Mature Matters Virtual Edition January 2011 by Beson4 Media Group

free Winter Volume 7, Issue 1

Joint Replacement Treatment Options Local Couple Embarks on Sailing Sabbatical Fun with the Grandkids Fibromyalgia Innovations

On a typical Monday morning, Joseph Mignone, MD, leaves his house by 6 a.m. to check in on his hospitalized patients. After three hours of hospital rounds, he heads to his office at 21st Century Oncology in Jacksonville, where he’ll spend the remainder of the day seeing patients and their concerned families. Most evenings end with hospital and tumor board meetings, charity events, or speaking engagements for local cancer support groups. On a typical Monday morning, Joseph Mignone, MD, leaves his house by 6 a.m. to check in on his hospitalized patients. After three hours of hospital rounds, he heads to his office at 21st Century Oncology in Jacksonville, where he’ll spend the remainder of the day seeing patients and their concerned families. Most evenings end with hospital and tumor board meetings, charity events, or speaking engagements for local cancer support groups. For this busy, board-certified medical oncologist, the days are long, but he’s not complaining. “With the current rate of invention of new cancer treatments, the field of oncology is finally offering its doctors the opportunity to cure many of their patients and to drastically improve the life quality of those who cannot be cured. I keep that in mind every day,” says Dr. Mignone, “and it makes for a very satisfying work day.” Dr. Mignone, who currently serves as the peer-elected Chairman of the Department of Medicine at Memorial Hospital and is an executive board member at 21st Century Oncology, knows how precious time can be, but he is never short on time for his patients. As a former assistant professor in the Oncology Department at the University of FloridaJacksonville, he encouraged the physicians he trained to always find time for compassion. “It’s not a disease sitting in front of you…it’s a person,” he says. “It’s imperative taking the time to answer all the questions a patient may have or to pick up the phone and get that patient seen quicker for his or her tests. For

cancer patients nothing is worse than not knowing or waiting for answers. So, if we can we should spare them that emotional agony.” The impact a cancer diagnosis has on both the patient and family members can lead to feelings of stress, fear and anxiety. “Each physician in our group takes call for our own patients 24 hours a day, Monday through Friday, and our hospitalized patients will be seen by their own doctor,” says Dr. Mignone. “That way, if a patient calls, they’re assured of reaching their own physician who knows and understands their condition.” On weekends, all of the medical oncologists in the group discuss each of their patients with the physician on call so that the continuity of care is not interrupted. The same personal touch is carried throughout each phase of the diagnostic and treatment processes. The group’s physicians and staff are always available to work with patients and families to answer questions and advise them of all treatment options. Their commitment to serving patients efficiently and compassionately is the reason physicians at 21st Century Oncology offer comprehensive cancer care in a single location, where patients can be assured of access to board-certified medical oncologists and radiation oncologists, as well as highly specialized surgical oncologists all under one roof. As one of the largest dedicated cancer treatment centers in Florida, the group delivers state-of-the-art medical care with a multidisciplinary approach. “It’s possible for me to see a new patient and

come up with a treatment plan which will include an immediate consultation with the radiation oncologist in our own building. This way we can expedite the process and start the best treatments right away,” says Dr. Mignone. 21st Century Oncology physicians have access to state of the art equipment, specifically designed for cancer treatment. “We’re fortunate to have the only tomotherapy unit in Northeast Florida, which allows us to treat our patients with some of the newest technology available today,” Dr. Mignone says proudly. This new generation radiation therapy equipment uses CT imaging to target the exact location of the tumor. Tens of thousands of radiation beamlets are then delivered directly to the site, reducing damage to surrounding tissues. As the tumor shrinks in size or changes occur, the real-time imaging ensures each treatment continues to be delivered precisely to the area intended. In addition, the center offers PET/CT imaging. This technology allows physicians to view even very small cancer lesions clearly. The size, shape and location of active cancer cells can be identified, allowing for more accurate diagnoses, treatment monitoring and surgical excisions. The comprehensive cancer treatment approach used at 21st Century Oncology also extends to the surgical oncologists who work in close collaboration with the medical and radiation oncologists. Dr. Mignone is quick to tout the skills of his fellow physicians, including the surgeons in the group. “Surgical oncologists are general surgeons who have com-

Specializing In:

pleted additional fellowship training that qualifies them to perform complicated and highly specialized cancer surgeries,” says Dr. Mignone, “these include breast, gastrointestinal, liver, pancreatic, melanoma, sarcoma and head and neck cancers, as well as minimally invasive procedures.” Studies have shown that experience matters. A highly trained, specialized physician who has performed a specific procedure multiple times often boosts a higher success rate than one who does the same procedure less frequently. The entire 21st Century Oncology surgical team uses a multidisciplinary approach including close consultation with radiation and medical oncology services to develop personalized treatment plans for every patient and their specific cancer type. When chemotherapy is used in combination with other treatments, care is carefully coordinated to achieve optimal results. “It’s possible for us to administer chemotherapy to shrink a tumor before our surgeons excise it,” says Dr. Mignone. “Reducing the size of the tumor makes surgery less traumatic and can produce more satisfying results. In cases of breast cancer, for instance, this can lead to better breast conservation making surgery less disfiguring.” As a premier cancer center, 21st Century Oncology continues to look for ways to promote healing and enhance patient wellbeing. Medical oncologists at the center also participate in national and international cancer research, health education and biological therapy, a type of treatment that assists the immune system in fighting cancer. “Many of our patients are enrolled in clinical trials giving them the opportunity of using developmental cancer therapies not yet available to the general public,” says Dr. Mignone. In the future the group also plans to look beyond conventional

medicine to incorporate some alternative medicine approaches. “We’d like to combine Eastern and Western medicine methods by offering nutrition counseling and acupuncture,” he says. Statistics from the American Cancer Society indicate half of all men, and one-third of all women, will develop cancer during their lifetimes. One of the most important decisions a patient has to make is finding the best medical care available. Patients at 21st Century Oncology can be assured of receiving comprehensive cancer care under one roof, eliminating the need for multiple appointments in various locations. The staff is happy to arrange all tests and therapies, ensuring a seamless delivery of care. “We make sure we look at the patient as a whole,” says Dr. Mignone, “not just as a cancer.” The group works with all hospitals in Jacksonville and accepts most insurance plans.

To Make An Appointment Call

904.493.5190

Breast Cancer

Lung Cancer

Gastrointestinal Oncology

Prostate Cancer

Lymphomas

Head and Neck Cancers

Southside office 7751 Baymeadows Road East, Ste. 205 Baptist South office 14540 St. Augustine Rd. , Ste. 2471 Orange park office 421 Kingsley Avenue, Ste. 401 Downtown office 1235 San Marco Blvd., Ste 3 fernandina beach office 1551 South 14th St., Ste D riverside office 2726 St. Johns Ave., Ste 103

Publisher A. J. Beson

CONTENTS

Business Development Director Michael E. Hicks Editor Vanessa Wells Art Director Christine Tarantino Operations Manager Stacey Cotner Marketing Consultants Stephanie Autry Lori Robinson

Welcome to the most informative publication for you, the mature adult. Inside you will find articles on a wide variety of topics, from healthcare to living a healthy life. Overall, the purpose of this publication is to help seniors enjoy the numerous benefits of living in North Florida. Remember, this community service is for you. Please take a moment to tell us your thoughts. We want to hear from you! Visit us on Facebook and Twitter: www.facebook.com/ maturematters and www.twitter.com/maturematters. Email editor@beson4.com to sign up for our enewsletter.

