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ďƒœ | Saturday, May 12, 2012 | Perspective


Perspective | Saturday, May 12, 2012 | 



Newer drug benefits Maine boy suffering

from rare




inda Burke recalls exactly when her family’s idyllic life came to a screeching halt: Sept 30, 2003. Burke and her husband, Brad, were parents to 10-month-old Hunter and were enjoying life with their new son. That fateful day, the Cape Elizabeth couple brought Hunter to Maine Medical Center in Portland only to learn that what seemed like a viral illness was instead a rare disease known as Atypical Hemolytic Uremic Syndrome (aHUS). “We were stunned to hear such a devastating diagnosis,” Burke said. Hunter became one of about 300 American children and 1,000 children across the world with aHUS. “Left untreated, some genetic forms of aHUS are unpredictable and life-threatening. The condition can progressively damage vital organs, leading to stroke, kidney failure, and death,” said Dr. Carrie Gordon, pediatric nephrologist at MMC. “The premature mortality in aHUS is caused by the formation of blood clots in small blood vessels throughout the body, known as thrombotic microangiopathy,” Dr. Gordon said, pointing out that “aHUS is a very uncommon condition; many doctors see less than a handful of cases in their careers.”

Photo courtesy of Linda Burke

Hunter Burke of Cape Elizabeth was only 10 months old when he was diagnosed with Atypical Hemolytic Uremic Syndrome, a rare disease that at the time affected only 1,000 children worldwide. He died in May 2008 from complications that arose during an attempted kidney-liver transplant at Mt. Sinai Hospital in New York

Benefitting from MMC’s collaborative approach to care, Hunter was hospitalized at MMC’s Barbara Bush Children’s Hospital from Sept. 30 until Dec. 23, 2003. A central line was surgically implanted so he could undergo plasmapheresis, a blood plasma exchange that utilized two units of packed red-blood cells and two units of plasma. “Prior to the use of Soliris, the only effective treatment for many patients with aHUS was plasmapheresis. Over time, even when [the treatment was] initially effective, patients can become resistant to pheresis,” Dr. Gordon noted. Dr. Matthew Hand, a pediatric nephrologist familiar with aHUS from his work at Boston’s Children’s Hospital, and Dr. Gordon treated Hunter right at MMC. “Having knowledgeable specialists is essential for successfully treating aHUS. Families usually commute long distances to receive experienced care for these ultra-rare diseases,” Burke said. Shortly after Hunter’s first birthday, the functions of his heart, lungs, and kidneys weakened, requiring him to be treated in the MMC intensive care unit. Now stabilized, Hunter took medications to keep his blood pressure in check. He returned to the hospital several times a week for plasmapheresis. Seven months later, the Burkes were back in the hospital: Linda, in the maternity ward, delivering baby Skyler; Hunter, on the sixth floor with a full-blown aHUS episode; and Brad, the busy go between. While the Burkes kept a positive attitude and their boys’ lives as normal as possible, Hunter’s frequent hospital stays impacted family life for more than four years. The Burkes learned of a kidney/liver transplant option that brought good results to one aHUS patient by eliminating the need for long plasmapheresis sessions. Hunter Burke, now 5½, underwent a similar double transplant operation at New York’s Mount Sinai Hospital in May 2008. “Unfortunately, everything that could go wrong, did,” Linda Burke sadly said. “Hunter died from complications from the operation.” Ten months after Hunter’s death, brother Skyler was diagnosed with an active case of aHUS. After trying plasmapheresis, the Burkes opted for Soliris, produced by Alexion Pharmaceuticals. Soliris, a drug previously approved for patients with paroxysmal nocturnal hemoglobinuria (a life-threatening blood disorder) was FDA approved in September 2011 for use with aHUS patients. “Soliris is proving to be a magic bullet for some aHUS sufferers. It directly targets uncontrolled complement activation, the underlying cause of progressive organ

Photo courtesy of Linda Burke

In September 2003, Hunter Burke (left) was diagnosed with Atypical Hemolytic Uremic Syndrome, an extremely rare disease. He died in May 2008 from complications that arose during an attempted kidney-liver transplant at Mt. Sinai Hospital in New York. Ten months later, his younger brother Skyler (right) was also diagnosed with an active case of aHUS. He has been treated with the experimental drug Soliris; Skyler is supposedly the third aHUS patient in the world to be treated with with Soliris, and currently his lab tests show no sign of disease activity. failure in aHUS patients,” Dr. Gordon said. “This is the first time I have seen a therapy with such a dramatic benefit, including restored kidney function. This drug can make a remarkable difference for aHUS patients,” said Craig Langman, M.D. and aHUS expert at Northwestern University. “Within 48 hours of Skyler’s first IV dose, lab tests indicated that his red blood cell destruction was halted, and he continued to improve,” said Linda Burke. “Soliris allows physicians to consider kidney transplants for patients who had previously lost their kidney to aHUS before the medication was available, as a possible way to prevent the disease from recurring in the new kidney,” Dr. Gordon said. Volunteering to support rare disease issues, the Burkes became involved with Bill and Cheryl Biermann’s Foundation for Children with Atypical HUS in Barnhart, Mo. With Linda’s brother, Steve Greene, the family created an aHUS interactive website for outreach and information: “We felt it vital to not let other families feel as helpless and isolated as we did when Hunter was first diagnosed,” Linda Burke said. Her recommendation to others with rare diseases? “Join to benefit from a disease-specific community created for your rare disorder.”

Photo courtesy of Linda Burke

Within 48 hours after he received his first IV-administered dose of Soliris, Skyler Burke of Cape Elizabeth started to respond positively to the experimental treatment. Like his older brother, Hunter, he was diagnosed with Atypical Hemolytic Uremic Syndrome. Skyler received Soliris every two weeks from April 2009 to May 2010, when his parents decided to discontinue the treatment because Skyler’s lab tests remained positive — and they still do.

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 | Saturday, May 12, 2012 | Perspective


Waldo County General hospital

Speech Department earns major accreditation



he speech pathology department at Waldo County General Hospital has received Training Program Accreditation from the American Telemedicine Association — and is only the fourth institution in the United States to receive that accreditation. But there is one big difference between the other three institutions and WCGH’s speech pathology department: WCGH is the only one that allows speech therapists to work from their offices with patients in their own homes on their own computers with a $29 web cam. The other three institutions have programs that often involve a patient going to a nearby clinic to work with a provider in a far-away large medical center. “Other telemedicine services are not usually webbased…they use expensive specialized equipment. That’s why an Internet-based approach using available computers in peoples’ homes is a game changer,” said Michael Towey, director of WCGH’s speech pathology department. He expects other speech therapists will be interested in obtaining the accredited training program (a 300-page digitized curriculum) that his department will soon offer to other professionals. In September 2008, Towey provided speech therapy to a teacher and softball coach in Fort Kent from Towey’s office in Belfast. The teacher was suffering from vocal cord lesions and a voice disorder that threatened to end her teaching career. After purchasing a $29 web cam, instead of traveling the 250 miles from Fort Kent, the teacher was able to receive voice therapy in her classroom, with no lost work time or travel expenses. When the teacher’s insurance company refused to pay for the care, Towey went to the Legislature with a bill to require health insurance coverage for telemedicine. The testimony of Towey and others in MaineHealth focused on the efficiency of telemedicine, especially the improved access to services for those in rural areas and the cost savings. When the bill passed, Maine became the eighth state in the nation to require insurance companies to pay for telemedicine services. Towey has since completed a study showing that MaineCare is saving $3,000 a month by using telemedicine to treat children with vocal cord problems who were previously believed to have asthma. Instead of purchasing medication and inhalers and making expensive trips to the emergency room, these children are being treated in one or two telemedicine visits from their own homes. Towey says that while many people are initially skeptical about telemedicine services, “we’re finding telemedicine services are as good, or better, than traditional in-office treatment.” In the comfort and

Photo courtesy of Waldo County General Hospital

From her office in Belfast, speech language pathologist Erica Ricker works with a man suffering from Parkinson’s symptoms. Her patient is at his home in Southwest Harbor. convenience of their own homes, patients are getting the same treatment as if they traveled to the office, which is often a long distance away. For example, last year one of his therapists was working with a child who lived in Camden. When the child and his family moved to Belgium, she was able to use telemedicine to continue his treatment. The training accreditation has led to a number of new challenges for Towey and his staff, including: • Teaching a three-credit graduate course for speech pathologists with the University of Maine on telemedicine (the first such course in the country); • Traveling to Ohio State University, which has the largest speech pathology department in the country, to

train professors in how to implement the curriculum written to receive this accreditation; • Conducting a half-day training at the American Telemedicine Association annual international symposium in San Diego on how to do web-based telerehabilitation for speech, occupational, and physical therapists; • Presenting to the Council of Academic Programs in Communication Sciences and Disorders on telepractice competencies; • In the future, offering three or four training sessions a year in Belfast to people from all over the country based on the accredited training program. But the bottom line for the speech language

pathologists at WCGH is the desire to “put patients first” and to be able to continue to offer quality services to the people who need help with speech, voice, or swallowing problems. Telemedicine provides the technology to do that with both quality and efficiency. WCGH’s speech pathology department joins the Alaska Federal Health Care Access Network, the Arizona Telemedicine Program, and the Academic Information Systems and Center of Health and Technology Telemedicine Education Programs at the UCDavis Health System in Sacramento, Calif. as the only accredited training organization in the United States.

Quality Care, Close to Home

You don’t have to travel far from home to get quality health care. Waldo County General Hospital operates a number of primary care offices, including five health centers, where dedicated, friendly staff can help you get the care you need, when you need it. Take advantage of special services, such as priority sick visits and on-site lab work. If you qualify, we also offer programs that can help you pay for doctor visits or prescriptions. For help finding a doctor, please call our physician referral line: 207-930-6766.

Departments of Waldo County General Hospital

ARTHUR JEWELL COMMUNITY HEALTH CENTER 55 Reynolds Rd., Brooks PH: 207-722-3488

SEARSPORT HEALTH CENTER 37 Mortland Rd., Searsport PH: 207-548-2475

DONALD S. WALKER HEALTH CENTER 43 W. Main St., Liberty PH: 207-589-4509

STOCKTON SPRINGS REGIONAL HEALTH CENTER 11 Cape Jellison Rd., Stockton Springs PH: 207-567-4000

LINCOLNVILLE REGIONAL HEALTH CENTER 2399 Atlantic Highway, Lincolnville PH: 207-236-4851

HOSPITAL-BASED DOCTORS 118 Northport Ave., Belfast PH: 207-930-6766 118 Northport Ave | Belfast, Maine 04915 207-338-2500 | 1-800-649-2536

Perspective | Saturday, May 12, 2012 | 



LifeFlight of Maine seeking

to add aircraft to its fleet



BDN Photo by Brian Swartz

ifeFlight of Maine is raising money to add an airplane to its fleet of two helicopters in response to growing demand for air ambulance services. Adding a third aircraft is expected to allow the statewide service to treat up to 300 more patients a year by freeing up the maxed-out helicopters. "As more and more physicians ask us to transport their most critical patients, our medical crews and helicopters are reaching their capacity," LifeFlight of Maine Executive Director Tom Judge said in an email. "Last year, on average, we transported a patient every six hours. Adding a fixedwing aircraft to our current resources will mean more patients have access to the care they need, when they need it." In 2009, LifeFlight was unable to care for 236 patients who needed air ambulance services because the helicopters already were occupied or unable to fly in bad weather. The airplane LifeFlight is eyeing, a Beech King Air 200 twin-engine turboprop, could transport patients over longer distances more quickly and fly in weather conditions such as freezing rain and fog that the helicopters can't handle, Judge wrote. The helicopters are clocking 900 flight hours a year, far more than LifeFlight anticipated, according to Melissa Arndt, marketing and educational outreach manager for the LifeFlight Foundation, which raises money for the service. "We've almost doubled the number of hours we expected to put on them," Arndt said. LifeFlight has raised about a third of the airplane's $3.5 million price tag, which includes costs to retrofit the interior and purchase medical equipment, Arndt said. The foundation hopes to collect the full amount within the next year. Established in 1998, LifeFlight is a nonprofit agency run by Eastern Maine Healthcare Systems in Bangor and Central Maine Healthcare Corp. of Lewiston. In the last year, LifeFlight transported more than 1,400 patients from all over the state. Many of them suffered

severe injuries in crashes. LifeFlight of Maine operates two Augusta 109E helicopters, including tail number N901EM, which is assigned to Eastern Maine Medical While LifeFlight helicopters sometimes land at crash scenes, Center in Bangor. LifeFlight is currently seeking to add an airplane to its fleet. the bulk of the flights transfer critically ill or injured patients from rural hospitals to trauma centers in Bangor, Portland and Lewiston. About 5 percent of LifeFlight's patients wind up in Boston for treatment, Arndt said. Even with the addition of an airplane better suited to longer flights, "we don't expect to see significantly more patients leaving the state," she said. The new airplane could be modified to land on the shorter runways typical of Maine's rural airports but still have the range to accommodate a wider flight ring including Montreal, Pittsburgh, Pa., and Richmond, Va., for patients needing specialized services unavailable in Maine. Adding the new aircraft also is expected to improve LifeFlight's coverage in southern TOM JUDGE, Maine by cutting down on long flights by LIFEFLIGHT OF MAINE EXECUTIVE DIRECTOR the Lewiston-based helicopter. "The same crew and the same equipment are going to be aboard either aircraft, so the care the patient receives will be the same," Arndt said. Airplanes are ideal for trips topping 175 miles, she explained. While fixed-wing aircraft require ambulances to transfer patients from the hospital to the airport and vice versa -- the helicopters land on hospital helipads -their speed over longer flights makes up for the extra time, she said. "In Maine, our typical helicopter flight is much longer than the national average," Judge wrote in the email. "A fixed-wing aircraft is faster and more efficient over these longer distances, helping the patient get to the care they need sooner." Maine's emergency medical services network already includes airplanes operating out of airports in Rockland and Caribou, though LifeFlight's crew receives a higher level of critical care training, Arndt said. Photodisc/iStockPhoto

“Last year, on average, we

transported a patient every six hours...”

