Healthy Living #3 - October 2015

four

corners

a series of three publications of the durango herald

your body

your practitioner

OCTOBER 2015

Assisted Living: When is the right time?

Match caregivers to unique needs

kids to exercise

Build a bond LOCAL EVENTS

raise awareness for breast cancer

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Providing the Best Services

Research shows that seniors who live in a supportive and socially active environment enjoy better mental and physical health.

Vista Mesa residents are provided the opportunity to live in an atmosphere of love and understanding, combined with a sense of independence and freedom. As a full-service assisted living and memory care facility, a wide array of services are offered.

(970) 564-1888 1206 N Mildred Rd, Cortez, CO 81321

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Assisted Living: Tips to find a good facility

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IVF: Medical miracle keeps getting better

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Breast cancer: Watch for these symptoms

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Domestic violence: A hard look at abuse

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Vets and pets: Advice on building a bond

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Kids on the move: Motivation for exercise

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Women’s screenings: Don’t skip these tests

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PVD: Holistic care alleviates pelvic pain

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Flashes and floaters: Get your retina tested

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Specialists: Research alternative caregivers

CHIEF EXECUTIVE OFFICER

DOUGLAS BENNETT VICE PRESIDENT OF FINANCE AND OPERATIONS

BOB GANLEY VICE PRESIDENT OF ADVERTISING

DAVID HABRAT

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ADVERTISING DESIGN/ PREPRESS

JIM DODSON OLIVIA DOMBACH LANEY LONGWELL MICHELLE MARTIN LINDA MCDARBY JUSTIN MEEK ACCOUNT EXECUTIVES

EDITOR

KARLA SLUIS ASSISTANT EDITOR/DESIGNER

RACHEL SEGURA

JUAN AYALA, BART COLLINS SHAWNA LONG, TERESSA NELSON KAROLANN LATIMER LAURA ROSS, COLLEEN DONELY

The Durango Herald uses reasonable effort to include accurate and up-to-date information for its special magazine publications. However, all information comes from a variety of sources and may change at any time for any reason. To verify specific information, refer to the organization or business noted. To view the online version of this guide, visit: www.durangoherald.com

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SENIORS Tips on choosing an assisted living facility as preventative care Photos courtesy of Erin Youngblood

By Karla Sluis Durango Herald Magazine Editor

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he decision to move yourself or a family member to an assisted living facility can be difficult.

When men and women begin to experience difficulty with everyday activities, such as bathing, dressing or getting around, families may need to explore assisted living facilities.

“People who live alone can be isolated,” said Erin Youngblood, administrator at Evenings Porch Assisted Living in Bayfield. “They forget to take medications, they stop cooking, and they can become depressed. In assisted living, they are getting exercise, good food, socialization – and they thrive.”

Many people wait too long to move a relative to assisted living, then loved ones are in crisis mode and their resources are limited, said Youngblood. “They might fall at home alone, breaking a hip and then need hospital care followed by a nursing home.”

Youngblood says assisted living is preventive care.

“Some of our residents are very healthy – they just need a little extra help. We do all cleaning, laundry and meals so they can have better quality of life.”

Millions of people in North America reside in assisted living facilities. The majority of residents in senior living are those who may need assistance with one or two daily activities, but who are otherwise mobile and self-sufficient. Families faced with moving relatives into assisted living facilities can consider the following pointers to find facilities

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“The best part of my work is becoming part of a bigger family with the staff and the residents.

We’ve had holiday dinners together with our families.”

– Erin Youngblood (pictured above, second from right), administrator at Evenings Porch Assisted Living in Bayfield their loved ones will enjoy. l Consider the arrangements and services offered. Some facilities offer single rooms, while others provide apartment-style living. Most assisted living facilities provide a variety of services, such as housekeeping, laundry, exercise and wellness classes, and social activities, for their residents. Investigate the offerings at each home you visit, looking for a facility that best suits your loved one’s needs. l Inquire about staff and their schedules. It is important to know how many staff members a facility has and how many people are working at any given

time. Do staffing schedules differ at night? If a resident has a particular rapport with one staff member, can he or she be requested? Look for a facility that is well-staffed and adept at dealing with elderly men and women. l Learn about individual service plans. Many assisted living facilities create individual service plans, or ISPs, for their residents to ensure individualized care is given. These plans are important for the safety and comfort of residents and also can help maximize a person’s independence. Some communities offer memory care programs for those with Alzheimer’s disease or other cognitive disorders. l Consider the security in place. A good assisted living facility has a 24-hour support system in place and immediate access to care. Rooms may be equipped with emergency phones that can be accessed day or night. Many homes have check-in desks so that residents are accounted for when going on outings and for announcing guests. l Check on licensing. In the United States, each state has its own licensing requirements for assisted living facilities. Confirm a facility is licensed and that it meets the expectations of the local regulatory agency. In addition, check with the Better Business Bureau to see if any complaints have been filed against the home.

