re going to drive in 18 days.’ No. When you have control of your leg, when you’re safe. You’re going to drive when you’re safe, and that’s up to you. I’m not your parent.” How long people are off 8

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Who is a candidate for knee or hip replacement? Knee or hip replacement surgery may be considered for those suffering from arthritic knee pain that severely limits the activities of daily living, according to information from Sparks Health System. It is only recommended after careful examination and diagnosis of a particular joint problem and only after other measures such as exercise, physical therapy and medications have proven to be ineffective. How long will a patient be in the hospital? With improvements in surgical techniques and post-op care, it is now common for many patients to be able to go home from the hospital after two to three days. Each patient is different, but the goal should be for you to recover in the comfort and privacy of your own home as soon as possible. Some patients may need to spend recovery time at a rehab facility or nursing home before going home. How long is recovery? Recovery can vary from person to person, but most people will need to use an ambulation aid such as a walker for two weeks or so. Driving may be possible in two to three weeks, and activities such as golf and bowling can be resumed in as few as 10 to 12 weeks. Some activities such as singles tennis and skiing are not recommended after knee replacement. How successful is a total knee or hip replacement? Total knee and hip replacements are recognized as some of the most successful procedures in all of medicine. There are more than 600,000 knee replacements and 285,000 hip replacements performed in the U.S. each year.

Sparks Health System work for recovery depends on the job they do, Dr. Heim says. Sit-down jobs may only require a couple of weeks, while other jobs may take longer. A lot also depends on whether a patient is on narcotics that may cause impairment. “And as far as therapy, I have some people who blow through therapy in four to six weeks, and some people need therapy for 10 weeks. Some people need more, and some people need less,” he said. Dr. Bohannan holds preoperation classes about two weeks before surgery to help patients understand what’s to be expected during the process

and afterward. Patients in the classes before a knee or hip replacement surgery are put on an exercise regimen to get the muscles ready for surgery, Dr. Bohannan said. Dr. Heim lauded the benefits of the pre-op classes Sparks has available. “They teach you what to expect,” Dr. Heim said. “And the patients have really taken to that. They know how much pain they’re going to be in, what they’re going to be expected to do before they go home (after surgery). That’s been very good.” Dr. Heim said there are risks involved with joint replacement surgery,

including infections and blood clots, so patients should not have the procedures if pain is not greatly affecting their lives. But complications are increasingly rare. He said Sparks’ operating procedures, including proper air flow during surgery and the doctors’ use of containment suits, help cut down on infections following joint replacements. The floor where surgery occurs is self-contained, which reduces the amount of outside bacteria coming in. “Infections, complications, fractures ... those things happen. They’re inevitable,” Dr. Heim said. “They’re going to happen to everybody. But you want somebody who does everything he can to prevent that, because if you get an infection, in an artifical joint, it’s a big, big deal. It’s a big ol’ piece of metal in your body, and if it gets infected, it has to come out, you go on antibiotics, another has to go back in, and the secondary one is not as good as the primary one.” Revisions — having a second, third or even fourth joint replacement — are common and must take place because of infections, fractures near the joint or even just wear and tear on the artificial joint. Revisions are never as good as the first replacement joint, Dr. Heim says, which is why you want to make the first one work. “The joints can outlive you, and that’s a good thing,” Dr. Heim said. “They’ve really gotten better. The way we put them in, our understanding of the biomechanics of the joint have gotten better. The prosthesis are so much better than they used to be. We basically custombuild a joint for you.” Ten years on an artificial joint used to be the norm, but Dr. Heim says he’s disappointed if he doesn’t

get 15, 20 or more out of the newer ones. While some doctors won’t operate on certain patients who have conditions such as obesity and diabetes, or even old age, Dr. Heim says that’s not the case for him. It’s good to stop smoking, lose weight and get diabetes under control, but none of that will affect the success or failure of your artificial joint, he says. Bohannan offered the example of a woman who weighed 400 pounds who had a double knee replacement recently. She went home after two days and did great, she said. Other patients in their 90s have done well following surgery. Before electing to have a knee or hip replacement, it’s important to be comfortable with your doctor and the overall procedure, Dr. Heim says. “First thing you need to consider is, you need to like your doctor,” he said. “Y’all need to be on the same page, because there are lots of different ways to do it. What you want your surgeon to do is to basically tailor your approach, your prosthesis, to you. One size does not fit all. There’s all kinds of prosthesis out there. There’s all kind of approaches, there’s all kinds of post-op care, and you want the one that’s going to give you the best result.” While patients experiencing knee and hip pain may be told they should get a replacement right away, Dr. Heim says there’s no real rush. “Let your pain and your quality of life be the main determining factor on if or when you have a total (replacement),” he said. “I don’t need to get you when (the pain) is just starting or anything like that. “I can replace your knee next month or next year ... your choice. Call me when you need me.”