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 | Saturday, May 12, 2012 | Perspective

Hand and shoulder patients benefit from


MCMH's pair of sub-specialists



hat are the odds of two orthopedic surgeons who are sub-specialists in hand and shoulder — a sub-specialty not common around here — finding themselves as partners in a community hospital on the Maine coast? Apparently, 100 percent. After a meeting born of a suggestion on a hiking trail, Dr. S. Craige Williamson and Dr. Gerald M. Rosenberg’s connection has resulted in what may be the most comprehensive hand/shoulder practice in all of Eastern Maine. The pair operate out of Maine Coast Memorial Hospital at Maine Coast Hand & Shoulder, where they’ve been bringing relief to patients suffering from hand and shoulder pain — to the tune of over 500 surgeries a year, and countless non-surgical solutions. MCMH Marketing and Public Relations Director Jane Sanderson said Williamson and Rosenberg are incredible assets not only to the hospital but the community at large. “The people in this area have benefited so much from having this team,” Sanderson said. “We’re just very lucky to have them. The news of their expertise has spread throughout the state with referrals coming from all areas in Maine.” “For upper extremities, Craige and I can help people with most of whatever their needs are,” said Rosenberg, with no need for patients to travel to Portland or Boston. “The capabilities that we have... are fairly unique for a small hospital.” “The amount of expertise that’s here for upper extremity is amazing,” Williamson agreed.

Meeting of the Minds How these doctors met up is a study in happenstance. Williamson grew up in Virginia, but when he attended Dartmouth College, he fell in love with the Northeast. After orthopedic training in New York and Boston, he came to work for MCMH in 1995. He’s been there since, minus a brief stint with Blue Hill Memorial Hospital, although even then he continued on with MCMH. Rosenberg grew up in northeast Ohio, attending college at Miami University and Ohio State. His sportsand-athletic nature focused him on orthopedics, and after his residency he did an upper-extremity surgical fellowship in New York, specializing in the shoulder, elbow, and hand. He and his wife, who he had met when he was 15, returned to Columbus to raise a family, and he practiced there for 26 years. But every summer they vacationed in Southwest Harbor, always planning to retire there. When it seemed likely he’d work longer than planned, they considered relocating to Maine, but he knew he’d

have to work in Bangor with a sub-specialty like his. Then, three years ago, while hiking in Acadia, he met a pathologist hiking on the trail. After chatting, the pathologist suggested he check out MCMH. “He said, ‘You should call Craige Williamson,’” Rosenberg recalled. So Rosenberg did, out of the blue. The two hit it off immediately. “I always thought it would be great to have a partner,” Williamson said. “One problem with doing subspecialty stuff is that you don’t have someone else to talk about cases with.” The odds of two doctors who both sub-specialize in the same field connecting at a small community hospital in Maine are extraordinary, but the result has been an astounding benefit to MCMH and to people suffering from pain they once thought they had to endure.

Diagnosis Many people simply accept shoulder and hand problems, unaware that they’re treatable. We all hear about hips and knees; they outnumber treated hand and shoulder cases 5 to 1. This is mostly because we feel hip and knee problems more; after all, we don’t walk on our hands. Typical shoulder problems include fractures, rotatorcuff tears, and arthritis. With the hand, cut tendons and nerves, fractures, small-joint arthritis, and carpal-tunnel problems are very common. All of these can be treated, but in many cases primary-care physicians aren’t even aware of many of the treatments. Patients end up living with their pain. For example, a torn rotator cuff is fairly common, but in many cases people with painful shoulders either don’t bother investigating them or assume nothing can be done about it. Tendonitis can be debilitating, but people frequently just grit their teeth and live with it. The problems tend to go from bad to worse. Determining the patient’s needs is easy. First, the doctor takes a detailed history to learn all he can about the injury and the patient’s pain. Then come physical tests to gauge range of motion, strength, sensation, and swelling. “As I say all the time, test drive the shoulder and see if it shows you what it can and can’t do,” Williamson said. If uncertainty remains, X-rays and MRI scans may reveal more. In extreme cases, arthroscopy might be in order — exploring the region with a tiny camera to see what everything else has missed.

Treatment In many cases, curing the problem involves

non-surgical techniques such as physical therapy, exercise, medicines, and cortisone injections. “We… always start out with the least aggressive, least invasive, most gentle treatment first,” Rosenberg said. “If it doesn’t work, we sequentially increase our invasiveness, with surgery typically being the last resort.” When it comes to surgery, arthroscopy often does the Photo by David M. Fitzpatrick trick. Instead Gerald Rosenberg (from left) and Craige Williamson in the lobby of Maine Coast Hand & Shoulder. The doctors are of just looking sub-specialists in a narrow field, but managed to connect in Ellsworth at Maine Coast Memorial Hospital, and have with a camera, been serving Mainers from across Eastern and Northern Maine who might otherwise have gone to Portland or the surgeon uses Boston for specialized hand and shoulder treatments. tiny surgical implements to repair rotator cuffs, fix dislocations, and remove spurs. seven months before its national release. Arthroscopy results in small incisions, minimal physical impact on the patient, and fast recovery times. Two of a Kind But when more drastic measures are needed, it may involve prosthetics, usually in the shoulder. And when One thing the doctors make clear is that you won’t get it comes to implants, Rosenberg adds a unique bonus an answering machine during business hours. That’s a to the hospital. For 15 years, he’s consulted for Stryker, view they share as a point of pride. a shoulder-implant company. Its engineers work with There’s a comfort factor with the two of them having specialist doctors in order to continually improve been around the block and seen so much over the prosthetic models. years. Williamson recalled that when he did general Stryker is one of a half-dozen shoulder-implant orthopedics, while he got experience in many things, manufacturers worldwide The doctors stress that it was easy to not see specific cases enough and be less Rosenberg and the hospital get no financial reward or than comfortable. incentive from using Stryker’s products, and particular “That’s part of the reason I wanted to sub-specialize,” implants are carefully chosen based on the patient’s he said. “If you have a home turf where ‘Oh, I’ve seen specific needs. this several times before, and I know how to deal with it “It’s been a really fun part of my practice to develop now,’ it’s a lot easier and more comfortable, and I think stuff that we actually use,” Rosenberg said. you do a better job.” “It’s a very fun addition to taking care of patients.” To learn more, or to make an appointment to In fact, Rosenberg installed the first of the investigate your hand or shoulder pain, visit Maine most recent generation of Stryker’s shoulder Coast Hand & Shoulder at implant in a patient at MCMH last July, or call (207) 664-5858.

Perspective | Saturday, May 12, 2012 | 



A Common Stone:


Acupuncture is a

holistic medical treatment

Not all stones are worth keeping, especially if they’re gallstones

What is acupuncture and how could it help you?




hen you hear the word “gallstone,” you probably think it is a problem only senior citizens deal with. But gallstones can afflict anyone regardless of age. And no matter who you are, a gallstone attack is painful. When I was 23 years old, I began waking up with sharp pain behind my shoulder blades. I blamed it on indigestion, took some Tums, hunkered down on the couch, and tried to get back to sleep. And it worked for quite some time. In 2007, I started having lower-right abdominal pain and nausea serious enough that my husband and I thought it was appendicitis. My mother had her appendix out in her 20s so I wasted no time getting in to see the doctor. The doctor ordered a computed tomography, or CT, scan; after waiting anxiously, the results showed I had a sizeable gallstone. The prescription: go on a low-fat, high-fiber diet and work on losing some weight. The doctors felt that the stone wasn’t large enough to be concerned with surgery. Relieved, I set about adjusting my diet and exercising. For two years I managed the problem successfully, with an occasional attack. But in February 2009, I began experiencing chronic abdominal pain, bloating, and nausea. I was busy and put off seeing the doctor until the symptoms were so chronic that I was miserable. When I ate, my belly bloated and I looked pregnant, and my side hurt. The location of my pain was lower than most typical gallbladder pain. To be safe, my nurse practitioner ordered an ultrasound. The ultrasound showed one large gallstone in the gallbladder, but I was told no surgery would be scheduled. But, I thought, if this stone were causing all these problems, shouldn’t it be taken out? I wasn’t ecstatic about the prospect of surgery, but was unhappy with constant nausea, bloating, heartburn, and pain. Weeks later, a referral

to a surgeon came in the mail. I was relieved. In April 2009, I saw Dr. Kimberly Leiber, a surgeon who had done many gallbladder surgeries. After reviewing my record and consulting with me, I found out I was a candidate for laparoscopic gallbladder surgery. The potential side effects were minimal compared with the complications resulting from not removing my gallbladder: continued pain, nausea, and bloating, and potentially jaundice, infection, and serious pain. The side effects from surgery could include pain, diarrhea, and damage to the common bile duct. Together, we decided surgery would be appropriate and set the date for May 18, 2009. I arrived at the hospital early in the morning with an empty stomach. They took a blood sample prior to admitting me to check my liver enzymes, and then I changed into hospital garb and settled into my gurney. An hour later, I was escorted into the operating room and the anesthesiologist sent me off to twilight. My surgery started (I’m told) at 12:30 p.m.; I was back in recovery by 1:30 p.m., awake by 2 p.m., and home by 4:30 p.m. Dr. Leiber told my family that I had come through surgery well. They removed the gallbladder and its stone with no complications, and even moved my colon back in place saving me a surgery down the line. From the surgery I have four small scars which have healed and are barely visible. It took about a week before I was able to easily get around without pain. Since my surgery, I have been pain free. Some foods trigger a quick visit to the bathroom (good-bye McDonald’s and really fatty foods). I enjoy eating again. I enjoy living pain-free. I enjoy my life again. I do not regret having the surgery. It’s given me my life back.


n increasing number of Americans looking for alternatives to conventional medicine and/ or pharmaceuticals are turning to this ancient Chinese practice. A 2009 study by the National Center for Complementary and Alternative Medicine, which is part of the National Institute of Health, found that 3.1 million adults and 150,000 children used acupuncture in 2007 while seeking relief from ailments such as back pain, insomnia, and headaches. Even the United States military has embraced the use of acupuncture, primarily for treating pain, but also for treating symptoms associated with post-traumatic stress. Acupuncture is the most widely used component of Chinese medicine, a practice dating back 2,500 years. The simple insertion of thin (hair-fine), sterile, and disposable needles into specific areas of the body is as effective today as it was in ancient China. When performed by a licensed professional, few, if any, side effects have been reported. In fact, the only predictable “side effect” is a deep state of relaxation. This, coupled with acupuncture’ proven efficacy, has contributed to an increased acceptance and popularity in the United States since the 1970s. Acupuncture treats holistically. A diagnosis is made based not only the primary complaint, but also on the overall condition of the patient. The headache of a 25-year-old man, for example, will most likely be treated differently from that of a 57-year-old woman. In the process, it is not unusual to find that seemingly unrelated symptoms, such as digestive problems or anxiety, can improve, if not resolve completely. As a holistic medicine, acupuncture does not distinguish between emotional and physical ailments. Acupuncture is also used increasingly to complement Western medical therapies. It has been shown to work well alongside conventional medicine in patient recovery from trauma and surgery; acupuncture helps the body better integrate other treatments from, for example, a chiropractor or physical therapist. Acupuncture and herbal medicine also effectively treat the side effects of pharmaceuticals and chemotherapy. Among the commonly treated ailments in an acupuncturist's office are low back pain, joint pain, headaches, insomnia, anxiety, depression, fibromyalgia, digestive disorders, allergies, substance abuse withdrawal, and stress. Once introduced to the benefits to acupuncture, many patients return for seasonal tuneups or maintenance. Acupuncture supports wellness. It boosts the immune system and releases endorphins, which are natural “feel-good” chemicals. A patient who feels better is

BDN Photo by Michael C. York

In late April, Marie Arnberg, L.Ac., works with a patient at Arnberg’s DownEast Community Acupuncture, a community clinic on Verona Island. more likely to initiate and stick to the healthy lifestyle choices that person have been meaning to make. Making lifestyle changes and adopting a healthier mindset can avoid costs of pharmaceuticals and doctor visits. Commonly seen in Asia, community acupuncture offers acupuncture in a group setting. Community acupuncture is a growing trend in the United States. This style of treatment provides acupuncture to many patients simultaneously, thus lowering the cost of treatment. Private sessions are another option for patients seeking individualized attention. During these appointments, herbal consultations, nutritional therapy, and other aspects of Chinese medicine may also be addressed and discussed.