Media relations manager Michelle Jacobs Media relations specialist Katie Whiteman Graphic Designer Summer R. Morris

Contributing Writers Laura Capitano Cheryl Lock Virginia J. Pillsbury Frederic H. Schilling Jon Vredenburg Photographer Keith Moody Send editorial ideas to: Beson4 Media Group 13500 Sutton Park Drive S., Suite 105 Jacksonville, FL 32224 editor@beson4.com www.beson4media.com For questions, comments, advertising options or to receive reprints, call 904-992-9945.

Mature Matters is published by Beson4 Media Group, 13500 Sutton Park Drive S. Suite 105 Jacksonville, Fl 32224. 904-992-9945. Copyright 2011. All rights reserved. Statements of fact or opinion are the responsibility of the authors alone and do not imply an opinion of the publishers or the officers or advertisers. Neither the publisher nor its affiliates warrant the accuracy of the information. The contents of this publication including articles, may not be reproduced in any form without the written permission from the publisher. 4 Mature Matters Magazine

33 8

J OI NT REPLACEMENT S URG ERY What you need to know

PRACTICING FOR RETIREMENT An 18 month sabbatical aboard a sailboat prepares one local couple for retirement

NEW KI D ON TH E CLOCK Youâ&#x20AC;&#x2122;re never too old to start fresh

S EPARATI NG FACT FROM FI CTI ON What to believe when it comes to fixed/index annuities

FUN WI TH TH E G RANDK I D S What to do and where to go can be as simple as playtime in the backyard

FI B ROMYALG I A I NNOVATI ONS Dr. Howard Groshell, Jr., DPM, frees patients from pain

I can’t remember a time when running was not my passion. My stress is relieved on the pavement; my fears are faced with every stride; for me, running is a release. Slowly, my incontinence began to interfere with my daily run. My friend told me about her urogynecologist, and how they specialize in the treatment of women’s pelvic health. As a subspecialty of Gynecology, Urogynecologists offer the most extensive knowledge and expertise in the treatment of women’s pelvic health. Today as I laced up my running shoes, I was thankful that I trusted Florida Urogynecology with my problem and excited to return to the road.

904-652-0373 I www.flurogyn.com

Robert G. Ellison Jr. M.D. FACS

904-394-LEGS (5347) www.ellisonveininstitute.com 836 Prudential Drive, Suite 1405 Jacksonville Fl 32207

For over 10 years Nurses as Needed’s goal has been to provide all necessary services ona professional level that encourage the patient’s independenceand security while living at home. If the patientis in a health care facility, our goal is to provide maxiumum support and comfort. In additon, we are committed to each patient’s recovery at the earliest and most practical time frame while ensuring safe patient care.

Services • RN, LPN, CNA, HHA, Sitter/Companion • Facility Staffing • Available 24/7 • Private Duty Home Care

NR 30211123 HCSP 584

A local stroke survivor can once again pursue his love of fishing, thanks to the newly opened Comprehensive Spasticity Management Clinic at Brooks Rehabilitation.

“Most people equate Botox with wrinkles and its cosmetic use, but most of the Botox used nowadays is for spasticity and movement disorders.”

— Kenneth Ngo, M.D.

For more information about the Brooks Comprehensive Spasticity Management Clinic, please call 904-345-7373

Rehabilitation Hospital • Home Health Care Outpatient Therapy • Skilled Nursing

BrooksRehab.org

“One of our patients had a stroke that affected his left arm,” explains Kenneth Ngo, MD, medical director for the brain injury program at Brooks Rehabilitation Hospital. “All he wanted to do was to be able to go fishing again. He could no longer hold a fishing rod, but with a little tweak with the neurotoxin, Botox, his hand was able to open again and hold the fishing rod,” he says. This is just one of the many successes the spasticity management clinic is seeing in its effort to help give back mobility and quality of life to its patients. Spasticity is a condition that often results from an upper motor neuron lesion, commonly seen in conditions including stroke, spinal cord injury, brain injury, cerebral palsy, and multiple sclerosis. “The problem typically affects the limbs and causes them to be tight. Our goal is to loosen the limbs and improve function and quality of life,” says Dr. Ngo of the first comprehensive spasticity management clinic in Jacksonville devoted to all conditions causing spasticity and movement disorders. “We provide all modes of treatment at the clinic,” explains Dr. Ngo. Those treatment options cover the overall spectrum of care from conservative management consisting of oral medications, physical and occupational therapy for casting/splinting and working on functional tasks, to using neurotoxins and implantable devices for medication delivery.

“We work very closely with our Brooks Rehabilitation physical therapists. I know the specializations of each physical therapist and they know what I want for our patients, so we can work together for the best outcomes,” explains Dr. Ngo, who thinks that the rehabilitation aspect of the clinic is what makes it unique and successful. Using neurotoxins for the treatment of spasticity is a very important component of the spasticity clinic, as it can provide excellent outcomes with very little side effects. “Most people equate Botox with wrinkles and its cosmetic use, but most of the Botox used nowadays is for spasticity and movement disorders,” explains Dr. Ngo. Another component of care offered at Brooks is the use of the intrathecal baclofen pumps to deliver medications. It is a device the size of a hockey puck that’s implanted in the belly, under the skin but outside the abdominal cavity, where there is a catheter tunneled to the spinal cord space. “This mode of medication delivery allows for use of very small doses as compared to oral, thus, producing very little side effects,” explains Dr. Ngo. Dr. Ngo finds the spasticity management clinic very rewarding because of the great outcomes. “The type of treatment and the length of treatment vary from patient to patient. Not every patient needs every mode of treatment available,” he says. “However, what makes our spasticity management clinic comprehensive is the complete spectrum of care we provide for patients,” explains Dr. Ngo. “Many patients who come to the clinic thought they had to just live with the condition and learn to adapt. Now, there are treatment options that can get movements back and offer a better quality of life.”

By Jon Vredenburg

Mark Twain stated his perspective on growing older was simply ‘mind over matter’. If you did not mind, then it did not matter. However, in the case of aging hip and knee joints that carefree perceptive is tough to embrace while dealing with ongoing pain. We decided to question some of the best minds in orthopedics to find out what really matters in joint replacement surgery.

William G. Pujadas, M.D. 8 Mature Matters Magazine

There have been great strides made in joint replacement surgery over the past thirty years. In the 1970s it was thought that most artificial joints would only last 10 years at the most. Today it is expected that the average artificial hip or knee can last twenty years or more. Hip and knee replacement surgeries are an effective means to restore functioning to joints that have been broken down by the processes of aging and other factors. Experts agree that a multidisciplinary approach to care for the treatment of knee and hip joints is essential for an improved quality of life. The prevalence of joint replacement surgery in older adults is at an all time high. The American Academy of Orthopedic Surgeons estimates that close to 800,000 hip and knee replacements are performed

nationwide each year. William G. Pujadas, M.D., a founding father of the Jacksonville Orthopaedic Institute, has observed this trend in the North Florida area. “The baby boomers are a lot more active than the previous generations,” he states. “You are seeing a lot more injuries from labor, as well as sports injuries.” Nuts and Bolts of Joints A basic understanding of both the hip joint and the knee joint is essential to better comprehend the disease process. The hip and knee joints are the largest joints in the body. The hip joint is a ‘ball and socket’ joint. The head of the femur, which is the largest bone of the body, forms a ball shape which sits in the acetabulum, or the socket. The knee joint is a complex hinge joint that allows some rotation as we bend or flex our knees.

