Leading Medicine Magazine, Vol. 6, No. 1, 2012

A PUBLICATION OF THE METHODIST HOSPITAL SYSTEM® VOLUME 6, NUMBER 1, 2012

LEADING MEDICINE

THE SILVER TSUNAMI Seniors: living longer, staying active Keeping the spark alive: aging and intimacy Nantz Alzheimer Center: honoring legacies and offering hope

®

RECOGNIZED IN: #!.#%2 s #!2$)/,/'9 (%!24 352'%29 s $)!"%4%3 %.$/#2)./,/'9 % ! 2 . / 3 % 4 ( 2 / ! 4 s ' ! 3 4 2 / % . 4 % 2 / , / ' 9 s ' % 2 ) ! 4 2 ) # 3 s ' 9 . % # / , / ' 9 . % 0 ( 2 / , / ' 9 s . % 5 2 / , / ' 9 . % 5 2 / 3 5 2 ' % 2 9 s / 0 ( 4 ( ! , - / , / ' 9 /24(/0%$)#3 s 05,-/./,/'9 s 52/,/'9

LEADING MEDICINE

®

Volume 6, Number 1, 2012

MARC L. BOOM, M.D. President and CEO ROBERTA SCHWARTZ

Executive Vice President RAMON “MICK” CANTU, J.D.

Executive Vice President, Chief Legal Officer and Strategy and Business Development Officer H. DIRK SOSTMAN, M.D.

Executive Vice President, Executive Vice Dean and Chief Medical Officer SUSAN H. COULTER, J.D.

9

Senior Vice President, Development, Marketing and Public Relations

12

34

ERIN SKELLEY

Director of Marketing Executive Editor

2 MEET THE CEO

27 CALCIUM & VITAMIN D

SHESHE GIDDENS

4 SILVER TSUNAMI

Managing Editor

America awash with growing senior population

DENNY ANGELLE

Associate Editor DENNY ANGELLE EMMA V. CHAMBERS SHESHE GIDDENS LINDA GILCHRIEST DONNA HURST MICHAEL E. NEWMAN GEORGE E. TAFFET, M.D. KATHRYN WATTS

6 A MALE AND FEMALE PROBLEM

-AINTAINING INTIMACY AS YOU AGE

9 SUPER-SIZE ME

%XTRA FAT MAKES YOU FAT AND OLD

Contributing Writers BRIDGETT AKIN/BRIDESIGN, INC.

12 NIP, TUCK

Design

FANTICH STUDIO

3ENIORS REJUVENATION EFFORTS on the rise

Photography Leading Medicine magazine is published by The Methodist Hospital System® Marketing Department for patients, physicians, employees and supporters. © 2012 The Methodist Hospital System All rights reserved. Materials may be reproduced with acknowledgement for noncommercial and educational purposes. Permission from the editor required for any other purpose.

Send address corrections and letters to Leading Medicine, The Methodist Hospital System, Publications Department 1707 Sunset Blvd.

Houston, Texas 77005 Tel.: 713-790-3333 or esource@tmhs.org

17

WEEKEND WARRIORS

%XERCISE SAFELY AS YOU AGE

20 NANTZ NATIONAL ALZHEIMER CENTER

3PORTS BROADCASTER HELPS ADVANCE THE lGHT AGAINST DEMENTIA

24 FRIEND AND FOE

4HE ROLE INmAMMATION PLAYS IN CHRONIC DISEASE

"ONE GROWTH AND MAINTENANCE HELP PREVENT OSTEOPOROSIS

30 CLINICAL TRIAL

4!6) OFFERS SAFE ALTERNATIVE FOR ELDERLY PATIENTS WITH AORTIC VALVE STENOSIS

34 FOUNDATION OF SUPPORT

4HE 0RESLEY ( AND 0ATTI % #HALMERS #HARITABLE 2EMAINDER 4RUST

38 FALL PREVENTION

.URSE STUDIES ANATOMY OF patient falls

40 HEALTHY LIVING

0ALLIATIVE CARE CAREGIVER RESPITE POLYPHARMACY

44 PLAN AHEAD

0ROPER DOCUMENTATION PROTECTS YOU AND YOUR LOVED ONES

46 ACCOLADES 48 CLINICAL NOTES

If you wish to cancel your free subscription to Leading Medicine magazine, contact us at 713-790-3333 or esource@tmhs.org.

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VOLUME 6, NUMBER 1 I 1

CEO

Meet the

New Methodist President Settles In

Marc L. Boom, M.D., talks about achievements, challenges and the future As the new president and CEO of The Methodist Hospital System, Marc L. Boom, M.D., has been visiting with journalists from a number of local publications, including the Houston Chronicle and Houston Business Journal.

The 45-year-old father of three and husband to a fellow physician shares everything from his favorite dish as the family cook to his vision for leading one of Houston’s largest health care systems to even greater national prominence. The following are excerpts from an interview that ran in the Feb. 1 issue of Texas Medical Center News.

No. 1 on your priority list in your Q. What’s new role?

!T -ETHODIST WE RE ALL ABOUT THE PATIENTS 7E WILL CONTINUE KEEPING A LASER LIKE FOCUS ON PROVIDING THE BEST CARE THE BEST SAFETY AND THE BEST QUALITY )T S WHAT WE RE KNOWN FOR AND YOU LL CONTINUE TO SEE THAT IN ALL OUR HOSPITALS AND PATIENT CARE SETTINGS .ATIONALLY U.S. News & World Report ranks us AMONG THE COUNTRY S BEST HOSPITALS IN SPECIALTIES MORE THAN ANY OTHER HOSPITAL IN 4EXAS AND ONE OF ONLY A HANDFUL OF HOSPITALS IN THE NATION TO RANK IN AS MANY !LSO GOVERNMENT STUDIES SHOW THAT OUR PATIENT MORTALITY RATES FOR HEART ATTACK

HEART FAILURE AND PNEUMONIA ARE SIGNIlCANTLY LOWER THAN THE NATIONAL AVERAGE 4HAT KIND OF QUALITY ACROSS OUR HOSPITAL SYSTEM IS WHAT WE WILL CONTINUE SEEING

the first physician to ever serve as Q. You’re president of Methodist’s hospital system and you also see patients. How do you balance both roles?

Dr. Marc L. Boom

2 I METHODISTHEALTH.COM

)T S REALLY NOT A BALANCE BECAUSE THE ROLE IS THE SAME !S A PHYSICIAN ) MAY BE LOOKING AT ONE PATIENT AT A TIME AS AN ADMINISTRATOR ) MAY BE LOOKING AT TENS OF THOUSANDS OF PATIENTS AT A TIME 5LTIMATELY IT S ALL ABOUT THE PATIENTS AND THE CARE THEY RECEIVE !S IN ALL INDUSTRIES WHEN YOU HAVE SOMEBODY IN A LEADERSHIP ROLE WHO UNDERSTANDS THE CORE BUSINESS IT S A GOOD THING ) HAVE A SMALL PRIMARY CARE PRACTICE OF OR PATIENTS FOLKS ) VE TAKEN CARE OF FOR YEARS 4HEY RE LIKE FAMILY THEY HAVE ALL OF MY PHONE NUMBERS AND MY EMAIL ADDRESS #ARING FOR PATIENTS IS WHAT MAKES ME TICK AND WHAT ) LOVE TO DO ) PROVIDE THEIR CARE WITHIN -ETHODIST S PHYSICIAN ORGANIZATION ) M NOT PERSONALLY COMPENSATED ) ALSO WORK AS

AN ATTENDING PHYSICIAN TWO WEEKS A YEAR AND SUPERVISE RESIDENTS ON THE WARDS $URING THAT TIME ) M IN THE ROLE OF DOCTOR INSTEAD OF BOSS AND THAT KEEPS ME ON THE FRONT LINES IT SHOWS ME HOW THINGS ARE GOING AND KEEPS ME GROUNDED

happening Q. What’s at Methodist’s research institute?

0ROGRESS HAS BEEN TREMENDOUS 7E SET A GOAL THAT WITHIN lVE YEARS OF OPENING THE BUILDING WE WOULD BE IN THE COUNTRY S TOP INDEPENDENT hospital research programs, with .)( FUNDING AS THE MEASUREMENT 4HE BUILDING OPENED LAST YEAR AND ALREADY WE RE AT ABOUT .O OR IN THE NATION WE LL KNOW MORE WHEN THE lNAL NUMBERS ARE IN 3O HERE WE ARE AHEAD OF SCHEDULE ATTRACTING people who can compete with the BEST AND BRIGHTEST IN A TIME WHEN .)( FUNDING IS mAT OR EVEN DECLINING IF YOU LOOK AT REAL DOLLARS )N

WHEN -ETHODIST S PRIMARY MEDICAL SCHOOL AFlLIATION WITH "AYLOR #OLLEGE OF -EDICINE ENDED THE LEADERSHIP HERE PUT FORTH THE GOAL THAT -ETHODIST WOULD BECOME A LEADING ACADEMIC MEDICAL CENTER 4O ACHIEVE THAT GOAL

YOU MUST HAVE A RESEARCH INSTITUTE 7E HAVE ONE NOW AND IT S GROWING

BY LEAPS AND BOUNDS

affiliated with Q. Methodist Weill Cornell Medical College once Methodist’s affiliation with Baylor ended.

How’s that working out?

7E RE EIGHT YEARS INTO A YEAR CONTRACT WITH 7EILL #ORNELL AND THEY VE BEEN THERE FOR US EVERY STEP OF THE WAY /UR CANCER CENTER DIRECTOR $R *ENNY #HANG IS COLLABORATING VERY HEAVILY WITH HER COUNTERPART AT 7EILL #ORNELL $R -AURO &ERRARI WHO HEADS -ETHODIST S RESEARCH INSTITUTE IS A WORLD LEADER IN NANOTECHNOLOGY AND

HE S COLLABORATING WITH #ORNELL S MAIN campus in Ithaca, which is one of the LEADING PLACES IN THE WORLD FOR NANOTECHNOLOGY 7EILL #ORNELL HAS BEEN AMAZINGLY HELPFUL TO US AS WE VE DEVELOPED OUR RESIDENCY PROGRAMS !BOUT PERCENT OF THEIR MEDICAL STUDENTS COME DOWN HERE FOR ROTATIONS AND WE EXPECT THAT NUMBER TO EXPAND 7E WELCOME MEDICAL STUDENTS FROM OTHER INSTITUTIONS AS WELL 3TUDENTS FROM 5NIVERSITY OF 4EXAS AND "AYLOR MEDICAL SCHOOLS ROTATE WITH US AS DO STUDENTS FROM OTHER INSTITUTIONS 7E D LOVE TO SEE MORE WE LL ROLL OUT THE RED CARPET

respect to the Weill Q. InCornell affiliation, is the distance between Texas and New York a problem? .OT AT ALL -ETHODIST HAS A RESEARCH AND EDUCATION COLLABORATION WITH 7EILL #ORNELL 4HERE NEVER WAS AN intention to make it a clinical colLABORATION OTHER THAN TO SHARE BEST PRACTICES WHICH WE VE DONE "UT 7EILL #ORNELL CARES FOR PATIENTS IN .EW 9ORK AND -ETHODIST CARES FOR PATIENTS HERE

is Methodist Q. How preparing for health care reform?

4HE ONLY THING CERTAIN IN HEALTH CARE REFORM IS THAT IT S COMPLETELY UNCERTAIN "UT LOOKING AT THE NATIONAL SITUATION AND THE PORTION OF OUR COUNTRY S BUDGET THAT S SPENT ON HEALTH CARE

CHANGE IS INEVITABLE WHETHER THE 3UPREME #OURT RULES THE CURRENT PLAN UNCONSTITUTIONAL OR NOT 0HYSICIANS AND HOSPITALS NEED TO LEAD THAT CHANGE )T S NOT THAT DAUNTING BECAUSE IT ALL COMES BACK TO hIF WE PROVIDE THE BEST VALUE FOR OUR PATIENTS AND WE GET THE BEST POSSIBLE OUTCOMES FOR OUR PATIENTS

AND WE FOCUS ON HOW TO DO THAT AS COST EFFECTIVELY AS POSSIBLE v WE CAN T BE BEAT -ETHODIST WILL THRIVE IN ANY FUTURE ENVIRONMENT BY KEEPING THAT FOCUS 0ATIENTS TOO NEED TO BE PART OF THE SOLUTION /NE OF THE CHALLENGES WE FACE IN THIS COUNTRY IS A LACK OF PERSONAL ACCOUNTABILITY 0EOPLE HAVE TO TAKE CONTROL OF THEIR OWN HEALTH 9OU CAN T JUST SIT BACK AND EXPECT EVERYTHING TO COME TO YOU )F YOU SMOKE DRINK TOO MUCH

DON T GET ENOUGH SLEEP OR EXERCISE

AND EAT POORLY YOU RE GOING TO HAVE TO GET HEALTHY AND CHANGE YOUR WAYS .OBODY CAN DO THAT BUT YOU

me about Q. Tell your family.

-Y WIFE *ULIE IS A PEDIATRICIAN AT 4EXAS #HILDREN S AND "AYLOR 3HE S ONE OF THE LEADING ADVOCATES IN 4EXAS FOR IMMUNIZATION 3HE ALSO DOES A LOT OF MISSION WORK AND CARES FOR THE UNDERSERVED IN A TEACHING CLINIC WITH RESIDENTS 4HE PATIENTS ARE MOSTLY -EDICAID AND #()0 PATIENTS WITH COMPLICATED PROBLEMS )T S VERY REWARDING WORK FOR HER 7E HAVE THREE WONDERFUL CHILDREN +ATHRYN

A SOPHOMORE IN HIGH SCHOOL *OHN

A SIXTH GRADER AND *ANIE

WHO S IN KINDERGARTEN

also like to cook, Q. You I’m told?

9ES ) M THE MAIN COOK IN THE HOUSEHOLD -Y KIDS ESPECIALLY LIKE A SHORT RIB DISH ) MAKE AND SASHIMI PIZZA

comments Q. Any in closing? *UST THIS 4HOSE OF US IN HEALTH CARE ARE INCREDIBLY FORTUNATE AND PRIVILEGED TO BE IN A POSITION TO COME INTO PEOPLE S LIVES AT TERRIBLY VULNERABLE TIMES DUE TO ILLNESS OR INJURY OR HAPPY TIMES LIKE THE BIRTH OF A BABY )F WE NEVER FORGET THIS WE LL ALWAYS DO OUR ABSOLUTE BEST FOR PATIENTS Q VOLUME 6, NUMBER 1 I 3

the silver

4 I METHODISTHEALTH.COM

tsunami

By George E. Taffet, M.D.

T

he demographic change of the American landscape that will occur during the next 40 years will be dramatic. Baby boomers turn age 65 at the rate of almost 10,000 per day, and will do so for the next two decades. This change, termed the “silver tsunami,” will wash over all aspects of life for seniors and the generations that help them financially.

While those aged 65 today are clearly more active, independent and healthy than the 65-yearolds of generations past, the needs, diseases and co-occurrence of illnesses in older people provide unique opportunities and challenges as medicine seeks to prevent, forestall and treat the chronic conditions that plague them.

With longevity, seniors become increasingly susceptible to injury and a flood of diseases, such as diabetes, cancer, cardiovascular disease and dementia. Physicians and researchers at The Methodist Hospital, in longstanding collaboration with the Geriatrics Section at Baylor College of Medicine, are working to help seniors to live not only longer, but also healthier lives.

U.S.News & World Report’s 2011 “Best Hospitals” issue names The Methodist Hospital as one of the best in the nation for geriatric care. The following pages highlight Methodist’s ongoing efforts to improve the quality of life for those who are approaching retirement age and older. Q

Dr. Taffet is the academic head of geriatrics at The Methodist Hospital and the Robert J. Luchi, M.D. Chair in Geriatric Medicine at Baylor College of Medicine.

VOLUME 6, NUMBER 1 I 5

UROLOGY

Keeping the

love light burning Declining sexual interest is somewhat common AS MEN AND WOMEN AGE BUT SHOULD BE ADDRESSED

6 I METHODISTHEALTH.COM

By Donna Hurst Frank and Hilda have been married for 43 years. 4HEY SHARE MANY PASSIONS TRAVEL GOURMET CUISINE DANCING AND EACH OTHER !S RETIREES THEY ENJOY THE FREEDOM TO INDULGE THOSE PASSIONS !ND ALTHOUGH THE COUPLE S LOVE FOR ONE ANOTHER HAS GROWN THROUGHOUT THEIR YEARS TOGETHER THEIR DESIRE FOR INTIMACY AND THE ABILITY TO PERFORM HAVE DIMINISHED 4OO EMBARRASSED TO DISCUSS IT WITH FRIENDS OR FAMILY THEY ASSUME IT IS JUST A NORMAL PART OF AGING 5NFORTUNATELY &RANK AND (ILDA AREN T ALONE (EALTH PROBLEMS OF EITHER PARTNER MEDICATIONS STRESS RELATIONSHIP PROBLEMS AND OTHER AGING ISSUES MAY CONTRIBUTE TO A DROP IN INTIMACY IN SENIORS

INTIMACY DURING THE GOLDEN YEARS Percentage of people remaining sexually active 29

AGE >80

25 87 AGE 60-64

89 0

50

SAYS h4HIS CAN LEAD TO ISSUES SUCH AS VAGINAL DRYNESS AND PAINFUL INTERCOURSE WHICH IN TURN LEADS TO DECREASED DESIRE AND LIBIDO 7OMEN GOING THROUGH MENOPAUSE ALSO MAY EXPERIENCE DECREASED SLEEP FROM HOT mASHES AND NIGHT SWEATS CAUSING FATIGUE AND AFFECTING THEIR DESIRE FOR INTIMACY v

3O WHAT EXACTLY IS NORMAL FOR MEN AND WOMEN WHEN IT COMES TO HEALTHY SEXUAL RESPONSE AND FUNCTION 4HE 7ORLD (EALTH /RGANIZATION SAYS SEXUAL HEALTH IS NOT JUST PHYSICAL EMOTIONAL MENTAL AND SOCIAL WELL BEING IT REQUIRES SOME DEGREE OF DESIRE

AN ABILITY TO ENJOY SEX AND A COMFORT LEVEL WITH SEX

!LTHOUGH NOT AS DRAMATIC AS FOR WOMEN

MEN EXPERIENCE HORMONE RELATED ISSUES TOO

He Said, She Said

'ONZALEZ SAYS MALE MENOPAUSE REALLY DOES EXIST /NCE CONSIDERED JUST A MYTH THE SYNDROME WHICH IS CALLED ANDROGEN DElCIENCY IN THE AGING MALE !$!- OR ANDROPAUSE

CAN AFFECT ENERGY LEVEL SEXUAL FUNCTION AND OR MOOD BECAUSE OF LOW TESTOSTERONE LEVELS 5NLIKE MENOPAUSE HOWEVER WHERE THERE IS ALMOST A COMPLETE WITHDRAWAL OF SEX HORMONE ESTROGENS IN WOMEN IN !$!- THERE TENDS TO BE A GRADUAL DECLINE IN TESTOSTERONE LEVELS IN MEN 'ONZALEZ AGREES WITH STUDIES THAT SHOW THAT TESTOSTERONE LEVELS GRADUALLY DECLINE THROUGHOUT ADULTHOOD ABOUT PERCENT A YEAR AFTER AGE ON AVERAGE "Y ABOUT AGE THE DECREASE IN A MAN S TESTOSTERONE LEVEL CAN BE AS MUCH AS PERCENT

)S LACK OF SEXUAL INTIMACY IN A RELATIONSHIP A MALE OR FEMALE PROBLEM 4HE QUESTION IS SIMPLE BUT THE ANSWER IS COMPLEX $R 3UNDARA +ULKARNI AN OBSTETRICIAN AND GYNECOLOGIST AT -ETHODIST 3UGAR ,AND (OSPITAL

SAYS THAT SEX DRIVE DECREASES GRADUALLY WITH AGE IN BOTH MEN AND WOMEN BUT WOMEN ARE TWO TO THREE TIMES MORE LIKELY TO BE AFFECTED

BY A DECLINE IN SEX DRIVE AS THEY AGE 2EDUCED SEX DRIVE BECOMES MUCH MORE COMMON IN WOMEN STARTING IN THEIR LATE S AND EARLY S 7HILE SOME WOMEN EXPERIENCE A BIG DECREASE IN SEXUAL DESIRE BEGINNING IN THEIR MIDLIFE YEARS OTHERS NOTICE NO CHANGE AND A FEW REPORT INCREASED INTEREST IN SEX PERHAPS DUE TO MORE PRIVACY AS CHILDREN LEAVE THE NEST AND THEY DON T HAVE WORRIES ABOUT CONTRACEPTION AFTER GOING THROUGH MENOPAUSE h-ANY WOMEN S ISSUES WITH SEXUAL PERFORMANCE STARTING IN MIDLIFE ARE RELATED TO DECREASED HORMONE LEVELS AND DECREASED BLOOD mOW TO THE GENITAL ORGANS v +ULKARNI

100 Source: Psychology Today

5ROLOGIST $R 2ICARDO 'ONZALEZ AT 4HE -ETHODIST (OSPITAL SAYS A MAN S LEVEL OF TESTOSTERONE hREACHES A PLATEAU AROUND AGE THEN BY AGE THERE IS A DECLINE IN TESTOSTERONE LEVELS v

Male patients with decreased libido should not hesitate to seek medical help and counseling if needed. There are a number of treatment methods available, such as testosterone replacement therapy, and men should discuss the risks and benefits of each with their physician.