Dietary needs change as we age By Jenna Siebenmorgen Mercy outpatient dietitian

Good nutrition is essential in all walks of life; however, it becomes increasingly important as we age. Age-related changes and concerns may make planning and preparing nutritious meals difficult. As we age, our bodies change physically and physiologically. Seniors may experience limited mobility, which may make cooking more challenging. Lack of transportation also can interfere with purchasing food. When seniors are unable to travel to purchase or obtain food, they may be at risk for poor nutrition. Senior citizen centers, Meals on Wheels, food banks and the Supplemental Nutrition Assistance Program (SNAP) can provide free or reduced meals to low-income, disabled, immobile and needy individuals. To locate a food pantry in your area, check out www. arkansas211.org or call 2-1-1 for assistance. Physiologically, aging individuals may experience decreased taste and loss of appetite. This can lessen the experience and pleasure of eating for seniors. One remedy for this is to try flavor combinations in seasoning. For example, add cinnamon and nutmeg on top of a baked sweet potato. Another is tart or bitter flavors like cranberry,

Jenna Siebenmorgen

coffee and citrus, which can pack a bolder flavor and may make food more appetizing. If lack of appetite is an issue, try small, frequent meals with a protein source. Examples might be cottage cheese and peaches, a peanut butter sandwich or oatmeal made with milk. Older adults may not absorb nutrients as efficiently as they did earlier in life. As we age, we produce less saliva and stomach acid, which serve to aid in digestion and absorption of food. This lack of stomach acid can result in a vitamin B12 deficiency. Additional nutrients of concern include B6, iron, folic acid, calcium and vitamin D. Talk to your doctor if you believe you may have a vitamin or mineral deficiency. Symptoms include thinning hair, brittle nails, overall weakness or increased fatigue. Itâ&#x20AC;&#x2122;s important to make sure we are aware of changes as we age.

intake of nutritious beverages such as milk, Ensure or Boost can help Older adults may not absorb nutrients as efficiently as they did earlier in older individuals get the life. As we age, we produce less saliva and stomach acid, which serve to aid in nutrients they need. digestion and absorption of food. Sharing meals with friends and family, incorporating enough fiber into your diet, staying hydrated Depending on the as baked chicken and poorly fit dentures, he by drinking water individual, for example, fish, and dairy, which or she may limit or avoid throughout the day this can mean lesser becomes increasingly tough or crunchy foods and exercising your calorie requirements important to ensure like some meats, nuts and brain and body are if activity decreases. adequate vitamin D to raw vegetables. In this additional tips to help Small, frequent meals help prevent or reduce case, it is important to seniors age well. usually are better than osteoporosis, a condition chew and swallow food If you are unsure fewer large meals. in which bones become slowly and thoroughly. you are getting proper No matter what your weak and brittle. Receiving appropriate nutrition, an assessment age, make sure all food Dental health is dental care and can be done that groups are included. The another aspect of aging modifying the diet to includes medical history, groups are vegetables, that can affect nutrition soft, ground, moistened activity level and diet. fruits, whole grains such status. If an individual is meats, creamy peanut Ask your primary care as oatmeal and wheat having trouble chewing butter in place of nuts provider to refer you to bread, lean protein such due to lack of teeth or or seeds and increasing an outpatient dietitian. HEALTHYU

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Barber Eric Muhammad, owner of A New You Barbershop, measures the blood pressure of customer Marc M. Sims in Inglewood, Calif. Black male customers at dozens of Los Angeles area barbershops reduced one of their biggest health risks through a project that paired barbers and pharmacists to test and treat customers. [AP PHOTO/DAMIAN DOVARGANES]

Trimming black men’s hair and blood pressure By Marilynn Marchione The Associated Press

ORLANDO, Fla. — Trim your hair, your beard, your blood pressure? Black men reduced one of their biggest medical risks through a novel project that shows the power of familiar faces and trusted places to improve health. The project had pharmacists work with dozens of Los Angeles barbershops to test and treat clients. The results, reported at a cardiology conference in March, have doctors planning to expand the project to more cities nationwide. “There’s open 10

