Your Monthly Guide to Healthy Lifestyles
e lthy l
ng ews
February 2013 • FREE
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Big brother meets baby Also in this issue: • • • • •
Facial rejuvenation: a new you in 2013 Lifestyle linked to cancer prevention Catholic schools: values received, excellence achieved Tax-smart retirement moves Guilt-free Super Bowl buckeyes
• • • • •
Health Crossword Patient Advocacy Nobody's Perfect Spiritually Speaking And much more!
What’s your weight loss wish?
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Facial Rejuvenation
Look your best in the new year!
V
ery few individuals realize that 80% of their facial appearance with aging is due to sun exposure and subsequent damage. All the brown spots (“age spots”), broken blood vessels on the face, fine lines, and sagging skin are caused almost entirely by sun! What about the “worry lines” between the eyes, deep smile lines, upper lip lines (lipstick runs uphill), and the sagging jowls and neck? These unfortunate processes caused from prior sun exposure can be improved dramatically with innovated and virtually pain-free cosmetic procedures performed by Dr. Handler. The Thermage NXT procedure painlessly heats Don’t let wrinkles and damaged collagen under age spots make you appear your skin to lift sagging older than your years. skin on the neck and jowls. Thermage NXT utilizes radiofrequency energy (not laser) to uniformly heat the dermis while the epidermis is cooled and protected. This heating of the dermis causes immediate collagen contraction followed by new collagen production over a period of time. The procedure also encourages a natural repair process that results in further tightening and younger-looking skin. It is also an excellent non-invasive and painfree procedure for tightening “crepe” skin on the abdomen of men or women and sagging skin on the upper arms. With only one treatment, results work over a 6-month time period to slowly lift and tighten the involved areas with results lasting 3-4 years. There is NO downtime and NO pain! For lines between the eyes, crows’ feet, and the “sleepy look with droopy eyelids,” the use of Botox or Dysport works well to improve these areas with resultant diminished lines and a more “wide-awake” The best prevention for look. This is also perearly aging and skin formed with minimal cancer is to protect your pain with results lasting skin from the sun. 5-7 months and longer.
2 February 2013 / Healthy Living News
The use of fillers, such as Restylane, Perlane, Juvederm, Radiesse, and others, to “fill” deep smile lines and the marionette (sad) lines from the corners of the mouth produces immediate results lasting 12-15 months! Since these products are combined with a numbing agent, the pain is minimal. For fine lines, large pores, and brown (age) spots, the Clear + Brilliant laser produces awesome results after 3-5 treatments. This is a painless procedure where a laser produces thousands of small columns in the dermis. Your body then produces collagen to fill these areas. There is NO downtime with this procedure. Dr. Handler is the only dermatologist performing this procedure in Northwest Ohio. Dr. Handler has performed these procedures for years with very gratifying results and very satisfied patients. All of these cosmetic enhancements are performed entirely by Dr. Handler.
Before
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Dr. Handler’s office now has available a new camouflage make-up that is excellent to cover red or blue veins on the face or anywhere else on the body; blue, red, or yellow bruises from prior cosmetic procedures; and, especially, facial, neck, and chest redness secondary to rosacea. For more information about the above-mentioned procedures or products, please call Dr. Handler’s office at 419-885-3400. His staff will be able to address your questions or concerns about these procedures. Please visit Dr. Handler’s website at drharveyhandler.com to view many before-and-after photographs of patients who have had these procedures performed. Also, check with the office staff to inquire about specials on many cosmetic procedures. ❦
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Mission Statement Healthy Living News offers the residents of northwest Ohio and southeast Michigan a monthly guide to news and information about healthy life styles, health care, sports and fitness, and other issues related to physical, mental and emotional quality of life. The publication promises to be an attractive, interesting and entertaining source of valuable information for all ages, especially those 35 to 50. Healthy Living News is locally owned, committed to quality, and dedicated to serving our great community. Healthy Living News is published the first of each month. The opinions expressed by contributing writers do not necessarily reflect the opinions of the publisher. Distribution of this publication does not constitute an endorsement of any kind. While HLN makes every attempt to present accurate, timely information, the publication and its publisher and/or advertisers will not be held responsible for misinformation, typographical errors, omissions, etc.
Contacts Business office:
To advertise: Healthy Living News, 375 Rose Glenn Drive, Toledo, OH 43615. Phone: (419) 841-8202 or email Kevin O’Connell sfstennis76@bex.net. Ad reservation deadline is the 15th of the month preceding publication. HLN reserves the right to refuse advertising for any reason and does not accept advertising promoting the use of tobacco.
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To submit an article or announce an event: Editor, Healthy Living News, 1619 Circular Dr., Toledo, OH 43614. Phone: 419-754-1339, fax 888-506-5790; email: editorhln@bex.net. Deadline for editorial submissions is the 10th of the month preceding publication.
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Sales Robin Buckey Layout and Design Jan Sharkey Distribution Jim Welsh • Alison Foster Dominion Distribution Distributech - Toledo Copyright © 2013 Healthy Living News Reproduction in whole or part without written permission is prohibited. Healthy Living News is published for the purpose of disseminating health-related information for the well being of the general public and its subscribers. The information published in Healthy Living News is not intended to diagnose or prescribe. Please consult your physician or health care professional before undertaking any form of medical treatment and/or adopting any exercise program or dietary guidelines.
February 2013 • Vol. 18, Issue 2
Your Monthly Guide to Healthy Living
Your Monthly Guide to Healthy Living
Health & Beauty
Taking Care of Your Life
2 Look your best in the new year 6 Healthy lifestyle can be powerful ally in preventing cancer 7 The Academy Corner Ovarian cancer: the silent disease, by Shweta Pai 9 Physical therapy helps Laurels patients minimize pain, maximize function 14 5 tips for preventing osteoarthritis 15 Mercy Weight Management Center puts focus on long-term success 26 Understanding acoustic neuromas by Shelly Horvat, AuD, CCC-A 30 Obesity, what you must know! by Ranvir Rathore, MD 34 The aging eye, part 1, by Bennett Romanoff, MD 37 Regular exercise program is first step toward fitness 38 How did I get so sick?! by Douglas Schwan, DC, Dipl Ac 41 Spiritually Speaking Wisdom—where is she? by Sister Mary Thill 45 Sound Advice from Northwest Ohio Hearing Clinic by Randa Mansour-Shousher, AuD, CCC-A
8 Health Crossword, by Myles Mellor 10 Patient Advocacy You need a patient advocate— whether you know it or not, by Jeff Kurtz 13 Kick Ash with Patte O’Connor 16 Running tips for beginners, by Amanda Manthey 18 Nobody’s Perfect How do I dispose of unused medicine? by Sister Karen Zielinski, OSF 28 Personal Finance Tax-smart retirement moves 31 A Walk in the Park Water, water everywhere by LeMoyne Mercer
Children & Parenting 5 Milestones: Meet your newborn sibling! 12 Cullen Center supports and empowers traumaexposed children and their caregivers 17 February health tip from Heartand Rehab Know the dangers of childhood obesity 21 Catholic education—Values received, excellence achieved 24 Middle years preparation crucial to college and career readiness
Our Community
Food & Nutrition
22 St. Clare Commons innovates senior choice by Jessica Derkis 29 HCF welcomes Bowling Green Care Center 39 Kingston Residence of Perrysburg breaks ground for 55,000-square-foot expansion 42 Yark donates life-saving gift to St. Francis 43 Wanted: girls who just want to have fun! 44 The Woodlands at Sunset House: Casually elegant independent living with a safety net
36 Fresh foods on the menu at Fetoosh Deli by Christine A. Holliday 40 Eating Well How to be a healthy loser by Laurie Syring, RD/LD 47 Guilt-free Super Bowl buckeyes, by Kelly Hanner
Editor Jeff Kurtz Travel Editor LeMoyne Mercer
Dear Readers, Thank you for picking up the February issue of Healthy Living News. By now, we’ve had a month to work on those New Year’s resolutions, and many of us are already feeling we may have bitten off a bit more than we can chew. If your dedication is beginning to falter, don’t lose heart! You’ll find ample advice to help keep your resolution on track in the pages of this issue—from healthy cooking ideas, to running tips for beginners, to smoking-cessation counseling and much more. When we launched HLN 17 years ago, our goal was to present a highly diverse variety of health-and-wellness topics so that readers of all ages would find something useful and informative in every issue. And this month’s lineup of articles definitely will not disappoint—running the entire age gamut
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from our cover story (p. 5) about helping young children adjust to the birth of a baby sibling (featuring my grandsons, Charlie and Rory) to advice on choosing the right retirement community (pgs. 22 and 44). Readers who have succeeded in losing weight in the past but seem to have difficulty keeping those extra pounds from piling back on won’t want to miss the article about Mercy Weight Management Center on page 15. The Center’s team of weight-management professionals helps patients refocus on longterm weight control—not just initial weight loss. This month’s issue also features important insights on cancer prevention from Heidi Nichols of The Toledo Clinic Cancer Centers (p. 6), an article underscoring the many benefits of Catholic education (p. 21), an explanation of acoustic neuromas from our
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friends at Northwest Ohio Hearing Clinic (p. 26), and a profile of ProMedica’s Cullen Center, a vital community resource offering support to trauma-exposed children and their caregivers (p. 12). We would also like to extend our heartfelt gratitude to Mercy CEO and President Andrea Price, ProMedica President and CEO Randy Oostra, and UT President Lloyd Jacobs for taking the time to share their thoughts with our readers last month on the healthcare changes they anticipate in 2013 and how their respective health systems continue to adapt and expand to meet our community’s growing needs. The feedback we’ve received from the story has been tremendous! Until next month, stay safe, active, and healthy!
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Milestones Meet your newborn sibling!
T
here’s no question that the arrival of a newborn is both a blessing and a challenge to parents. The seemingly endless nights with little or no sleep, constant feeding and diaper changes, and ever-present ear-splitting crying can be a trial for even the most patient, mature moms and dads. In all the excitement and stress, it’s easy to forget that older children, too, have a lot of adjustments to make when a newborn sibling arrives. After all, there’s now competition for the parental time and attention that was, until recently, focused exclusively on them. It’s normal for children to feel a little resentment under these circumstances, even if, on one level, they’re thrilled about having a new brother or sister. The good news is, with a little preparation and understanding, parents can help smooth this transition for older children and nip sibling rivalry in the bud. Here’s how:
Set the stage If all goes as planned, you’ve got nine months of pregnancy to get ready for your baby’s arrival. Be sure to use some of that time to prepare your older child for the changes ahead. It’s a lot easier for kids to adjust to change when they know what to expect. Read some
children’s books about pregnancy and new babies together to help him understand what’s happening and how things will be different when the baby comes. Encourage him to discuss any feelings or concerns the books might elicit. Young kids often have unrealistic expectations about a newborn’s capabilities. Explain to your child that it will be quite some time before his new sibling will be able to play or interact in any meaningful way. Also, make sure he understands that babies are a lot of hard work and demand a lot of time and attention, so you might be tired for a while. Many hospitals offer a special sibling class to help prepare kids for a newborn’s arrival. Take advantage of one if available. These programs may include a tour of a maternity room so kids know where Mom is going when it’s time to have the baby. This period of preparation is also a good time to teach your child the proper way to touch, hold, and behave around a baby. Encourage him to practice holding a newborn and properly supporting his or her head using a baby doll or stuffed animal.
negative feelings about the baby, it’s never okay to express them through aggressive behavior toward the baby. Instead, encourage him to draw a picture showing how he feels or act out his emotions using a doll.
Reinforce your child’s importance
Assuring your child that he’s always been and always will be precious to you can significantly allay his anxiety over a newborn’s arrival. Take a few minutes together to look back over his infant photos or videos and remind him how exciting it was when he was the baby of the family. Tell him how proud you are now that he’s such a good big brother to his baby sibling and such a good helper for you.
Get your child involved Another great way to help your child develop a positive attitude toward his relationship with the new family member is to encourage him to take an active (and age-appropriate) role in caring for the
baby. For instance, he could hand you supplies at bath time, choose which outfit to put on the baby (out of two or three options pre-approved by you, of course), fetch wet wipes, help push the stroller, carry the diaper bag, retrieve bottles, or anything else that is suited to his capabilities and safe for the baby.
Be mindful of relatives’ gushing
When a baby is born, it’s not uncommon for visiting relatives and friends to gush over the newborn while forgetting about the feelings of the older sibling. If your older child seems to be having a particularly hard time adjusting to your new family member, you might want to discreetly mention this fact to visitors or make a point of praising him in front of others for how helpful and mature he’s been since the baby came.
Spend one-on-one time together
Most importantly, parents should set aside some time every day to play with and listen
Don’t sweat behavioral setbacks
Still, don’t be surprised if a child who seemed excited about the pending birth has second thoughts after the baby actually comes home to stay. For example, once a newborn arrives, it’s not uncommon for older children to display some degree of regressive or disruptive behavior, such as using baby talk, wanting to be fed with a bottle, having toileting accidents, or having temper tantrums. Though this behavior might add to your workload and frustration, don’t worry; it typically resolves within a relatively short time. However, it’s important to teach your child that, while it’s okay to have
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to their older child one-on-one so he knows he’s loved and still an important member of the family. Babies don’t give parents much of a break,
but Mom and Dad can always take turns—with Dad spending time with the older child while Mom tends to the baby and vice versa. ❦
Healthy lifestyle can be powerful ally in preventing cancer
F
ebruary has been designated National Cancer Awareness Month to heighten public awareness of the increasing cancer rates observed over the last few decades as well as to promote preventive measures that can help keep cancer at bay. While efforts at prevention cannot guarantee a cancer-free life, more and more evidence is accumulating to support the notion that adopting certain healthy behaviors—or abandoning unhealthy
ones—can make an enormous difference when it comes to cancer risk. “For example, a growing body of evidence indicates that up to 35 percent of cancer deaths could be attributed to unhealthy diet and lack of exercise,” notes Heidi Nichols, a certified nurse practitioner with The Toledo Clinic Cancer Centers. She goes on to explain that obesity and a high-saturated-fat diet have been linked to an increased risk of
specific cancers, including breast cancer, colorectal cancer, and possibly others. But diet and exercise aren’t the only lifestyle factors with links to cancer. Most people are aware that smoking can lead to lung cancer, but they may be surprised to learn that tobacco use is also associated with an increased risk of six other cancers—breast, cervical, colon, oral, pancreatic, and kidney. Excessive alcohol consumption is high on the list of lifestyle choices that boost cancer risk, as well. According to Nichols, women should drink no more than one alcoholic beverage per day (more increases breast cancer risk) and men should not exceed two drinks per day. “There are definitely lifestyle changes we can all commit to that will reduce cancer risk, including avoiding smoking—or quitting if you do smoke, drinking alcohol in moderation, eating more fruits and vegetables, consuming less red meat and saturated fats, exercising more, and maintaining a healthy weight. Those last points, increasing physical activity and controlling weight, seem
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to be especially significant. Multiple studies have indicated that exercising and maintaining a healthy body weight can reduce the risk of primary cancer or cancer recurrence by as much as 25 to 30 percent. The current general recommendation is to get 30 minutes of moderate exercise four to five times per week,” Nichols says. Lifestyle modification is just one half of the cancer-prevention equation, however. The other half is early detection and screening. If cancer does develop, the outcome is usually much more favorable if it is detected and treated in the earliest stage. Thus, it’s vitally important to follow routine screening recommendations for cancers of the breast, cervix, colon, prostate, or other forms for which a screening test is available and appropriate. The benefits of screening are clearly evident in the increased rate of early breast cancer and cervical cancer detection among uninsured and underinsured women, owing to free mammograms and Pap tests offered through local health departments across the country. Nichols is also encouraged by new lung-cancer-screening guidelines that were just introduced. An August 2011 study published in the New England Journal of Medicine showed that screening reduced mortality among a select population of high-risk individuals who were all between the ages of 55 and 74 with at least 30 pack years of smoking (one pack year is the equivalent of having smoked one pack of cigarettes per day for a year) and who quit within the last 15 years. The study participants, who were screened with a low-dose CT once a year for three years, showed a reduction in mortality of about 20 percent specific to lung cancer and about seven percent from all other causes. If you fall in this high-risk group, it may be appropriate to discuss yearly CT scans with your healthcare provider, she advises. Still, much work needs to be done with respect to the prevention and treatment of lung cancer. “It’s exciting to see the new screening guidelines come out in that field, but we still have a long way to go for both men and women. Lung cancer treatments have been largely unchanged for the past 15 years, and the survival rate remains dismal. Also, we’re seeing more women in their 40s and 50s with lung cancer, many of whom are not smokers. We don’t know
ow was I going to “Once Hospice of Northwest Ohio wHo can I call for Help? wHat wIll It cost? wHat If He’s In e care of him? What stepped in, my worries were gone.” s I going to have to paIn?Howwas can I takeit caregoing of HIm? wHo can I call for Help? ? What HOw cAN I care forI him? cost? How would wHat wIll It cost?was wHat If He’s paIn?How can I take care nage? How I Ingoto takeWhat care if ofHe’s him? pAIN? wHo can I call for Help? wHat wIll It cost? wHat If hatof HIm? was I going toIN ve to do? What was we are the area’s largest and most experienced provider of He’s In paIn? How can I take care of HIm? wHo can I call for going to cost? How hospice care, a nonprofit organization solely dedicated to wHO cAN I call for help? uld I manage? How providing the best possible end-of-life experience for our Help? wHat wIll wHatcare If He’s In paIn?How canpatients I takeand their families. I going toIt cost? take him? What gowHAtwas wILL ItIcost? ask for us by name. the sooner you do, the more we can help. to have to do? What care of HIm? wHo can I call for Help? wHat wIll It cost? as it going to cost? w would manage? wHat If He’s InIpaIn?How can I take care of HIm? wHo can I ow was I going to e care What call forof Help?him? wHat wIll It cost? wHat If He’s In paIn?How s I going to have to ? What it wHo going can I takewas care of HIm? can I call for Help? wHat wIll cost? How would I 6 February 2013 / Healthy Living News To read this issue online, visit www.hlntoledo.com nage? How was I goto take care of him? “I constantly felt like I was in the hands of experts with
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exactly why. In fact, lung cancer is the number-one cause of cancer death in women and is second only to breast cancer in the number of cases per year,” says Nichols. Skin cancers, including melanoma, are also on the rise among young people. The good news is, the population as a whole is becoming more aware of skin cancer, so many cases are found early while the cancer can still be surgically removed. Nichols urges people to take simple preventive measures, such as avoiding direct sun during the hottest hours of the day, shunning tanning beds, being conscientious about sunscreen use, and having an annual skin exam (especially those who are fair-skinned). Nichols urges HLN readers to adopt all the healthy habits mentioned above, but if there’s only one message they’ll take away from this article, she hopes it’s the importance of getting more exercise and controlling weight. “Not only will these healthy habits potentially reduce your risk of cancer or cancer recurrence by up to 30 percent, but they can also help control your blood-glucose level, lower blood pressure, reduce your risk of heart disease, simulate your immune system, and reduce feelings
of depression while increasing your energy level, flexibility, mobility, bone density, muscle strength, and overall sense of well-being. There’s no pill that can provide all those benefits. We need to get moving!” she emphasizes. When facing a diagnosis of cancer, more and more patients are choosing The Toledo Clinic Cancer Centers. With eight board-certified hematologists/oncologists and eight nurse practitioners on staff, The Toledo Clinic Cancer Centers can provide imaging and laboratory diagnostic services, chemotherapy services, and IV services. Also, there are several offices (including the main location at 4235 Secor Road and satellite centers in Maumee, Bowling Green, Oregon, Adrian, and Monroe) for the convenience of the patient. Many Toledo Clinic Cancer Centers patients are enrolled in the latest cancer research and studies in our region through the Toledo Community Oncology Program (TCOP). ❦ For more information, please call the Toledo Clinic Cancer Centers at 419479-5605.