R. David Heekin, M.D., FACS

“The leading cause [of functional loss] is osteoarthritis – the wear and tear form of arthritis that tends to accumulate with age. The reason that arthritis exists is because there is no healing process for cartilage.” - R. David Heekin, M.D., FACS

The joint surfaces are normally covered with cartilage that is several millimeters thick. Cartilage is connective tissue that provides structure and support, but most notably provides cushioning to the joints. The hip joint is connected by thick ligaments binding the head of the femur to the acetabulum. Ligaments are responsible for connecting bone to bone. The knee joint is connected by cruciate and collateral ligaments which connect the femur to the tibia. The kneecap, also known as the patella, is connected to the tibia by a tendon. Tendons connect muscle to bone so the patella is really a bone (called the sesamoid bone) within a tendon. Problems with pain can begin as the cartilage on these different joints begins to wear, eventually leading to bone-onbone contact. Not surprisingly, arthritis is to blame for much of the joint deterioration in our knees and hips. “The leading cause [of functional loss] is osteoarthritis – the wear and tear form of arthritis that tends to accumulate with age,” states R. David Heekin, M.D., FACS, of Heekin Orthopedic Specialists in Jacksonville. Osteoarthritis is a progressive breakdown of the cartilage between our joints. Although osteoarthritis can occur in just about any joint in the body, it most commonly occurs in weight bearing joints such as the hip or the knee. “Arthritis is a degenerative process that gets worse with time. The reason that arthritis exists is because

there is no healing process for cartilage,” states Dr. Heekin. “It is unlike many other tissues in the body. Cartilage has no repair mechanism so once it starts to wear, it just continues to wear.” Since the hip and knee are weight bearing joints, America’s obesity crisis has contributed to the increased prevalence of hip and knee replacements. Even the simple act of getting off our couch can be a stressor. “The force on the kneecap part of your knee is four to six times your body weight when you get up from a chair or go down stairs,” states Dr. Heekin. “If you can reduce your body weight, you can largely reduce the amount of pressure on the joints.” Just in case you needed another reason to lose weight. Non-surgical Treatment Options Although there is not a true healing process for cartilage, it does not mean that surgery is the only answer. There are a variety of non-surgical treatment options for ailing hip and knee joints. “Start out with an antiinflammatory medication and a good exercise program that strengthens the muscles around the joints. This seems to help unload the joints and helps with some of the discomfort,” states Dr. Pujadas. Orthopedic specialists may also use splints to help ease discomfort. This method can be beneficial if one side of the joint is more deteriorated than the other side. The nutrition supplements glucosamine and chondroitin Mature Matters Magazine 9

Although the research is inconclusive, glucosamine has been shown to be most effective in treating pain and improving functionality associated with moderate to severe cases of osteoarthritis.

can also potentially help alleviate pain and discomfort. Although the research is inconclusive, glucosamine has been shown to be most effective in treating pain and improving functionality associated with moderate to severe cases of osteoarthritis. Researchers have hypothesized that glucosamine can help form the structural basis for cartilage. “It has been shown to be a good cartilage ‘vitamin’,” states Dr. Pujadas. Although their effectiveness may be inconsistent, many orthopedic surgeons provide advice regarding their use since they typically have little to no side effects. The same cannot be said for many of the other over-thecounter medications recommended for pain treatment. Non-steroidal anti-inflammatory drugs, or NSAIDs, should be used with caution in older adults. NSAID medications such as aspirin or ibuprofen can increase the risk for bleeding and lead to ulcers. When Surgery is Needed Nobody enjoys going under the knife, but ultimately surgery may be necessary. The good news is that advances in surgical technique have favorably impacted the hospital experience. The typical length of stay for hip or knee surgery is around two to three days. During hip or knee surgeries, patients are given anesthesia to put them into a temporary sleep and to also relax the muscles. Sometimes in knee surgery an epidural anesthetic may be used which can block pain in the lower

10 Mature Matters Magazine

extremities. The surgeon will then make an incision across the front of the knee and remove the damaged part of the joint from the surface of the bones. In a hip replacement a cut is made along the side of the hip and then the surgeon has to move the muscles connected to the top of the thighbone to expose the joint. What happens from there in each situation depends on the status of the ailing joints. “There are several types of replacements that are occurring. From partial replacements, both in the hip and the knee, to some resurfacing procedures, especially in the hip, and then of course there is total joint replacement which replaces all of the surfaces in the joint,” states Michael Patney, D.O., a surgeon with First Coast Orthopaedics in Orange Park, Florida. A variety of materials are available for use during major joint surgeries. “Most of the joint replacements that we are doing these days are either made out of ceramics, metals or plastics or combinations thereof.” Post-surgery Process No surgery is without risk but the prognosis following major joint replacement surgery is typically very good. Postponing surgery too long though can impact the overall result. “More and more studies are being done that indicate that when these procedures are done early in the course of arthritis the outcomes are significantly better,” states Dr. Patney. “One of the big indicators

Jennifer Bunao

on how a patient will do when control pain and reduce edema. we talk about knee replacement It is critical for patients with or hip replacement is what their total knee replacements to attain pre-operative function level is.” terminal knee extension early Not surprisingly, a significant on in their rehabilitation,” states reduction in pain is experienced Jennifer Bunao. Jennifer consults once the joint is remedied. for the Florida-based Ardor Health The complications that may as a traveling Physical Therapist. be observed following joint “Strengthening the musculature replacement surgery include surrounding the joints is also very infections, bleeding and pain at important for patients to attain the incision site. maximum level of Because of the function,” states “There are several recent advances Bunao. “The length types of replacements in surgical of recovery is that are occurring. procedures the largely dependent complication on the individual, From partial rates are much replacements, both in however, on lower compared average, patients the hip and the knee, to a few decades can expect four to some resurfacing ago. “We have to six weeks of perfected the procedures, especially physical therapy.” techniques we Compliance with in the hip, and then of use to implant a well designed course there is total the components. physical therapy joint replacement The surgical program helps procedure when improve overall which replaces all of I started [22 years the surfaces in the outcomes. Ronald ago] used to take Breaker compares joint.” - Michael Patney, D.O. about three hours his experiences and now takes with joint about one hour for both the hip replacement therapy to having full and the knee,” states Dr. Heekin. time employment. “The recovery This efficiency translates into is like a job. You have to do the less blood loss, less time under exercises, and they can be tough anesthesia and a lower overall at times but you have to do them rate of infection. “Certainly the and follow the instructions of techniques that we use today are the physical therapist.” Breaker a lot more advanced and have a has had both knees replaced by lower complication rate.” Dr. Pujadas at the Jacksonville Physical therapy is a critical Orthopaedic Institute. He piece to the overall recovery attributes much of his success to process and begins shortly after a series of pre-operative exercises the surgery. “The initial goal is designed to strengthen the area to restore full range of motion, around his joints. When asked

Ronald Breaker

what advice he would give to individuals considering joint replacement surgery, he states. “Get in the best shape you can get in and if you are overweight try to lose a few pounds.” Making the Decision The decision to have major joint replacement surgery is a collaborative process. It should involve you, your family, as well as your medical and surgical team. A physical examination can help your doctors understand your level of functionality and the extent of your pain. X-rays, magnetic resonance imaging and bone scanning may be used to determine the conditions of the bones and soft tissues in the joint areas. Aftercare planning is also part of the process so your treatment team can determine what adaptive equipment, if any, may be needed after your surgery. You can keep your joints healthy through lifestyle modifications which would include maintaining a healthy weight and limiting impact loading activities such as longdistance running if you are experiencing mild pain around the joints. It seems that prevention is still good medicine. “I have a lot of patients that say I wish I knew I was going to feel this bad now. I would have taken better care of myself,” states Dr. Pujadas. The good news is that joint replacement is not always an inevitable consequence of aging. The bad news is that there is still no cure for the common birthday.