31% Percentage of men 57 to 64 who report having erectile dysfunction.

Source: University of Chicago/Reuters

h!LSO PHYSICAL CHANGES THAT HAPPEN WITH AGE CAN RESULT FROM A NUMBER OF FACTORS SUCH AS MEDICATIONS FOR HIGH BLOOD PRESSURE OR HARDENING OF THE ARTERIES THAT AFFECT BLOOD mOW TO THE GENITALS CAUSING ERECTILE DYSFUNCTION v 'ONZALEZ SAYS h)F A MAN IS HAVING PROBLEMS WITH ERECTILE DYSFUNCTION AND THINKS HE WILL FAIL HE MAY AVOID SEXUAL ENCOUNTERS ALL TOGETHER v

VOLUME 6, NUMBER 1 I 7

Aging and Intimacy: What’s Your IQ?

UROLOGY

$O YOU KNOW THE FACTS ABOUT AGING AND SEXUAL HEALTH 4EST YOUR KNOWLEDGE BY TAKING OUR ONLINE QUIZ AT www.methodisthealth.com/intimacyIQ.

MIND over BODY… Understanding the psychology of intimacy

0SYCHOLOGICAL FACTORS HAVE A POWERFUL EFFECT ON SEXUAL PERFORMANCE 7HILE THIS IS TRUE FOR MEN

PSYCHOTHERAPIST -ARY *O 2APINI WHO WORKS WITH PATIENTS WHO HAVE UNDERGONE PROCEDURES AT THE -ETHODIST #ENTER FOR 0ELVIC 2ESTORATIVE -EDICINE SAYS WOMEN ESPECIALLY OLDER ONES ARE MORE PRONE TO PSYCHOLOGICAL INTIMACY ISSUES A popular speaker, author, AND RADIO AND TELEVISION PERSONALITY 2APINI KNOWS A THING OR TWO ABOUT THE SUBJECT “A lot of sexual performance DIFlCULTY IN OLDER INDIVIDUALS HAS TO DO WITH THE BODY IMAGE OF WOMEN v SHE SAYS h/UR SOCIETY VALUES SEXUALITY AND YOUTH *UST TELLING A WOMAN SHE IS SEXY OR PRETTY ISN T ENOUGH 7OMEN NEED TO FEEL GOOD ABOUT THEMSELVES )F A WOMAN FEELS GOOD ABOUT HER SEXUALITY AND HER BODY IT IS GOOD FOR MEN v 2APINI SAYS A STUDY THAT APPEARED IN The Journal of Sex Research SHOWED THAT REGARDLESS OF THE WOMAN S

age or menopausal status, SHE WAS MORE LIKELY TO CONSIDER HERSELF MORE ATTRACTIVE WHEN SHE WAS YEARS YOUNGER .EARLY PERCENT OF THE RESPONDENTS COULD NOT THINK OF EVEN ONE ATTRACTIVE FEATURE THEY HAD AND REPORTED AN OVERALL SENSE OF DISSATISFACTION WITH THEIR BODIES

-EN HAVE THEIR OWN PSYCHOLOGICAL PROBLEMS ASSOCIATED WITH INTIMACY HOWEVER SUCH AS PERFORMANCE ANXIETY 2APINI SAYS SINCE MEN ARE STEREOTYPED IN BOOKS AND MOVIES TO APPEAR TO BE THE ones who want sex most often, failure to perform takes more of a toll on their SELF ESTEEM

h-OST MEN THAT ) WORK WITH REGARDING SEXUAL INTIMACY TELL ME IT WASN T THEM WHO REJECTED THEIR WIVES MOST OF THEM TELL ME THEIR WIVES ARE BEAUTIFUL BUT THAT IT WAS THEIR WIVES WHO REJECTED THEMSELVES v 2APINI SAYS

h! GUY CAN T TELL ANOTHER GUY THAT HE DOESN T DESIRE SEX WITH HIS FEMALE PARTNER v SHE SAYS h! MAN MAY FEEL AWKWARD WITH SEX OR MAY NOT HAVE A HIGH SEX DRIVE -OST of the time, performance ISSUES ARE DUE TO PREMATURE EJACULATION OR ERECTILE DYSFUNCTION WHICH IS MORE LIKELY A SIGN OF AGING v

Between 25 and 45 percent of postmenopausal women find sex painful.*

Help for an Age-Old Problem (ELP IS AVAILABLE FOR INTIMACY ISSUES +ULKARNI SAYS AND TREATMENT SHOULD BE TAILORED TO A PATIENT S INDIVIDUAL NEEDS !CCORDING TO +ULKARNI WOMEN MAY BENElT FROM EXERCISES AND NUTRITIONAL CHANGES AS WELL AS ALTERNATIVE MEDICINE INCLUDING MEDITATION YOGA ACUPUNCTURE MASSAGE NATURAL SUPPLEMENTS AND VITAMINS h6AGINAL MOISTURIZERS AND LUBRICANTS AND LOCAL VAGINAL ESTROGEN THERAPY ARE SAFE TO USE AND CAN REVERSE CHANGES SIGNIlCANTLY v SHE SAYS h(ORMONE THERAPY IN THE FORM OF PILLS

PATCHES GELS AND SPRAYS CAN IMPROVE SENSE OF WELLNESS EVEN THOUGH THERE ARE SOME RISKS INVOLVED (OWEVER LOCAL VAGINAL HORMONE TREATMENT IS VERY SAFE v

h4HIS IS SUCH A WORKING SOCIETY AND ANY KIND OF RECESSION OR MONEY ISSUE CAN CONTRIBUTE TO LOWERED SEX DRIVE WHETHER MALE OR FEMALE v 7HEN 2APINI COUNSELS COUPLES ABOUT INTIMACY issues, she encourages them to come in together to TALK 3HE ASKS COUPLES TO TALK FOR MINUTES FOUR DAYS A WEEK AND THE TOPIC CANNOT BE ABOUT THE KIDS h4ALKING AND FOCUSING ON each other will turn a sexless MARRIAGE AROUND v 2APINI ADDS h)F YOU CAN HAVE GOOD INTIMACY IN A MARRIAGE YOU CAN HAVE A GOOD SEX LIFE v Q * Source: National Women’s Health Resource Center

3TRESS ALSO APPEARS TO LOWER PEOPLE S LIBIDOS

REPLACEMENT THERAPY AND MEN SHOULD DISCUSS THE RISKS AND BENElTS OF EACH WITH THEIR PHYSICIAN v 'ONZALEZ SAYS -EN SHOULD BE HONEST WITH THEIR DOCTORS AND MAKE SURE THEY DISCUSS ANY UNDERLYING PHYSICAL OR EMOTIONAL ISSUES OR MEDICINES THAT MAY CONTRIBUTE TO DECLINING SEXUAL PERFORMANCE 'ONZALEZ ADDS THAT MEN ALSO CAN BENElT FROM EATING A HEALTHY DIET AND ENGAGING IN REGULAR PHYSICAL ACTIVITY TO HELP BOOST STRENGTH ENERGY AND LEAN MUSCLE MASS 0ROPER DIET AND EXERCISE HAVE OTHER BENElTS INCLUDING BETTER SLEEP AND IMPROVED MOOD AND ABILITY TO FOCUS +ULKARNI ALSO ADVOCATES GIVING WOMEN THE OPPORTUNITY TO TALK ABOUT SEXUAL PROBLEMS AS THEY AGE AS A FUNDAMENTAL PART OF HEALTH CARE THAT IMPROVES THEIR QUALITY OF LIFE

'ONZALEZ ADDS THAT DECLINING SEXUAL INTEREST IS SOMEWHAT COMMON AS MEN AGE BUT SHOULD BE ADDRESSED

h! MIND BODY AND SPIRIT APPROACH IS CRUCIAL AT THIS AGE MORE THAN ANY OTHER TIME OF A WOMAN S LIFE v +ULKARNI SAYS

-ALE PATIENTS WITH DECREASED LIBIDO SHOULD NOT HESITATE TO SEEK MEDICAL HELP AND COUNSELING IF NEEDED h4HERE ARE A NUMBER OF TREATMENT METHODS AVAILABLE SUCH AS TESTOSTERONE

7HEN MEN AND WOMEN WORK TOGETHER AND SEEK HELP AND TREATMENT THEY CAN lND TREASURE IN THEIR GOLDEN YEARS WITH CLOSER RELATIONSHIPS AND IMPROVED INTIMACY Q

8 I METHODISTHEALTH.COM

Weight Management

the skinny on

and aging

By Linda Gilchriest

O

NE OF THE NICEST COMPLIMENTS YOU CAN GIVE MEMBERS OF THE SENIOR SET IS TO TELL THEM THEY LOOK YOUNG FOR THEIR AGE 7HILE SAYING IT CANNOT MAKE IT SO EATING THE RIGHT KINDS OF FOOD AND EXERCISING TO MINIMIZE FAT BUILDUP CAN GET AND KEEP YOU ON THE RIGHT TRACK ACCORDING TO RESEARCHERS AT 4HE -ETHODIST (OSPITAL .OT ADHERING TO A HEALTHY LIFESTYLE RISKS BUILDING UP FAT THAT CAN CAUSE YOU TO LOOK AND FEEL OLDER THAN YOU ARE $ATA FROM THE .ATIONAL )NSTITUTE OF $IABETES AND $IGESTIVE AND +IDNEY $ISEASES CONlRMS WHAT MOST OF US ALREADY KNOW !MERICA IS IN AN OBESITY EPIDEMIC 4HE !SSOCIATED 0RESS AND POPULAR BABY BOOMER WEBSITE ,IFE'OES3TRONG COM SURVEYED BOOMERS 2ESULTS SHOWED A GREATER PERCENTAGE OF BABY BOOMERS ARE OBESE than other generations, which puts them at a higher risk for HEART DISEASE DIABETES HYPERTENSION AND ARTHRITIS 4HE SURVEY ALSO FOUND THAT MANY BOOMERS ARE NOT MEETING THE WEEKLY HOURS OF MODERATE INTENSITY AEROBIC ACTIVITY AND STRENGTH TRAINING RECOMMENDED TO STAY lT AND lGHT MUSCLE LOSS AS THEY AGE

AMOUNT OF FAT WE STORE CAUSING US TO PUT MORE WEAR AND TEAR ON THE BODY THUS CAUSING US TO AGE FASTER &OR EXAMPLE A YEAR OLD MAN WHO SMOKES IS OVERWEIGHT

GETS LITTLE OR NO EXERCISE AND HAS A COMORBIDITY FACTOR SUCH AS DIABETES OR HIGH CHOLESTEROL CAN HAVE A hREAL AGEv OF OR OLDER BECAUSE OF HIS HEALTH CONDITIONS AND LIFESTYLE ,IKEWISE A MAN AT WHO HAS HIS WEIGHT IN CHECK GETS REGULAR EXERCISE AND SLEEPS SIX TO EIGHT HOURS EACH NIGHT COULD HAVE A METABOLIC AGE OF $R #HRISTIE "ALLANTYNE CHIEF OF THE #ARDIOVASCULAR 2ESEARCH 3ECTION OF THE $IVISION OF !THEROSCLEROSIS AND 6ASCULAR -EDICINE AND DIRECTOR OF THE #ENTER OF #ARDIOVASCULAR $ISEASE 0REVENTION AT THE -ETHODIST $E"AKEY (EART 6ASCULAR #ENTER

SAYS STUDIES THAT LOOK AT HEALTH AND LONGEVITY SHOW ONE OF THE WORST THINGS YOU CAN DO IS EAT TOO MANY CALORIES AND GET FAT h4AKING IN TOO MANY CALORIES AND TAKING IN TOO MUCH FAT IS HOW ANIMALS DIE FASTER 4HIS RESEARCH IS HOLDING UP FOR HUMANS AS WELL v "ALLANTYNE SAYS WITH HIGH FAT DIETS NOT ONLY DO PEOPLE GET FATTER BUT THE FAT TISSUE DOES NOT FUNCTION PROPERLY AND THE CELLS CAN BECOME INmAMED

4HOSE EXTRA POUNDS MAY COST YOU MORE THAN YOU KNOW 2ESEARCHERS AT 4HE -ETHODIST (OSPITAL 2ESEARCH )NSTITUTE ARE lNDING THAT EXCESS BODY FAT ACTS ON TISSUE TO INCREASE THE

VOLUME 6, NUMBER 1 I 9

Weight Management

"ODY FAT MAKES ADIPONECTIN A PROTEIN HORMONE THAT REGULATES METABOLISM OF LIPIDS AND GLUCOSE )T CAN AFFECT INSULIN SENSITIVITY AND INCREASE YOUR RISK OF BECOMING DIABETIC h!S YOU GET FATTER THE LEVEL OF ADIPONECTIN DROPS v "ALLANTYNE SAYS h)T IS NOT A MARKER OF HOW MUCH FAT TISSUE YOU HAVE

BUT A MARKER OF HOW THAT FAT TISSUE IS FUNCTIONING h7E HAVE DATA IN HUMANS v HE SAYS h7E HAVE LOOKED AT THE PROGRAM AT THE -ETHODIST 7EIGHT -ANAGEMENT #ENTER .OT ALL OF THESE PEOPLE HAVE THIS PROBLEM BUT OBESE PEOPLE WHO HAVE METABOLIC SYNDROME HAVE LOW LEVELS OF ADIPONECTIN v -ETABOLIC SYNDROME IS THE GROUP OF RISK FACTORS LARGE WAISTLINE HIGH TRIGLYCERIDE LEVEL LOW ($, GOOD CHOLESTEROL

HYPERTENSION HIGH FASTING BLOOD SUGAR FOR CORONARY ARTERY DISEASE

Breaking Down the Fat $R 7ILLA (SUEH A SENIOR MEMBER OF THE 2ESEARCH )NSTITUTE AND DIRECTOR OF THE -ETHODIST $IABETES -ETABOLISM )NSTITUTE SAYS THE HUMAN BODY IS COMPOSED TO TWO KINDS OF FAT WHITE ADIPOSE AND BROWN ADIPOSE TISSUE

INmAMMATORY PATHWAYS IN ALL TISSUES INCLUDING FAT TISSUE 7HEN THE TISSUE BECOMES INmAMED THE IMMUNE SYSTEM FALTERS h/UR STUDIES SUGGEST THERE IS MORE OXIDATIVE STRESS IN AGING BECAUSE AS WE AGE PARTICULARLY IN THE PRESENCE OF A LOT OF RISK FACTORS LIKE METABOLIC SYNDROME AND DIABETES OUR BODIES CELLS ARE LESS CAPABLE OF HANDLING THE OXIDATIVE STRESS BECAUSE SOME OF THE ANTIOXIDANT ENZYMES ARE NOT FUNCTIONING v (SUEH SAYS h7E THINK THAT CERTAIN ANTI INmAMMATORY MEDICATIONS MAY REDUCE THE INmAMMATION AND THEN THE OXIDATIVE STRESS v SHE ADDS 2ESEARCHERS AT -ETHODIST ARE LOOKING AT BROWN FAT AND HOW TO INCREASE ITS PRODUCTION TO INCREASE WEIGHT LOSS h'# HORMONE ACTUALLY ENHANCES BROWN ADIPOSE TISSUE ACTIVITY IN MICE v (SUEH SAYS 4HE REPORT ON THE RESEARCH TEAM S lNDINGS WILL BE PUBLISHED SHORTLY AND CLINICAL TRIALS FOR HUMANS WILL SOON BE AVAILABLE

! MAN AT WHO HAS HIS WEIGHT IN CHECK GETS REGULAR EXERCISE AND h6ERY SIMPLY BROWN FAT IS THE GOOD FAT AND WHITE FAT IS THE BAD FAT v (SUEH SAYS 7HITE FAT IS DISTRIBUTED EVERYWHERE THROUGHOUT THE BODY 4HERE ARE TWO MAIN TYPES VISCERAL THE STUFF INSIDE YOUR ABDOMEN AND SUBCUTANEOUS THE FAT RIGHT UNDER YOUR SKIN "!4 BROWN FAT WORKS IN THE PRODUCTION OF HEAT AND LIPID OXIDATION WHILE 7!4 WHITE FAT REGULATES APPETITE ENERGY METABOLISM AND GLUCOSE AND LIPID METABOLISM (SUEH SAYS BROWN FAT IS GOOD BECAUSE IT BURNS BOTH THE FAT YOU TAKE IN AND THE FAT YOU ACCUMULATE 3O THE FAT STORAGE OR THE WHITE FAT GOES TO THE BROWN FAT AND IS BURNED h4HESE FATS ARE SIMILAR IF YOU CATEGORIZE THE CELLS BUT THEY HAVE DIFFERENT INmAMMATORY CAPACITIES )T S THOUGHT THAT VISCERAL FAT IS THE MORE INmAMED FAT WHILE THE SUBCUTANEOUS IS LESS INmAMED "UT WHEN PEOPLE GAIN A LOT OF WEIGHT OUR STUDIES SUGGEST BOTH TYPES BECOME INmAMED v SHE SAID 7HAT CAUSES FAT TO BECOME INmAMED IN AGING 2ESEARCHERS SUGGEST THERE IS MORE OXIDATIVE STRESS IN AGING /XIDATIVE STRESS IS THE IMBALANCE IN TISSUE CAUSED WHEN DETOXIFYING ELEMENTS ARE INTRODUCED TO REACTIVE OXYGEN 4HIS IMBALANCE CAN BE FOUND IN PATIENTS WITH !LZHEIMER S 0ARKINSON S

CHRONIC FATIGUE SYNDROME AND OTHER DISEASES )T ALSO CAN BE IMPORTANT TO PREVENTING AGING 4HE BODY MUST PRODUCE MORE ANTIOXIDANTS TO COUNTERACT THE OXIDATIVE STRESS AND THE OXIDATIVE STRESS ACTIVATES MAJOR

10 I METHODISTHEALTH.COM

7HILE SCIENCE ADVANCES WITH RESEARCH TO COMBAT THE EFFECTS OF FAT AS WE AGE "ALLANTYNE SAYS THERE ARE THINGS WE CAN DO TODAY TO HELP h7E BELIEVE THAT IN TERMS OF HEALTHY AGING

THE lRST THING YOU CAN DO IS LOOK AT YOUR WEIGHT AND YOUR LIFESTYLE v HE SAYS h)T SEEMS SIMPLE BUT UNFORTUNATELY LIFESTYLE CHANGE IS DIFlCULT TO IMPLEMENT h7E KNOW THAT CHANGES IN DIET ALONG WITH EXERCISE CAN MAKE A MARKED IMPROVEMENT )F YOU REALLY WANT TO LOSE WEIGHT AND KEEP IT OFF WEIGHT MAINTENANCE EXERCISE IN CRITICALLY IMPORTANT v HE SAYS !LTHOUGH THE RECOGNIZED BENCHMARK FOR EXERCISE IS CONSIDERED THREE HOURS A WEEK OR MINUTES lVE TO SIX TIMES A WEEK "ALLANTYNE SAYS THAT IS REALLY JUST THE MINIMUM h!S PHYSICIANS WE UNDER PRESCRIBE EXERCISE 0EOPLE SAY @) M TOO BUSY 7ELL ) THINK ) AM AS BUSY AS MOST OF MY PATIENTS

AND ) GET IN SIX OR SEVEN HOURS OF EXERCISE A WEEK v HE ADDS "ALLANTYNE SAYS PEOPLE SHOULD KNOW THEIR WEIGHT "-) OR BODY MASS INDEX AND OTHER WARNING SIGNS ABOUT OBESITY BLOOD PRESSURE TRIGLYCERIDES LEVELS ($, AND MARKERS FOR INmAMMATORY DISEASE h)N ANTI AGING TWO THINGS THAT REALLY SEEM TO WORK ARE REDUCING CALORIES AND REGULAR EXERCISE v HE SAYS h9OU CAN lGHT THIS BUT YOU ALSO ARE GOING TO HAVE TO WATCH WHAT YOU EAT 9OU CANNOT EAT THE WAY YOU USED TO 4HAT IS JUST ONE OF THE ADJUSTMENTS TO LIFE WHEN AGING v Q

SLEEPS SIX TO EIGHT HOURS EACH NIGHT COULD HAVE A METABOLIC AGE OF

Dr. Christie Ballantyne

VOLUME 6, NUMBER 1 I 11

PLASTIC SURGERY

New face of

plastic surgery 12 I METHODISTHEALTH.COM

Cosmetic and rejuvenation procedures have gone from being something that purely the rich and famous do, to a trend seen in mainstream America.