The Academy Corner Presented on behalf of
The Academy of Medicine of Toledo & Lucas County
Ovarian cancer: the silent disease by Shweta Pai
A
t 59 years old, Sarah believed she was defying her age. Six months ago, she had just finished her third triathlon and she was still working full time as an accountant. However, over the past three months, she had noticed some changes in her body. She was recently becoming constipated and often felt full and bloated after eating only a little bit of food. Assuming this was a normal sign of aging, she modified her diet and thought nothing of it. Over the past week, she started having the urgent need to use the restroom and was urinating more frequently than
normal. She also felt a constant pain in her bladder area. Sarah knew these signs very well, having had several urinary tract infections in the past, so she decided to make an appointment. When Sarah first arrived, she began to describe her urinary symptoms and asked for the “usual” antibiotics. However, as I began to probe a little deeper, she opened up about her recent GI symptoms and the constant pain in her bladder area. When I asked whether the pain radiated to her back, she said that she had noticed some lower back pain but attributed it to
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7
her exercise regimen. When I asked whether she had lost any weight recently, she replied that she had lost ten pounds over the past few months but has been keeping a healthy diet and exercise program. The more questions I asked, the more I could see Sarah’s face become strained and tense. As I moved through the interview, I asked the question that would signal a red flag, “Have you noticed any abnormal or bloody
vaginal discharge?” Reluctantly, she replied that she had seen some blood on occasion but didn’t want to bring too much attention to it because she was in “perfect health.” As I began to think about a potential diagnosis, my heart sank as I put together the pieces. I explained to Sarah that since her aunt and her grandmother had had breast cancer, she was at risk to be a carrier of the BRCA1 or BRCA2 gene. This gene is linked not only to breast cancer, but in a small number of cases also to ovarian cancer. I reassured her that she had done the right thing by coming into the doctor’s office and that some of her symptoms warranted a workup for ovarian cancer. Women with ovarian cancer can at first have vague symptoms, but patients should see their doctor if the following occur on a daily basis for a few weeks: bloating or a swollen belly, difficulty eating or feeling full quickly, and pelvic or lowerabdominal pain. Sarah demonstrated these signs as well as other associated symptoms: constipation, weight Crossword by Myles Mellor loss, and increased urinary urgency and frequency. She also Across had the “red flag” symptom of vagi1. Effective Chinese medical technology nal bleeding, as any vaginal bleeding in a 9. Went solid woman who is past ERVICE menopause automati10. Toothed wheel cally warrants a gyneIS OUR cologic workup. 12. Ball and ____ joint The next step was I G N AT U R E to discuss Sarah’s di14. Powerful agnostic tests. I told her that we would be 15. Rock doing a pelvic exam and an ultrasound to get a better picture 17. Steak request of her pelvic organs and to see if there 19. Say what's wrong were any abnormalities. I was also going 20. Bank note, short 4607 W. Sylvania Ave. |for Toledo, Ohio 43623 to check her Ca-125 (419) 841-7773 level, which is a pro21. Social Security card, e.g. tein in the blood that has high levels in signaturebankna.com 22. Sweet fruit women with ovarian cancer. If these tests 25. Remained Member FDIC came back positive
A FOUNDATION OF
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8 February 2013 / Healthy Living News
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for ovarian cancer, I would refer her to a gynecologic oncologist who would then go through her surgical and chemotherapy options. Sarah was very upset and confused as to how a person in perfect health could end up in this situation. I explained to her that ovarian cancer is the fifth most common cancer among women and its cause is still unknown. Risk factors include never having children or having children later in life, being a carrier of BRCA gene mutation, and having a family
history of ovarian cancer. Currently, there is no screening test for ovarian cancer, so detecting the disease early in its course is difficult. I reassured Sarah that she was only in the preliminary stages of diagnosis and that if the workup showed ovarian cancer, with the support of her healthcare team, family, and friends, she would be able to battle this disease. ❦ Shweta Pai, UTCOM MS4, submitted on behalf of The Academy of Medicine of Toledo and Lucas County.
by Myles Mellor Across 1. Effective Chinese medical technology 9. Went solid 10. Toothed wheel 12. Ball and ____ joint 14. Powerful 15. Rock 17. Steak request 19. Say what’s wrong 20. Bank note, for short 21. Social Security card, e.g. 22. Sweet fruit 25. Remained 28. Zodiac sign 30. Aromatic oil 33. Greens 36. ___, shucks! 37. Wedding words (2 words) 1
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Answers on page 27 38. Kumquat, for example 39. Natural laxatives 41. Blame 43. Contribute to the environment 44. Restaurant choices
11. Happening 13. Vitamin C filled juice (2 words) 16. Band ___ 18. Time period 19. Fade out, in a way 23. Australian jumper Down 24. Ace 1. Take into the blood 26. Expression of discovery stream 27. Avoid answering 2. Stomach problem that 29. Tooth holder can result from stress 31. Beef ____ 3. Addict 32. ____ metabolism 4. Tennis or fishing? 33. Antitoxin 5. Newhaven locale 34. Pillowcase, for example 6. Stressed out 35. Quantities of medicine 7. Study of the relationship 39. Desktop between living things 40. Practice and their environment 42. This, in Paris 8. Intellectual
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Physical therapy helps Laurels patients minimize pain, maximize function
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hysical therapy is a powerful tool that can help people get back to their daily lives free of pain and with maximum strength, function, and mobility following an injury, surgery, or illness. This evidence-based, cost-effective, conservative approach to treatment can even serve as an alternative to surgery in many cases. At The Laurels of Toledo, a skilled nursing and rehabilitation center located at 1011 Byrne Road, physical therapy is about making patients’ quality of life better by restoring and improving their ability to move. It’s one more component in the Laurels continuum of care that helps patients return home sooner, safer, and stronger. “A physical therapist, in many cases, can work with you to manage and eliminate pain without medications and side effects,” says Julie Leidel, Rehab Services Director for The Laurels. “When patients come to us with a physician’s order for therapy, we examine them and develop a plan of care, using treatment techniques that promote the ability to move, decrease pain, increase functional mobility and balance, and
prevent disability.” Leidel notes that one major area in which physical therapy can make a tremendous difference—and one of particular importance to many employers—is the treatment of back injuries. In fact, the Occupational Safety and Health Administration rates back injury as the number one workplace safety problem. Not only are back injuries painful, but they can also lead to lifelong disability and a great deal of expense. There are myriad potential causes for back pain, such as poor posture; aging; osteoarthritis; tension and stress, which can lead to muscle spasm; trauma, such as a motor vehicle accident; and repetitive trauma, such as repeatedly lifting incorrectly or sitting in an awkward posture while working. The therapy team at The Laurels has the expertise to determine the origin of patients’ back pain and, utilizing state-of-the-art techniques, equipment, and modalities, help them manage or eliminate the pain. Laurels physical therapist Alan Easly explains that the right exercise or modality depends on the type of
back problem. “For instance if you’re dealing with a problem involving the musculature, we can utilize stretching and range-of-motion exercises as well as transcutaneous electrical nerve stimulation, or TENS, to relax the muscle and reduce pain. Also, ultrasound is sometimes used to provide deep heat. On the other hand, if the problem is related to a disc with nerve involvement, we then need to use very specific position exercises to get the disc back where it belongs,” he says. Sometimes pain that seems to originate in the back is actually caused by nerve impingement elsewhere. Easly points out that anything that causes a nerve to be impacted—such as muscle spasm, surgery, swelling, or strain—can produce symptoms that mimic back injury and that the appropriate exercises and stretches would need to change based on the actual cause. “Muscular problems are generally the easiest to correct, followed by impingement of a peripheral nerve,” Easly states. “The
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challenge is much greater once you get into the spinal column because the spinal nerve doesn’t regenerate. If you can catch the problem before nerve damage is done, the outlook is best.” Easly is also enthusiastic about a new form of technology for managing arthritis pain that expands significantly upon the TENS concept. This technology, called JStim, combines three therapeutic elements—electrical stimulation, infrared heat, and compression—in a single system. These components are integrated in a fabric wrap, which can be applied to various parts of the body, and connected to a programmable master controller. “This is an impressive, very user-friendly piece of equipment that, like a TENS unit, can be issued to the patient for home use if it’s helping. Basically, you ‘set it and forget it.’ You can even wear it at night without any concern for burns or other problems. JStim is a great
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representation of the changing world of physical therapy. It’s so much more effective than older modalities, such as heat and cold packs, and our facility is the only one in the Toledo area using it,” says Easly. ❦
Health Care is complicated But that’s where you come in.
The Laurels of Toledo accepts Medicare, Medicaid, and all private commercial insurances. For more information, please call 419-536-7600 or visit www. laurelsoftoledo.com.
Patient advocates, or professionals who act as liaisons between patients and the health-care provider, are needed now more than ever. You can supplement your undergraduate degree with training in this field through The University of Toledo’s Graduate Certificate in Patient Advocacy Program. This is a 100 percent online graduate certificate that can be completed in just two semesters. For more information call or e-mail Debra O’Connell – 419.530.5421 or Debra.Oconnell@utoledo.edu.
You need a patient advocate—whether you know it or not
JHHS 32 0113
by Jeff Kurtz
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f you’ve ever attempted to navigate the healthcare system, either on your own behalf or for a loved one, you know what a dizzying, frustrating maze it can be. My family discovered this firsthand when my dad recently underwent two laminectomy surgeries, with an intervening stay in inpatient rehabilitation, to correct severe stenosis in his lumbar and cervical spine. A result of osteoarthritis, Dad’s stenosis was causing disabling pain and significantly limiting his ability to stand and walk. He’s also had several joints replaced over the years, including both shoulders and his left hip. Further complicating matters, Dad had a mass growing on one of his kidneys that had to be surgically
removed. Needless to say, he has spent a lot of time in hospitals and rehab environments lately and several medical specialists are overseeing his care. These circumstances were the crux of our recent frustration. With Dad battling several ailments at once and seeing so many different specialists, it was easy for important information to get lost in the shuffle. Oftentimes, we weren’t sure whether we were fully understanding all his treatment options and making the best possible decisions about his care. Now, before I go any further, let me clarify that this article is by no means intended to disparage any of the wonderful healthcare professionals or organizations who have been caring for Dad, helping with his recovery and rehabilitation, and motivating him along the way. I’ve always believed that we are extremely fortunate to have so many exceptional healthcare providers and world-class facilities serving Toledo and the surrounding communities. But the simple fact is, today’s healthcare provider is beyond busy trying to meet the ever-growing demands our aging society is placing on the system—and sometimes that level of busyness can have a negative impact on communication. For example, while recuperating in various hospitals, Dad often voiced frustration that doctors and other clinicians would rush into his room to discuss his treatment options or provide follow-up information—all the while talking to his back as he was lying on his side. Dad is deaf in one ear and has some hearing loss in the other, so he was usually left with more questions than answers after they rushed back out again. Sometimes he would have to ask his nurse or medical assistant, “Who was I just talking to?” Even more aggravating from Dad’s perspective, some providers in their haste—and perhaps mistaking his hearing impairment for a lack of understanding—would often talk
Northwest Ohio Chapter
10 February 2013 / Healthy Living News
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past him to Mom or one of us kids. A major shock came while Dad was in inpatient rehab following his first laminectomy. We were under the impression that his insurance provider had approved 100 days at the facility. However, after just 40 days of rehab, we were suddenly advised that Dad was being sent home. The insurance company had decided he wasn’t making sufficient progress and terminated coverage. The facility and rehab staff were just as surprised as we were. The biggest problem was, Mom and Dad’s house wasn’t even close to being ready to accommodate Dad’s needs. Dad still couldn’t support his weight, let alone walk, so at the very least, a hospital bed and lift would need to be in place before he could go home. The only option left to us was paying out of pocket for several more days at the rehab facility while we got things ready at home. Things were getting out of hand pretty quickly, and we were feeling helpless. We decided we needed someone in our corner—someone working on Dad’s behalf to ensure he received all the care he deserved. That’s when we contacted Debra
(Deb) O’Connell. Deb is the director of the University of Toledo Patient Advocacy Program. She stepped in immediately and had soon taken the proverbial bull by the horns. When the rehab facility’s social worker requested a meeting with our family to discuss Dad’s pending discharge, Deb cleared her schedule so she could attend. In fact she actually arrived at the meeting before I did! Her knowledge proved to be invaluable during the meeting. She knew exactly what questions to ask—things that hadn’t even entered our minds yet, such as what Dad’s op-
tions were for in-home nursing care, physical therapy, and occupational therapy and how to source all the supplies we would need to care for
Dad at home. She also initiated negotiations with the rehab facility and insurance company to see if there was any way to help smooth this transition, and the staff at the rehab facility very graciously did everything in their power to accommodate us. And that’s just scratching the surface. You see, Deb isn’t just a patient advocate; she’s a family advocate. Whenever we have questions or concerns about Dad’s care, she’s just a phone call away. She reminds Mom and all of us that we have to take care of ourselves in order to be the best possible caregivers for Dad. She also prompted Mom and Dad to make sure they have a healthcare power of attorney and living will in place—and even accompanied Mom to a class on the subject at the University of Toledo. Most importantly, by taking so many concerns off or plate, she’s given Dad the opportunity to focus his energy on getting stronger and all of us the freedom to simply be a family. I would urge anyone dealing with a healthcare issue to seek the aid of a patient advocate. He or she can help you better understand your diagnosis and treatment options, accompany you to medical appointments or hospitalizations to ask questions
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and take notes, help you sort out insurance and billing issues, act as a liaison between you and medical providers, and much more. But don’t wait until a crisis arises or you’ve already been denied vital services. Get a patient advocate involved at the very beginning of treatment. Enlisting the aid of a patient advocate will not only make it easier to navigate the healthcare and insurance systems, but it could actually lead to a better outcome and lower out-of-pocket expenses. By working with a patient advocate like Deb O’Connell, you have nothing to lose and a great deal to gain. For more information regarding The University of Toledo Patient Advocacy Program go to: http://www. utoledo.edu/dl/programs/certificates/ cert_advocacy.html or feel free to contact Deb O’Connell by email of Debra.Oconnell@utoledo.edu or 419-530-5421. ❦ Jeff Kurtz is the editor of Healthy Living News and the senior consulting editor for Tropical Fish Hobbyist Magazine. He’s also the author of The Simple Guide to Marine Aquariums, The Simple Guide to Mini-Reef Aquariums, Clownfishes and Other Damselfishes, and The Saltwater Aquarium Problem Solver.