Mature Matters Magazine 11

Raymond H. Daugherty knows to pay attention when his wife, Judy, makes a suggestion! Judy was so pleased with the results she received from Smart Body Physical Therapy, that she thought her husband might benefit from Smart Body as well. She suggested that Ray give it a try, and he is so glad that he did

The results? Ray, age 74, suffered from pain for years. The Jacksonville native and University of Florida graduate decided to seek the help from Smart Body Physical Therapy as his wife suggested. “Edsel at Smart Body said he had never seen anyone in so much pain,” says Ray.

A year ago Ray needed a wheelchair to maneuver through the Houston Airport. This year he and his family recently returned from a vacation to Costa Rica. On the first day there, Ray and his daughter completed a ten mile hike.

Physical therapists at Smart Body taught Ray exercises that provided him with pain relief. “I had tried an epidural, facet injections, and cryo and only had temporary relief,” says Ray. But at Smart Body he learned how to do a variety of exercises that got him moving better and eased the pain.

He calls himself a graduate of Smart Body after a regular three day a week regimen. And he remains grateful for their help. “Smart Body helped improve my ability to cope with pain,” says Ray. “I enjoy a better quality of life as a result.

He is delighted with those results.

6639 Southpoint Parkway, Ste. 103 Jacksonville, FL 32216 904-296-4140 phone 904-279-0963 fax www.SmartBodyPT.com www.PelvicFloorRehab.com

We accept most major insurances, including:

Auto/PIP Tricare Medicare BCBS Aetna MMSI Humana

The first thing you see when you look at someone is their smile. It tells a lot about who they are. If you refrain from smiling because you lack confidence in your teeth, it can affect your self image. Whether you have failing teeth, missing teeth or are unhappy with dentures, Dr. Cherry can restore your smile and self-esteem with dental implants.

Ask About Our Dental Implant Community Seminars

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Dr. James Cherry 904.281.2225 Board Certified: American Board of Oral and Maxillofacial Surgery National Dental Board of Anesthesiology

4100 Southpoint Drive East, Suite 5 Jacksonville, Florida 32216

www.Oralternatives.com

Dr. Cherry brings over 20 years of experience to North Florida

BETTER BREATHERS CLUB

2011 MONTHLY MEETING SCHEDULE

The American Lung Association of Florida’s Better Breathers Clubs meet regularly in a support group setting to learn about tips and techniques to better manage their disease. Talk to others who might have the same questions, share stories of support and help, and connect with those in your community with chronic lung disease.

Southside Second Tuesday, 2-3:00 PM

All meeting locations are accessible without climbing stairs.

Lake City Third Thursday, 2-3:30 PM

Riverside/Downtown Second Monday, 2-3:30 PM St. Vincent’s Heart & Vascular Medical Bldg. 1824 Kings Street, Jacksonville, FL 32204 Contact: Heather Newby, R.N., 904-308-7560

Beaches Fourth Tuesday, 12-1:00 PM

Mayo Clinic Hospital, Cardio-Pulmonary Rehab Dept. 4500 San Pablo Road, 2nd Floor 2 N., Jacksonville, FL 32224 Contact: Jayne Trawick, RRT, 904-956-3390

American Lung Association, 6852 Belfort Oaks Place, Jacksonville, FL 32216 CONTACT: Courtney Weatherby or Christie Romino, 904-520-7120

Oxy Life Lake City, 155 NW Enterprise Way, Lake City, FL 32055 Contact: Linda Jones, 386-755-9511

St. Augustine Second Monday, 1-2:00 PM

Flagler Wellness Center (same complex as Flagler Hospital) 120 Health Park Blvd., St. Augustine, FL 32086 Contact: Nikki Chagnon, 904-819-4338 Local and meeting times are subject to change, for the most current information please contact the meeting facilitator.

For more information about the American Lung Association in Florida, please contact

1-800-LUNG-USA

Regain Control of Your Bladder...Take Control of Your Life For 20 million women in the United States, urinary incontinence (UI) is a way of life. For them, physical activity or even a simple sneeze or cough, can result in embarrassing leakage. A recent study showed that in the United States, over $20 billion dollars a year is spent on UI, with up to 75% of those dollars going to laundry costs, pads and other incontinence supplies. But, even more costly is the impact UI has on quality of life. Bladder control problems can mean avoiding social situations, travel and sexual intimacy. Women with UI are also less likely to exercise and have a higher incidence of depression.

Steven Goldwasser, M.D. Urogynecology A division of North Florida OB/GYN

14546 Old St. Augustine Rd., #203 Jacksonville, FL 32258

904-245-1328

Fax 904-562-5335 www.bladderdoc.com

Steve Goldwasser, M.D., a fellowship trained urogynecologist in Jacksonville, says it’s important for women to be aware that help is available. “Sometimes women suffering with these problems think they are just a part of aging, or that nothing can be done,” he says. “Actually, there are many non-surgical and minimally invasive outpatient procedures which are very effective in treating these issues.” Dr. Goldwasser advises women experiencing pelvic pain, pelvic organ prolapse, recurrent bladder infections, fecal incontinence or urinary incontinence to seek the best help available. Urogynecology is a medical subspecialty that blends gynecology and female urology. Physicians who specialize in this area have undergone advanced training that enables them to treat pelvic floor disorders. A former Chief of Urogynecology and Pelvic

a data base of more than 300 patients and followed their surgical outcomes. Five years after surgery, he has a 96% success rate for patients who have undergone minimally invasive procedures. As a part of North Florida Obstetrical and Gynecological Associates, Dr. Goldwasser combines the strength of a 50 physician network with the personal touch of a private practice. They’re committed to providing the highest quality care in a comfortable, convenient setting and offer extensive diagnostic testing done in the privacy of their own

Surgery at the University of Florida with eleven years of practice experience, Dr. Goldwasser’s practice offers women the high level of medical expertise they require, and the personal attention they deserve. “It’s so important for patients to feel comfortable A recent study showed that in the discussing specific problems United States, over $20 billion dollars with their phya year is spent on UI, with up to 75% sician,” says of those dollars going to laundry costs, Dr. Goldwasser. “I want my pads and other incontinence supplies. patients to be assured I’ll take the time to listen to them office. “Our entire staff is and to tailor a treatment really focused on making plan to meet their needs. sure each patient receives Each patient is also given friendly, personalized attenmy email address so that tion,” says Dr. Goldwasser. they can contact me at any “Many of the pelvic floor time.” issues women live with are In cases where surcommon problems, and gery is needed, the best there are some very effecchance for success is with tive treatments available. a procedure done well the If you’re willing to make first time. After extensive the first move, we can help research in the treatment you regain control of your of pelvic organ prolapse, life and enjoy the things Dr. Goldwasser developed you used to do.” n

For 18 months, H. Dale Boyd, M.D., and his wife Lorie sported ten different currency bags, so that no matter where they docked their boat, they could get the supplies they needed.