By Linda Gilchriest

D

ON 4RUBY IS BEAMING (IS SMILE BROADENS AS HE LOOKS ACROSS THE ROOM AT HIS WIFE !RDEN h(E JUST SITS AND STARES v !RDEN 4RUBY SAYS h(E JUST LOVES THE NEW ME v 4RUBY SPENT YEARS CONTEMPLATING PLASTIC SURGERY AND DOING RESEARCH ON WHAT TO DO AND WHO SHE WOULD SELECT TO PERFORM IT &INALLY

$R !NTHONY "RISSETT A FACIAL PLASTIC SURGEON AT 4HE -ETHODIST (OSPITAL GAVE !RDEN AND $ON THE FACE THEY HAVE BEEN WANTING

Dr. Anthony Brissett

h7HEN YOU TURN AND YOU LOOK IN THE MIRROR

OR WHEN YOUR HUSBAND MAKES COMMENTS THAT YOU ARE GETTING JOWLS YOU SAY @/+ ,ET S DO IT v 4RUBY SAYS

VOLUME 6, NUMBER 1 I 13

Arden Truby, before and after

Plastic Surgery in Seniors in 2010 Other Breast Lifts Forehead Lifts

4% 5%

Breast Reductions Liposuctions

ODY REJUVENATION PROCEDURES

16% 31% Face Lifts

7% 8% 29%

Cosmetic Eyelid Operations Source: American Society for Aesthetic Plastic Surgery

14 I METHODISTHEALTH.COM

ARE AT AN ALL TIME HIGH ACCORDING TO THE !MERICAN 3OCIETY OF 0LASTIC 3URGEONS )N MORE THAN !MERICANS AGE AND OLDER CHOSE SOME TYPE OF 4HAT AGE GROUP REPRESENTS PERCENT OF THE TOTAL COSMETIC SURGERY MARKET AND A PERCENT INCREASE OVER THE PREVIOUS YEAR )T S CLEAR THAT PEOPLE ARE BECOMING INCREASINGLY AWARE OF REJUVENATION PROCEDURES v SAYS "RISSETT WHO IS ALSO DIRECTOR OF FACIAL PLASTIC AND RECONSTRUCTIVE SURGERY "AYLOR #OLLEGE -EDICINE

PLASTIC SURGERY

Plastic surgery was spoken about in hushed tones 15 or 20 years ago, but these days, people are fairly open.

In 2010, more than

3.2

million

AMERICANS 55 and older chose some type of cosmetic surgery.

Source: American Society of Plastic Surgeons

L

AST YEAR, TRUBY SAYS SHE SAW

A MAGAZINE S LIST OF TOP SURGEONS IN (OUSTON AND FOUND "RISSETT 3HE REVIEWED HIS CREDENTIALS AND MADE AN APPOINTMENT 3HE DID HER HOMEWORK h/F COURSE ) DID IT IS MY FACE v SHE SAYS h9OU HEAR SO MANY HORROR STORIES 9OU WANT TO MAKE SURE YOU RE GOING TO THE RIGHT PERSON 7HEN ) WENT IN FOR MY lRST CONSULTATION x HE JUST MADE ME FEEL RELAXED v SHE SAYS h(E SAID RIGHT OFF THE BAT @) DON T WANT TO DO THIS IN A HURRY ) WANT TO MAKE SURE THIS IS WHAT YOU REALLY WANT TO DO v h(E ALSO WANTED TO MEET MY HUSBAND TO MAKE SURE WE WERE ON THE SAME PAGE GOING INTO SURGERY v SHE SAYS 4RUBY HAD THREE APPOINTMENTS WITH "RISSETT TO GIVE HER A CHANCE TO HAVE ALL HER QUESTIONS ANSWERED AND TO GIVE HER AND HIS STAFF A CHANCE TO CONDITION HER SKIN WHICH INCLUDED TREATMENTS TO MAKE HER SKIN SMOOTH AND READY FOR SURGERY

h4HERE ARE SOME PEOPLE WHO ARE BUT LOOK LIKE THEY ARE !ND THERE ARE SOME PEOPLE WHO ARE WHO LOOK LIKE THEY ARE v SAYS $R *EFFERY &RIEDMAN CHAIRMAN OF THE $IVISION OF 0LASTIC 3URGERY AT -ETHODIST h(OW PEOPLE AGE IS IN THEIR GENES AND YOU CAN T CHANGE IT 7E SET THE CLOCK BACK IN TERMS OF ONE S FACIAL APPEARANCE v

4RUBY SAYS SHE WAS ONE OF THOSE LOOKS OLDER THAN HER AGE TYPES h) LOOKED BUT ) M v 3HE ATTRIBUTES THE SAGGING AND WRINKLES TO THE STRESS OF CARING FOR A TERMINALLY ILL CHILD WHILE ALSO TAKING CARE OF TWO OTHER CHILDREN A VERY STRESSFUL lRST MARRIAGE AND SMOKING UNTIL SHE WAS ! BIKER BABE WHO ENJOYS RIDING ON THE BACK OF HER HUSBAND S (ARLEY $AVIDSON MOTORCYCLE 4RUBY FEELS LIKE SHE HAS TURNED BACK THE HANDS OF TIME h.OW ) LOOK ABOUT THE SAME AS WHEN ) WAS IN MY S v SHE SAYS "RISSETT PERFORMED A FACELIFT BLEPHAROPLASTY UNDER THE EYE LIFT A CHEMICAL PEEL SUBMENTAL LIPOSUCTION AND PLATYSMAL PLICATION A LOWER FACE AND NECK LIFT IN *UNE 4HE SURGERY TOOK EIGHT HOURS !FTER AN OVERNIGHT HOSPITAL STAY SHE LEFT THE HOSPITAL WITHOUT HAVING TO WEAR BANDAGES BUT SHE CONTINUES TO WEAR A SUPPORT BAND FOR HER NECK AT NIGHT 4RUBY S RECOVERY PROCESS WILL CONTINUE FOR A FEW MORE MONTHS 3HE STILL HAS SOME NUMBNESS ALONG HER JAW LINE

AROUND HER EARS AND NECK h"UT IT S NOT ANYTHING YOU CAN T LIVE WITH OR THAT WILL DISRUPT YOUR DAILY ROUTINE )T IS NOTHING THAT WILL KEEP YOU DOWN v SHE SAYS 3UCH SURGERY CAN COST BETWEEN AND

WHICH DOES NOT INCLUDE HOSPITAL COSTS 3HE SAYS IT WAS MONEY WELL SPENT AS FAR AS SHE AND HER HUSBAND ARE CONCERNED h) M MY HUSBAND S NEW -ERCEDES v SHE LAUGHS

VOLUME 6, NUMBER 1 I 15

PLASTIC SURGERY

Rejuvenation efforts are not limited to the face.

In 2010,

55+ represented

26% TOTAL

of the

T

HERE ARE MANY EXPLANATIONS for the INCREASE IN REJUVENATION PROCEDURES &OR TO YEAR OLDS IN PARTICULAR THE INCREASE REmECTS THEIR DESIRE TO LOOK GOOD AND FEEL BETTER ABOUT THEIR BODIES !NOTHER REASON FOR THE INCREASE IS THAT MANY OF THE MINIMALLY INVASIVE PROCEDURES LIKE SOFT TISSUE lLLERS OR BOTULINUM TOXIN

ARE NOW AVAILABLE AT AN OFlCE VISIT h7E ARE AT THE LEADING EDGE OF MEDICINE PUSHING THE ENVELOPE IN DEVELOPING AND PERFECTING NEW TECHNIQUES v "RISSETT SAYS h-ETHODIST HAS BEEN A LEADER IN THE USE OF CONTEMPORARY CONCEPTS AND MODERN TECHNOLOGY FOR COSMETIC AND RECONSTRUCTIVE PROCEDURES v (E SAYS ABOUT TO PERCENT OF HIS COSMETIC PATIENTS ARE MEN AN INCREASE IN THE PAST FEW YEARS h)T IS NOT JUST MEN WHO ARE STRIVING TO LOOK YOUNGER IN THE WORKPLACE BUT THAT OFTENTIMES IS A FACTOR THAT BRINGS THEM INTO THE OFlCE v HE EXPLAINS h7E ARE SEEING MEN WHO WITH A CHANGE IN THE ECONOMY

NEED TO STAY IN THE WORKFORCE LONGER 4HEY ARE lNDING THEMSELVES IN A COMPETITIVE ENVIRONMENT WHETHER IT IS A SALES RELATED INDUSTRY OR SOME OTHER COMPETITIVE INDUSTRY WHERE WORKERS ARE YOUNGER AND THEY PERHAPS WANT AN OPPORTUNITY TO COMPETE FOR THE SAME JOBS v &RIEDMAN SAYS REJUVENATION EFFORTS ARE NOT LIMITED TO THE FACE WOMEN WHO ARE PAST THE POINT OF CHILDBEARING AND ARE SHOWING THE SIGNS OF PAST PREGNANCIES CONSIDER TUMMY TUCKS 0LASTIC SURGERY WAS SPOKEN ABOUT IN HUSHED TONES OR YEARS AGO BUT THESE DAYS PEOPLE ARE FAIRLY OPEN ABOUT THEIR DESIRE TO REJUVENATE THEIR BODIES h#OSMETIC AND REJUVENATION PROCEDURES HAVE GONE FROM BEING SOMETHING THAT PURELY THE RICH AND FAMOUS DO TO A TREND SEEN IN MAINSTREAM !MERICA v "RISSETT SAYS (E SAYS THERE IS A MULTITUDE OF REASONS FOR THIS SHIFT h!S PEOPLE AGE THEY WANT TO CONTINUE TO LOOK YOUTHFUL v HE SAYS h7E HAVE A GROUP OF BABY BOOMERS WHO ARE SEEING AGE RELATED PHYSICAL CHANGES IN THEIR APPEARANCE AND HAVE

16 I METHODISTHEALTH.COM

cosmetic surgery market.

Source: American Society of Plastic Surgeons

THE lNANCIAL MEANS TO SLOW THE PROCESS 4HESE TWO FACTORS COME TOGETHER TO CREATE A DESIRE FOR REJUVENATION PROCEDURES h7E ALSO SEE AN INCREASE IN CULTURAL DIVERSITY AS IT RELATES TO PEOPLE PURSUING THOSE PROCEDURES 3O WE HAVE !FRICAN !MERICANS (ISPANICS AND !SIANS WHO INCREASINGLY ARE PURSUING COSMETIC AND SURGICAL REJUVENATION PROCEDURES v HE SAYS "OTH &RIEDMAN AND "RISSETT BELIEVE THAT IT IS IMPORTANT FOR PATIENTS TO DO THEIR HOMEWORK +NOW WHAT YOU WANT AND WHAT YOUR EXPECTATIONS ARE h/UR ULTIMATE GOAL IS TO MAKE OUR PATIENTS HAPPY BUT IF THEIR EXPECTATIONS ARE FAR BEYOND WHAT CAN BE ACHIEVED THEY WILL NOT BE HAPPY v &RIEDMAN SAYS h)N MY PRACTICE ) DON T OPERATE ON ANYBODY UNLESS ) VE SEEN THEM TWICE SO THAT THEY GET A FULL SENSE OF WHAT THEY ARE GETTING INTO AND THEY ARE GETTING ALL THEIR QUESTIONS ANSWERED ) GET THE OPPORTUNITY TO MAKE SURE ) MEET ALL THEIR EXPECTATIONS v h4HERE ARE CERTAINLY PEOPLE WHO MIGHT NOT BE GOOD CANDIDATES FOR THESE PROCEDURES v "RISSETT SAYS h)F THEIR DESIRED GOAL IS NOT REALISTIC OR IF THEY ARE NOT IN GOOD HEALTH WHETHER IT BE FROM AN OVERALL PHYSIOLOGICAL PERSPECTIVE OR EVEN A PSYCHOLOGICAL OR PSYCHIATRIC PERSPECTIVE v "OTH DOCTORS SAY YOU NEED TO HAVE WELL THOUGHT OUT REASONS FOR HAVING PLASTIC SURGERY h3URGERY IS NOT GOING TO SAVE A MARRIAGE IT IS NOT GOING TO KEEP PEOPLE FROM GETTING A DIVORCE AND IT IS NOT GOING TO GET YOU A JOB )T NEEDS TO BE DONE FOR THE RIGHT REASON SELF SATISFACTION v &RIEDMAN SAYS h) WOULD TELL PEOPLE TO THINK ABOUT IT RESEARCH IT $ON T BE IN A HURRY AND MAKE SURE YOU VE GOT THE RIGHT PERSON TO DO THE SURGERY BEFORE YOU TAKE THAT STEP v 4RUBY SAYS h) FEEL LIKE IF ) WANTED TO GO BACK TO WORK ) COULD PROBABLY GET REHIRED ) COULDN T BE HAPPIER v Q

EXERCISE

exercise aging Experts say start slowly and work that body

By Sheshe Giddens

Each morning, you join the rhythmic thumping of fellow joggers hitting the trail. Pushing yourself to the limit, you are now up to four miles a day — a significant increase from where you started a few months ago. Just as you hit your stride, you feel something in your lower leg — a pain so deep you feel it in the bone.

Doctors have spent years urging patients to eat right and exercise. But as we age, we are more prone to develop “boomeritis,” a phrase used to describe a growing number of exercise-related injuries suffered by a generation of health-conscious baby boomers, people age 49 or older.

When we reach our 40s, we begin to lose muscle and calcium in our bones. Our blood

vessels thicken, and our weight, resting heart rate, blood pressure and blood sugar can increase. In our 50s, our muscles and tendons become significantly less elastic, and hormone levels for both men and women drop, causing bones to become more brittle. And by our 60s, conditions such as osteoarthritis and osteoporosis can complicate exercise.

Overuse injuries such as stress fractures, golfer’s elbow and shin splints are just a few of the common culprits that send patients of all ages to their doctors’ offices. Baby boomers are more susceptible to these types of injuries as well as back, hip, knee and ankle pain.

PERCENTAGE OF SENIORS, BY AGE AND GENDER, WHO EXERCISE REGULARLY 38.5% 31.1%

23% 14% % 0

5

10

15

20

25

30

35

40

Source: Administration on Aging, Department of Health & Human Services

VOLUME 6, NUMBER 1 I 17

MIX IT UP: Four Types of Exercises to Help You Stay Healthy -ATT (OLLAND RECOMMENDS THAT BABY BOOMERS FOCUS ON FOUR AREAS OF EXERCISE TO STAY HEALTHY 1. STRENGTH TRAINING %XERCISES SUCH AS WEIGHT LIFTING CAN SLOW OR REVERSE THE DECLINE IN MUSCLE MASS STRENGTH AND LOSS IN BONE DENSITY

Matt Holland, manager of physical 2. FLEXIBILITY 3TRETCHING IS AN ESSENTIAL PART OF WARMING UP therapy and occupational therapy BEFORE EXERCISE )T ALSO HELPS KEEP THE BODY LIMBER AND ASSISTS at Methodist, works with patients WITH BALANCE 0ILATES YOGA AND TAI CHI ARE THREE POPULAR mEXIBILITY EXERCISES like Kathleen Berger, who is in 3. BALANCE "ALANCE EXERCISES HELP PREVENT FALLS THAT CAN RESULT IN AN INJURY (IP mEXIONS ARE A GOOD EXERCISE TO BUILD physical therapy at the Methodist BALANCE Center for Sports Medicine twice a 4. CARDIOVASCULAR ! CARDIOVASCULAR WORKOUT CAN HELP DECREASE BODY WEIGHT AND REDUCE STRESS HIGH BLOOD week following torn meniscus repair.

PRESSURE AND THE COMPLICATIONS OF DIABETES A torn meniscus, one of the most h)F YOU COMMIT TO BEING ACTIVE AND DOING THE RIGHT TYPES OF EXERCISE YOU CAN OFFSET THE CHANGES common knee injuries, occurs when the THAT COME WITH AGING v (OLLAND SAYS knee is forcefully twisted or rotated, resulting in trauma.

Q

18 I METHODISTHEALTH.COM

EXERCISE

1 FIVE TIPS TO KEEP YOU OUT OF THE DOCTOR’S OFFICE

GET YOUR BODY READY "EFORE STARTING

warm up those MUSCLES

3

2 DON’T DO TOO MUCH TOO SOON 7HEN WALKING OR running, increase DISTANCE AND TIME

BY INCREMENTS OF PERCENT PER WEEK

5

4

DON’T BE A SUPERHERO

GET A TRAINER

TAKE IT EASY

&OCUS LESS ON BUILDING BULKY MUSCLES AND MORE ON OVERALL lTNESS AND WEIGHT REDUCTION BY using lighter WEIGHTS AND WITH MORE REPETITIONS

3EEK ADVICE FROM A PHYSICAL THERApist or trainer to create a workout regimen that is appropriate for YOUR AGE AND BODY TYPE

"ALANCE REST BETWEEN WORKouts with sleep AND PROPER NUTRITION

4HE OLDER WE GET THE MORE LIKELY WE ARE TO BE DIAGNOSED WITH A CONDITION THAT CAN BE SIGNIlCANTLY IMPROVED BY EXERCISE -ORE EXERCISE IS A GOOD THING "UT SOMETIMES NEW CONCERNS ABOUT HEALTH CAN LEAD THE OVERZEALOUS TO DO TOO MUCH TOO SOON OR ATTEMPT TO RECAPTURE THEIR YOUTH BY TAKING UP EXERCISES AND SPORTS ACTIVITIES THAT THEY DID BACK IN THEIR S h/UR GENERATION HAS RECOGNIZED THE IMPORTANCE OF EXERCISE MORE THAN OUR PARENTS GENERATION v SAYS $R 0ATRICK # -C#ULLOCH ORTHOPEDIC SURGEON AT 4HE -ETHODIST (OSPITAL AND ASSISTANT PROFESSOR OF ORTHOPEDIC SURGERY AND SPORTS MEDICINE AT 7EILL #ORNELL -EDICAL #OLLEGE h!S PHYSICIANS

WE LOVE IT WHEN A YEAR OLD PATIENT PLAYS TENNIS OR IS OUT RUNNING THREE MILES EVERY DAY "UT THAT COMES WITH SOME RISK OF INJURY v -C#ULLOCH WHO SERVES AS A TEAM PHYSICIAN FOR THE (OUSTON !STROS RECOMMENDS THE FOLLOWING STEPS TO PREVENT INJURIES Q 4ALK TO YOUR PRIMARY CARE PHYSICIAN BEFORE STARTING AN

EXERCISE REGIMEN Q 2EMEMBER THAT YOU AREN T ANYMORE SO TAKE YOUR AGE AND LEVEL OF COMFORTABLE ACTIVITY INTO ACCOUNT Q 3ET REALISTIC GOALS Q 7HEN STRIVING TO LOSE WEIGHT START WITH LOW IMPACT EXERCISE SUCH AS SWIMMING BICYCLING AND WEIGHT LIFTING UNTIL YOU GET CLOSER TO YOUR IDEAL BODY WEIGHT 4HEN YOU CAN INCORPORATE HIGH IMPACT EXERCISES SUCH AS RUNNING

h&OCUS ON STRENGTHENING THE CORE 4HAT IS WHERE OUR POWER COMES FROM )T IS GOOD FOR POSTURE GOOD FOR BALANCE AND GOOD FOR BREATHING v -C#ULLOCH ADDS "ECAUSE THE RISK OF OSTEOPOROSIS INCREASES WITH AGE OLDER WOMEN WHO LOSE BONE FASTER THAN THEIR MALE COUNTERPARTS

CAN QUICKLY RUN INTO TROUBLE WHILE EXERCISING -C#ULLOCH RECOMMENDS ALL WOMEN ADD SOME WEIGHT RESISTANCE EXERCISE SUCH AS WALKING WITH LIGHT WEIGHTS IN ORDER TO SLOW THE RATE OF BONE LOSS (E ALSO HAS A WARNING FOR THE AGING WEEKEND WARRIOR 3HORT PERIODS OF INTENSE EXERCISE CAN BE DETRIMENTAL TO YOUR BODY h4HE GENERAL RULE IS TO START SLOW AND BUILD FOR THE LONG HAUL v HE SAYS The Methodist Center for Sports Medicine offers leading-edge treatment and rehabilitation for sports-related and orthopedic injuries. Methodist has six athletic training and physical therapy locations throughout the greater Houston area. Methodist is proud to be the official health care provider of the Houston Astros, Houston Texans, Houston Dynamo and Rice University. To learn more, call 281-39-SPORT (77678). Q

“As physicians, we love it when a 70-year-old patient plays tennis or is out running three miles every day.

But that comes with some risk of injury.”

— Dr. Patrick McCulloch

VOLUME 6, NUMBER 1 I 19

ALZHEIMER’S

Broadcaster Jim Nantz (right) is shown with his father Jim Nantz Jr.

Honoring thy fa

By Denny Angelle

“It’s no accident that we brought this center to Houston and to The Methodist Hospital.”