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communication in a barbershop. There’s a relationship, a trust,” said Eric Muhammad, owner of A New You Barbershop, one of the barbers who participated. “We have a lot more influence than just the doctor walking in the door.” Black men have high rates of high blood pressure — a top reading over 130 or a bottom one over 80 — and the problems it can cause, such as strokes and heart attacks. Only half of Americans with high pressure have it under control; many don’t even know they have the condition. Churches, beauty salons and other community spots have

been used to reach groups that often lack access to doctors, to promote cancer screenings and other services. Dr. Ronald Victor, a cardiologist at Cedars-Sinai Medical Center, wanted to reach black men. “Barbershops are a uniquely popular meeting place for African-American men,” and many have gone every other week to the same barber for many years, he said. “It almost has a social club feel to it, a delightful, friendly environment” that makes it ideal for improving health. Victor did a study in 17 Dallas barbershops a few years ago. In that one, barbers tested patrons

and referred them to doctors. Improvements were modest. In the new study, “we added a pharmacist into the mix” so medicines could be prescribed on the spot, he said. The new work involved 303 men and 52 barbershops. One group of customers just got pamphlets and blood pressure tips while they were getting haircuts. Another group met with pharmacists in the barbershops and could get treatment if their blood pressure was high. At the start of the study, their top pressure number averaged 154. After six months, it fell by 9 points for

customers just given advice and by 27 points for those who saw pharmacists. Nearly two-thirds of the men who saw pharmacists lowered their pressure to under 130 over 80 — the threshold for high blood pressure under new guidelines adopted last fall. Only 12 percent of the men who just got advice dropped to that level. “This is a home run ... hightouch medicine,” said one independent expert, Eileen Handberg, a heart researcher at the University of Florida in Gainesville. Most drug trials only dream about such good results, yet they were

achieved in a regular community setting, she said. Nineteen of Muhammad’s customers finished the program, and “all their blood pressures were down, every single one of them,” he said. Marc Sims, a 43-yearold records clerk at a law firm, is one. He didn’t know he had high pressure — 175 over 125 — and the pharmacist said he was at risk of having a stroke. “It woke me up,” said Sims, who has a young son. “All I could think about was me having a stroke and not being here for him. It was time to get my health right.” Medicines lowered his pressure to 125 over 95. Treatment doesn’t always mean medicines; healthier lifestyles can do a lot. Poor diets, lack of exercise and other bad habits cause

most high blood pressure. The National Institutes of Health paid for the study. Results were discussed at an American College of Cardiology conference in Orlando and published by the New England Journal of Medicine. The cost of doing this isn’t really known. Victor now aims to do a study of 3,000 men in many cities around the country that will include a look at that. He also hopes to tackle high cholesterol with a similar approach. The results show that “you don’t need cardiologists” to improve things, said Dr. Willie Lawrence, an American Heart Association spokesman and blood pressure specialist in Kansas City, Mo. “We can partner with others in the community and get this epidemic under control.”

Barber Eric Muhammad, owner of A New You Barbershop, cuts the hair of customer Marc M. Sims before measuring his blood pressure in Inglewood, Calif. [AP PHOTO/DAMIAN DOVARGANES]

Mercy offers faith-based, home-based end of life care. When life expectancy is six months or less, and life-prolonging treatments have ended, it’s a comfort to have the right hospice team by your side. Mercy Hospice provides patients and their loved ones with the best possible quality of life while they remain in the comfort of their own home.

Learn more at mercy.net/FortSmithHospice Hospice is covered by Medicare, Medicaid and most insurance plans.

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F O R M E R T E AC H E R G O E S F R O M

retired to rejuvenated

Terry Cranford before he began exercising through Mercy Fitness Center’s SilverSneakers program. [SUBMITTED PHOTO]

SilverSneakers at Mercy Fitness Center just the right medicine By Todd Nighswonger Mercy Media Relations

Terry Cranford retired from teaching several years ago and eventually was just plain tired. Cranford, who taught junior high English in Fort Smith schools and worked for the local teachers union, had heart trouble for many years, including bypass surgery in 1992. The heart problems resurfaced about 10 years later and resulted in stints placed in his heart every year 12

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or so until 2014, when he was 68 years old. After also developing diabetes and weighing as much as 213 pounds, he realized he had slowed down too much in retirement. “I was not physically active at all and continued to gain weight,” he said. Finally, Cranford decided it was time to reverse a downward health trend that left the Marine and Navy veteran too many years and pounds removed from when he was a medivac helicopter corpsman during the Vietnam War. “I realized then that I’d never be any healthier than