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about the trauma, they might feel bad at first, but they soon realize it’s not the emotional ‘tidal wave’ they thought it would be,” says Dr. Elhai. Parents and other caregivers appreciate the fact that the Cullen Center really strives to support and infancy up to age 18 using evidenceempower them withbased therapies that involve the whole out assigning blame. As family,” says Adrienne Elhai, PhD, Dr. Elhai notes, trauma Director of the Cullen Center. “Most exposure often leads to of the kids we see have experienced emotional disregulation interpersonal trauma, such as abuse and a broad range of beor the loss of a loved one, so we see a havioral problems, such lot of depression, anxiety, attachment as temper tantrums or issues, and behavioral problems. Also, acting out in school. In many children exposed to trauma tend many instances, a negato go off track developmentally, so tive behavioral cycle gets it’s not uncommon to see regression established in the home, to a younger developmental age.” which can be very frustrating for parTherapy usually ents. “It’s so easy to blame parents, begins with psychobut the fact that they’re bringing education to normalize their child to the center indicates what the children are that they’re trying to help. When we feeling. The goal is to come in and support parents and help help them understand them understand that trauma is the that their emotions are underlying cause, they start to see normal considering the their child’s behavior in a different trauma they’ve been light, which can start to change the through and to help whole dynamic. Then, when they them figure out better see their child getting better, they feel much more empowered because they have more control over what’s going on in the home,” she explains. What sets the Cullen Center apart is that they approach therapy from a traumainformed perspective. • If your stay at the hospital is a minimum of 3 qualifying They treat with an midnights, Traditional Medicare will pay 100% of your stay understanding of the up to 20 days.* connection between the patient’s trauma • Today there are many private insurances that offer history and the psythe same 100% coverage without the 3 midnight qualifying chological, emotional, stay minimum. or behavioral sympOur administrative staff is experienced not only with Medicare but many toms that stem from it. other private-insurances. Our professionals can assist you with this and In other words, they much more. treat symptoms as a manifestation of the underlying problem, not as the problem itself. The center is part of the National Child Traumatic Stress Network (NCTSN) and was created after 911 by the Substance Abuse and Mental Health Services Administration (SAMHAdmissions 7 days a week SA) to ensure children exposed to trauma receive evidenceOur wide range of services include: based, trauma-focused
Cullen Center supports and empowers trauma-exposed children and their caregivers
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hen a traumatic event occurs, it can be difficult for people of any age—even mature adults—to come to grips with the experience. But when children are exposed to trauma, such as abuse or neglect, domestic or community violence, the death of a family member or friend, a natural disaster, or a serious accident or injury, the psychological and emotional impact can be especially profound. If not dealt with in a positive, therapeutic manner, the intense emotions that such events trigger in children can be overwhelming and lead to unhealthy and disruptive coping behaviors. In our community, vital support for trauma-exposed children and their caregivers is offered at the Cullen Center, an outpatient therapy center devoted to helping families move beyond traumatic events and begin healing. “We work with kids from
ways to cope with those feelings. An important element of this process is encouraging the children to create a narrative of their trauma through writing, art, play acting, movies, or whatever method suits their style and comfort level. Little ones, for example, may be more comfortable telling a joint story with their parents in family-therapy style. Incidents of sexual abuse or domestic violence are typically discussed alone with the therapist at first and then with the caregivers when they’re ready to hear the story. “Whichever approach we take, we begin by making sure children understand that it’s important to talk about what happened—that it’s not something they’ll ‘just get over’ or that time alone will heal. The issue will still be there even if they don’t talk about it, but it will then come out in other ways. Once they start talking
Post-Hospital Care, redefined Did you know?
short term rehab, outpatient therapy, skilled nursing, long term placement, memory care 12 February 2013 / Healthy Living News
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services. “We’re an affiliate member of the NCTSN, so we have access to other experts in the field of trauma, all the research in that area, and a wealth of data that keeps us up to date. Also, we use all their materials to hand out to clients and try to get as much feedback from clients as
possible so we can continue to make our services better,” says Dr. Elhai. ❦ The Cullen Center now accepts private insurance plans in addition to Medicaid. For more information, please call 419291-7919.
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Kick Ash with Patte O’Connor
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joy is overwhelming; their joy is my etting Patte O’Connor to talk about what she’s passionate joy, and that is why I will help people about is easy. Getting her to stop is quit for the rest of my working days. the hard part. “When I was growing Not only do you increase their health up, never in my wildest dreams did I and quality of life, but you help that think I would finally land on helping person be around more for the people people to quit smoking—never!” she who love them.” exclaims. But that is exactly She stops cold in the conwhat she found to be the versation and states, “Pasmost rewarding of all the sion, it’s all about passion. fields she has ever worked in. My clients know it and feel In mid-December, she it from me. My concern for chose to leave one of the them is genuine, and they largest healthcare insurcan feel it. It’s really hard to ance agencies, after workexplain, but any one of my ing to help their members clients will say that about me.” quit smoking. “They kept Patte O'Connor Patte started her comclose metrics on our success rates,” she recalls. “I was pany, Kick Ash LLC, in late always at least 20 percent higher than December, 2012. In addition to her the rest of my team. It was funny; work experience helping people quit they kept trying to figure out why I smoking in her past position, she was so successful at helping people also received her Tobacco Treatment quit. I told them my motto, ‘People Specialist Certification from the Mayo don’t care about how much you Clinic Nicotine Dependence Center, know, until they know how much Rochester, MN. Patte said obtaining you care.’ that certification from the number“The relationship between me one-rated program in the world was and the person trying to quit is key “the icing on the cake.” “We learned to the success. Most people know in-depth information regarding all how unhealthy it is, and they have aspects of tobacco dependence. It also tried quitting numerous times. was an incredibly intense learning I don’t even go there with them. We experience.” Additional information form a team and work together. If I can be found at www.ndc.mayo.edu. feel they don’t have what it takes, I Patte also wants to encourage put the cards on the table and we stop “veteran quitters,” those who have right then and there. When people tried quitting over and over, to give come to me, they are going to walk her an opportunity to help change away being a successful ‘quitter.’ If their lives and free them from their I think that won’t be the outcome, addiction. “If you’ve tried everything we have that ‘tough love’ kind of out there, before you completely give discussion. up, call me,” she urges. “The initial “There is nothing in the world consultation is free. Seriously, what do you have to lose?” ❦ better than when they do quit. The
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5 tips for preventing osteoarthritis
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lifetime of wear and tear can really bone starts to rub and scrape directly take a toll on the human body. It against bone, eventually leading to seems as though the older we get, the pain and swelling and reducing range less our bodies—especially the weightof motion. Early signs of OA include bearing joints—want to cooperate. For pain in the affected joint during or the estimated 27 million Americans after activity; tenderness to touch; who live with osteoarthritis (OA), stiffness, especially in the morning degeneration of the joints can have or after periods of inactivity; loss of flexibility; a grating sensation (like a significant impact on the ability to perform activities of daily living and sand is trapped between the joints); can even become disabling. In fact, in and the development of abnormal the United States, OA is among the bony growths, called bone spurs, most common causes of disability around the joint. in adults. There is no cure for OA, and it’s OA usually occurs in people over a complex condition with many poage 40. It can, however, develop at a tential causes. Various medical and younger age if certain risk factors are surgical interventions can help reduce present. By age 70, according to the symptoms, increase range of motion, American College of Rheumatology, and limit further joint damage, but 70 percent of people have at least there are also many simple things some x-ray evidence of the disease. you can do to help prevent or manThe joints typically affected include age OA. They include: the hands, knees, hips, spine, neck, Lower the load and ankles, though it can develop in other joints as well. Excess body weight can lead According to the Mayo Clinic, facto or aggravate a wide range of tors that increase the risk of developing chronic ailments, and OA is among OA include older age; gender (women them. Remember, every extra pound are at greater risk than men); bone of weight on your body exerts a threemalformations; joint injuries, such as fold increase of pressure on your knees those sustained in sports or accidents; and a six-fold increase on your hips. obesity; sedentary lifestyle; having The five pounds you put on over the an occupation that places repetitive holidays may not seem like such a big stress on a joint; and having certain deal, but as far as your knees and hips diseases, such as diabetes, underacare concerned, you’ve actually added tive thyroid, gout, or Paget’s disease 15 and 30 pounds of pressure respecof bone. A genetic predisposition to tively. Also, carrying excess weight developing OA in certain joints has tends to adversely impact posture been noted, as well. and gait, further stressing the joints, OA develops when cartilage—the muscles, ligaments, and tendons. smooth tissue that cushions the ends As far as foods are concerned, of the bones at a joint—begins to break there’s no specific diet for people with down and wear away. As a result, (or those hoping to prevent OA) 10.25x4_ES_moveAd_co#6693B0.pdf 10/16/12OA 8:58:19 AM
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as there is for diabetics. Foods that promote proper body weight and good health in general are your best bet. Focus on getting more fruits and vegetables, whole grains, and lean protein sources while reducing sugar and unhealthy fats (i.e., saturated fats and trans fats).
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Stay active
Exercise will not only help you maintain a healthy body weight, but it will also strengthen the supporting muscles surrounding joints so they can function more efficiently. Strive to incorporate a minimum of 30 minutes of moderate exercise into your schedule at least five days a week. If you can’t manage that much initially, don’t push it. Start slowly and increase gradually as your strength and stamina improve. Even a modest level of exertion can make a big difference. However, it’s critical to use proper form and mechanics when exercising (seek the advice of a professional trainer if you’re uncertain), and if you are at increased risk of developing OA or already have the condition, it’s important to choose activities that don’t put excessive or repetitive stress on the joints. Low-impact activities, such as water aerobics, deep water running, or cycling, are preferable for preventing or managing OA.
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Take precautions on the job
It’s easy when focused on a task at work to overexert, use incorrect posture, or over-utilize the same joint without even realizing it.
Be mindful of your body mechanics in the workplace, and be sure to use any available ergonomic or safety equipment. If the job you’re doing involves the repetitive use of a limb, be sure to alternate sides frequently to avoid overworking one joint. And remember, these same rules apply when you’re doing work in your home or yard.
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Prevent joint injury
Because prior joint injuries predispose people to OA, all possible precautions should be taken to prevent them. No one can predict when an accident will occur, but common sense tells us that certain activities or situations greatly increase the risk of joint injury—such as participating in sports. Be sure to use proper body mechanics and any available protective/supportive equipment when playing sports or doing any other high-risk activity. If you do experience a joint injury in sports or any other activity, see your doctor for treatment immediately. If a joint injury is treated in an appropriate, timely manner, the joint is much more likely to heal in proper alignment.
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Listen to your body
Most importantly, never try to “push through the pain.” Pain is your body’s way of telling you, “Stop what you’re doing; something is wrong!” That same rule applies to work, play, and exercise. Remember, when it comes to your joints, too much of a good thing can be harmful. ❦
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Mercy Weight Management Center puts focus on long-term success
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ost people who struggle with excess body weight know from repeated firsthand experience that shedding pounds is not particularly difficult. The real challenge is preventing those pounds from piling right back on and bringing a few “friends” along with them. The weight-loss professionals at Mercy Weight Management Center understand how unhealthy and discouraging this cycle can be, so their primary focus is on helping patients achieve successful long-term weight management, not just initial weight loss. “We offer comprehensive medical weight-loss options for anyone who needs to lose weight, regardless of how many extra pounds they’re carrying, as well as for people who may not need to lose weight but just want to improve their health,” explains Amy Watkins, Director of Mercy Weight Management Center. “But what really sets us apart is our focus on sustaining long-term success. That’s the hardest part for patients, so our team is dedicated to helping them keep that weight off.” The Mercy Weight Management Center, which recently moved from the corner of Talmadge and Laskey to a new location at 3930 Sunforest Court, offers not only comprehensive non-surgical weight-loss programs, but also surgical weight loss and a new state-of-the-art, weight-friendly fitness center. The key message that the Center’s patients continually receive—from the bariatric surgeon, health coaches, dietitian, support groups, and behavioral classes—is that long-term weight-loss success is achievable only through lifestyle and habit modification. Bariatric surgery and meal replacements can be great tools for losing weight, but they’re not magic pills. The focus has to be on learning and adopting new eating and exercise behaviors. Watkins notes that bariatric surgeon Dr. Matthew Fourman, Director of Surgical and Medical Weight Loss for Mercy Weight Management Center, offers a very different, holistic approach to weight loss and maintenance. Fellowship trained in Bariatric & Minimally Invasive Surgery at Case Western Reserve University Hospital and having hundreds of successful weight-loss procedures to his credit,
Dr. Fourman performs Gastric Bypass Surgery, Sleeve Gastrectomy (robotically), and Adjustable Gastric Banding—all laparoscopic—for patients who have 100 or more pounds to lose. However, he emphasizes to patients that initial weight loss is only the beginning of their journey. “Dr. Fourman is not just about surgery. He makes clear that it’s relatively easy to lose weight for the first year or so after surgery, but then if patients don’t adopt and stick with good habits, bad behavior will gradually slip in and the weight will come right back on. In fact, he won’t even approve surgery until patients demonstrate that they’re working on lifestyle and behavior modification,” Watkins says. A series of focus groups conducted by Mercy Weight Management Center revealed that many overweight people desire to work out, but only in a weight-friendly environment—not surrounded by the already fit, slender people they’ll likely encounter in a regular gym. Thus, the new fitness center was designed specifically with this premise in mind. Patients receive a membership to the new fitness center during their initial consults. Dr. Fourman then helps them get started on an exercise program and will even work out right alongside Mercy Weight Management Center's new facility allows patients to exercise in a weight-friendly environment.
them. The health coaches also work closely with patients, either exercising with them or doing small group training. In fact, the entire weightmanagement team can be found working out with patients at times. Patients who use the fitness center experience a greater level of comfort and confidence knowing they’re working out, using locker rooms, etc. alongside people who have the same goals and are practicing the same behaviors. Another fitness barrier that often confronts significantly overweight
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people is the limited weight capacity of gym equipment. But the new fitness center has a solution to that problem, as well. Included in the center’s array of cardio- and strength-training equipment are several pieces that can accommodate up to 500 pounds. “We know that exercise, in addition to healthy eating habits, is essential to long-term weight-loss success, so we don’t want our patients feeling self-conscious and uncomfortable while working out. That’s why we created a fitness center that caters specifically to their needs,” Watkins states. Patients who could benefit from
a little one-on-one training can currently set up personal training sessions with Dr. Fourman. Group fitness classes will be forming soon, as well. Patients can also purchase fitness center memberships ala carte for as little as $17 a month. Anyone interested in learning more about Mercy Weight Management Center is invited to attend one of the Center ’s monthly informational seminars. These sessions are offered at no charge and no obligation to participants. To register or for more information, please call 419-251-8760 or visit www.mercy weightmanagement.com. ❦
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Personal Service to fit you right Running • Walking • Cross-Training
16 February 2013 / Healthy Living News
by Amanda Manthey
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re you interested in running but afraid of the first steps? Here are a few tips to get you off on the right foot and on your way to enjoying the sport of running. Most important, consult your physician before starting any exercise program. As a runner, the most important piece of equipment is your pair of running shoes. Before starting your running program, visit a shop such as Dave’s Performance Footgear, which specializes in running shoes, for an assessment of your needs and a personalized fit. One of the most common complaints of new runners is, “I can’t breathe.” Focus your energy on exhaling rather than inhaling. As your need for air increases, think about forcing the air out of your lungs rather than sucking it in. This will make you less tired than when you are huffing and puffing and will also help prevent hyperventilation. In the beginning, take frequent short runs after resting sufficiently. Your runs should last long enough for your body to get a workout but still be able to recover in time for your next run. If you over exercise and your muscles do not recover to their original condition, you will not gain any benefit. Strength is gained during rest when your muscles repair the fibers that are broken down during exercise. But remember, every runner is different when it comes to the
amount and frequency of exercise that is appropriate. Listen to your body. As a novice runner, take quick steps rather than long ones. You will not tire as fast if you take short, fast steps rather than long, slow ones, especially when you are tackling hills. When running downhill, lean your body forward in order to try to keep your body perpendicular to the hill. Novice runners need motivation and a schedule. Join a beginner running group or seek out a running partner. Some runners find that taking music along on their workouts helps make running fun. When using headphones, though, play the music at a reasonable level so you can hear traffic noise and remain alert to potential hazards. Speaking of hazards, if you are running alone, carry identification and always run against traffic, preferably on sidewalks or running paths. One of the best ways to improve and get more enjoyment out of running is to enter road races. The experience of finishing a running race is exhilarating. Start with the goal of a 5K (3.1-mile) road race, “fun run,” or a relay race with your running friends. Races can provide a foundation for enjoying a long life of running. Happy running! ❦ Amanda Manthey is a former collegiate runner for Eastern Michigan University. She writes about running and fitness for Dave’s Performance Footgear.
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February health tip from Heartand Rehab
Know the dangers of childhood obesity
T
he epidemic of childhood obesity has been making headlines for many years now, and with good reason. According to research published in the Archives of Pediatrics & Adolescent Medicine, one out of every five children in America is obese. That statistic is worrisome enough, but the trend appears to be heading in the wrong direction. The American waistline continues to expand, starting with our kids, and this growing problem is affecting children in both mind and body.
What are the health risks? What are the potential health ramifications of childhood obesity? From a psychological standpoint, obese kids are more prone to low self-esteem, poor body image, and eating disorders. They’re also at greater risk of depression and substance abuse. With respect to physical health consequences, obese kids are at increased risk for developing a wide range of ailments, such as type 2 diabetes (once known as “adult-onset diabetes”),
high blood pressure, high cholesterol, liver and gall bladder disease, early puberty, and sleep apnea. Of course, overweight children typically grow up to be overweight adults, subject to even more health complications.
How do I know whether my child is obese? A child is considered obese if he or she has a BMI, or Body Mass Index (an indication of body fat based on a person’s weight and height), that is equal to or greater than the 95th percentile for their age and gender. BMI is calculated by taking someone’s weight in pounds and dividing it by their height in inches. Then, divide that number by their height again and multiply the result by 703. So, the calculation for someone who is six feet tall and weighs 168 pounds would be (168 ÷ 72 ÷ 72) x 703 = 22.7. What does the result of the calculation tell us? Below 18.5 is considered underweight, 18.5 to 24.9 is normal, 25 to 29.9 is overweight, and 30 and above is obese. Thus, the individual
in our example would be considered normal with respect to body weight. People with a higher BMI are at increased risk for high blood pressure, type 2 diabetes, heart disease, gall bladder disease, and colon and breast cancer. At the other end of the spectrum, people with a belowaverage BMI are at greater risk for osteoporosis, falls and fractures, lower immune function, respiratory disease, digestive disease, and cancer. It’s important to note that BMI should be used only as a general guide in determining whether someone is carrying too much body fat. Because muscle is heavier than fat, people with greater muscle mass may have a BMI that suggests they need to lose weight when, in fact, they have a very healthy percentage of body fat.
What can I do to prevent obesity in my child? Kids tend to do as their parents do, not as they say, so the best thing you can do to prevent your child from becoming obese is to model healthy eating and exercise habits. In other words, lead by the example you and the rest of the family set. Just as poor lifestyle habits established in child-
hood lead to health problems later in life, good eating and exercise habits formed early in life lead to a much healthier adulthood. But don’t try to change your child overnight. Incorporate healthy changes gradually and give them time to solidify into habits that your child will, hopefully, continue for life. Heartland Rehabilitation Services can also help. In addition to providing outpatient physical and occupational therapy, Heartland offers wellness opportunities such as gym memberships, pilates, personal training, and fitness bootcamps. ❦ Heartland Rehabilitation Services has five locations in the Toledo and Bedford, Michigan areas with knowledgeable staff to assist with your physical and occupational therapy needs. Each location also offers a monthly membership for a small fee, with no contract, and the expertise of licensed clinicians to help you with your exercise routine. If you have any questions about Heartland Rehabilitation Services or how physical and occupational therapy can benefit you, please feel free to contact Jim Berger at 419-787-6741 or visit us at www. heartlandrehab.com.
