COMPLIMENTARY MAR - APR 2011
T H E P R E M I E R M AG A Z I N E C E L E B R AT I N G T H E
P E O P L E & L I F E O F K E R R CO U N T Y
Kerrville Landscapingâ€™s Zack Derese and family How one man's vision is changing the landscape
People Kerr County
THE PREMIER MAGAZINE CELEBRATING THE
PEOPLE & LIFE OF KERR COUNTY
Dear Friends & Neighbors, Just as I'm excited to see new spring growth after winter, I love seeing friends begin new endeavors. Since starting Salada's a few years ago, the Varwigs have continued to expand and are now offering special occasion cakes. No doubt this will be very successful--I've tasted some of their delectable cakes and personally recommend them. So if you have a special occasion, don't settle for inferior "supermarket" cakes, made from whoknows-what. Stop by "Sweet Treats at Salada's" and ask Tori and Ada to help you design your personal cake. You'll be glad you did!
inside March - April â”‚ 2011
EVENTS 22 Engagements 24 Weddings 26 KACC Chocolate Fantasy
ARTIC LES 5 Palladium of Liberty 8 Raw Nature - The Art of Bill Zaner 10 Cover Story - Kerrville Landscaping 14 Enrich Your Life at the Dietert Center
14 Choosing Your Best Hair Color 16 The First Backyard Bird
Zack and Kara Derese with their children Garrett, Taya and Gavin
17 The Cost of Comfort
Photo by Scott Allen Boss Photos 210-602-1971
20 Menopause and Your Skin
18 Conserving Energy 19 Title Talk 30 Selling to Sell Again at Ken Stoepel Ford 32 Fight Cancer Naturally 33 Hospice Care 34 Surviving a Stroke 37 Home Health Care
Visit us online at kerrcountypeople.com Diane Ferrell Editor & Publisher firstname.lastname@example.org
830-285-0973 Mark A. Jackson Studio Rio Art Director email@example.com
Kerr County People PO Box 291402 Kerrville, TX 78029 KCP reserves the right to edit and/or refuse any submitted materials. The opinions expressed are those of the authors and do not necessarily reflect the opinion of KCP. Ads created for this magazine are copyrighted by Studio Rio and and may not to be used in other publications or print without permission . All Rights Reserved Copyright 2011 Kerr County People Magazine.
38 Peterson RMC Volunteers
D EPARTMENTS 6 The Arts 36 Women's Health
With High-Quality and Excellent Service. We Provide You the Best Selection. Roberts Auto Sales is a full service auto dealer in Kerrville Texas.
We make it simple to find your next vehicle. We offer in house financing and carry a wide range of vehicles to suit your needs. Stop by the showroom or visit us online at www.RobertsAuto.us
We Make It Simple!
830.257.0625 2410 Memorial Blvd, Kerrville, TX
Palladiums of Liberty: Jury Nullification
olitical safeguards intended to protect our individual liberty and freedoms are enshrined in our federal and state constitutions and in particular, enumerated in our state and federal bill of rights. Among these are the right to bear arms, to be free of unlawful search and seizure, and the right to trial by jury. All these palladiums of liberty are specifically intended to protect the individual from government tyranny. We should ask whether or not we enjoy the same unfettered right to trial by jury as our forefathers intended. The 6th and 14th amendments to the United States Constitution guarantee a trial by jury in criminal cases. What if the government passes an unjust law or attempts to enforce a law in an unjust manner? Can the jury nullify the law or refuse to apply the law in the manner presented by the government? Not likely, because in Texas the judge will instruct the jury that it can only decide the facts and that the jury cannot ignore the law nor the government’s application of the law to the facts. No matter how much the jury might disagree, the defense attorney will be prohibited from arguing for nullification. However, things may be about to change. Recently, the New Hampshire state legislature introduced and is considering a new bill, HB 146, (quoting from the bills analysis) “. . .in all criminal proceedings the court shall instruct the jury of its inherent right to judge the law as well as the facts and to nullify any and all actions they find to be unjust. The court is also mandated to permit the defendant or counsel for the defendant to explain this right of jury nullification to the jury.” The historical record immediately before and after passage of the bill of rights is disturbingly inconsistent with Texas’ current
by Doyle Weaver
judicial policy on jury nullification. President John Adams’ pre-constitution writings are quoted in the Supreme Court case Sparf v United States, 156 US 51, 143-44 saying “. . . it is not only his right (the jury), but his duty, in that case, to find the verdict according to his own best understanding, judgment, and conscience, though in direct opposition to the direction of the court.”