Assisted living facilities can meet the needs of people who cannot live independently but do not require the around-the-clock care of a nursing home.

Evenings Porch in Bayfield provides individualized care in an intimate setting. There are special services, such as yoga twice a week, massage beds, two vehicles to transport people, and a raised-bed garden (above). Below, staff members celebrate a birthday.

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MIRACLE In-Vitro Fertilization is getting even better

By Joseph C. Gambone Special to the Herald

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hen a pioneer in any field passes, the event provides a pause in time to remember how things were before his or her pioneering work. Howard Jones, MD, passed away recently at the age of 105. His work and vision changed how infertility is treated and the way families start and grow worldwide.

Dr. Jones was responsible for the first in-vitro fertilization (IVF) baby born in the U.S. Past the retirement age at Johns Hopkins University, he moved to the Eastern Virginia Medical School in the early 1980s and started the first IVF program in the country. Prior to IVF, only about 50 to 60 percent of infertile couples could expect to conceive with the best treatment. Now with IVF added, more than most (about 85 percent) will conceive and deliver a baby if they persist and have the procedure.

There is quite a bit that can be done in the way of treatment before IVF is resorted to, however, and there are other options to consider before undertaking the emotional and financial burden of treatment with IVF. Adoption, for example, is a wonderful and noble way to start or enlarge a family. And here in Durango there are competent and caring counselors and facilitators for those who want to parent

“You can’t replace that person who’s responsible for bringing you into the world and having an impact on bringing 5 million babies into the world.”

– Elizabeth Carr, first IVF baby, speaking about the late Howard Jones, pictured at right

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a child who has already been born. For those who feel that they would rather keep trying to conceive “biologically,” the IVF procedure can be a good way to go when conventional therapy fails. Since Dr. Howard Jones and others started IVF, the way the procedure is performed is changing and the success rates are higher than ever before.

Higher doses of fertility drugs, given to induce the large number of human eggs necessary to make IVF worth doing, have now been replaced by protocols using less medication. Once fertilization is verified outside of the body, embryos can be tested so that those that would miscarry are not transferred back into the uterus. This testing significantly decreases the early pregnancy losses that may occur after going through the expense and effort of IVF. To do this testing means that the embryos are frozen, and later thawed and replaced after adequate analysis has occurred.

It turns out that it is much better to transfer embryos in a later, more normal cycle than it is to transfer them in the cycle that the eggs are obtained. The mother is less likely to have pregnancy complications and the embryos grow in a less inflamed, healthier and more natural uterine lining.

By using this technique, a single, more advanced embryo can be transferred with a very good chance that implantation will occur and a single birth will

follow. This newer technique reduces the chance of multiple births, triplets and more, that are dangerous for the mother and for the infants that are almost always premature.

The cost of IVF is still too high, with very little coverage from insurance to help couples who need it. Some policies do provide limited coverage. A few states have mandated coverage for infertility, and this trend should continue. Colorado and New Mexico have so far not mandated coverage for couples who are having difficulty conceiving.

Expanded insurance coverage can help to increase the value and lower the cost of infertility treatment by providing more monitoring of the results and contracting for care.

And so, as we pause to remember the life and accomplishments of Dr. Howard Jones, it is worth noting that his efforts, and the efforts of others that have followed him, are making infertility treatment safer and far more effective than it has ever been.

This makes starting and growing families possible for many in our community.

Dr. Gambone is American Board certified in Reproductive Endrocrinology and Infertility. He directed the fertility center at Ronald Reagan UCLA Medical Center in Los Angeles for 15 years and now practices at Durango Reproductive Medicine.

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Journey of Hope 5K Family Fun Walk/Run Named Southwest Colorado’s largest cancer event, proceeds from the Journey of Hope benefit Mercy Health Foundation’s Journey of Hope Fund, which provides free mammograms to residents of Southwest Colorado who need financial assistance. The Colors for Cancer Oct. 3 10K Trail Run supports Mercy’s Cancer Program, benefiting patients with all types of cancer.

Following the walk/run, participants will enjoy food, activities for kids and live music at the Three Springs Neighborhood main plaza. Call (970) 764-2800.