By Virginia J. Pillsbury

This was just one of many planned steps that made their extended “cruising” adventure a smooth one. Dr. Boyd, who is also a retired Naval officer, and Lorie always planned to set sail during their retirement years. “I met my wife in San Diego and picked up sailing there. I took my first sailing course in 1972, I served as a surface warfare officer in the Navy and enjoyed the nautical aspects, and we’ve just always enjoyed sailing,” says Dr. Boyd. They always had a family sailboat or power boat, but in 2000 the Boyds bought a 45 foot Hunter Center Cockpit sailboat as the first step of their preparation. “Our long range plan was to buy a new piece of equipment for the boat each year to get it ready to cruise,” Dr. Boyd explains about those future retirement plans. But a series of events made it possible and practical for them to try a practice cruise before retirement. “We called it our sabbatical,” says Dr. Boyd. “We were seeing a lot of couples going into retirement with big plans like Winnebago trips, but they would return quickly because they found they didn’t like being together,” he says. “I also saw a number of people having strokes and heart attacks and not being able to fulfill the plans that they had.” So the Boyds took the sabbatical opportunity and it gave them a peek into what retirement life might be for them. They learned some life lessons and made lifelong friends along the way. Preparing for the Trip Before setting sail, it took a year for them to get the planning settled. “We sold the business, made mail and bill paying arrangements and finished the 16 Mature Matters Magazine

boat for a long trip,” he says. The Boyds have four grown children who encouraged them. “They had known for years that we planned to do this, so it wasn’t really a surprise” says Dr. Boyd. “They all agreed that if it was something we wanted to do then we should do it.” Blogging and skyping extensively helped them to stay in touch with family and one daughter flew to Puerto Rico and spent two weeks with them. They left Jacksonville on November 1, 2005, and worked their way down to Fort Pierce and Miami. Their travels took them to the Bahamas, the Eastern Caribbean Islands and down to Venezuela. During the first hurricane season they spent four months in Trinidad. They also met friends in Puerto Rico and sailed with them across to Venezuela, and sailed to St. Kitts, St. Barts and Antigua. They also went to Buenos

“We were seeing a lot of couples going into retirement with big plans like Winnebago trips, but they would return quickly because they found they didn’t like being together.” - H. Dale Boyd, M.D.

Mature Matters Magazine 17

Dr. Boyd back home in his office.

Aires. The boat returned through the Bahamas and sailed back into the St. Johns River in July of 2007. “We learned that we could live together 24/7 and enjoy it,” says Dr. Boyd. “We can now comfortably say that we can do this when we retire.” While sailing the two enjoyed the different cultures they encountered and found most people to be friendly and outgoing. “We bounced around from French, to Creole, to Spanish and back to English and it was very eye opening and broadening,” he says. And it was fun. “It was like, it’s Tuesday, what country are we in?” he says. A Cruising Community The Boyds met other “cruisers” as well. “At any given time, there are about 5,000 cruisers on the water doing what we did. The ones that we met were all very outgoing, self sufficient, independent and enjoyable,” he says. “You can do very well with meager supplies and living conditions,” he says. Some people had 24 foot sailboats and some had 250 foot sailboats, but the common denominator of a love of sailing and water and travel 18 Mature Matters Magazine

was an immediate bond former. While they’d connect with cruisers in many locations, at others they might be on an island where they were the only boat. “We became close friends with some of the other cruisers, and even traveled for six months with two other couples,” he says. “It’s always nice to travel in groups if you can and we’ve stayed in touch with many of the cruisers we met – even the ones we met the first day as we pulled away from the pier.” Living Off the Local Economy Fellow cruisers were also very environmentally concerned. “We all left clean wakes behind us and we would help other countries clean up when we could,” he says. “We would try to help in poorer countries as much as we could.” They always tried to live off the local economy of wherever they were docked, and would try to learn and communicate in that location’s native language. “24 years in the Navy taught us that,” he says. “We would eat whatever the locals ate,” he explains. They enjoyed some of the best veggies and fruit they’ve ever had. “We would go out and bargain for the cost of the produce,” says Dr. Boyd who particularly remembers the fresh pineapple and tomatoes in the Dominican Republic. For basic necessities, they shopped at stores up and down the islands they visited too. “We all have the same basic needs and we found that we had over planned on the supplies we brought with us because other places always had what we needed,” says Dr. Boyd.

“I didn’t notice the lack of stress until a few weeks into the trip. As the stress came off, I noticed that I started dreaming again. I think we both learned self resilience from this and how to deal better with stress when we returned.” - H. Dale Boyd, M.D. An onboard water maker did come in handy. “Most islands have an open market for getting groceries. It was always fun to go to the local markets and see all sorts of fruits and veggies,” he says. They fished off of the boat some and ate what they caught. “Lorie wasn’t a fish eater before we left and now she loves fresh fish, especially Wahoo and Mahi Mahi,” he says. They also enjoyed some great restaurants. “In the Dominican Republic one dollar would go ten times further than at home,” he explains. For a fifteen dollar total, the couple could enjoy dinner, drinks and music. “It was almost cheaper for us to eat out than on the boat,” he says. Sailing Soothes the Soul They loved the camaraderie that they encountered between the cruisers and the countries they visited. “It really is a small world and we are all pretty much the same,” says Dr. Boyd. “We all struggle with the same day to day existence issues.” A sense of independence grew for the Boyds as they cruised too. “It was just the two of us on the boat and she stood watch as much as I stood watch,” says Dr. Boyd. “It was a great trust building experience and we gained a lot of trust in each other.” For the most part the Boyds stayed healthy on the trip. “We found that cruisers tend to be a very hearty group of people,” he said. “Lorie’s blood pressure even improved while we were away.” Dr. Boyd realizes that they carried a lot of stress with them at the start of their trip and lost it along the way. “We were at a stressful place

in life with me being an individual provider in a private practice,” he says. “I didn’t notice the lack of stress until a few weeks into the trip. As the stress came off, I noticed that I started dreaming again,” he notes. “I think we both learned self resilience from this and how to deal better with stress when we returned.” They also learned a bit about patience and enjoying the moments. “When things broke on the boat we had to fix our own stuff,” he says. “The boat supply market is fairly expensive and we would look for budget supply places in bigger ports,” he says of their boat repairs. And while Dr. Boyd is used to working on boats and fixing repairs, one repair required a month-long wait in Grenada for a part. They made the most of their stay. “We had access to a free swimming pool and some great food,” he says. Logistics of Island Living Internet communication with family and friends was vital to them during the trip. With limited space, the Boyds couldn’t bring back a lot of souvenirs – instead they brought back memories, and they shared experiences and photos on a blog. “We were always on a search for the next wifi hot spot,” he says. “At one location we walked five miles looking for internet access.” In Martinique they were able to talk computer to computer which they found very inexpensive and convenient. And they found that in some places there are no land line telephones. “Everyone in those countries has a cell phone because it is cheaper than a hardwire

phone,” he says. Some places were more modern than others. “In Trinidad we saw “Pirates of the Caribbean” the same week that is was released. Washing clothes was done on the boat using a washboard and ringer, or at a local Laundromat. “Sometimes we would have the locals wash our clothes for a reasonable price – but that might mean that a pair of black pants would come back gray,” he says. Taking local tours whenever available allowed them both to learn more about the history of the various islands and stops along the way. “Lorie got see about 15 botanical gardens and I got to see about 15 forts,” he says. When in Trinidad, they saw the leatherback turtles come in and lay eggs on the beach. “We are water people and enjoy the snorkeling too,” he says. “We had some of the most fabulous snorkeling and diving in the Caribbean,” he says. “Though some of the best was in the Bahamas.” Looking Forward to Sailing into Retirement Reflecting on their journey, Dr. Boyd and Lorie agree that they look forward to sailing together when they retire. And they encourage others to start looking ahead as well. “A lot of people are coming up on retirement and you need something to wake up for in the morning or you will whither away,” he says. “Look for and take the opportunities. Charter a weekend boat or rent a Winnebago and see how you like it,” he encourages. “Our health is such a gift and we don’t know if it is going to be here tomorrow, so we need to follow our dreams now.”

Mature Matters Magazine 19

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By Laura Capitano

In today’s professional environment, career change is part of the natural progression, no matter what your age. Sticking with one job field from entry level until retirement is no longer the employment reality. If you’re losing interest in your current career, or considering an industry that interests you more than your current one, know that it’s never too late to transition into a new, satisfying job opportunity.