E. Marie Arnberg, L.Ac. operates DownEast Community Acupuncture, a community clinic on Verona Island. She can be reached at (207) 479-2944 or Lea Elliott, L.Ac. operates Maine Coast Acupuncture & Herbal Medicine in Ellsworth. She can be reached at (207) 812-8747 or

BDN Photo by Michael C. York Photodisc/iStockPhoto

Lea Elliott, L.Ac., treats a patient at Maine Coast Acupuncture & Herbal Medicine in Ellsworth in late April. Elliott owns the business.

May is

American Stroke Awareness Month



ccording to the American Stroke Association, a division of the American Heart Association, about 795,000 Americans suffer a new or recurrent stroke each year, which means that a stroke occurs every 40 seconds on average. About 610,000 of these are first or new strokes, and an estimated 185,000 people who survive a stroke go on to have another in their lifetime. The American Stroke Association notes that major milestones have been reached in the fight against stroke. Earlier this year federal statistics showed that for the first time in 50 years, stroke has dropped from the third to the fourth leading cause of death in our nation. However, stroke still claims an estimated 130,000 Americans each year and remains a leading cause of long-term disability. The American Stroke Association urges everyone to participate this May in American Stroke Awareness Month by taking time to learn about warning signs and ways to prevent this often deadly and debilitating disease. Stroke is a type of cardiovascular disease that occurs when a blood vessel that carries oxygen and nutrients to the brain is either blocked by a clot or bursts. When that happens, part of the brain cannot get the blood that it needs to function. Know the signs of a stroke: • Sudden numbness or weakness of the face, arm, or leg, especially on one side of the body; • Sudden confusion or trouble speaking or understanding; • Sudden trouble seeing in one or both eyes; • Sudden trouble walking, dizziness, or loss of balance; • Sudden, severe headache with no known cause. If you or someone with you has one or more of these signs, call 9-1-1 immediately. Time is of the essence

when it comes to a stroke. If a clot-busting drug called tissue plasminogen activator (tPA) is given within the recommended start of symptoms, it can reduce longterm disability for the most common type of stroke. The American Stroke Association notes that some stroke risk factors are hereditary or are part of natural processes, including a prior stroke or heart attack, age, family history, gender, or race. African Americans have almost twice the risk of experiencing a first-ever stroke compared to white Americans Other risk factors can be changed or controlled, including high blood pressure, smoking, high blood cholesterol, poor diet, and physical inactivity. The American Stroke Association recommends the following to lessen your risk for stroke: • Eat a healthy diet. Eat a variety of nutritious foods from all of the food groups. Choose foods like lean meats, fish and poultry without skin, vegetables, fruits, whole-grain products, and fat-free or low-fat dairy products. Cut back on foods and beverages high in cholesterol, salt, and added sugars. • Know your blood pressure. • People with normal blood pressure have about half the risk of stroke as those with high blood pressure. • Exercise every day. Walk or do other forms of physical activity for at least 30 minutes on most or all days. Check with your doctor before beginning any exercise routine. • Stop smoking. Nonsmokers have about half the risk of stroke as people who smoke cigarettes. • Avoid excessive alcohol consumption. An average of more than one alcoholic drink a day for women or more than two drinks a day for men raises blood pressure and can lead to a stroke. • Stop any illegal drug use.


Intravenous drug abuse carries a high risk of stroke. Cocaine use has also been linked to strokes and heart attacks. Some have been fatal even in first-time users. • Make sure you receive quality care. Finding a doctor you can trust can be challenging. That’s why the National Committee for Quality Assurance (NCQA) and the American Heart Association/ American Stroke Association joined forces

to create a new program that recognizes primary care physicians and others who care for patients with cardiovascular disease and stroke. To learn more, visit

Brenda Vitali is the communications director for the American Heart Association/American Stroke Association in Maine.

 | Saturday, May 12, 2012 | Perspective

30-Second Guacamole


and RAWsome Cowboy Chips



vocados are RAW-mazing. Sadly, these little green buggers are often cast aside as too fatty. (Insert game show incorrect buzzer ) Avocados have zero cholesterol and only about three grams of (mostly) monounsaturated fat–a fast food cheeseburger has 12 grams of saturated fat! Avocados are incredible nutrient dense–in fact, avocados contain most of the 13 vitamins the human body must have in order to thrive. Not to mention they are super delish. One of the most popular ways to eat an avocado is to make Guacamole. Below are two recipes. You can dunk cut veggies into it or make the Cowboy Chips that follow. Either way, you are in for a creamy, healthy snack that will make your body happy. TIP: Make sure the avocados are ripe. If they aren’t, store them in a paper bag overnight to speed up the process. You want the skin to give slightly when you press.

Avocado Pop Quiz!

Everyone seems to have a way they like their guac. Share your recipes with us!

THIRTY SECOND GUACAMOLE When your cupboards are bare or you are feeling lazy, here is the perfect way to whip up a fabulous dip. MASH together: The flesh of 2 ripe avocados, the juice of one lime and a dash of sea salt. If you have some fresh cilantro, sprinkle on top.

COWGIRL GUAC In a medium bowl, mash together 4 ripe avocados, 1 chopped tomato, 1/2 chopped sweet or red onion, 1 clove minced garlic, handful fresh chopped cilantro, juice from 1 or 2 limes, generous pinch sea salt.

COWBOY CHIPS - makes 2 trays 3 cups frozen corn 1 cup flaxmeal 1 cup meat from baby thai coconut 3/4-1 cup water 2 cloves garlic, minced 1/2 tsp chili powder 1 tsp sea salt 2 TBSP chia seeds sprinkles of sea salt

Where are 90% of the US supply of avocados grown? a) New Mexico b) Arizona c) California d) Maine

Blend all ingredients except chia seeds and sea salt sprinkles in a food processor until smooth and creamy. The consistency will be thick. Spread into two Teflex dehydrator sheets, about 1/8 inch thick. Sprinkle with chia seeds and sea salt. Dehydrate at 110 for 30-36 hours. After TWO HOURS score the chips into triangles. After six-eight hours, peel them from Teflex sheets and continue to dehydrate another 24 hours. They will not feel crispy until you take them out and let them cool. If you do not have a dehydrator, you can do this in the oven on the lowest temp–it will take much less time, so keep checking. POP QUIZ ANSWER. Sunny California is the proud grower of 90 percent of the nation’s avocado supply. A single tree can produce 500 of the fruit!

Kids Gone Raw is a place for kids & their people to learn about healthy living. We want to share and inspire you to have fun in the kitchen, take pride in your health and to play in nature. Maggie Knowles, Maine writer and editor, and Elizabeth Fraser of Girl Gone Raw are teaming up for some wicked good fun. They are hard at work on their upcoming un-cookbook, “Kids Gone RAW.” So hold on, because they are going to RAWK your world! Read their blog at

Building a

Foundation for Healing



e feel overwhelmed at the start of any recovery process and folks need to understand that this is normal and that fear is part of every new beginning. Some of us approach healing with great trepidation and others of us want to dive right in. This is a process. It hurts, it sucks, and it’s scary. It’s also totally worth it. There are no shortcuts. You need to know that going in. Just as you’d get yourself prepared for any big undertaking, there are small achievable tasks that will help you get off to a strong start. There are things that always work. When people tell me they don’t know where to start I tell them to drink water, eat an occasional salad and take multi vitamins. They almost always shrug this off and want to go deeper. I go back to Maslow and encourage them to consider that first we crawl, then we walk, then we run. As much as they hate hearing this they hate what comes next even more: Get organized. Write down everything and make lists. This will reduce your stress. Make a schedule. Put it on a calendar. I know, I know – you do better flying by the seat of your pants, you have a well organized mess, and you do your best work when your back is up against the wall. Trust this – as you start working through memories you will forget day to day stuff. There’s something about a flashback that will leave you not concerned with picking up milk on your way home and you’ll feel ridiculously bad about not having milk because you’re dealing with some really powerful emotions from the past. Get grounded. A huge part of trauma recovery is separating the past from the present. Being grounded in today means using your five senses to have a strong

sense of being in the here and now, being safe in your own skin, and having a sanctuary (a place you can feel safe – at first this is a place – later in the journey it becomes a place within us). There are hundreds of ways to get grounded. Getting more comfortable with your body is a great start. It’s really a matter of personal style. I hate yoga, working out, and I have no intention of dieting or quitting smoking). I like eating healthy, walking, and massage therapy (best form of self care ever especially since I just lay there). The idea here is that ultimately we’re bringing the different parts of ourselves together and physical safety/connectedness is the most basic part of this process. For those of us who abuse our bodies it’s best to make this a priority in treatment. Cutting, burning, purging, bingeing, starving, hair pulling, and other forms of self abuse are to varying degrees attempts to cope, attain a sense of self control and achieve an emotional release. Addressing past traumas while continuing to abuse one’s body is like pouring kerosene on a fire. Self abuse tends to add a level of shame to recovery. Better to view it as one more thing that can be improved upon. Self abuse is generally not something that we simply stop doing. It’s something we replace with a far healthier form of coping and means of release. People tend to have a lot of misconceptions where self harm is concerned. Folks tend to believe that those who do damage to their bodies are also suicidal. In the vast majority of cases, the person doing harm to themselves has no intention, plan, or desire to die. The person who fears addressing these behaviors in treatment generally expects that they will be judged and may fear being hospitalized against their will. There are exactly

three criteria by which a clinician or medical professional can force a person to be hospitalized: Imminent threat to self (suicidality), imminent threat to others (serious harm or homicidal), or being medically compromised in a manner that impairs a person’s ability to make choices for themselves and which creates opportunity for serious harm or death. Other than that, it is not possible to hospitalize a person against their will. For those of us abusing our minds and bodies with drugs and alcohol…I am very sorry, but in a big way my field has lied to you. In our quest to be seen as a more respected science (mental health) we have thrown the proverbial baby out with the bathwater (one of the many things I dislike about getting older is that using these old expressions cause young people to stare at me like the kids from South Park). I’m referring to “dual diagnosis treatment.” With some notable exceptions (psychosis and other severe forms of mental illness), it makes no sense whatsoever to start mental health work until a person has a reasonable foundation in recovery from addiction. If we’re dealing with today in a way that is destructive then it flies in the face of common sense to even look at the past. This is the most important distinction between substance abuse COUNSELING and mental health THERAPY – counseling is about today forward. Therapy is largely about exploring how the past impacts the present. There are exceptions to the rule. Trauma survivors are often amongst them. Judy was a notable exception. She explained herself to me so well. She simply said, “Every time I get sober, I remember and every time I remember (her past abuse) I get drunk.” Developing a manageable life without drugs and alcohol was something a good

substance abuse counselor could do for her. Judy needed to understand how to cope with flashbacks and develop a sense of personal safety in order to maintain sobriety. There’s an old adage about how if the only tool you have is a hammer, everything looks like a nail. If the only way we know to deal with overwhelming emotions is to abuse substances, then we must add some tools to our tool box because coping with substances always creates a downward spiral. Starting any recovery process requires a solid foundation in exactly the same way that houses need solid foundations You can build something beautiful – but it has to be solid and built to last.