SYMPTOMS

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ublic perception that breast cancer is only identified by lumps detected through self-examination or routine mammography may prevent thousands of women from receiving an early diagnosis and the care they need.

Although lumps are the most common symptom associated with the disease, women should recognize that breast cancer can produce additional symptoms.

Susan G. Komen for the Cure, one of the premier organizations for breast cancer research, advocacy and treatment, advises that the warning signs for breast cancer are not the same for all women (or men).

Various changes in the breast and body can occur, including the following conditions. l Breast-size changes: Many left and right breasts are not completely symmetrical, and women familiar with their bodies know that one breast is often slightly larger than the other. However,

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Some breast cancer signs are lesser known to public

breast-size changes that occur out of the blue may be indicative of a medical problem. l Skin rash or redness: Women who are breastfeeding can experience a rash on the breasts from an infection of breast tissue. But those who are not breastfeeding should be evaluated by a doctor if redness, irritation or rash appears. l Nipple changes: Nipple discharge that starts suddenly and is not associated with breastfeeding can be indicative of cancer. Other changes to the nipples, such as pulling in of the nipple (inversion) or itchy, scaling skin on the nipple, should be brought to the attention of a doctor. l Changes to the skin: Dimpling of the skin, peeling, flaking, or scaling skin can be a cause for concern as well. l Lumps elsewhere: Cancerous tumors may not only be felt in the breasts.

Breast cancer can spread to the lymph nodes around the breasts, and lumps

Four Corners Healthy Living

may be felt under the arms. l Unexplained pain: The Mayo Clinic advises that less than 10 percent of people diagnosed with breast cancer report pain as a symptom. But unexplained pain in an area of the breast should not be ignored. Breast pain that doesn’t go away and seems to involve one area of the breast should be checked. l Fatigue: General cancer symptoms can include unusual fatigue and unexplained weight loss. These symptoms should not be left unchecked.

One of the best things women and men can do is to familiarize themselves with their bodies so they will be more capable of pinpointing any irregularities that may develop. Individuals can routinely look at their breasts and inspect for subtle changes. But remember that hormonal breast changes occur during the menstrual cycle, so it’s best to be familiar with how breasts look and feel both during and after menstruation.

Pretty in Pink Fashion Show Oct. 15, 7 p.m. This annual Cortez event benefits the Women’s Cancer Coalition. The Women’s Cancer Coalition helps women in Montezuma and Dolores Counties with financial assistance toward regular reproductive screenings and costs related to reproductive cancer. Clothing for the show will be provided by Love on a Hanger, hair done by Salon Serenity, space provided by Four Seasons Greenhouse.

“Pink Streaks” in local salons takes place again this year with hair salons dyeing pink streaks – temporary or permanent – in hair.

The cost of the streak (typically $20) is donated to the Women’s Health Coalition of Southwest Colorado’s emergency fund.

Free mammograms are available for Colorado residents 40 to 64 years old, with certain income requirements, through the Women’s Wellness Connection. Call (970) 259-3527.

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By Robert B. Bricca

dance of its victims on its perpetrators.

Teens are significant survivors of DV. Each year approximately one in four he topic of domestic violence adolescents reports verbal, physical, (DV) is difficult and painful, emotional or sexual abuse. Nearly 80 but also extremely important to percent of girls who have been victims the health of our community. It occurs of physical abuse in dating relationships without regard to age, income, gender, continue to date the abuser. Approxireligion or race; only level of education seems to lessen its incidence. To address mately 70 percent of young women who or prevent it, one must first recognize have been raped know their rapist; the it, and be willing to discuss it. I will perpetrator was or had been a boyfriend, provide definitions, demographics and friend or casual acquaintance. impact of domestic abuse, and provide The abuse of children is particularly local resources available to all citizens harmful, as the effects of such maltreatof La Plata County. ment are profound and frequently longThe Merriam Webster Dictionary lasting. According to the CDC, in 2012 defines DV as the inflicting of physical over 680,000 children were reported or psychological injury by one famsurvivors of maltreatment. However, ily or household member on another. the generally accepted actual rate of Women are more frequently assaulted child abuse in the U.S. is one in four. than men, and chilAbout 50 percent of dren are particularly LOCAL RESOURCES child survivors were vulnerable. This refers younger than 5 years l Women’s Resource Center, not only to physical or old, with the highest 247-1242 sexual abuse, but also rate of victimization l Domestic Violence Hotline/ takes the form of what being among children Alternative Horizons, 247-9619 is known as intimate under 1. Fully 80 l Sexual Assault Service Organiterrorism, which is an percent of perpetrazation, 259-3074 ongoing, complicated tors were parents. l La Plata County Child Abuse use of control, power It has been conReporting, 382-6150 and abuse in which one vincingly shown l Southwest Safehouse, person tries to assert that childhood abuse 259-5443 systematic control over is associated with another. numerous adverse DV is widespread, outcomes in adult survivors. These with women six times more often include, but are not limited to, tobacco subjected to it, often more severely, than men. According to the CDC, use, illicit drug abuse, alcoholism, 4.8 million women in the U.S. suffer ischemic heart disease, liver failure, intimate-partner physical assaults and COPD/emphysema, morbid obesity, rapes yearly, and 2.9 million men are depression/anxiety, STDs, risky sexual survivors of physical assault from inbehavior, teen pregnancy, premature timate partners. Men are significantly birth, chronic pain syndrome and suiless likely to report victimization. The cide attempts.

