2024 Medical Handbook

MEDICAL HANDBOOK

Natio N al walki N g mo N th // gastroi N testi N al health // social w ell N ess

»Contents

publisheD bY

AIM Media Indiana

eD itor

Rachel Hensley

graphic D esig N er

Keely Spitler

copY eDitor

Michael Donohue

a rt Director

Amanda Waltz

aD vertisi N g Desig N

Erin Caplinger

Mar Carson

Katelin Gephart

Rebecca Lecher

Josh Meyer

Wesley Rowles

Robert Wilson

aD vertisi N g o peratio N s m a N ager

Stacy Doub

aD vertisi N g sales

Rhonda Day

Christy Hubbard

m arketi N g a ND e ve N ts m a N ager

David Hyde

p hotograph Y Adobe Stock

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© 2024 by AIM Media Indiana. All rights reserved. Reproduction of stories, photographs and advertisements without permission is prohibited. For more information, contact Rachel Hensley, special publications editor, at 812-379-5630, or rhensley@aimmediaindiana.com.

nursing occupational and speech therapies outpatient) and emergency response semi-private rooms

HealtH Care Servi

record with the State Board of Health chef-prepared restaurant style meals social, cultural, spiritual events

HealtH Care ServiCeS

Community.

The Health Center at Four Seasons provides care and services for residents requiring both short-term rehabilitative and long-term care.

• Medicare

and services for residents requiring both short-term

The Health Center at Four Seasons provides care and services for residents requiring both short-term

• Medicare skilled nursing

• Physical, occupational and speech therapies (including outpatient)

• Physical, occupational and speech therapies (including outpatient)

• Physical, occupational and speech therapies (including outpatient)

• Physical, occupational and speech therapies (including outpatient)

• Physical, occupational and speech therapies (including outpatient)

Providing care in columbus for more than 50 years, Four Seasons health center offers a comprehensive set of skilled nursing services, including rehabilitation services, long term care, and short-term respite stays.

• 24-hour security and emergency response

• 24-hour security and emergency response

• 24-hour security and emergency response

• 24-hour security and emergency response

• 24-hour security and emergency response

• Private and semi-private rooms

• Private and semi-private rooms

• Private and semi-private rooms

• Private and semi-private rooms

• Private and semi-private rooms

• Outstanding record with the State Board of Health

Four Seasons professional staff are compassionate, respectful, caring and capable. We offer our residents recreational activities, social programs and weekly chapel services.

• Outstanding record with the State Board of Health

• Outstanding record with the State Board of Health

• Outstanding record with the State Board of Health

• Outstanding record with the State Board of Health

• Delicious chef-prepared restaurant style meals

• Delicious chef-prepared restaurant style meals

• Delicious chef-prepared restaurant style meals

• Delicious chef-prepared restaurant style meals

• Delicious chef-prepared restaurant style meals

• Full calendar of social, cultural, spiritual and recreational events

You want to make sure that your loved one is provided with the best health care and rehabilitation services in a safe and secure environment, and that’s what we’ll help you do.

• Full calendar of social, cultural, spiritual and recreational events

• Full calendar of social, cultural, spiritual and recreational events

• Full calendar of social, cultural, spiritual and recreational events

• Full calendar of social, cultural, spiritual and recreational events

Walk of life

Get yourself moving to celebrate National Walking Month

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»May is National Walking Month and boy does Columbus have a plethora of places you can celebrate in May and year-round!

Walking is easy, free and the health benefits far outweigh a sedentary lifestyle.

Walking month started as an initiative in the United Kingdom called “Living Streets,” and soon after, the United States developed National Walking Month, which “was born out of the desire to encourage more people to get moving and stay healthy,” according to daysoftheyear.com

Specialized equipment isn’t necessary, and Dr. Tim VonFange,

a fellowship-trained sports medicine physician of Columbus Regional Health Orthopedics & Sports Medicine, suggests starting out with the focus on time spent walking rather than distance. Starting a new walking habit can be difficult if you’ve not been active, and VonFange suggests to “find an area you enjoy to make it more worthwhile.”