Jim LaPierre LCSW CCS is a Recovery Ally, mental health therapist and addictions counselor. He specializes in assisting people in recovery (whether from drugs, alcohol, trauma, depression, anxiety, or past abuse) overcome obstacles and improve their quality of life. Read his blog at




Perspective | Saturday, May 12, 2012 | 

UMaine nursing

students take the classroom into the

real world


tudents from all disciplines are expected to take their classroom lessons into the real world — but none more so than nursing students. That’s why prospective nurses choose the University of Maine’s School of Nursing. In fact, UMaine has a trifecta effect that is setting its nursing program apart. Educators with real world experience, a supportive environment where nursing students learn to lean on each other for support, and the opportunity to learn in real-world settings all contribute to UMaine’s successful program.

Hands-on learning prepares Army nurse According to Spencer Pelkey, a fourth-year nursing student and Army ROTC cadet, the School of Nursing has prepared him for military service as an Army nurse. A Stearns High School graduate, Pelkey already had a full scholarship that he earned as high school valedictorian. He intended to enter UM as a pre-med student. “Three-quarters of the way through the semester, it clicked that doctors don’t work a lot with patients,” he said. “I really liked the compassion and time with patients that nurses got.” He changed his concentration to focus on nursing and now wants to go into ICU nursing in the Army. An internship in Hawaii gave him experience the day-today workings of the ICU nurse. His training at UMaine will help him attain that goal. “We got to know all the professors very well. They were willing to take the time to work with us individually,” he said. Pelkey’s partnerships spanned various specialties. He had a partnership with St. Joseph Hospital and did some training at Eastern Maine Medical Center as well as at Acadia Hospital. He especially liked his experience with Acadia Hospital. The training ground of real-life settings was imperative. “You can read books for 20 hours a day, but when you’re dealing with real patients, it’s freaky at first because you’re really dealing with a person,” Pelkey said.

BDN Photo by Debra Bell

Spencer Pelkey will graduate from the University of Maine School of Nursing this month. Also an Army ROTC cadet, he was commissioned an Army second lieutenant on May 4. He wants to become an ICU nurse in the Army.

Non-traditional student finds new career path in nursing For Chrissy MacDonald, a nurse from Manchester, giving birth to her daughter sparked a desire to go into nursing. MacDonald, a 1990 UMaine business administration graduate, used her UMaine training to succeed in nursing. When her daughter was born in 2004, she decided to spend some time at home and later made a “complete career change” by returning to college and earning a nursing degree. “Nursing is not for the light of heart,” MacDonald said. “The care that people gave me [at the hospital] and the fact that they actually paid attention to my needs was what I really liked. I knew I wanted to work with people, like when I saw when my daughter was born.” Having a four-year degree was an advantage when she returned to UMaine. “The nursing program at UMaine is tough,” she said. “But it’s tough for a reason: [Nursing] is a highly skilled profession and is stressful. But you get used to what you’ll see when you [enter the workforce].” MacDonald did her first clinical at St. Joseph Hospital and gained practical experience at Eastern Maine Medical Center and St. Joseph Healthcare. But the medical/surgical rotation at Inland Hospital really caught her attention; today she’s a nurse in that department. The combination of her advisor’s guidance, the assistance of a peer mentor, and guidance from teachers within the school allowed her to finish a degree in nursing and find a job quickly. “They can give you a solid foundation, but you have to build the apartment building,” she said.

BDN Photo by Debra Bell

After graduating from the University of Maine School of Nursing in 2011, Courtney Wright took a position as a cardiac nurse at Eastern Maine Medical Center in Bangor.

Cardiac nurse credits UMAINE School of Nursing with success Courtney Wright, an Ellsworth native and 2011 UM nursing graduate, said that her position as a cardiac nurse at EMMC is entirely due to the skills she developed at UMaine. “My job at EMMC is due to the School of Nursing,” Wright said. “They set me up with a partnership that turned into a job offer. It was a huge relief to be offered the position the Monday before graduation. I had to pass my boards first, but now here I am.” She first got a taste for the healthcare field through her interest in a high school anatomy and physiology class. She credits that Ellsworth High School class for sparking her interest in health and the human body. “I considered being a [physician’s assistant], but then decided I wanted to practice patient care. I was always interested in people and what I could do to make a difference,” she said. Wright knew she wanted to stay close to home for college, and she earned a full academic scholarship to a Maine school of her choice. “I had a lot of friends who went to UMaine, and they have a high pass rate for the NCLEX [the nursing board test],” she said. “I also liked the one-on-one with the instructors. When I visited campus, I knew it was right.” Her first clinical was in the cardiac unit at EMMC. “I loved cardiac from the start,” Wright said. “My teacher had a huge impact on me. She really prepared me for progressing by having high expectations and setting the bar high.” Wright developed partnership opportunities that would make her competitive for jobs. “They were very helpful in steering my partnership experience,” she said. “My partnership was a huge opportunity to take on a full patient-care assessment.

BDN Photo by Debra Bell

Almost 15 years after she graduated from the University of Maine with a business administration degree, Chrissy MacDonald returned to UMaine and earned her nursing degree in 2011. She now works at Inland Hospital in Waterville.

“I take care of five patients now, and because of the one-on-one nursing time with my instructors, the 192 hours you put in allows you to get used to working 12-hour shifts and balancing your life outside of work,” she said. All UMaine nursing students are required to complete a 192-hour final practicum. Wright said that because the instructors at the School of Nursing are still working themselves, they’re in tune with the needs and challenges students will face. “UMaine is just a small gem.” she said. “The education they get there really prepares [a nurse] for the workforce and helps them make the transition. They still take pride in their students even after they’re out [in the workforce].”

 | Saturday, May 12, 2012 | Perspective


Skilled emergency physicians at


Calais hospital are involved in the community


partnership between Calais Regional Hospital and BlueWater Emergency Partners has paid extensive dividends for patients visiting the hospital’s Emergency Department. Last year, the hospital and BlueWater established a partnership to staff the CRH Emergency Department with skilled emergency physicians. “BlueWater committed to joining the CRH family in its efforts to promote the Emergency Department’s continued growth and development,” said CRH Chief Executive Officer Michael Lally. “Their commitment and understanding of our quality measurements was a great strength,” he said. The Brunswick-based BlueWater Emergency Partners staffs emergency departments at CRH and at Mid Coast Hospital in Brunswick. “We’re a private group of emergency physicians,” said Dr. Guy Nuki, MD, the BlueWater regional medical director. “We bring quality emergency-department staffing and quality emergencydepartment management to hospitals in Maine.” The company’s physicians are residency-trained and board-certified in emergency medicine or are boardcertified in primary care and have at least five years’ full-time experience in emergency medicine. According to Nuki, the BlueWater staff includes eight physician partners, three full-time physicians, and several physician assistants and nurse practitioners. The physicians forming the core providers for the CRH Emergency Department are Nuki and: • Michael Bell, M.D.; • Cressey Brazier, M.D.; • Walter Doerfler, M.D., the Emergency Department medical director. These four physicians will staff the Emergency Department 28 days a month; other BlueWater physicians will staff the CRH Emergency Department the remaining days.

No matter who is on duty, patients will be seen by an emergency physician or an advanced practice provider fully dedicated to patient care. “The Emergency Department is more than just its four walls,” Nuki explained. “For our physicians, it’s not just their education and credentials: Their approach to their jobs and careers is based on knowing they’re part of a team that’s centered around the patient.” According to CRH Chief Nursing Officer Cheryl Zwingman-Bagley, RN, “when we worked with the previous company” that staffed the Emergency Department, “we had a number of physicians … who were irregularly scheduled” and did not have “that commitment to the Calais Regional Emergency Department as an entity. “We knew that wasn’t what we wanted for our patients,” she said. “Emergency physicians have to take into account not only what happens in the hospital, but in the community,” Nuki said. “Health care is not just when you get sick.” He cited “wearing a seat belt” or donning “a bike helmet” as steps that people can take to “care for themselves.” “We will be involved in the community,” with BlueWater emergency physicians speaking at “health education classes held locally” and “working with local Emergency Medical Services teams,” he said. Other positive changes are occurring in the CRH Emergency Department. When Mark Nischwitz was the department’s interim nurse director last spring and summer, he and hospital personnel held multiple meetings to improve and streamline patient care in the Emergency Department. “We knew that we needed to do things differently,” Zwingman-Bagley said. A multidisciplinary team drawn from the Emergency Department, Inpatient Care, the Laboratory, Radiology, and Registration recommended specific steps to reduce the time needed to treat a patient. “Bedside [patient] registration was an important change,” Nuki said. “The goal is to get the patient to see a medical provider as soon as possible,” he said. The Emergency Department has significantly reduced its “door-todoc” time from 60 minutes last June to 20 minutes in

December. This means that a patient entering the Emergency Department will typically be seen by a medical provider in 20 minutes. “People come to the Emergency Department to see a [medical] provider,” Nuki said. “The shorter the time it takes to do that is better care. “These times are very good,” he said. “The national standard is 30 minutes for door-to-doc time.” For a stroke patient, the average time from arrival at CRH to having a CT scan is now 10 minutes, 60 percent sooner than the nationally recommended 25 minutes. “This is an excellent time,” Zwingman-Bagley said. Another positive change has involved creating standardized patient treatment plans. In the past, Emergency Department physicians often prescribed different treatment plans for patients suffering BDN Photo by Brian Swartz from similar ailments, according to Whitney Hayward, RN, enters a patient's information into an Emergency Zwingman-Bagley. “We felt disjointed; we Department computer at Calais Regional Hospital. had to adapt to each doctor’s prescription. They weren’t standardized,” she said. start our [patient-care] system when EMS picks up the In the past several months, the CRH Emergency patient” for transportation to Calais Regional Hospital, Department has standardized its patient treatment Nuki pointed out. By the time the patient arrives at care. “We’re setting up guidelines and protocols for the Emergency Department, the hospital staff “is ready different medical issues,” including heart attack, to start treating the patient immediately,” he said. pneumonia, sepsis, and stroke, Nuki said. Another positive change has involved Emergency With such guidelines in place, “we provide Department staffing. Past experience indicates that consistency in evidence-based quality care,” he said. certain days — Mondays, for example — and certain Explaining the standardized patient care in a layman’s times of day — 10 a.m. to 10 p.m. — are the busiest terms, Nuki said that “emergency medicine is a periods “in the ED,” Zwingman-Bagley said. “We have team sport” that requires “a playbook with specific added coverage to meet the increased demand.” guidelines” for all hospital departments and personnel A BlueWater Emergency Partners physician is on duty involved in emergency medical care. No doubt exists as 24 hours a day. To support the doctor and respond to to how a patient with a specific medical condition will higher demand for Emergency Department services, be treated; the published guidelines and protocols are Calais Regional Hospital has created additional shifts located in the Emergency Department and elsewhere and staffed these with nurses trained in emergency care. in the hospital, and CRH staffers adhere to them. All the changes made recently in the Emergency “Everybody knows the timelines” for Department are noticeable inside and outside patient care, Zwingman-Bagley said. Calais Regional Hospital. “We’re all a lot happier Physicians from BlueWater Emergency Partners now,” Zwingman-Bagley said. “Internally our trained CRH staff in the new guidelines and work environment is a lot more positive … there protocols. “I’ve been amazed at coming to this is a lot of dialoging and discussion going on.” hospital and seeing such a strong desire among “We’ve had several stories of people in the the staff for quality improvements,” Nuki said. community commenting on the changes they’ve With guidelines and protocols in place, “we can noticed and how much they like it,” Nuki said.

BDN Photo by Brian Swartz

Dr. Guy Nuki is the regional medical director for the Brunswick-based BlueWater Emergency Partners, which recently contracted with Calais Regional Hospital to staff the hospital’s Emergency Department with skilled emergency physicians.


Perspective | Saturday, May 12, 2012 | 


Husson School of Pharmacy offers the


right prescription for an education


hink being a pharmacist is “just counting pills”? Think again, because today’s pharmacist is an advisor and a caregiver who helps patients learn about the medicine they are taking. In addition, students in Husson University’s School of Pharmacy know that they are entrusted with a sacred oath: To be a steward of the community while also keeping people healthy. The Husson School of Pharmacy, set to welcome its fourth class in the fall, is considered a professional-level school. While Husson’s program is currently in candidate stage, in one more year the school will qualify for full accreditation when the first pharmacy class graduates.

“We generally get

interest from over 400 qualified candidates for 65 seats per class. We’re one of the smallest schools of pharmacy in the country, but [Husson] boasts one of the lowest private tuition costs.”