National Violence Against Women To address the serious and widespread Survey for the year 2000 reported that problem of DV, we must first recognize 25 percent of women and 7.6 percent it in ourselves, our families and those of men reported being survivors of around us. We must either confront its intimate-partner violence at some point perpetrators or report it to the approin their lives. Not surprisingly, in selfpriate authorities. Finally, we must be reported domestic violence, 95 percent willing to assist and advocate for its of survivors are women. victims. There should be zero tolerance Elder abuse is also a significant probfor domestic violence. lem in the U.S., and is becoming more Dr. Robert B. Bricca is Board Certiwidespread as our population ages. As in fied in Family Medicine and practices at child abuse, its detection is characterized and complicated by the marked depenPerins Peak Healthcare.

Special to the Herald

ABUSE

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Doctor in Durango offers statistics, demographics and impact of domestic violence

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PETS

Tips on building a bond with your pets’ caregiver

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eveloping a solid relationship with a pet’s veterinarian is important to the health of the companion animal and can offer peace of mind for the pet owner.

It is a pet owner’s primary job to keep a pet safe, healthy and happy. By achieving a strong working relationship with the vet, and knowing he or she will be there to offer advice and treatment, pet owners can help their pets live long, healthy lives.

Pet owners are introduced to veterinarians in various ways. Vets may be affiliated with a particular animal shelter or adoption agency, prompting new pet owners to work with such veterinarians upon adopting their animals. Friends or family members may recommend vets they know and trust. However pet owners find a vet, the key is to ensure it’s a good match between pet, pet owner and vet.

If a vet shares the same approach to health care as the pet owner and has a welcoming personality, there’s a greater chance pet owner and vet can work together successfully. Pet owners should be able to openly discuss their concerns about health or treatment options.

To develop a solid working relationship with their pets’ veterinarians, pet owners should prioritize annual health checkups and immunizations. Over time, the vet will get to know the owner and animal and learn what makes the pet unique. Familiarity with the animal can make it easier to recognize potential illnesses or conditions. Vets should see animals when pets are sick as well as when the animals are healthy so they can better recognize the often subtle changes in pets that may be indicative of larger issues.

Pet owners should arrive on time to appointments.

Some people prefer early-morning appointments because the staff and vet is fresh for the day. However,

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appointments may need to be customized according to personal schedules. Vets who offer flexible office hours are very popular. For instance, when pet owners have a number of questions or believe they will need more of the vet’s time, they should speak with the receptionist to book longer time slots for their appointments. This way neither the owner nor the vet feels rushed, and proper care can be given to the animal.

Ongoing communication is often needed to monitor the treatment plan of an animal. Vets frequently offer follow-up calls to see how pets are responding to medication or therapy. If the vet asks the owner to call with progress reports, owners should make the time to notify the vet, whether the animal’s condition is improving or worsening. Prompt attention can alleviate pain for animals and reduce anxiety for pet owners.

Although you cannot always judge a book by its cover, a clean, organized and well-run veterinary office is indicative of a staff that takes their profession seriously. Friendly, caring staff and a knowledgeable doctor can help make vet visits pleasant.

Pet owners invest in their companion animal’s health by making an effort to develop a good relationship with the pet’s vet. This can keep the animal healthy and happy through the years.

Winter pet hazards Much like many of their human counterparts, pets do not always relish winter. Animals can experience arthritis pain or fatigue when the cold sets in. Shorter periods of daylight also may make them less active and likely to sleep for longer periods of time. In an effort to stay warm, some pets get creative. Cats can unintentionally put themselves in danger just to chase a chill away. The American Animal Hospital Association says cats will curl up against almost anything, including car engines, to stay warm. Cats caught in moving engine parts can be seriously hurt or killed.