“If you have trouble walking to the mailbox, set a small goal like five minutes,” he said. “Biggest thing is that as long as you feel comfortable on a level hard surface or solid grass surface,” he added. As your time spent walking

gets easier, you can increase.

However, VonFange cautions people with orthopedic and health issues: If there is an issue with your ability to walk from heart disease, lung issues or knee/hip/ joint problems, it is best to get with your primary care physician and have things checked out before you hit the trails.

Once you’re given the green light, there are more than 30 miles of the Columbus Parks & Recreation’s People Trails in and around Columbus where you can use your walkin’ shoes.

The map of the Columbus People Trails is located at:

Providing Quality Spine Care for over 20 years

The Full Spectrum of Spine Care

At Indiana Spine Group, we understand the challenges facing patients with back and neck pain, or lower body weakness. Our board certified, fellowship trained specialists work together to determine the best treatment options, giving YOU the most comprehensive spine care available. Our physicians believe in the use of evidencebased treatments to determine the most effective and appropriate treatment plan for each individual patient. Our compassionate, patient-centered care aims at reducing pain while regaining physical function and quality of life. Our providers are excited to provide both operative and non-operative spine care to the residents of southern Indiana.

To schedule an appointment, call:

https://columbus.in.us/walkingbiking, and features trails that cater to the beginner as well as someone who is looking for a bit more challenge with elevation and distance. The webpage has several trails mapped out, showing distance traveled and what you will see on your walk. Imagine enjoying exercise! While walking the trails, you can visit a few of Columbus’ favorite parks, such as Mill Race Park and Noblitt Park, located near downtown Columbus, large, mature trees providing shade on warmer days, and some of the paths nestle right against the river, providing a great visual experience, as well.

If you’re into Columbus’ worldrenowned architecture, the People Trails are the perfect way to enjoy the beauty of many works of art at a leisurely pace. Some trails wind around works by I.M. Pei, Eliel and Eero Saarinen and Harry Weese, to name a few.

According to an article published in Scientific American, it takes 66 days to incorporate a new, daily activity, and VonFange shared that the excuse he hears from people not wanting to start a physically active routine is lack of time available. To help combat this reservation, he suggests setting aside time and making it a priority. Though VonFange doesn’t recommend any fitness apps for your phone, there are apps available that can help make walking more of a game, and allow you to set goals for yourself or track your progress as you increase the time you spend walking. There are even sensors you can use to put on your shoes to track distance and speed, sending the information to your phone or wrist fitness tracker for you to review later.

If you enjoy music while you walk, be sure to have the volume at a level where you, can still hear sounds around you and never

listen to music while walking near vehicular traffic. If you want to personalize your playlist to a certain tempo while you walk, there are suggestions online that offer playlists you can download, often for free.

If staying motivated is difficult, involve a friend to join you on your walks. You both can keep each other accountable and have fun at the same time.

Improving your mood, reducing stress, improving heart health and reducing the risk of chronic disease are just some of the many benefits you can enjoy from starting a walking routine. People who walk regularly for fitness also tend to live longer. Perhaps the band Dire Straits was onto something with their hit 1985 song, “Walk of Life.”

Wherever you choose to walk, do it safely and have fun doing it. You may even find a favorite trail that you’ll want to share with others.

Legacy Fire & First Aid

Imagine a service that combines cutting-edge technology with top-notch emergency response techniques. A service that’s not just about reacting to emergencies but also about preventing them *and ensuring you’re fully equipped to handle whatever comes your way. That’s what Legacy Fire & First Aid is all about.

• Innovative Solutions: We’re talking about the latest in fire prevention and first aid advancements. Get ready for products and services that are easy to use and incredibly effective.

• Expert Guidance: From tips on fire safety to first aid tutorials, our team of experts will ensure you have the knowledge you need to protect yourself and your loved ones.

• Community Engagement: We believe in the power of community. That’s why we’re committed to creating opportunities for learning and sharing experiences that can help us all be safer together.

