Healthy U

A SPECIAL EDITION OF THE TIMES RECORD

VOLUME 1, EDITION 4, MAY 2017

Living well, staying young

Understanding hospice care

Local doctor urges healthy lifestyle

100-year-olds share secrets to longevity

HEALTHYU Contents VOLUME 1, EDITION 4 | MAY 2017

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Local doctor says lifestyle is key Small changes in habits can have big health impact

Understanding hospice care Group meets ‘more than just physical needs’

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Living well, staying young Local woman stays healthy with an active lifestyle — including marathons

Medical directory

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

about HEALTHYU

Eating habits tied to big portion of deaths

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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 Staff Writers Thomas Saccente, Larry Williams II, Buck Ringgold

Contributor Carole Medlock Photographers Brian Sanderford, Jamie Mitchell

Production Manager Christy Morrison

ADVERTISING Sales Manager Julie Newman Account Executives Monica Carter, Mike Opolka, Kathie Smith, Ashley Yeary

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HEALTHYU

Small changes in lifestyle habits are key Local doctor urges holistic approach to health

is important if, say, you’re overweight or having your cholesterol checked regularly may not be something someone who’s in their early 20s may be thinking about,

By Larry Williams II but it’s very important if you Staff Writer have those genetic tags or a family history that could lead Not many people know to something further down what osteopathy is, and if the road.” they look up the definition Even something like regufor it, they may be led to lar diabetes screening, adds believe doctors of osteopathy Speake, is necessary. In fact, are nothing more than masall types of screenings need sage therapists. However, to be considered early on for nothing could be farther from those with a family history of the truth. health or weight problems.

Instead, osteopathy is “We’re starting to see more essentially a branch of mediand more people in their 20s cal science that addresses coming in with those kinds of some of the most common serious health issues,” said medical issues without the Speake. “It’s important to use of prescription medistart seeing your doctor as cine, addressing something early and as often as posmany patients complain sible, because, once you about: harmful side effects. know where you stand, [your So, rather than treating high doctor] can kind of tailor a blood pressure with a series plan for you, because it varies Dr. Joseph Speake with Mercy Primary Care Clinic on Waldron Road talks about the importance of having healthy of pills, even over-the-coun- habits early in life to avoid medical issues later in life. [BRIAN D. SANDERFORD/TIMES RECORD] a lot. Depending on how ter ones, osteopathic doctors severe it is, a person could And, as fast-paced as life in himself, he emphasizes the “If you start in your 20s attempt to treat a patient’s need to start taking medicine our 20s is, it’s easy for us to and every year, work on high blood pressure with life- importance of developing even in their 20s.” fall into a routine of fast food healthy habits early on to changing something else, style changes, including diet But the outlook isn’t all avoid major medical issues as and sitting on the couch, healthwise, by the time and exercise. negative as we age. Speake binge-watching the latest and we age. you’re in your 40s, you’re That’s certainly a goal Dr. said that small changes can greatest from online streaming really doing well,” said “To me, it’s all about Joseph Speake tries to reach even be a way to reward ourbuilding good habits, because services.

Speake. with his patients at Mercy selves, such as moving away “I think, realistically, we But for some, it’s not so Primary Care Clinic, 1000 S. you can’t just transform and from milk chocolate to dark be a perfectly healthy person could all do a better job,” said simple a road. Some people Waldron Road. chocolate.

Speake. “Very, very few people are born with genetic factors, overnight,” said Speake. “It “I use medicine like other “No one succeeds the first at that age are doing 100 takes time, so starting in such as childhood obesity or doctors, of course, but I still time,” said Speake. “We percent. I’m a big believer that a family history of diabetes, your 20s and getting good have the thought behind know for sure by studying habits in place are going to be you have a set amount of willthat are unavoidable and not smokers that no one ever every treatment of a more power. What I see a lot of times cured merely with lifestyle key.” holistic approach to get quits smoking for good the is, people will have something Many of us feel downright changes. Speake says in those first time they try to quit. people to develop better happen to them, and they’ll go cases, it’s best to do someindestructible in our 20s, as habits for their health,” said Most studies show that the on this crazy diet, and they do we feel we’re in the prime of thing else people in their 20s people who succeed are the Speake. our lives. We’re just starting really well for a while, but then aren’t used to doing: regular Speake graduated from ones who keep trying, and they just burn out.” checkups with their primary Oklahoma State University’s to taste true independence it’s the same thing with diet.

Rather than looking for care physicians.

College of Osteopathic Medi- as, for some, we’re expeSo, if switching to dark choc“crash diets” or what is often riencing financial freedom “There is a wide variation cine in 2010 and completed olate is what helps you keep termed as “fad diets,” Speake of metabolisms that people from Mom and Dad, so diet his residency at Texas A&M trying, then that’s great, says you should make small and exercise are usually the have,” said Speake. “Getting because it’s still a positive College of Medicine in 2013. changes. last things on our minds. your labs checked early on As a relatively young person change.”

HEALTHYU

MAY 2017

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How menopause affects athletic women Bonnie Snyder Berkowitz | The Washington Post

Hey, active women of a certain age: The good news is that you are probably going to weather menopause better than your sofa-bound sisters. The bad news is that “the change of life” doesn’t just affect your mood and your lady parts — it also drags down your race times.

Menopause is when the monthly waves of estrogen and other hormones that women have been surfing since puberty finally ebb for good. Periods cease, of course. But all kinds of other biological processes change as well, including some that affect athletic performance.

Combine that with other age-related decline, and you find that your body is a different machine from the one that glided through your 20s and 30s. You’re still an athlete, you just have to figure out your new normal.

“Just because you hit a certain age, your body doesn’t stop,” said Stacy T. Sims, a nutrition scientist and physiologist in New Zealand who has studied women’s performance for 25 years. “The fitter you are, the less of a problem these are. When you are competing, that’s when you really feel them, because you are, like, ‘What is going on?’ But when you’re a general woman and you’re keeping fit, then all these things are” easier to handle.

But what if you’re not very fit right now?

“It is definitely not too late — that’s the greatest thing about this,” said Monica Serra, a research scientist at the VA Maryland Health Care System who has written about post-menopausal competitive athletes.

“If you start exercising, you can build your bone mass, you can build your lean mass, you can lose the fat mass, you can improve the quality of your muscle ... . Research says people who exercise have a better quality of life.”

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Doctor urges education is skin cancer on melanoma May awareness month

By Thomas Saccente | Staff Writer

For dermatologists across the country, the month of May is an important time of year.

Dr. Garrett Nelson, a board certified dermatologist at Johnson Dermatology Clinic in Fort Smith, said May is Skin Cancer Awareness Month. It is a period dedicated to educating the public about the importance of skin cancer prevention, diagnosis and treatment, with the American Academy of Dermatology doing significant promotional work during this time.

“There’s different local programs all over the country, but generally, it’s a reminder to us as dermatologists to talk a little bit more to our patients about the dangers of sun exposure and the different risk factors that can cause melanoma and cause other types of skin cancers, and it’s a time that we generally offer free skin cancer screenings ...” Nelson said.

Nelson said about one in five people will develop skin cancer during their lifetimes. Skin Cancer Awareness Month began May 1, which was given the name “Melanoma Monday.”

“Melanoma Monday is always designated as the first Monday in May, and it is a day that the American Academy of Dermatology and dermatologists across the country try to raise awareness about melanoma, and so, on this day, we’re encouraged to, one, educate the public about melanoma, and, two, many dermatologists offer free skin cancer exams on this day,” Nelson said.

