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Goss is a true believer after tracheotomy procedure

BY GREG WILLIAMS Sentinel reporter gwilliams@lewistownsentinel.com

LEWISTOWN – If the third time is the proverbial charm, Carol Goss is a true believer.

Carol, who moved to Lewistown in 1975 with husband Bill, a well-known and respected dentist in Mifflin County for decades, suffered from uncomfortable levels of wheezing, coughing and shortness of breath for more than a decade.

Starting in 2011, Carol was subjected to a variety of tests and scans to no avail until a CAT Scan of her neck in 2023 revealed she was suffering from tracheal stenosis.

“This is the tube located alongside the esophagus through which air enters our lungs,” Carol explained. “As I looked up info on tracheal stenosis, my clinical symptoms seemed to be textbook perfect.”

Carol found herself frequently coughing to clear her throat, wheezing and loud breathing, shortness of breath and overall hoarseness.

“Although I was told that I needed to be seen by an ENT doctor, no specific provider’s name was suggested to me,” Carol said. “So, I advocated for myself.”

Carol randomly selected an ENT provider and scheduled an appointment with Dr. Jennifer Rager.

“I really anticipated this appointment; I needed a diagnosis,” she added.

“I prayed and kept God’s scripture verses up close and personal to me – in my mind and in my heart.”

In mid-June – after seven weeks of anxiously waiting – Carol finally had her appointment with a physician assistant in Selinsgrove. Almost immediately, she felt like she was in good hands as the physician assistant seemed very knowledge-

while she waited. By nightfall, she had several IVs and could not eat or drink. The next day she finally learned her surgery was to take place.

However, she waited and waited for the operating room nurse, who told Carol that her name was still not on the schedule. A surgeon – Dr. Kevin Kovatch – came to her room and said he didn’t want to perform a tracheotomy but had a different plan to insert a balloon into her trachea, or windpipe, and remove the scar tissue.

low my vocal cords. He explained how he had removed the scar tissue. He remarked that two times I had held my breath for six to eight minutes. Normal is only 45 seconds. Therefore, my lungs had grown accustomed to the lack of air and had accommodated their job accordingly.”

Except for a lack of sleep, Carol felt really well and was discharged the next afternoon.

able and professional. After scoping Carol’s throat and larynx, live pictures revealed that her trachea was only open about a quarter of what it should have been.

The physician assistant brought in a local doctor from Selinsgrove, who suggested Carol go the Emergency Room for an immediate tracheotomy. “She held

our hands and prayed with Bill and I,” Carol recalled. “Her prayer felt so good, so right. We knew we had chosen a good doctor.”

The Gosses drove to Geisinger Medical Center in Danville for the tracheotomy, but Carol had to wait for the operating room to have an opening.

Hours seemed like days

An hour later, she was in surgery having the procedure done. Shortly thereafter, Carol found herself back in her room. The wheezing had stopped as had her shortness of breath. “I was alert and I felt good,” said Carol, who only suffered a minor sore throat.

“The surgeon said that my lungs and O2 levels were healthy,” she added.

“The area of repair was be-

Doctors warned Carol that if the wheezing returns in the future that she will need to undergo the balloon procedure again. It might need to be redone every two to three years.

Currently, Carol is under the care of Catherine Michaels, a physician assistant-certified from Geisinger Reedsville Medical Clinic. Her daughter, Brandi Peachey, is employed as a nurse practitioner at Geisinger’s pediatrics critical care unit in Danville.

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Photo courtesy of GEISINGER

Carol Goss (left), of Lewistown, with her daughter, Brandi Peachey, at the Juniata Valley YMCA.

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Matchmaker

Continued from Page 4

as a CAN in 2019. Like Morrison, she has also worked throughout the Haven, but she primarily serves in Memory Lane. “My grandmother worked here for 20 years as a CNA.”

When Hill started out in her job, she had no idea that she would soon be adding another reason why she would like Valley View so much.