We’re just getting started, and we can’t wait to share more details with you. Keep an eye on our social media channels for updates, sneak peeks, and more. Legacy Fire & First Aid is not just a service; it’s a commitment to a safer future for everyone.

your gut Liste N to

Don’t overlook your gastrointestinal health

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»People who are health conscious know the importance of paying attention to your cardiovascular and respiratory systems. However, an often overlooked area of health involves your gut. To use a more technical term, your gut is your gastrointestinal, or GI system, which includes your stomach, intestines and colon. Everyone has a “gut,” but how often do you stop to listen to yours, and why is it important to do so? Also, what steps do we take to have positive gut health?

Medical experts in the GI field talk about the reciprocal relationship that exists between gut health and mental health. If you have ever experienced twists or knots in your stomach prior to giving a presentation, you have firsthand knowledge of this link. It is called the gut-brain axis, a biochemical connection between the GI tract and your nervous system. Your gut contains many nerve cells that communicate with your brain, or vice versa, causing physiological reactions that have direct ties to overall mental health.

AffordAble Assisted living

• Private studio or one-bedroom apartment

• Kitchenette with sink, refrigerator and microwave

• Ample closet space

• Individually controlled heating and air conditioning

• Emergency call devices

• On-going health monitoring and nursing assessments

• Pet Friendly

• Three restaurant meals served daily

• Transportation available

Two hormones in particular — ghrelin and serotonin, are strong drivers of the gut-brain axis. The hormone ghrelin tells your brain whether your stomach is full or not, and serotonin acts as a mood stabilizer. When these hormones are disrupted, you can experience symptoms like nausea and diarrhea. The causation of such symptoms compounded over time may lead to a more chronic GI diagnosis.

Another simpler way to understand the gut-brain axis linkage is learning the relationship of eating habits to mental health. Your mental health often impacts how and what you eat. Stressinduced eating, which often consists of comfort foods or overeating, can leave your gut feeling distressed. Anxiety and depression may be compacted or improved, according to eating habits and gut health. It’s a twodirectional relationship. Many eating disorders have their origin in mental health matters.

But a person’s gut health impacts more than their mental health. A technical term inherent to this discussion is “microbiome.” Microbiome is the bacteria and microorganisms contained in your GI tract. Research shows that the gut’s microbiome can affect every organ in the body. In other words, gastrointestinal health is important because there are direct links with gut health and the immune system, as well as mental health, endocrine (kidney) disorders, cardiovascular disease, quality of sleep and the risk of cancer. That is quite a list, and it doesn’t even include the more common GI concerns like bad digestion, inflammatory bowel disease or irritable bowel syndrome. Some early studies have shown that a healthy microbiome may reduce the progression of Alzheimer’s and other forms of dementia, as well as reduce inflammation in the body.

Less inflammation can lead to a healthier heart and greater skeletal mobility. Our gut health and the GI system have a proven connection to many other bodily systems.

Your microbiome is impacted by stress, sleeplessness, diet and adverse reactions to antibiotics. The most basic, positive dietary contribution you can make to improving and maintaining good gut health is through the proper intake of fiber. The American Heart Association reports that the average American consumes only 15 grams of fiber per day, while the recommended daily amount of fiber is between 25-30 grams.

Good sources of fiber include vegetables, beans and legumes, fruit, bread and cereal, as well as nuts and seeds. Eliminating or reducing processed foods and drinking plenty of water, engaging in regular exercise and learning to eat slowly are all additional habits that can

improve GI health.

If you are among the many Americans who have poor gut health, the good news is you can do something about it. What should you do if your mind and digestive system are not getting along? Or if you suspect your gut health may be contributing to other health problems?

Don’t suffer alone. Consulting with your family doctor or a gastroenterologist is a good first step. Together, you can begin to map out a plan of good, guthealth practices that should be able to help you take control of a physiological system that you may not have previously given much attention.