The school is not easy to get into. According to Kristen Card, the director of graduate admissions, Husson’s pharmacy school is highly competitive. It is one of only two pharmacy schools in Maine. “We generally get interest from over 400 qualified candidates for 65 seats per class,” Card said. “We’re one of the smallest schools of pharmacy in the country, but [Husson] boasts one of the lowest private tuition costs.” Applicants come from across the country, Card said, and each participates in an on-site interview with faculty and current students. Applicants need a minimum of two years worth of pre-pharmacy collegiate preparation before they can be admitted into our four-year professional program, with many having completed additional coursework prior to being accepted. “Husson has the closeness of a college and the

breadth of a university,” Card said. Students benefit from a faculty that is both experienced and still invested in teaching and research. “We provide students with many of the resources you’d find at a large university, but in an environment where a student gets to know the faculty and staff,” Card said. A benefit to the small class size, she said, is that students get the opportunity to work and learn alongside quality faculty members, such as Aaron Domina, Ph.D. and Archana Jhawar, Pharm.D. Both are highly educated in their fields and chose to work for Husson’s School of Pharmacy. Each believes that the small class sizes are beneficial to students. “You can do a lot more with a small class than a large one,” Dr. Domina said. For instance, he teaches a class about HIV-AIDS. “You’re able to get in-depth about biology discussions about treatments as well as social implications. That’s a really intriguing part of pharmacy, as well as the relationship to how patients are treated,” he said. Teaching students how to handle those relationships as well as medical relationships means that pharmacy schools like Husson’s need to have high standards. “Pharmacy schools are the gatekeepers to one of the most trusted of the professions,” Domina said. “That’s why we need to have high standards.” Standards are also included when it comes to research. First and second year pharmacy students — P1s and P2s — don’t usually get to participate in staff research, he said. However, once students become P3s and P4s, they’re not only working in the field under the guidance of pharmacy professionals, but they’re helping faculty members. “For those students who have a research interest, a few can participate in meaningful research and get another perspective in the field,” Domina said. “That additional level of interaction is one thing that a small pharmacy school [can provide]. We also get to know our students pretty well.” Dr. Jhawar echoes that belief. While she works with P3s, she also supervises clinical experiences at the Acadia Hospital in the field of psychopharmacology. Husson caught her attention when she interviewed there, and it felt like a discussion, not an interview. “The students here are wonderful and very bright and very inquisitive,” Jhawar said. “I’m not lecturing to the masses. Instead I know the first name, last name, as well as the names of spouses and children of the students here. It makes this job a joy.” Husson pharmacy professors, she said, have an opendoor policy. This benefits students and professors alike. “We have a very close relationship with the students,” she said. “I like that and the easy access they have to stop in, or I can easily call them in here too.”

Pharmacy student perspectives For student pharmacist Shawn Rich (’14), choosing Husson was a no brainer. Rich, a graduate of Hampden Academy and Husson University, also served in the Army Reserve. He chose to attain a degree in pharmacy from Husson to build on his love of working with people. “Community pharmacists are the front line of where healthcare is,” Rich said. “It can be trying, but we’re advisors and provide comfort. I like the sense of community and family.” Carmel resident Lindsay Ulman, also a P2, echoes that feeling. Ulman had experience working with healthcare because her mother has diabetes. But she also enjoyed the customer relationship she developed as a bank teller. “I wanted the personal touch,” Ulman said. Her cousin, a local pharmacist, encouraged her to look to the medical field for a rewarding career. “I really enjoyed my time here as a business major,” Ulman said. “I like the small school feel. It’s a small school; I come from a small town, so it’s a good fit.” Students experience many facets of the pharmacy profession. “A lot of our lectures teach technical terms,” Ulman said. “Then we go to practice labs and learn how to talk to patients about those same terms. You really have to know who you’re speaking with: technical with doctors and user-friendly when talking with patients.” Etna resident Kelsie Anderson, a P1 student, became interested in the medical field when she was in high school. Having had first-hand experience translating medical terminology into everyday English for friends and family with health issues, she knew she wanted to work in a profession that would allow her to make a difference. In addition, Anderson knew some P3s and their experiences with Husson. “Before I got [into the pharmacy program], I thought classes were easy and you

Optimizing drug therapy. It’s what I will be doing for my patients.

didn’t have to study much. Now, that’s not an option. There’s more group work, but it also helps to have [other] students available to collaborate with. I’m learning a lot more,” she said. Some collaboration comes from the university asking for input from its students. “Because this program is new, we have the opportunity to shape the school,” Ulman said. “We recently made recommendations for course changes, and they made the changes quickly.” Students are also encouraged to give back to the community through various research opportunities and outreach events hosted by the School of Pharmacy. “Part of being a pharmacist is being expected to give back,” Rich said. “On a student level, community outreach helps us practice our craft and give back at the same time. It also helps us find our niche.” For more information, visit BDN Photo by Debra Bell

With the guidance of experienced faculty members, students enrolled in the Husson University School of Pharmacy learn about the many aspects of pharmacology.

School of Pharmacy > Jerinda Watson

Learn more about Husson University’s PharmD program at

If you’re interested in a career in pharmacy and have the drive and determination to advance your career, Husson University is where your future begins. Top-notch faculty and facilities that promote hands-on learning are just two reasons why. Discover many more, including everything that will make U & Husson such an unbeatable team at














 | Saturday, May 12, 2012 | Perspective


Bar Harbor Trust Services

non-profits with planned giving



BY brian swartz, CUSTOM PUBLICATIONS editor

ar Harbor Trust Services helps Maine non-profits attract planned gifts. “Fundraising is becoming critical for nonprofit organizations,” said Joe Pratt, Managing Director and Trust Officer at Bar Harbor Trust Services. “The tough economy has made it even more important for charities to find new ways to attract donor support. Most donors know they can ‘write a check’ to support their favorite charity, but many donors are unfamiliar with planned gifts.

“Planned gifts

include charitable bequests, charitable trusts, pooled income funds, charitable gift annuities, and several other gift options.”

is a written agreement between a donor and a charity, where the charity agrees to pay the donor a lifetime income in exchange for the gift.” Typically, a donor gives the charity cash or investment securities. The charity invests the funds and makes annuity payments to the donor. Upon the donor’s death, the charity is free to use the remaining principal for its charitable purposes. Internal Revenue Service rules “assume [that] 50 percent of the original gift will be left when the donor dies,” Pratt said. “Nationally, though, the amount left for charity has averaged around 70 percent.” According to Pratt, the donor is also eligible for a charitable income-tax deduction. “As a rule of thumb, the donor will get a tax deduction of about 25 to 33 percent of the value of the gift,” he said. “This has the effect of increasing the rate the donor receives.

with Bar Harbor Trust Services have received planned gifts that range from $10,000 to more than $1 million in value. “These are gifts that would not have happened without the charity’s decision to offer additional planned gift options to their donors,” he said. “We know the charities need the financial support, and we know their donors have a desire to give,” said Pratt. “What we do is bring both sides together by finding a planned gift

arrangement that fits their respective needs and circumstances. “As donors become more familiar with planned giving, it is less a question of if they will give and more a question of which charity will they support,” Pratt said. “As charities recognize the importance of planned giving, we’re getting more calls about our services. “We enjoy working with so many worthy organizations and the donors who support them,” he said.

“...we have partnered with 24 Maine nonprofits and helped them facilitate dozens of individual gifts...”




“Planned gifts include charitable bequests, charitable trusts, pooled income funds, charitable gift annuities, and several other gift options,” said Pratt. “Donors are generally unfamiliar with planned gift options, and many non-profits don’t have the infrastructure to attract or accept such gifts,” he said. “This limits the options that charities offer their donors and prevents them from receiving what could be substantial gifts. “We work with charities and help them become more familiar with planned giving and then help them put in place the mechanisms necessary to accept these gifts,” Pratt said. During the last 12 years, Bar Harbor Trust Services “has developed a comprehensive planned giving service. We educate non-profit boards, staff, volunteers and donors about planned gifts,” Pratt explained. “We help the charity decide which planned gift options to offer to their donors,” he said. “We then help them integrate planned giving into their existing fundraising efforts. “Charitable gift annuities are very popular with donors, in part because the rates are so attractive,” Pratt said. “A charitable gift annuity


“The number of Maine non-profits that are establishing planned giving programs is increasing,” Pratt said. “In 2001, we had no planned gift clients and zero planned gift dollars. “Since then we have partnered with 24 Maine non-profits and helped them facilitate dozens of individual gifts with a [combined] value of more than $8 million,” he said. Bar Harbor Trust Services works with charities that range “from quite small to very large in size,” he said. Maine Coast Healthcare Foundation in Ellsworth is an example. “Three years ago,” Pratt said, “we met with the MCHF staff and board to discuss whether they should offer charitable gift annuities to their donors. The board voted to do so,” Pratt recalled. “The donor response has been positive,” Pratt said. “In the past three years their donors have made gifts of about $200,000. We feel it has been a successful partnership [with MCHF]. We enjoy working with their development staff, board, and donors.” According to Pratt, the charities that have partnered

BDN Photo by David M. Fitzpatrick

Among the Maine non-profits with which Bar Harbor Trust Services has worked is the Maine Coast Healthcare Foundation, which raises funds to support the Maine Coast Memorial Hospital in Ellsworth.

Proton-beam therapy is new


weapon in fight against prostate cancer

BY Robert Langreth, Bloomberg

magine a prostate cancer therapy that has almost no side effects. Hospitals say it exists, and they’re vying to be among the first to offer it. Too bad the treatment may not work as well as advertised and could boost America’s already spiraling health-care costs. The technology uses narrowly focused proton beams to deliver precisely targeted blasts of radiation. The particle beams are delivered by 500-ton machines in facilities that cost from $100 million to $200 million, and can require a football- field sized building to house. A typical treatment costs about $50,000, twice as much as traditional radiation therapy though it is usually covered by Medicare or private insurance.

“Proton-beam therapy

is like the death star of American medical technology; nothing so big and complicated has ever been confronted by the system,”



For U.S. taxpayers and employers facing spiraling healthcare costs, that’s a worry. “Proton-beam therapy is like the death star of American medical technology; nothing so big and complicated has ever been confronted by the system,” said Amitabh Chandra, a health economist at Harvard University’s John

F. Kennedy School of Government. “It’s a metaphor for all the problems we have in American medicine.” Yet even though the machines are breathtakingly expensive, hospitals and for-profit clinics are in a race to build proton- beam facilities for their prestige, perceived benefits, and potential revenue. One machine can generate as much as $50 million in annual revenue, and new facilities are sprouting up around the country. “It’s like a nuclear arms race now, everyone wants one,” said Anthony Zietman, a radiation oncologist at Boston’s Massachusetts General Hospital, which has had a protonbeam accelerator since 2001. Proponents of the technology say it can zap cancerous tumors without damage to surrounding tissue. That’s a major benefit for the relatively small number of people who suffer from tumors of the spine, brain and eyes, where stray radiation may blind or paralyze, or in children who are more sensitive to radiation. The therapy has even wider appeal for treating prostate cancer, a much more common disease, since existing treatment often causes rectal bleeding as well as impotence. More than 240,000 American men were diagnosed with prostate cancer in 2011, making it the nation’s most-diagnosed tumor, according to the American Cancer Society. Most of those men are potential candidates for proton-beam therapy. “The easiest group to market to in the country is a group of men worrying about the functioning of their penis,” said Paul Levy, former head of Beth Israel Deaconess Medical Center in Boston. The problem is that despite the push to build protonbeam facilities and the groundswell of enthusiasm for the treatments, it remains unclear whether the therapy does a better job of shrinking tumors or avoiding side

effects than the far less costly traditional therapy. Clinical trials haven’t yet provided a clear picture proving the treatment’s worth for common tumors such as prostate cancer. Lower rates of impotence, for one, are unlikely from the use of proton therapy because proton and traditional treatments deliver high doses of radiation to the nerves to the penis, Zietman said. So whether the pricey treatments will do a better job managing prostate cancer while also preserving sexual function is an open question. Proton-beam therapy and traditional X-rays are equally effective at killing tumor cells. The debate is over side effects. Proton-beam therapy works by shooting intense, narrow beams into targeted areas of the body. Protons slow down as they travel deep in the body. Doctors can manipulate the speed of the atomic particles, allowing them to deposit most of their radiation as they come to a stop inside a tumor. X-rays used in conventional radiation therapy are made up of photon beams that zip through a patient, exposing tissues along the way to excess radiation. While modern machines use multiple beams sculpted to intersect and concentrate high doses on a tumor, lower doses are spread over a much larger region. The proton technology isn’t new, but only in recent years has it caught on. Loma Linda University Medical Center in Loma Linda, California, built the nation’s first hospital proton-beam accelerator in 1990, but the treatment became more viable after the American Medical Association granted proton therapy an insurance billing code in 2000, making reimbursement easier, said Allan Thornton, a radiation oncologist at Hampton University’s proton-beam center, which opened in August 2010. “That brought proton therapy out of the closet,” he said.