A few months later, Hill started orientation in Peaceful Avenue where Morrison worked, and they struck up a friendship and exchanged numbers. Soon, they were meeting after work for mini dates, which eventually turned into something more serious.

By May 2020, the two were officially dating, a development which certainly delighted many residents.

“They are very interested in our relationship,” Hill said. Over the past four years, residents notice when they are working in the same neighborhood together.

“Our co-workers call us the Dream Team,” Morrison added. Residents seem to agree.

“It’s a great feeling knowing that not only our coworkers, but the residents say things like ‘The Dream Team is with us tonight,’” Hill said.

Both of them also started classes toward becoming a Registered Nurse. Nick has taken general education classes at Harrisburg Area Community College for the past three years, while Olivia will start at the Geisinger School of Nursing in August. When she graduates, Nick will finish his degree.

“I knew that nursing was always the career that I wanted, and I wanted my experience as a nurse to be in a place that has such a good name,” Hill said.

She said that the best part of her job is the bond that she makes with residents. “I love each and every one of them like my own family. I love that I get to make them laugh and ask them about their life stories as well. But my favorite part of all is seeing how much of an impact I’ve made on them and their

lives at Valley View. Seeing myself through their eyes makes me realize how great I would be as a nurse, and it has solidified even more why I’ve chosen this career path.”

Nick agreed, saying, “Being there for the residents has given me a feeling of worth and belonging. I’ve thrived here and loved every single second of the eight years I’ve spent here.”

Last past August, Hill and Morrison got engaged. They are not sure which year they will get married, but they know the date. It will be May 25, which is the day they started officially dating.

Residents and co-workers are trying to convince Hill and Morrison to get married in Valley View’s chapel. And while they haven’t decided on the location, they both credit their lives together to one thing.

“I’m grateful that I have gotten to work here and meet Nick and such wonderful people here,” Hill said.

Morrison added, “I love this place. I do.” The same two words he will say for his upcoming nuptials.

Or nd a niche for a loved one. e price for a columbarium and urn is $1,000. If interested, contact the church o ce at 717-248-8327. We are St. Mark’s Episcopal Church 21 South Main Street Lewistown, PA All are welcome

Photo courtesy of VALLEY VIEW RETIREMENT COMMUNITY

Nick Morrison (left) shakes hands with Jim Hoover, a resident at Valley View Retirement Community in Belleville, as Olivia Hill looks on.

Apnea

Continued from Page 7

When your airway is obstructed, oxygen levels drop, carbon dioxide levels rise and blood vessels dilate. This combination can cause morning headaches. And waking up with a dry throat and mouth or a severely sore throat are signs of sleep apnea, too.

There are 2 major types of sleep apnea: obstructive and central.

The most common of the 2 types, obstructive sleep apnea, is caused by a complete or partial blockage of the airway. It occurs when your throat muscles relax or collapse and block the flow of air into the lungs.

Risk factors include being male, over 40 or overweight, and having a large neck and tonsils. People with gastroesophageal reflux (GERD), a family history of sleep apnea and nasal obstruction are also at risk. Ethnicity can play a role, too.

Central sleep apnea occurs when your brain doesn’t transmit the proper signals to your breathing muscles. Those who are using certain opiate medications or who have had heart failure or a stroke are at risk.

Loud snoring and disrupted sleep can leave you tired

and irritable the next day, but the effects of depriving the body of oxygen numerous times throughout the night can run much deeper.

Recognizing the type of sleep apnea and getting the proper treatment is very important. Otherwise, it can lead to a range of serious health problems and even traffic accidents. Untreated sleep apnea is also a major cause of hospital readmissions, including for diseases such as COPD.

Resulting health problems include:

Heart failure

Arrhythmia, such as atrial fibrillation

Heart attack

Stroke

High blood pressure

Type 2 diabetes

Headaches or migraines

Cognitive and memory issues

Mood changes, such as depression or irritability

Your treatment options will vary depending on how severe your symptoms are and the type of sleep apnea you have.