Two local GI medical practices available to Columbus and Bartholomew County residents include the Columbus Franciscan Physician Network Primary and Specialty Care – 812-342-3339 and Columbus Regional Health Gastroenterology – 812-372-8680.

heal others reach out to

s ocialization is key to mental health wellness

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»Sociological studies about the dwindling connectedness of people in our society have been steadily increasing over the last quarter century — as has the problem itself. Harvard Public Policy Professor Robert D. Putnam’s 2000 book “Bowling Alone: The Collapse and Revival of American Community” looks at how activities such as attendance at club meetings, family dinners and friends visiting had declined in the previous 25 years, and participation in these activities has not gone up in the years since. More recently, Social Psychologist

Jonathan Haidt has linked cell phones and social media to the dramatic uptick in teen mental health issues. Harvard epidemiologist Tyler VanderWeele recently wrote, citing several studies, that there appears to be a clear link between the decline in church attendance and the rise of mental health problems in America.

The Mill Race Center’s Executive Director Dan Mustard has a diagram on his office wall showing the eight dimensions of wellness. It’s based on a six-dimensional model formulated in the 1970s by the National Wellness Institute’s co-founder,

“isolation is a key factor in a lot of issues people have. s ocialization is more important than even nutrition and fitness.”

—

Bill Better. The original six dimensions are emotional, intellectual, spiritual, physical, social and vocational — The Mill Race Center added environmental and financial to the model.

“Isolation is a key factor in a lot of issues people have,” said Mustard. “Socialization is more important than even nutrition and fitness.”

Mustard mentioned the work of Dan Buettner, a National Geographic fellow and producer, who conducted a study of commonalities among societies with the highest percentage of people over the age 100.

“The factor linking it all together is a strong network,” said Mustard. “Most people have a need for at least three close associations.”

He also points out a connection between socialization and dementia, saying the risk of dementia is reduced by 50% with improved socialization. “When you’re not around other people, your brain just goes quiet.”

Certainly the COVID-19 lockdown exacerbated the already existing problems.

“That’s when it became more real for everybody,” said Mustard. “Afterward, it became more widely acknowledged. The United Kingdom now even has a cabinet-level Minister of Loneliness.”

Mustard said he grants that addressing the pandemic took public-policy specialists into uncharted territory, but that it didn’t take long for a connection between isolation and overall health to appear.

Da N mustar D

“In 2020, we had already lost our yearly average of 55 center members by May, and only two or three were actually from COVID,” he said. “We were trying to protect people from tigers by putting them in the lion’s den.”

Mustard said the Mill Race Center has ambassadors among its membership: People who “ask folks what they might do to check some of the dimensions-of-wellness boxes.”

He also noted that in each issue of the center’s newsletter, “We discuss which point of the dimensions of wellness a given event on our calendar is addressing.”

Dr. Vinita Watts, chief medical officer at Centerstone Health Services, said her organization is “rolling out an initiative to focus on whole health.”

Centerstone’s Director of Nursing, Teresa Setnar, said the initiative will connect medical services with mental

health services more seamlessly by “improving communication across our large, complex organization.”

However, Watts also noted that the decreased state and federal funding for programs has had a negative impact.

“We used to have more day hospital programs, groups we could host and crafts sessions,” she said. “We’re doing what we can with the current level of funding.”

She also cited private-sector partners as an immensely helpful resource. “We don’t do this alone. United Way, food banks and shelters are an important part of the equation.”

Setnar said, “If you look at all the initiatives across the country trying to reduce the stigma of mental illness, you see the connection being made to physical health. When we see conditions like obesity, we’re starting to ask how they might be connected to

a patient’s mental health.”

She also mentioned the pace of modern life. “In our technological age, we emphasize doing more and being increasingly mobile at the expense of the nuclear family.”

Dr. Watts noted that there is a selffeeding cycle in rural counties that Centerstone serves. The economies of small communities withered as major employers have either left or shut down, leading to decreased civic bonds and possibly substance abuse, which further entrenches isolation.

“And there are fewer professionals serving these areas,” she said. “Most rural counties don’t have a psychologist.”

If there’s a common thread among all these observations, it seems to be this: Friendship and belonging are crucial to a life that flourishes.

A little reaching out help start the process of healing for those in need.

aPoL1-mediated kidney disease can impact you and your family genetic connection

»A genetic condition that can cause kidney failure, APOL1mediated kidney disease (AMKD) represents a group of kidney diseases associated with mutations (changes or variants) in the apolipoprotein L1 (APOL1) genes.