Before you turn your engine on, check beneath the car or make a lot of noise by honking the horn or rapping on the hood. Also, if you have exposed radiators in a home or apartment, construct a cover to prevent cats and dogs from climbing on the exposed coils. The hot water pumping through radiators can cause burns.

Cats and dogs also may get too close to fireplaces, so use a protective screen to keep them away from hot embers. Pets also can knock over portable heaters in an attempt to get warm. Look for models that automatically shut off if they fall over to reduce your risk of fire.

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KIDS

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oday’s students arguably have more on their plates than any generation that came before them. But even with their hectic schedules, kids still have free time, which many are not always using in the healthiest ways possible.

According to the Centers for Disease Control and Prevention, nearly one-third of high school students play video games or computer games for three or more hours on an average school day. Sedentary lifestyles can increase kids’ risk for being overweight or obese, and many parents struggle in their efforts to encourage their school-aged children to get off the couch and embrace physical activities. The following are a handful of strategies concerned parents can employ as they attempt to

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Strategies to incorporate exercise into family life motivate youngsters to be more physically active. l Choose the right activity. Physical activity and organized sports are not one and the same. Kids can still be physically active even if they are not athletic or if they are simply not interested in sports. Find an activity kids can embrace, such as hiking, swimming or even riding bikes, and they will be more likely to get off the couch. l Limit screen time. Kids spend lots of time in front of computer and television screens, which can be detrimental to their overall health. Parents can place restrictions on the amount of time kids are allowed to spend surfing the Internet, playing video games and watching television, encouraging youngsters to

spend time enjoying the great outdoors or playing with friends rather than spending it staring at a screen. l Join in the fun. Parents can set positive examples by being physically active and even exercising with their children. Rather than retiring to the couch after dinner, take nightly walks or bike rides as a family.

This is a great way to get kids off the couch, but also a great way to spend more time together as a family. l Involve kids in your own pursuits. Parents who are weekend warrior athletes can involve their kids in their own activities. Take kids along on weekend jogs, kayaking trips and so on, all the while explaining the important role physical activity plays in living a healthy lifestyle.

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DON’T-MISS Five health appointments women shouldn’t skip

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nutritious diet and daily exercise can promote longterm health, but preventative care also plays a key role in keeping adults healthy as they age.

Routine health screenings can head off potential problems, preventing illnesses and possibly limiting the duration of sickness. Women may have longer life expectancies than their male counterparts, but that does not mean they can afford to overlook preventative care. The following are five health screenings women should include as part of their healthy routines.

1. Pap tests and pelvic exams: Beginning at age 21 (or earlier if they are sexually active), every woman should get regular Pap smears and pelvic exams to test for any abnormalities in their reproductive systems. Pap smears may be suggested every two to three years depending on a woman’s age. A routine visit with a gynecologist is recommended annually to discuss any changes or worrisome symptoms.

2. Mammograms and breast exams: In addition to conducting self examinations, women should get clinical manual breast exams.

Women age 40 and older should get a manual breast exam each year and an annual or biannual mammogram.

3. Cholesterol checks: The ideal level of total cholesterol is below 200 mg/DL. Individuals with a higher level of cholesterol may be

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at a greater risk for heart disease.

Cholesterol screenings can alert doctors to potential trouble and help them develop plans for their patients to lower cholesterol levels. Doctors may suggest dietary changes and advise women to adopt more active lifestyles. Some doctors may even prescribe medication if cholesterol levels are especially high.

4. Skin examination and cancer screening: Women should examine their skin every month for new moles or changes in existing spots or moles to detect early signs of skin cancer.

Be sure to check all areas of the body, as skin cancer can appear just about everywhere. Some doctors perform skin cancer screenings as part of routine physical exams, or women can visit a dermatologist.

5. Bone density screening: Those with a risk for osteoporosis, such as women with fractured bones or slender frames, should be screened earlier and more regularly than women without such histories or body types.

Doctors generally recommend that women receive annual bone density screenings beginning at age 65.

Healthy bones will show a T-score, or the measurement to determine bone density, of -1 or higher. These suggested screenings and tests are based on general medical guidance.

Women should work with their doctors to develop wellness schedules that promote their long-term health.