So far, 35,000 Americans have gotten proton-beam treatment and reimbursement payments from Medicare and insurance companies amount to only a small fraction of that paid out for traditional radiation therapy. In 2010, the most recent year for which figures are available, Medicare spent $41.8 million on outpatient proton- therapy treatments, versus $1.06 billion for standard external- beam radiation. The amount so far reimbursed for proton-beam therapy is small because most of the 10 existing facilities have been open only a short while. Another 10 facilities are slated to open within the next few years, according to Leonard Arzt, executive director of the National Association for Proton Therapy based in Silver Spring, Maryland. Dozens more hospitals and medical centers have expressed an interest in developing their own protonbeam facilities. The bottom line for proton centers, said Sean Tunis, chief executive officer of the Center for Medical Technology Policy, and a former Medicare official, is that hospitals can afford to build them because they are “extremely favorably reimbursed” by Medicare and many private payers. “The finances are favorable to put in a lot of these centers and treat a lot of prostate cancer even though there is no evidence prostate cancer is treated better with it,” he said. A report on proton therapy done by the U.S. Agency for Healthcare Research and Quality in 2009 suggests the benefits aren’t clear. After studying 243 published articles on the therapy, the group said it found only a handful that compared proton therapy to the standard treatment, and that “no trial reported significant differences in overall or cancer-specific survival or in total serious adverse events.”

Perspective | Saturday, May 12, 2012 | 



Health care symposium at

Saint Joseph’s College to draw national experts

BY Alana Conn and Charmaine Daniels


ore than 20 of the nation’s preeminent health care experts will invigorate the Saint Joseph’s College’s Fifth Annual Health Care Symposium in July. The program, titled “Health Care’s Future: Realizing the Promise” in celebration of the college’s Centennial anniversary, will cover topics ranging from health-care reform and ethics to traumatic brain injuries and breast care. The symposium is designed for anyone in a supervisory position in health care, including administrators, nurses, and technician. Attendees can opt to stay for any or all of the days during the July 23-27 sessions. In the end, participants will have acquired the knowledge necessary to face any obstacle in the constantly changing health-care field. “The goal,” says symposium coordinator Larry Messner, is “to educate and update health-care leaders regarding the current health-care climate. We want to prepare them for the changes that will affect their organizations in the future.” He is a faculty member for the Saint Joseph’s online undergraduate and graduate health administration programs. Well-known leaders presenting at the program include keynote speaker Sr. Carol Keehan, president and CEO of the Catholic Health Association; Dr. Merrill Matthews, director of the Council for Affordable Health Insurance; and Steven Chies, senior vice president for operations at the Benedictine Health System. Anne Logan, a North Carolina-based nurse who attended the symposium in 2010, says access to national experts is a highlight of the program. “My favorite part is networking and learning from instructors and guest speakers… In 2010, I had the opportunity to have a case study published in [past speaker] Diana Crowell’s textbook,” Logan said. In addition to general sessions, the symposium will offer tracks focused on specific industries for the first time, including radiologic technology, long-term care administration and interdisciplinary leadership.

Health-care leaders prepare for the challenges and reforms that await the industry. The sessions themselves — both general and specific — span a wide range of subject areas. Twila Weiszbrod, director of the college’s health administration program, describes these subjects as a “mosaic of topics” designed to give attendees “a lot of information in a short period of time.” That format allows attendees to meet degree or employment requirements quickly, she explains.

Microscope Hemera/Thinkstock

General Session Schedule ■■ Monday, July 23 ■■ Health Reform: What It Means Now and Into the Future for Our Country ■■ Tuesday, July 24 ■■ The Ethics of Health Care Reform ■■ Wednesday, July 25 ■■ Preventing Hospital Readmissions…It Takes a Team! ■■ Thursday, July 26 ■■ Health Industry Integration and Physician Readiness for the New Health Care Environment ■■ Friday, July 27 ■■ Simplifying Change in a Complex Health Care Environment ■■ Hospital Efficiency: The Key to Health Reform Survival

Breakout Session Schedule ■■ Monday, July 23 ■■ What Every Clinician and Health Care Professional Needs to Know About Destructive/Exploitive Cults ■■ Innovations in Eldercare: Promising Approaches to Age-Old Challenges ■■ Integrating Mission: The Heart of Who We Are and What We Do ■■ Tuesday, July 24 ■■ Breast Care 101 ■■ From Administrator to Resident: Perspective from the Other Side ■■ Transformational Leadership and the Culture of Quality ■■ Wednesday, July 25 ■■ Quality Control in the Age of Digital Imaging ■■ Health Care Reform and the Future for Long-term Care Providers ■■ Health Care for the Homeless: 101 ■■ Thursday, July 26 ■■ Concussions 101: The Science Behind Mild Traumatic Brain Injury ■■ Shaping New Leaders for a New Era ■■ Shared Decision Making: More Than Just the Right Thing To Do



Registrations are being accepted through July 16. To register or for more details, please, visit www. To register by phone, call: 207-893-7841 or 800-752-4723.

Saint Joseph’s College offers


new online graduate program in accountancy

s Saint Joseph’s College celebrates its Centennial this year, the first graduates of its online Master of Accountancy program will walk across the graduation stage this May. Online business programs director Nancy Kristiansen says the program, launched in August 2010, was conceived in response to new requirements that have been established nationally for Certified Public Accountant (CPA) state licensure. “We knew that aspiring CPAs would have to meet new state licensure requirements,” says Kristiansen. “We wanted to help students accomplish that, plus we already had an online Master of Business Administration degree. It was a good fit.” Kristiansen’s plan was to offer a program catered to accountants and accountants-to-be, including those who had already passed the CPA exam and those who hadn’t. With courses devoted to taxation, audits, and financial reporting, that’s exactly what she did. “The program’s designed to prepare students to work as accountants, primarily CPAs,” says Kristiansen. Yet she distinguishes the Saint Joseph’s MAcc as more than a “test prep program.” Though focused and technical, dialogue-intensive courses in leadership and management integrate foundational business practices into the curriculum, too. “Students aren’t working in isolation,” explains Kristiansen. “They need to know how to communicate. They need to think critically, they need to process diverse perspectives, and they need to apply this combination of skills to their work.” Joshua Wiseman serves as a good example of Kristiansen’s ideal student. A member of the first graduating class, Wiseman said that a Veterans Affairs educational advisor recommended him to Saint Joseph’s College. He enrolled in the first term offered and completed the program within 18 months. Since then, he’s used his degree for more than accounting; he now owns his own business in southern Maine. “I’ve expanded my services and consultation business, Crux Business Solutions.” says Wiseman. He credits his education at Saint Joseph’s College in part for his professional success – particularly his faculty and advisors.

“One day I was frustrated with some new material, so I called the professor, Douglas Abbott. He happened to live close by. We met for dinner, and I left laughing and feeling as though I had a usable knowledge of the formulas,” Wiseman says. When asked about his advisor, Sandy Leblanc, Wiseman describes her as “a friend with answers.” Loretta Austin Burleson, another MAcc graduate, shares his opinion of Leblanc. “I loved her,” says Burleson. “She was the best advisor. She was so understanding and supportive… She was very helpful with any concerns I had.” Burleson, a student from North Carolina, juggled being a full-time accountant, wife, and mother while earning her master’s degree. Still, she loaded up on classes and worked to graduate in as short a time as possible, which she did. After first hearing of her plans, however, one of her professors feared she might be pushing too hard. “If the professor thinks there’s any problem, they’ll contact the advisor,” says Burleson. “Everyone’s on the same page: the student, the advisor and the teacher. That’s a good thing.” Having earned her undergraduate degree through distance education, Burleson knows online learning, and she knows Saint Joseph’s support system is unique. “Saint Joseph’s College has very caring and supportive advisors and faculty members that are attentive to the students’ performance and understanding … it’s something I’ve never experienced before,” she says. Saint Joseph’s College offers more than 30 online graduate and undergraduate programs in business, criminal justice, education, health administration, nursing, and theology. Online courses are open 24/7, providing the flexibility of attending class and participating in discussion at times convenient to each student’s personal schedule. At the start of each program, we connect studentswith a personal academic advisor who acts as a coach and mentor, guiding them through their program of study to help them achieve their goals. For more information, call 800-752-4723 or 207-893-7841 or log onto

Online health-related undergraduate degrees: ■■ BS in Nursing is for registered nurses who want to increase their knowledge in evidencebased care, clinical decision making, ethical practice, population-based care, and health promotion and disease prevention. ■■ BS in Health Administration the necessary foundation and framework for growth and success as a health care administrator. ■■ BS in Long-Term Care Administration students for administrative positions in long-term care settings. ■■ BS and AS Radiologic Science Administration radiologic science professionals for supervisory and teaching positions within radiology departments and schools.

Online health-related graduate degrees: ■■ Master of Health Administration health care managers for leadership roles in organizations that deliver, regulate, or provide health care services. ■■ Master of Science in Nursing practicing nurses and others in the health-care community for leadership nursing roles in education or administration.

Accounting Hemera/Thinkstock

 | Saturday, May 12, 2012 | Perspective


Milk does a body good,

especially athletes



t the end of nearly every training session, Matt Whitmore downs a pint of milk straight from the bottle. “I do it pretty religiously,” said Whitmore, 25, a gym trainer in London. He first started drinking milk after exercise about 10 years ago when he couldn’t afford expensive supplements or protein shakes. “Milk helps me recover faster and I feel great afterwards,” he said. “And now, I hate to train without it.” Researchers are giving scientific support to a view that Whitmore vouches for from experience: that milk may be just as good or even better than sports drinks for serious athletes recovering from exercise. The health benefits of milk – which has carbohydrates, electrolytes, calcium and vitamin D – have long been established. But for athletes, milk also contains the two proteins best for rebuilding muscles: casein and whey. Muscles get damaged after an intense bout of aerobic exercise like running, playing football, or cycling. The casein and whey proteins in milk are precisely what the body needs to regenerate muscles fast. Glenys Jones, a nutritionist at Britain’s Medical Research Council, said milk’s protein content makes it an ideal post-exercise drink. “Milk provides the building blocks for what you need to build new muscles,” said Jones, who has no ties to the dairy industry. She said sports drinks mainly replace lost carbohydrates and electrolytes, and don’t usually have the necessary nutrients for

muscles to regenerate themselves. Experts have generally been divided over whether milk outperforms sports drinks. Dairy producers have been eager to break into the multibillion-dollar market, often sponsoring research into milk’s athletic benefits that some call biased. So the debate continues, but milk has been getting a lot of attention. In a study published in the journal Applied Physiology, Nutrition and Metabolism in June, researchers found people who drank milk after training were able to exercise longer in their next session than people who had sports drinks or water. “It’s the form of the carbohydrate and the nutrients in milk that is most important,” said Emma Cockburn, a lecturer in sports coaching at Northumbria University in northeast England who led the study, which was partially paid for by the dairy industry. Cockburn advised athletes to drink milk immediately after working out. “The damage caused by exercise leads to a breakdown of the protein structures in your muscles, but that doesn’t happen until 24 to 48 hours later,” she said. If athletes drink milk right after training, then by the time it is digested, the milk’s nutrients are ready to be absorbed by the muscles that have been hurt. Drinking milk also may help athletes recover quicker if they are performing multiple times in a day. For people who can’t stomach the idea of plain milk, experts recommend adding some chocolate or other artificial

flavor. At the Beijing Olympics, six-time gold medallist Michael Phelps regularly downed a flavored milk drink in between races. Scientists at Loughborough University have found low-fat milk is better than sports drinks for replacing fluids lost during exercise. Scientists suspect there may be two reasons for that. Not only does milk have a lot of electrolytes, but it is emptied from the stomach more slowly than sports drinks, keeping the body hydrated for longer. Though the vitamins and proteins found in milk are present in soy milk or dietary supplements, experts say milk has better proportions of those nutrients. Milk also may help athletes shed fat and build muscle. In a small Canadian study, experts found women who drank milk after lifting weights gained about 4.4 pounds (2 kilos) of muscle and lost about the same amount of body fat. Women who drank sports drinks put on about 3.3 pounds (1.5 kilos) of muscle but didn’t lose any body fat. “It may be that some of the components of milk – the protein, the vitamin D and the calcium – act in a synergistic fashion to promote fat loss,” said Stuart Phillips, a professor of kinesiology at McMaster University who led the research. Phillips has advised the Canadian Olympic Association about milk and the dairy industry paid for part of his research. But some experts warned that drinking milk after

exercise isn’t for everyone. Catherine Collins, a spokeswoman for the British Dietetic Association and a dietician at London’s St. George’s Trust, said while milk may be beneficial for elite athletes who burn thousands of calories a day during their intensive training, occasional gym-goers may be better off drinking sports drinks or plain water. “If you’re just a gym bunny trying to lose a bit of weight, water is probably sufficient after exercise,” she said, warning that chocolate milk in particular could add unwanted calories. At the Vancouver Olympics, dairy farmers trucked in about 85,000 extra quarts (80,000 liters) of chocolate milk. Canadian athletes won a record-setting 14 gold medals. “I don’t know if the milk helped, but it can’t have hurt,” Phillips said. Still, even those who promote milk as a recovery drink say it cannot entirely replace sports drinks. Because it is harder to digest, people should only drink milk after they are finished exercising, not during. In comparison, sports drinks like Gatorade have easily digestible sugars so athletes can chug it during events to get an instant boost. Whitmore says it may be a tough sell to persuade people to swap their sports drinks or even water, for milk. “Most gym goers have very particular routines,” he said, acknowledging he takes a bit of ribbing for his milk habit from his rugby teammates. “They call me the Milky Bar kid.”

