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Healthy Living




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Healthy Living

102 N. Main Street, Kendallville, IN 46755 (260) 347-0400

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Megan Knowles

Chief Financial Officer

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Terry G. Housholder


Michele Trowbridge Jenny Ernsberger Cindy Miller Machele Waid

Daniel J. Tollefson

Learn to adapt to each of life’s seasons


April 14, 2018 Vice President of Sales

Joy Newman Advertising Director

Healthy Living is a special supplement to The Herald Republican, The News Sun and The Star, which are publications of KPC Media Group Inc. ©2018 All rights reserved

As I’ve transitioned from my 20s to my 30s, I’ve noticed things about myself have changed. I’ve gained some weight since I left high school 12 years ago, and even since I left college eight years ago. I’ve found I can’t stay up as late as I did in those days. In addition, doing certain outdoor work leaves my muscles sorer the next day than it once did. But it’s not all doom and gloom. Most days, I sleep better than I ever have. Though I’ve gained weight, I’m more mindful about why, and about the importance of a good diet and exercise — even though I don’t always follow my own advice. And I’m starting to care about things I never thought about before, like my cholesterol or TSH levels.

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The point is, we change as we age. Though things sometimes get harder or we find we can’t do the things we once could, that doesn’t mean we can’t still lead a healthy lifestyle. Likewise, as we age we gain the knowledge and experience about ourselves and the world that can help us make better decisions about our health. Whether it’s being mindful of the best exercises for us or knowing what kind of screenings we need to get, we can be our healthiest selves at any age, and it’s never too late, or too early, to start the path toward that goal. Who knows, maybe this next decade will be my healthiest one yet. — Megan Knowles

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April 14, 2018

Healthy Living



Schedule exams to detect common risks


t’s no secret that the older you get, the more likely you are to develop certain health conditions, but you may not know when’s the best time to start looking out for certain signs. You don’t need — and probably can’t afford — to get every test every year and certain diseases, conditions and cancers are unlikely to develop at a young age. So what should your health screening calendar look like? Parkview Health RN and community health nurse Leshia Howell helped walk through some different types of tests and when’s the best time to start them. The main goal: Catch problems early when they’re most treatable or before they advance to the point that they’re harder to treat or, in the case of some cancers, more likely to result in death. “I believe the more information you have about your body, the more knowledge you have, the more you can prevent before it gets completely out of control,” Howell said. “If you notice something different in your body, make sure you report that to the doctor, because we know our bodies better than anyone.” Physical Who: Everyone When: Annually, any age A general physical with your doctor is recommended every year. With an annual blood test, your physician can monitor your vitals and get an early jump on helping with problems with high blood pressure, obesity or other chronic health problems. The best part is that your annual physical should be 100 percent paid for by your health insurance, so it’s an affordable way to stay on top of your health. “It’s important to have screenings every year because you have baselines and anything that is out of the ordinary from the year before, at least you have a baseline to compare if things have changed,” Howell said. Pap smear Who: Women When: Every 1-3 years once you’re sexually active, or starting at age 21 Pap exams are the screening for

cervical cancer, which can develop in people who are infected with the common, sexually-transmitted human papillomavirus (HPV). Cancer is unlikely in women younger than 20, so screenings are recommended for women age 21-65 on a three-year basis. If an exam shows non-normal results, your doctor may suggest more frequent screenings to monitor. Pap exams can be tied in with a woman’s annual pelvic exam, which is a recommended yearly reproductive health exam for women. “It is a slower-growing cancer. If you have (the test) early, you have your baseline,” Howell said. Howell also recommended an HPV screening every five years, which can help inform whether a patient might be at increased risk for cervical abnormalities. Human papillomavirus (HPV) vaccine Who: Those 26 or younger When: Once HPV is a common virus, affecting about one in four people, according to the Centers for Disease Control and Prevention. While most people with HPV never develop symptoms or problems, about 30,700 cancers in men and women each year are caused by the virus. “HPV vaccination can prevent most of the cancers (about 28,000) from occurring,” according to the CDC website. Meningococcal vaccine Who: Those 23 or younger, or those who haven’t had all the vaccines and are going to college or joining the military When: Once at 11-12, with a booster at 16 Meningococcal vaccines can help prevent illness caused by Neisseria meningitidis bacteria, whose side effects include fever, headache, stiff neck, nausea, vomiting, sensitivity to light and confusion. Thyroid stimulating hormone (TSH) test Who: Those 35 or older When: Once every five years if thyroid is functioning normally “A high TSH level indicates that the thyroid gland is failing because of a problem that is directly affecting the