This was true for both Dr. Sandy Johnson, another dermatologist at Johnson Dermatology Clinic, and Nelson, who offered free skin cancer screenings on May 1 and May 4 in conjunction with the Donald W. Reynolds Cancer Support House in Fort Smith.

Nelson said melanoma is a type of skin cancer that can spread internally and cause death. It is also one of the most common types of cancers overall in young adults.

“The good news is that if we catch it early, melanoma has a great prognosis,” Nelson said. “It can be treated

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6 EASY TIPS FOR PROTECTING YOUR HEARING THIS SUMMER 1. Walk away and plug your ears. If a loud noise takes you by surprise, quickly plug your ears with your fingers and walk away.

Increasing the distance between you and the source of the sound will help reduce the intensity (or decibels) at which the sound is reaching your ears.

Dr. Garrett Nelson, right, discusses skin cancer treatment with patient Ralph W. Adcock at Johnson Dermatology Clinic. [THOMAS SAC-

2. Use earplugs. When you know you’ll be around loud sounds, use earplugs. Disposable earplugs, made of foam or silicone, are often available at local pharmacies or you can stop by Center for Hearing anytime and pick up a free pair. They’re practical because you can still hear music and conversation when they’re in your ears. But when they fit snuggly, they’re effective in adequately blocking out dangerously loud sounds.

CENTE/TIMES RECORD]

by just incision and given oftentimes a clean bill of health. It’s whenever they have spread internally and gone to the lymph nodes or internal organs that the prognosis becomes poor, and that’s whenever we see death from this particular type of skin cancer.”

This is in contrast, according to Nelson, to the other two major types of skin cancers, basal cell carcinoma and squamous cell carcinoma, which are the most common types of skin cancer. These generally occur in older adults and do not spread internally as quickly as melanoma. “... We can treat them even if it’s been there for several months to a couple of years,” Nelson said. “We can often identify it and still treat it before it’s had a chance to go internal, so melanoma’s the type that really scares us as dermatologists because it spreads quickly, and once it spreads, there’s not any good treatments for it at this time, although there are new medications that had been developed in the past several years, but it’s still one of the more difficult types of cancers to treat at this current time.”

Some of the most common risk factors for skin cancer include exposure to ultraviolet radiation from both the sun or tanning beds, a history of sunburns and having light-colored skin, according to Nelson. However, in many cases skin cancer can be prevented by protecting one’s skin. This includes avoiding tanning beds and the midday sun, as well as by wearing wide-brimmed hats, broad spectrum sunscreens, sunglasses and sun protective clothing.

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3. Be smart when you celebrate 4th of July festivities. Leave the fireworks to the professionals. And when watching the show, stay a safe distance away—where you can enjoy the colors and lights but not expose yourself and your family to loud noises. To protect your hearing, make sure you’re wearing earplugs and that they’re securely in place before the show begins. Also be sure to keep them in for the entire show.

4. Limit your time in noisy environments. Do all you can to limit the length of time you spend in a noisy environment. When you do participate in noisy activities, alternate them with periods of quiet.

And remember to use ear protection.

5. Turn it down. When listening to smartphones and other electronics, keep them at a low volume. Importantly, limit your use of headphones and ear buds. Remember, it’s not just the volume that matters. It’s also the duration of time spent listening.

6. Visit Center for Hearing to establish a baseline on your hearing.

Our audiologists can provide a hearing test and determine if you have normal hearing or a hearing loss that needs to be addressed. Center for Hearing also provides many forms of custom ear protection. Visit the clinic today and get a free pair of disposable ear plugs for use with your summer fun!

Pictured: Dr. Lori Boyd, Dr. Kelley Linton, Dr. Trace Cash

HEALTHYU

MAY 2017

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Hospice care a team effort Group meets ‘more than just physical needs’

By Carole Medlock Contributing Writer

While the process of aging typically encompasses enduring some type of illness, knowing about the care options available can minimize discomfort and increase quality of life.

Melissa Moody, RN and certified hospice and palliative care nurse, said understanding and utilizing either hospice or palliative care can help patients facing a serious illness in a number of ways.

“Someone once told me that at every stage of life, you need different levels of medical care,” Moody said. “Hospice is a level of medical care. Choosing hospice just means you are choosing symptom management to feel better.”

She said many view a decision to utilize hospice care as giving up.

Moody explained the difference in palliative and hospice care, saying palliative care is geared toward a physician managing a patient’s symptoms while that patient is seeking aggressive treatment for a potentially life-ending disease. Hospice care, however, is characterized by an entire team of people meeting a wide range of needs when a patient has no treatment options left, or has chosen not to pursue further treatment.

Moody, who works for Peachtree Hospice, said their main focus is hospice care, although they also have 6

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Melissa Moody, RN, CHPN, Palliative Care Unit manager, works with hospice care at Sparks Regional Hospital.

[JAMIE MITCHELL/TIMES RECORD]

palliative care patients.

A hospice team can include a registered nurse, a certified nursing assistant, a social worker, a chaplain, a massage therapist, various volunteer services, a pharmacist and a physician, all working together to meet a broad spectrum of needs and provide quality of life for a patient, Moody said.

“The reason for the team is to meet more than just physical needs,” Moody said.

Most hospice care is outpatient and usually takes place in a patient’s residence, although care can also be provided in assisted living or nursing home facilities. There are also patients who are admitted for

inpatient hospice or palliative care.

Patients typically benefit most from daily interaction with a CNA who helps patients with personal care, meals, and even some light housework.

“They build a relationship with the patient. They can pick up on something not right, and catch things on the front end,” said Moody.

Moody traced hospice care back to the 1980s, noting services were more volunteerbased when the concept began.

But over time, the medical service has become legitimized, being recognized by Medicaid and eligible for reimbursement. However, Moody said

many patients do not understand hospice care and are still frightened by it.

The actual guidelines for hospice care state that for a patient to receive care, they must have a life expectancy of 6 months or less if their disease takes its normal course, Moody said. This statement is frightening to patients. Many patients live longer, she said, citing a university study that showed hospice patients lived an average of 30 days longer with hospice care and pointing out that disease affects everyone differently.

“If you can get a patient’s symptoms managed, it makes all the difference in their

quality of life,” Moody said.

The typical patient would have hospice benefits as a part of their health insurance, Moody said. However, Peachtree Hospice does not accept or decline patients based on their ability to pay, and neither a patient nor family member is ever billed for services, she said.

Another beneficiary from hospice care can often be a family member who has been caring for a loved one alone, Moody said.

“The families (of a patient) are the ones that say ‘I wish I would have known about you sooner,’” said Moody.

Hospice care provides security for the family who have the support of a team member 24 hours a day. It also provides bereavement services including mailings, phone calls and even support groups if a family is willing.

Moody said palliative care looks to become a more utilized service in an acute care setting in the future. She said hopefully through more palliative care, the anxiety of hospice care will be removed from patients and families.

Patients can talk to their physician about hospice care but do not need a referral to request information or even seek treatment. Even though the conversation about hospice care is a difficult one, Moody encourages those who are curious to explore hospice as an option.

“Let us come talk to you.

You are not committing to anything. Let us tell you what we do and how we can help you. If it’s not for you, it is OK, but you are getting your questions and anxieties out of your mind,” said Moody.

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HEALTHYU

MAY 2017

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TIRED & WEAK?

Don’t assume it’s just your age Fat ig ue , depre ssion not re su lt s of g e t t i ng older

Judith Graham | Kaiser Health News

When Christopher Callahan examines older patients, he often hears a similar refrain.