Our constitutional right to a jury trial has been turned on its head... From the same case, Sparf, Alexander Hamilton’s writings are quoted as arguing, “. . . That in criminal cases, the law and fact being always blended, the jury, for reasons of a political and peculiar nature is entrusted with the power of deciding both law and fact.” In 1781 and 1782, Thomas Jefferson wrote “These magistrates have jurisdiction both criminal and civil. If the question before them be a question of law only, they decide on it themselves: but if it be of fact, or of fact and law combined, it must be referred to a jury. In the later case, of a combination of the law and fact it is usual for the jurors to decide the fact, and to refer the law arising to the decision of the judges. But this division of the subject lies with their discretion only.”
defendant from government oppression by enabling juries to interject their “community consciousness.” Our constitutional right to a jury trial has been turned on its head as defendants are no longer entitled to argue for nullification of the law, for any reason. Nevertheless, the government is permitted to urge the jury to “send a message” by conviction. Apparently sending a “Jury” message is constitutionally protected only as long as the message is from the government, but not “to” the government. Doyle Weaver earned his JD from Regent University School of Law in 1990; was licensed to practice law in Virginia, 1991 and in Texas, 1997.
WEAVER LAW OFFICES Doyle Weaver Attorney At Law Licensed in Texas and Virginia
IRS Tax Collection Criminal Defense Personal Injury Civil Law Litigation Wills, Trusts & Estates
In 1794, the first U.S. Chief Justice, John Jay, instructed a jury in a civil case as follows (see State v Brialsford, 3 Dall. 1, 4): “For, as on the one hand, it is presumed, that juries are the best judges of facts; it is, on the other hand, presumable, that the court are the best judges of law. But still both objects are lawfully, within your power of decision.”
The intent of the 6th Amendment of the federal constitution is to protect the
843 Sidney Baker St., Suite 101 Kerrville, Texas 78028 KCP │ Mar-Apr 2011 │5
YOUTH PROGRAMS COMING
Youth Art Show April 7 - 24
Spring Break Youth Art Workshops March 14 - 18
Summer Youth Art Program July 11 - 29 KERR ARTS AND CULTURAL CENTER
Gallery Hours: Tues. - Sat. 10–4, Sun. 1–4 228 Earl Garrett - Downtown Kerrville 830-895-2911 www.kacckerrville.com
ARSENIC KING and Old Lace A Broadway Experience In Your Home Town ARTHUR CHRONICLES THE noises CRUCIBLE Much Ado About Nothing THE MUSIC MAN
830.896.9393 caillouxtheater.com Featuring Oil Paintings By
Bill Zaner Gallery - Framing - Printing 832 Water St. Kerrville, TX 830.895.5184 riversedgegallery.net firstname.lastname@example.org
April Tenth 30x24
Landscape Oils, Jewelr y and Other Original Ar tworks
the arts index
american indian jewelry & art • paintings • sculpture • pottery
Life is too short to wear ordinary jewelry—put color in your life… Gift Certiﬁcates & Lay-away
Wayne J. Este, Owner
american west handbags •
Because it just
feels good! Feeling the stresses of life? Escape life's hectic pace through the meditative quality of pottery-making. As you focus on molding the wet clay in your hands, you'll feel your stress fade away. Master potter Mark Jackson's past students have said, "If I'd realized how throwing clay would dissolve all the cares of the day, I would have signed up sooner!" Come join Mark's classes now and discover a whole new creative way to relax. New classes begin in April. Register now to reserve your potter's wheel.