Typically, the APOL1 genes — of which every person has two, one from each parent — create proteins that play a role in immunity. However, some people are born with mutations in one or both genes, and having mutations in both can increase the risk of developing kidney disease and even kidney failure.

Consider this information from the experts at the

American Kidney Fund to better understand the disease and become APOL1 aware.

understanding risk factors

Research shows Black people with kidney disease are more likely to develop kidney failure than any other racial or ethnic group. The reasons for these health disparities include social determinants of health, a higher burden of diabetes and high blood pressure in the Black community, barriers to health care access and genetics.

The APOL1 gene mutations evolved over the past 3,00010,000 years in people who lived in western and central

Africa and are associated with increased protection from a parasite carried by the tse tse fly that causes African sleeping sickness. While protecting from one disease, the mutation — if inherited in both APOL1 genes — is more likely to lead to kidney disease in those of certain African descent, including people who identify as Black, African American, AfroCaribbean or Latina or Latino.

In fact, an estimated 13% of Black Americans have two APOL1 gene mutations, according to the American Kidney Fund. While not everyone who has two APOL1 mutations will get kidney

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disease, there is a 1 in 5 chance they will go on to develop AMKD.

identifying symptoms

If you have kidney damage, symptoms may not occur until your kidneys are close to failing. As kidney damage worsens, one or more of these symptoms may occur:

n Protein in urine.

n Swelling in legs or weight gain.

n Feeling weak or tired.

n High blood pressure. Should these symptoms occur and you have a family history of kidney disease, talk to a doctor about getting tested for kidney disease, as testing is the only way to determine kidney function. AMKD can cause damage to parts of the kidney that filter blood or, in some cases, cause cells in the kidneys to die, which can lead to damage and scarring that may eventually lead to kidney failure.

Getting a diagnosis

The only way to know if you have APOL1 gene mutations is to do genetic testing via a blood or saliva sample. Genetic testing may be considered if you have kidney disease and don’t know the cause or if you’re considering donating a kidney. Testing may also be considered if a family member is a carrier for the mutation. If you have questions about genetic testing, discuss your options with a doctor or ask for a referral to a genetic counselor.

prevention

There are currently no treatments available for AMKD. However, there are steps you can take to protect your kidneys and promote general health. Work with your doctor to create a plan to prevent or delay the progression of kidney disease, which may include:

n Doctor visits to check how

your kidneys are working through urine and blood tests.

n Checking for and managing diabetes and high blood pressure.

n A healthy eating plan, which may involve limiting things like sodium (salt).

n Taking prescription medications as directed.

n Being active at least 30 minutes each day of the week.

n Quitting smoking or using tobacco.

If you have the APOL1 gene mutations, you may be able to take part in clinical trials. Trials could provide an opportunity for researchers to develop and test safe treatments for AMKD. Also, speak with family members about having genetic testing done if you have the mutation, as they may also have it.

Learn more and find additional resources at kidneyfund.org/APOL1aware

i MPacts o F

LDL

cholesterol

steps to maintain a healthy cholesterol level

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About 38% of American adults have high cholesterol, which can be caused by poor lifestyle habits or genetics, according to the Centers for Disease Control and Prevention. Having a high, low-density lipoprotein (LDL) cholesterol number — considered “bad” cholesterol — can contribute to fatty buildups (plaque) and narrowing of the arteries.

LDL cholesterol is also the type of total cholesterol most closely associated with an increased risk for a heart attack or stroke. 75% of heart attack and stroke survivors reported having high cholesterol, according to a Harris Poll survey conducted on behalf of the American Heart Association, yet less than half (49%) prioritize lowering their cholesterol.

“There’s a pervasive lack of public awareness and understanding around bad cholesterol and its impact on your cardiovascular health,” said Joseph C. Wu, MD, PHD, FAHA, American Heart Association volunteer president and director, Stanford Cardiovascular Institute and Simon H. Stertzer, MD, professor of medicine and radiology at Stanford School of Medicine. “As bad cholesterol usually

has no symptoms, we often find that many patients are walking around without knowing they’re at risk or how to mitigate it.”