Marilyn Feldstein is President of Career Choices Unlimited, a certified career coach and professional speaker with a client niche comprised of managers and professionals between ages 40 and 60. Through her years in career placement, she has developed a system to increase job search success rate for her clients in the late-career age range.

Find a System that Works “People spend more time planning their vacation than they spend planning their careers or financial retirement,” Feldstein noted. “We just kind of flounder and go with what comes along.” Feldstein, who said she’s remade herself within her career four or five times, uses her career coach status to teach her clients everything she’s learned about the process of conducting a rewarding job search. “If I can figure it out, anyone can,” Feldstein said. The very first question Feldstein asks her clients: do you know what you want to do next? According to Feldstein, “They either don’t know, or they’ve been thinking about it and they’ll give me 10 or 12 different things that interest them. My favorite clients say, ‘I don’t know what I want to be when I grow up.’ If someone says that, then we start with assessments to find out how much insight they have.”

Mature Matters Magazine 23

Abbie Williams, owner of OmVelo fitness fusion studio enjoys teaching something she’s passionate about.

“It’s been an adjustment to be an employee with a superior younger than my daughters. I worked hard to create my personality and what I bring to the organization based on the fact that I have this experience and wisdom. But, I have to be respectful to those on the ladder higher up than I am.”- Linda Pomerantz

24 Mature Matters Magazine

Through a battery of assessments, Feldstein is able to better grasp a client’s personality, values, motivations and career interests — information critical to any job search. From there, she helps clients build a resume that describes where the individual wants to go with his or her career. “Most people write a resume for where they’ve been, rather than for where they want to go,” Feldstein explained. For a more proactive resume, she recommends noting your unique skill sets that can be transferred to a new job. “The resume should repackage people for where they want to go,” Feldstein said. “I teach people how to present themselves, how to introduce themselves. We come up with long, short and short-short introductions and rebrand people. It’s your responsibility to reeducate people about what you’re doing now,” Feldstein continued. A strong resume is not enough, Feldstein warns. “People will call me for just a resume, and I will not write a resume for people who have no direction.” Feldstein

encourages her clients to see the career change as a process, one that requires a networking strategy, marketing strategy and meeting with people to get access to the hidden job market. She also sees value in conducting mock interviews with her clients, which allows them to both make and correct mistakes, which leads to a higher success rate. And, she makes a point to help her clients learn to negotiate salary and benefits. “Most people have not learned this, and women are the worst at it,” Feldstein said. “You’ve got to negotiate. If you don’t do it right on the front end, you will pay on the back end.”

Suit Up for the Career that Suits You After 24 years of owning and operating an industrial supply business with her now ex-husband, Linda Pomerantz, age 60, knew she had amassed skills that would be valuable in a new career undertaking. “You develop a set of skills that can take different directions and you adapt them to a new situation,” Pomerantz explained. After she sold her business, she decided to pursue a career opportunity that was more in line with her personal interests than industrial supplies. In April 2010, she accepted a position as the Director of Office Operations with the 26.2 with Donna marathon, an organization for which she had already been volunteering since 2008. Pomerantz explained some of

Linda Pomerantz

the biggest changes in transitioning from business owner to employee. “It’s been an adjustment to be an employee with a superior younger than my daughters,” Pomerantz offered. To deal with the transition, Pomerantz said she prepared herself not to fall into a parental role with her young superior or to feel like she was sacrificing her experience or wisdom just because she was in a subservient role. According to Pomerantz, “I worked hard to create my personality and what I bring to the organization based on the fact that I have this experience and wisdom. But, I have to be respectful to those on the ladder higher up than I am.” For others considering career transitions, Pomerantz urges older job seekers to not limit themselves to the field they’re used to. “Trust your skill sets to reach out into different areas, broaden your job search to include areas where you think you can use your skills and don’t think you’re too old to learn how to adapt.” If you’re open minded and proud of the wisdom of your years, Pomerantz said, “You could find after all these years a career where you’re best suited.” Charles Williams, age 68, was released from his manufacturing job at age 60. Since then, he has found career fulfillment in substitute teaching, which he started doing six years ago. Substitute teaching appealed to him because it fit with his semi-retirement. “Substitute teaching lets me pick the days I

want to work and there’s a lot of time off. I select grade levels and schools I want — I go to primarily Westside middle schools and high schools. It’s really gratifying when you have a class of students that wants to learn,” Williams said. Williams urges his job seeking peers that, “You have to believe that there’s life after wherever you came from. There’s something there; you just have to pursue it. People shouldn’t give up, that’s for sure.” Abbie Britton, 55, saw her midlife career transition as an opportunity to pursue what had been a lifelong personal passion of hers: physical fitness. After 25 years working in journalism as a beauty and fitness editor, she opened OmVelo fitness fusion studio in Jacksonville Beach in June, where she is creative director and master instructor. “While I was a journalist, I always taught some sort of fitness class, just to burn the stress off,” Britton explained. As she moved away from the travel demands of journalism, she figured she had until around age 70 to teach, and so she would do so. From her journalist days, she had access to some of the great fitness revolutionaries, and realized she wanted to bring non-impact fitness fusion, yoga, indoor cycling and TRX strength training, to Jacksonville. According to Britton, “Yoga and cycling keeps you young like nobody’s business.” Britton’s advice to those seeking career changes is, “First and foremost you have to absolutely

Marilyn Feldstein

Charles Williams

have a passion for it. As a studio owner I have passion to pass on how great these types of training make me feel, and I knew I could make the business work.”

Age is Not the Enemy It is a common pitfall for job seekers past a perceived “prime” career age, to cite age discrimination as a reason for fruitless employment searches. Career coach Feldstein explained that some clients who get to the interview stage, but don’t get the job offer, have cited age discrimination. “What I tell older clients is that they have so much to offer. That they have more years of experience than a young person can command. If you’re in the right place, the employer will want to pay you for that experience.” Feldstein noted that people are quick to cite discrimination, when really they have not stopped to figure out what they should do, or they are applying to jobs on the Internet for which they’re not qualified. “The worst way to look for a job is to sit at your computer and send out resumes,” Feldstein insisted. “Ninety to 95 percent of people get jobs through people they know.” And since employers want to read only 10 years of job experience on a resume, not 30, the resume alone shouldn’t be an agerevealing document. According to Feldstein, who has been placing an average of one client a week into a new career, “I refuse to believe age discrimination is a problem.”

Mature Matters Magazine 25

By Frederic H. Schilling

Well you can believe this. Over the past 15 years the fixed/index annuity has survived and even excelled despite inaccurate, fraudulent and slanderous articles by Wall Street’s biggest periodicals. The funny thing is all the authors of these articles are pro-risk and pro-stock market authors. Imagine that?

Frederic H. Schilling

Hopefully by illustrating and debunking some of the common fallacies that have perpetuated through the years I can provide clarity and insight that you can use.

Debunking Fixed/Index Annuities Fallacies 1. “Fixed/index annuities are investments.” Wrong. By description, an investment can lose principle due to market volatility. With a fixed/ index annuity the purchaser is always protected by a minimum floor of at least 0% annually, as well as a minimum guarantee surrender value, and a guarantee of principle protection from market volatility. 2. “There is danger in purchasing a fixed/index annuity.” If danger is the description of having the ability to deposit money with a highly regulated, highly rated insurance company, defer income taxes until you want distribution, receive 10% annually without penalty, pass on 100% of the account to loved ones without probate and make a competitive return each year without risk, then sign me up for one of these dangerous products. 3. “Fixed/index annuities are high cost investments.” The fixed/index annuity has no annual fees like variable annuities. Index annuities do have surrender schedules like all annuities, whether fixed or variable. However, the surrender charges are reasonable and cannot exceed ten years in Florida despite having a premium bonus of up to 10% which immediately boasts the purchaser’s cash value. These boasted values can be available by 10% free withdrawals annually or at death with no fees or surrender charges. 4. “Fixed/index annuities are high commission products.” Fixed/index annuities are not high commission products. The average commission on fixed/indexed annuities as of third quarter of 2010 was 6.3%. I must remind you this is comparing a onetime commission paid on a fixed/index annuity to the consistent, generous commissions being paid on such products as mutual funds. So comparing apples to apples is impossible in this case, but I can assure you the onetime fee would be much less than a mutual fund over a normal investment period of five to 10 years.