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17
nobody’s perfect Sister Karen Zielinski, OSF
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18 February 2013 / Healthy Living News
I
How do I dispose of unused medicine?
n January and February, I usually clean out stuff around the house. I open my sock drawer and match my socks, look at the quality of my shoes, and cut up some old T-shirts into rags. I donate any clean clothing to various agencies that recycle and throw out the one or two odd socks that do not have a mate. (I never know how I lose just one sock, and yes, I checked everywhere for it!) Then I went into my bathroom. My medicine cabinet had some unused prescription drugs and lots of over-the-counter (OTC) medicines. There were things like generic Motrin, Claritin for my sinuses, and some generic Antivert for my occasional motion sickness spells. I needed to dispose of some of these pills. Growing up, I remember people flushed unused medications down the toilet. I knew that was not the best and only way to dispose of unused and unneeded drugs, but I wondered if there was a guideline for throwing out these pills so they do not damage the environment or fall into someone’s hands and cause harm. I checked with the Food and Drug Administration (FDA) online to see what their drug-disposal guidelines are. Of course, the federal government did have guidelines on drug disposal. (Why would I doubt the federal government having guidelines on something?!) They had plenty of suggestions for disposing of medications that are expired or no longer used. Most drugs can be thrown in the household trash, but consumers should take certain precautions before tossing them out, according to the FDA. A few drugs should be flushed down the toilet. And a growing number of community-based “take-back” programs offer another safe-disposal alternative.
Guidelines for drug disposal The FDA worked with the White House Office of National Drug Control Policy (ONDCP) to develop the first consumer guidance for proper disposal of prescription drugs. Issued by ONDCP in February 2007 and updated in October 2009, the federal guidelines are summarized here: •Follow any specific disposal instructions on the drug label or patient information that accompanies the medication. Do not flush prescription drugs down the toilet unless this information specifically instructs you to do so. •Take advantage of community drugtake-back programs that allow the public to bring unused drugs to a central location for proper disposal. Call your city or county government’s household trash and recycling service (see blue pages in phone book) to see if a take-back program is available in your community. The Drug Enforcement Administration, working with state and local lawenforcement agencies, is sponsoring National Prescription Drug Take Back Days throughout the United States. •If no instructions are given on the drug label and no take-back program is available in your area, throw the drugs in the household trash. First take them out of their original containers and mix them with an undesirable substance, such as used coffee grounds or kitty litter. The medication will be less appealing to children and pets and unrecognizable to people who may intentionally go through your trash. Also, put them in a sealable bag, empty can, or other container to prevent the medication from leaking or breaking out of a garbage bag. The FDA’s Deputy Director of the Office of Compliance, Ilisa Bernstein, Pharm.D., J.D., offers some
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additional tips: •Before throwing out a medicine container, scratch out all identifying information on the prescription label to make it unreadable. This will help protect your identity and the privacy of your personal health information. •Do not give medications to friends. Doctors prescribe drugs based on a person’s specific symptoms and medical history. A drug that works for you could be dangerous for someone else. •When in doubt about proper disposal, talk to your pharmacist. Bernstein says the same disposal methods for prescription drugs could apply to over-the-counter drugs as well.
instructions for flushing to reduce the danger of unintentional use or overdose and illegal abuse. For example, the fentanyl patch, an adhesive patch that delivers a potent pain medicine through the skin, comes with instructions to flush used or leftover patches. Too much fentanyl can cause severe breathing problems and lead to death in babies, children, pets, and even adults, especially those who have not been prescribed the drug. “Even after a patch is used, a lot of the drug remains in the patch,” says Hunter, “so you wouldn’t want to throw something in the trash that contains a powerful and potentially dangerous narcotic that could harm others.”
Why the precautions?
Environmental concerns
Disposal instructions on the label are part of the FDA’s “risk-mitigation” strategy, says Capt. Jim Hunter, R.Ph., M.P.H., senior program manager on FDA’s Controlled Substance Staff. When a drug contains instructions to flush it down the toilet, he says, it’s because FDA, working with the manufacturer, has determined this method to be the most appropriate route of disposal that presents the least risk to safety. Powerful narcotic pain relievers and other controlled substances carry
Despite the safety reasons for flushing drugs, some people are questioning the practice because of concerns about trace levels of drug residues found in surface water, such as rivers and lakes, and in some community drinkingwater supplies. However, the main way drug residues enter water systems is by people taking medications and then naturally passing them through their bodies, says Raanan Bloom, Ph.D., an environmental assessment expert in FDA’s Center for Drug Evaluation and Research. “Most drugs are not
completely absorbed or metabolized by the body, and enter the environment after passing through waste-water treatment plants.” A company that wants FDA to approve its drug must submit an application package to the agency. FDA requires, as part of the application package, an assessment of how the drug’s use would affect the environment. Some drug applications are excluded from the assessment requirement, says Bloom, based on previous agency actions. “For those drugs for which environmental assessments have been required, there has been no indication of environmental effects due to flushing,” says Bloom. In addition, according to the Environmental Protection Agency, scientists to date have found no evidence of adverse human health effects from pharmaceutical residues in the environment. Nonetheless, FDA does not want to add drug residues into water systems unnecessarily, says Hunter. The agency reviewed its drug labels to identify products with disposal directions recommending flushing or disposal down the sink. This continuously revised listing can be found at FDA’s web page on Disposal of Unused
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Medicines. Another environmental concern lies with inhalers used by people who have asthma or other breathing problems, such as chronic obstructive pulmonary disease. Traditionally, many inhalers have contained chlorofluorocarbons (CFC’s), a propellant that damages the protective ozone layer. The CFC inhalers are being phased out and replaced with more environmentally friendly inhalers. Depending on the type of product and where you live, inhalers and aerosol products may be thrown into household trash or recyclables, or may be considered hazardous waste and require special handling. Read the handling instructions on the label, as some inhalers should not be punctured or thrown into a fire or incinerator. To ensure safe disposal, contact your local trash and recycling facility. ❦ Sister Karen Zielinski is the Director of Canticle Studio. Canticle Studio is a part of the Sisters of St. Francis of Sylvania, OH’s overall advancement effort and has a mission of being a creative center where artists generate works, products, and services in harmony with the Mission of the Sisters St. Francis. She can be reached at kzielins@sistersosf.org or 419-824-3543.
19
Catholic Schools Nurture Academic and Spiritual Growth Visit an Open House and see what makes us different.
Franciscan Academy of Lourdes University
419-885-3273 • www.franciscanacademy.org
The Franciscan Academy of Lourdes University students have plenty of opportunity to expand their skills, learn the value of sportsmanship and have fun in the numerous programs we offer. From Preschool through Grade 8, students are inspired to think critically in their classes, to be centered in their faith, and to make a difference in their world. The Franciscan Academy has been changing hearts, teaching minds and leading the way for 40 years. COME, VISIT AND CELEBRATE.
OPEN HOUSE • Sun., March 3 • 12– 3 p.m. 5335 Silica Drive, Sylvania OH 43560
Lial Catholic School
St. Joan of Arc School
419-866-6177 Preschool through eighth grade, offering a wide array of curriculum opportunities including Spanish, project-based learning, advanced enrichment, student iPads, electives, and intervention services – all in a faith-filled setting. Tuition assistance available. OPEN HOUSE • Sun., March 3 • 1 p.m. - 3p.m. 5950 Heatherdowns Blvd. • Toledo, Ohio 43614
St. Patrick of Heatherdowns School
419-877-5167 Multi-age Continuous Progress School Readiness through Middle School www.lialschool.org
419-381-1775 • www.toledostpats.org debora.oshea@toledostpats.org 3 1/2-year-old Pre-K through eighth grade Financial assistance available
OPEN HOUSE Sun., March 3 • 12:00 p.m. - 3:00 p.m. 5700 Davis Rd. • Whitehouse, OH 43571
OPEN HOUSE Sun., March 3 • 1 p.m. - 4 p.m. 4201 Heatherdowns Blvd. • Toledo, Ohio 43614
Or call for a tour any time.
Regina Coeli School
419-476-0920 Preschool (half day or all day) through eighth grade www.regina-coeli.org
OPEN HOUSE
Sun., March 3 • 1 p.m. - 3 p.m. 600 Regina Parkway • Toledo, OH 43612
St. Pius X School
419-535-7688 Four-year-old preschool through eighth grade Full-day kindergarten Financial assistance available www.stpius.tld.pvt.k12.oh.us email: stpiusx_oshea@nwoca.org OPEN HOUSE • Sun., March 3, 12 p.m. - 2 p.m. 2950 Ilger Ave. • Toledo, OH 43606
Or, call for a tour any time.
20 February 2013 / Healthy Living News
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Catholic education Values received, excellence achieved
I
t seems as though two distinct and divergent sets of values are emerging in our society. One set seems to promote egocentrism, entitlement, moral relativism, instant gratification, and self-aggrandizement while the other embraces concepts such as faith, compassion, self-discipline, determination, accountability, and respect and empathy for others. Parents who hope to raise their children with the latter set of values definitely have their work cut out for them these days. The media and popular culture continually undermine their efforts to instill positive values in their children by sending and reinforcing the message that individual desires and impulses always take precedence over the needs of others and by dismissing positive values as antiquated or obsolete notions. But parents who send their children to Catholic schools find that the
U.B.U. at St. Francis de Sales
values they hope to impart to their children are upheld and reinforced in a supportive, caring environment. As a result, kids educated in Catholic schools emerge better educated, better citizens, and better prepared to deal with the opportunities and challenges life has in store for them. Here’s what a Catholic education will mean for your child.
The Top Choice in Catholic Schools! 42% of 8th grade boys taking the Catholic
Safe, supportive learning environment
High School Placement Test named St. Francis as their first choice high school.
With their emphasis on Catholic faith, individual responsibility, parental involvement, and respect for human dignity, problems such as behavioral challenges, substance abuse, and risks of violence are significantly lower in Catholic schools than in non-faithbased school systems. In addition, smaller class sizes mean that all students receive the support, personal attention, and interaction they need to excel academically.
That’s because St. Francis offers spiritual, academic, social, and physical development— and a personal focus that lets U.B.U.
There’s still time to take the Placement Test—call today to schedule a test or a visit!
Elevated expectations
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Catholic school teachers understand the basic principle that self-esteem
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Monday - Wednesday: 9 a.m. - 8:30 p.m. Thursday - Saturday: 9 a.m. - 5:30 p.m.
Maumee, 501 River Rd. Waterville, 800 Michigan Ave.
Monday and Tuesday: 9 a.m. - 8:30 p.m. Wednesday - Saturday: 9 a.m. - 5:30 p.m.
Kent, 3101 Collingwood Blvd.
Complete schedule at toledolibrary.org
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419.259.5200 21
At St. Ursula Junior Academy...
results from accomplishment, not vice versa. Students are expected to achieve in their academic endeavors, and they’re given the tools and support they need to do so. The bar of achievement is set high with the goal of preparing students for the rigors of secondary education and the working world.
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Christ’s example is the foundation upon which Catholic education is based. Children are encouraged and nurtured to be Christ-like people and to recognize the presence of Christ in others. Parents appreciate the fact that Catholic schools uphold and strengthen the religious formation they’ve begun in the home.
Emphasis on self-discipline Personal responsibility is a hallmark of Catholic education. Students are given the decision-making skills they need to make sound judgments throughout their lives and to extend the respect and dignity deserved by others. Selfdiscipline leads to academic success, which leads to a more significant contribution to society.
Parents who care Just like you, other parents of Catholic
school students want to play an active role in their children’s educational experience. In fact, many parents volunteer in a variety of capacities, such as playground or lunchroom supervision, classroom assistance, fieldtrip support, fundraising assistance, and many other areas. And the support works both ways. The schools are also happy to work together with parents as a team to help solve any problems or challenges that might arise.
Part of a community When your child becomes a part of a Catholic school, your family also becomes a member of this supportive, enriching community, which will allow your entire family to continue growing in their Catholic faith.
College in the future A college degree is critical to career success, and Catholic schools are focused on preparing students for entry into college. A very large majority of elementary and secondary Catholic school students attend college. In fact, according to the National Catholic Educational Association, 99% of Catholic secondary school students graduate and 97% go on to college.❦
By Jessica Derkis
St. Clare Commons innovates senior choice
St. John’s Jesuit High School & Academy Men for Others
These years will be measured by the men that they become.
Consider St. John’s Jesuit for your son!
Enrolling Now for Fall 2013 Contact Rob Taylor, Admissions Director at rtaylor@sjjtitans.org or 419.865.5743, ext. 257
St. John’s Jesuit High School & Academy | Grades 6 - 12 5901 Airport Highway | Toledo, OH 43615 | 419.865.5743 | www.sjjtitans.org 22 February 2013 / Healthy Living News
An intelligent mind acquires knowledge, and the ear of the wise seeks knowledge. —Proverbs 18:15
“T
his is not your granny’s nursing home!” exclaimed a son of a prospective resident taking the pictorial tour of St. Clare Commons recently. (While not quite ready for hard-hat tours, there are lots of architectural drawings, floor plans, and more to help paint the overall picture.) There are no long expanses of linoleum hallways. No beeping call system. No stark white, box-type rooms. No herd-mentality dining. What St. Clare Commons does offer is an abundance of choices. What choices are offered? Everything is optional. Where and when would you like to dine today? If you enjoy music, is Beethoven, Merle Haggard, or Dean Martin more to your liking? Do you prefer to recuperate quietly or amongst friends? What is your beverage of choice: coffee, tea, juice, wine? Do you like to host cof-
fee klatches, pinochle tournaments, or dinner parties? Does a perfect day include a good book and a window seat? Whatever you enjoy, St. Clare Commons can accommodate. Why are choices important? In a word: independence. More than that, when you have choices, you are empowered to think for yourself, which leads to your mind staying sharper, your body more active, and your heart more engaged. You have a whole team of advocates and helpers who have a vested interest in keeping you well and happy. They listen to you. People who are invested in your everyday happiness make choosing well even easier. How are all these choices possible? Choices are built into the very design of the community. When completed, St. Clare Commons will offer everything from assisted living, memory
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care, rehabilitation, and nursing care to future independent villas and apartments as the Toledo area’s only Catholic “Continuing Care Retirement Community.” As defined by helpguide.org, Continuing Care Retirement Communities (CCRCs) are facilities that include independent living, assisted living, and nursing care in one location, so seniors can stay in the same general area as their housing needs change over time. A CCRC offers peace-of-mind if you would like to stay in the same community regardless of your care needs. It also can mean spouses can still be very close to one another even if one requires a higher level of care. A well-planned Continuing Care Retirement Community is the strong suit of Architects Plus of Cincinnati (www.architectsplus.com). There are many features that are conducive to making everyday choices. What kinds of features are good for choice? A well-appointed San Damiano Chapel offers a space for restful contemplation as well as regular services including weekly Mass offered by
Father Herb Weber of Blessed John XXIII (blessedjohn.org). There are also many other connections planned in ministry as well as physically by road and transportation until the campuses are eventually united. Looking to expand your horizons? Education space is built right in. St. Clare Commons is set to accommodate meetings; staff, resident, and community education; as well as pertinent senior innovation conferences serving nearly a hundred participants. With a total of five dining rooms and a restaurant in the first phase, you choose your atmosphere and menu based on the day’s appetite and cuisine preferences.Two great spots to relax and socialize are the piano bar and lounge offering a variety of entertaining options and the coffee shop serving Starbucks™ beverages. A green and accommodating memory garden and two rooftop terraces offer outdoor living spaces that feel either rural or urban depending on your mood. A state-of-the-art rehabilitation lab, fitness center, library, and walkable grounds with five ponds and fountains round out some of
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23
that will be available to move in to in October.
the many amenities that make St. Clare Commons a community full of possibility.
In other news
What will be available this year? Reservations are being accepted, and many families are already making plans for their loved one’s move to St. Clare Commons. The first phase of St. Clare Commons will offer 60 private skilled-nursing suites that are planned to be ready for first residents in July and 56 assisted-living apartments and 36 memory-care studios
To learn more, join St. Clare Commons at the Educational Seminar and Luncheon at St. Rose Parish on February 7 or March 7 at 11:30 a.m. in the church basement. Call 419-8744995 for reservations. As you can see, it is vital to build a team who embraces the power of choice, innovation, and caring. Those
who are the best in their fields are invited to the St. Clare Commons Job Fair on Wednesday, April 3, at Blessed John XXIII at 24250 Dixie Hwy from 11 a.m. to 4 p.m. Bring your resume and ideas for improving senior care in Northwest Ohio. Click Careers at
www.StClareCommons.org for more information. ❦ For more information, contact Jessica Derkis, Director of Marketing, at 419250-5227 or jderkis@stclarecommons. org.
Middle years preparation crucial to college and career readiness
“T
he level of academic achievefor girls who need more challenge in ment that students attain by the areas of math, foreign languages, eighth grade has a larger impact on technology, fine arts, English, and their college and career readiness by social studies. the time they graduate from high NDJA is the only Catholic seventhschool than anything that happens and-eighth-grade school using a block academically in high school,” accordschedule. The program provides ing to The Forgotten Middle, an Executive Summary by ACT on College Readiness. The report goes further on to say, “The process of preparing students to make successful transitions from middle school to high school is just as important as the process of preparing them to make successful transitions from high school to postsecondary education.” These critical learning years were one of the reasons Notre Dame Junior Academy (NDJA) “Living at Swan Creek Retirement was started over five years ago Chinese is just one of four languages open to Junior Village is a gift I have given myself and for seventh and eighth graders. Academy students as part of their curriculum. my family – I feel secure, content and NDJA’s all-girls, seventh-andinvolved. I have a great apartment, eighth-grade program can play a an easier transition to high school wonderful neighbors, and the services pivotal role in college and career classes. Block scheduling ensures provided are second to none!” readiness for your daughter. The early preparation for college, time Junior Academy develops critical for more in-depth and interactive study and organizational skills in learning, better academic retention, 419-865-4445 preparation for the crucial high school and time for academic support serwww.swancreek.oprs.org years. NDJA focuses on developing vices if required. This schedule opens an individualized academic program the door to taking high school level classes in seventh and eighth grade. “Many of the Junior Academy girls are participating in the International Baccalaureate Program, working toward a full diploma or a certificate in a favorite subject,” said Kim Grilliot, principal grades 7-12. As students of the first all-girls, Catholic school in Ohio to offer the Experience Academics Internationally Recognized IB Program and the largest program • Earn College Scholarships in Northwest Ohio, Junior Academy girls are benefiting from the • Discover Fine Arts Opportunities philosophy of global learning and • Participate in the Best Athletics critical-thinking-skill development that permeates the high school cul• Grow in Your Faith • Build Self Confidence ture as well. IB is the world’s most respected academic program and is recognized by the most prestigious Sponsored by the Sisters of Notre Dame colleges and universities. Grades 7-12 • All Girls • 419-475-9359 • www.nda.org “The girls were well-prepared for high school academics and have
Life
Looks Good From Here
Beli eve •
in the future
your daughter can achieve.