Terry Cranford participates in a SilverSneakers ﬁtness class at Mercy Fitness Center. [BRIAN D. SANDERFORD/TIMES RECORD]

I was right then if I didn’t do something about it,” he said of early 2015. “I thought. ‘If I’m ever going to be able to exercise, now is the time.’” After consulting with his health-care providers, Cranford set a goal of getting down to 190 pounds, which he considered unlikely. “I didn’t think I could do much and that it would be a lost cause,” he said. Cranford embarked on his healthy journey by going on a low-carb, low-fat diet and exercising in SilverSneakers classes at Mercy Fitness Center in Fort Smith. He noticed right away that the classes for ages 65 and

older were at a safe level for someone with heart problems. “At first, I had no stamina, but now I can do it all,” he said. “Most of my medicines have been eliminated or have reduced dosages.” Cranford blew past his goal of losing about 15 pounds and lost 60. Looking back, the biggest step for the 71-yearold was the first one. “Just bite the bullet and start,” he said. “The more you work at it, the easier it gets.” SilverSneakers SilverSneakers classes are held several times a week at Mercy Fitness Center, 7600

Dallas St., and are led by Lori Louks, an exercise technician. SilverSneakers is comprised of classic, circuit and yoga classes. Most participants start with classic as an introduction to the program, although they may stay with the class long term. It begins with simple, choreographed moves to get warmed up, moves on to weight and resistance training and includes water breaks. Circuit class provides a higher-intensity workout and results in 3,500 to 4,000 steps. Yoga class is all about improving range of movement and flexibility. SilverSneakers classic

classes are 11 a.m. Mondays, Wednesdays and Fridays. Circuit classes are 1:30 p.m. Tuesdays and Thursdays. Yoga classes are at noon Mondays and Fridays and 2:30 p.m. Tuesdays. All classes at the fitness center are 45 minutes. The cost to participate can be reduced or free with qualifying health insurance plans. The program provides unlimited access to thousands of fitness locations across the country. Like with Cranford, Louks suggests that new participants first check with their primary care provider to make sure they’re healthy enough to exercise. If they are, start out slow and at their own pace. “I tell anyone new to my class, ‘This is your workout. You do what feels comfortable to you. If you can’t do what I’m doing, just wait until you can jump back in,’” she said. “If someone’s struggling, I’ll work with them to reduce the weight or duration.” SilverSneakers also is an ideal exercise program for older adults because they work out with their peers. “It’s a lot of fun and it works,” Louks said. “They can relate to each other so much better. They really enjoy being around each other, so much so that sometimes you can’t get them to stop talking.” Exercise program Seniors don’t have to participate in SilverSneakers to develop an exercise program. Louks recommends a combination of cardiovascular exercise like walking or aerobics and weight training. For many older people, it’s not necessarily about getting in the best shape of their lives

Exercise technician Lori Louks leads a SilverSneakers ﬁtness class at Mercy Fitness Center. Classes with several levels of intensity are held throughout the week at the center, 7600 Dallas St. in Fort Smith. [BRIAN D. SANDERFORD/TIMES RECORD]

“I tell anyone new to my class, ‘This is your workout. You do what feels comfortable to you. If you can’t do what I’m doing, just wait until you can jump back in.’ If someone’s struggling, I’ll work with them to reduce the weight or duration.” Lori Louks exercise technician

Terry Cranford exercises along with others during a SilverSneakers ﬁtness class at Mercy Fitness Center. [BRIAN D. SANDERFORD/TIMES RECORD]

and may be nothing more than being able to walk longer distances or more easily pick up items, such as a mixing bowl. “It can be something simple like that,” Louks said, “but it’s a big deal to them.” Louks said seniors should aim for cardio/aerobics exercise and weight training at least three times a week and up to five times for at least 30 minutes each.

“The best way to age well when doing cardio and weight training is low impact because it will be better on the joints,” she said. Louks suggests scheduling a personal assessment to know where to start and to set goals. “Doing cardio will strengthen the heart and the lungs. They both are muscles, so by keeping them strong, it can help you live longer,”

she said. “Weight training is important as we age because it helps slow the natural loss of muscle mass.” It’s also important for people to work on their balance as they age, Louks said. “Balance is something most people don’t think about when it comes to exercise, but it’s something we lose as we age,” she said. “It’s just as important as cardio and weight training.” The overall goal with exercise is to age well and enjoy life more. “When it comes to physical fitness, find something you like doing. Find people you enjoy being around and work out with them,” she said.