— Jim Nantz

A

S A TELEVISION SPORTS ANNOUNCER FOR THE #"3 NETWORK *IM .ANTZ IS OFTEN AT THE CENTER OF THE WORLD S BIGGEST SPORTING EVENTS (IS TICKET CANNOT BE PURCHASED OR NEGOTIATED HE EARNED IT SIMPLY BY BEING ONE OF THE BEST IN THE BUSINESS FOR MORE THAN YEARS

%VEN SO .ANTZ HAD A DREAM ONE DAY HIS FATHER WOULD JOIN HIM AT EVENTS LIKE THE 3UPER "OWL THE -ASTERS 'OLF 4OURNAMENT OR THE .#!! &INALS TO SHARE THE EXCITEMENT OF THESE GREAT COMPETITIONS 4HIS TOO WOULD BE A UNIQUE ALL ACCESS TICKET FEW COULD OBTAIN "UT THAT DREAM WOULD NEVER BE REALIZED 4HE ELDER .ANTZ WHOSE NAME WAS ALSO *IM LEARNED IN THAT HE HAD !LZHEIMER S DISEASE /VER THE NEXT YEARS

THE .ANTZ FAMILY WOULD SEE THE INEVITABLE DETERIORATION OF A PERSON LOCKED IN THE GRIP OF THE DISEASE *IM .ANTZ *R DIED IN WITHOUT HIS SON EVER FULLY REALIZING HIS DREAM 4HE YOUNGER .ANTZ KNOWN AS hTHE VOICE OF #"3 3PORTS v AUTHORED A BEST SELLING BOOK Always by My Side: The Healing Gift of a Father’s Love ABOUT HIS FATHER S BATTLE WITH !LZHEIMER S AND THE AMAZING STRETCH IN EARLY WHEN HE BECAME THE lRST BROADCASTER TO CALL A 3UPER "OWL .#!! &INAL &OUR AND -ASTERS TOURNAMENT ALL IN THE SAME YEAR )T WAS A JOURNEY .ANTZ WISHED HE COULD HAVE SHARED WITH HIS FATHER WHO WAS IN THE lNAL STAGES OF HIS DISEASE AT THE TIME h) D HAD THIS DREAM THAT ) WAS GOING TO HAVE MY DAD WITH ME OUT ON THE ROAD WITH A PURPOSE v .ANTZ SAYS h4HIS MAGICAL THREE EVENT JOURNEY IN DAYS WOULD HAVE BEEN THE GREATEST FATHER SON ROAD TRIP EVER v !LZHEIMER S MAY HAVE SHUT THE DOOR ON .ANTZ S DREAM BUT IT OPENED HIS EYES TO ANOTHER WORLD A HIDDEN NETWORK OF MILLIONS OF FAMILIES WHO DEAL EVERY DAY WITH THE HEARTBREAKING REALITY OF LOVED ONES SLOWLY FADING FROM THEIR LIVES

4HIS AWARENESS IN TURN CREATED A NEW DREAM FOR *IM .ANTZ (E WOULD TURN HIS CELEBRITY INTO AN ADVOCACY IN WHICH HE WOULD ACTIVELY SEEK SUPPORT TO ADVANCE RESEARCH INTO AND GENERATE GREATER AWARENESS OF !LZHEIMER S )T LED TO THE CREATION OF THE .ANTZ .ATIONAL !LZHEIMER #ENTER INAUGURATED IN *ANUARY AS AN ALL INCLUSIVE CENTER FOR PATIENT CARE RESEARCH AND EDUCATION FUNCTIONING UNDER THE WING OF THE -ETHODIST .EUROLOGICAL )NSTITUTE 20 I METHODISTHEALTH.COM

.ANTZ WHO ATTENDED THE 5NIVERSITY OF (OUSTON AND WORKED AT HIS lRST BROADCASTING JOBS IN (OUSTON IS PROUD THAT HE IS ABLE TO CREATE THIS CENTER IN A CITY HE SAYS IS CLOSE TO HIS HEART h)T IS NO ACCIDENT THAT WE BROUGHT THIS CENTER TO (OUSTON AND TO 4HE -ETHODIST (OSPITAL v .ANTZ SAYS h-Y FAMILY AND ) BELIEVE IN THE FOLKS HERE AT -ETHODIST AND WE BELIEVE IN THEIR ABILITY TO RESEARCH AND CREATE CHANGE TO MAKE PROGRESS THAT WILL HOPEFULLY IMPROVE THE LIVES OF MILLIONS OF PEOPLE AROUND THE WORLD v 4HE ELDER .ANTZ WAS TREATED FOR HIS !LZHEIMER S AT -ETHODIST (IS FAMILY WAS SO IMPRESSED WITH THE CARE HE RECEIVED THEY SOUGHT TO CREATE THIS CENTER IN HIS NAME IN (OUSTON

ather

Broadcaster’s family creates national Alzheimer’s center at Methodist

(Left to right) Dr. Stanley Appel, Jim Nantz and Dr. Gustavo Román VOLUME 6, NUMBER 1 I 21

ALZHEIMER’S

“We hope to one day give patients the best quality of life and ease the burden on their families.”

— Dr. Gustavo Román R 3TANLEY !PPEL THE 0EGGY AND 'ARY %DWARDS $ISTINGUISHED %NDOWED #HAIR OF THE $EPARTMENT OF .EUROLOGY AT 4HE -ETHODIST (OSPITAL AND CO DIRECTOR OF THE -ETHODIST .EUROLOGICAL )NSTITUTE WAS ONE OF THE DOCTORS WHO TREATED THE ELDER .ANTZ h4HIS PARTNERSHIP WITH THE .ANTZ FAMILY IS A GREAT ALLIANCE ONE THAT WILL CERTAINLY HELP ESTABLISH -ETHODIST AS A LEADER IN THIS INITIATIVE THAT IS SO IMPORTANT FOR OUR OLDER POPULATION v HE SAYS h%VEN BEFORE THIS IMPORTANT CENTER WAS CREATED -ETHODIST HAD MADE GREAT STRIDES IN !LZHEIMER S RESEARCH AND TREATMENT v

D

%VERY SECONDS SOMEONE IN THE 5NITED 3TATES IS DIAGNOSED WITH !LZHEIMER S 4HE PROGRESSIVE NEUROLOGICAL DISEASE IS MOST PREVALENT IN PEOPLE OVER AGE BUT IT AFFECTS YOUNGER PEOPLE AS WELL -ORE THAN MILLION !MERICANS LIVE WITH !LZHEIMER S TODAY &ROM TO !LZHEIMER S DISEASE DEATHS SURGED PERCENT )N THE lRST WAVE OF BABY BOOMERS BEGAN TO TURN

AND THAT MILESTONE IS EXPECTED TO INCREASE THE NUMBER OF LIVES AFFECTED BY !LZHEIMER S !S MANY AS MILLION PEOPLE ARE PROJECTED TO DEVELOP THE DISEASE BY THE YEAR h7E UNDERSTAND SOME OF THE RISK FACTORS THAT PLAY A ROLE IN DEVELOPING !LZHEIMER S v !PPEL SAYS h/NE VASCULAR DISEASE TWO TRAUMA AND THREE ENVIRONMENTAL FACTORS x SO -ETHODIST IS A UNIQUE PLACE BECAUSE WE UNDERSTAND AND STUDY THESE SUSPECTED ROOT CAUSES v .ANTZ SAYS HE WAS ATTRACTED TO -ETHODIST BECAUSE OF ITS EMPHASIS ON THE STUDY OF CONCUSSION AND HEAD TRAUMA PARTICULARLY AS IT MAY AFFECT THE LATER DEVELOPMENT OF !LZHEIMER S h-Y FATHER WAS A GIFTED ATHLETE HE PLAYED IN THE LEATHER HELMET DAYS OF FOOTBALL v .ANTZ RECALLS 0LAYING AT 'UILFORD #OLLEGE IN .ORTH #AROLINA *IM .ANTZ *R SUFFERED A SERIOUS CONCUSSION WHEN HE ATTEMPTED TO BLOCK A PUNT h4HE KICKER S LEG CAUGHT MY FATHER ON THE SIDE OF THE HEAD v .ANTZ CONTINUES hAND THE FORCE BURST HIS EARDRUM 9EARS LATER MY FATHER HAD RINGING IN HIS EARS AND A HEADACHE THAT WOULDN T GO AWAY

22 I METHODISTHEALTH.COM

h4HERE IS NO DOUBT IN MY MIND THAT THIS HAD SOMETHING TO DO WITH MY FATHER DEVELOPING !LZHEIMER S v HE ADDS 4HE .ANTZ .ATIONAL !LZHEIMER #ENTER IS STILL IN ITS EARLY STAGES OF DEVELOPMENT BUT MANY KEY COMPONENTS ARE ALREADY IN PLACE )N -ETHODIST NAMED ACCLAIMED !LZHEIMER S CLINICIAN RESEARCHER $R 'USTAVO 2OMÉN TO LEAD THE CENTER AND BECOME HOLDER OF THE *ACK 3 "LANTON $ISTINGUISHED %NDOWED #HAIR (E LEADS A MULTIDISCIPLINARY TEAM THAT IS CONDUCTING TRANSLATIONAL RESEARCH ON MEMORY DISORDERS AND THE RELATIONSHIP BETWEEN BRAIN CIRCULATION AND DEMENTIA !LSO IN -ETHODIST CREATED THE 4ING 4SUNG AND 7EI &ONG #HAO #ENTER FOR "IOINFORMATICS 2ESEARCH AND )MAGING FOR .EUROSCIENCES TO STUDY PROGRESSIVE NEURO DEGENERATIVE DISEASES INCLUDING !LZHEIMER S h4HIS CENTER IS A PLACE WHERE CLINICIANS AND SCIENTISTS CAN WORK TOGETHER AND IDENTIFY EARLY DIAGNOSES AND INTERVENTIONS v 2OMÉN SAYS h7E HOPE TO ONE DAY GIVE PATIENTS THE BEST QUALITY OF LIFE AND EASE THE BURDEN ON THEIR FAMILIES v %ARLIER THIS YEAR THE .ANTZ .ATIONAL !LZHEIMER #ENTER CONDUCTED A SYMPOSIUM OF MORE THAN CLINICIANS AND RESEARCHERS FROM %UROPE AND THE 5NITED 3TATES TO EXPLORE THE LATEST DEVELOPMENTS IN EVERYTHING FROM VACCINES THAT COULD POTENTIALLY PREVENT !LZHEIMER S TO ADVANCES IN BRAIN IMAGING WHICH WOULD ALLOW EARLIER DETECTION OF THE DISEASE 2OMÉN REGULARLY ENGAGES COLLEAGUES AROUND THE WORLD WHO ARE ALSO STUDYING !LZHEIMER S AND DEMENTIA h4HE ABILITY TO RESEARCH POSSIBLE TREATMENTS FOR !LZHEIMER S AND DEMENTIA IN MULTIPLE LOCATIONS WITH OUR COLLEAGUES WILL GIVE US A BETTER CHANCE TO MAKE A BREAKTHROUGH v HE SAYS *IM .ANTZ FOR HIS PART PROMISES TO BE AN ACTIVE AND TIRELESS ADVOCATE FOR THE CENTER THAT BEARS HIS FAMILY NAME h) M GOING TO BE RAISING A LOT OF MONEY AND GIVING A LOT OF MONEY FOR THIS CAUSE v HE SAYS h) THINK THIS IS AN AREA OF SCIENCE AND MEDICINE WHERE OUR EFFORTS WILL ONE DAY MAKE A VERY BIG DIFFERENCE v Q

Forgetfulness vs.

Alzheimer’s vs.

Dementia 4HE FOLLOWING ARE IDENTIlERS OR CHARACTERISTICS THAT ARE OFTEN ASSOCIATED WITH THESE MEMORY ISSUES

&/2'%4&5,.%33 Q .ORMAL PART OF THE AGING PROCESS OR A CONDITION RELATED TO

HEAD TRAUMA OR UNDERLYING DISEASE Q 0ERHAPS SYMPTOM OF ANOTHER CONDITION OR DISEASE Q $IFlCULTY REMEMBERING NAMES AND DATES

!,:(%)-%2 3 Q ! FORM OF DEMENTIA Q -EMORY LOSS E G TROUBLE FOLLOWING A RECIPE FOLLOWING A

PLAN OR REMEMBERING THE RULES OF A GAME Q 4AKING LONGER TO PERFORM SIMPLE TASKS Q #ONFUSION ABOUT WHERE YOU ARE OR HOW YOU GOT THERE Q 4ROUBLE FOLLOWING OR PARTICIPATING IN A CONVERSATION Q $EMONSTRATING POOR JUDGMENT WITH MONEY Q -ISPLACING THINGS AND NOT BEING ABLE TO RETRACE

YOUR STEPS TO lND THEM Q %ASILY AGITATED BY PEOPLE OR SITUATIONS Q 7ITHDRAWING FROM SOCIAL SITUATIONS

$%-%.4)!

Q &ORGETFULNESS OFTEN ASSOCIATED WITH AGING Q #ONDITION CALLED VASCULAR DEMENTIA CAN FOLLOW

a stroke Q $IFlCULTY MAKING DECISIONS CALCULATING NUMBERS

OR THINKING AHEAD Q

Orientation issues

Q .OTICEABLE AGITATION Q 0OOR JUDGMENT DEALING WITH MONEY Q

VOLUME 6, NUMBER 1 I 23

INFLAMMATION

Dangerous liaisons The links between inflammation and chronic diseases

By Michael E. Newman

A for arthritis, B for bronchitis, C for conjunctivitis …

ARTHRITIS

TENNIS ELBOW

CHRONIC INFLAMMATORY BOWEL DISEASE

'O THROUGH THE ALPHABET AND YOU LL lND A PLETHORA OF DISEASES THAT END IN hITIS v 7HY )TIS MEANS INmAMMATION AND EVERY TISSUE AND ORGAN IN THE HUMAN BODY IS SUSCEPTIBLE TO IT 7E VE ALL SEEN INmAMMATION IN ACTION "ANG YOUR ARM AGAINST A CHAIR

CUT YOUR lNGER SLICING A BAGEL OR CATCH A VIRUS THAT S GOING AROUND )NmAMMATION MAY BE UNCOMFORTABLE BUT IT S A NECESSARY AND BENElCIAL PART OF THE IMMUNE PROCESS

What Is It? )NmAMMATION WHICH IS THE BODY S response to infection, irritation or INJURY MAKES IT EASIER FOR THE BODY TO LOCATE AND REMOVE AN AGENT KNOWN AS AN ANTIGEN 9OU LL OFTEN KNOW WHEN INmAMMATION IS AT WORK BECAUSE IT CAUSES REDNESS HEAT

JOINT PAIN OR STIFFNESS AND SWELLING 2EDNESS AND HEAT OCCUR WHEN TISSUE DAMAGED OR IRRITATED BY AN ANTIGEN

24 I METHODISTHEALTH.COM

SWOLLEN KNEE

ALZHEIMER’S

BRONCHITIS

ATHEROSCLEROSIS

releases proteins that ENLARGE CAPILLARIES AND INCREASE BLOOD mOW TO THE AFFECTED AREA

LEADING CAUSE OF DEMENTIA THE LOSS OF COGNITIVE FUNCTION THAT IMPAIRS THE ABILITY TO THINK REASON AND REMEMBER

At the same time, other PROTEINS ARE PRODUCED THAT MAKE THE CAPILLARY WALLS MORE POROUS 4HIS ALLOWS WHITE BLOOD CELLS THE BODY S GARBAGE COLLECTORS TO MOVE FREELY FROM THE BLOODSTREAM TO THE AFFECTED AREA WHERE THE BATTLE BEGINS 4HE WHITE CELLS CAPTURE THE ANTIGEN BREAK IT DOWN WITH ENZYMES AND REMOVE THE REMAINS FROM THE BODY

7HILE SOME TREATMENTS THAT MAY SLOW THE PROGRESSION OF THE DISEASE ARE AVAILABLE

THERE IS NO CURE 4O lND ONE OR TO DEVELOP BETTER MEANS OF THERAPY RESEARCHERS ARE WORKING TO BETTER UNDERSTAND THE ROLE INmAMMATION PLAYS IN THE BRAIN S DEGENERATION

4HE MASSIVE REGIMEN OF WHITE CELLS ADVANCING INTO the area, along with the mUID THAT TRANSPORTS THEM

CAUSES SWELLING 4HIS CAN LEAD TO PAIN IF THE SURROUNDING NERVES ARE COMPRESSED

BY THE SWOLLEN TISSUE

PROSTATE CANCER

It’s like an army attacking its own troops with friendly fire. )NmAMMATION CEASES ONCE THE ANTIGEN HAS BEEN REMOVED SO ITS EFFECTS ARE USUALLY GONE WITHIN A DAY OR TWO "UT INmAMMATION THAT BECOMES CHRONIC IN NATURE CAN SOON GO FROM THE BODY S ALLY TO A VICIOUS FOE ATTACKing the same tissues that it PREVIOUSLY HELPED DEFEND

Attack of the Amyloids Researchers at the Nantz National Alzheimer Center at THE -ETHODIST .EUROLOGICAL Institute are looking at the RELATIONSHIP BETWEEN INmAMMATION AGING AND !LZHEIMER S DISEASE !LZHEIMER S IS A

7HAT THEY ARE lNDING IS A CAUSE AND EFFECT BETWEEN THE PRODUCTION OF ANTIBODIES AND PROTECTION FOR THE BRAIN h7HEN NEURONS NERVE CELLS IN THE BRAIN ARE INJURED OR IRRITATED IMMUNE CELLS IN THE area, known as microglias, RELEASE PROTEINS CALLED CYTOKINES WHICH ELICIT AN INmAMMATORY RESPONSE v SAYS $R 'USTAVO # 2OMÉN DIRECTOR OF THE !LZHEIMER CENTER h.ORMALLY THE INmAMMATION HELPS DIRECT THE IMMUNE SYSTEM TO TAKE CARE OF THE PROBLEM v "UT FOR SOME REASON

PEOPLE WITH !LZHEIMER S OVERPRODUCE A SECOND PROTEIN CALLED BETA AMYLOID AND THE EXCESS FORMS PLAQUE FATTY MATERIAL AROUND THE NEURONS 4HE result is that the immune CELLS ASSAULT BOTH THE PLAQUE AND THE NEURONS THEY EN CASE h)T S LIKE AN ARMY attacking its own troops WITH FRIENDLY lRE v SAYS 2OMÉN WHO HOLDS THE *ACK 3 "LANTON $ISTINGUISHED %NDOWED #HAIR -OST RESEARCHERS THINK THAT REDUCING THE CONCEN TRATION OF BETA AMYLOID IN THE BRAIN WILL STOP OR AT LEAST SLOW THE NEURAL DESTRUCTION IN !LZHEIMER S PATIENTS 4WO WAYS TO DO THIS ARE BEING STUDIED

Normally, inflammation helps direct the immune system. h)N CLINICAL TRIALS A VACCINE AGAINST A BETA AMYLOID FRAGMENT HAS BEEN USED TO STIMULATE THE PRODUCTION OF ANTIBODIES THAT ARE SPECIFIC AGAINST PLAQUES AND SPARE THE NEURONS v 2OMÉN SAYS h!LTHOUGH THE EARLY RESULTS SHOW MINIMAL CLINICAL IMPROVEMENT WE STILL think such a treatment has PROMISE IF GIVEN EARLIER IN THE COURSE OF THE DISEASE v !DDITIONALLY 2OMÉN SAYS

RESEARCHERS ARE STUDYING ANOTHER POTENTIAL THERAPY INTRAVENOUS INJECTION OF IMMUNOGLOBIN ' ANTIBODY

WHICH REDUCES INmAMMATION AND STEMS THE OVERACTIVE IMMUNE RESPONSE New treatments for AlzheimER S ARE IMPORTANT BECAUSE THEY OFFER HOPE FOR A RAPIDLY GRAYING 5 3 POPULATION (OW FAST ARE WE AGING 4HE $EPARTMENT OF (EALTH AND (UMAN 3ERVICES REPORTS THAT MILLION !MERICANS PERCENT OF THE NATION ARE CURRENTLY AGE OR OLDER "Y THE COUNT IS EXPECTED TO NEARLY DOUBLE TO ABOUT MILLION OR PERCENT !ND AS THE POPULATION GETS OLDER THE NUMBER OF PEOPLE WITH !LZHEIMER S DISEASE WILL LIKELY RISE ACCORDINGLY

Fueling the Fires of Cancer "ECAUSE INFLAMMATION OCCURS IN ALL TISSUES AND ORGANS IT S NOT SURPRISING

VOLUME 6, NUMBER 1 I 25

INFLAMMATION THAT MEDICAL PROFESSIONALS ALSO HAVE LINKED IT TO CANCER h7E KNOW THAT CHRONIC INmAMMATIONS DUE TO INFECTIONS OR CONDITIONS SUCH AS CHRONIC INmAMMATORY BOWEL DISEASE ARE ASSOCIATED WITH UP TO PERCENT OF ALL CANCERS v SAYS $R -ARY 'OSWITZ