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970-247-0042

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The Centers for Disease Control and Prevention notes that humans never outgrow their need for vaccinations. Although certain vaccinations may no longer be necessary, others may be needed in adulthood. Certain vaccinations, which can safeguard individuals from long-term illness, hospitalization and even death, are now recommended for all adults. The following are some of the immunizations you may need as you age. l Influenza: Flu vaccines protect against various strains of the flu virus, and the vaccine is recommended for just about everyone between the ages of 6 months and older, including middle-aged adults. l Pneumococcal disease: This disease can cause meningitis if it affects the spinal column. Adults 65 and older need one dose of the pneumococcal conjugate vaccine followed by the pneumococcal polysaccharide vaccine. l Shingles: The virus can cause a painful skin rash and blisters. Other symptoms include chills, pain, fever, and even loss of vision. Because shingles most often occurs in people age 50 and older, the shingles vaccine is recommended for those in this age bracket. l Pertussis (whooping cough): All adults between the ages of 19 and 64 need a one-time whooping cough booster vaccine, particularly if they will be in close contact with infants younger than 12 months. Adults are the most common source of pertussis infection in infants. l HPV: Human papillomavirus, or HPV, is a common virus spread mostly through sexual contact. The HPV vaccine is recommended for both males and females between the ages of 17 and 50.

www.southwestwomenshealth.com

We Accept Most Insurance

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PFD?

Holistic care alleviates Pelvic Floor Dysfunction

By Maureen Goldman and Debbie Meyers Special to the Herald

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omen may be led to believe that problems they are experiencing are considered “normal” when, in fact, these issues may often be symptoms of a medically defined and treatable condition called Pelvic Floor Dysfunction (PFD).

What is PFD in women?

PFD includes a broad range of concerns that occur when there is disruption of the normal function of the pelvic muscles. The pelvic floor refers to a group of muscles, ligaments and connective tissue that attach to the front, sides and back of the pelvic bone. In women, similar to a sling or hammock, they support the pelvic organs including the bladder, uterus, vagina and rectum. The coordination of contracting and relaxing these muscles controls bladder, bowel and other organ functions.

What causes PFD? Common contributing factors may include pregnancies, estrogen deficiency in menopause, trauma, abuse, previous surgery and obesity.

What are some common symptoms?

Symptoms of PFD may include: l Urinary leakage, urgency, frequency, hesitancy, incomplete emptying, discomfort, stopping or starting of urine stream l Leakage of stool, constipation, straining, or pain with bowel movement l Pain in pelvic region, genital area, back, or rectum l Pain during or after intercourse How is PFD evaluated?

Providers who are specially trained in Pelvic Floor Rehab (PFR) obtain a medical history, review the pelvic floor symptoms the woman is experiencing, and conduct an exam.

Biofeedback with specialized equipment is used to evaluate pelvic muscle function.

How is pelvic floor dysfunction treated?

A non-surgical approach is used to treat and educate women in strengthening pelvic floor muscles by integrating biofeedback, electrical muscle stimulation, and behavioral

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techniques. Progress is evaluated each week with a review of symptoms and measurement utilizing the PFR equipment.

How successful is pelvic floor treatment?

Success may vary depending on the skill level and training of the provider, comprehensiveness of the PFR approach and the level of a woman’s participation in the behavioral and exercise recommendations. One study of 680 women completing a PFR program was conducted by the University of Missouri School of Medicine. Nurse Practitioners (NPs) utilizing PFR equipment during a five-session program showed statistically significant success rates: 80-85 percent median improvement in urinary and rectal symptoms, 50-90 percent median reduction in pelvic pain, and global improvement of 80 percent or better.

Why seek a Nurse Practitioner Board Certified in Pelvic Muscle Dysfunction PMD) Biodfeedback by BCIA? In the above study, positive results were attributed to the utilization of nurse practitioners to provide PFR because they are equipped to address a diversity of pelvic floor health needs. Patients find comfort with a women’s health NP and their holistic approach to women’s issues and care. Understanding the sensitive nature of pelvic dysfunction concerns and having the knowledge of reproductive, gastrointestinal and genitourinary anatomy and function, health care counseling skills and the ability to prescribe medications such as vaginal estrogen, are critical to the success of a PFR program. Biofeedback Certification International Alliance (BCIA) certifies and recertifies individuals who meet educational, training and mentorship standards on an ongoing basis.

Maureen Goldman, CNP, BCIA Board Certified in Pelvic Muscle Dysfunction Biofeedback, has performed Pelvic Floor Rehab with MDs in the Four Corners and is now at Sage Health Care in Durango. Debbie Meyers, CNP, MS, is a Nurse Practitioner and the owner of Sage Health Care in Durango.

Four Corners Healthy Living

The pelvic floor refers to a group of muscles, ligaments and connective tissue that attach to the front, sides and back of the pelvic bone.