thyroid (primary hypothyroidism). The opposite situation, in which the TSH level is low, usually indicates that the person has an overactive thyroid that is producing too much thyroid hormone (hyperthyroidism),” according to the American Thyroid Association’s website. Mammogram Who: Women When: Annually starting at 40 About 1-in-8 women will develop breast cancer in their lifetime and mammograms are the best screening test to look for any unusual growth in a woman’s breast tissue. For women who have a history of breast cancer, especially types with a genetic component, their doctor may suggest earlier screening. But for most women, breast cancer is less likely to develop in their younger years so starting at age 40 is recommended. Recommendations for mammograms have been in debate recently, and Howell said it’s possible to go every-other-year on mammograms if the results are clean and a physician OKs it. Heart scan Who: Everyone When: Age 40 for men, 45 for women Heart disease is a leading killer of both men and women and can develop due to a variety of different health issues including high blood pressure, high cholesterol, obesity, smoking or diabetes. A heart scan can be a lowcost, quick test that will give doctors an idea of your heart health early before you’re at serious risk of cardiac problems. Parkview offers scans for $50 and the test takes about 15-20 minutes, making it an easy test you can do, Parkview Noble community relations specialist Julie Buttgen said. Blood sugar screening Who: Everyone When: Every three years, starting at 45 Diabetes can be one of the most expensive and problematic chronic diseases for people, so keeping an eye on blood sugar levels is an easy way to monitor for the condition. For people who don’t have early warning signs,

the Mayo Clinic suggests getting an initial blood sugar screen done at 45, then follow up every three years. Getting an A1C test annually can be a way to really stay ahead of diabetes, since physicians can identify if you’re entering a “prediabetic” stage and help you make adjustments before the condition worsens. “You can be prediabetic and a lot of times you can reverse that before going into full diabetes,” Howell said. Prostate exam Who: Men When: Annually starting at 50 The American Cancer Society recommends that men at average risk of prostate cancer should get a digital rectal exam starting at age 50 to begin checking for prostate issues. Men with a history of prostate cancer in their family may want to start earlier, at 40 or 45. This test is a good way to notice any problems early and men can also get a blood test to help identify any issues. “With the prostate screens, it’s really important to have those things done. It can be caught early and if there’s an issue it can be taken care of. We’re saving lives with prostate cancer,” Howell said. Colonoscopy Who: Everyone When: Every 10 years starting at 50 A colonoscopy helps doctors view the entire colon and locate polyps, growths of cells in the colon that are usually harmless but can be a precursor to cancerous growths. Colorectal cancer is a slow-growing cancer, so patients can take a long break in between tests if results come back normal. At this age, though, doctors are likely to suggest other screening procedures in the meanwhile including a fecal blood test annually and possible other screenings like a barium enema or flexible sigmoidoscopy procedure, which looks only at the rectum and lower colon, on a five-year basis. After the results of your first colonoscopy, it’s best to discuss the results with your doctor and determine a schedule going forward, Howell said. — Steve Garbacz and Megan Knowles


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April 14, 2018


Screenings for seniors


Doctors recommend certain tests, vaccines for those 50 and older

o keep people healthy well into their golden years, doctors recommend certain screenings and immunizations to help keep an eye on common concerns for seniors. For example, once a person reaches 50 years old, Parkview Noble Hospital recommends bone density screenings. Bone density screenings can detect osteoporosis and the risk of a person breaking a bone, according to information from the Mayo Clinic. “A bone density test uses X-rays to measure how many grams of calcium and other bone minerals are packed into a segment of bone,” the Mayo Clinic’s website states. “The bones that are most commonly tested are in the spine, hip and sometimes the forearm.”

In addition, daily stretching and flexibility exercises are suggested to help maintain balance, flexibility and core strength, Cameron Hospital Exercise Physiologist Amy Krebs said (see more on this in our story on exercise on Page 5). Zoster, or shingles, vaccines are also recommended for those 50 and older whether or not they’ve had varicella, commonly known as chickenpox, according to the CDC. Shingles is a painful rash that can cause blisters and long-lasting pain in some people. In addition, pneumococcal immunizations are advised for those 65 and older, according to the Centers for Disease Control and Prevention. Pneumococcal disease can cause