A RADIATION ONCOLOGIST AT 3AN *ACINTO -ETHODIST (OSPITAL h2ECENT RESEARCH SHOWS THAT INmAMMATION MAY CAUSE THE OVERPRODUCTION OF CERTAIN PROTEINS THAT INCREASE THE RISK OF CELLULAR MUTATIONS )F THESE MUTATIONS ACCUMULATE OVER TIME

THEY PRODUCE ABNORMAL CELLS THAT CAN EVENTUALLY BECOME MALIGNANT v )NmAMMATION MAY NOT ONLY INCREASE THE RISK OF CANCER IT MAY ALSO BE LINKED TO THE DISEASE S PROGRESSION h2ESEARCH SUPPORTS THE THEORY THAT INmAMMATION TRIGGERED BY A PROTEIN PRODUCED BY MANY CELLS MAY HELP TUMORS GROW AND AVOID ATTACKS BY THE IMMUNE SYSTEM v 'OSWITZ ADDS 4HIS PROTEIN INTERLEUKIN ),

PROMOTES INmAMMATION AROUND A TUMOR

INCREASES BLOOD mOW TO IT AND NOURISHES THE MALIGNANT GROWTH h3INCE A STRONG WELL FED TUMOR IS TOUGHER FOR THE IMMUNE SYSTEM TO ELIMInate, the cancer cells keep pumping ), TO KEEP THE INmAMMATION GOING 4HE SOLUTION MAY BE DRUGS OR VACCINES THAT SPECIlCALLY ELIMINATE PROBLEMATIC PROTEINS SUCH AS ), v SHE SAYS “Or perhaps the use of strong antiINmAMMATORY MEDICATIONS THAT PREVENT TUMORS FROM USING INmAMMATION AS A TOOL SHOULD BE CONSIDERED v

Inflammation as Both Friend and Foe &OR CHRONIC DISORDERS OF THE CIRCULATORY SYSTEM LIKE HEART DISEASE AND STROKE

INmAMMATION IS ALSO A KEY FACTOR )N BOTH CASES IT IS PART OF THE PROCESS LEADING TO ATHEROSCLEROSIS THE HARDENING AND BLOCKAGE OF THE ARTERIES SAYS $R *OHN 6OLPI DIRECTOR OF THE #EREBRAL "LOOD &LOW ,AB AT THE .EUROLOGICAL )NSTITUTE

26 I METHODISTHEALTH.COM

)F THE BLOCKAGE OCCURS IN ONE OR MORE OF THE VESSELS FEEDING BLOOD TO THE HEART OR A PIECE OF THE BLOCKAGE BREAKS OFF TO FORM A CLOT IN AN ARTERY

A HEART ATTACK OCCURS ,IKEWISE IF A CLOT BECOMES LODGED IN THE ARTERY TO THE BRAIN AND CUTS OFF ITS OXYGEN SUPPLY A STROKE OCCURS !THEROSCLEROSIS DOES ITS DAMAGE BY DEPOSITING PLAQUE ON VESSEL WALLS

PROVOKING AN IMMUNE RESPONSE h4HIS REACTION LEADS TO INmAMMATION WHICH

IN TURN INTENSIlES THE ATTACK ON PLAQUE

BY THE IMMUNE CELLS v 6OLPI SAYS h4HE IMMUNE CELLS v HE SAYS hPRODUCE ENZYMES DESIGNED TO BREAK DOWN THE PLAQUE BUT UNFORTUNATELY THIS ALSO CAN CAUSE THE PLAQUE TO RUPTURE INTO SMALL PIECES )F ONE OR MORE OF THESE FRAGMENTS ENTERS THE BLOOD THEY CAN BLOCK VESSELS AND LEAD TO A STROKE v

Inflammation may be uncomfortable, but it’s a necessary and beneficial part of the immune process. ,UCKILY ONE OF THE ENZYMES RELEASED IN THE BATTLE AGAINST ATHEROSCLEROSIS HAS RECENTLY BEEN TURNED FROM A VILLAIN TO A HERO h# REACTIVE PROTEIN OR #20 IS PRODUCED IN RESPONSE TO INmAMMATION )T IS RELEASED BY THE IMMUNE CELLS AS PLAQUE IS DEPOSITED INTO THE ARTERIES AND INCREASES AS THE BUILDUP CONTINUES v SAYS $R 'EORGE -AMMEN AN INTERVENTIONAL CARDIOLOGIST AT -ETHODIST 7EST (OUSTON (OSPITAL h+NOWING THIS MEDICAL PROFESSIONALS DEVELOPED A SIMPLE BLOOD TEST TO MEASURE THE AMOUNT OF #20 IN THE BLOOD v -AMMEN SAYS h7ITH THIS DIAGNOSTIC TOOL WE CAN DETERMINE HOW FAR ATHEROSCLEROSIS HAS PROGRESSED AND PREDICT who is at greatest risk for a heart attack or STROKE !ND IF PERFORMED EARLY ENOUGH

USE IT AS A SIGNAL TO BEGIN INTERVENTION SO THAT NEITHER ONE OCCURS v

Nothing Sweet About It ,IKE A LOVE TRIANGLE IN A ROMANCE NOVEL

THE RELATIONSHIP BETWEEN INmAMMATION AND 4YPE DIABETES IS OFTEN COMPLICATED BY A THIRD PLAYER OBESITY h$URING THE PAST YEARS STUDIES ON MICE HAVE SHOWN THAT CHRONIC

LOW GRADE INmAMMATION ASSOCIATED WITH OBESITY RESULTS IN A RESISTANCE TO insulin, the hormone that regulates BLOOD SUGAR LEVELS v SAYS $R 4IFFANY "URNS CHAIR OF THE $EPARTMENT OF &AMILY -EDICINE AT -ETHODIST 7ILLOWBROOK (OSPITAL h)T IS HIGHLY LIKELY THAT THE SAME SITUATION OCCURS IN HUMANS v 4HE CONNECTION BETWEEN INmAMMATION OBESITY AND DIABETES "URNS SAYS

IS THOUGHT TO BE ESTABLISHED WHEN THE WHITE BLOOD CELLS PRODUCED IN AN IMMUNE RESPONSE ARE ABSORBED BY ADIPOSE FAT TISSUES h4HESE WHITE CELLS v SHE SAYS hPRODUCE PROTEINS THAT CAUSE INmAMMATION WHICH THEN CAUSES THE ADIPOSE TISSUES TO STOP RESPONDING TO INSULIN 7HEN THIS HAPPENS THE ADIPOSE TISSUES STOP ABSORBING THE GLUCOSE THEY NEED FOR ENERGY )F ENOUGH INSULIN RESISTANCE OCCURS IT CAN LEAD TO 4YPE DIABETES v "URNS SAYS RECENT STUDIES SUPPORT THIS THEORY BECAUSE WHEN MICE ARE BRED WITHOUT WHITE BLOOD CELLS AND ARE PUT ON A HIGH FAT DIET THEY CAN BECOME MORBIDLY OBESE AND NEVER DEVELOP DIABETES "ASED ON THESE STUDIES "URNS SAYS health professionals can offer a twoPRONG APPROACH THAT MAY HELP PREVENT 4YPE DIABETES IN OBESE PATIENTS WHOSE RISING BLOOD SUGAR LEVELS ARE STARTING TO INDICATE INSULIN RESISTANCE h7E lRST PRESCRIBE METFORMIN A DRUG THAT HELPS REGULATE THE PRODUCTION OF INSULIN AND LOWER BLOOD SUGAR TO A MORE NORMAL LEVEL v "URNS SAYS h4O THIS WE ADD A PROGRAM OF HEALTHY DIET EXERCISE AND WEIGHT LOSS MAINTENANCE TO ELIMINATE OBESITY PREVENT INmAMMATION AND BREAK THE CHAIN LEADING TO DIABETES v Q

OSTEOPOROSIS

the ONE

TWO Punch

Calcium, Vitamin D combination essential for healthy bones

By Linda Gilchriest

If Jo-Ann Byler had it to do over again, she would have stayed more active, because now she, like almost 10 million older Americans, battles the effects of osteoporosis. Another 34 million are at risk.

"YLER WAS DIAGNOSED WITH OSTEOPOROSIS ABOUT YEARS AGO !LTHOUGH SHE HAD NO SYMPTOMS IT DIDN T COME AS A GREAT SHOCK SINCE HER MOTHER AND MOST OF HER AUNTS HAD THE SAME MALADY FOR YEARS /STEOPOROSIS CAN OCCUR WHEN THE BONES BECOME WEAK

CAUSING THEM TO BREAK MORE EASILY $R 2ICHARD 2OBBINS

CHAIRMAN OF THE $EPARTMENT OF -EDICINE AT 4HE -ETHODIST (OSPITAL SAYS THE AMOUNT OF CALCIUM IN YOUR BONES IS A MAJOR FACTOR IN DETERMINING YOUR RISK FOR OSTEOPOROSIS h4HE SCAFFOLDING THAT HOLDS CALCIUM IN PLACE IS THE PROTEIN COLLAGEN v SAYS 2OBBINS WHO HOLDS THE #HARLES AND !NNE $UNCAN $ISTINGUISHED %NDOWED #HAIR h4HE ARCHITECTURE

VOLUME 6, NUMBER 1 I 27

OSTEOPOROSIS

Older adults need weight-bearing exercise to create muscle and strengthen bones.

OF THE BONE IS JUST AS IMPORTANT AS THE AMOUNT OF CALCIUM IN THE BONE WITH REGARD TO FRACTURES AND THAT IS WHAT WE ARE ALL WORRIED ABOUT 7E WANT TO PREVENT FRACTURES &OUR PRIMARY FACTORS CAN BE AT PLAY IN DEVELOPING OSTEOPOROSIS THE AMOUNT OF CALCIUM IN THE BONE YOUR AGE HEREDITY AND BREAST FEEDING 2OBBINS SAYS A BONE DENSITY TEST IS THE BEST WAY TO MEASURE YOUR RISK FOR THE CONDITION h9OU GET A VERY SPECIlC NUMBER WHEN YOU PERFORM A BONE DENSITY SCAN AND THE RESULTS FROM THE SCAN compare the patient to other people OF THE SAME GENDER AND AGE GROUP v HE SAYS (EREDITY IS AN IMPORTANT RISK FACTOR )F WE KNOW THAT A PERSON S PARENTS HAD AN OSTEOPOROTIC BONE FRACTURE IT PUTS THAT PERSON AT A MUCH HIGHER RISK 'ENERALLY THE INCIDENCE OF OSTEOPOROSIS IS MUCH HIGHER IN WOMEN )T OCCURS IN MEN TOO BUT TYPICALLY YEARS LATER

shrinking the time frame for risk of FRACTURES "REAST FEEDING CAN BE ONE REASON WHY THE NUMBER FOR WOMEN IS MUCH HIGHER h"REAST FEEDING REMOVES A LOT OF CALCIUM FROM THE MOM S SKELETON SO THE BABY CAN START TO BUILD THEIR OWN SKELETON v 2OBBINS EXPLAINS 3INCE MOST WOMEN HAVE BABIES IN THEIR S OR EARLY S THE BONE LOSS IS OVERCOME

BY THE FACT THAT WOMEN ARE IN THEIR PEAK

28 I METHODISTHEALTH.COM

CALCIUM PRODUCTION DURING THOSE SAME YEARS h4HE GOOD NEWS IS YOU CAN REBUILD BONE AT ANY AGE v 2OBBINS SAYS h%VEN WOMEN WHO ARE WHO HAVE GONE ON CERTAIN KINDS OF TREATMENT CAN MARKEDLY INCREASE THEIR DENSITY STRENGTH AND REDUCE THEIR CHANCE OF A FRACTURE v

Keys to the Turnaround h0OOR NUTRITION IS A BIG CONTRIBUTING FACTOR TO THE PROGRESSION OF OSTEOPOROSIS v SAYS +ARI +OOI A REGISTERED DIETITIAN WITH -ETHODIST 7ELLNESS 3ERVICES h!DULT BONES ARE NO LONGER GROWING BUT THEY ARE IN A CONSTANT STATE OF TURNOVER CALLED BONE REMODELING AND NUTRITION IS VITAL TO THIS PROCESS h#ALCIUM AND VITAMIN $ HAVE LONG BEEN KNOWN FOR THEIR ROLES IN PROMOTING BONE GROWTH AND MAINTENANCE v SHE SAYS !S WE AGE WE ARE lGHTING BOTH BONE AND MUSCLE LOSS h-USCLE IS THE CENTERPIECE FOR BEING VITAL AND INDEPENDENT

BUT AT SOME POINT WE BEGIN TO BREAK DOWN MORE PROTEIN THAN OUR BODIES MAKE 4HAT STARTS IN THE LATE S EARLY S AND A LOT OF PEOPLE LOSE ABOUT A QUARTER POUND OF MUSCLE EACH YEAR v +OOI SAYS "ESIDES WEIGHT BEARING EXERCISE THE BEST WAY TO RESTORE THE BALANCE IS TO EAT HIGH QUALITY PROTEIN AND DISTRIBUTE IT THROUGHOUT THE DAY +OOI SAYS OLDER ADULTS TYPICALLY EAT MEALS HIGH IN CARBO-

HYDRATES AND LOW IN PROTEIN ESPECIALLY DURING BREAKFAST h4HEY HAVE BAGELS OR MUFlNS IN THE MORNING AND LOAD UP ON PROTEIN IN THE EVENINGS h)T S BETTER TO DISTRIBUTE PROTEIN THROUGHOUT THE DAY BECAUSE THERE IS A LIMIT ON HOW MUCH PROTEIN YOUR BODY CAN USE FROM ONE MEAL TO CREATE MUSCLE !ND CONSUMING TOO MUCH PROTEIN DOESN T CREATE MORE MUSCLE v +OOI SAYS 4O MAINTAIN OR GAIN MUSCLE YOU WANT TO aim for the amount of protein in grams EQUAL TO HALF YOUR WEIGHT IN POUNDS )F YOUR IDEAL BODY WEIGHT IS POUNDS

THEN YOU NEED ABOUT GRAMS OF PROTEIN A DAY ! FOUR OUNCE BROILED CHICKEN BREAST EQUALS GRAMS OF PROTEIN h(IGH QUALITY PROTEIN WORKS BEST TO GAIN MUSCLE v +OOI SAYS h'O FOR LEAN MEATS 4HINGS LIKE CHICKEN lSH BEANS EGGS

DAIRY YOGURT AND MILK TOFU NUTS AND NUT BUTTER LIKE ALMOND BUTTER AND NATURAL PEANUT BUTTER v !LONG WITH PROTEIN OLDER ADULTS NEED AN ADEQUATE SOURCE OF CALCIUM h7E ARE SUPPOSED TO GET OUR DAILY CALCIUM FROM FOOD BUT IF WE DON T GET ENOUGH FROM FOOD OUR BODIES USE OUR BONES LIKE A LENDING INSTITUTION BORROWING THE CALCIUM IT NEEDS 4HIS CREATES A CALCIUM DEBT TO YOUR BONES h4HE DEBT ISN T REPAID UNLESS YOU EAT ENOUGH CALCIUM RICH FOODS v +OOI SAYS

Exercise Strengthens Bones !LONG WITH DIET OLDER ADULTS NEED WEIGHT BEARING EXERCISE TO CREATE MUSCLE AND STRENGTHEN BONES -ETHODIST #ENTER FOR 3PORTS -EDICINE PHYSICAL THERAPIST -ATT (OLLAND SAYS MUSCLE MASS BEGINS TO DECREASE WHEN PEOPLE ARE IN THEIR S AND S AND CONTINUES

UNLESS YOU EXERCISE TO PREVENT THAT h"Y STRENGTHENING THE MUSCLES YOU INCREASE THE STRENGTH AND SIZE OF THE MUSCLE AND THOSE MUSCLES IMPART MORE STRESS ON THE BONE WHICH MAKES THE BONE STRONGER 3O THOSE GO HAND IN HAND v (OLLAND SAYS (E SAYS MANY OF HIS PATIENTS WHO ARE IN THEIR S AND S HAVE SUFFERED SERIOUS FALLS h4HERE S A LOT OF GOOD LITERATURE THAT INDICATES THAT STRENGTH TRAINING CAN REDUCE THE NUMBER OF FALLS IN THE ELDERLY v (OLLAND SUGGESTS EXERCISING lVE TIMES A WEEK WITH A COMBINATION OF CARDIOVASCULAR AND STRENGTH TRAINING AS WELL AS mEXIBILITY EXERCISES #ARDIO CAN BE AS SIMPLE AS WALKING 3TRENGTH TRAINING OR WEIGHT BEARING EXERCISES STRENGTHEN YOUR LEGS AND SPINE AND GIVE YOU THE ADDITIONAL SUPPORT TO PREVENT FALLS AND BUILD CALCIUM h9OU ARE NEVER TOO OLD TO EXERCISE 9OU JUST HAVE TO lND A WAY TO EXERCISE SAFELY v HE SAYS 2OBBINS SAYS SOMETIMES DIET AND EXERCISE ARE NOT ENOUGH AND MEDICATIONS MUST BE ADDED "ISPHOSPHONATES CAN SLOW BONE LOSS .EW DRUGS SOME ADMINISTERED INTRAVENOUSLY ALSO ARE AVAILABLE 7HETHER YOU ARE OR OSTEOPOROSIS IS A SERIOUS CONDITION THAT NEEDS TO BE ADDRESSED 2OBBINS SAYS THERE ARE MORE WOMEN WHO DIE OF HIP FRACTURES EVERY YEAR IN !MERICA THAN DIE OF BREAST CANCER h/F WOMEN WHO SUFFER HIP FRACTURES ONLY HALF OF THEM REGAIN THE ABILITY TO WALK 4HERE IS A VERY HIGH INCIDENCE OF DEATH SIX MONTHS AFTER A HIP FRACTURE 3O IT IS A DANGEROUS EVENT IN ANY WOMAN S LIFE v HE SAYS Q

Strengthening Your Body METHODIST WELLNESS REGISTERED DIETICIAN KARI KOOI RIGHT SAYS CALCIUM AND VITAMIN $ ARE ESSENTIAL TO RESTORING BONES IN PEOPLE WHO HAVE OSTEOPOROSIS OR OSTEOPENIA Although sunlight is an excellent source OF VITAMIN $ PEOPLE TEND TO STAY INDOORS MORE AS THEY AGE !ND WHEN WE ARE OUTSIDE +OOI SAYS WE ARE ENCOURAGED TO USE SUNSCREEN WHICH CAN BLOCK VITAMIN $ S BENElTS #ALCIUM IS AVAILABLE IN FOODS SUCH AS MILK SOME VEGETABLES AND DAIRY PRODUCTS &ORTUNATELY WE HAVE EXCELLENT SUPPLEMENTS THAT CAN PROVIDE CALCIUM AND VITAMIN $ +OOI SAYS 4HE .ATIONAL )NSTITUTES OF (EALTH SUGGESTS THESE GUIDELINES Q 7OMEN BETWEEN THE AGES OF TO SHOULD TAKE IN MG OF CALCIUM DAILY BUT NO MORE THAN MG AT A TIME +OOI SAYS YOU CAN TAKE MG WITH EACH MEAL -EN IN THIS AGE GROUP SHOULD ALSO TAKE MG Q 7OMEN AGE POST MENO PAUSAL SHOULD TAKE MG WHILE MEN CAN CONTINUE TO TAKE MG -ENOPAUSE ROBS THE BONE OF CALCIUM Q "OTH WOMEN AND MEN OVER THE AGE OF SHOULD TAKE MG OF CALCIUM DAILY

+OOI SAYS CALCIUM CITRATE TABLETS ARE EASIER TO TOLERATE AND MORE READILY ABSORBED THAN CALCIUM CARBONATE -OST ALSO HAVE THE VITAMIN $ REQUIREMENTS ADDED IN +OOI SAYS A DIET THAT HELPS REDUCE BONE AND MUSCLE LOSS SHOULD HAVE ADEQUATE PROTEIN 3OME OF THE BEST SOURCES ARE Meat (4 ounces cooked) Chicken or turkey breast, skinless CALORIES AND G PROTEIN Q Fish and shellfish CALORIES AND G PROTEIN Q Ground beef, 20% fat CALORIES AND G PROTEIN Q

Beans (½ cup cooked PROVIDES CALORIES AND G PROTEIN Nuts (¼ cup) PROVIDES CALORIES AND G PROTEIN Greek yogurt (plain, 6 oz.)

PROVIDES CALORIES AND G PROTEIN Milk (fat-free, 1 cup) PROVIDES CALORIES G PROTEIN Egg (one) PROVIDES CALORIES AND G PROTEIN

Calcium is useless without vitamin D because it is crucial to optimal calcium absorption.

VOLUME 6, NUMBER 1 I 29

CLINICAL TRIALS

Without surgical intervention, aortic valve stenosis makes the heart work harder to pump blood, eventually wearing out the muscle and leading to certain cardiac failure or death.