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Sally Zabriskie, Debbie Meyers, CNP, Jami Hennesy, Maureen (Mo) Goldman, CNP, Amy Johnson

Debbie Meyers, CNP, MS – Adult Nurse Practitioner offering services that include Women’s Wellness Care, Pap Smears, STD Testing, Gynecological Problems, Menopause and Hormonal Care, Birth Control and Primary Care

Introducing our NEW Nurse Practitioner, Maureen Goldman, CNP, BCB-PMD – Women’s Health Nurse Practitioner and the only BCIA Certified in Pelvic Muscle Dysfunction Biofeedback provider in the Four Corners region.

NOW TREATING PELVIC FLOOR DYSFUNCTION FOCUSING ON PRIMARY CARE AND WELLNESS FOR WOMEN! accepting most insurance plans

FACES YOU KNOW, CARE YOU CAN TRUST 191643

72 Suttle St., Suite C, Durango • 970-403-8812 • SageHealthDurango.com

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Educating yourself could save your vision

By Moss J. Fenberg Special to the Herald

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f you have flashes or floaters in your eyes, it’s time for an eye exam. A doctor can check if these symptoms are nothing to worry about, or if they indicate a serious condition that could damage your vision.

Here is a list of potential concerns: l Posterior Vitreous Detachment: One of the most common ocular changes to occur with age is the breakdown of the gel, or vitreous, that fills the back of the eye and gives it form. This is called a Posterior Vitreous Detachment (PVD). It is called posterior because the gel pulls away from the back of our eyes as it shrinks and becomes less viscous. In this process we begin to see small clumps of vitreous floating in our vision. The PVD process often begins abruptly and may be associated with new flashes of light. Although

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most PVDs are benign, you should have a dilated eye exam when symptoms begin to evaluate for the possibility of an associated retinal tear and/or retinal detachment. l Retinal Tear: When a PVD occurs it can sometimes pull just enough to cause a sight-threatening retinal tear. The retina is the thin, light-sensitive neural tissue lining the interior of the eye. It is responsible for converting light to electrical impulses, which are then transmitted to the brain via the optic nerve.

Retinal tears are small breaks in this delicate tissue. A tear must be treated in a timely way to prevent it from progressing to a retinal detachment. If recognized and treated early, the likelihood of vision loss is very low.

Treatment involves applying laser energy to “spot weld” the retina in place. l Retinal Detachment: Untreated retinal tears allow ocular fluid to work its way behind the retina

through the opening made by the tear. This process detaches or lifts the delicate photoreceptors, or rods and cones, from their source of nourishment on the back of the eye. Once detached, it’s a race against time to prevent the highest-prized photoreceptors in your central vision from becoming affected. This is why every PVD, or new-onset floater needs a good dilated eye exam.

If you experience flashes of light, new floaters, or a shadow or curtain in your vision call your eye doctor immediately and request a same-day or following-day appointment. If a retinal tear or detachment is found, you will often be referred to a retinal specialist for treatment.

Moss J. Fenberg, MD, is an Ophthalmologist and Retinal Surgeon at Southwest Retina Consultants, PC.

EXPERIENCE BETTER HEARING

“Hearing aids have benefited our family tremendously. Grandpa Bill no longer has to listen to the TV too loud, he can participate in family dinner conversations, and he is hearing a lot of what he has been missing for years. Our family is very grateful for your time and your services donated to our veterans, as well.”

—Emily B. (and Bill & Judy C.)

Improving the Quality of Life Through Better Hearing

MontezumaHearing.com

Lucia Arriola-Story, Au.D., Doctor of Audiology, ABA Certified, Member of the Tinnitus Practitioners Association

Cortez • 970.565.4655 Monticello • 435.587.5054 Blanding • 435.651.3818 892 Cottonwood St, Ste 2 380 W 100 N 799 S 200 W

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THE BEST

SPECIALISTS

How to find complementary or alternative medical providers

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hen the time comes to find a traditional doctor, many people find the process to be relatively easy. Some doctors may be recommended by a friend, while others opt for a physician that has been treating their families for years. Certain health management and insurance plans may dictate certain “in-plan” providers, searchable by a particular location and practice. Finding an alternative medical provider, or one who specializes in complementary medicine, may not be as simple.

Practitioners who provide complementary and alternative medicine, known as CAM, are those who specialize in chiropractics, naturopathy, acupuncture, and herbal remedies. Millions of people now see CAM providers in addition to their standard physicians.

The U.S. Department of Health and Human Services estimates that at least 40 percent of adults and 12 percent of children have used a CAM provider.

Complementary and alternative medicine is made up of a diverse set of therapies and healing philosophies.