5. “Fixed /index annuities are for people with limited financial resources.” No way. Fixed/ index annuities are for anyone looking for the safety of a minimum guarantee, protection of principal from market volatility, protection from lawsuits, the ability to outpace CD rates and the chance of keeping pace with inflation. From the very wealthy to those on a fixed income, people are choosing fixed/index annuities as their retirement vehicle so they can have protection while participating in limited market gains without risk to their original deposit or the gains from years past. 6. “The fixed/index annuities insurer can go broke.” This is another false statement. Not a single fixed/index annuity purchaser has lost a penny as a result of market declines. Can the stock market make that claim? Alternately, 251 banks have failed and the FDIC has been in danger since March of 2008. The fixed/ index annuity state guaranty fund associations (which insure the safety of the insurance purchaser’s values) are not experiencing these same difficulties. The Fine Print Be advised these insurance products are not for everyone and you should never put all your eggs in one basket. Furthermore, due to new strict Florida suitability standards not everyone is allowed to have these insurance products. You should have ample income to cover your expenses and you must have a large percentage of your savings in liquid accounts for emergencies. There are approximately 25 insurers who offer these savings vehicles and each one is different. These products are well worth a thorough examination, but be sure you are working with a reputable agent who can offer you referrals and has been approved by state regulators as well as the National Ethics Bureau and the Better Business Bureau.

Frederic Schilling is a Certified Estate Planner, has an A+ rating with the Better Business Bureau and is a member in good standing with the National Ethics Bureau. For questions or comments, you may contact Mr. Schilling toll-free at 888-891-3381 or by email at ricschilling@comcast.net.

26 Mature Matters Magazine

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28 Mature Matters Magazine

Fun Things to Do with Grandkids Alhambra Theatre Grandparents have the chance to love, play, teach and interact with their family’s next generation. They often have more free and relaxed time to just enjoy grandchildren, without the busyness of work and schedules. And they have the fun of watching their own children’s traits and personalities blossom in their grandchildren.

Enjoying Life Outdoors Dan and Rosemary Martin moved to Jacksonville to be closer to their four grandchildren, ages seven to one and a half, and they make the most of their time with them by doing simple things. “We get as much out of our time together as they do,” says Dan. “We get a lot of joy.” Their backyard is a perfect playground for the grandkids, with trees and shade, and the big swing that often has a small grandchild being pushed by “Papa.” A playhouse gives them space to make pretend food and drinks to serve their grandparents. “We are helping them to develop their imagination,” says Dan. They also love to feed the turtles and fish in the yard’s pond, and they’ve gone fishing on camping trips with their grandparents. Bird feeders in the backyard help the kids learn about birds and

they can even identify a few. The Martins also planted a garden with their grandson Logan. “We want to teach them how things grow,” explains Dan. The hanging tomato plant yielded one tomato which Logan got to take home with him. “His parents said that he treated it like gold,” says Dan. For this family, enjoying time together at home makes everyone happy. Singing together and teaching their grandchildren songs from the 1950’s and 60’s is not only a way to bridge the age gap, but Dan and Rosemary hope that it will help instill a love for music in their grandchildren. “Our kids were band kids in high school and it was a godsend for them and for us,” says Dan. “We hope our grandchildren will do the same thing.” “We are more involved in their lives than we ever anticipated,” says Dan. “And there are rewards that you just don’t get when

Info: http://www.alhambrajax.com/ Description: One of the oldest dinner theatres in the country, the Alhambra has several shows slated for 2011, including Willy Wonka.

Baja Buggyz

Info: http://www.bajabuggyz.com/ Description: When you add dune buggies and go-karts with a little mud, it equals tons of fun for kids.

Jacksonville Farmers Market

Info: http://www.jaxfarmersmarket.com/ Description: The farmers market is a unique experience that just might get kids excited about their fruits and vegetables.

Fort Clinch State Park

Info: http://www.floridastateparks.org/fortclinch/ Description: Fort Clinch is one of the most well preserved 19th century forts in the country. Visit the first weekend of the month and see what life was like during the Civil War era. Fort Clinch staff members offer first person interpretations of fort life circa 1864.

Hands-on Children’s Museum

Info: http://handsonchildrensmuseumjax.com/ Description: Learning and fun go hand in hand when kids get hands-on with art and science.

Kid Kampus

Info: Located across from Everbank Field next to Metropolitan Park. Description: Kid Kampus is a giant playground where kids’ imaginations have room to run wild.

MOCA

Info: http://www.mocajacksonville.org/ Description: On the fifth floor of the Jacksonville Museum of Contemporary Art, kids enjoy the ArtExplorium Loft which includes 16 fun and interactive stations that link basic visual art principles with works in the MOCA collection.

Oceanfront Park

Info: 1st Street South between 5th & 6th Avenues South Description: This two acre oceanfront park with playground and educational kiosk system gives the kids an opportunity to play while you relax by the ocean. continued on next page...

Ritz Theatre and Museum

Info: http://www.ritzjacksonville.com/ Description: Kids can learn about Jacksonville’s historic African American community.

Sally Animatronics

Info: http://www.sallycorp.com/ Description: The makers of amusement park rides and animatronics offer free tours for kids five and above.

Sweet Pete’s

Info: http://www.sweetpete.net/ Description: Kids taste all natural sweet treats handcrafted by owner Sweet Pete (he’s the Peter in Peterbrooke).

St. Johns River Ferry

Info: http://www.stjohnsriverferry.com/ Description: The St. Johns River Ferry connects Mayport Village with Fort George Island. It’s something inexpensive and interesting for kids especially if you spy a dolphin pod on the way across.

Tunnelz and Tumblez

Info: http://www.tunnelzntumblez.com Description: Laser tag, mini golf and tons of tunnels – what’s a kid not to love?

Yes You Canvas!

Info: http://www.yesyoucanvas.com/ Description: Inspire the next Picasso by signing them up for a kids’ class.

Alison Peters-Carlson

For more great stuff to do with grandkids, visit www.jax4kids.com.

LIKE MATURE MATTERS ON FACEBOOK What do you like to do with your grandchildren? Visit us on Facebook and tell us your favorite pastimes with grandkids. www.facebook.com/ maturematters

30 Mature Matters Magazine

you are raising your own children and are so busy providing for them,” he adds. “Now we get so much joy and pleasure out of watching them be themselves.” Rosemary believes being a grandparent has many rewards. “The bonding with grandchildren is immediate and I enjoy seeing my children in the grandchildren,” she says. “It is just a delight to be with them.” Dan agrees. “I am overjoyed to interact with my grandchildren. We would rather spend time with them than anything else. We hope that we are storing memories.”