-ETHODIST PATIENT 2OBERT "ROWN 30 I METHODISTHEALTH.COM

alternative

interventions for the HEART I

CLINICAL TRIALS STUDY OPTIONS FOR EFFECTIVE BLOOD FLOW

By Michael E. Newman

MAGINE HAVING A MEDICAL PROBLEM FOR WHICH A PROVEN SUCCESSFUL TREATMENT EXISTS BUT YOU RE NOT STRONG ENOUGH TO RECEIVE IT 5NFORTUNATELY FOR MANY PATIENTS SUFFERING FROM SYMPTOMATIC AORTIC VALVE STENOSIS THE HARDENING AND NARROWING OF THE MAIN GATEWAY FOR BLOOD mOW FROM THE HEART THIS #ATCH EXISTS h7HILE MOST OF THE APPROXIMATELY AORTIC VALVE REPLACEMENT SURGERIES PERFORMED ANNUALLY IN THE 5NITED 3TATES ARE SUCCESSFUL THEY ONLY REPRESENT ONE TO TWO THIRDS OF THE PATIENTS WITH SYMPTOMATIC AORTIC VALVE STENOSIS v SAYS $R -ICHAEL 2EARDON MEDICAL DIRECTOR AT THE -ETHODIST $E"AKEY (EART 6ASCULAR #ENTER AND PROFESSOR OF CARDIO THORACIC SURGERY AT 7EILL #ORNELL -EDICAL #OLLEGE h-ANY OF THE PEOPLE WE SEE WITH THE CONDITION ARE BETWEEN AND YEARS OF AGE

OFTEN WITH OTHER MEDICAL PROBLEMS 4HEIR PRIMARY PHYSICIAN HAS DEEMED THEM TO BE LESS LIKELY TO TOLERATE OR SURVIVE OPEN HEART SURGERY WHICH IS THE PRIMARY TREATMENT FOR A DEFECTIVE AORTIC VALVE 3OMETIMES THEY ARE NOT EVEN REFERRED FOR CONSIDERATION FOR AORTIC VALVE REPLACEMENT v HE SAYS 7ITHOUT SURGICAL INTERVENTION AORTIC VALVE STENOSIS MAKES THE HEART WORK HARDER TO PUMP BLOOD EVENTUALLY WEARING OUT THE MUSCLE AND LEADING TO CARDIAC FAILURE OR DEATH 2EARDON IS HOPEFUL THAT THERE MAY BE AN OPTION FOR THESE PATIENTS IN THE NEAR FUTURE $R 2EARDON AND $R .EAL +LEIMAN AN INTERVENTIONAL CARDIOLOGIST AND DIRECTOR OF THE CATHETERIZATION LABS AT 4HE -ETHODIST (OSPITAL ARE PRINCIPAL INVESTIGATORS FOR THE -ETHODIST PORTION OF A NATIONAL CLINICAL TRIAL EVALUATING THE MERITS OF TRANSCATHETER AORTIC VALVE IMPLANTATION 4!6) AN ALTERNATIVE INTERVENTION FOR PATIENTS UNABLE TO UNDERGO CONVENTIONAL OPEN HEART SURGERY VOLUME 6, NUMBER 1 I 31

Clinical Trials

For patients who are not good candidates for conventional surgery, it’s looking like TAVI may provide a minimally invasive option to treat severe aortic stenosis.

The CoreValve® System used in patients with severe aortic stenosis enrolled in the Medtronic CoreValve® U.S. Pivotal Trial.

Brown, who is grateful that he was able to receive a valve replacement by participating in the trial. Like many people with aortic valve stenosis, he was unaware of his condition because he did not experience symptoms until late in its course.

“In TAVI, a small incision is made, usually in the individual’s groin, and a catheter is threaded through the femoral artery into the heart,” Kleiman says. “Using the catheter, the narrowed natural aortic valve is opened with a balloon, and then a replacement aortic valve is placed. The new valve is deployed within the defective one, without the need to stop the heart or use the heart-lung machine.”

“I had no idea anything was wrong. After coming home one evening, I decided to take a shower and go straight to bed because I hadn’t been feeling well that day. I felt progressively worse, but it was the shortness of breath that most alarmed me,” says Brown, who doesn’t recall any symptoms prior to that day. Concerned, he called his son, who called 911. By the time the paramedics arrived, Brown was lying unconscious on the floor.

Minimally invasive procedures, such as TAVI, may potentially provide a life-saving option to elderly patients such as Robert

“Severe aortic stenosis with symptoms is a clear-cut indication for aortic valve replacement. Because of Brown’s age

AORTIC VALVE STENOSIS Blood is unable to flow freely from the left ventricle to the aorta during aortic stenosis

Aorta Aortic valve

Left ventricle Right ventricle

32 I methodisthealth.com

Stenosis of aortic valve

What is it? Aortic valve stenosis is the narrowing of the aortic valve, a valvular connection between the blood-pumping chamber of the heart, the left ventricle, and the body’s largest artery, the aorta.

What causes it? The most common cause of stenosis in people over 65 is a buildup of calcium on the flaps of the valve. “Like a faucet that stops working properly when hard water encrusts it with calcium, the aortic valve tissue gets replaced by calcium deposits, causing it to stiffen and preventing the flaps from opening and closing properly,” explains Methodist heart surgeon Dr. Michael Reardon.

What are the effects? The result is a significantly restricted opening through which greater effort is needed for normal amounts of oxygenated blood flow. “In severe cases of stenosis,

AND RISK STATUS HE QUALIlED FOR THE CLINICAL TRIAL !T SURGICAL AORTIC VALVE REPLACEMENT WOULD CARRY A HIGH RISK FOR HIM v 2EARDON SAID "ECAUSE IT IS MUCH LESS INVASIVE 4!6) MAY OFFER A VIABLE OPTION FOR ELDERLY PATIENTS AND OTHERS FOR WHOM TRADITIONAL OPEN HEART SURGICAL REPAIR OF THE AORTIC VALVE MIGHT BE TOO DANGEROUS !T THE TIME THIS ARTICLE WAS WRITTEN 4!6) WAS ONLY AVAILABLE IN THE 5NITED 3TATES AS PART OF AN &$! APPROVED TRIAL AND CARRIES IMPORTANT RISKS AS WELL AS POTENTIAL BENElTS !LTHOUGH 4!6) AVOIDS THE USE OF THE HEART LUNG MACHINE AND THE NEED TO STOP THE HEART IT IS STILL A MAJOR PROCEDURE 4HIS CURRENT TRIAL IS DESIGNED TO TEST THE EFFECTIVENESS OF 4!6) IN TREATING SEVERE AORTIC STENOSIS WITH SYMPTOMS AND SHOULD ALSO HELP US DElNE THE COMPLICATIONS THAT MAY ACCOMPANY THE PROCEDURE 4HE POTENTIAL RISKS ARE DISCUSSED WITH EACH INDIVIDUAL AT THE TIME OF THE SCREENING PROCESS FOR THE STUDY "ROWN S STORY IS ONE OF WHAT 2EARDON AND +LEIMAN HOPE WILL BE MANY DURING A MULTIYEAR CLINICAL TRIAL OF THE -EDTRONIC #ORE6ALVE® AORTIC VALVE REPLACEMENT SYSTEM -ETHODIST IS ONE OF HOSPITALS NATIONWIDE PARTICIPATING IN THE TRIAL )N ADDITION TO EVALUATING THE SAFETY AND EFlCACY OF THE -EDTRONIC SYSTEM THE RESULTS OF THE STUDY WILL BE COMPARED TO PATIENTS WHO UNDERWENT CONVENTIONAL OPEN HEART AORTIC VALVE REPLACEMENT SURGERY

WE SEE AN AORTIC VALVE THAT FORMERLY COULD ALLOW A QUARTER TO PASS REDUCED TO THE DIAMETER OF A PENCIL v 2EARDON SAYS )N TURN THE HEART STARTS WORKING HARDER TO FORCE BLOOD INTO THE AORTA %VENTUALLY THE OVERWORKED HEART ENLARGES AND BREAKS DOWN 4HE INEVITABLE PROGNOSIS IS CARDIAC FAILURE AND DEATH WITHOUT TREATMENT 7HAT ARE THE SYMPTOMS 4HE SYMPTOMS OF SEVERE AORTIC VALVE STENOSIS INCLUDE SHORTNESS OF BREATH CHEST PAIN OR TIGHTNESS FEELING FAINT OR WEAK AND CHRONIC FATIGUE

“I

N TWO PREVIOUS CLINICAL TRIALS USING A DIFFERENT DEVICE FROM THE ONE WE ARE STUDYING NOW 4!6) WAS SHOWN TO BE AS EFFECTIVE AS OPEN HEART SURGERY IN OUTCOME AFTER AORTIC VALVE REPAIR v +LEIMAN SAYS (E IS HOPEFUL THAT 4!6) MAY BE AN OPTION FOR PATIENTS WHO ARE NOT GOOD CANDIDATES FOR CONVENTIONAL SURGERY 2EARDON AGREES h)F RESULTS FROM THIS 5 3 0IVOTAL 4RIAL CONlRM THE lNDINGS OF THE EARLIER STUDIES WE COULD SEE RELATIVELY RAPID APPROVAL FOR THE TECHNIQUE BY THE &OOD AND $RUG !DMINISTRATION v HE ADDS 0ATIENTS ELIGIBLE FOR THE -EDTRONIC #ORE6ALUE® 5 3 0IVOTAL 4RIAL AT -ETHODIST ARE MEN AND WOMEN WITH SEVERE AORTIC STENOSIS WHO ARE EXPERIENCING SYMPTOMS SUCH AS DIFlCULTY BREATHING CHEST PAIN OR PRESSURE OR FAINTING 7HILE THE SYMPTOMS DO NOT HAVE TO BE SEVERE THE LEVEL OF STENOSIS IN THE AORTIC VALVE DOES +LEIMAN SAYS THAT A TEAM OF EXPERTS AT -ETHODIST THOROUGHLY SCREEN CANDIDATES BEFORE THEY ARE ACCEPTED INTO THE TRIAL h)T S A TREMENDOUS MULTIDISCIPLINARY INSTITUTIONAL EFFORT TO ENSURE A HIGHLY SUCCESSFUL STUDY v HE SAYS h!ND THE SAME GROUP THAT HELPS WITH THE SCREENING SURGEONS LABORATORY TECHNICIANS

#4 SCANNERS ECHOCARDIOGRAPHERS AND OTHERS MAKE UP THE PATIENT S TREATMENT TEAM IF HE OR SHE QUALIlES FOR 4!6) INTERVENTION v To learn more about the Medtronic CoreValue® U.S. Pivotal Trial at the Methodist DeBakey Heart & Vascular Center, contact study coordinator Nicole Hakala at 713-441-6539 or 281-615-9407 or nhakala@tmhs.org. Q

7HILE MOST OF THE APPROXIMATELY

VALVE REPLACEMENT SURGERIES PERFORMED ANNUALLY IN THE 5NITED 3TATES ARE SUCCESSFUL THEY ONLY TAKE CARE OF ABOUT ONE THIRD OF THE PATIENTS ESTIMATED TO HAVE SEVERE AORTIC VALVE STENOSIS

4HE LIKELIHOOD OF DEVELOPING AORTIC VALVE STENOSIS INCREASES WITH AGE APPROXIMATELY PERCENT OF PEOPLE OVER AGE PERCENT OF PEOPLE OVER AGE AND PERCENT OF PEOPLE OVER AGE HAVE THE DISORDER Q

VOLUME 6, NUMBER 1 I 33

His passion for the field of anesthesiology always burned brightly, leading him to serve

A lasting

as president of The Methodist Hospital medical staff in the

LEGACY mid-1970s.

By Donna Hurst

Department of Anesthesiology benefits from Chalmers charitable trust

4HE YEAR WAS A TIME OF NEW IDEAS AND A HOST OF lRSTS 4HE 5NITED 3TATES #ENSUS "UREAU RECEIVED THE 5.)6!# THE lRST COMMERCIAL COMPUTER PRODUCED IN THE 5NITED 3TATES FANS SAW THE lRST ."! !LL 3TAR GAME PLAYED IN THE "OSTON 'ARDEN THE WORLD S lRST EXPERIMENTAL NUCLEAR POWER PLANT %"2

OPENED IN A DESERT NEAR !RCO )DAHO AND h) ,OVE ,UCYv MADE ITS TELEVISION DEBUT ON #"3

The Methodist Hospital circa 1951

34 I I METHODISTHEALTH.COM METHODISTHEALTH.COM 34

Dr. Presley H. Chalmers

FOUNDATION OF SUPPORT NOTHER lRST OCCURRED THAT YEAR WHEN $R 0RESLEY ( #HALMERS JOINED 4HE -ETHODIST (OSPITAL AS ITS lRST ANESTHESIOLOGIST ONE OF ONLY A FEW IN THAT SPECIALTY IN THE (OUSTON AREA AT THE TIME #HALMERS SOON MADE A NAME FOR HIMSELF WITH -ETHODIST PHYSICIANS SUCH AS HEART PIONEER $R -ICHAEL % $E"AKEY WHO FREQUENTLY ASKED FOR HIS EXPERTISE IN PROVIDING ANESTHESIA TO PATIENTS UNDERGOING GROUNDBREAKING OPEN HEART PROCEDURES

A

4HAT SAME DECADE #HALMERS CREATED THE -ETHODIST !NESTHESIA 'ROUP WHICH CONTINUES TODAY AS 'REATER (OUSTON !NESTHESIOLOGY (IS PASSION FOR THE lELD OF ANESTHESIOLOGY ALWAYS BURNED BRIGHTLY LEADING HIM TO SERVE AS PRESIDENT OF 4HE -ETHODIST (OSPITAL MEDICAL STAFF IN THE MID S AND TO BE A PART OF NUMEROUS ORGANIZATIONS THROUGHOUT HIS CAREER THAT SHAPED THE lELD OF ANESTHESIOLOGY !S A SURGICAL NURSE #HALMERS WIFE 0ATTI ALSO WAS AN IMPORTANT PART OF -ETHODIST SERVING A NUMBER OF YEARS AT THE HOSPITAL S ORIGINAL DOWNTOWN LOCATION 3HE LEFT NURSING IN TO TAKE ON HER CHERISHED ROLE AS HOMEMAKER AND MOTHER OF THE #HALMERS THREE SONS (OWARD 2ODDY AND -IKE

CHARITY BEGINS AT HOME #HALMERS DEDICATED YEARS TO HIS POST AS -ETHODIST S CHIEF OF ANESTHESIOLOGY UNTIL HIS RETIREMENT IN !T THAT TIME HE AND HIS WIFE BEGAN TO FULlLL THEIR DREAM OF SELLING THEIR HOME A FARM NEAR 4OMBALL TO MOVE TO THE 4EXAS (ILL #OUNTRY COMMUNITY OF 7IMBERLEY 3ON (OWARD #HALMERS WHO OWNS A MARKETING AND MANAGEMENT CONSULTING lRM IN !USTIN SUGGESTED THAT HIS PARENTS MEET WITH SOME OF HIS CLIENTS WHO WERE INNOVATIVE lNANCIAL PLANNERS TO DISCUSS THE BEST WAY TO MANAGE THE PROPERTY SALE !FTER DISCUSSING A NUMBER OF OPTIONS THE FAMILY THEN CONSULTED WITH A LAWYER TO CREATE A WIN WIN PLAN A CHARITABLE REMAINDER TRUST h4HE TWO STEP PLAN BEGAN WITH THEIR CREATING A CHARITABLE REMAINDER TRUST 4HIS INVOLVED MY PARENTS GIFTING THEIR PROPERTY TO THE TRUST AND ) AS TRUSTEE SOLD THE PROPERTY INVESTING THE PROCEEDS OF THE SALE IN CONSERVATIVE INVESTMENTS FOR THEIR BENElT FOR THEIR LIFETIME AND FOR THEIR DESIGNATED CHARITY UPON THEIR DEATHS v HE EXPLAINS h.EXT WE CREATED AN INSURANCE TRUST TO PRESERVE THE VALUE OF THAT PROPERTY IN THE FORM OF A DEATH BENElT ON BOTH THEIR LIVES v

Dr. Presley H. Chalmers and Mrs. Patti E. Chalmers

VOLUME 6, NUMBER 1 I 35

FOUNDATION OF SUPPORT (OWARD SAID THAT FROM DAY ONE WHEN THE ADVISORS OUTLINED THE CONCEPT OF THE CHARITABLE REMAINDER TRUST FOR HIS DAD

#HALMERS WAS lRM h) WANT TO GIVE IT TO 4HE -ETHODIST (OSPITAL v #HALMERS DIED IN AND HIS WIFE IN *ANUARY LEAVING THEIR ESTATE TO THEIR THREE SONS AND TRIGGERING THE PASSING OF THE PRINCIPAL OF THE CHARITABLE REMAINDER TRUST TO -ETHODIST AS BENElCIARY

ANOTHER FIRST 4HE 0RESLEY ( AND 0ATTI % #HALMERS #HARITABLE 2EMAINDER 4RUST IS THE lRST OF ITS KIND TO REACH MATURITY FOR -ETHODIST 4HROUGH THE ASSETS OF THE TRUST

THE #HALMERS FAMILY PROPOSES TO ESTABLISH A PERMANENT ENDOWMENT 4HE 0RESLEY ( AND 0ATTI % #HALMERS -EDICAL %DUCATION AND 2ESEARCH %NDOWMENT &UND AT 4HE -ETHODIST (OSPITAL BENElTING THE $EPARTMENT OF !NESTHESIOLOGY AT -ETHODIST 4HE DEPARTMENT WILL USE THE FUND TO FULlLL ITS EDUCATION AND RESEARCH MISSION

SIBLE FOR DEVELOPING THE EXCELLENCE IN ANESTHESIA THAT S BEEN PRESENT AT -ETHODIST FOR MANY YEARS v h0RESLEY AND 0ATTI #HALMERS HISTORY IS FOREVER ENTWINED WITH -ETHODIST S v ADDS 2ON 'IROTTO -ETHODIST (OSPITAL 3YSTEM PRESIDENT AND #%/ h7E ARE INCREDIBLY GRATEFUL TO THE #HALMERS FAMILY FOR ALLOWING US THE OPPORTUNITY TO USE THEIR DONATION STORY TO INSPIRE THE GENEROSITY OF OTHERS AS WE STRIVE TO COMPLETE OUR FUNDRAISING CAMPAIGN Leading Medicine. Giving Hope. 0RESLEY AND 0ATTI #HALMERS ARE WONDERFUL EXAMPLES OF HOW TO DO BOTH v "Y CREATING A LEGACY THAT REmECTS THE INTERESTS OF THEIR PARENTS AND THE HIGHEST PRIORITIES OF 4HE -ETHODIST (OSPITAL THE #HALMERS SIBLINGS AND THEIR FAMILIES ARE PLAYING AN IMPORTANT ROLE WITH THEIR GENEROSITY TO A MUCH BELOVED INSTITUTION THAT CONTINUES TO BE A REVOLUTIONARY FORCE IN MEDICINE BENElTING PHYSICIANS AND PATIENTS IN THE DECADES TO COME Q

)N ADDITION THE #HALMERS FAMILY HAS APPROVED 4HE 0RESLEY ( AND 0ATTI % #HALMERS !NNUAL ,ECTURESHIP IN !NESTHESIOLOGY

WHICH WILL FOCUS ON TIMELY SIGNIlCANT TOPICS PRESENTED BY EXPERTS IN THE lELD !ND IN HONOR OF THE FAMILY S ENDURING LEGACY A CONFERENCE ROOM LOCATED NEAR THE GROUP PRACTICE WHERE #HALMERS SERVED FOR MANY YEARS HAS BEEN NAMED 4HE 0RESLEY ( AND 0ATTI % #HALMERS #ONFERENCE 2OOM h7E ARE VERY APPRECIATIVE OF THE #HALMERS FAMILY FOR BEING SO GENEROUS IN DESIGNATING THESE FUNDS TO mOW TO OUR DEPARTMENT v SAYS $R *OSEPH * .APLES CHAIRMAN OF THE $EPARTMENT OF !NESTHESIOLOGY AT -ETHODIST AND PROFESSOR OF CLINICAL ANESTHESIOLOGY AT 7EILL #ORNELL -EDICAL #OLLEGE h$R #HALMERS WAS A PIONEER IN ANESTHESIA AND IS RESPON-

give take

&

Understanding the advantages of a charitable remainder trust

(Left to right) Former Methodist President and CEO Ron Girotto with Howard and Mike Chalmers

Charitable remainder trusts, like The Presley H. and Patti E. Chalmers Charitable Remainder Trust described in the accompanying article, are designed to provide financial security while supporting a philanthropic organization like Methodist. A charitable remainder trust is a deferred gift that lets the donor commit a substantial amount to support Methodist’s mission later while securing income now. Donors contribute assets to the trust and receive income distributions for the rest of their lives. Benefits of a charitable remainder trust can include: Q Reduced income taxes Q Reduced estate taxes Q Reduced capital gains taxes Q Stable income “At the time Mother and Dad decided to sell their property, Dad had no inclination of giving the property to anyone but wanted to preserve the value of it for his heirs — me and my two brothers — without having the value of the estate reduced by payment of federal taxes,” says son Howard Chalmers. “Mother and Dad bought the farm in the late 1950s for $35,000 and 40 years later when they were ready to move, its value had appreciated to $440,000.”