5 tips for transitioning your loved one to a nursing home


BY Ethelle G. Lord

he time may come when long-term care placement becomes necessary for a loved one with Alzheimer’s. It was true for me. My husband lived at home for about 10 years after his bypass surgery in 1999 and subsequent diagnosis of Alzheimer’s in 2003. When he was unable to walk on his own and I was exhausted from 24/7 care for him, I found I needed to seek placement for my husband in a nursing center. Observing a few key tips can make the difference between a successful placement for memory loss or a difficult one. • Familiarize yourself with nursing home etiquette. This website offers a helpful guide, • Show gratefulness and kindness to the nursing staff by occasionally bringing in a box of candy. • Ask for what you want for your loved one (brushing teeth, special activities, etc.) • Decorate the room so it feels like home. • Identify one staff member to confide in and to share your concerns with. If your loved one appears restless and even aggressive toward others, offer to come in yourself or send another relative during the day to help. No one should live in fear or have to endure threats from a resident who is out of control and aggressive. Nursing staff provide much needed care with little

to no thanks in return. An offer of your assistance may be welcome and even prevent total refusal of services, which would leave you searching for another placement or even taking your loved one back home. It takes time for a new resident to adjust to a nursing center. It also takes time for the family to adjust. The Alzheimer’s Association offers resources on how to handle the transition. Some research shows that people with Alzheimer’s can die quickly once placed in a memory loss unit, while other research shows they can live as long, if not longer, than staying at home. With continued nursing care, a balanced diet, regular visits from caregivers and appreciation for who he or she is as an individual, a

person with Alzheimer’s can even thrive in a memory loss unit. Ask the nursing center for a copy of its Caregiver’s Partnership Agreement. If it doesn’t have one, ask its staff to consider an agreement in order to fully participate in the continued care of your loved one.

Ethelle G. Lord, former president of the Gerontological Society of Maine, runs Alzheimer’s coaching and consulting business She is married to Maj. Larry S. Potter, USAF retired, and lives in Mapleton.

Dandelion greens:

Gardeners versus cooks

BY Georgia Clark-Albert, BDN Columnist


lthough gardeners are preparing for another year’s battle with the yellowflowered dandelion weed that grows wild in their yards, cooks view its jagged-edged leaves with delight. Dandelion is a bitter-tasting green that’s packed with beta carotene (vitamin A). Dandelion greens have a little bit of a peppery flavor to them. They can be used raw in a salad, where a vinaigrette dressing might soften the green’s bitterness. They also are great braised in a liquid and served warm. Traditionally, dandelion roots and leaves were used to treat liver problems. Native Americans also boiled dandelion in water and took it to treat kidney disease, swelling, skin problems, heartburn and upset stomach. In traditional Chinese medicine, dandelion has been used to treat stomach problems, appendicitis and breast problems such as inflammation or lack of milk flow. In Europe, it was used in remedies for fever, boils, eye problems, diabetes and diarrhea. So far, there aren’t any good-quality scientific studies on dandelion. Today, the roots are mainly used as an appetite stimulant and for liver and gallbladder problems. Dandelion leaves are used as a diuretic to help the body get rid of excess fluid. The use of herbs is a time-honored approach to strengthening the body and treating disease. Herbs, however, contain components that can trigger side effects and interact with other herbs, supplements or medications. For these reasons, you should take herbs with care, under the supervision of a health care provider. Dandelion is generally considered safe. Some people may develop an allergic reaction from touching dandelion and others may develop mouth sores. If you are allergic to ragweed, chrysanthemums, marigold, chamomile, yarrow, daisies or iodine, you should avoid dandelion.

How to select dandelion greens Choose flat leaves that are crisp, upright and not wilted. Avoid greens with leaves that are wilted, yellowing or have dark green patches of slime on parts of the leaves.

How to store dandelion greens Place unwashed greens in the crisper section of the refrigerator for up to 5 days.

Nutrition benefits of dandelion greens Low in fat and sodium and free of saturated fat and cholesterol, dandelions are an excellent source of vitamins A, K and C and a good source of fiber, calcium, manganese, iron and vitamins B1, B2 and B6

All parts of the dandelion are edible Dandelion root can be roasted as a coffee-substitute or boiled and stir-fried as a cooked vegetable. Dandelion flower can be made into a wine and boiled or stir-fried as a cooked vegetable. Dandelion greens, or the leaves, can be boiled, as you would spinach, and used as a cooked vegetable in sandwiches or as a salad green with some “bite.” Consult recipes for dandelion greens for ideas.

Dandelion Greens with Chopped Onion Topped with Parmesan Cheese Serves 4 1 pound dandelion greens ½ cup chopped onion 1 clove garlic, minced 1 whole small dried hot chili pepper, seeds removed, crushed ¼ cup cooking oil Salt and pepper Parmesan cheese Discard dandelion green roots and wash greens well in salted water. Cut leaves into 2-inch pieces. Cook greens uncovered in a small amount of salted water until tender, about 10 minutes. Saute onion, garlic and chili pepper in oil. Drain greens and add to onion-garlic mixture. Taste dandelion greens and season with salt and pepper. Serve dandelion greens with grated Parmesan cheese.

Georgia Clark-Albert is a registered dietitian and adjunct nutrition instructor at Eastern Maine Community College who lives in Athens. Read more of her columns and post questions or email her at

Dandelion flowers iStockPhoto/Thinkstock



Perspective | Saturday, May 12, 2012 | 

Bariatric surgery offers

new hope

to patients with Type 2 diabetes



t took Matt Madore years to accept the idea of bariatric surgery. Like his father before him, the 30-yearold Hampden resident was overweight and developed Type 2 diabetes. More than 85 percent of the people diagnosed with the disorder are overweight. Doctors have long observed the link between obesity and Type 2 diabetes. In healthy individuals, pancreatic beta cells monitor glucose in the bloodstream and then secrete insulin to keep glucose at normal levels. The results of a recent study conducted by University of California-Santa Barbara and the Sanford-Burnham Medical Research Institute suggest that the onset of Type 2 diabetes in obese individuals arises from a malfunction in Dr. Michelle Toder of EMMC’s Surgical their pancreatic Weight Loss Program says that 90 beta cells caused percent of her patients with Type 2 by a high-fat diabetes have gone into remission diet. The fat cells following bariatric surgery. release factors that inhibit the body’s response to insulin from the pancreas. Over time, this resistance results in inadequate metabolism of carbohydrates and sugars, resulting in elevated blood sugars. Long-term complications from Type 2 diabetes can include coronary artery disease, kidney disease, stroke, high blood pressure, high cholesterol, frequent infections, and circulation problems. Madore, who was diagnosed with diabetes at age 25, even had a cautionary tale about what could result from diabetes. “My father was diagnosed in his late 30s or early 40s,” he explained. “He was a very large man and did not take care of himself. I watched him fall apart. He lost his eyesight completely in one eye and all but 20 percent in the other and had a lot of foot issues.” Madore’s father ended up having a laparoscopic adjustable gastric banding done by bariatric surgeon Dr. Michelle Toder, of Eastern Maine Medical Center’s Surgical Weight Loss Program. In such a surgery, a band is placed around the top of the stomach to create a small pouch. Food leaves the new pouch slowly, so the patient feels full longer. “My father had already done so much damage to his body that the lap band was done as a lifesaver,” Madore said. “He’s been very successful with it.” Having gotten a glimpse of his future about seven years ago, Madore went to see Toder about taking the six months of classes and counseling that preceed bariatric surgery. Patients must learn behavior modification, such as eating more nutritionally and getting more exercise, and most lose weight before surgery. Madore found out that he wasn’t a candidate for a lap band. Instead Toder suggested a Roux-en-Y gastric bypass. In such a procedure, a large portion of the stomach is closed off. This leaves a small

pouch to hold food, restricting the amount that can be eaten at one time. The small intestine is cut below the duodenum and reattached to the new stomach pouch, leaving a shortened path for food to travel through. As a result, the patient feels full sooner, and less food is absorbed, causing the body to use excess fat for energy. The patient then loses weight. Candidates for such a procedure have a body-mass index of 35 or higher, or are 50 to 60 pounds above their ideal weight. Madore wasn’t ready yet. “I was scared, and I walked away from the process,” he recalled. “And that was it for quite a few years.” After Madore was diagnosed with diabetes, his family physician, Dr. David Koffman, again brought up the idea of gastric bypass. Madore, whose weight was up around 290, opted to try to lose weight on his own. “I got down to around 267, but that wasn’t down enough,” he said. “My diabetes was getting worse. I was spending so much money on medications. I went in to see Dr. Koffman last spring said this is it. I needed help. I was lost.” Bariatric surgery has been used as a weightloss tool for 40 years, but its use as a powerful tool for diabetes management is a more recent

“I got down to

around 267, but that wasn’t down enough. My diabetes was getting worse. I was spending so much money on medications. I went in to see Dr. Koffman last spring said this is it. I needed help.”


development over the past decade. “Diabetes is a lifelong diagnosis, but it can be put into remission,” explained Toder. “Bariatric surgery is performed with five small incisions, robotics minimize pain, and recovery and complication rates are extremely low. Ninety percent of my patients are in remission by the time they hit the recovery room.” Studies back up Toder’s anecdotal observations. A study at the Cleveland Clinic, published in a March 2012 issue of the New England Journal of Medicine, compared results between Type 2 diabetes patients who had surgical intervention and behavior modification versus those who underwent behavior modification alone. After one year, 42 percent of the surgical group were off all diabetes medications, with only 4 percent still needing insulin, compared to 12 percent of the medical group, with 40 percent still on insulin. Eighty to 85 percent of the surgical group had lost their excess weight, compared to 13 percent for those using diet and exercise alone. Why this occurs is the question, one that’s actively being studied now. “No one knows why,” Toder said. “If we knew why,

Photo courtesy of Matt Madore

Walking has been Matt Madore’s chosen form of exercise.

it could be mimicked through pharmacology instead.” Madore is a shining example how bariatric surgery can be a life-changer. He’s now down to 168 pounds. His diabetes is in remission, and he’s been off the diabetes meds since before his bypass last July. Madore is a music teacher in Waterville who also coaches football and softball and directs show choir. With an hour-long commute each way, it’s 12 to 14 hours a day between the time he leaves home and returns. His new sense of well-being helps. “I feel like a completely different person,” he said. “I never felt full before the surgery, so that’s been the biggest change. Also my energy level is huge. I can’t sit still. My brain is racing because of what my body can do now.” Both Madore and Toder cautioned that the surgery alone is not a miracle cure. Lifestyle changes have to be part of the formula as well. For Madore, this has meant eating proteins first, shooting for 40 to 70 grams a day, supplemented by fresh produce. And walking. Lots of walking, up to 15 miles a day. Gone from his diet in high-fat and sugary foods, carbonated beverages and alcohols. He takes many vitamins in order to counter the malabsorption that can happen with gastric bypass. “The surgery didn’t take the weight off for me,” he said. “To put myself through what I did, I couldn’t make any other choice than to work hard.” Perception might be the biggest obstacle that bariatric-surgery patients may face.

Madore remembers the response he got after returning to school: “Before I said anything [about his surgery], the first person I saw said, ‘Well, at least you didn’t cheat and have surgery.’ Because of that response, I had chosen not to share about my surgery in my workplace, which is something I should have celebrated.” Such an uninformed attitude infuriates Toder. “You wouldn’t tell a cardiac patient to skip surgery and fix their condition through diet and exercise alone,” she said. “Yet those with an eating disorder should suffer and struggle and live with the consequences of that disorder rather than have the life-changing surgery. That’s because our society thinks it’s socially acceptable to treat obese people in a bigoted, biased way.” Madore praised those in his support system: “My wife Vanessa is amazing and has been very supportive of my nutritional choices. My parents and her parents have been so supportive. People around town [who know about the surgery] have been really supportive.” Madore has no regrets about his choice. “It’s the easiest decision to make, but the hardest work I have ever had to do in my life,” he said. “If you do this [surgery and behavior modification], your life can be this way.”