“Doing that will make it so much easier for you to stick with it and create a healthy lifestyle.” Mercy Fitness Center, 7600 Dallas St., can help assess someone’s existing level of fitness and suggest a cardio and weight training regimen to help them improve. The 36,000-square-foot center is open seven days a week and offers group exercise, a variety of exercise equipment, a private women’s workout area, an indoor walking/ running track, a swimming and therapy pool, lockers rooms and more. For more information, call 479-3147400 or visit mercy.net/ practice/mercy-fitnesscenter-fort-smith. HEALTHYU

MAY 2018

‘You are not alone’ Workshop in Fort Smith offers support for Alzheimer’s, dementia patients’ caregivers By Carole Medlock Special to the Times Record

A group of family caregivers met recently at a local health-care facility to gain information and encouragement about caring for family members with dementia or Alzheimer’s Disease. Kristi Cowell, a registered nurse with the West Central Center on Aging, had an encouraging message for those who gathered for the free family caregiver workshop to learn about caring for an adult, usually a family member, with dementia or Alzheimer’s. “You’re not the only one going through this,” Cowell told a room full of caregivers who attended the seminar. “Your situation is your own, and all (of them) are going to be a little different. But it’s nice to see that you are not alone.” The workshop was held at Brookfield Assisted Living facility in Fort Smith and funded by the Arkansas Geriatric Education Collaborative and the American Association of Retired Persons. Cowell said the purpose for the workshop was to provide tools for those caring for a loved one with a dementia-causing disease. “These people are underserved; people caring for people with Alzheimer’s,” Cowell said. “Anything to get them some kind of training and help them understand how to handle them.” According to information 14

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Debi Rakes of Fort Smith and Cindy Frye of Huntington participate in a “virtual dementia” exercise in an effort to understand how everyday tasks become more difﬁcult and sometimes frustrating for someone suffering from age-related barriers. Simple chores like folding socks or sorting medicine are often hampered by conditions like glaucoma or arthritis, as illustrated in the virtual dementia demonstration. Rakes and Frye are both caring for their mothers who have Alzheimer’s Disease. [CAROLE MEDLOCK/SPECIAL TO THE TIMES RECORD]

provided by Cowell, 16.1 million Americans provide unpaid care for people with Alzheimer’s or other dementias. Caregivers are estimated to provide 18.4 billion hours of care valued at more than $232 billion. Cowell shared her own personal experience, not only with patients in home-health and hospice care, but with family members who have suffered from the disease.

She said that dementia is most frequently diagnosed in adults 65 years old or older, and that any dementia diagnosed earlier is considered early onset. Alzheimer’s disease is the most common form of dementia accounting for 60 to 80 percent of all cases. Dementia is a destruction or lack of communication between brain cells and can be caused by diseases other

than Alzheimer’s including Huntington’s disease, Parkinson’s disease and Lewy body dementia, among others. Cowell reassured attendees that dementia is not a part of the normal aging process and that memory loss does not always indicate dementia. She said mild cognitive impairment does not mean that a person will have dementia and that most healthy older adults usually

retain their ability to perform daily living activities. She also illustrated the difference in delirium and dementia, saying the former appears suddenly, is reversible, and can be caused by many things including stress, infection, medication, dehydration and even constipation. The latter, however, has symptoms that appear gradually and although there are

Kristi Cowell, a registered nurse with the West Central Center on Aging, provides information about dementia and Alzheimer’s Disease at a family caregiver workshop. The event was held at The Brookﬁeld Assisted Living facility in Fort Smith and aimed to provide helpful information for those who may be caring for a family member suffering from dementia or Alzheimer’s. [CAROLE MEDLOCK/SPECIAL TO THE TIMES RECORD]

medications that may slow the progression of the disease, it cannot be reversed. If a family member exhibits symptoms including diminished short-term memory, mood swings, loss of words, and difficulty performing daily living activity, among others, it may indicate the need for further evaluation to determine whether they have Alzheimer’s or another type of dementia causing disease. Cowell stressed the importance of helping preserve a loved one’s dignity and quality of life through the early, middle and late stages of the disease. She suggested maintaining patience, keeping an open posture, staying calm and redirecting a family member who may be experiencing frustration or agitation

as the result of symptoms of dementia. Identifying triggers to challenging behavior and being mindful of environmental, medical and emotional triggers can help maintain calm. Cowell said Alzheimer’s disease is the sixth-leading cause of death in the United States seeing an increase of 123 percent in just five years. The disease is not often thought of as a cause of death, but many times is the underlying cause. Alzheimer’s kills more people than breast and prostate cancer combined. The West Central Center on Aging is an arm of the University of Arkansas for Medical Sciences. Cowell said although she works from Fort Smith, her center provides education and services to 14 counties in Arkansas.