Because the assets are donated to a charity, charitable remainder trusts do not pay any capital gains taxes. These trusts are ideal for assets like stocks or property with a low initial cost but high appreciated value, such as the Chalmerses’ property. These gifts may also qualify the donor for an income tax deduction in the year of the contribution. The deduction is based upon the estimated present value of the remainder interest that will ultimately go to the charity.

To learn more about establishing a charitable remainder trust or other planned gifts to Methodist, please visit plannedgiving.methodisthealth.com. Q

36 I METHODISTHEALTH.COM

CREATE A LEGACY.

Lead the Way.

Creating a legacy of giving that continues beyond your lifetime requires leadership, vision and a commitment to the future. Your legacy gift to The Methodist Hospital Foundation can advance leading medicine for years to come.

Your generosity will also qualify you for membership in the prestigious Norsworthy Legacy Society.

To learn more about planned giving, contact us at 832-667-5816 or plannedgiving.methodisthealth.com.

VOLUME 6, NUMBER 1 I 37

Chung was able to cut the fall rate on her hospital unit in half.

stop, start, rewind

Heather Chung, Ph.D., R.N.

.URSE STUDIES ELDERLY PATIENTS FALLS

By Denny Angelle

It can happen in the blink of an eye — in less than a fraction of a second — between the beats of a heart. When a person loses balance and falls, the sequence of events can happen too fast for the mind to process.

"UT EVERYTHING CATCHES UP WHEN mESH HITS THE mOOR AND IN OLDER ADULTS THE RESULT IS OFTEN SERIOUS )N HOSPITALS ACROSS THE COUNTRY PATIENT FALLS ACCOUNT FOR NEARLY PERCENT OF REPORTED ACCIDENTS !ND ABOUT A THIRD OF THESE FALLS RESULT IN SERIOUS INJURY AND AN EXTENDED HOSPITAL STAY (EATHER #HUNG 0H $ 2 .

A NURSING DIRECTOR AT 4HE -ETHODIST (OSPITAL HAS SEEN THE DISAPPOINTING AND SOMETIMES DISTURBING RESULTS WHEN PATIENTS FALL IN HOSPITALS h&ALLS CAN BE LIFE THREATENING IN SOME CASES AND IT SEEMS TO HAPPEN MOST OFTEN AMONG OLDER PATIENTS v THE YEAR VETERAN NURSE SAYS h#OMMON SENSE WOULD TELL YOU THAT IT SHOULD BE EASY TO PREVENT FALLS WHILE IN THE HOSPITAL BUT THE TRUTH IS THAT HOSPITALS HAVE STRUGGLED WITH THIS ISSUE FOR MANY YEARS v 3O #HUNG SET OUT TO DISSECT A PATIENT FALL SCIENTIlCALLY LIKE ONE WOULD STOP START AND REWIND A VIDEO AND ANALYZE THE

38 I METHODISTHEALTH.COM

ACTION IN HOPES OF ACQUIRING SOME NEW INSIGHT h)T WAS MY THESIS IN SCHOOL AS ) WAS GOING BACK TO EARN MY 0H $ v #HUNG SAYS h) WANTED TO BREAK DOWN THIS TYPE OF INCIDENT AND LOOK AT IT FROM THE PATIENT S PERSPECTIVE v 'OING IN #HUNG KNEW THAT MANY PATIENT FALLS OCCUR WHEN A NURSE OR OTHER HOSPITAL CAREGIVER IS NOT PRESENT /LDER PATIENTS OFTEN HAVE A DISABILITY HINDERING THEIR BALANCE OR ABILITY TO WALK !DD TO THAT THE UNFAMILIAR ENVIRONMENT THE LAYOUT OF A HOSPITAL ROOM AND THE TYPE OF MEDICATION A PATIENT MAY BE RECEIVING AND YOU COULD HAVE A FORMULA FOR A FALL #HUNG INTERVIEWED FORMER -ETHODIST PATIENTS ALL OLDER THAN WHO HAD FALLEN WHILE IN THE HOSPITAL 3HE ASKED MANY QUESTIONS INCLUDING WHAT THEY WERE DOING AND THINKING IN THE MOMENTS BEFORE THEIR ACCIDENT 3HE FOUND THAT MANY OF THEM REPORTED FALLING WHILE THEY WERE GOING TO OR RETURNING FROM THE BATHROOM h4HAT WAS THE .O

FALL PREVENTION CONDITION THAT STARTED EVERY CHAIN OF EVENTS 4HE PATIENT HAD TO GO TO THE BATHROOM AND HE OR SHE DIDN T WANT TO CALL A NURSE TO HELP v #HUNG SAYS

CAREGIVERS RECOGNIZE AND ACKNOWLEDGE OTHER RISK FACTORS MEDICATION WEAKNESS VISION OR OTHER PHYSICAL LIMITATIONS AND INCREASE SUPERVISION OF THESE PATIENTS

)N SOME CASES PATIENTS MISJUDGED THEIR SURROUNDINGS AND OR THEIR ABILITY TO TRAVEL SAFELY TO THE BATHROOM AND BACK #HUNG ALSO FOUND THAT SOME INJURIES OCCURRED WHEN PATIENTS EXTENDED A HAND TO HELP BREAK THEIR FALL 3HE SAYS MANY OF THE PEOPLE SHE INTERVIEWED SAID THEY FELT ASHAMED STUPID OR FRIGHTENED THAT THEY HAD FALLEN !LL OF THE PATIENTS SHE INTERVIEWED HAD A STRONG DESIRE TO MAINTAIN AS MUCH INDEPENDENCE AS THEY COULD

h/UR APPROACH IS TO MAKE EVERYONE WHO WORKS ON A UNIT EVEN THE HOUSEKEEPERS PART OF A TEAM TO KEEP AN EYE OUT FOR SIGNS THAT A PATIENT MAY BE ABOUT TO DO SOMETHING THAT CAN RESULT IN A FALL v #HUNG SAYS h4HE HEIGHTENED VIGILANCE REALLY SEEMS TO MAKE A DIFFERENCE v

7ITH THE RESULTS OF THESE INTERVIEWS #HUNG SAYS SHE HAD ENOUGH RAW DATA TO SET UP A CONTINUUM OR TIMELINE OF A TYPICAL PATIENT FALL 7ITH THAT SHE DETERMINED THAT A PATIENT S URGENCY TO GET TO THE BATHROOM COUPLED WITH THEIR DESIRE TO PRESERVE THEIR INDEPENDENCE AND AVOID CALLING A NURSE FOR HELP WERE RISK FACTORS IN A FALL h9OU TAKE THESE RISK FACTORS INTO ACCOUNT AND YOU ARE ABLE TO NOT ONLY PREDICT FALLS BUT PREVENT THEM TOO v #HUNG SAYS )DENTIFYING HIGH RISK OLDER PATIENTS WITH THIS METHOD #HUNG WAS ABLE TO CUT THE FALL RATE ON HER HOSPITAL UNIT IN HALF h4HE MAIN THING WE DID WAS TO GET THESE HIGH RISK PEOPLE A BEDSIDE COMMODE v SHE SAYS h4HEY WERE ABLE TO MAINTAIN SOME INDEPENDENCE WHILE NOT HAVING TO MAKE THAT DANGEROUS TRIP TO THE BATHROOM v #HUNG ALSO MADE OTHER RECOMMENDATIONS BASED ON HER lNDINGS 3HE SUGGESTED A POST FALL hHUDDLEv WITH THE PATIENT TO HELP DETERMINE WHAT HAPPENED AND HOW THE PATIENT CAN AVOID A SIMILAR ACCIDENT 3HE ALSO RECOMMENDED THAT

0ATIENTS WHO HAVE BEEN IDENTIlED AS HIGH RISK WEAR YELLOW ARM BANDS AND SOCKS AND YELLOW DOTS ARE PLACED ON THEIR CHARTS TO HELP ALERT EVERYONE INVOVED IN THEIR CARE #HUNG IS WORKING WITH AN ARCHITECTURAL COMPANY TO CONSIDER REDESIGNING SOME HOSPITAL ROOMS WITH BEDS CLOSER TO THE BATHROOM

AND WITH HANDRAILS FOR WALKING ASSISTANCE 3HE PRESENTED HER lNDINGS AND RECOMMENDATIONS AT CONFERENCES WITHIN 4HE -ETHODIST (OSPITAL AND SOON OTHER NURSING UNITS WERE ADOPTING HER SUGGESTIONS #HUNG ALSO SUBMITTED HER WORK TO 4HE -ETHODIST (OSPITAL 2ESEARCH )NSTITUTE

AND IN SHE BECAME ONE OF THE lRST NURSES TO RECEIVE A RESEARCH GRANT FROM THEM 0HASE OF HER ONGOING STUDY WILL EMPLOY A STATISTICIAN

PHARMACIST AND REHABILITATION PHYSICIAN AND WILL FOCUS ON A GROUP OF PATIENTS h7E WANT TO PEEL BACK MORE LAYERS TO SEE HOW MANY MORE PATTERNS AND COMMON RISK FACTORS WE CAN UNCOVER v #HUNG SAYS h7E CAN NEVER PREVENT EVERY SINGLE ACCIDENT IN THE HOSPITAL BUT WE CAN SURELY TAKE STEPS TO PREVENT MANY FALLS AND AVOID FURTHER INJURIES v Q

SLIPS, TRIPS AND OTHER MISHAPS ! SENIOR FALLS AT HOME 3HE CAN T GET UP NOR CAN SHE CALL FOR HELP 9OU DON T HAVE TO SEE A 46 COMMERCIAL TO KNOW THAT FALLS ARE A VERY SERIOUS MATTER &ALLS RESULTING IN BONE FRACTURES AND HEAD TRAUMA CAN THREATEN A SENIOR S INDEPENDENCE 4HEY CAN EVEN BE FATAL !CCORDING TO THE #ENTERS FOR $ISEASE #ONTROL AND 0REVENTION ONE OUT OF THREE ADULTS AGE AND OLDER FALLS EACH YEAR !PPROXIMATELY MILLION SENIORS SUSTAINED NONFATAL INJURY IN WITH MORE THAN A QUARTER OF THOSE FALLS REQUIRING HOSPITALIZATION 3ENIORS AND THEIR CAREGIVERS SHOULD TAKE THE FOLLOWING STEPS TO HELP REDUCE THE RISK OF FALLS AND SAFEGUARD THEIR INDEPENDENCE Q 0LACE NONSLIP SURFACES IN THE BATHTUB OR SHOWER Q )NSTALL GRAB BARS BOTH INSIDE AND OUTSIDE OF THE BATHTUB OR SHOWER AND NEXT TO THE TOILET Q 3TAY ACTIVE AND EXERCISE REGULARLY TO IMPROVE BALANCE AND STRENGTH Q +NOW WHICH MEDICATIONS CAN MAKE YOU DIZZY OR DROWSY AND DISCUSS WAYS TO REDUCE THE SIDE

EFFECTS WITH YOUR PHYSICIAN Q 2EMOVE ALL TRIPPING HAZARDS FROM AROUND THE HOUSE Q /BTAIN ASSISTANCE WHEN NEEDED Source: Centers for Disease Control and Prevention

VOLUME 6, NUMBER 1 I 39

Aging Primer

By Emma V. Chambers and Donna Hurst

Palliative Care: )MPROVING QUALITY OF LIFE FOR PATIENTS AND THEIR FAMILIES

T

he next time you’re seated in your favorite restaurant or coffee bar, take a look around. Nearly half the adults in the room suffer with a chronic illness. From arthritis to diabetes to heart disease and cancer, chronic diseases are threatening the nation’s health.

While physicians and other medical professionals concentrate on treating the illness itself, the palliative care team — a specialized group of physicians, nurses and social workers — works to treat the physical, emotional and spiritual needs of the patient and their family.

Supportive and palliative care, which grew out of the hospice movement, is sometimes confused with hospice. While hospice is only The palliative care team works available to terminally ill patients who have a alongside the patient’s physician to prognosis of six months or less to live and don’t desire curative treatment, palliative care is treat physical, emotional specialized medical treatment for people facing and spiritual needs a serious or life-threatening illness — no matter and improve quality of life. the diagnosis or prognosis.

40 I METHODISTHEALTH.COM

HEALTHY LIVING

800 The number of patients seen per year

by Methodist’s supportive and palliative care team.

0ALLIATIVE CARE ADDRESSES THE SYMPTOMS OF CHRONIC DISEASE SUCH AS PAIN SHORTNESS OF BREATH FATIGUE CONSTIPATION

NAUSEA LOSS OF APPETITE AND SLEEPING DIFlCULTIES 4HE PALLIATIVE CARE TEAM WORKS ALONGSIDE THE PATIENT S PHYSICIAN TO POSITIVELY AFFECT OUTCOMES AND IMPROVE QUALITY OF LIFE !CCORDING TO A !MERICAN (OSPITAL !SSOCIATION SURVEY

NEARLY PERCENT OF HOSPITALS IN THE 5NITED 3TATES WITH MORE THAN BEDS HAVE A PALLIATIVE CARE PROGRAM 4HE NUMBER OF BEDS MAY DECREASE IN THE FUTURE AS MOST PATIENTS WITH SERIOUS CHRONIC ILLNESSES ARE NOT IN THE HOSPITAL 4HE BENElTS OF PALLIATIVE CARE WERE DOCUMENTED IN RESEARCH PUBLISHED LAST YEAR IN THE New England Journal of Medicine

4HE STUDY SHOWED THAT OF NEWLY DIAGNOSED PATIENTS WITH METASTATIC LUNG CANCER THOSE WHO RECEIVED PALLIATIVE CARE ALONG WITH STANDARD CANCER THERAPY HAD A BETTER QUALITY OF LIFE EXPERIENCED LESS DEPRESSION WERE LESS LIKELY TO RECEIVE AGGRESSIVE END OF LIFE CARE AND LIVED NEARLY THREE MONTHS LONGER THAN THOSE WHO RECEIVED CANCER TREATMENT ALONE Q

Palliative Care Provides Close communication Q Expert management of pain and other symptoms Q Help navigating the health care system Q Guidance with difficult and complex treatment choices Q Emotional and spiritual support for you and your family Q

Source: getpalliativecare.org

Leading Medicine recently sat down with Libby Tsubai, M.S., R.N., director of operations, supportive and palliative care at The Methodist Hospital, to discuss palliative care.

How can supportive and palliative care help patients and their families?

4HE SUPPORTIVE AND PALLIATIVE CARE TEAM CAN TREAT A PATIENT S PAIN AND OTHER SYMPTOMS THAT ARE DIFlCULT TO CONTROL 7E ALSO HELP THEM AND THEIR FAMILIES COPE WITH ILLNESS AND DIFlCULT DECISIONS PROVIDE SUPPORT LISTEN AND COORDINATE OTHER SERVICES -OST INSURANCE PLANS INCLUDING -EDICARE AND -EDICAID COVER SUPPORTIVE AND PALLIATIVE CARE IN THE HOSPITAL

How does supportive and palliative care work with the patient’s other doctors?

4HE PATIENT S DOCTOR OR DOCTORS WILL ASK THE SUPPORTIVE AND PALLIATIVE CARE STAFF TO CONSULT WITH THEM ABOUT THE PATIENT S CARE 4HE TEAM CAN HELP WITH MANY OF THE TIME INTENSIVE ASPECTS OF CARING FOR PATIENTS WITH SERIOUS ILLNESS SUCH AS FAMILY MEETINGS GOALS OF CARE DISCUSSIONS EMOTIONAL AND PSYCHOSOCIAL SUPPORT COMPLEX PAIN AND SYMPTOM BURDEN 7E ALSO CAN COORDINATE OTHER ASPECTS OF CARE 3UPPORTIVE AND PALLIATIVE CARE SPECIALISTS DON T TAKE OVER CARE )T IS A SERVICE TO THE PHYSICIAN S AND OTHERS WORKING IN PARTNERSHIP WITH THEM

What kind of patients do you see?

4HESE PATIENTS TYPICALLY HAVE SERIOUS ADVANCED ILLNESSES THAT REQUIRE SPECIALIZED SUPPORT AND SERVICES ! FAIR NUMBER OF OUR PATIENTS ARE AT THE END OF LIFE BUT THE TEAM TREATS PATIENTS WHO ARE IN ALL PHASES OF ILLNESS

Where can patients obtain information about supportive and palliative care?

4HEY CAN ASK THEIR PHYSICIAN OR NURSE ABOUT SUPPORTIVE AND PALLIATIVE CARE 4HEY ALSO MAY CALL 4HE -ETHODIST (OSPITAL S 3UPPORTIVE AND 0ALLIATIVE #ARE $EPARTMENT AT 4HESE WEBSITES ALSO OFFER HELPFUL INFORMATION ABOUT PALLIATIVE CARE GETPALLIATIVECARE ORG AND PALLIATIVEDOCTORS ORG Q

VOLUME 6, NUMBER 1 I 41

HEALTHY LIVING

Care FOR THE #AREGIVER

C

aring for an aging parent or spouse who becomes ill or disabled can become stressful for the primary caregiver. This expression of love and kindness can lead to burnout, frustration, anxiety and depression if the caregiver does not find a way to balance the demands of caring for a loved one with other relationships and responsibilities.

As the stress escalates, often caregivers withdraw instead of seeking support from family, friends and community. Despite the difficulties, there are ways to help ease the burden.

Steps You Can Take Q 2ESIST ISOLATION &IND SUPPORT AMONG FRIENDS FAMILY AND

COWORKERS *OIN COMMUNITY CAREGIVER GROUPS FOR EMOTIONAL SUPPORT AND SEEK OUT LOCAL RESOURCES FOR HELP 4AKE ADVANTAGE OF RESOURCES TO COORDINATE CAREGIVING TASKS WITHIN YOUR FAMILY AND SUPPORT NETWORK Q 4AKE CARE OF YOURSELF SO THAT YOU CAN TAKE CARE OF OTHERS

!S OFTEN AS YOU CAN GET ENOUGH SLEEP %AT A SENSIBLE DIET AND EXERCISE REGULARLY 4AKE A BREAK WHEN THE PRESSURE BECOMES TOO GREAT EVEN IF IT S JUST A HOT BATH OR A SHORT WALK 7ALKING WITH A BUDDY CAN COVER TWO NEEDS AT ONCE FRIENDSHIP AND EXERCISE

Q )F YOU ARE EMPLOYED FIND OUT WHAT BENEFITS SUPPORT

SERVICES AND RESOURCES SUCH AS AN EMPLOYEE ASSISTANCE PROGRAM MAY BE AVAILABLE TO YOU ESPECIALLY IF YOU NEED TO TAKE TIME OFF FROM WORK Q "UILD A SUPPORT SYSTEM BY CONNECTING WITH OTHER CARE

GIVERS IN YOUR COMMUNITY )T S LIKELY THAT SOME OF YOUR FRIENDS COWORKERS OR ACQUAINTANCES HAVE FACED SIMILAR ISSUES Q )F YOU SHARE CAREGIVING RESPONSIBILITIES WITH SIBLINGS OR

OTHER RELATIVES STRESS OR UNRESOLVED ISSUES AMONG YOU MAY LEAD TO RELATIONSHIP AND CAREGIVING CHALLENGES )F SO CONSIDER lNDING AN OBJECTIVE THIRD PARTY SUCH AS A FRIEND OR LOVED ONE ELDERCARE MEDIATOR OR A GERIATRIC CARE MANAGER Q

Top Five Caregiving Recipient Conditions

Aging Q Alzheimer’s/confusion Q Heart disease Q Cancer Q Stroke Q

Source: National Alliance for Caregiving in collaboration with AARP

42 I METHODISTHEALTH.COM

This expression of love and kindness can lead to burnout, frustration, anxiety and depression …

Managing THE MEDICATION MAZE

W

e’ve all seen plastic pill organizers at drugstores. Some have compartments labeled “a.m.” and “p.m.” — visual reminders to take morning and evening doses of medicines. Then there are the larger versions with multiple compartments and reminders for not only morning and evening medicine dosing, but other times as well. Imagine having to fill up one of these regularly or even having to take more medicine than can fit into one pill box.

Many of us use our own little reminders to take a pill or two, or perhaps keep up with an antibiotic regimen. But for some, managing multiple medicines can be a daily struggle.

The clinical term for this is polypharmacy.