Call The Hill Country Arts Foundation’s Visual Arts Department for details. 830-367-5120.
10 01 J U N C T I O N H W Y. AT I N N O F T H E H I L L S K E R R V I L L E • T E X A S • 2 5 7- 4 3 0 0
fine silver • gemstone jewelry
hat’s what artist Bill Zaner calls “God’s best work.” And Kerrville’s Rivers Edge Gallery on Water Street calls Zaner one of the most important painters they feature. Zaner earns that honor through his self-expressed goal to create fine, naturalistic paintings of American landscapes— especially Texas landscapes. Zaner’s artwork mirrors Texas in all its majesty—from the glorious Hill Country to the Gulf Coast, from the Panhandle to the Piney Woods, throughout the West Texas desert, including Big Bend National Park. His use of light is distinctive, offering glimpses into magical moments created by sun on live oak stands, flower-filled meadows, Guadalupegreen waters. He skillfully crafts depth and texture with oils on canvas, improvising from his made-on-location watercolor sketches. Zaner’s art has an organic appeal and encourages the viewer to ask, as he does when beginning a painting, “how am I a part of this landscape?”
24 x 48
Zaner intuitively understands passion; he sold his first painting at the age of 13, and 65 years later still manifests heart and spirit through his art. His works appear in many private and public collections, including Texas Artist Collection of Texas A&M University, Frost Bank Collection in San Antonio, Dow Chemical USA, Amoco, and Paragon Group. Bill Zaner’s plein air style conceives an authenticity that goes beyond realism, to naturalism, the result of years spent immersed in the grandeur of “raw nature.” See Zaner’s works, many sizes available and commissions accepted, at Rivers Edge Gallery, 832 Water Street, 830-895-5184. The Gallery also offers Zaner’s book, Landscapes of Texas! Words and Pictures. Hill Country November 6 x 16
8 │ KCP │ Mar-Apr 2011
Beneﬁting Meals on Wheels
You won’t want to miss ReRuns’ spectacular Tabletop Show to beneﬁt Dietert Center’s Meals on Wheels program! Offering themed tablescapes to delight your eye, tickle your imagination, with great home décor for purchase.
Friday, May 13th, 10 AM - 4 PM Saturday, May 14th, 9 AM - 1 PM River Side Grill, 451 Guadalupe Street, Kerrville, Texas Tickets are $10.62 (that’s the cost of preparing two Meals on Wheels dinners) and proceeds beneﬁt Meals on Wheels. Come support this essential program providing 57,000 meals a year, and enjoy the fun and refreshments as ReRuns and Dietert promise you a visual bonanza and great bargains.
Best Bargains with Beneﬁts! Funding services to help today's victims of abuse and neglect–preventing tomorrow's
Jewelry, Clothing, Furniture, Gifts, Housewares & More
Store & Donation Hours 9-5 Monday-Saturday
515 Hays, Kerrville, Texas
www.ReRunsResale.org KCP │ Mar-Apr 2011 │9
The Art Of Land by Skye Alexander
How one man's vision is changing the landscape. Here
in the Texas Hill Country,
we’re blessed with so much pleasant weather that our outdoor living environments are as important as our indoor ones. Now that spring is here, it’s time to evaluate your property and start planning ways to make it more comfortable, functional, and attractive. Whether you just add a few shrubs or install multi-tiered terraces, water features, meandering trails through shady groves, and a putting green, the planning stage is crucial. Zack Derese, owner of Kerrville Landscaping, Inc., believes, “Design is the first and most critical step in landscaping.” One of the first landscapers in Kerrville to use CAD-based computer technology, he says, “I take a lot of time planning and streamlining ideas on paper. That saves headaches later.”