Simple Outings Help Create a Bond Howard and Linda Shumate have three grandsons, ages four, three and seven months. They live about a mile apart from their grandsons and

“Papa” (Dan Martin) fishing with Logan; Calin, Logan and Megan sitting with “Nana” (Rosemary Martin)

see them several times a week. “We moved here in 1973 with our family and away from their grandparents,” remembers Howard. “My mother still says that was the worst time of her life.” So the Shumates were delighted when their daughter and her family moved close by. “We can be a support system for them,” says Linda. The Shumates enjoy taking their grandsons to the movies, the swimming pool and the beach. “We take them to the library once a week to get books and videos,” says Linda. “I do things with them that I wouldn’t do if it wasn’t for them like going to the pool. So I get to enjoy being with them but I also get the extra physical activity,” says Howard. McDonald’s and Chick-Fil-A also make great outings. “We have more time to give to them

that we needed a central grandchildren. Jax4kids now that we are retired activity and information is a great website go-to and don’t have to be so resource for someone with source and it is a very concerned about time,” easy, grandparent friendly, a child in their care,” she says Linda. “We don’t have explains. “I’d been thinking click away. (www. as many stresses as we about it for years, so when jax4kids.com). The site did when we were the I had the chance to come is easy to navigate and parents.” on board I was delighted.” understand with very The boys also love Obviously it is a hit with clear categories, lots of spending time at their grandparents because adventures, information grandparents’ house. they can now easily find and special deals for “You know you’ve hit the little known places in the children. jackpot when they’d rather area. “This is such a large Alison Peters-Carlson go to your house than any city and that makes the is the current owner/ place else,” says Howard. operator of Jax4kids and website a valuable tool,” “We’re so lucky to see them so much and we get as much if I had always thought that we needed a central not more out of it activity and information resource for someone as they do,” says with a child in their care.”- Alison Peters-Carlson Linda. Howard’s advice she explains its history. says Peters-Carlson who is to not let the younger “A grandfather actually loves seeing it grow and years go by without started the website as a catch on and that children spending time with your way to find things to do are benefiting. grandchildren. with his own grandchild,” “When I took it over, she explains. When his we had about 100 people A Resource for own business activity got using the site,” says PetersGrandparents busier, he offered the Carlson. “We now have There is a great resource website to Peters-Carlson 230,000 people using it for grandparents to find and she happily accepted. and they view more than 2 all kinds of activities and “I had always thought million pages a year.” fun entertainment for Mature Matters Magazine 31

By Cheryl Lock

It’s a sweet story, really, the way that Dr. Howard G. Groshell, Jr., came to realize that his lifelong career was going to be in podiatry.When he was in third grade, Dr. Groshell went to a podiatrist to have an ingrown toenail removed, and he was so impressed with the skill and ease with which that podiatrist removed it that he made a decision right then and there. Podiatry it would be. Even though he knew at such a young age that he wanted to be a podiatrist, Dr. Groshell couldn’t have known at that point just how many lives he would touch, and how many people would be forever grateful to him for the help that he gives them in terms of relieving their pain. “The pain in fibromyalgia starts from a foot imbalance that effects energy fields in the entire body,” the doctor said. “It’s a universal statement to say that when someone has foot pain, they have pain all over the body, but no one before had recognized the way that foot biomechanics effect the energy fields in the body, and when you do that, you can narrow in on 6070 percent of the levels of pain.” Mature Matters Magazine 33

Understanding Fibromyalgia To understand the type of treatment that Dr. Groshell has revolutionized for his patients, and for anyone who is willing to put a little bit of faith into his method, it is important to first understand exactly what fibromyalgia is. “It’s a generalized pain that a patient has throughout the body,” says Dr. Groshell. “A patient with fibromyalgia could come in experiencing fatigue, anxiety, depression and sensitivity to cold, among other things, and it can be hard to get an actual diagnosis at first.” That’s when the vicious cycle normally begins. Pain becomes the first symptom that doctors hone in on, says Dr. Groshell, and they work hard to alleviate that for their patients, which almost always means pain medication. And those pain medications have side effects. And so now the patient hasn’t actually treated the source of the problem, and they are on medications that will most likely cause them more problems.

“When I see patients, it’s important for me to break down their problems to the root cause, because in most cases 60-70 percent of their pain is coming from poor foot biomechanics where the foot is sending weakened neurotransmitter signals to the brain. This theory of mine can be backed up by the treatment I’ve developed, which is a micromanipulation of the joints in the foot. It’s a relatively new practice, and it’s even better because people can do it themselves.” Treating the Root Cause The essence of Dr. Groshell’s treatment is to get patients to be able to help themselves relieve pain without medication. “What I do is give the root cause for the first level of pain, where others are just treating the acute symptoms,” he said. “The first level is called latent pain, and that’s the type of pain that a person doesn’t even know they have. It’s where you press on an area and the person says, ‘Oh, I didn’t know that

Middle photo: L to R: Howard G. Groshell, Jr., DPM; Howard J. Groshell, M.D., DPM; Mary Rellahan Groshell, DPM; Megan Watson, AC; Juan Martinez, AC; Far Right Photo: Dr. Groshell in his office.

was sore.’” When a patient first starts out on this treatment, it can be a bit difficult to get the hang of the micromanipulation of the foot. “You just need to figure out the pattern of your own body, and then it gets really simple,” he said. “I first learned this technique at a seminar in Ohio back in 1961 and I started using it in my practice and my patients were suddenly saying their headache, shoulder and back pain were gone. And it was all stemming from the low energy fields in the body. Unfortunately there isn’t any literature on this type of problem right now, but there’s going to be.” Of course the manipulations help, but there are lifestyle issues at play when it comes to pain, as well. “Some people have a short fuse, and their temper is just waiting to erupt,” Dr. Groshell said. “For that person, as soon as his temper is triggered, his energy fields will be lowered and he’ll start to feel muscle pain right

away. These are lifestyle things that happen, which is why energy fields always have a tendency to go out of balance, and it’s important to continue doing the exercises, as well as to wear proper fitting shoes and control the biomechanics in the foot as much as possible.” Dr. Groshell readily admits that since this idea of energy fields and biomanipulations is a whole new area in medicine, some people may be wary to accept it or believe in its validity. “But I’ve treated hundreds and hundreds of people with fibromyalgia over my years in practice and I’ve seen really great results,” he said. “I’ve seen people feeling miserable for years, and they don’t have a life anymore, and they can’t be a part of a family program because when everyone else wants to get up and go, it hurts them to get up and go. And it doesn’t have to be like that.” The doctor developed a simple test to be sure that the pain is coming from his patient’s feet

before diving into treatment. The person sits in a chair and his heels are pulled forward slightly. “It’s what’s called a free flow energy test and that theoretically disconnects the foot at the ankle joint and allows the body to go about its normal energy flow without the influence from the foot telling the rest of the body what to do. So when I interrupt that flow, which is a negative flow if it’s coming from the foot, the body energy fields will clear within three to four minutes. If you have a shoulder that you’re having trouble moving and there’s nothing traumatic involved, the shoulder will move into a better range of motion. This simple thing helps, when more expensive tests, like MRIs, won’t show anything.” For now, Dr. Groshell is happy that he can bring relief to any patients, and the excited, ecstatic attitudes he receives from those he has helped is payment enough. But still, he hopes to some day broaden the base of this treatment so that more and more patients can benefit from it. “Anything new in medicine that has not been discovered by the establishment, or anything different, people always wonder, ‘How can that be?’ ‘How could we not have heard of this?’ Well they’re hearing of it now, and I can absolutely back up everything I have to say about it.” Dr. Groshell provides the treatment on a consultative basis at the Podiatry Centers of North Florida, a practice Dr. Groshell’s son, Howard J. Groshell, M.D., DPM, took over for him a few years ago. Dr. Howard J. Groshell describes the manipulative protocol of treating fibromyalgia as the foundation of his practice. All doctors in the practice are trained in the technique. Mature Matters Magazine 35

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