Sugar Hemera/Thinkstock Apple, tape and glucometer iStockPhoto/Thinkstock

What you need to know about gallbladder disease The gallbladder is a small organ nestled under the liver and above the pancreas. It stores and concentrates bile, a fluid that helps the body digest fat. After eating, the gallbladder goes to work contracting and releasing bile through the common bile duct and into the small intestine. Gallstones form for a variety of reasons. Cholesterol gallstones are the most common, developing when there is too much cholesterol in the bile. The liver secretes cholesterol into bile in order to eliminate excess cholesterol from the body. In order to dissolve the cholesterol secreted, the liver also secretes bile acid and lecithin into the bile. When too much cholesterol is secreted, some does not dissolve and remains trapped in the gallbladder. Eventually the leftover cholesterol collects and form stones. My gallstone was one of these, measuring about 1 centimeter by 1 centimeter by 1.3 centimeters. Pigment gallstones are the second most common type, developing when bilirubin, a chemical from hemoglobin, is removed from the blood by the liver. A modified bilirubin is secreted into bile and turns into a stone in the gallbladder. Being overweight and a woman put me at greater risk for developing gallstones. It didn’t help that I had a family history — both my parents and all of my grandparents had gallbladder surgery. Other risk factors for gallstones include age, obesity, pregnancy, rapid weight loss, and several medical conditions including sickle cell anemia

and Crohn’s disease. Some people have lots of gallstones, but in my case it was one large stone. Classic symptoms of gallbladder disease The most common symptom of gallstones is pain in the stomach area or in the upper right part of the belly, under the ribs. The pain may: ■■ develop suddenly in the center of the upper abdomen and spread to your right upper back and shoulder blade area. Moving won’t take the pain away and it’s usually difficult to get comfortable; ■■ prevent normal and deep breaths; ■■ last from 15 minutes to one day. The most common amount of time for continuous pain is between one and five hours; ■■ begin at night and may cause you to wake up; ■■ occur after meals. An underperforming or blocked gallbladder can cause additional problems. If a gallstone is blocking the common bile duct, symptoms might include fever and chills, light-colored stools, dark urine, and jaundice. Other conditions that have similar symptoms include heartburn, pain from a heart attack, liver problems, stomach flu, and food poisoning. By Debra Bell Custom Publications Writer

Weekly Photo by Dale McGarrigle

At his peak, Matt Madore of Hampden weighed close to 300 pounds.

 | Saturday, May 12, 2012 | Perspective


Radon testing standards for


apartments focus of state mandate

BY Debra Bell, custom publications writer

f you rent an apartment in Maine or if you’re a landlord take note: The state of Maine is requiring that all buildings must be tested for radon. “More people die from lung cancer caused by radon than drunk driving accidents,” said Reese Perkins, owner of Perkin’s Home Inspections in Bangor. Radon is a colorless, odorless gas that is particularly prevalent in Maine. That’s partly due to the state being relatively high in natural uranium-238. That element increases the level of radon in the air and the water.

Some fast facts about Radon ■■ According to the Environmental Protection Agency, radon is the top cause of lung cancer among non-smokers and is the second leading cause of lung cancer among all sufferers. ■■ The EPA reports that radon is responsible for 21,000 lung cancer deaths per year. Of those deaths, 2,900 occur among people who never smoked. ■■ The U.S. Surgeon General’s health advisory in 2005 stated that Indoor radon gas is the “secondleading cause of lung cancer in the United States and breathing it over prolonged periods can present a significant health risk to families all over the country. It's important to know that this threat is completely preventable. Radon can be detected with a simple test and fixed through well-established venting techniques." ■■ According to the Harvard Center for Risk Analysis, radon gas is the number one home health risk, ahead of fires, poisoning, and injuries sustained from falls.

Why are rental units being tested? According to the state of Maine, landlords are required to test their rental properties for radon by March 1, 2014. Maine law gives tenants some basic rights, including an "implied warranty of habitability." In essence, the home or apartment that a tenant occupies must be safe and fit to live in. Maine Department of Health and Human Services recognizes the danger posed by radon gas. That’s why the state now requires landlords to include this in their testing and maintenance. Landlords are required to give written notice to tenants about when radon testing will be done. If tests deem radon levels to be dangerous — above 4.0 picocuries per liter in air — the landlord has six months to lower the levels to an appropriate level. Another test is then run to ensure the levels are acceptable. After that, testing must be done every 10 years. Landlords may not conduct radon tests themselves,

Maine law stipulates. Instead, radon testing must be conducted by a testing agent that has registered with the Department of Health and Human Services. Perkins is one of those licensed and registered agents. His role is simple: be the “first responder” to determine if there is radon on the property or not. By setting up specialized tests, sometimes in tamperproof containers, he’s able to ensure that the tenants will be breathing fresh and not tainted air. Should the building come back with unacceptable levels of radon, the next step is to retain the services of a radon mitigation contractor. Perkins said he works closely with several local mitigation services, including Air and Water Quality in Ellsworth.

“The real estate

market drives the radon testing. But people are taking a big risk if they don’t test. With cancer rates in Maine being so high, between arsenic and radon there’s a lot of potential exposure. But testing is inexpensive and easy.”



“Mitigation is a problem that’s easy to fix,” Perkins said. “It’s a lot of money up front, but compared to lung cancer costs, it’s a small dollar item.” According to Ryan Haulk at Air and Water Quality in Ellsworth, radon mitigation is more than just treating the air. Because of the large amount of uranium in the bedrock in Maine, radon can also be released into air in the the home through the water supply. Air and Water Quality has been doing radon mitigation in Maine since 1989. When installing water radon systems, “a lot of times we pre-treat the water before installing the mitigation system,” Haulk said. “Radon itself comes from naturally

decaying uranium found in the ground. It’s not unusual to have elevated levels in both air and water.” Mitigation consists of increasing air flow in the building. Depending on the building, mitigation can be as simple as a pipe from the basement to the outdoors or as complex as several special mitigation machines and a network of pipes. “If someone gets an elevated test result, we’ll perform a free estimate to determine the appropriate radon mitigation system for the property,” Haulk said. Older homes often don’t have good materials under the slab or basement, Haulk said. In addition, slab homes often have more problems than homes with basements. For people selling or buying a home, both Perkins and Haulk recommended requesting a radon test just to ensure that any potential problems are resolved before the transaction is finalized. But the first step is to ensure that people are testing the home. “The real estate market drives the radon testing,” Haulk said. “But people are taking a big risk if they don’t test. With cancer rates in Maine being so high, between arsenic and radon there’s a lot of potential exposure. But testing is inexpensive and easy.” There are other financial reasons for landlords to comply with the new standards. Failure to comply with the Maine state requirements can result in a landlord being fined of up to $250 per violation. If a landlord knowingly doesn’t comply or install the appropriate mitigation system, tenants can file litigation on behalf of the individuals who have been harmed by radon exposure. Businesses operating out of rented or leased buildings should also consider testing for radon. Perkins noted that older buildings, especially should be tested.

Smoke Detector Periodic Table Hemera/Thinkstock

Perspective | Saturday, May 12, 2012 | 




Sherry Johnston of

‘The Biggest Loser’ to speak in Bangor

ANGOR, Maine – St. Joseph Healthcare’s Center for Sleep Medicine will co-sponsor a visit by Sherry Johnston, contestant in season 9 of the NBC reality series “The Biggest Loser.” Johnston will speak at 6 p.m. Wednesday, May 16, at the Hilton Garden Inn as part of an educational seminar on obstructive sleep apnea. Johnston will share her experiences using continuous positive airway pressure therapy to help her control her sleep apnea. Additional speakers at the seminar will be Ganesha Santhyadka, a pulmonologist at St. Joseph Respiratory Care, who will speak on the signs and symptoms

of obstructive sleep apnea; and Bangor dentist John Hauge, who will discuss the use of dental appliances for treating obstructive sleep apnea. Obstructive sleep apnea occurs when a person’s breathing is interrupted during sleep by a blockage in the airway. People with untreated sleep apnea stop breathing repeatedly during their sleep, which can lead to oxygen starvation, daytime drowsiness and other complications. Additional co-sponsors of this event are Philips Respironics, Coastal Med Tech Inc. and Apria Healthcare.

UNE student working with

Hawaii State


Department of Health

nursing student at the University of New England’s Westbrook College of Health Professions is part of an education team working with the Hawaii state Department of Health supporting the Million Hearts campaign, a Centers for Disease Control and Prevention project introduced last year to prevent one million heart attacks and strokes. Amy Miele is a senior in UNE’s RN-to-BSN completion program and a master blood pressure trainer. Her involvement was funded in part by the Maine Centers for Disease Control. UNE students Kaitlin Stolberg and Sharon Staples also have been educated as master blood pressure trainers and have facilitated trainings across all health professions at the university and as well as to outside clinical partners. High blood pressure is one of the leading risk factors of heart disease and stroke. In Hawaii, one in three adults has heart disease or has had a stroke. According to the American Heart Association, accurate blood pressure measurement is an exacting process that requires careful attention and periodic retraining. All types of blood pressure equipment should be regularly inspected and calibrated. “Taking a blood pressure reading is a routine procedure, yet so critical to identifying lifethreatening conditions,” Hawaii’s Health Director Loretta Fuddy said in a recent press release. “I’ve seen clinical studies show that a surprising number of health care professionals in the United States take a blood pressure incorrectly, and we wind up with unnecessary costs, inappropriate treatment and missed diagnoses. This training initiative is a perfect example of where public health can step in and make changes that will benefit thousands of our residents.”

Hawaii Sunset Hemera/Thinkstock

Patient experience ratings


listed for Maine

he Maine Health Management Coalition Foundation recently began reporting patient experience data on Maine hospitals on its website at The new Patient Experience ratings are based on the results of the widely used H-CAHP Survey, which measures patient perspectives on eight aspects of a hospital stay: ■■ Cleanliness and quietness. ■■ Communication with doctors. ■■ Communication with nurses. ■■ Getting follow-up instructions. ■■ Help from the staff. ■■ Help managing pain. ■■ Help understanding medicines. ■■ Overall hospital rating. “Patients are in the best position to judge how they are treated in our health care system, and these publicly reported measures will drive continued improvement in Maine hospitals,” said Elizabeth Mitchell,


CEO of the Maine Health Management Coalition Foundation. “Since we started publishing health care quality data eight years ago, we have seen consistent improvement in quality ratings at Maine hospitals, and the doctors and staff at our hospitals should be recognized for that improvement, however, there is still room for further improvement, and the patient perspective is an important new metric in this effort.” lists providers in two groups: hospitals and physician practices. A user enters his or her ZIP code and indicates how far they are willing to travel from home and the site then lists the number of hospitals or physician practices within the designated area. GetBetterMaine.Org is a project of the Maine Health Management Coalition Foundation, the Maine Quality Forum and Maine Quality Counts with additional funding provided by the Maine Health Access Foundation and the Robert Wood Johnson Foundation.

Older couple iStockPhoto/Thinkstock


Celebrating Older Americans Month

osscare of Bangor is proud to acknowledge that May is Older Americans Month and encourages community members to thank the older Americans in their life for their service to our communities. “During this month, we hope all community members will take the time to recognize how older adults have positively affected our communities yesterday, today, and will continue to do so in the future. At Rosscare, we believe in improving life by valuing aging and want to ensure that seniors continue to have access to quality healthcare resources,” said Amy Cotton, Eastern Maine Healthcare Systems Continuum of Care director of Operations and Senior Service Quality. The United States Administration on Aging has chosen “Never Too Old to Play” as the theme for this

year’s recognition. Through this theme, older adults are encouraged to stay engaged, active, and involved in their own lives and in their communities. Local organizations are encouraged to be creative and find different ways to host intergenerational days of play to get people together to recognize this special time. The Administration on Aging developed Older Americans Month in 1963 as a time to pay tribute to the contributions of past and current older Americans and to raise awareness of the needs of this population to live a healthy, enriching life. Rosscare is a member of EMHS. By collaborating with other agencies and organizations in the area, Rosscare is able to provide area seniors with unique opportunities that complement a healthy and fulfilling life. For information, visit Rosscare

Bangor Daily News Perspective 2012: Health  

Perspective 2012: Health edition focuses on healthcare, health-related topics, and wellness in Maine.