from mowing lawns to winning awards
Zack and his his right-hand man, Mike Burroughs Jr. designing a new landscape. 10 │ │ KCP KCP │ │ Mar-Ap Mar-Apr2011 2011 10
While he was a student at Tivy, Zack mowed lawns to earn money and helped his dad, Joe Derese, with horticultural projects. Zack and Terry Massey (see story on page 30) often worked together, keeping Kerrville beautiful. When he graduated, Zack planned to pursue a career in real estate and got his license. Then in the early ’90s real estate sales slumped––but he still had plenty of lawn-care jobs and decided to make landscaping his full-time business. In 1998 he bought Kerrville Landscaping, and in 2000 moved the company to its present location: the green building at 512 Jefferson Street, Kerrville.
scaping “The landscaping was absolutely beautiful for the wedding!” says the pleased client, Candace Williams. Today, Kerrville Landscaping employs up to twenty-five people during the summer months and handles every phase of landscaping: design consultation, retaining walls, patios, custom rockwork, arbors, landscape lighting, irrigation systems, water features, plantings, and maintenance. In 2009, the company won two Texas Hill Country Tour of Homes Awards for best landscaping, one for the Hyde property at Comanche Trace and one for a Centurion Homes’ model home. Trevor Hyde, President and Director of Comanche Trace, praises Kerrville Landscaping, saying, “Jennifer and I were very pleased, from the budget to being timely, and the professional work that the staff preformed.”
You can’t drive around Kerr County without seeing the company’s work. Recently, they landscaped the KROC Center. Other clients include the Cailloux Foundation, UltraFit, Schreiner University, and Bank of the Hills. And every time you drive to the San Antonio Airport you pass the handsome palm trees and other plantings they installed at the entrance. Although Kerrville Landscaping works mainly in the Hill Country, they also do jobs all around Texas. Last year they even spruced up a mission in Brazil. (See Zack’s article in the September-October 2010 issue of Kerr County People.) However, because private residences make up the bulk of the company’s business, Zack explains, “Our biggest and nicest jobs won’t ever be seen by the public.”
large and small, we do it all Once the planning stage is complete, “get-‘er-done” Project Manager Mike Burroughs, Jr., crew leaders Alonzo Navarro, Jose Gonzales, and Silvino Segura, and the rest of Kerrville Landscaping’s staff shift into high gear. During the summer, the “green guys” usually have about half a dozen jobs going simultaneously. Alonzo manages the hardscaping (walls, patios, lighting, et cetera). Jose’s extensive background in golf course horticulture makes him a wizard at softscaping (plantings and irrigation). When the younger guys hit a snag and can’t figure out how to do something, Zack goes to his father, Joe, for advice. “If you’re searching for a company that’s all-round, talk to us,” says Mike. “We’re a good team. We do it all.” Last year the team undertook one of its biggest and most rewarding challenges: a ranch spanning several hilltops in Medina. The owners’ son planned to be married on a large deck built over one of the lakes on the property, and a tight deadline added to the demands of the job. (See Kerr County People’s July-August 2010 issue.) “The landscaping was absolutely beautiful for the wedding!” says the pleased client, Candace Williams. continued on page 28 KCP KCP │ │ Mar-Apr Mar-Apr 2011 2011 │11 │11
u tcolor F r e e � Cwith Alice
*Valid until April 31, 2011
(new clients only)
Open Mon-Sat, 9 till 7 Walk-ins welcome – Appointments Recommended
12 │ KCP │ Mar-Apr 2011
HAIR SPA & MORE kerrville 257-1311
100 Guadalupe Plaza, St. 100, (behind Jack-in-the-Box)
Enrich Your Life by Tina Woods
very day at the Dietert Center, vital connections enrich the lives of Kerr County’s ‘seasoned citizens’ and their families. You’ll find a vibrant atmosphere of enthusiasm, fun, and renewal.
Research shows that meaningful connections improve everyone’s quality of life. This is especially critical as the years add up. Aging well is what we all strive for and it can be achieved. Today’s older adults are active, vital and involved. They seek opportunities for growth and enrichment that empowers their intellect and independence. Our later years are a time for pursuing long-delayed dreams and exciting possibilities—and it all happens at the Dietert Center! In a recent survey of our participants, 90% of respondents stated the Center has had a positive impact on their lives; 75% see friends more often or make new friends, plus feel happier and more satisfied with their lives.