several types of illnesses, including ear infections and meningitis, according to the CDC. Once seniors reach their 70s, a fall assessment is also recommended by Parkview Noble Hospital. One in four “older adults” reported a fall in 2014, totaling 29 million, according to information from the CDC’s Stopping Elderly Accidents, Deaths and Injuries (STEADI) initiative’s website. The CDC recommends three steps to help prevent falls. The first step, screen, involves asking about falls in the past year, if the person feels unsteady while standing or walking and if the person worries about falling. The review step looks at medications that may contribute to a fall, and the

recommend stage encourages taking vitamin D “for improved bone, muscle and nerve health.” Regardless of a person’s age, DeKalb Health Chief Medical Officer Dr. James Ingram advised people to focus on their lifestyle decisions that may be affecting their health, including diet, exercise, “not having bad habits and not doing dangerous things,” he said. Ingram said it is never too late to begin to follow a healthy lifestyle. “People just have to start where they are and make a good habit change, then another good habit and then another good habit and then over time they can see some incredible transformations,” Ingram said. — Megan Knowles

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April 14, 2018

Exercise essential as we age

Healthy Living



s we age, exercise remains an important part of a healthy lifestyle. “Aerobic exercise is going to be an important part of getting older,” Cameron Health Exercise Physiologist Amy Krebs said. These exercises include activities like swimming, biking, jogging — anything that gets the heart pumping. “I like to promote these at any age,” Krebs said. While there are many kinds of exercises available, the key is to pick an exercise a person enjoys to increase the likelihood they will continue with it. “I think the motivation for exercise should be to have better health, not necessarily to lose weight. It should be to have fun, enjoy our bodies and better health,” DeKalb Health Chief Medical Officer Dr. James Ingram said. To keep up consistently getting aerobic exercise, Krebs recommended keeping it fun and exercising at the same time each day “to increase compliancy.” As people age, another important factor in considering any exercise is whether it can be done

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exercise/ safely, Ingram said. “As you age it’s not only a question of interest but functional ability,” he said. This includes weight training, which is important as we age as well. If a person is too sedentary, he or she will lose muscle mass. “That becomes a critical problem in retirement when people fall down. If they don’t break a bone, then sometimes they can’t get off the floor to take care of themselves. … There’s a real need to have enough strength to get off the floor so you can take care of yourself, you can cloth yourself, bath yourself, clean your house. So as people age they do need to engage in some form of exercise so they can maintain their strength and their ability to be independent,” Ingram said. Both Ingram and Krebs said as people age they may find they need to do fewer reps with lower weight than they once did to keep from injuring themselves. “A lot of people try to get out of their comfort zone, but you need to stay within a comfort zone to help protect yourself,” Krebs said. “(Go) slow and steady and then increase the intensity as tolerated.”

Stretching before exercising also becomes more important as we age to prevent injury, Krebs said. An especially important area to keep strong is one’s core, Krebs said. Some popular, low-impact exercises for doing this, as well as maintaining important balance and flexibility, are Pilates, yoga and tai chi. Husband-wife duo Greg and Cathy Vick teach tai chi and yoga, respectively, at various locations around DeKalb County. They say both exercises are popular for their relaxed atmosphere. In both tai chi and yoga “there’s no pressure to perform,” Cathy Vick said. “You do what your body can do that day, so if you’re not as flexible one day that’s OK, you just go as far as you can go.” That being said, both exercises do focus on core strength, as well as flexibility and balance. In fact, Greg Vick said he will sometimes focus on walking on snow and ice during his classes in the winter and spring months. “We show them, give them ideas on how best to maintain balance in those situations,” he said. “There’s a lot of research that tai chi

is helpful in that area,” he added. “Of course you’re going to improve your core strength, balance abilities, leg strength through (tai chi and) yoga as well.” Both tai chi and yoga – as well as activities like walking, jogging and running – are weight-bearing exercises, which are especially important for women as they age, Ingram said. “That’s a critical problem for women as they age because the lack of estrogen causes them to lose bone,” he said. One other benefit of exercise can be the social aspect – whether playing tennis with friends or participating in an exercise class. “That’s part of getting out and exercising, especially as we age, being in that community of people who you can interact with,” Cathy Vick said. “I think it’s social, because when we feel good we want to get out and do things with other people, but it’s also deciding the quality of life that you want to have as well. “I think that staying active and moving in one way or another can only benefit you on many levels.” — Megan Knowles

Dave Kurtz

Greg Vick demonstrates some tai chi poses at Metro Creative Services his studio, the Changing Dragon, in Auburn.