To learn about LDL cholesterol, its impact on heart health and the steps you can take to maintain a healthy number, consider this information from the Lower Your LDL Cholesterol Now initiative, nationally sponsored by Amgen.

Get to know your lDl number

According to the survey, nearly half (47%) of heart attack and stroke survivors are unaware of their LDL numbers. While cholesterol levels can vary by race and ethnicity, with higher levels of LDL seen most often among Asian men and Hispanic women, various research studies on LDL have shown “lower is better.”

For healthy adults an LDL at or below 100 mg/dL is ideal for good health. If you have a history

of heart attack or stroke and are already on a cholesterol-lowering medication, your doctor may aim for 70 mg/dL or lower. In addition to race and ethnicity, family history, age, sex, tobacco use or exposure to secondhand smoke, eating habits, lack of physical activity, heavy alcohol usage and obesity can impact LDL numbers.

understand how often to check

Because high LDL does not typically cause symptoms, it’s important to have your number checked by your health care professional. Ask your doctor for the right frequency for you. Generally, healthy adults ages 2039 should have their cholesterol checked every 4-6 years. Adults over age 40, or those who have heart disease (including prior heart attack) or other risk factors, may need their number checked more often.

learn risks associated with lDl

Too much LDL cholesterol can lead to a buildup of fatty deposits inside your arteries, a condition known as atherosclerosis, which can narrow arteries and reduce blood flow. If a piece of the plaque breaks free, it might travel into the bloodstream and block a blood vessel to the heart or brain, causing a heart attack or stroke. This narrowing also elevates the risk of peripheral artery disease.

Take steps to manage high lDl

Managing high cholesterol is not one size fits all. Talk with your healthcare professional to determine the right treatment plan for you. According to American Heart Association guidelines, lifestyle habits can help control your cholesterol, including:

n Eating a healthy and balanced diet (emphasizing fruits, vegetables, nuts and seeds, lean protein and fish).

n Staying active and aiming to get at least 150 minutes of moderate activity each week — such as brisk walking.

n Managing stress.

n Eliminating tobacco use. However, some individuals, especially heart attack and stroke survivors, should have a conversation with their doctor about cholesterol-lowering medications.

Talk to your doctor about getting your cholesterol tested and visit heart.org/LDL for more information.

A1C Testing - Available twice a month. Call for more information.

Children’s Dental Health Program - Emphasizes good oral hygiene, nutrition, and regular visits to the dentist. Education is provided to requesting community groups, schools and longterm care facilities. Referrals and assistance are also available through this program.

Immunization Program - Provides county residents with immunity against specific diseases. Immunizations are administered to infants through adults. Medicaid, underinsured, uninsured and some other insurance accepted. Call for an appointment. Individuals can also be signed up for MyVaxIndiana, which gives access to immunization records anytime and anytime in the world.

Lead Program - Every child should be tested for lead at 12 and 24 months of age. Lead testing can be completed at the primary physician’s office or the Bartholomew County Health Department for no charge. Education on lead poisoning, sources of lead, symptoms of lead poisoning and ways to reduce your child’s risk of lead poising can also be provided.

Pregnancy Testing and Prenatal Vitamins - Available at no charge.

Public Health Nursing Program - Provides home visits to our high-risk elderly population who are in need of assistance with medication setup.

Sharps Program - Provides and disposes of sharps containers at no charge to county residents. Residents must provide proof of need via prescription or medication box at initial pickup.

STD/HIV/Hepatitis Program - All potential clients are assessed for individual risk factors. The STD/HIV/Hepatitis program provides testing, diagnosis and treatment. All services are provided by appointment, often at non charge.

Condoms are available at the Health Department - Nursing Division upon request.

Tuberculosis - QuantiFERON Gold blood test is available by appointment. Please call for fee.

Know Your Status - Anyone who has immunization records from previous years can bring them to the Health Department to have them entered into the registry.

Bartholomew County Health Department Nursing Division

2625 Foxpointe Drive | Columbus, IN 47203

812-379-1555 opt 1 | Monday-Friday 8 a.m. - 5 p.m.