Notre Dame Academy
24 February 2013 / Healthy Living News
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25
Getting just what you paid for?
continued to progress steadily. We have seen dramatic results in higher confidence levels and leadership. Many of our seventh- and eighthgrade graduates are involved in high school leadership roles in student government, clubs, and on service core teams,” explained Mrs. Grilliot. Now as the first graduates are seniors at Notre Dame Academy high school, you can see the results. Many are taking Honors and Advance Placement (AP) courses as well as
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26 February 2013 / Healthy Living News
participating in the International Baccalaureate (IB) World School Program. NDJA is accepting applications now for seventh grade. Students who would like to shadow, test, or get more information can call 419475-9359, ext. 3126. NDJA is located on the Notre Dame Academy campus at 3535 W. Sylvania Avenue, conveniently located near Westfield Mall. For more information, including a brochure, go to www.nda.org. ❦
Understanding acoustic neuromas
NOHC
by Shelly Horvat, AuD, CCC-A
O
ne of the questions patients often ask when they are experiencing ringing in the ears or pain near the ears is, “Do I have a brain tumor?” A rare cause of hearing loss and ringing in the ear is a tumor in or near the ear. In the United States, statistics show that about ten people per million are diagnosed with small tumors in the brain near the ear each year. These tumors are called acoustic neuromas or vestibular schwannomas. The acoustic neuroma is a benign (non-cancerous), slow-growing tumor that arises on the eighth cranial (hearing and balance) nerve in a very small area of the skull just behind the ear. An acoustic neuroma will not spread to other parts of the body; however, it can damage important nerves as it grows and puts pressure on them. As the tumor grows, it typically affects a Brain person’s hearing first as it presses on the hearing nerve. Larger tumors can put pressure on the facial, or trigeminal, nerve, which also passes through the same area. In the majority of cases, acoustic neuromas grow very slowly over a period of many years. Acoustic neuromas account for about 6% of all brain tumors. They occur in all races and are slightly more prevalent in women than in men. Most acoustic neuromas occur on one side of the brain only and occur spontaneously, with no hereditary or environmental factors as proven causes. However, one genetic disorder, Neurofibromatosis Type
2 (NF2), is known to cause acoustic neuromas on both sides of the brain. There are signs and symptoms that develop from the tumor pressing on the adjacent nerves or nearby blood vessels or brain structures. As the tumor grows, it may be more likely to cause signs and symptoms, although tumor size doesn’t always determine effects. Common symptoms include abnormal feeling of movement or dizziness; hearing loss in the affected ear, which makes it hard to hear conversations; and possible ringing (tinnitus) in the ear. Less common symptoms include difficulty understanding speech, headache, numbness or decreased feeling on one side of the face or one ear, pain in the face or one ear, weakness or drooping of one side of the face, or unsteady walk. The audiologist or physician may suspect an acoustic neuroma based on medical history, an examination of the nervous system, and certain tests. Often, the physiAcoustic cal exam is normal Neuroma when the tumor is diagnosed. If the above-listed symptoms are present, certain tests may be ordered. The most useful test to identify an acoustic neuroma is an MRI of the brain. Other tests audiologists can use to diagnose the tumor and tell it apart from other causes of dizziness or vertigo include: • Hearing test • Test of equilibrium and balance (electronystagmography)
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• Test of hearing and brainstem function (brainstem auditory evoked response, BAER).
tumors, tumors that are causing multiple symptoms, or tumors that are growing quickly or pressing on the brain. Surgery may be considered Treatment depends on the size to remove the tumor and prevent and location of the tumor, along with other nerve damage. There are risks, the age and overall health of the pathough, that may include partial tient. The patient and physician will or complete loss of hearing in the decide whether to watch the tumor affected ear, weakness in the face (typically by an annual MRI test), use muscles, and balance difficulty. The radiation to stop it from growing, or damage is more likely to occur when try to remove it. the tumor is large. Many acoustic neuAnother treatment opromas that are small and tion is stereotactic radiogrow very slowly and surgery, which focuses show few or no symptoms high-powered x-rays on a may be followed, espesmall area. It is considered cially in older patients, to be a form of radiation with an annual MRI and a therapy, not a surgical visit to the physician and procedure. It’s an option to audiologist to determine slow and stop the growth the status of their hearing of the tumors, which are and possible vertigo. An MRI may be ordered if hard to remove surgically. Without treatment, symptoms of acoustic neu- Another reason may be some acoustic neuromas roma exist. to treat those unable to can damage the nerves complete the surgical responsible for our hearprocedure. ing and balance, as well as the nerves An acoustic neuroma is not cancer. responsible for movement and feelThe tumor does not spread (metasing in the face. Rarely, very large tasize) to other parts of the body. tumors can lead to a buildup of fluid However, it may continue to grow and (hydrocephalus) in the brain, which press on important structures in the can be life-threatening. skull. People with small, slow-growing Removing an acoustic neuroma tumors may not need treatment. Once is more commonly done for larger hearing loss occurs, it does not return
after surgery or radiosurgery. Acoustic neuromas are not seen every day in our practice, but we do come across them. If you or someone you love is suffering from symptoms such as hearing loss, tinnitus, or vertigo, please do not ignore it. As always, please feel free to call the audiologists at Northwest Ohio Hearing Clinic if you have any questions about your hearing-loss symptoms.❦ Shelly Horvat, AuD, CCC-A, is a Doctor of Audiology with Northwest Ohio Hearing Clinic, located at 3000 Arlington Ave. in Toledo (419-383-4012) and 1601 Brigham Dr., Suite 160 in Perrysburg (419-873-4327).
Independent Living Assisted Living Nursing Care Respite Care Short Term Rehabilitation Outpatient Therapy
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Independent Living Condos available NOW. Call 419-861-5616. Lutheran Village at Wolf Creek, a ministry of Lutheran Homes Society in partnership with St. Luke’s Hospital.
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• Roth workplace plans and Roth IRAs don’t provide an immediate tax break, but you generally won’t pay tax on your distributions. • Ordinary taxable accounts face taxes on realized gains and investment income each year.
Personal
Tax-smart retirement moves
S
mart investing often involves choosing the right assets to meet your specific needs. It can also involve holding those investments in the right types of accounts—particularly when it comes to retirement savings. When managing your retirement savings, aim for tax efficiency, recommends Bev Doolin, IRA product manager at Wells Fargo Advisors. “And make sure you involve your tax professional as well as your Financial Advisor in assessing the tax implications of any investing strategy you’re considering.” You can save for retirement in a variety of accounts: • Traditional IRAs and workplace plans such as 401(k)s can lower your taxes now, but your distributions will be taxed as ordinary income.
“The various types of accounts offer different advantages, not only when making contributions but also when taking funds out,” Doolin says. “But you have to set up the accounts properly to get the benefits.” Here are a few considerations to help you make the most of the accounts available to you: Tax deductions. Some investors delay making a traditional IRA contribution until they know whether it will qualify for a tax deduction. If there’s any doubt, Doolin suggests contributing to a Roth IRA. “It’s a nobrainer,” she says. You can contribute directly to a Roth IRA if you earn less than $125,000 (single) or $183,000 (married filing taxes jointly) in 2013. Otherwise you can contribute to a traditional IRA and then convert it to a Roth. One benefit of Roth IRAs: They don’t require minimum distributions after you reach age 70½. Growth versus income. As a general rule, it’s wise to keep investments with strong growth potential in Roth
accounts, which shield you from tax on any appreciation. Taxable accounts can also be a good option for growth stocks, as long as you hold the stocks for the long haul. The reason: The capital gains tax you’ll pay when you sell the shares is likely to be lower than the income tax you’d pay if you held them in a traditional IRA, sold them, and then distributed the cash—but be sure to review such a strategy with your own accountant and Financial Advisor to make sure that would be the case for you. Investments that regularly spin off taxable income, such as highdividend-paying stocks or bonds, are likely best kept in tax-advantaged accounts. The same is likely to prove true for mutual funds with high turnover. The funds’ frequent trading tends to generate significant short-term capital gains, which are distributed to shareholders. The result can be a hefty tax bill in a taxable account. Estate planning. A Roth IRA is the undisputed champion of accounts when it comes to passing down assets. You won’t have to take withdrawals during your lifetime, and while your
heirs will have to distribute a required minimum amount each year, they generally won’t pay any tax on it. Securities in taxable accounts come in second, at least in terms of tax efficiency: The inheritors won’t have to take required minimum distributions, and they’ll pay capital gains tax only on appreciation that occurs after your death. On the other hand, if you pass a traditional IRA or 401(k) to your heirs, they will be required to take minimum annual withdrawals and pay taxes on those distributions. Note that assets in all types of accounts are considered part of your estate, and so may trigger estate taxes. Your Financial Advisor can work with your estate attorney and tax professional to help you craft a plan for minimizing the impact of estate tax on your financial legacy. Distribution strategy. The rule of thumb for retirement distributions is to start tapping your taxable accounts first, your traditional IRAs second, and your Roth IRAs last. But that’s not always the most effective order, Doolin says: “Liquidating an asset in your taxable account might
Save now, pay taxes later With a traditional IRA, not only are the earnings tax deferred, but your contributions may also be tax deductible. You pay no taxes on any investment earnings until you distribute the money, which is typically in retirement when your tax bracket may be lower.* Call today to find out whether a traditional IRA is right for your personal retirement strategy. * Traditional IRA distributions are taxed as ordinary income. Withdrawals before age 59 1/2 will be subject to ordinary income tax and may be subject to 10% federal tax penalty. Wells Fargo Advisors does not provide tax or legal advice. Be sure to consult with your own tax and legal advisors before taking any action that may have tax or legal consequences.
Michael Foster First Vice President - Investments Quantitative Choice Portfolio Manager 419-872-3859 • 1-800-245-5782 Fax: 419-874-6315 michael.r.foster@wfadvisors.com
Marcus Jones First Vice President - Investments Quantitative Choice Portfolio Manager 419-872-3858 • 1-800-245-5782 Fax: 419-874-6315 marcus.w.jones@wfadvisors.com
Investment and Insurance Products: u NOT FDIC Insured
u NO Bank Guarantee
David Hollinger Vice President - Investments 419-872-3875 • 1-800-245-5782 Fax: 419-874-6315 david.r.hollinger@wfadvisors.com
Matthew Langham Financial Advisor 419-872-3857 • 1-800-245-5782 Fax: 419-874-6315 matt.langham@wfadvisors.com
28300 Kensington Lane Perrysburg, OH 43551
u MAY Lose Value
Wells Fargo Advisors, LLC, Member SIPC, is a registered broker-dealer and a separate non-bank affiliate of Wells Fargo & Company. ©2012 Wells Fargo Advisors, LLC. All rights reserved. 1212-03217 [79468-v3]
28 February 2013 / Healthy Living News
To read this issue online, visit www.hlntoledo.com
push you into a higher tax bracket, which could affect everything from the taxes you owe to the cost of your Medicare Part B premium.” Her suggestion: Lay out a general distribution strategy that reflects your anticipated income needs, then adjust your withdrawals depending on your situation in any given year. Again, consult with your Financial Advisor and your tax professional to make sure the strategy you develop takes into account all relevant changes in tax regulations as well as your own needs. You worked hard to save money for retirement, so it makes sense to be as tax efficient as possible. But Doolin points out that any added value is less important than the benefits of saving in the first place. “Most mistakes you
might make in terms of tax efficiency can be fixed with time,” she says. “That’s not the case if you haven’t saved enough for retirement. So save first—and then think about taxes.”❦ Wells Fargo Advisors is not a legal or tax advisor; however, we will be happy to work with your chosen advisor to help you reach your financial goals. This article was written by Wells Fargo Advisors and provided courtesy of Michael R. Foster, First Vice President – Investments, Quantitative Choice Portfolio Manager, Marcus W. Jones, First Vice President – Investments, Quantitative Choice Portfolio Manager, David R. Hollinger, Vice President – Investments, and Matthew Langham, Financial Advisor, in Perrysburg at 419-872-3840. Investments in securities and insurance products are: not fdic-insured/not bank-guaranteed/may lose value. Wells Fargo Advisors, LLC, Member SIPC, is a registered broker-dealer and a separate non-bank affiliate of Wells Fargo & Company. ©2012 Wells Fargo Advisors, LLC. All rights reserved.
HCF welcomes Bowling Green Care Center
HCF
is pleased to welcome Bowling Green Care Center to its family of companies. Formally operated as Blakely Care Center, Bowling Green Care Center is a skilled nursing and rehabilitation center located at 850 West Poe Road in Bowling Green. Bowling Green Care Center will maintain its rich heritage in the community and continue many of the traditions its residents and family have come to expect. From family to family, HCF is grateful to the Blakely staff and residents who have so warmly embraced our vision for Bowling Green Care Center. The warm and welcoming homelike environment is inviting for all who visit Bowling Green Care Center. It’s important to us that each resident feel completely at home and comfortable. Each room is designed for comfort and ease of living, and several décor options are available to complement taste and treasured possessions. The various amenities feature comfortable surroundings that encourage visitation and resident interaction. Bowling Green Care Center will maintain its commitment to treating those with Parkinson’s disease. The staff members have advanced training to allow them to effectively work with patients and their families to manage the symptoms of Parkinson’s disease while preserving quality of life. Bowling Green Care Center is recognized for their success with this unique programming, and that will continue.
The staff at Bowling Green Care Center exemplifies HCF’s commitment to providing the best care possible in an environment that promotes quality of life. Starting with traditional care practices and high standards, HCF continuously enhances individualized care plans and implements Person Centered Care values, thus taking patient care to the next level, resulting in care of excellence. Bowling Green Care Center provides a comprehensive range of quality healthcare services, including: • 24-hour skilled and intermediate nursing care • Admissions 7 days a week • Short-term rehabilitation • Long-term care, hospice care, respite stays • Post-operative care • Tracheotomy care, wound management, pain management • IV, TPN, and IV antibiotic therapy • Physical, occupational, and speech therapies • Restorative nursing program • Specialized dietary services.
NAMI Basics - Wednesdays February 20 - March 27, 2013 6:30-9:00 pm F2F Afternoon Class - Thursdays February 7 - April 25, 2013 3:15-5:15 pm F2F Morning Class - Tuesdays March 5 - May 21, 2013 9:30-11:30 am F2 Evening Class - Tuesdays F2F March 5 - May 21, 2013 6-8 pm
Whether you are interested in post-hospital rehabilitation, chronicdisease management, rehabilitation to home, or even long-term care, Bowling Green Care Center continues its family-owned and -operated tradition and is there to meet your care and rehabilitative needs. ❦
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29
Obesity What you must know! by Ranvir Rathore, MD
O
besity has become one of the most important public health problems in the United States. As the prevalence of obesity increased, so did the prevalence of the co-morbidities associated with obesity. The body mass index (BMI) is the accepted standard measure of overweight and obesity. Adults with a BMI between 25 and 30 are overweight; those with a BMI of 30 or higher are obese. Having an obese parent increases the risk of obesity by two to threefold. Almost one-third of children and adolescents in the US are either overweight or obese, and the prevalence of obesity among school-aged children and adolescents in the US dramatically increased in recent times
30 February 2013 / Healthy Living News
Almost all obesity in children and adults is strongly influenced by environmental factors, either a sedentary lifestyle or a caloric intake that is greater than needed. Important contributing factors are sugar-sweetened beverages, cheap availability of high-calorie food, more expensive healthy food, and the cultural shift toward a more sedentary lifestyle. Every two-hour increment spent watching TV was associated with a 23-percent increase in obesity and a 14-percent increase in the risk of diabetes. Getting fewer than eight hours of sleep daily is also associated with weight gain. Obesity has significant deleterious effects on a person’s medical and psychiatric health. The medical
rationale for weight loss in obese multiple low-calorie servings helps. patients is that obesity is associated Avoiding breakfast and eating fewer with many health risks, including but larger meals are associated with type 2 diabetes mellitus, hypertension, weight gain. dyslipidemia, coronary heart disease, Many patients and some clinicians and many others. At any given level have unrealistic expectations of the rate of BMI, the risk to health is increased that people can lose weight. A loss of by more abdominal fat, dyslipidemia, five percent or more by six months is hypertension, age less than 40 years, realistic. If less than five percent is lost male sex, and a strong family history in the first six months, something else of diabetes, hypertension, or heart should be tried. One option would be disease. With these measures, the to use portion-controlled foods, such presence of the Metabolic Syndrome as frozen dinners or lunch entrees, can be diagnosed. Its presence sugand shakes or food bars that have a gests increased risk for diabetes and defined number of calories. Increasing heart disease. energy expenditure through physiBehavioral interventions may also cal activity is especially effective for help individuals maintain their weight long-term maintenance of a lower loss. Exercise consistently stands out body weight. as an important factor in maintaining On the diagnosis of obesity, a weight loss after any weight reducthorough physical exam with a blood tion. Characteristics of those who are test is often needed to rule out a polikely to succeed include a weight tentially treatable medical condition loss of more than 2 kilograms (4.4 that is causing weight gain, such as pounds) in four weeks, frequent low thyroid or Cushing’s disease/ and regular participation in a syndrome (high blood steroid). weight-loss program (such as A medical-weight-loss clinic Weight Watchers), and the subject’s with excellent team work, includbelief that his or her weight ing a dietitian, behavioral therapy, group sessions, and approprican be controlled. Behavior modification, ate drugs to help weight loss or behavior therapy, is for eligible candidates, is the one cornerstone in the key to significant weight treatment for obesity. loss and the maintenance Eating small servings or of an ideal weight. Dr. Ranvir Rathore
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Most of the currently available drugs have minor side effects that diminish with treatment; however, a few serious side effects have been identified that should preclude shortterm use in those who wish to lose small amounts of weight. Even with potentially dangerous drugs, chronic treatment may be needed when the magnitude of the obesity carries larger risks, e.g., a BMI above 30 or between 27 and 30 with complicating factors such as diabetes mellitus or hypertension. Along with diet, exercise, and behavior modification, drug therapy may be a helpful component of treatment for overweight or obese patients. The decision to initiate drug therapy in overweight patients should be made only after a careful evaluation of risks and benefits. Pharmacologic options include orlistat (decreased fat absorption), lorcaserin (appetite suppressant), combination phentermine-topiramate, phentermine, benzphetamine, and phendimetrazine. Of these options, orlistat is preferred as initial therapy because of its efficacy and long-term safety record. For patients with specific co-morbidities, a weight-centric approach to chronic disease management is best, trying, if possible, to select the drugs to treat the co-morbidity that may produce weight loss, rather than weight gain. As an example, for patients at high risk for developing diabetes, metformin does not cause weight gain and may cause weight loss. Over-the-counter dietary supplements including ephedra, green tea, chromium, chitosan, and guar gum are widely used by individuals attempting to lose weight, but evidence to support their efficacy and safety is limited. For select patients who failed medical management, laparosopic bariatric surgery is the choice of treatment, the three most common surgeries being gastric bypass, gastric sleeve, and banding. The risk of immediate complications with these surgeries is less than having a gall bladder taken out laparoscopically. A typical patient would be someone with a BMI of 40 or higher with acceptable risk for surgery who has failed previous non-surgical weight loss. Adults with a BMI of 35 or greater who have serious co-morbidities, such as severe diabetes, sleep apnea, or joint disease, may also be candidates. A majority of patients undergoing bariatric surgery for obesity experience complete resolution or improvement in diabetes, hypertension, hyperlipidemia, and obstructive sleep apnea. In addition, a randomized clinical trial found that laparoscopic adjustable
gastric banding is significantly more effective than medical management at two years follow-up in patients with mild to moderate obesity. With the surgical procedure liposuction (removal of large volumes of subcutaneous abdominal fat with suction), waist circumference decreases, but it does not improve insulin sensitivity or risk factors for coronary heart disease. In summary, obesity is a significant public health concern spreading across all age groups, genders, and nationalities, especially in the United States. Due to its adverse health effects on multiple organ systems in the body, it is imperative that we recognize it and take measures to curb and cure it in a realistic and sustainable way by working closely with physicians and healthcare providers. If you have any questions, we would be happy to answer them. ❦ Dr. Ranvir Rathore is an American board of Internal Medicine certified physician and can be reached at Oregon Clinic, Oregon, OH. You can also write to him at franklin1857@gmail.com.