“I’m tired, doctor. It’s hard to get up and about. I’ve been feeling kind of down, but I know I’m getting old and I just have to live with it.”

This fatalistic stance relies on widely held but mistaken assumptions about what constitutes normal aging.

In fact, fatigue, weakness and depression aren’t to-be-expected consequences of growing older, said Callahan, director of the Center for Aging Research at Indiana University’s School of Medicine.

Instead, they’re a signal that something is wrong and a medical evaluation is in order.

“People have a perception ... that aging equals decline,” said Jeanne Wei, a geriatrician who directs the Donald W. Reynolds Institute on Aging at the University of Arkansas for Medical Sciences. “That’s just wrong.”

Of course, peoples’ bodies do change as they get on in years. But this is a gradual process. If you suddenly find your thinking is cloudy and your memory unreliable, if you’re overcome by dizziness and your balance is out of whack, if you find yourself tossing and turning at night and running urgently to the bathroom, don’t chalk it up to normal aging.

Go see your physician. The earlier you identify and deal with these problems, the better.

Here are four common concerns that should spark attention - only a partial list of issues that can arise: • Fatigue. You have no energy. You’re tired all the time.

Don’t underestimate the impact: Chronically weary older adults are at risk of losing their independence and becoming socially isolated.

Nearly one-third of people age 51 and older experience fatigue, according to a 2010 study in the Journal of the American Geriatrics Society.

(Other estimates are lower.) There are plenty of potential culprits: Sleep problems, pain, gastrointestinal reflux and medications for blood pressure can induce fatigue, as can infections, arthritis and other conditions, an underactive 8

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thyroid, poor nutrition and alcohol use.

All can be addressed, doctors say. Perhaps most important is ensuring that older adults remain physically active and don’t become sedentary.

“If someone comes into my office walking at a snail’s pace and tells me, ‘I’m old; I’m just slowing down,’ I’m, like, ‘No, that isn’t right,’ “ said Lee Ann Lindquist, a professor of geriatrics at Northwestern University’s Feinberg School of Medicine in Chicago.

“You need to start moving around more, get physical therapy or occupational therapy and push yourself to do just a little bit more every day,” she said.

• Appetite loss. You don’t feel like eating, and you’ve been losing weight.

This puts you at risk of developing nutritional deficiencies and frailty, and it raises the prospect of an earlier-than-expected death.

Between 15 and 30 percent of older adults are believed to have what’s known as the “anorexia of aging.”

Physical changes associated with aging — notably declines in vision, taste and smell, all of which make food attractive — can contribute. So can other conditions: decreased saliva production (a medication-induced problem that affects about one-third of older adults); constipation (affecting up to 40 percent of seniors); depression; social isolation (people don’t like to eat alone); dental problems; illnesses and infections; and medications (which can cause nausea and reduced taste and smell).

If you had a pretty good appetite before and that has now changed, pay attention, said Lucy Guerra, director of general internal medicine at the University of South Florida in Tampa.

Treating dental problems and other conditions, adding spices to food, adjusting medications

and sharing meals with others can all make eating a more enjoyable and healthy experience.

• Depression. You’re sad, apathetic and irritable for weeks or months at a time.

Depression in later life can have profound consequences, compounding the effects of chronic illnesses such as heart disease, leading to disability, affecting cognition and, in extreme cases, resulting in suicide.

Half a century ago, it was believed that “melancholia” was common in later life and that seniors naturally withdrew from the world as they realized that their days were limited, Callahan explained. Since then, researchers have shown that older adults tend to be happier than people in other age groups: Only 15 percent have major depression or minor variants.

Late-life depression is typically associated with a serious illness such as diabetes, cancer, arthritis or stroke; deteriorating hearing or vision; and life changes such as retirement or the loss of a spouse.

While grief is normal, persistent sadness that is accompanied by apathy, withdrawal from social activities, disturbed sleep and selfneglect is not, Callahan said.

With treatments such as cognitive behavioral therapy and antidepressants, 50 to 80 percent of seniors can expect to recover.

• Weakness. You can’t rise easily from a chair, screw the top off a jar or lift a can from the pantry shelf.

You may have sarcopenia — a notable loss of muscle mass and strength that affects about 10 percent of adults older than 60. If untreated, sarcopenia will affect your balance, mobility and stamina, and raise the risk of falling, becoming frail and losing independence.

Age-related muscle atrophy, which begins when people reach their 40s and accelerates when they’re in their 70s, is part of the problem. Muscle strength declines even more rapidly - slipping about 15

percent per decade starting around age 50.

The solution: exercise, including resistance and strength training exercises, and good nutrition, including getting adequate amounts of protein.

Other causes of weakness can include inflammation, hormonal changes, infections and problems with the nervous system.

Watch for sudden changes. “If you’re not as strong as you were yesterday, that’s not right,” Wei said.

Also, watch for weakness on only one side, especially if it’s accompanied by speech or vision changes.

That could be a sign of a stroke, which would require immediate medical attention.

Taking steps to address weakness doesn’t mean you’ll have the same strength and endurance as when you were in your 20s or 30s. But it may mean that doctors catch a serious or preventable problem early and forestall further decline.

HEALTHYU

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Eating habits tied to big portion of deaths Bacon, soda and too few nuts the problem, doctors say

By Lindsey Tanner | The Associated Press

CHICAGO — Gorging on bacon, skimping on nuts? These are among food habits that new research links with deaths from heart disease, strokes and diabetes.

Overeating or not eating enough of the 10 foods and nutrients contributes to nearly half of U.S. deaths from these causes, the study suggests.

“Good” foods that were undereaten include: nuts and seeds; seafood rich in omega-3 fats includaand nd ing salmon and sardines; fruits an vegetables; and whole grains.

“Bad” foods or nutrients that were over-eaten include salt and salty foods; processed meats including bacon, bologna and hot dogs; red meat including steaks and hamburgers; and sugary drinks.

The research is based on U.S. government data showing there were about 700,000 deaths in 2012 from heart disease, strokes and diabetes and on an analysis of national health surveys that asked participants about their eating habits. Most didn’t eat the recommended amounts of the foods studied.

The 10 ingredients combined contributed to about 45 percent of those deaths, according to the study.

It may sound like a familiar attack on the typical American diet, and the research echoes previous studies on the benefits of heart-healthy eating. But the study goes into more detail on specific foods and their risks or benefits, said lead author Renata Micha, a public health researcher and nutritionist at Tufts University.

The results were published in the Journal of the American Medical Association.

Micha said the foods and nutrients were singled out because of research linking them with the causes of death studied. For example, studies have shown that excess salt can increase blood pressure, putting stress on arteries and the heart. Nuts contain 10

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HEALTHYU

healthy fats that can improve cholesterol levels, while bacon and other processed meats contain saturated fats that can raise levels of unhealthy LDL cholesterol.

In the study, too much salt was the biggest problem, linked with nearly 10 percent of the deaths.

Overeating processed meats and undereating nuts and seeds and seafood each were linked with about 8 percent of the deaths.

The Food and Drug Administration’s recent voluntary sodium reduction guidelines for makers of processed foods and taxes that some U.S. cities have imposed on sugar-sweetened beverages are steps in the right direction, Micha said.

A journal editorial said public health policies targeting unhealthy eating could potentially help prevent some deaths, while noting that the study isn’t solid proof that “suboptimal” diets were deadly.

The study’s recommended amounts, based on U.S. government guidelines, nutrition experts’ advice, and amounts found to be beneficial or harmful in previous research.