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April 14, 2018


a key facto r a g r Su

in w eig h


Though metabolism may change as we age, diets and activity are more likely to account for fluctuation in weight. Our bodies use a certain amount of the calories we consume for involuntary activities such as our heartbeat, brain function and digestion. This level is called the basal metabolic rate (BMR) and depends on numerous factors, one of them being muscle mass. Muscles require more calories than fat to sustain themselves. In addition to the BMR, a person burns more calories by being active. Active children naturally burn calories as they play, while sedentary adults with decreasing muscle mass do not. But this is only part of the story as to why we might gain weight as we age.


Healthy Living


as we age

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We all have something at stake when it comes to water, and everyone shares responsibility for it. We need to be unified in our efforts to keep our water clean and healthy. Turning on the tap or flushing the toilet is as simple as turning a knob or pushing a handle. What you don’t see is the vast infrastructure - 800,000 miles of water pipe and 600,000 miles of sewer line - that takes over from there. Every community is literally built on top of this infrastructure and wouldn’t be possible without it. These systems have worked silently for years, in some cases more than a century, without major interruptions, but now they need your attention. Your investment is needed to keep infrastructure functional for current and future generations.

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• The United States has a remarkable infrastructure system that has silently and reliably provided safe drinking water, wastewater collection and treatment, and stormwater and floodwater management for many years. • Much of the U.S. water infrastructure was built nearly a century ago. It is aging and crumbling at a significant rate but investment is lagging and we are fast approaching a critical point. In some cases, our pipes and plants are literally falling apart. • The U.S. Government Accountability Office estimates that water and wastewater utilities are not generating enough revenue from user rates to cover the full cost of their service. As a result, we are starting to experience the effects of chronically postponed maintenance from funding shortfalls. • U.S. cities are spending more dollars on water and wastewater each year, but the investment needs far outweigh local governments’ abilities to keep up with aging infrastructure. Americans will likely face increased service disruptions, increased water main breaks, and greater impacts on local economies and threats to public health. This message is brought to you by…

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Why should you care about water?

Our communities and our lives are built on water. In addition to protecting our health and the environment, we need clean water for a healthy and growing economy. Clean water and wastewater services support a $50 billion per year recreation industry, $300 billion in coastal tourism, $45 billion in commercial fishing and shell fishing industries and hundreds of billions of dollars a year in basic manufacturing. Without water, we don’t have a future.

• Don’t take water for granted. The water we have now is all that we will ever have. Use it wisely. • Think before you flush. Everything you send down the pipe ends up at your local wastewater treatment plant. We are all part of the water cycle. We all live downstream. • Educate yourself. Take a tour of your local water and wastewater treatment plant to learn what happens to the water that you drink and use. • Read and understand your water and wastewater bill. • Stay informed about the water quality issues facing your community by contacting your local municipality and attending public meetings.

You need water. Water needs you.

Indispensable to jobs, the economy, our health and our communities, water runs through out lives in many ways, Everyone uses water and everyone is responsible for it. We must all work together to keep our water clean and healthy. To do that, we each need to learn to value water.

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April 14, 2018

More than 2 of 3 of Americans are overweight or obese, DeKalb Health Chief Medical Officer Dr. James Ingram said. That number began increasing around 1980, he said. “One of the reasons is portion sizes are larger than they used to be. The total amount of energy we consume has gone up,” Ingram said. When we consume more calories than we burn through BMR and activity, the extra is stored in the body. But Ingram believes there is even more to the story. “During that time we’ve seen a lot of sugar added into foods,” he said. “Sugar is uniquely fattening and it makes everything taste good. It doesn’t satisfy us and we want more and more and it also creates a hormonal response in that it increases insulin. Insulin is a hormone that lowers sugar but it also creates fat so when you have a (carbohydrate)-heavy diet you have a need for a lot more insulin to control the sugar but it also stores fat in the process.” One of the effects of insulin is to

decrease fat burning and increase fat storage, Ingram said. When the body detects sugar it assumes nutrition is plentiful, so it stores some for the future when there might be food scarcity — a rarity for most Americans. “When you eat food that’s more fat and protein heavy you don’t produce the insulin response, you don’t create as much fat tissue, you don’t store as many of those calories,” Ingram said. In addition, fat and protein make us feel full, thus reducing our calorie intake, he said. “If we can reduce added sugar in the diet then that’s the critical thing,” Ingram said. He advised people to be savvy consumers, removing as much processed food as possible and reading labels. Ingram advised to be mindful of “euphemisms” for sugar — such as honey, agave or extract — and low-fat products. “If you take away the fat you have to add sugar or salt to make it taste good, usually both,” he said. — Megan Knowles

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a day in the life/ Running provides Ingram health benefits, time with family

Photo contributed

DeKalb Health Chief Medical Officer Dr. James Ingram, left, poses for a picture with his wife, Laura, after they had finished a half-marathon in Kona, Hawaii. The photo was after Metrotaken Creative Services Ingram’s father-in-law finished the marathon.