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SUNSET RETIREMENT COMMUNITIES
32 February 2013 / Healthy Living News
and flowed south at 100 feet a day. The Everglades is this 50-mile-wide sawgrass savannah called “The River of Grass.” Until the 1950s, South Florida was the real estate equivalent of the Brooklyn Bridge. Only fools bought it. Until some of the fools decided that it might be possible to drain the swamp. Billions of gallons a day of “excess” water was diverted via a network of canals and dikes to the Atlantic and the Gulf. By 1960, Miami had a population of five million. By 2000 it was 16 million. “Draining the swamp” helped create ribbons of resort and retirement communities along the coasts. Inland, farmers began to raise sugar cane, beef and dairy cattle, and an enormous quantity and variety of fruits and vegetables. At the same time, agriculture and population growth increased the demand for water. In 1989, Congress created the Comprehensive Everglades Restoration Plan to restore water flow to a more natural pattern of distribution. The 2012 wet season was wetter than normal. When Shirley and I arrived in Everglades National Park in time to celebrate the New Year, we noticed that the savannah along the park road held pockets of water. The water held birds—ibis, egrets, storks, and herons. Some pockets were big enough to hold alligators. During the dry season, the Anhinga Trail along Taylor Slough is one of the best places in the world to view wildlife. Tourists come from every country that has an airport. Any day on the Anhinga Trail you can hear a regular United Nations of languages. Some of them are even close to “English.” We met a family from Australia that included a girl who had done a school report on the Everglades—Wonder of the World. Naturally, they had to come. The tourists are there because the animals are there. The animals are
Florida is wonderful in January. Say hello to the folks in Hinkley, OH, and tell them all the boys plan to be back on March 15.
there because the water is there. This is where the irony comes in. This year there is more water but less wildlife on the Trail. “Lucy,” I hear you saying, “you’ve got a lot of esplainin’ to do.” But it really is quite simple. In the wet season, most places in the Everglades hold up to six inches of water. In the dry season, the water recedes into the deeper pockets and sloughs that may hold one to three feet of water. In a typical year, the wildlife population is concentrated in a relatively small area. This is great news for tourists because it makes wildlife viewing really easy. When there is more rain than
The little green heron fishes from a low, overhanging branch. He leans over to grab his lunch without ever leaving his perch.
usual, the wildlife can disperse over a much wider area. Great news for them. Not so much for us. At dusk in the park, rangers lead tours along the Anhinga Trail to see alligators that, as nocturnal feeders, are more active then. A gator snoozing in the sunshine is interesting. A gator catching a water snake, turtle, or big Florida gar is much more so. Visitors who shine their flashlights into the slough are rewarded by the view of bright red gator retinas like a string of Christmas lights. But not on Jan. 7. Shirley and I have spent the last eight Januaries in the Everglades. Some of the gators have become friends and are always glad to Ranger Kirk apologized see us. to his tour group beTo read this issue online, visit www.hlntoledo.com
cause they saw only three alligators. If you expected to see one and saw three, that might have been pretty good. But Shirley and I have seen them by the hundreds in the past. Even so, the gators were there all the time. That same morning, Shirley and I had heard them roaring. Not just two or three but in large numbers—back in the swamp, out of sight. At a place on the Anhinga Trail we call the Wisconsin Hole, we are accustomed to seeing a couple dozen gators sunning themselves on the
Who you callin' an old coot? I splash water in your general direction.
bank. This year, high water meant less bank and, therefore, fewer gators. Still, visitors seemed just as excited to see one dozen as two dozen. People are also impressed by what they perceive as the exceptional bravery of the wading birds. Right among the gators you can see egrets, purple gallinules, ibis, wood storks, little green herons, and little blue herons. They go about their business of fishing, apparently oblivious to the danger all around them. But they scatter when a great blue heron arrives with a raucous “Grawk!” So, what is different this year is not so much the reduction in the number of species but the reduction in the number of individual birds. When we drove down to Flamingo, on Florida Bay, we stopped along the way to walk the short trails at Pinelands, Pa-hay-okee, and Mahogany Ham-
mock. Climbing over Rock Reef Pass (elevation: three feet) we entered the bald cypress forest and then the mangrove forest along the coast. Places we have found dry in the past held six inches or more of water. This may not sound like much, but it is enough to hold small fish. Small fish there had attracted wading birds that might otherwise have been found in Taylor Slough. This pair As we get further of ospreys into the dry season, was just those wetlands will beginning dry up and the birds the nesting and alligators will season down move to where they at Flamingo. usually hang out. Perhaps. That Everglades Restoration Plan has some interesting aspects. The government (i.e. the taxpayer) is buying land that now supports sugar cane and dairy and beef cattle. It is dry now, but it is destined to return to what we used to call “swamp land in Florida.” In addition, some man-made obstacles to the flow of water are being adjusted or removed. The Tamiami Trail is the highway that runs across the southern tip of the state. In effect, it is a 50-mile-long dike that interrupts the flow of water in the Everglades. Portions of the Trail are being rebuilt as an elevated causeway. The net effect of all of this is that a huge area of South Florida will again
resemble its natural state. It is as if the Dutch woke up one morning and said, “You know, maybe those dikes weren’t such a good idea.” The restoration of natural water flow will dramatically increase the area used by wildlife. This may mean that the total population will increase. In the meantime, the existing population is likely to be more widely dispersed. On the Anhinga Trail, you can often approach the great wading birds and the gators to within two or three feet. If you approached exactly the same bird out on Mahogany Hammock, it would fly away before you could get anywhere near that close. Wildlife is tolerant of human proximity when it has no other option. More water
Bald cypress are conifers that drop their needles in the dry season to conserve moisture. This year they were up to their knees in water.
equals more options. By the middle of January, the water level in the Everglades had receded noticeably, though it was still higher than usual. For the soaring and perching birds, water level was never an issue. The vultures continued to soar and squabble among each other in appreciable numbers. Tree swallows came through in great swarms, twisting and turning as they filtered tons of insects out of the air. Thank you very much! At site 8 in Long Pine Key Campground, we enjoyed our morning coffee in the company of mockingbirds and catbirds. Two pairs of cardinals flitted about among the palmettos and pond apples. A pair of rufoussided towhees kicked up the leaves in the underbrush in search of bugs. A red shouldered hawk announced his arrival with a high-pitched skreeskree-skree and then sat in the top of a long needled slash pine to survey his domain. And the barred owls ended our days with their hoot-toot-to-hoo. However the water issue unfolds, we hope that, as in the past, a visit to the Everglades will continue to be just a walk in the park. ❦ LeMoyne Mercer is the travel editor for Healthy Living News and the regular contributor of A Walk in the Park.
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33
Life at Swan Pointe...
The aging eye, part 1 by Bennett Romanoff, MD
A ~ Lois loves Swan Pointe Life at Swan Pointe for Lois Leninger was quite busy for a while. She received both physical and occupational therapy services and has now successfully completed her rehab services. Lois stated that “she loves living at Swan Pointe”. Both she and her daughter Carol are very pleased with the thoughful care Lois receives.
At Swan Pointe Care Center, we are always,
Providing Service with Our Hearts and Hands.
SWAN POINTE CARE CENTER
3600 Butz Road Maumee, OH 43537 P. 419-867-7926 | f. 419-868-3515
a Consulate Health Care Facility
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34 February 2013 / Healthy Living News
s one grows older, there are numerous changes that take place in the body. As in all other parts of the body, there are many changes that take place in the eyes as well As we age, we are more likely to develop eyesight issues. Some people don’t seek medical care for eye problems because they feel nothing can be done. Others do not have regular eye exams because they feel that they see well and nothing hurts. Both of these scenarios are simply incorrect and sometimes may lead to unnecessary blindness or loss of vision. Too many eye diseases, like glaucoma and diabetic eye disease, initially have no symptoms and can cause permanent loss of vision if not diagnosed and treated early on. It is recommended that eye examinations be performed every two years starting at four to five years old and annually after the age of 60. “An ounce of prevention is worth a pound of cure” is a very true saying in regard to the eye. Besides the multitude of eye diseases, approximately one-third of all systemic disease is potentially diagnosable by an ophthalmologist during a routine eye exam. Over my career as a physician ophthalmologist, I have diagnosed many diseases in the body, including breast cancer, plaques in the carotid arteries, multiple
sclerosis, diabetes, brain tumors, high blood pressure, and so many more. All of these diseases were not known to the patient until they were discovered during a routine eye exam. Early diagnosis and prompt treatment of eye or systemic disease can greatly reduce the chance of more severe problems later on. In some cases,
systemic disease diagnosed through an eye exam can mean the difference between life and death! Only an ophthalmologist, a medical eye doctor, is trained to diagnose and treat all forms of eye disease. Ophthalmologists are also trained in the use of lasers as well as eye surgery. Some of the more common aging conditions of the eye are: • • • • • • •
Presbyopia Flashes and floaters Glaucoma Cataracts Dry eye syndrome Diabetic eye problems Macular degeneration
This list contains only the more common conditions related to aging. There are many more conditions that can occur, but they are much less prevalent. In part 1 of this article, I will discuss presbyopia, floaters and flashes, and glaucoma. Next month, I will discuss cataracts, dry eye syndrome, diabetic eye problems, and macular degeneration.
Presbyopia The lens in the eye is very soft and flexible in the earlier years of life. It is this flexibility that allows us to focus up close to read and for farsighted people to see clearly at a distance. At around the age of 40 to 45, the lens becomes gradually harder and less flexible in most people. The lens can’t flex enough to focus up close. It can also go into spasm, making focusing from close to far away momentarily difficult. This loss of flexibility is called presbyopia and is a normal aging condition. There are no exercises or medications to reverse or halt this condition. Bifocals or reading glasses are necessary to allow clear vision for close visual tasks. Around every two years until about the age of 60, stronger bifocals or reading glasses are necessary.
Floaters Floaters appear as small “bugs,” dots, or lines that move in one’s field of vision. They are most easily seen
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when looking at a clear background, such as the sky or a white piece of paper. Floaters are actually clumps of normal tissue in the vitreous humor, the semi-clear liquid that keeps our eye ball “inflated.” In reality, these floating clumps are inside the eye, but visually they appear to be floating in the air. Since the vitreous is semi fluid or jelly-like, when one’s eyes turn or move, the clumps move inside the vitreous. When they float in our line of vision, we see them. Floaters are more noticeable with aging since the vitreous slowly degenerates with age. Also the vitreous gel can shrink with age, a condition known as a posterior vitreous detachment. This can result in a sudden increase in floaters and flashes. There are some medical conditions that also result in floaters. Iritis, vitreous bleeding, and certain ocular laser surgeries, such as a YAG laser capsulotomy, are just a few conditions that cause floaters. Sometimes a retinal detachment can also cause floaters. Generally, floaters are normal and only rarely signify a serious problem. When they occur suddenly and are accompanied by flashes of light or a loss of the peripheral vision, this could be a detached retina, which needs prompt medical or surgical therapy. There is no practical treatment for floaters. They are typically harmless, and at the most they are annoying. One can try to move them out of the way by turning one’s eyes rapidly and thus shifting the semi-liquid vitreous.
Flashes When the vitreous pulls or tugs on the retina by head movements or rubbing one’s eyes, the illusion of flashing or streaking lights may occur. Some people describe this as “shooting stars” in their vision. Flashes tend to increase with age. On other occasions, when these light flashes are accompanied by floaters and vision loss, this could signify a serious condition such as a detached retina. Sometimes when flashes last a long time or appear to shimmer and look like heat waves or zigzag lines, it could be a symptom of a migraine headache. Usually, these episodes last 10 to 30 minutes and may be associated with temporary decreased or loss of vision. These episodes, known as a scintillating scotoma, may or may not be followed by a migraine headache. Anyone who does experience floaters or flashes should undergo a comprehensive ophthalmologic exam to exclude a more serious problem.
Most of the time, floaters and flashes are not serious, and they are usually considered a normal part of the aging process.
Glaucoma
LIVE ON STAGE
Glaucoma is one of the most common causes of blindness in the United States. Even though it can occur at any age, it is much more likely to occur as we age. Risk factors for glaucoma include: • • • • • •
Being over the age of 40 Family history Afro-American ancestry Significant nearsightedness Past history of eye trauma Steroid medication use.
Glaucoma is known as the “silent blinder” or the “thief in the night” because there are no symptoms in the vast majority of cases and one doesn’t notice the permanent vision loss until it’s too late. It is estimated that 50% of all people with glaucoma remain undiagnosed. Early diagnosis and treatment is essential. Simple, painless office testing can easily detect glaucoma in most cases.
Once diagnosed, glaucoma is usually easily controlled with lasers or eye drops. Only rarely is surgery necessary when drops and/or lasers fail to control the disease. Even though glaucoma mainly occurs over the age of 40, it can occur at any age. There are many types of glaucoma. A very rare form of glaucoma, called narrow angle glaucoma, is associated with terrible eye and head pain. Glaucoma cannot be cured; however, therapy can control the disease. Medication and/or lasers cannot restore lost vision or damage to the optic nerve caused by the glaucoma. This is why regular eye care and the early detection of this disease are so important. Please be sure to pick up next month’s issue of Healthy Living News to read the conclusion of “The Aging Eye.” ❦ Dr. Bennett Romanoff is Chief of Ophthalmology at Flower Hospital, a Clinical Assistant Professor of Ophthalmology at the University of
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that include lamb and marinated chicken. The number one seller is falafel, the patties made from chick peas, parsley, onion, and spices, and they are served individually or as part of sandwich and combo plates. Shbat explains, “The falafel is like by Christine A. Holliday our burger; they are very popular.” A large deli case is full of foods, from rice to meat pies, that are available for purchase for eating at home Also in demand at Fetoosh are the smoothies and health drinks. re you still recovering from Christand through his catering business. Those who forego the typical soft mas cookie overload or fruitcake “All of our foods are designed for drinks can watch as Shbat feeds the feasts? Still walking off the eggnog people who want to eat right. Our large commercial juicer and the fudge that you enjoyed over two mottoes are ‘Eat healthy and with the fresh the holidays? Thinking about how to live longer’ and ‘If it’s fresh, it’s from ingredients for a eat better this year without sacrificing Fetoosh.’ We really do want people Health Blast drink flavor and fun? to enjoy the food because it is deli(carrots, apples, Ismail Shbat, owner of Fetoosh Deli cious and because it is made with celery, parsley, and and Catering, formerly of Maumee, fresh ingredients.” a bit of ginger) or but now in Sylvania, might have The menu board in the Deli miran Energy Blast the answer for you. He has owned rors the emphasis on foods from (carrots, beets and Fetoosh since 1996 and has been paya Mediterranean diet. Specifically, apples, ginger oping attention to the food requests of the salads, sandwiches, and soups tional). Smoothies his customers. He hears increasing are full of the ingredients that have feature juices (carrot, numbers of them expressing concern promoted health in people near the orange, or mango) about eating better and losing weight. Mediterranean Sea for centuries: with plenty of fresh fruit In the last 18 months, especially, he has healthy fats, fruits, vegetables, whole and a hint of honey. A noted that his customers are looking grains, and plenty of flavorful spices. delicious way to get valufor good, filling food that won’t add There are plenty of familiar Midable nourishment! pounds or endanger their health, and Eastern offerings—hummus, fetoosh, Baklava, in all its he is happy to provide it in his deli tabbouli, grape leaves, and choices honey and pistachio splendor, is a wonderful dessert, and there are plenty of other cookie-like goodies available—Mmm! No reason to feel guilty after such healthy meals. Shbat reports that he finds more and more Americans (sometimes perceived as picky eaters) willing to try these foods for the first time. He is very pleased that so many parents are introducing their young children to the flavors of these foods, saying, “It is a good thing to start with youngsters. Give them good food early on and they will develop healthy eating habits for a lifetime.” And it’s promoting longevity that makes a Mediterranean diet so worth examining and pursuing. Research in recent years, and the personal Toledo College of Medicine, and an instructor of Ophthalmology in the Family Practice residencies with Flower and Toledo Hospitals. Since setting up his
practice in 1978, Dr. Romanoff has helped thousands of patients in Northwest Ohio achieve better quality of vision with upto-date treatments and solutions.