The Good vs. The Bad “GOOD” INGREDIENTS • Fruits: 3 average-sized fruits daily • Vegetables: 2 cups cooked or 4 cups raw vegetables daily • Nuts/seeds: 5 1-ounce servings per week — about 20 nuts per serving • Whole grains: 2½ daily servings • Polyunsaturated fats, found in many vegetable oils: 11 percent of daily calories • Seafood: about 8 ounces weekly

“BAD” INGREDIENTS • Red meat: 1 serving weekly — 1 medium steak or the equivalent • Processed meat: None recommended • Sugary drinks: None recommended • Salt: 2,000 milligrams daily — just under a teaspoon.

The Associated Press

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Vicky Hallett | Special to The Washington on P Post ost os

ABOUT THE AUTHOR: I’ve heard that in-home care is Lori Williams only for those who are very sick. Is CEO & co-owner that correct?

A: Non-medical, and available to any adult who is looking for a little 2613 Market Trace extra help around the house. This Fort Smith, AR includes help with personal care and hygiene, meal preparation, medication 72908 reminders, transportation, etc. or maybe 479-242-2273 just the enjoyment of the company of a caring and capable companion. www.GAHSC.com Is quality of care we would receive at home inferior to care in a facility?

A: In-home care is highly personalized, one-on-one care, with a dedicated caregiver or care team that comes to you, to meet your unique needs at a time that works best for you.

Is In-home care expensive; more than assisted living or a nursing home?

A: The cost care is based on the number of hours you need each week, and sometimes the level of care. The wonderful thing is that you will not be paying for time or services that you do not need or desire. This means in-home care is typically an economical option, and good value, as compared to assisted living or nursing home care. Medicare does not currently pay for NON-MEDICAL, at-home care services, but most long-term insurance policies will reimburse for these expenses.

I’m am providing the care for my loved-one and wondering if I might need some help?

A: To remain healthy and strong - physically, emotionally and mentally we all need a break from time to time.

Caring for a loved-one often turns into a 24/7 job leaving the family caregiver exhausted, emotionally and physically.

Every caregiver needs to have periods of relief so that they have time to recharge and take care of themselves. In-home care is the perfect choice to provide care while you rest, regenerate, and refresh.

My loved-one needs 24-hour care, would in-home care be an option for her?

A: In-home care can be provided for just a few hours or around the clock!

Once you have expressed your unique situation and needs an experienced care team will be created to provide care to your loved-one 24 hours a day, 7 days a week.

Is in-home care only for those who are 65 or older?

A: The majority of clients receiving

Be on the lookout for signs of stroke

in-home care are 65 or older. However, services can be provided to anyone who is 18 or older and just needs a little extra help at home. This includes those that may have a disability, chronic illness, is on hospice or those recovering from a recent surgery or injury.

We have used other care options, such as a hospital, assisted living, nursing home, and now hospice. How can in-home care services help improve my loved-one’s quality of life?

A: In-home care services often supplement the care provided by hospitals, assisted living centers, nursing homes and hospice by working closely with all those involved in your care, including LWK\WZ[ [WKQIT _WZSMZ[ IVL PW[XQKM [\I‫ ٺ‬ to ensure you are receiving the highest quality of care possible. These other care options work with you on their set schedule. In-home care services are available to you 24 hours a day, 7 days a week including holidays.

Will I have any say about who comes to my home and provides my care?

A: <PM ÅZ[\ XZQWZQ\a Q[ \W XZW^QLM you with the best care possible and your input will be invaluable to accomplish this! Your personality and care requirements will be the starting point to match you with the perfect caregiver. However, sometimes people just don’t “click.” Be sure to provide your feedback as to who you are comfortable with and when/if changes to your care team need to be made.

An emergency room nurse took k one look at Sarah Porter — an athhletic sophomore at the University y off Maine — and diagnosed her as faking king g a stroke. Porter hadn’t uttered the word “stroke,” so it was terrifying when the nurse told her, “No one your age in good health has a stroke.

You’re just trying to avoid taking your finals.”

Porter tried to respond. But she couldn’t: “There was a disconnect between what was in my head and what was coming out in my speech.”

That’s because she wasn’t faking.

The 26-year-old may be alive today only because other staffers in the emergency room took her symptoms seriously, according to a profile in the February issue of Good Housekeeping.

“At 20 Years Old, I Had a Stroke and Didn’t Realize It” by Marisa Cohen spotlights Porter’s story to remind readers to be on the lookout for signs of stroke, no matter your age.

For Porter, it all started in math class, where she briefly blacked out.

A concerned classmate told her he suspected she’d had a seizure, but she stayed in her seat. When it came time to grab her books and leave, another odd thing happened: Her right arm felt tingly, and her right leg wouldn’t work properly. As Porter dragged herself back to her dorm room, her

face started spasming.

That’s when she called home. Her mom (a physician assistant) and dad (a nurse practitioner) arranged to get her to the ER. Porter left the hospital a week later, after regaining the ability to walk on her own. But she couldn’t remember any of her sophomore year of college, or big parts of her childhood. And she later suffered a second stroke.

Both, it turns out, were caused by an abnormal cluster of blood vessels, which is rare. The majority of strokes, the article notes, are caused by blood clots “that either originate in the brain or travel there from elsewhere in the body.”

Maintaining a healthy diet and getting regular physical activity reduces one’s risk for the more common kind of stroke. So Porter has found purpose in her recovery by raising awareness about the issue. She serves as a spokeswoman for the American Heart Association’s Go Red for Women campaign.

Maybe her story can help more people — even ER nurses — recognize a stroke when they see one.

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MAY 2017

11

Active lifestyle keeps local woman young Brinkman cites running, social interaction, work as inspirations

By Carole Medlock Contributing Writer

There’s not just one thing that has helped a local septuagenarian age well.

Many might speculate that it is Mary Jo Brinkman’s commitment to running that keeps her young, but she says that is only part of it.

Brinkman, a facility compliance and privacy officer and risk manager at Sparks Medical Center in Van Buren, is an accomplished runner, having just returned from the successful completion of both the Boston and London marathons.

However, Brinkman said her job, her family, social interaction and a commitment to education are all a part of her recipe for youthfulness.

“I love my job. I love what I do. It’s work, but it’s enjoyable. It makes me feel fulfilled and gives me a sense of accomplishment,” Brinkman said.

Working in risk management provides Brinkman the opportunity to exercise her mind, as she fields problems with patients, helping them understand what happens at the hospital and why things may not have happened the way they anticipated.

Brinkman also mentioned a closeness with her two children and their families, both of whom live close by, as a source of energy.

“They are very important to me, and they help me stay young,” Brinkman said. That same family

was waiting for her as she completed the Boston Marathon recently.

And Brinkman mentioned the social interaction that comes with running. “Everyone in the running community … they are such good friends of mine,” she said.

LeAnn Karnes, director of rehabilitation at Sparks Medical Center in Van Buren, reiterated each of the components for successful aging mentioned by Brinkman.

Karnes worked with Brinkman in a patient/therapist capacity when Brinkman had to quit running recently because of serious leg pain. Through a variety of therapy, Brinkman was able to overcome that obstacle and return to running without pain.

Karnes said staying active and regular exercise are both imperative for aging well, but she added that exercise looks different for some than it does for others.

Dancing … gardening … walking with friends … they are all activities that can provide an adequate amount of exercise.

RIGHT: Mary Jo Brinkman warms up near her home in Fort Smith just days after returning from a trip that included running the Boston Marathon and the London Marathon.

TOP: Mary Jo Brinkman, left, talks about how much she enjoys the work she does at Sparks Medical Center in Van Buren as LeAnn Karnes, director of rehabilitation, looks on. [BRIAN D. SANDERFORD/TIMES RECORD]

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She echoed that staying socially active is important and can help fight off depression that can set in as a person ages.