Marshall Sharpe of Fort Smith adjusts his headphones, intended to demonstrate hearing loss suffered by many who are aging. The exercise followed an informational session for those who are caring for a loved one suffering from dementia or Alzheimer’s Disease. Sharpe attended a workshop at The Brookﬁeld Assisted Living Facility, where his 91-year-old aunt is a resident. [CAROLE MEDLOCK/SPECIAL TO THE TIMES RECORD]

HEALTHYU

MAY 2018

Happiness in simplicity St. Scholastica sister, Mercy doctor reflect on ‘aging well’ By Mardi Taylor Times Record

Dr. Amita Heaser, MD, internist with Mercy Fort Smith, left, and Sister Barbara Bock stroll through the garden area at St. Scholastica. [BRIAN D. SANDERFORD/TIMES RECORD]

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It takes a balance of both mental and physical well-being to truly “age well,” according to one local doctor. Dr. Amita Heaser, MD, internist with Mercy Fort Smith, puts a strong emphasis on having a sense of purpose as we age in order to avoid things like depression and isolation. “Having a sense of purpose in one’s life is so crucial to aging well,” she said. “Having the sense of purpose increases our desire to maintain our well being. Without those, there’s the risk of falling into depression, feeling a sense of emptiness in our lives.” Dr. Heaser said activities such as volunteering at places like a hospital, nursing home or animal shelter can help provide that sense of purpose. One of Dr. Heaser’s patients is Sister Barbara Bock, 77, who has been at St. Scholastica Monastery in Fort Smith since 2010 after spending four decades in Missouri and almost 60 in the religious order. Sister Barbara says the opportunities she has to help others provides her with that sense of purpose. She helps her fellow sisters out by driving them to their doctor’s appointments and helping around the monastery. She also works as a fill-in assistant in the infirmary and plays the organ. She stays healthy in a number of ways, from following a healthy diet to spending time outdoors to interacting socially with other sisters at the monastery. Dr. Heaser says Sister Barbara’s approach to interacting socially is an important step in maintaining a healthy lifestyle. She said she’s observed Sister Barbara doing things often for the other sisters, from everyday activities such as laundry to being there emotionally for them. “I just see Sister Barbara doing so much; you’re making such a huge difference in the other sisters’ lives,” Dr. Heaser told her recently. “I just think you’re such a huge source of support to

them, and I think that also gives you such a sense of purpose; it must. I just know that it’s such a huge impact to the sisters that are there. “Just listening to Sister Barbara, it seems there’s so much happiness in simplicity.” Dr. Heaser cites higher congitive function as another factor that goes along with aging well, which ties in with social interactions with others. “I think that aging well, as it means less chronic conditions, more social interaction with others, that entails better mental health, less chance of depression, less chance of anxiety,” she said. “I think that it’s extremely important to focus on mental health as well as physical health, because the two are so closely tied together. Depression can rise from having chronic conditions, and chronic conditions can rise from having depression. I just think the two are so closely tied together.” Good genes can help determine how well someone will age, but how well someone takes care of themself plays an essential part, Dr. Heaser says. “Of course, genetics play a huge role in our risk of cancer, diabetes, heart disease and other conditions,” Dr. Heaser said. “However, we should keep in mind that our environment has a significant impact and also works with our genetics. That would be following a healthier lifestyle, maintaining a healthy diet, exercising. There are so many things that we have control over ... although we may have the genes that cause us to have more risk of having these conditions, you should also keep in mind that our lifestyle and our environment play a huge role as well.” Sister Barbara said she enjoys spending time outdoors and in the garden. She tries to walk every day but also is able to get her steps in walking