Fresh food is on the menu at Fetoosh Deli
experience of those who have benefitted from these foods, shows a variety of benefits from diets low in saturated fats, sodium, and red meat. Those benefits include improved brain function, longer life, lowered risk for heart disease, help with weight loss and depression, to name just a few. Fetoosh offers catering of Mediterranean foods as well as more typically “American” foods like lasagna, beef
A
● ● ●
stroganoff, and chicken fettucini, as well as boxed sandwiches. No crowd is too big (Shbat has fed as many as 400), but a bit of notice is required. The website (www.fetooshdeli.com) gives details about the catering service, including prices, menus, and photos of the food. The restaurant moved from Maumee to its current location at 6725 W. Central Avenue, #K, at the corner of McCord Road. It is open Monday through Saturday from 10:00 a.m. to 9:00 p.m. and offers dine-in, carryout, catering, and delivery. Phone 419-593-0011, FAX 419-593-0012. ❦ Chris Holliday is a freelance writer and regular contributor to Healthy Living News.
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Regular exercise program is first step toward fitness
T
he Medical Mutual Glass City Start an exercise program Marathon is less than three months “The toughest step in an exercise away. For many area runners and program is getting startwould-be participants, their ed, but it’s also the most New Year’s resolution likely important,” said Connie included the desire to begin Beutel, Manager of Health training to participate in Promotion and Wellness for one of the events. Medical Mutual. “People Experienced runners often think they need to generally know what kind tackle a strenuous program of training plan they need to right away to prove they follow to be fully prepared are committed, but in realto complete the 26.2-mile ity, slow and steady is the circuit or the 5K, marathon best way to begin.” relay, or half-marathon You need a workable, events that also are offered. realistic plan to change your But what about the lifestyle from sedentary to person who has not been Having a support sys- physically active. Begin by exercising or is a running tem is crucial in starting checking with you doctor to a workout program. novice with little or no exensure that you can safely perience? You may want exercise without restricto consider just starting a regular tions. Once you have the “okay,” exercise routine before embarking surround yourself with supportive on a running program. Medical Mupeople and role models. Having a tual’s Health Promotion and Wellness support system is crucial in starting experts recommend that you decide a workout program. at what level you want to participate Beutel offers some simple steps to and then map out a plan to reach help you begin your journey. your goal. Here are some suggestions that Think F.I.T.T. can help you begin improving your To make physical improvements, level of fitness: you need to work your body harder
than usual. This is referred to as the overload principle. As your body becomes more conditioned, you need to increase the frequency, intensity, or time of your workouts in order to continue improving your fitness level. Frequency: How often you exercise. For beginners, consider starting with two to three sessions per week. Intensity: How hard you exercise. For example, the pace you walk or run, the amount of weight you lift, or your heart-rate count. Time: How long you perform an activity. “Time” can also refer to the number of sets or repetitions you perform in weight training. Type: What kind of activity you’re doing. Examples of cardio include running, walking, dancing, sports, etc. For strength training, include some type of resistance (bands, dumbbells, machines, etc.).
Exercise component 1: aerobic exercise Aerobic exercise increases the health and function of your heart, lungs, and circulatory system. For maximum effectiveness, aerobic exercise needs to be rhythmic, continuous, and involve the large muscle groups
(primarily located in the lower part of your body). Walking, jogging, cycling, aerobic classes, and stair climbing are examples of activities that use large muscle groups. Activities combining upper- and lower-body movements, such as cross-country skiing, rowing, and swimming, can lead to even higher levels of aerobic capacity.
Exercise component 2: strength training Strength training is the process of exercising with progressively increasing resistance to build or retain muscle. Unless you perform regular strength exercises, you will lose up to one-half pound of muscle every year of life after age 25. Muscle is a very active tissue with high energy requirements; even when you are sleeping, your muscles are responsible for over 25% of your calorie use. An increase in muscle tissue causes a corresponding increase in the number of calories your body will burn, even at rest.
Exercise component 3: flexibility Flexibility is a critical element of an exercise program, but it is often overlooked. Stretching is important
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for a number of reasons, including increasing physical performance, decreasing risk of injury, increasing blood supply and nutrients to the joints, increasing neuromuscular coordination, reducing soreness, improving balance, decreasing risk of low-back pain, and reducing stress in muscles.
Determining your starting point To achieve cardiovascular benefits, the American College of Sports Medicine (ACSM) recommends exercising three to five times per week with a training heart rate of 60 to 85 percent of your maximum heart rate for 20 to 60 minutes in duration. To attain the benefits of muscular fitness, the ACSM recommends weight training 2 to 3 days per week, performing 1 to 3 sets of 10 to 15 repetitions of 8 to 10 different exercises each day. If you’re just beginning an exercise program, start in the low range of the above recommendations. For example, participate in a cardiovascular activity (walking, aerobics, cycling, etc.) for 20 minutes, three times a week and add strength training exercises to your workout, twice a week. Schedule your strength training workouts with 48 hours rest in between to allow your
muscles to recuperate and repair after each workout.
How did I get so sick?!
Begin slowly and build gradually If you attempt “too much, too soon,” it will lead to soreness, fatigue, and/ or injuries. Work at your own pace, start slowly, and gradually increase duration and level of difficulty as your body progresses. Getting fit is not an overnight proposition; it’s a lifestyle commitment. Don’t expect immediate dramatic changes in your body shape or body weight. Although changes are happening internally, most external benefits won’t become visible for the first 4 to 6 weeks. Keep your focus, and celebrate the internal benefits you’re experiencing, such as increased energy, less stress and anxiety, higher self-esteem, and an increased feeling of well-being. Making the personal decision to begin exercise is the first step. Committing to make it a priority in your life is the next! Email Marathon@ MedMutual.com for more information about starting and maintaining an exercise program or how to find training recommendations for any of the Medical Mutual Glass City Marathon events. ❦
by Douglas Schwan, DC, Dipl Ac
D
on’t feel good? Take a pill. Something not right inside you? Whack it out! This has been medicine’s approach so long we take it for granted. Drug companies are now marketing directly to patients and bypassing those pesky know-it-all doctors! You now need a pill every single day to lower your cholesterol, to sleep at night, to get up in the morning, to handle that little bit of anxiety that life brings and, of course, for the aches and pains you just might get later. We now see healthy adults and children coming into our office carrying a sack full of prescriptions! If all these preventative drugs are necessary, why is our healthcare system out of control? What America needs is a paradigm shift in its thinking about health. No more stuffing mouths full of fast food and then relying on cardiac stents and medications when our hearts invariably fail too soon. What the economy needs is a new emphasis on Alternative Medicine. People are looking for a more natural way to health. People are beginning to realize the folly of waiting for their health to actually fail before they seek out medical help. Many people come into our office thinking acupuncture or chiropractic is just for back or neck pain. Our staff puts great effort into educating people about how Alternative Medicine is an approach to a wide range of disorders as well as a way to maintain optimum health. As a second-generation
Alternative Medicine practitioner, I have had many patients in my office for decades utilizing me as their primary care physician. I refer out when drugs or surgery are indicated. This may surprise many people, but the benefits of conservative Alternative Medicine as a first choice are readily apparent. Studies by Alternative Medicine Integrated group, as published in 2004 and again in a follow-up study in 2007, demonstrated that when chiropractic physicians functioned as primary care doctors, pharmaceutical costs fell by 58 percent and hospital admissions by 43 percent. Clearly we are on to something here. Drugs and surgery have their place, but I don’t think there is a practitioner of any medical discipline that doesn’t feel that drugs and surgery are prescribed far, far too often. Let’s face it, most of modern medicine is geared toward fighting symptoms. Rarely is the body encouraged to stay healthy or even seek a way to restore health. Instead, we cover up the symptom and hope the body figures out how to fix itself. Medical care is so specialized these days that a cardiologist tends to see a heart walk into his office, a pulmonary specialist tends to see a lung, and so on. An Alternative Healthcare doctor tends to look at health a little differently. For example, when we see a case of infertility walk in the office, we tend to see a stressed-out women and not a set of bad ovaries. Alternative Medicine doctors also strive to prevent the onset of disease. We all know that for every 5% we are overweight, there is a significant
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38 February 2013 / Healthy Living News
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increase in the risk of getting diabetes. One simple approach is just to eat breakfast! That’s right, studies have shown that people who eat breakfast every day have a 34% decrease in diabetes onset and have significantly better energy levels and fewer problems with weight loss. Another health risk we counsel our patients on is cholesterol. Still, it seems to be the goal of drug companies to get everyone on these potent medications and stay on them for decades! Your family heart history actually tells you more about your risk of heart disease than your blood levels. Also, diet is less associated with elevated levels of cholesterol than you would imagine. That’s because the liver is perfectly happy to make more of it. We counsel our patients, after a careful history, to utilize a more natural approach to clearing their blood of the “bad” LDL (low-density lipoprotein) cholesterol molecule and raising the “good” HDL (high-density lipoprotein) portion. Niacin (nicotinic acid) is a B vitamin that’s used by your body to turn carbohydrates into energy. But it also has a surprising effect in that it boosts the HDL, which, in turn, sweeps up the LDL in the bloodstream. Adding niacin to your holistic regime can lower your dosage or even eliminate the need for
potent cholesterol lowering drugs. Your Alternative Medicine doctor will help you look within yourself to fight disease. To fight infection, you use techniques to build up your immune system. To fight disease, you reduce your exposure to toxic elements in food and the environment and supplement with a holistic approach. In the old days, our clinics saw patients who came in only when they had a complaint or injury. The health paradigm is now shifting. More and more patients, in otherwise good health, are coming in to restore balance to their systems, strengthen their immune systems before they get sick, and seek general guidance on how to maximize and maintain their health. After all, the easiest condition to cure is one you never get.
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Nutritional Nugget: It is Valentines month, so a Heart Healthy tip seems appropriate. We all know that red wine is good for the heart. Grapes contain polyphenols and resveratrol, which are strong antioxidants that not only retard plaque buildup in the arteries, but can dissolve some arterial plaque already present and thus maintain blood vessel pliancy. Unfortunately, not all of us can afford to guzzle red wine every day. The alternative is to take grape
Compassion. Courage. Comfort.
Kingston Residence of Perrysburg breaks ground for 55,000-square-foot expansion of Perrysburg, which began operations in 1996, provides assisted-living and memory-care services to the local community. The new addition will complete the continuum of care that Kingston provides in Perrysburg. It will serve the rehabilitation needs of our existing residents as well as new residents from the community. Denise McGee-Grimme, Kingston’s Regional Manager for the Toledo area, said, “We are extremely excited about the opportunity to expand our tradition of high-quality care that our employees in Perrysburg have been providing as evidenced by our recent perfect state survey. Kingston’s rehabilitation services are known for their high quality in every market in which we operate, including our Sylvania facility, and we are looking forward to bringing this service to the Perrysburg market, as well.”
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ingston HealthCare Company is pleased to announce the beginning of construction on a $10 million, 55,000-square-foot addition to its facility in Perrysburg, Ohio. The addition will house a 60unit rehabilitation and skillednursing facility, which will include a state-of-the-art rehabilitation center, including an aquatic therapy pool. It will have private rooms, flat-screen TVs, wireless internet, built-in cabinets, and spacious common areas. Rudolph/Libbe Inc. is the general contractor for the approximately $10 million construction project, and DSI Architects is the architect. The facility is expected to begin operations in September 2013 with 75 new full-time positions. The addition allows Kingston to build upon its successful current operation, Kingston Residence of Perrysburg. Kingston Residence
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9/18/12 9:52 AM
seed extract, which contains high amounts of the polyphenols and resveratrol while retaining their natural ratios. ❦
& Acupuncture Clinic with offices in Toledo and Perrysburg, OH. Doctor Schwan is available to speak to your group on a variety of Alternative Health topics. He may be contacted at Dr_Schwan@acupuncturetoledo.com. For more information on Alternative Medicine, please visit our website at www.acupuncturetoledo.com.
Dr. Schwan is a Doctor of Chiropractic and a Diplomate of the International Academy of Medical Acupuncture. He is president of Schwan Chiropractic
Eating Well by Laurie Syring, RD/LD
How to be a healthy loser
I
f you resolved to lose weight in 2013, you’re in good company. In fact, losing weight is one of the top five resolutions made every New Year. Knowing weight loss is such a popular pledge, I turned last month’s column into a “blueprint” for a healthy diet. So how’s it going for you so far? Strange as it may seem, losing weight really isn’t all that difficult. Studies show that we can do it. But anyone who has ever fought the “Battle of the Bulge” (not the one in the Ardennes back in World War II, but the one waged every day on the bathroom scale) knows the real struggle is keeping the pounds from piling back on. After losing weight, most people go right back to the old eating and lifestyle habits that got
them in trouble in the first place, so they gradually regain everything they’ve lost—plus interest. The simple truth is, good health practices aren’t just something you learn; they have to become a regular habit and way of life. Research shows that it takes as long as 18 months of practicing a lifestyle change before it will stick. Who gives a “diet” 18 months? Most people throw in the
towel at five weeks! Why not make 2013 different? This time around, don’t just resolve to lose weight, but take the necessary steps to keep if off for good. Here are four simple steps that will help you reach—and maintain—your desired body weight:
1. Count calories consumed Most people underestimate the number of calories they take in each day. A good way to keep a more accurate record is to write down everything you eat in a food journal. Be sure to include all those bites, licks, and tastes—or “BLTs,” as I call them. They can add in a surprising number of unwanted calories. Also, be sure to check food labels for calorie and fat content and choose wisely. Furthermore, keep a close eye on your portions. But don’t trust your eyes to determine serving size! Remember, your eyes are usually bigger than your stomach. Use measuring cups/ spoons whenever you can.
2. Stay active All too often, I hear people say they’re going to lose weight by exercising more, not eating less. This may seem reasonable on the surface, but it’s much more difficult than you might think to shed pounds strictly through exercise. Typically, you need to cut 500 calories to lose one pound a week, and that assumes your weight is stable, not climbing, when you start. Without modifying your calorie intake,
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you would need to do a full hour of vigorous exercise every day. A much more attainable goal is to increase your daily activity (by taking the stairs, parking farther away from store entrances, etc.) and exercising for 30 minutes three to five days a week. Buying a pedometer can also help you meet your goal. Try to achieve 10,000 steps a day. It’s fun to challenge yourself—or even to compete with a friend or coworker! If it helps your motivation, give yourself a reward for your exercise successes—a new outfit or something else you’ve had your eye on. Just don’t reward your exercise efforts with food—no stopping for ice cream on the way home from the gym or fettuccine Alfredo for dinner!
3. Establish routine mealtimes Your body needs a steady stream of glucose throughout the day to maintain an optimal energy level and to prevent your metabolism from slowing down. Be sure to eat breakfast every day and then a meal every three to four hours. Work in one to two healthy snacks during the day, as well, so your metabolism keeps chugging along. Try not to go over five hours without eating.
4. Get sufficient sleep Bet you weren’t expecting that one! Studies now show that people who get fewer than six hours of sleep at night have higher levels of appetitestimulating hormones. What’s worse, their appetite increases for high-calorie, high-carbohydrate foods, not fruits and veggies. Less sleep can also raise the level of cortisol—the so-called “stress hormone”—which can lead to weight gain. I think it’s crazy that two-thirds of the people in this country are on a weight-loss diet right now. You’ll never maintain a healthy weight if your good eating habits have a start and end date. Think of eating right and losing weight as a skill—much like ice skating or riding a bike. You need lots of practice and good instruction. You also need support to help you get back up when you fall down and feel frustrated. But if what you do isn’t sustainable, you’ll simply fall back into the same old habits that keep sabotaging your weight-loss and -maintenance efforts. We know the four habits outlined above—tracking calories and watching portion sizes, increasing daily
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activity, scheduling regular meals, and getting enough sleep—are the habits of successful losers. Don’t be fooled that maintenance is easy; it is tough. But like any skill, it does get easier with time and practice. And
the longer you keep the weight off, the more likely you are to keep it off permanently. ❦ Laurie Syring, RD/LD, is chief clinical dietitian at ProMedica Flower Hospital.