Tired of living with aches and pains, DeKalb Health Chief Medical Officer Dr. James Ingram decided to change his lifestyle and is now working toward running his first marathon. In 2015 Ingram weighed about 180 pounds. “I was as heavy as I’d ever been,” he said. While he tried to follow a lowfat diet with “plenty of vegetables,” he said he did have a bit of a sweet tooth and hadn’t been exercising. “I enjoy sugar and dessert and so I never passed Starbucks without getting a white mocha,” Ingram said. “If I didn’t like the cafeteria food for the day I’d get a chocolate chip cookie with M&M’s in it. If that didn’t fill me up, I’d have another one. So over a long period of time I slowly

gained more and more and more and more weight.” Ingram had enjoyed running at one point, but a pinched nerve in his foot required surgery. That, coupled with work, family and missionary work commitments, further put exercising on the back burner. “So I ‘didn’t have time,’” he said. “I felt like I was too busy… (that) there’s no way I can go out and run.” Ingram said he developed pains in his legs, ribs and back from injuries sustained when he was younger. “There were times when I was pretty sore and tired at the end of the day just seeing patients,” he said. “I just knew I (had) to do something to change my life. “I started out slow, started out walking and then, when that

started feeling better, started jogging slow and just gradually increased the distance more and more.” Ingram said family support has been a great help in his fitness journey, as his father-in-law and wife are runners. “I had the added benefit of the more I ran the more I got to hang out with my wife and do things together,” he said. “I’m now running about 25-30 miles a week and I’m going to run 16 miles on Saturday.” But the transition from running to training for a marathon wasn’t a seamless one. Ingram signed up for three half-marathons in 2016, but he was unable to run in two due to leg cramping. During one in Hawaii, he cramped at the fourth mile, but decided to run the remaining

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Healthy Living


a day in the life/ nine miles of the race. “It was very painful, but I finished,” he said. Ingram rested that fall and winter when he learned about magnesium supplementation to help with cramps. The next spring, he again signed up for three half-marathons. “A year (after the Hawaii half-marathon) when we were running the next half-marathon it felt really great and then I ran slower than I could have because I didn’t want to cramp and then a month later I ran a second half and I ran a little faster and then a month after that I ran another one and I ran a little faster and I was much more confident and I just went as fast as I could,” he said.

His fastest time so far came March 31 in the Carmel Half Marathon, where he ran in a time of 1:49:28. “I’m still a middle-of-the-pack runner for guys. I’m definitely not fast, but it felt great to be able to do that consistently,” he said. Ingram continued to run through the fall and winter, then decided to take on a full marathon. “In the midst of all this running I got the idea that it would be fun to do a marathon and I thought, where should I go, where should I do it?” he said. Ingram went to high school in Amelia, a suburb of Cincinnati, and was being raised by an aunt after both his parents had passed away. That aunt, Mary Jo, passed away several years ago.

Cincinnati is home of the Flying Pig Marathon, which Ingram said includes a 4- or 5-mile run from the river up a hill. “I was scared to sign up for that one but then I thought I’d do it in memory of my aunt Mary Jo,” he said. Ingram got an additional surprise when he discovered his high school friend and the best man at his wedding was also interested in running the Flying Pig. “We haven’t seen each other in a long time so we’re looking forward to being able to hang out that weekend and run together,” Ingram said. For Ingram, running isn’t about getting the fastest time or losing weight, although he has lost 25 pounds since

2015. “I’m just hoping to be able to finish (the Flying Pig) because it’s going to be a very long way and it’s going to be a hard course,” he said. “I’m very determined and proud and committed so I wanted to complete that challenge and conquer that.” Mostly, however, Ingram runs for his health. “I don’t want to go back to how I felt before,” he said. “When we’re teenagers we exercise to impress girls, but when we’re 50 we exercise to stay alive and stay healthy so that’s my goal now. I want to be an old grandpa, I want to have lots of grandchildren and run around with them.” — Megan Knowles

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Healthy Living Spring 2018  
Healthy Living Spring 2018