Sister Barbara Bock, left, with St. Scholastica and Dr. Amita Heaser, MD, internist with Mercy Fort Smith, talk about the importance that social interaction has on staying healthy as one ages. [BRIAN D. SANDERFORD/TIMES RECORD]

indoors throughout the day. She believes she inherited good genes from her parents, who both lived into their 90s. They offered good examples on how to live a healthy lifestyle, which included spirituality. “When I came here (to St. Scholastica), it was kind of like similarities with my own family,” Sister Barbara said. “I came from a large family, and so here, I came with a bigger ‘family.’ It’s the interaction here with one another, too, support when I need it. We pray together; that was important with my home family, too.” “Spirituality plays a large role in aging well,” Dr. Heaser said. “There’s strength to be found through one’s religious faith and through prayer. We’re better able to cope with illness, and negate the

stressors that come to us as we age in our lives. And spirituality offers us hope that allows us to keep going in the face of illness, in the face of the hardship that sometimes comes more so with time.” The ability to maintain an independence as we get older is also an important part of aging well, Dr. Heaser said. Being mobile helps reduce a loss of bone density and muscle mass for many older adults, which reduces the risk for falls and fractures. “Aging well, to many of us, is a person who has minimum to no chronic conditions, but I also think that in aging well, there should be an ability to adapt well to both physical and functional changes that occur over time,” she said. “Our ability to perform activities that we used to do in our

younger years declines, but aging well, I think, involves a shift in our thinking, focusing less on things that we can no longer do and shifting that focus to things that we are still able to do.” Wear and tear on the body, including osteoarthritis, is common as we age, Dr. Heaser said. Joint pain is very common. Signs of something more serious would be if there is pain occurring in unusual sites or inflammation, rapid progression of pain, fevers and unusual weigh loss. That’s when it’s a good time to go be checked out, Dr. Heaser said. Ideally, a person would put focus on his or her health at an early age, but Dr. Heaser says making healthy lifestyle changes is a good idea at any point during a person’s life. Changes may include improving

diet, taking medications and improving overall lifestyle. “There’s never a time when it’s too late to make changes,” she said. “I think that regardless of how many chronic conditions a person may have — heart disease, diabetes, whatever condition it may be — there’s never a time that it’s too late to really empower oneself and take charge of oneself and try to control one’s chronic conditions.” Some good habits are in our control, Dr. Heaser said, include things like taking medications, and getting a routine checkup. “There are always things that are beyond our control, things we may not be able to control as well,” she said. “But I think it’s important that we do everything that we are able to do, that’s in our control, to try to age well.” HEALTHYU

MAY 2018

Creative approaches to combat symptoms of menopause Brandpoint

Many women and their doctors are still confused about the safety of estrogen. When introduced, estrogen was believed to be good for you. But, following the Women’s Health Initiative study 15 years ago, women were told that hormone therapy could, in fact, lead to an increased risk of cancer, blood clots and heart disease. Nothing could be further from the truth, according to Dr. Mache Seibel, author of The Estrogen Fix. Today, women are learning that use of hormone therapy can minimize risks and maximize menopausal relief for common symptoms like hot flashes, dryness, mood swings, fractured sleep, brain fog, irritability and weight gain. When taken at the right time, estrogen therapy can lead to substantial improvements in health and quality of life and lower the risk of breast cancer, heart disease, and dementia. Women should be aware of one caveat: beginning estrogen after a woman’s estrogen window closes at age 65 may increase their risk for breast cancer, heart disease, Alzheimer’s and osteoporosis. Heeding advice about how and when to stop taking HT is important and revealed in new studies featured in Dr. Seibel’s The Estrogen Fix. The book reaffirms the safety of vaginal estrogen for the heart and brain, as well as its effectiveness in controlling weight; additionally, the book outlines newly available estrogens and progesterones, discusses misconceptions about compounded hormones and estrogen pellets and offers the latest hormone-free FDA solutions for women with vaginal dryness. The following are five creative approaches to combat menopausal symptoms: 1. Hot flashes: Women 18