“Find what you love and do it,” Karnes said.

Karnes added that if it has been awhile since an aging person has been physically active, they may wish to seek the help of a physical therapist to give them a good start toward a healthy lifestyle that includes activity and good nutrition.

The last piece of the “aging well” puzzle for Brinkman is to never stop learning.

“Don’t stop with education. Education is something no one can ever take away from you. It’s important to keep your mind active as well as your body,” Brinkman said.

Brinkman said continuous learning and training to keep up with the demands of her job takes a lot of studying and is one way she keeps her mind sharp. She also earned a Ph.D in health care administration about 10 years ago.

More and more studies show that physical exercise has been shown to reduce the risk of Alzheimer’s and dementia, according to Karnes. But exercising the mind is also important.

“I think it helps to keep your mind active,” Karnes said. Those who have retired can find other ways to keep their minds active, like crossword puzzles or other activities that challenge the brain.

Asked if Brinkman saw retirement in her future, she replied, “Work? Forever.

I’m not going to quit. I don’t know what I would do.”

LeAnn Karnes, director of rehabilitation at Sparks Medical Center in Van Buren, says there are many ways to stay active and to get regular exercise as one ages, from dancing to gardening. [BRIAN D. SANDERFORD/TIMES RECORD]

Brinkman runs recent London Marathon for charity

By Buck Ringgold | Staff Writer Less than one week after running the Boston Marathon, a Mary Jo Brinkman went overseas to run in the London Marathon. While running two marathons may have been exhausting, not to mention the travel, for Brinkman, going to London was running for a good cause.

Brinkman went to London as part of her training with Team In Training (TNT) and raising money for The Leukemia and Lymphoma Society (LLS), which helps to fund blood cancer research, among other programs.

She was the lone Arkansas representative and was one of a group of nine American runners who went to London for the April 23 race.

“It was a fabulous experience, and then the nine of us that were from the United States, we were able to raise $300,000 for leukemia and lymphoma,” Brinkman said.

“The London Marathon has a lot of charities in it. It’s similar to Boston in that there’s a lot of elite runners, but the charities are also real important because they raised money for so many good causes.”

Brinkman has been involved in running to raise funds for the LLS for more than 10 years and has personally raised more than $24,000 for LLS through TNT, which is the charity sports endurance training program of the LLS. “In the 10 years I’ve been involved, I’ve seen the improvements in the blood cancers of children,” Brinkman said. “Children are living longer, the drugs are working better, I’ve just seen the value of it.

“I used to run just for myself, but when I run for TNT and raise funds, I am helping other people who can’t run.

I run to help fund blood cancer research that will benefit those with other types of cancer as well.”

Brinkman began her love of running nearly 15 years ago, when she took part in a running class at her exercise gym. She was able to increase her miles, and then got to the point where she felt able to run a marathon.

“It was just a gradual thing for me,” Brinkman said.

Since then, Brinkman has ran numerous races, even internationally in Madrid, Dublin and Paris. She has also run in five Boston Marathons, considered the pinnacle of running in America.

Following her latest Boston Marathon, on April 17, Brinkman boarded a plane and went to London to prepare for her next run. Because of her involvement with the LLS, Brinkman was guaranteed an automatic entry for the London Marathon.

Before she traveled to London, Brinkman also raised funds in a number of different ways, including solicitation letters. She also hosted a private dinner at her home.

At the same time, Brinkman was also battling the aftereffects of a leg injury she suffered after running last year’s Boston Marathon. She wasn’t able to run as much as she wanted to, but Brinkman was determined to recover in time to go back to Boston, and more importantly, run in London.

“Since these last two marathons, my leg has not bothered me,” Brinkman said. “I don’t have the same strength I have because I haven’t had the time to train. ... But to run

Mary Jo Brinkman stands at the start of the London Marathon.

SUBMITTED PHOTO

both the Boston and London marathons, it was a dream come true and it’s been fabulous.”

Brinkman said she enjoyed running in London, which included going past several of the city’s notable landmarks.

“It was beautiful; the architecture in London is gorgeous,” she said. “We also ended up at Buckingham Palace, which was pretty exciting.”

Brinkman added she was among 40,382 runners at London, the biggest marathon she has ever run. There were also numerous spectators on hand at the event.

“There was wall-to-wall people in Boston, but this one, it was wall-to-wall three or four (rows) deep and plus bands (that were playing music at various stops along the marathon route),” she said. “There was just so much support and so much emotion.”

The London Marathon was also attended by British royalty, as Brinkman said Prince Harry, along with the Duke and Duchess of Cambridge, were on hand at the starting line while also supporting a mental health charity.

“I would love to run London again, it was absolutely fabulous, but there’s so many other races I would like to do,” she said.

While Brinkman plans to continue running to raise funds for LLS, she also encouraged other runners to do the same, whether it is for the LLS or for another charity.

“I think it’s good for runners to be involved instead other than just running for themselves,” she said. “I think it’s good to think about others who can’t run, I think it makes it all worthwhile.

“I’ve been blessed with being able to run for many years, and I’m just glad that I’m able to do something for others who can’t, and especially for children because leukemia does affect children.”

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13

Wa n t t o l i v e p a s t

100?

Centenarians share secrets of knee bends and nips of Scotch

By Sharon Jayson Kaiser Health News

Gertrude Siegel is 101 and hears it all the time. “Everyone says, ‘I want to be just like you.’ I tell them to get in line,” she said.

John and Charlotte Henderson, 104 and 102, often field questions from wannabes eager to learn their secrets.

“Living in moderation,” he said. “We never overdo anything. Eat well. Sleep well. Don’t overdrink. Don’t overeat.

And exercise regularly.”

Mac Miller, who is 102, has a standard reply.

“People ask me ‘What is the secret?’

The answer is simple. Choose the right grandparents. They were in their 80s.

My mother was 89, and my father was 93,” he said.

Genetics and behaviors do play roles in determining why some people live to be 100 or older while others don’t, but they aren’t guarantees. And now, as increasing numbers are reaching triple digits, figuring out the mysteries of longevity has taken on new importance among researchers.

Although those 100 and older make up a tiny segment of America’s population, U.S. Census reports show that centenarian ranks are growing.

Between 1980 and 2010, the numbers rose from 32,194 to 53,364, an increase of almost 66 percent. The latest population estimate, released in July 2015, reflects 76,974 centenarians.

“The number of centenarians in the U.S. and other countries has been doubling roughly every eight years,” said James Vaupel, founding director of the Max Planck Institute for Demographic Research in Rostock, Germany.

“When the baby boomers hit, there’s 14

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going to be acceleration, and it might be doubling every five or six years,” he said.

Henderson and his wife of 77 years live in Austin in the independent living section of Longhorn Village, a community of more than 360 seniors, many of whom have ties to the University of Texas at Austin.

Henderson is UT’s oldest-living former football player, arriving in 1932 as a freshman. They’re the only centenarians in the complex and are a rare breed: married centenarians.

Charlotte Henderson said she believes being married may have helped them reach these 100-plus years.

“We had such a good time when John retired. We traveled a lot,” she said.

“We just stay busy all the time, and I’m sure that helps.”

Bernard Hirsh, 100, of Dallas agrees.

His wife, Bee, is 102. They married in 1978 when both were in their early 60s and each had been widowed, she for the second time.

“I think it’s been such a wonderful marriage, and we’ve contributed to each other’s benefit,” he said.