While traditional doctors may treat illnesses, many CAM providers are employing techniques to prevent illnesses in the first place. Dissatisfaction with traditional medicine has led many people to seek the help of CAM providers. In fact, a study in the Journal of the American Medical Association found that the majority of alternative medicine users appear to be doing so largely because “they find these healthcare alternatives to be more congruent with their own values, beliefs, and philosophical

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orientations toward health and life.”

Men and women can find a CAM provider in several ways. l Start with your doctor or another health care provider, who may offer a referral, particularly if this doctor is in favor of traditional medicine working in conjunction with alternative therapies. l Some regional medical centers and hospitals may have CAM practitioners on staff. You can seek information from such organizations by calling them directly or going online to see a listing of staff. l There are a number of professional organizations for CAM providers. An online search may yield various organizations that offer regional referrals. l Contact state, provincial or municipal regulatory licensing boards for health care professionals. Health departments and boards may have information on nearby practitioners. l To meet the rising demand for complementary and alternative care services, many health insurance plans have options for you to access these services. However, many plans provide only limited coverage for many CAM services. l Referrals from friends and family members may yield the name of an effective local CAM practitioner.

Individuals should keep in mind that unless CAM services are covered by insurance, it is very likely that all expenses will be out-of-pocket. When searching for a specialist, be sure to find one who is qualified and verify his or her training, certifications and licensing before beginning any treatment.

Holistic Therapist

Jordan Wildman, MS, LPCC Holistic Therapy

Natural Treatments for Mental Health

• Substance Abuse • Crisis Intervention • Mindfulness • Anxiety • Depression • Eating Disorders • Trauma

Nicola St. Mary, ND Naturopathic Medicine

Acupuncture & Chinese Medicine

Rikki Gensheer, LAc Acupuncture and Chinese Medicine

• Insomnia • Headaches • Stress • Digestion • PMS • Menopause

• Depression • Anxiety • ADHD • Bipolar • Insomnia • Fatigue • Disordered Eating • Digestion

Clinical Herbalist & Aromatherapist 970.426.1684 160 E. 12th St., Suite 1 Durango, CO puravidahealthcare.com

Anna-Marija Helt, Ph.D Herbalist and Aromatherapist

• Natural Fertility & Reproductive Health • Digestion • Immune System Support • Thyroid & Adrenal Health

• Family Health Care • Hormone Balancing • Digestive Repair • Nutritional Therapy - Food Allergies - Celiac Disease • Stress Relief • Heart Health • Detoxification

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COMPREHENSIVE CARE FOR THE ENTIRE FAMILY SAME-DAY APPOINTMENTS FOR MINOR INJURIES SAME-DAY APPOINTMENTS FOR ACUTE ILLNESS LOW CASH PAY PRICES

The names you know, the physicians you trust. Now in a convenient new location in Bodo Park.

NOW SCHEDULING APPOINTMENTS WITH DR. ROB KLEIN

After over thirty years in Durango, our board certified physicians continue to provide the same high quality care you expect including: primary care for newborns through elderly, immunizations, well child exams, physicals, acute and chronic disease management, women’s health, contraception and hormone management, worker’s compensation injury management and minor acute injuries.

Dr. Rob Klein is a Board Certified Family Physician. He is fluent in Spanish and accepts patients of all ages. Appointments are available Monday – Thursday 8am-7pm, Friday 8am-5pm and Saturday 9am-5pm and will always be with a Board Certified Family Physician.

Appointments 970-259-3110 316 Sawyer Drive in Bodo Park.

Sports Physicals and Well-Child Care Immunizations and Vaccinations Women’s Healthcare – Breast and Pap Exams Contraception Management Treatment of Skin Growth and Rashes BOARD CERTIFIED FAMILY PHYSICIANS

Jude Harrison, MD Susan Weber, MD Brad Lyons, MD Jordan Loftis, MD Lauren Loftis, MD Mandy Morford, MD Rob Klein, MD

Occupational and Industrial Medicine Services

Call for an appointment at 259-3110 “Hablamos Espanol”

Website: lpfma.com

Visit us at lpfma.com

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Voted Best Podiatrist in Durango!

We specialize in quality medical and surgical care for all types of foot and ankle problems.

• Ankle Sprains • Bunions • Flat Feet • Hammertoes • Heel Spurs • Plantar Fasciitis • Custom Fit Orthotics • Toenail Issues Don’t let foot pain keep you from enjoying life!

“Your feet are in good hands with us!”

Four Corners Foot & Ankle 575 Rivergate Lane, Suite 95, Durango, CO 81301 (970) 259-5303 • www.4cornersfeet.com

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