A Tough Pill to Swallow )T IS VERY COMMON FOR PEOPLE OVER AGE TO HAVE MORE THAN ONE CHRONIC CONDITION WHICH MEANS TAKING MORE THAN ONE MEDICATION !CCORDING TO THE .ATIONAL #OUNCIL ON 0ATIENT )NFORMATION AND %DUCATION ALMOST PERCENT OF SENIORS ARE UNABLE TO READ PRESCRIPTION LABELS AND PERCENT DON T UNDERSTAND INFORMATION THEY RECEIVE #ONSIDERING THESE STATISTICS CHANCES ARE MANY ELDERLY PERSONS ARE NOT TAKING THEIR MEDICATIONS PROPERLY WHICH COULD LEAD TO SERIOUS CONSEQUENCES INCLUDING Q !DVERSE DRUG INTERACTIONS Q 0OORER QUALITY OF LIFE OR FUNCTIONAL ABILITY Q Decline in mental status !NYONE TAKING MULTIPLE MEDICINES NEEDS TO HAVE A PLAN IN PLACE TO MANAGE THEM SAYS +ATHRYN 0IDCOCK A CLINICAL PHARMACIST IN INTERNAL MEDICINE AT 4HE -ETHODIST (OSPITAL h0ATIENTS WHO TAKE A LOT OF MEDICATIONS SHOULD MAKE A LIST OF THEIR MOST CURRENT ONES v 0IDCOCK SAYS h)N ADDITION TO PRESCRIPTION MEDICINES THEY NEED TO INCLUDE OVER THE COUNTER MEDICINES VITAMINS AND HERBAL SUPPLEMENTS SINCE THEY CAN INTERFERE WITH PRESCRIPTIONS v

0IDCOCK ALSO RECOMMENDS THE FOLLOWING IF YOU TAKE MULTIPLE MEDICATIONS

1. "RING AN UPDATED LIST OF ALL MEDICATIONS TO EVERY DOCTOR S APPOINTMENT AND WHEN HAVING ANY PROCEDURE

2. 0ATIENTS AND CAREGIVERS SHOULD USE A PILL PLANNER TO ALLEVIATE CONFUSION ABOUT THE FREQUENCY AND SCHEDULE

3.

5SE ONE PHARMACY WHENEVER POSSIBLE TO AVOID DUPLICATIONS IN MEDICATION THERAPY

4. -AKE SURE ALL PHYSICIANS PRIMARY CARE AND SPECIALISTS KNOW WHICH MEDICATIONS EACH HAS PRESCRIBED FOR YOU AND ARE AWARE OF ANY CHANGES BEING MADE

5.

&OLLOW THE INSTRUCTIONS ON THE BOTTLE PRECISELY SOME PATIENTS FEEL THE NEED TO OVER OR UNDER SELF PRESCRIBE THEIR MEDICATIONS )F YOU FEEL A CHANGE IS NEEDED

ALWAYS CONSULT WITH YOUR PHYSICIAN

3HE ADVISES SENIORS AND THOSE CARING FOR THEM TO BE AWARE THAT SOME MEDICATIONS MAY HAVE ADVERSE SIDE EFFECTS IN OLDER INDIVIDUALS h$ON T WAIT TO NOTIFY YOUR PHYSICIAN OR PHARMACIST IF YOU EXPERIENCE ADVERSE AFFECTS OF NEW MEDICATIONS DRUG INTERACTIONS COULD BE CAUSING TOXIC SIDE EFFECTS OR THE DOSE MAY BE TOO HIGH FOR YOU v SHE SAYS Q

What is polypharmacy?

This term describes when a patient takes numerous medications or when more medications are taken than are actually necessary (overmedication).

VOLUME 6, NUMBER 1 I 43

LEGAL DOCUMENTS

Planning Ahead Legal documents that will give you and your family peace of mind

By Emma V. Chambers and Linda Gilchriest

W

ho will make your medical decisions when you can’t? Who will take care of your small children in the event of your death? And what happens to all your things?

Knowing the answers to these questions is good, but it’s only a first step. If you want to make sure your wishes are observed, legal specialists recommend putting it in writing.

If you are procrastinating about these decisions, you’re not alone. More than half of all Americans die without a will. It’s commonplace for young adults to they think they have their whole lives ahead of them to draw up their legal documents before they die. Others think only wealthy people need wills.

The reality is that unexpected situations arise. Regardless of your age or health status, you need to be prepared. It’s also important that your family and friends be aware of your wishes in the event you are unable to communicate them. Just because you don’t have a stock portfolio or own a home, doesn’t mean you don’t need a will. Even if everything you own fits into a brown paper bag, you need a will. Otherwise, the state could dictate how to dispose of your property.

Here’s a primer that will help you determine which legal documents you need to protect you and your loved ones.

If you want to make sure your wishes are observed, legal specialists recommend putting it in writing.

44 I METHODISTHEALTH.COM

Last Will and Testament A will is the most practical first step in ESTATE PLANNING )T CLEARLY STATES HOW YOU WANT YOUR PROPERTY TO BE DISTRIBUTED 0REPARING A WILL CAN BE AS SIMPLE AS WRITING OUT HOW YOU WANT YOUR ASSETS TO BE TRANSFERRED TO LOVED ONES OR CHARITABLE ORGANIZATIONS AFTER YOUR DEATH BUT YOU MAY ALSO WANT TO CONSULT A LAWYER FOR HELP )F YOU DON T HAVE A WILL WHEN YOU DIE YOUR ESTATE WILL BE HANDLED IN PROBATE

AND YOUR PROPERTY COULD BE DISTRIBUTED DIFFERENTLY THAN HOW YOU WOULD LIKE

Advance Directives !DVANCE DIRECTIVES ARE WRITTEN DOCUMENTS THAT TELL YOUR FAMILY AND DOCTORS WHAT KIND OF TREATMENT YOU WANT IF YOU BECOME UNABLE TO MAKE MEDICAL DECISIONS SUCH AS IF YOU RE IN A COMA &ORMS AND LAWS VARY WITH EACH STATE SO IT S A GOOD IDEA TO HAVE A LEGAL EXPERT ASSIST WHEN YOU WRITE AN ADVANCE DIRECTIVE

#/--/. 2%!3/.3 &/2 ./4 #2%!4).' ! 7),, s 5NCOMFORTABLE SHARING PERSONAL INFORMATION with strangers s #OSTS TOO MUCH s "ELIEF THAT ONLY RICH PEOPLE NEED WILLS s 0ROCRASTINATION s "ELIEF THAT ONLY OLDER PEOPLE NEED WILLS

Regardless of your age or health status, you need to be prepared.

Living Will !LSO CALLED A $IRECTIVE TO 0HYSICIANS A LIVING WILL IS ONE TYPE OF ADVANCE DIRECTIVE THAT GOES INTO EFFECT WHEN A PERSON IS TERMINALLY ILL ! LIVING WILL ALLOWS YOU TO SPECIFY THE KIND OF TREATMENT YOU WANT IN SPECIFIC SITUATIONS 4HIS IS NOT THE SAME AS A $O .OT 2ESUSCITATE ORDER

Medical Power of Attorney 3OMETIMES CALLED A DURABLE MEDICAL POWER OF ATTORNEY THIS DOCUMENT SPECIFIES THE PERSON YOU VE CHOSEN AS YOUR AGENT TO MAKE MEDICAL DECISIONS FOR YOU WHEN YOU CANNOT )T IS ACTIVATED ANY TIME YOU RE UNCONSCIOUS OR UNABLE TO MAKE MEDICAL DECISIONS

Do Not Resuscitate Order ! $.2 ORDER IS WRITTEN BY YOUR DOCTOR TO CARRY OUT YOUR DESIRE TO NOT BE RESUSCITATED IF YOUR HEART STOPS BEATING Q Sources: A ARP.org and consumeraction.gov

GETTING STARTED Forms and laws vary with each state, so it’s a good idea to have a legal expert assist when you write an advanced directive. For sample advance directive and medical power of attorney documents, visit methodisthealth.com/directives.

PLANNED GIVING Planned giving allows you to create a lasting legacy at Methodist that supports innovative research, exceptional patient care and training for the next generation of physicianscientists. To learn more, visit plannedgiving.methodisthealth.com.

4().'3 4/ #/.3)$%2

1 2 3 4 5 6 7 8

(AVE YOU TALKED WITH FAMILY OR FRIENDS ABOUT TYPES OF TREATMENT AND CARE YOU WOULD WANT IF YOU WERE NOT ABLE TO MAKE MEDICAL DECISIONS $O YOU HAVE AN ADVANCE HEALTH CARE DIRECTIVE $ID YOU CREATE OR REVIEW YOUR ADVANCE HEALTH CARE DIRECTIVE AFTER A MAJOR LIFE EVENT SUCH AS A MARRIAGE

DIVORCE OR SEPARATION OR A NEWLY DIAGNOSED ILLNESS (AVE YOU REVIEWED YOUR ADVANCE HEALTH CARE DIRECTIVE IN THE PAST YEARS (AVE YOU TALKED WITH YOUR DESIGNATED HEALTH CARE AGENT ABOUT END OF LIFE CARE $OES YOUR HEALTH CARE AGENT HAVE A COPY OF YOUR ADVANCE HEALTH CARE DIRECTIVE $OES YOUR PRIMARY CARE DOCTOR HAVE A COPY OF YOUR ADVANCE HEALTH CARE DIRECTIVE (AVE YOU ORGANIZED YOUR IMPORTANT PAPERS INSURANCE INFORMATION IMPORTANT CONTACTS MEDICATION RECORDS

BANK STATEMENTS ETC SO OTHERS CAN EASILY FIND THEM IN AN EMERGENCY Q

Source: A ARP.org

This information is not meant to replace legal consultation, but will put you on the right track for planning for the future.

VOLUME 6, NUMBER 1 I 45

ACCOLADES

T

he Methodist Hospital ranked among the country’s top hospitals in 11 specialties in U.S.News & World Report’s 2011 “Best Hospitals” issue, ranking in more specialties than any other hospital in Texas.

The hospital also ranked No. 1 in the Houston area in the magazine’s “Best Metro Area Hospitals” list. San Jacinto Methodist Hospital ranked No. 9 and Methodist Willowbrook Hospital ranked No. 17 in the Houston metropolitan area. Q

M

ethodist Sugar Land Hospital receives The Joint Commission Primary Stroke Center Certification. The certification recognizes Methodist Sugar Land’s commitment and success in implementing a higher standard of care by ensuring that stroke patients receive treatment according to nationally accepted standards and recommendations. This achievement is the best indicator to the community that the quality of care provided by a hospital is effectively managed to meet the unique and specialized needs of stroke patients with the best possible outcomes. Q

S

an Jacinto Methodist Hospital Cancer Center earns Commission on Cancer Accreditation. This re-accreditation by The American College of Surgeons’ Commission on Cancer reflects San Jacinto Methodist’s high level of compliance with the standards that represent the full scope of a cancer program. Q

46 I METHODISTHEALTH.COM

$R %UGENE # ,AI joined the Methodist Neurological Institute as the Robert W. Hervey Distinguished Endowed Chair for Parkinson’s Disease Research and Treatment.

(E IS ALSO A PROFESSOR OF NEUROLOGY AND DIRECTOR OF THE .EURODEGENERATIVE $ISEASE #LINIC ,AI IS A CLINICIAN SCIENTIST WHO HAS SPECIAL INTERESTS IN THE CAUSES AND TREATMENTS OF NEURODEGENERATIVE DISEASES SUCH AS 0ARKINSON S DISEASE !LZHEIMER S DISEASE AMYOTROPHIC LATERAL SCLEROSIS AND OTHER RELATED DISORDERS Q

$R 2OBERT ' 'ROSSMAN, chairman of neurosurgery and co-director of the Methodist Neurological Institute, received the Rick Hansen Difference Maker Award for his outstanding contributions in the field of spinal cord injury (SCI) research.

'ROSSMAN IS KNOWN INTERNATIONALLY FOR HIS CONTRIBUTIONS TO ADVANCING THE TREATMENT OF HEAD AND SPINAL CORD INJURIES

0ARKINSON S DISEASE DYSTONIA AND EPILEPSY (E IS THE PRINCIPAL INVESTIGATOR FOR THE #HRISTOPHER $ANA 2EEVE &OUNDATION S .ORTH !MERICAN #LINICAL 4RIALS .ETWORK A NETWORK OF HOSPITALS IN THE 5NITED 3TATES AND #ANADA FOCUSED ON TRANSLATING 3#) research into treatments for patients Q

ACCOLADES

$R 2ICHARD 3IMPSON, neurosurgeon at the Methodist Neurological Institute, was the first physician to implant a next-generation device for deep brain stimulation therapy.

-EDTRONIC S !CTIVA® 3# NEUROSTIMULATOR TREATS THE SYMPTOMS OF ADVANCED 0ARKINSON S DISEASE AND ESSENTIAL TREMORS 4HE NEW DEVICE PROVIDES A GREATER ABILITY TO lNE TUNE STIMULATION AND CUSTOMIZE PATIENTS THERAPIES WHICH MAY HELP PHYSICIANS TREAT THEIR DISEASES MORE EFlCIENTLY AND IN SHORTER AMOUNTS OF TIME Q

$R 3COTT 0ARAZYNSKI, physician and former NASA astronaut, has been named chief medical officer and chief technology officer of The Methodist Hospital Research Institute.

0ARAZYNSKI COMES TO -ETHODIST WITH AN EXTENSIVE HISTORY OF INNOVATION IN CHALLENGING

EXTREME ENVIRONMENTS !S ONE OF .!3! S MOST EXPERIENCE SPACEWALKERS HE SPENT YEARS AS A MISSION SPECIALIST ASTRONAUT (IS INNOVATIONS AND PATENT lLINGS INCLUDE TOOLS FOR EXTRAVEHICULAR ACTIVITY SPACEmIGHT EXERCISE COUNTERMEASURES AND MEDICAL DEVICES AND TECHNOLOGIES FOR MOUNTAINEERING SAFETY AND OTHER HARSH ENVIRONMENTS Q

.EAL #OPELAND 0H $ AND .ANCY *ENKINS 0H $

the powerhouse husband/wife team of cancer geneticists, have been named to key roles at The Methodist Hospital Research Institute. #OPELAND AND *ENKINS ARE AMONG THE MOST CITED BIOMEDICAL SCIENTISTS IN THE WORLD 4HEY ARE THE lRST LUMINARY SCHOLARS RECRUITED BY 4EXAS THROUGH THE #ANCER 0REVENTION AND 2ESEARCH )NSTITUTE OF 4EXAS 4HEY WILL DIRECT BASIC RESEARCH FOR THE 2ESEARCH )NSTITUTE AND THE -ETHODIST #ANCER #ENTER SERVING AS CO DIRECTORS OF CANCER BIOLOGY Q

T

he Methodist Cancer Center recently opened a triple negative breast cancer clinic, the first of its kind in the nation. The clinic provides patients with access to services including genetic counseling, psychosocial support, nutritional counseling, lymphedema management and even massage therapy. Usually breast cancer is diagnosed based on three common receptors known to help the cancer develop. The cells in triple negative breast cancer do not express any of these receptors, making them generally unresponsive to standard treatments. Q

VOLUME 6, NUMBER 1 I 47

CLINICAL Notes Dr. Brian Bruckner, cardiac surgeon, and Dr. Michael Reardon, cardiovascular surgeon, at the Methodist DeBakey Heart & Vascular Center

"RUCKNER AND 2EARDON PERFORMED A FOUR HOUR BYPASS PROCEDURE ON A YEAR OLD (OUSTON MAN WHO BECAME THE lRST INDIVIDUAL IN THE 5NITED 3TATES TO ENROLL IN A STUDY USING STEM CELL TRANSPLANTATION DURING CARDIAC BYPASS TO TREAT SEVERE HEART FAILURE #LINICIAN RESEARCHERS AT THE -ETHODIST $E"AKEY (EART 6ASCULAR #ENTER ARE INVESTIGATING WHETHER STEM CELL INFUSION DELIVERED DURING BYPASS SURGERY WILL GENERATE NEW BLOOD VESSELS AND IMPROVE HEART FUNCTION MORE THAN WHAT IS ACCOMPLISHED THROUGH BYPASS SURGERY ALONE Q

Dr. David M. Brown, retinal surgeon, at The Methodist Hospital

"ROWN OVERSAW A .ATIONAL )NSTITUTES OF (EALTH STUDY WHICH FOUND THAT !VASTIN® AND ,UCENTIS® ARE EQUALLY EFFECTIVE IN TREATING AGE RELATED MACULAR DEGENERATION !-$ !-$ IS A MAJOR CAUSE OF CENTRAL VISION LOSS AND IS ONE OF THE LEADING CAUSES OF BLINDNESS IN PEOPLE OVER Q

Drs. M. Faisal Khan, Scott Rivenes, Majid Basit, Uttam Tripathy and Mike Yuan at Methodist Sugar Land Hospital

0HYSICIANS PERFORMED A NEW HYPOTHERMIA TECHNIQUE AT -ETHODIST 3UGAR ,AND (OSPITAL TO HELP RESTORE HEART ATTACK PATIENTS BACK TO HEALTH USING THE !RCTIC 3UN 4EMPERATURE -ANAGEMENT 3YSTEM A THERMOREGULATORY DEVICE THAT ENABLES MEDICAL STAFF TO CONTROL A PATIENT S TEMPERATURE 2ECENT RESEARCH INDICATES THAT DAMAGE TO THE BRAIN MAY BE DECREASED BY COOLING THE BODY S TEMPERATURE WHICH REDUCES THE BODY S METABOLIC NEEDS Q

48 I METHODISTHEALTH.COM

STUDENT PHYSICALS Extracurricular Pre-Participation Physicals

Saturday, May 19, 9 a.m. – 2 p.m.

Reliant Stadium Cost: $15 (cash only accepted) | Ages 12-18 Plan Ahead! Download UIL medical history and consent forms at methodistsportsmed.com or call 713-790-3333.

Please join The Methodist Hospital System® and the Houston Texans for the third annual Extracurricular Pre-Participation Physicals. This community service event will not only provide comprehensive student physicals, but also offer on site specialists from the departments of cardiology, internal medicine, orthopedics and neurology to address any potential health concerns raised during individual assessments.

NOTE: According to the University Interscholastic League (UIL) guidelines, students participating in school sports must complete and pass a pre-participation physical screening. Students must bring the UIL physical evaluation medical history form and Methodist consent form filled out and signed by a parent or guardian.

Thank you to our 2011 sponsors whose commitment and support made a difference in our community.

.ONPROlT /RG 5 3 0OSTAGE PAID (OUSTON 4EXAS 0ERMIT .O

6565 Fannin Houston, TX 77030 A Founding Member of the Texas Medical Center

®

LEADING MEDICINE

The Methodist Hospital System

®

San Jacinto Methodist Hospital

Methodist Imaging Center

6565 Fannin Street Houston, TX 77030 713-790-3311

4401 Garth Road Baytown, TX 77521 281-420-8600

8333 Katy Freeway Houston, TX 77024 713-793-XRAY (9729)

Methodist Sugar Land Hospital

Research

%MERGENCY #ARE

The Methodist Hospital Research Institute

Methodist Emergency Care Center

(OSPITALS The Methodist Hospital

16655 Southwest Freeway Sugar Land, TX 77479 281-274-7000

Methodist West Houston Hospital 18500 Katy Freeway Houston, TX 77094 832-522-1000

Methodist Willowbrook Hospital 18220 Tomball Parkway Houston, TX 77070 281-477-1000

/FlCERS OF 4HE -ETHODIST (OSPITAL "OARD OF $IRECTORS Ewing Werlein Jr. Chair John F. Bookout Senior Chair David M. Underwood Vice Chair D. Gibson Walton Vice Chair Marc L. Boom, M.D. President and CEO Gregory V. Nelson Secretary Robert K. Moses Jr. Assistant Secretary Carlton E. Baucum Treasurer Joseph C. “Rusty” Walter III Assistant Treasurer

6670 Bertner Street Houston, TX 77030 713-441-1261

Imaging Methodist Breast Imaging Center 2615 Southwest Freeway Suite 110 Houston, TX 77098 713-441-PINK (7465)

2615 Southwest Freeway at Kirby Drive Houston, TX 77098 713-441-ER24 (3724)

7ELLNESS Methodist Wellness Services 713-441-5978

0HILANTHROPY The Methodist Hospital Foundation 1707 Sunset Boulevard Houston, TX 77005 832-667-5816

0HYSICIAN 2EFERRAL (EALTH )NFORMATION 713-790-3333 Health information via the Internet at methodisthealth.com

"OARD OF $IRECTORS

!DVISORY -EMBERS

Morrie K. Abramson Emily A. Crosswell Mary A. Daffin Connie Dyer Gary W. Edwards Victor Fainstein, M.D. Mark A. Houser Bishop Janice Riggle Huie Lawrence W. Kellner Rev. Kenneth R. Levingston Vidal G. Martinez Dr. Tom Pace Keith O. Reeves, M.D. Elizabeth Blanton Wareing Dr. Steve Wende Sandra Gale Wright, RN, Ed.D.

Eric Haufrect, M.D. Rev. B.T. Williamson

,IFE -EMBERS Jack S. Blanton Ernest H. Cockrell James C. Dishman Charles W. Duncan Jr. Isaac H. Kempner III Nat S. Rogers

LMV6N1-SUNSET2-SG0312