For mild cases (breathing stops up to 15 times per hour), lifestyle changes, such as weight loss, limiting alcohol and quitting smoking, changing sleep positions and practicing good sleep habits may resolve it. If these methods don’t

work or you have a moderate (breathing stops between 15 and 30 times per hour) to severe case (more than 30 times per hour), other interventions may be necessary.

CPAP (continuous positive airway pressure)

A CPAP breathing machine delivers a steady stream of air through a mask worn over the nose or mouth to keep the windpipe open when you sleep. It’s the most effective form of treatment for obstructive sleep apnea.

Alternate treatments, such as dental devices worn during sleep to reposition the tongue and jaw, as well as nasal devices, have shown variable success.

Some people find a CPAP machine uncomfortable or might still have symptoms. There are many reasons for this, including having a more complicated breathing problem than obstructive sleep apnea. That’s why you need to follow up with your sleep physician for regular monitoring if you’re on a CPAP. Advanced technology allows sleep physicians to track your breathing using an internet-based system while you’re using the CPAP at home.

Luckily, many other treatment options exist for obstructive and central sleep apnea. Tell your sleep pro-

vider if you have difficulties with CPAP so they can find a better approach for you.

Surgery

Surgical therapies to treat sleep apnea have traditionally included tonsillectomies and other tissue-removing surgeries that open the nasal or throat passages.

A newer means of treating obstructive sleep apnea is an implantable pacemaker device called hypoglossal nerve stimulation, or the Inspire® device. It works by delivering mild electrical stimulation to the hypoglossal nerve, which forces the tongue forward to keep it in a position that doesn’t block the airway.

For central sleep apnea, there’s a similar implantable pacemaker-type apparatus called phrenic nerve pacing, or the Remed® System. It

works by stimulating the phrenic nerve, which causes the diaphragm to contract, mimicking natural breathing and stabilizing gas exchange during sleep.

Weight-loss medication

Weight loss can be an effective treatment for obstructive sleep apnea, particularly for overweight and obese patients, by significantly reducing symptoms and severity. Zepbound®, a weight-loss drug, has recently been approved by the U.S. Food and Drug Administration to treat moderate to severe obstructive sleep apnea. Compared to other sleep apnea treatments, Zepbound addresses the underlying obesity, a major risk factor for sleep apnea.

A multi-pronged approach

Given the advances in sleep medicine, managing sleep apnea and sleep disorders has become a multidisciplinary process. After your initial visit with a sleep specialist, you may be referred for ENT (ear, nose and throat) surgery, oral maxillofacial surgery or psychological treatment to improve your sleep health — which should lead to better health overall.

Work with your sleep provider to determine the right therapy for you. Effective sleep apnea treatment can help you feel more alert, rested and improve your overall health. Why put up with another night of snoring? Everyone deserves a good night’s sleep.

For more health and wellness tops, visit Geisinger. org/balance.

LEE J. BOHN - SUPERVISOR

IRA contribution mistakes you should avoid

BY CHRISTINE BENZ Morningstar

From contributions to conversions to distributions, don’t fall into these traps when managing your IRA.

Waiting until the 11th hour to contribute

Investors have until their tax-filing deadline—usually April 15—to make an IRA contribution if they want it to count for the year prior.

Many investors squeak in their contributions right before the deadline rather than investing when they’re first eligible (Jan. 1 of the year before). Those last-minute contributions have less time to compound, and that can add up.

Assuming Roth IRA contributions are best

Funding a Roth instead of a traditional IRA may not always be the right answer.

For investors who can deduct their traditional IRA contribution on their taxes, and who haven’t yet saved much for retirement, a traditional deductible IRA maybe better. That’s because their in-retirement tax rate is apt to be lower than it is when they make the contribution.

Thinking of IRA contributions as an either/or decision

Deciding whether to contribute to a Roth or traditional IRA depends on your tax bracket today versus where it will be in retirement.

If you have no idea and your income allows you to make a deductible IRA contribution, it’s reasonable to split the difference and invest half in each.