Little research exists on the effects of marriage on longevity. One 2015 Belgian study of centenarians born between 1893 and 1903 did focus on their living arrangements during ages 60 and 100 and found “in very old age, living with a spouse is beneficial for men but not for women, for whom living alone is more advantageous than living with a spouse.” The study explained that “living with one’s spouse at the oldest ages does not provide the same level of protection as it does at younger ages. This may be explained by the decline of the caregiver’s own health as the needs of his or

her spouse increase. Caregiving could also have negative consequences for the health and economic condition of the spouse who is the primary caregiver, especially for older women.”

However, Vaupel, who directs the Institute’s International Research Network on Aging, said being married is a positive for both.

“Especially if you’re quite old, it’s very helpful have a spouse. If you’re very old and don’t have a spouse, the chance of death is higher,” he said.

Siegel, who lives in a senior living community in Boca Raton, Fla., outlived two husbands. She never smoked and occasionally has a glass of dry, red wine.

“I am not a big eater. I don’t eat much meat,” said Siegel, who said she weighs 90 pounds and used to be 5 feet tall but is shrinking.

She stays active by walking inside the building about a half-hour each day, playing bridge twice a week and exercising.

“I feel that’s what really kept my body pretty good. It wasn’t sports. It was exercises,” she said of the routine she does daily twice a day for about 20 minutes.

Miller, of Pensacola, Fla., also outlived two wives.

He was a fighter pilot in the Marine Corps during World War II and spent eight years in active duty, which Miller said “was not so good for me because I

sat in the cockpit of a plane for 5,000 hours.”

But, he was active as a youth — running track, playing football and spending hours surfing while living in Honolulu.

Miller is gluten-free because of allergies and doesn’t eat many carbohydrates. He also never smoked. And, he still enjoys a scotch in the evening.

The Hendersons usually have wine or a cocktail before dinner. She never smoked. He quit in 1950.

Hirsh, of Dallas, another nonsmoker, attributes his long life to “good luck.”

“I was very active in my business and did a lot of walking during the day. I was not sedentary,” he said.

Now, exercise is limited to “some knee bends every morning to keep my legs stronger.”

“My father died of a heart attack in his early 50s, and my mother died in her early 60s of a stroke, so I don’t think my genes were very good,” Hirsh said.

Geriatrician Thomas Perls, director of the New England Centenarian Study at Boston Medical Center, said research shows that behaviors have a greater influence on survival up until the late 80s, since he said most people have the right genes to get there as long as their behaviors aren’t harmful. But once people reach the 90s and beyond, genetics play a more significant role.

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“To get to these very oldest ages, you really have to have the right genes in your corner,” he said.

As an international leader in the field, Perls’ focus is on finding the right mix of behavior, environment and genetics to produce long lives.

His work includes a National Institute on Aging study called the Long Life Family Study.

“There are always questions about environment versus genes,” said endocrinologist Nir Barzilai, founding director of the Institute for Aging Research at the Albert Einstein College of Medicine in Bronx, N.Y. “We are with our genes in this environment. It’s really 50-50, no matter how you look at it.”

Barzilai’s studies include centenarians and their children, as well as efforts to slow the process of aging.

Among those who reach the 100-year-old milestone, Perls’ said his research and that of Barzilai and others has found certain commonalities: few smoke, nearly all of the men are lean, and centenarians have high levels of the “good cholesterol.” Studies show that whatever their stress level, they manage its

well. And they’re related to other centenarians or have a parent or grandparent who lived past 80.

These lessons of long life are playing well with the public, who have made changes for the better in the 21st century, Vaupel said.

“We don’t smoke or drink so much, and we’re better at exercise. People are taking better care of themselves. People are better educated, and the more educated know when to go to the doctor and follow the doctor’s advice,” he said, adding that people now tend to have higher income and can spend more on health care and improved diet.

“The most important thing is we’re living longer and living longer healthy,” Vaupel said.

KHN’s coverage related to aging & improving care of older adults is supported by The John A. Hartford Foundation and its coverage of aging and long-term care issues is supported by The SCAN Foundation.

Kaiser Health News is a national health policy news service. It is an editorially independent program of the Henry J. Kaiser Family Foundation.

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15

Is it wor th it to star t using a

geriatrician?

Know some basics when considering a change

By Judith Graham | Kaiser Health News

For months, Teresa Christensen’s 87-year-old mother, Genevieve, complained of pain from a nasty sore on her right foot.

She stopped going to church. She couldn’t sleep at night. Eventually, she stopped walking except when absolutely necessary.

Her primary-care doctor prescribed three antibiotics, one after another. None worked.

“Doctor, can’t we do some further tests?”

Christensen remembered asking. “I felt that he was looking through my mother instead of

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looking at her.”

Referred to a wound clinic, Genevieve Christensen was diagnosed with a venous ulcer resulting from poor circulation in her legs. A few weeks earlier, she had had a procedure to correct the problem and returned to her home in Cottage Grove, Minn., a suburb of St. Paul.

Teresa Christenson wondered: Would her mother benefit from seeing a geriatrician? And, if so, she added in an email to me, how would she go about finding one?

I reached out to several medical experts, and they agreed that a specialist in geriatrics might help a patient like this, someone with a history of breast cancer and heart failure, someone who had had open heart surgery at age 84 and whose mobility was now compromised.

Geriatricians are “experts in complexity,” said Eric Widera, director of the geriatrics medicine fellowship at the University of California at San Francisco.

No one better understands how multiple medical problems interact in older people and affect their quality of life than these specialists on aging.

But their role in the health-care system remains poorly understood and their expertise underused.

Interviews with geriatricians offer insights useful to older adults and their families.

medication management; extensive care coordination; and providing palliative and end-of-life care.

Underlying these skills is an expert understanding of how older adults’ bodies, minds and lives differ from middle-aged adults.

“We take a much broader history that looks at what our patients can and can’t do, how they’re getting along in their environment, how they see their future, their support systems and their integration in the community,” said Kathryn Eubank, medical director of the Acute Care for Elders unit at the San Francisco Veterans Affairs Medical Center.

“And when a problem arises with a patient, we tend to ask, ‘How do we put this in the context of other concerns that might be contributing?’”

Basic knowledge

Another essential competence is a focus on issues that other primarycare doctors often neglect — notably falls, incontinence, muscle weakness, frailty, fatigue, cognitive impairment and delirium. In medicine, these are known as “geriatric syndromes.”

“If you’re losing weight, you’re falling, you can’t climb a flight of stairs, you’re tired all the time, you’re unhappy and you’re on 10 or more medications, go see a geriatrician,” said John Morley, a professor of geriatrics at Saint Louis University. “Much of what we do is get rid of treatments prescribed by other physicians that aren’t working.”

Recently, Morley wrote of an 88-year-old patient with metastasized prostate cancer who was on 26 medications. The man was troubled by profound fatigue, which dissipated after Morley took him off all but one medication. (Most of the drugs had minimal expected benefit for someone at the end of life.) The patient died peacefully eight months later.

Eubank tells of an 80-year-old combative and confused patient whom her team saw in the hospital after one of his legs had been amputated. Although physicians recognized the patient was delirious, they had prescribed medications that worsened that condition, gave him insufficient pain relief and overlooked his constipation.

Geriatricians are typically internists or family physicians who have spent an extra year becoming trained in the unique needs of older adults.

They can serve as primary-care doctors, mostly to people in their 70s, 80s and older who have multiple medical conditions. They also provide consultations and work in interdisciplinary medical teams caring for older patients.

Recognizing that training programs can’t meet expected demand as the population ages, the specialty has launched programs to educate other physicians in the principles of geriatric medicine.