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experiencing hot flashes and night sweats can find relief using an FDA-approved estrogen hormone therapy called Divigel, a cool, clear gel that is applied to the upper thigh daily. It contains the plantbased estrogen hormone estradiol, the same hormone made naturally by a woman’s ovaries before menopause and delivers estrogen identical to that naturally produced in the body. 2. Irritability/sleeplessness: Quality sleep is often a challenge during menopause and can contribute to high blood pressure, diabetes, heart disease and obesity. A natural supplement with melatonin like Vitafusion Beauty Sleep promotes a good night’s sleep without

prescription medication. Sex and/or self-pleasure are natural ways to decrease stress and can help with the onset and quality of sleep. The oxytocin released with hugging, stimulation and orgasm can increase feelings of calm and safety, causing cortisol levels to drop, thus optimizing sleep. Orgasm releases prolactin, helping you fall asleep faster and more efficiently. 3. Painful sex: Internal vaginal dryness can be relieved for three days with hormone-free Replens Vaginal Moisturizer. Alternatively, prescription remedies like vaginal estrogen or DHEA can be used. Don’t forget to incorporate a personal silicone lubricant like Replens Silky Smooth just before sex

to ease penetration, increase comfort and reduce abrasion. 4. Weight gain? Eat to defeat menopause: Food is the fuel for every cell in your body, so avoid packaged and processed foods and limit sugary drinks and desserts to ensure you’re optimizing energy. Stick to unprocessed whole foods as there are no hidden ingredients or calories. Your body will also appreciate fresh and/or organic produce and hormone-free meat or grass-fed beef as often as possible. Eat to Defeat Menopause: The Essential Nutrition Guide for a Healthy Midlife offers practical advice and information on how to choose and prepare meals to optimize health during menopause.

5. Hair lacking luster, lessthan-glowing skin and brittle nails: Loss of estrogen leaves many women dealing with thinning hair, increased dry skin and brittle or breaking nails. Introducing biotin into your diet with a raspberry-flavored gummy like Vitafusion Gorgeous Hair, Skin & Nails can ensure you’re consuming sufficient biotin and other helpful nutrients including vitamins C and E. Every woman has safe, new options, from prescription HT to those available over-thecounter, to suit her unique needs. Schedule a chat with your health provider to discuss the right hormone therapy or alternative option for your personal menopausal challenge.

Moms of babies with heart defects also could be at risk of later heart disease smoking, to having a healthy body weight and being physically active.” Women who have About 40,000 babies, babies with a heart defect which is about 1 percent have a 25 percent greater of births in the U.S., are risk of being hospitalized affected by congenital for cardiovascular issues defects affecting the struclater in life, according to ture of the heart and the a new study that says the way it works, according baby’s condition could be to the federal Centers for an early warning of heart Disease Control and Predisease for some mothers. vention. Meanwhile, heart The research, pubdisease already affects lished in the American nearly 48 million women Heart Association journal in the United States and is Circulation, included the leading cause of death more than 1 million young in women, killing about moms who delivered 414,000 in 2015. infants between 1989 and For Anne Joles of 2013 in Quebec, Canada. Dallas, the study results Researchers categorized hit all too close to home. women whose infants Her first-born son, Gabe, had critical, noncritical or had open-heart surgery no heart defects, and fol- at 9 months for a heart lowed them up to 25 years defect. He’s 7 years old past pregnancy. now and doing well, but “As far as we know, this heart health is always in is the first study to look the family story. at the correlation of heart “I think once you have defects with heart disease a baby with CHD, heart in mothers who didn’t health is always on the have it to begin with,” forefront of your mind,” said lead study author Dr. said Joles, 38. “It never Nathalie Auger, associate goes away. You know the clinical professor at the symptoms, you know the University of Montreal’s benefit of having great School of Public Health. care and good medica“Having a baby with tion. … That worry and a heart defect is a sign concern never go away. of future health, and we Knowing there’s research should be thinking of and just one study that this as an opportunity there’s been a link, maybe to reduce your own risk there’s time for moms to of heart disease,” Auger slow down and get to the said. “Women who doctor and put themhave a child with a heart selves first.” defect should definitely Auger said more pay attention to cutting detailed research is By American Heart Association News

needed to determine why there’s a link. A few factors could be at play, she said. Diabetes, obesity and preeclampsia have been tied to both CHD and heart disease; genetics could influence both conditions; and there’s stress and the financial and emotional toll when a family is faced with such a serious diagnosis in their baby. Stress is something every mother knows, said Joles, who left her career teaching fourthgraders to care for Gabe. She also has a younger son, 3-year-old Mick, who does not have a heart defect. “In having a child with CHD and one without, I know there’s a different kind of stress,” said Joles, who also has gotten to know many other families affected by heart defects while volunteering with the nonprofit Mended Little Hearts. “By nature of going to the doctor’s appointments, discussing heart health and being with other families, you know the spectrum of possible outcomes, and it breaks your heart in lots of ways to see other families and what they go through,” she said. “Even when your child is stable, you’re grateful and your situation is resolved, there’s what could have been.”