Avoid traps when managing your IRA.

Making a nondeductible IRA contribution for the long haul

If you earn too much to contribute to a Roth IRA, you also earn too much to make a traditional IRA contribution that’s tax-deductible.

The only option open to taxpayers at all income levels is a traditional nondeductible IRA, but this subjects investors to two big drawbacks: required minimum distributions (RMDs) and ordinary income tax on withdrawals.

Assuming a backdoor Roth IRA will be tax-free

The backdoor Roth IRA should be a tax-free or nearly tax-free maneuver in many instances

But for investors with substantial traditional IRA assets that have never been taxed, the maneuver may be partially taxable, thanks to “ the pro rata rule.”

Assuming a backdoor Roth IRA is off-limits

Investors with substantial traditional IRA assets

that have never been taxed shouldn’t automatically rule out the backdoor IRA idea, however.

If they have the opportunity to roll their IRA into their employer’s 401(k), they can effectively remove those 401(k) assets from the calculation used to determine whether their backdoor IRA is taxable.

Not contributing to an IRA later in life

Making Roth IRA contributions later in life can be attractive for investors who plan to pass the money on to their heirs, who in turn will be able to take tax-free withdrawals. After all, Roth IRAs don’t impose RMDs. Traditional IRA contributions will tend to be less attractive for older adults because they do.

Delaying IRA contributions because of shortterm considerations Investors might put off making IRA contributions, assuming they’ll be tying their money up until retirement. Not necessarily.

complicated if your money is in a Roth because you converted traditional IRA assets.

So, get some tax advice if you need to pull money out of a Roth IRA shortly after depositing it.

Doubling up on tax shelters in an IRA

It also makes sense to avoid any investment type that offers tax-sheltering fea-

tures itself. That’s because you’re usually paying some toll for those tax-saving features, which you don’t need because the money is inside of an IRA.

This article was provided to The Associated Press by Morningstar. For more personal finance content, go to https://www.morningstar. com/personal-finance.

Roth IRA contributions can be withdrawn at any time and for any reason without taxes or penalty, and investors may withdraw the investment-earnings component of their IRA money without taxes and/or penalty under specific circumstances.

Running afoul of the Roth IRA five-year rule

All investors must satisfy the “ five-year rule,” meaning that the assets must be in the Roth for five years before they begin withdrawing them. And things get more

Torquato & Davis Law, LLC

AP Photo/Mark Lennihan

Tips to make a house or apartment safe and accessible for older adults living at home

The Associated Press

With a majority of Americans preferring to live in their own homes as long as possible, experts stress the importance of modifications to keep dwellings safe and accessible. Here’s a summary of tips from the National Institute on Aging and AARP, which offers a free room-by-room guide with practical suggestions for older adults living independently.

Entrance way

Have at least one exterior doorway with step-free access. If not possible, consider a ramp.

Add a bench in the foyer to sit on when removing shoes or to set down items while locking or unlocking

the door.

Bathroom

Install a walk-in shower with a bench and nonskid decals or mats to prevent falls.

Add a hand-held nozzle to the shower head to facilitate rinsing off while seated.

Install grab bars on the shower wall and near the toilet.

Put in a taller toilet or add a toiler riser.

Consider plugging in a nightlight.

Bedroom

If stairs are too difficult to manage, create a bedroom on the main level by transforming a den or an office. Make sure the bed is easy to get in and out of. Purchase bed risers, if needed. Invest in an adjustable

bed for extra comfort.

Kitchen

Purchase a stove with safety features that alert the resident when a burner is on or have automatic shut-offs.

Relocate major appliances to make them easier to reach.

Add slide-out drawers or trays to existing cabinets for better access.

Install a lever-style, lighttouch or sensor faucet, which is easier to use than a faucet with turn-style knobs or handles.

Furniture and rugs

Get rid of furniture and clutter to make rooms easier to move around in.

Replace chairs with armrests to make it easier to stand and sit.