BySister Mary Thill
Spiritually Speaking Wisdom—where is she? In the soil of a quick fix is the seed of a new problem, because our quiet wisdom is unavailable. —Wayne Muller (Wisdom) teaches moderation and prudence, justice and fortitude, and nothing in life is more useful for men than these. —Book of Wisdom 8:7
A
s I write this article, I am reminded that it’s been almost a month since the terrible tragedy in Newtown, CT. As the days and weeks pass, I am finding myself still very sad at such a massacre happening in the country in which I live. Other such events have brought feelings of sadness, but the killing of 20 six- and seven-year-olds as well as their teachers really has me wanting to do something to stem the tide of violence and change the culture of death that has taken over in this beautiful country of ours. When vampires have become the new cult of the young, when violent video games/TV shows/movies have become part of our regular entertainment, when people suffering with mental illness have no place to go for help and healing, and where guns that do kill people are so readily available, I must ask myself—what am I doing to stop this violence? I must realistically say that I have done some things but nowhere near what I could be doing to stop the violence even in my own spheres of influence. I am a member of the Mareda Board, the board that is responsible for the HUD housing sponsored by the Toledo Diocese. When the babies were shot at Moody Manor last fall, I hoped that the diocese would have done something to show its concern for the terrible violence that goes on in the neighborhoods where some of the housing is located. I myself did not participate directly in any prayer or show of support for the family. I know that such things are
complicated and the people directly involved with the family have done things to help them, but the violence continues and the attitude of “nothing can be done” seems to permeate the meetings that are held. Between June, 2011 and March, 2012, I participated in an ad hoc Crisis Care Committee sponsored by the Mental Health and Recovery Services Board of Lucas County. The monthly meetings were eye opening for me as I learned about the difficulties in accessing the existing resources we have in our community for people who are facing a crisis in their mental illness. We looked at the needs of adults and youth in crisis, the need for better cooperation between our hospitals and other mental health providers, the relationship between Rescue Crisis and emergency departments, the involvement of police and jails as some people enter that system, and the need for electronic health records that would help simplify so much of what needs to be done in a crisis situation. I was impressed with the expertise and honesty assembled around the table, but I must admit I’m not sure we accomplished anything directly affecting anyone in a mental illness crisis today. Funding seemed to get the blame for things not happening, and I think that’s part of the problem, but I felt that a greater passion about the issues is also needed to really effect change. I haven’t done anything about gun control even though I work in an area of Toledo where shootings and killings are almost daily occurrences. I do know that St. V’s, the Mareda Board, and the Toledo police are all engaged in frequent conversations about what can be done to stop the violence in this area. I wonder how the youth and gang members get so many guns. I wonder what brings them to the point where they want to injure or kill someone they usu-
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ally know. I wonder what families, schools, churches, police officers, ordinary people like me can really do to change this culture of violence and death. I’m aware of the social research done about gangs and guns, but I really want to know why these shootings are happening in our communities. Are we really living in such hopeless and miserable conditions that we need to be at war with our families and neighbors? My current answer to myself about these serious issues is that we need people with wisdom who can assemble and talk with one another in a compassionate and loving way. We need to find solutions with moderation and prudence and take action with justice and fortitude. As the Book of Wisdom says, “…nothing in life is more useful for (us) than these.” Just who are these people with wisdom? People who have lived through difficult situations, the families of people with mental illness,
good guys and bad guys who own guns, the elders in our midst who have much wisdom to share, and women—if you’ve read the Book of Wisdom, you will know that Wisdom is identified with the feminine and all her virtues. We must also pray, and that I have done with many tears shed. I also remind myself and you as we do pray over this difficult time in our country and culture that, as Sister Joan Chittister, OSB, reminds us, we do not go to prayer to coax God to create the world according to our personal designs and fancies. We are there to learn how to live well in the life and world we have. May the quiet wisdom needed these days be available to us all. ❦ Sister Mary Thill is a Sylvania Franciscan Sister. She is Patient Liaison for Mature Health Connections at Mercy St. Vincent Medical Center. She can be reached at 419-251-3600.
Yark donates life-saving gift to St. Francis
A
very alarming statistic: almost students will become certified life88 percent of all SCAs (sudden guards through the American Red cardiac arrest) or heart attacks will Cross. occur at home. This means the life These students will also become you can save knowing how to do certified in safety and first aid, CPR CPR is most likely to be the life of (cardio pulmonary resuscitation), and someone you love. Approximately AED (automated external defibrillator) 70 percent of Americans feel helpless for the professional rescuer. This means to act during a cardiac emergency. they can perform adult, child, and infant They either do not know how to CPR. They will have the knowledge to administer CPR or their training has deal with aquatic emergencies as well significantly lapsed. as dry-land emergencies, the ability to At St. Francis de Sales High School, use a BVM (bag valve mask resuscitator) there are three instructors on camin dealing with respiratory distress and arrest, and the knowledge and ability pus who can provide the students, to perform two-man CPR. athletic coaches, staff, and adminisThere’s nothing more gratifying tration the knowledge and training than hearing of an SFS-trained life necessary to learn how to save a life guard sharing his “first save” story by administering immediate care in with Mr. Schaefer, the primary Aquata cardiac emergency. Recently, the Yark Automotive ics Instructor at St. Francis. Group—with the help of the National St. Francis de Sales appreciates Auto Dealers’ Association—obtained this generous gift and acknowledges a grant to purchase a Little Annie CPR manikin and donated it to St. Francis de Sales High School to aid in the school’s educational efforts in training students, coaches, faculty, and staff in these life-saving procedures. Through this donation, 140 students will learn to administer CPR and become certified through the American Red Cross as part Zach Doran of the Ohio Auto Dealers’ Association; Steve Weber, of their physical educa- athletic trainer at St. Francis; John Yark, a graduate of the SFS class of 1975 and president of Yark Automotive Group; Little Annie; DJ tion class in the school’s Yark, executive manager of Yark Automotive Group; and George natatorium. Another 40 Schaefer, SFS instructor, at the pre-basketball game presentation. To read this issue online, visit www.hlntoledo.com
not only Yark Automotive Groups’ leadership in the community, but
also its support of St. Francis and its mission. ❦
Wanted: girls who just want to have fun!
W
ant to try something different? Want to try something that will relieve stress and add some zest to your spirit? You are invited to our 15th annual “Girls Weekend.” Come to our Women’s Wellness Spa Weekend. Or, if you can’t come for the weekend, try the “Spa Day.” This weekend will be held on April 20 and 21, 2013, in Port Clinton at the Commodore Perry Resort Inn right across from Lake Erie. Register early and get a water-view room. Call Jane today at 419-3811956 to register. This is the most affordable spa weekend you will ever find. Everyone has a different idea of what would be a stress reducer for them. That is why a Women’s Wellness Weekend would be just the right fit. You can try all different
activities and spa treatments to see what you need to incorporate into your life or just relax. You can do this for a fraction of the cost of other spa weekends or spa days. For example, during this weekend you can try Tai Chi, Yoga, Water exercise, or Urban Funk and Pump or Zumba. You can have spa treatments, “do” crafts, listen to a health talk, shop, see an “intuitive counselor” or astrologer, or just come and enjoy the view and relax alone or with “old and new” friends, sisters, neighbors, cousins, etc. You can sample what a great massage or facial can do for you or discover what a cranial-sacral, zero-balancing,
lymph-drainage, or Reiki treatment is all about. Just to give you an idea: here are some brief descriptions of some of the treatments and activities that we offer during the weekend: Yoga is a physical discipline involving particular postures and breathing techniques. The most common reasons that people practice yoga are to improve posture; increase flexibility, strength, and vitality; improve concentration; and, of course, enhance relaxation. Tai Chi has often been described as “meditation in motion.” The
slow, graceful movements of the Taoist Tai Chi increase strength and flexibility and improve balance and circulation. Our wonderful teacher, Sr. Suzette Fischer, is able to lead the sequence of movements so that everyone can take part in the class no matter what your skill level is at the time. Urban Funk and Pump is a funfilled dance exercise program using great music to get us all in the mood to burn calories. Cranial-Sacral treatments are given by Lisa Lutman of Alternative Physical Therapy in Toledo. These treatments release areas of restriction throughout the body. Light touch is used on the body and head. It is very helpful with sinus problems, headaches, anxiety, and chronic back and neck pain. Reiki is an ancient Japanese healing art. It is the universal life force or energy that keeps the body healthy.
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43
Reiki is a spiritually guided energy treatment. Spa Services are offered only by licensed therapists. Nothing can duplicate how you feel after a great massage. Sure, muscles are relaxed and toxins are getting released from your body, but the therapeutic value of human touch is immeasurable. You can also get a facial, reflexology, a Thai (foot and full-body) massage, a manicure, or a pedicure. An experienced and well known psychic will also be available. Of course there is our famous P.J. party, where you can try belly dancing, learn some line dances, or just observe the fun. You really need to experience the event to get a good picture of what it can do for you. I can’t forget to mention that there will be unique shopping experiences; Mindi with Stella and Dot will have a trunk show and demonstrate the latest styles in jewelry. Purse Love.com will also be there with wonderful boutique items. What you do is up to you. You can do everything or just take the weekend to relax. The weekend is $165 per person, which includes three meals, all the activities, and the overnight stay at the beautiful Commodore Perry Resort Inn. (Rooms are double occupancy.) We pride ourselves on making this the most affordable spa weekend you will ever find! If you can’t make it for the entire weekend, we have now made it possible for you to come for just the Spa Day for only $65, which includes the Saturday activities and lunch. There are even bigger price re-
ductions for three or more ladies to a room, referring a new participant, or adding the Friday night to your weekend. (The spa services are offered for an additional fee paid to the therapists. These services are offered
for considerably less than what they charge at their own businesses.) You can come by yourself, bring a friend, or come with a group, but space is limited. These weekends have been going on now for 15 years,
The Woodlands at Sunset House Casually elegant independent living with a safety net The decision to move from their family home to a retirement community can be very difficult for seniors to make. On the one hand, the idea of being liberated from burdensome chores, such as shoveling show, mowing the lawn, and tending to those never-ending home repairs, may hold considerable appeal for them. On the other hand, they may fear that making the move also means adopting a less vibrant lifestyle or sacrificing some degree of autonomy. But people who choose to make The Woodlands at Sunset House their home quickly discover that these anxieties are completely unfounded as a whole new world of cultural, social, and recreational opportunities unfolds before them. The Woodlands at Sunset House, located at 4030 Indian Road in Toledo, is an independent-living community situated on a beautiful, lushly landscaped campus. Residents enjoy their own private living space in a one- or two-bedroom apartment, featuring a full, all-electric kitchen with range, refrigerator, and garbage disposal; wall-to-wall carpeting and window
blinds; spacious closets; individually controlled heating and air-conditioning; smoke alarms and an automatic sprinkler system; telephone and cable hookups; wireless internet access; and the added safety and reassurance of an emergency alert system. Some apartments even feature a patio and fireplace. Residents’ favorite
furnishings and cherished possessions add the finishing touches and make their new living space feel more like home. Miriam Wagoner, Sunset’s Life Enrichment Coordinator, describes the atmosphere at The Woodlands as “casually elegant.” She notes that the design, furnishings, and décor create the perfect blend of luxury and coziness to make residents and their guests feel right at home and
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and word has spread. So contact Jane Mathias at 419-381-1956 or jmathias @bex.net to find out more about the April event or to register. Don’t let this fun weekend pass you by. You need it! You will love it! ❦
comfortable doing their favorite activities—which they now have much more time to pursue since they’ve left all the worries of homeownership behind. In fact, Woodlands residents find that the community allows them to maintain whatever lifestyle they choose. “When you come here to The Woodlands, your lifestyle does not have to change in any drastic way,” remarks Dorothy Mockensturm, Sunset’s Director of Development & Communication. “If you have a job or other outside interests, there’s absolutely no reason you have to give those things up. We believe our community will enhance—not replace—your current lifestyle. For example, if you enjoy entertaining friends or family, you can do it here and then leave the cooking and cleaning to us.” For those residents who enjoy keeping busy, socializing, and trying different things, The Woodlands certainly has no shortage of activities and events to choose from. Exercise classes, coffee klatches, baking classes, book groups, Bible study, a Wii bowling league, bridge and mahjong groups, movie nights, wine tastings, breakfast and lunch outings, shopping excursions, holiday parties, and barbecues are just a sampling of the activities residents enjoy together. One of the many highlights at The Woodlands is its restaurant, The Golden Oaks at The Woodlands, which serves delicious, home-cooked evening meals (included with residents’ monthly fees) as well as pub-style lunches. Lunch, offered from 11:30 a.m. to 3:00 p.m. Monday through Friday, is open to the public. Catering services, guest meals, and meal delivery to resident apartments are also available for the asking. Other services and amenities include periodic wellness checks provided by a nurse; housekeeping services every two weeks; scheduled transportation to shopping, banking, and other destinations; personal transportation to medical appointments (four per year); a full-service salon; a fitness center/weight room
To read this issue online, visit www.hlntoledo.com
complete with a wide-screen TV; home maintenance and lawn care; attractive gardens and a courtyard; libraries; a professionally designed putting green for resident golfers who could use a little practice on their short game; and much more. Additional housekeeping and laundry services can be arranged, as well. “What really sets us apart is that, as a small, stand-alone organization, we have the freedom and flexibility to cater not only to residents’ needs, but also to their desires. Our goal is to ensure residents know their satisfaction is always our top priority, and there is a strong sense of camaraderie between the residents and staff here as a result,” Mockensturm says. Another factor that distinguishes The Woodlands from many other independent-living facilities is that, if needed, they will provide assistance with one activity of daily living at no additional cost. This is an important consideration for many seniors who are generally independent but could use just a little help in a certain area, such as bathing or dressing. Wagoner points out that independent living at The Woodlands is
just the beginning of the continuum of care at Sunset. “As residents’ care needs change, we have services to accommodate them, whether they require assisted living, skilled nursing, memory support, respite care, rehab, or hospice and palliative care. That means you only have to make the decision of where to go once,” she says. Wagoner urges anyone who is considering moving to an independentliving community to visit The Woodlands to meet the residents and experience the warm, welcoming atmosphere firsthand. Currently there is no waiting for apartments (except for certain room styles), but availability can change, so it’s a good idea to get your name on the waiting list even if you’re not ready to make a commitment. Doing so will not obligate you to move in. “This is a major decision that people should make only when they feel ready,” Wagoner says, “but once you make that decision, you’ll be glad you did. After they get settled in and discover all The Woodlands has to offer, many residents tell us their only regret is that they didn’t make the decision to come here sooner.” ❦
Q
commit to doing something different for yourself: research and effectively treat your hearing loss and tinnitus? Now is the perfect time to take action. Stop wondering what your hearing loss has caused you to miss. Stop wondering what it would be like if that darn tinnitus wasn’t so loud and you weren’t as dizzy anymore. Northwest Ohio Hearing Clinic is available and committed to help you focus on your hearing health by providing solutions to improve hearing in noisy environments, improving communications in your home, helping you communicate with your coworkers, and helping you enjoy your extracurricular activities.
: What does living a healthy lifestyle really mean in relationship to your hearing?
A
: With the New Year come the inevitable New Year’s resolutions. Now is the perfect time to do better for ourselves. Living healthier is a universal concept we hear over and over again, but it’s one that so many of us struggle with when it comes to taking care of our hearing health. With the abundance of advertising and information we have available at our fingertips, we have every opportunity to lead and choose a healthy lifestyle. The turn of the calendar gives us a clean slate. In 2013, why not
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Communication skills are central and vital to a successful and happy life, in your work and personal lives. The inability to effectively communicate can adversely affect your education, employment, and overall wellbeing. Not only do a high number of Americans suffer from hearing loss, but the disability takes a toll on family members as well. The number of individuals with hearing loss has doubled
over the past 30 years from 13.2 million to over 28.6 million today. Hearing loss is growing exponentially, and now is the time to take charge and treat it. Don’t allow yourself to miss out on any more conversations and laughs! If you or a family member has a questionable issue with hearing or tinnitus, reach out and let us help you. We are offering an opportunity today to take the first step;
we’re here to help you. Call us to schedule your appointment, and we’ll gladly schedule you with one of our doctors to reduce your hearing struggle. ❦ Randa Mansour-Shousher, AuD, CCC-A, is a Doctor of Audiology with Northwest Ohio Hearing Clinic, located at 3000 Arlington Ave. in Toledo (419-383-4012) and 1601 Brigham Dr., Suite 160 in Perrysburg (419-873-4327).
Guilt-free Super Bowl buckeyes, by Kelly Hanner
W
ith the Super Bowl coming up, Super Bowl parties will commence with loads of rich, salty, sweet, and tantalizing foods. One treat normally found at football parties are the infamous buckeyes—little yummy morsels packed to the brim with peanut butter, butter, sugar, and chocolate. This recipe is a spin on buckeyes, amped up with a hidden ingredient—chickpeas!
These chickpeas replace the butter, meanwhile increasing the protein content of the buckeyes yet keeping them sweet and moist. The chickpeas are to the buckeye what black beans are to the brownie. So while I am sure people were scared not too long ago to add black beans to their brownies, they
✃ Healthier Buckeyes 1 15-oz can chickpeas, drained 1.5 cups of natural peanut butter or any other nut butter 1/4 cup maple syrup 1 tsp. vanilla 1/2 tsp. Himalayan salt 3/4 cup Enjoy Life chocolate chips 1.5 Tbs. unrefined, extra-virgin coconut oil Directions: In a heavy-duty blender (like a Vitamix) or a food processor, process the chickpeas
were delightfully surprised to learn that they actually made the brownies taste better—the same goes for the chickpeas in my buckeyes! ❦ Kelly Hanner has a degree in Dietetic Technology and is a full-time health, fitness, wellness, and financial mentor at www.tubbytotoned.com.
Vegan, gluten-free, lower-calorie, high-protein Prep time 45 minutes. Makes roughly 70 buckeyes (1 serving = 1 buckeye)
until they are as close to broken up and uniform as possible. I used my Vitamix and had to use the tamper to push all the chickpeas around. Add the peanut butter, maple syrup, vanilla, and salt, and process until well blended. Line a cookie sheet with parchment or wax paper. Using a teaspoon, scoop out overflowing portions of the vegan buckeyes dough and roll between clean palms. Do this until dough is gone. Place in the freezer for about 10
to 15 minutes. While the vegan buckeyes are in the freezer, melt the chocolate and the coconut oil together in the microwave for 40 seconds. Remove, stir, and put back in for another 40 seconds. Once the time has passed, pull out the vegan buckeyes, pierce with a toothpick, and twirl them around in the mixture. When done, place in freezer to solidify. Remove from freezer and keep the buckeyes in the fridge until ready to serve. ❦
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Connect with our advertisers online. Click their web address in this issue’s interactive PDF at www.hlntoledo.com
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What’s your weight loss wish?
Whether it’s to fly on a roller coaster or keep up with your kids on the playground, Mercy Weight Management Center can help make it reality. We have surgical and nonsurgical options to help you lose the weight, and an unmatched coaching program so you keep it off for life.
Come to our FREE Surgical Weight Loss Seminar. Register at MercyWeightManagement.com or call 419-251-8760
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