“We’ve been trying to get all clinicians trained in what we call the ‘101 level’ of geriatrics,” said Rosanne Leipzig, a professor of geriatrics at the Icahn School of Medicine at Mount Sinai in New York.

Essential competences Researchers have spent considerable time in recent years examining what exactly geriatricians do.

A 2014 article by Leipzig and others defined 12 essential competences, including optimizing older adults’ functioning and well-being; helping seniors and their families clarify their goals for care and shaping care plans accordingly; comprehensive

Geriatric syndromes

“Medications contributing to the patient’s delirium were stopped. We made his room quieter so he was disturbed less and stopped staff from interrupting his sleep between 10 p.m. and 6 a.m.,” Eubank said. “We worked to get him up out of bed, normalized his life as much as possible and made sure he got a (hearing device) so he could hear what was going on.”

Over the next four days, the patient improved every day and was discharged to rehabilitation.

Finding help A geriatric consultation typically involves two appointments: one to conduct a comprehensive assessment of physical, psychological, cognitive and social functioning, and another to go over a proposed plan of care.

For help in finding a geriatrician, you can consult the American Geriatrics Society’s website. Also, you can check whether a nearby medical school or academic medical center

has a department of geriatrics.

Many doctors claim competence in caring for older adults. Be concerned if they fail to go over your medications carefully, if they don’t ask about geriatric syndromes or if they don’t inquire about the goals you have for your care, advised Mindy Fain, chief of geriatrics and co-director of the Arizona Center on Aging at the University of Arizona.

Also, don’t hesitate to ask pointed questions: Has this doctor had any additional training in geriatric care? Does she approach the care of older adults differently? If so, how?

Are there certain medications she doesn’t use?

“You’ll be able to see in the physician’s mannerisms and response if she takes you seriously,” Leipzig said.

If not, keep looking for one who does.

This column is produced by Kaiser Health News, an editorially independent news service that is a program of the Kaiser Family Foundation.

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MAY 2017

17

Communities offer seniors peace of mind More Content Now

Are you worried you might one day outlive your retirement savings?

Running out of money is a common concern, and the sad reality is it does happen to some people. The Administration on Aging predicts the number of Americans age 65 and older will reach 98 million in less than 50 years, so it’s possible many will struggle to take care of themselves physically, medically and financially.

Seventy percent of everyone 65 and older will need some type of long-term care at some point in their lives, the Department of Health and Human Services says. When health issues force seniors to require a higher level of care, they can quickly exhaust their retirement savings. The burden of caring for them either falls on loved ones or Medicaid.

A growing number of seniors are turning to life care communities to preserve their own long-term wellbeing and to ease emotional and financial stresses on their families.

A life care community — also commonly referred to as continuing care community — charges an upfront entry payment and a monthly fee in exchange for long-term accommodations and health-related services.

A contract formalizes the arrangement between the community and the residents, guaranteeing seniors receive the agreed-upon care even if their financial resources are eventually exhausted.

Here are some common questions about life care communities: • Who is a candidate for a life care community?

Anyone older than 62 may be eligible to live in a life care community, if they meet financial and medical qualifications. Most continuing care retirement communities offer multiple types of accommodations — including independent living, assisted living, Alzheimer’s and dementia care, and rehabilitation and skilled nursing.

This means you can enter the community at any stage, including when you are still independent. As your care needs increase, you can move between 18

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accommodation and care levels.

• What should I know about entry and monthly fees?

Continuing care communities charge an entry fee that is typically in the range of $150,000-$200,000. Many seniors choose to fund this fee through the sale of their homes when they need to downsize into a more manageable living situation. Fees can vary depending on the type of accommodations and level of care you need. Monthly service fees average $2,500-$3,500, depending on the type of contract. While the fee may vary slightly from year to year and depending on the level of care you need, your community may agree to cap increases; Brookdale voluntarily caps annual increases at the consumer price index plus 2 percent at most of its life care communities.

• How will entering a life care community affect my taxes and estate planning?

The IRS considers life care to be a pre-paid medical expense, so tax

deductions are often available for portions of the upfront entry fee and monthly service fee — typically up to 40 percent of the fee. Because deductions can vary state to state, you should consult with your tax adviser to get a better idea of the tax benefits.

Entering a life care community can also affect your estate planning. A life care contract takes care of the portion of your planning that would address funding your health care needs; the contract ensures your health care needs will be met even if you run out of money (through no fault of your own). You may also choose a refundable contract that returns a portion (up to 90 percent) of your entry fee to your designated beneficiary after you pass away.

• What are the health benefits of living in a life care community?

A life care community ensures your medical needs will be met throughout your life — without you having to worry about how you’ll pay for the care

you need. The communities also offer mental health benefits. Live entertainment, special meals and events, daily opportunities to dine with others or participate in games and hobby groups ensure you’ll never lack stimulating activities or interaction with others.

Life care also encourages seniors to remain independent for as long as possible, without restrictions on driving, traveling and shopping as long as you’re able.

“Longer lives and increasing health care costs mean it’s a harsh reality that many seniors will struggle to care for themselves later in life,” says Dr. Kevin O’Neil, a clinical professor of aging studies at the University of South Florida, and chief medical officer of Brookdale Senior Living. “The good news is life care communities can be a long-term solution, helping seniors maximize the value of their retirement savings, and ensuring they’ll have access to the care they need throughout their lives.”

Seniors benefit from natural movement exercise More Content Now

Exercise is good for everyone, but seniors with mobility or balance issues may wonder what kind of exercise they can do that will be safe, easy and effective. Jogging outdoors, running on a treadmill or lifting weights at the gym aren’t always practical — or enjoyable — activities for everyone. However, one type of exercise works for everyone, no matter your age or ability, because it relies on improving practical movements often involved in everyday activities.

Rather than engaging in strenuous activity for its own sake alone, natural movement training emphasizes improving the efficiency of practical movements, which can include rising from a seated to a standing position, getting up off the floor, crawling, stepping under or over objects, and more.

Natural movement is for everyone because at its most basic level it incorporates movements that are instinctual to all humans. For example, a natural movement workout might include crawling on your hands and knees for 30 seconds to a few minutes, sitting on the floor and swiveling hips and knees to facilitate standing up, or balancing while walking across a beam.

• Pay attention to your movement and strive to develop awareness of your body’s sensations, and how different movements feel.

For example, where do you feel pressure and/or tension in your body when making a particular move? How does shifting your body weight or changing position alter those sensations?

• Only perform movements and positions that your body allows without producing pain. Just as walking, sitting, standing and other everyday movements shouldn’t cause pain, your natural movement workout should also be pain-free.

• It’s all right — and even advisable — to use your hands for support or raise your hips with bolsters or pillows until you develop greater mobility and strength.

• Be kind to yourself and realize it is important to meet yourself where you currently are, rather than where you used to be or feel you should be.

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HEALTHYU

MAY 2017

19

Defying the odds

Heart transplant patient still alive 30 years later

By Colby Itkowitz | The Washington Post

Eva Baisey had been going stir crazy.

She’d spent weeks in isolation, unable to see her two small children, allowed to see her mom only from a distance for a few minutes a day. The risk of infection was simply too great, her immune system too compromised from the surgery.

Nurse Deirdre Carolan worried about her patient’s mental health and received permission to take her for a quick drive off campus. But they never told Edward Lefrak, Baisey’s doctor, where they went that day.

Three decades later, the nurse, the surgeon and the patient stood together in the lobby of the Inova Heart and Vascular Institute in Fairfax, Va. Carolan wrapped her arms affectionately around Baisey. They laughed as they told Lefrak that weeks after he’d performed the first-ever heart transplant in the Washington area, his patient went to McDonald’s for a cheeseburger and fries.

All Lefrak could do was shake his head with mock disapproval. What could he say? Baisey had beat all the odds.

Just days after Christmas, in the predawn hours of Dec. 28, 1986, Lefrak sliced the heart out of a 19-year-old man who had died that previous morning. The surgeon wheeled the healthy heart several feet to the operating room next door, where Baisey, the 20-year-old mother of two, lay waiting. He removed her weak, engorged heart exactly as he’d practiced doing dozens of times on bodies in the morgue and stared into the gaping hole in her chest. He then sewed in the donor’s heart and waited.

It was quiet except for some country music playing on a radio in the background.

Then the electrocardiogram monitor started to beep. Her new heart was beating.

Earlier that year, Baisey was in and out of the hospital, complaining of 20

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HEALTHYU

Nurse Deirdre Carolan, left, greets Eva Baisey as Dr. Edward Lefrak looks on in Falls Church, Va. Lefrak performed his first heart transplant on Baisey 30 years ago. Carolan was Baisey’s floor nurse. [BONNIE JO MOUNT, THE WASHINGTON POST]

shortness of breath, little appetite and extreme fatigue. After months with no explanation, doctors determined that her heart was failing, diagnosing her with idiopathic cardiomyopathy, a disease whose cause is typically unknown. Without a new heart, it was unlikely that Baisey would live more than a few months.

Meanwhile, Lefrak, then a 43-yearold cardiac surgeon at Fairfax Hospital, had spent the better part of three years learning the techniques of heart transplants. In between his operations, he would slip into the morgue to practice, until the act of removing a heart and replacing it with

another became almost second nature.

U.S. surgeons had been performing successful heart transplants since 1968, but in the mid-1980s, the closest options for a D.C. area resident needing a new heart were Johns Hopkins University in Baltimore or the Medical College of Virginia/Virginia Commonwealth University School of Medicine in Richmond. Lefrak felt it was a terrible burden on patients and families to travel so far for a procedure that would require weeks, if not months, of inpatient recovery and then regular follow-ups to monitor the body’s acceptance of the new organ.

At that time, heart transplants were

no longer novel, but they still weren’t common. There had been 1,787 performed between 1968 and 1985, according to The Washington Post.

Today, about 2,000 are performed a year.

There was a political dispute about whether smaller hospitals should be in the business of organ transplants.

When Lefrak first took his case to the local Northern Virginia health agency for approval to bring a program to the D.C. area, he was denied. He appealed to the state, bringing along Christiaan Barnard, the celebrated South African doctor who performed the world’s first heart transplant, to help him

lobby, a power move described then

by The Washington Post as “having the air of Hank Aaron dropping by a neighborhood baseball sandlot.”

Lefrak won approval in March 1986. Then he had to find the perfect patient. Eight months later, after one patient died waiting and another was deemed too ill to undergo the operation, Baisey was transferred to Fairfax Hospital in dire need of a new heart.

Weeks later, a man who matched her blood type and chest size died.

A murder-suicide, she’d find out later. At just 20 years old and gravely sick, she also didn’t fully realize that Lefrak and his team had never performed a heart transplant on a living person before. That they had no experience keeping a person alive after the heart was replaced.

As she listened to him now describe how he taught himself and practiced between shifts in the morgue, her eyes grew wide.

“Oh, wow, thanks,” she said, laughing. “That’s his secret. I didn’t know.”

Nearly every Dec. 28, Baisey receives at least two phone calls.

One from Carolan. The other from Lefrak. She is their miracle as much as they are hers.

Living 30 years with a new heart is extremely rare. Lefrak has tried to track down the exact statistics, and most experts have told him that there are probably no more than six people in the United States who have lived as long as Baisey after such a transplant. In 2012, Johns Hopkins University did a study looking at the survival rate of heart transplant patients between 1987, the year after Baisey received her transplant, and 1999. Of the 22,000, just about half lived a decade, but those who received a new heart before age 55 were 24 percent more likely to live longer than 10 years.

“It’s a bigger deal than I even realized,” Lefrak said. He pats Baisey on the back, “She’s pretty special.”

“Eva’s going to set the record,” he said.

“I think I am,” she said, reaching down to knock on wood.

Lefrak is now retired. Carolan teaches nursing at Catholic

University. Baisey is a nurse in Reston, Va. She was just starting schooling when she got sick, and it took years for her to finish and then for her immune system to be strong enough for Lefrak to allow her to be around sick patients.

Which may be why Baisey doesn’t complain about her two-hour commute from Maryland: driving to the subway, taking the train, transferring to a bus and then walking about half a mile to work.

The three, joined by Mary Dellinger, the operating room nurse by Lefrak’s side during Baisey’s surgery, sat together in a room in Inova, which was the first time they were all together in many years. They reminisced about the hard times, especially that first year after the transplant when it was still tenuous whether Baisey’s body would accept the heart; when she’d find herself back in the hospital in isolation for days or weeks at a time; when she couldn’t live with her small children because of the risk of infection.

She doesn’t think about the donor much. In the early days of transplants, there were rumors that a transplant recipient would adopt mannerisms or personality traits from the donor. Baisey said she does look for them. She plays with her eyebrows a lot, and she never did that before. She said, “I always wonder, is that a habit of his?”

Today, Baisey is all infectious spunk and joy. Lefrak said that “the positive attitude she exudes” has played a significant role in her survival. Carolan is working part time now as a nurse, but she always tries to be there when Baisey comes in for her annual checkup.

Baisey considers Carolan one of her best friends.

But her real best friends are her children. It’s not lost on her what she would have missed if not for Lefrak, Carolan and the others who cared for her.

“I always prayed — let me see them be old enough to take care of themselves, 18 or 21, and I’d be happy and He gave me more than that,” she said, her eyes misty for a moment.

“Even if I went away today or tomorrow, I’m blessed. I’m very happy.”

In Falls Church, Va., Edward Lefrak views a photograph taken of him 30 years ago with heart transplant patient Eva Baisey - when she was discharged from the hospital. [BONNIE JO MOUNT, THE WASHINGTON POST]

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21

HEALTH & WELLNESS DIRECTORY 3505 S. 79th Street Fort Smith, AR 479-709-8686

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CONVENIENT CARE Mercy Convenient Care – River Valley 22

MAY 2017

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HEALTHYU

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2074 Rice Road Waldron, AR 479-637-0250

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GERIATRICS

Mercy Family Medicine – Booneville 128 Daniel Ave. Booneville, AR 479-675-2455

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Mercy Clinic Primary Care – Cliff Drive 3700 Cliff Drive Fort Smith, AR 479-259-9286

Mercy Family Medicine – Magazine 351B E. Priddy Street Magazine, AR 479-969-8768

HEARING

Mercy Clinic Primary Care – Free Ferry 1000 Waldron Road Fort Smith, AR 479-221-9922

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Mercy Clinic Family Medicine – Rice Road

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COMING UP....

ALL ABOUT HEALTHY SKIN healthy NEXT EDITION: SATURDAY, JUNE 17TH

living well in the river valley

HEALTHYU

MAY 2017

23

Not afraid of thunder.

Bedroom monsters.

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Being a hero isn’t all that tough. If you’re 50 or older, or younger with risk factors for colon cancer, a colonoscopy could save your life.

People are counting on you.

Defend yourself against colon cancer.

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Your life is our life’s work.

24

MAY 2017

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