The Center’s programs include: • More than 40 exercise, wellness, educational and recreational activities. • Senior Nutrition which provides 80,000+ lunches annually, served in our dining room and “Meals On Wheels.” • Independent Living which helps less-active seniors through the “Take Five Club” caregiver respite service; information and referral; PAL emergency response systems; medical equipment lending and call reassurance services. • More than 300 volunteers who assist in every aspect of our operation, including running our thrift shop and travel programs. For more than 40 years, we’ve been making the adventure of aging better. Come join us! Tina Woods is the Dietert Center’s Executive Director. Contact her at (830) 792-4044, ext. 247, or visit the Center’s website: www. dietertcenter.org. The Dietert Center is a 501 (c) (3) non-profit organization located at 451 Guadalupe Street in Kerrville.
Our mission is to proactively support healthy aging by providing information, services, activities and rewarding volunteer opportunities that enhance the quality of life.
Choosing Your Best Hair Color by Katie Kleespies complement warm skin tones, while cool shades look great on cool skin. However, before choosing a color you must know which colors are warm and which are cool.
Know Your Skin Tone
So, how do you know if your skin is warm or cool? Here’s a quick trick to find out—get a piece of gold jewelry and a silver piece, hold each one against your skin and see which one stands out. If the gold stands out, then your skin tone is warm, if the silver one does, it’s cool. Another quick way is to check the color of your veins. If they’re on the greener side, you probably have warm skin; a bluish tinge indicates cool skin. Once you know your skin tone, the rest is easy. The general rule of thumb is that warm colors 14 │ KCP │ Mar-Apr 2011
Warm Colors for Warm Skin Tone
Warm skin is generally lighter with pale, peach or golden undertones. Women generally have a freckled complexion. The natural hair color for this skin tone is red, reddish or golden brown, deep brown, strawberry blond or natural golden blond. Hence, if you have warm skin, the best hair colors for you, apart from your natural hair color, is shades of copper, cinnamon, ginger, russet and strawberry red, etc. Red or copper highlights with rich base colors such as burgundy, dark golden brown, auburn or chestnut looks fabulous.
Cool Colors for Cool Skin Tone
Cool skin may be light or dark skin with pink or no undertones. There is a tint of blue under eyes. The complexion is pale or true olive. The natural hair color for this skin tone is bluish-black, dark brown, medium ash or golden blond. Apart form these natural colors, the hair colors that look great are burgundy, ruby, garnet, cherry or bordeaux. You can contrast these base colors with the highlights of wheat, honey or taupe. It is always better to stick to shades that are close to your natural hair color. Katie is a nail technician and hairdresser. Call Katie at 370-4945, the Tin Star Salon, 319 Earl Garrett, Kerrville. www.hairbykatiek.com.
INTRODUCING Joan Calabraese Dresses
WHAT'S NEW AT Still The Most Complete Children‛s Store in the Hill Country
More Ladies' Wear Than Ever!
NEW ARRIVALS Bobby Schandra Handbags
NEW IN STOCK Melissa & Doug Educational Toys Hundreds to choose from-starting at $5.99
Only A Sampling Of Our Many New Spring Arrivals! NEW DESIGNS Miss Me Jeans
from Napa Firelites
Focus Lifestyle Jeans
227 Earl Garrett • Kerrville, Texas • 830.896.1033 • Open 10-5 Mon-Sat KCP │ Mar-Apr 2011 │15
Bedding Plants • Fruit Trees • Vegetable Plants Organic Gardening Products
THE FIRST BACKYARD BIRD
Plant Haus 2
“We have everything you need!”
792-4444 528 Jefferson St., Kerrville
z i L h t i w l Trave is e r g r o u p s a r d n u f in s s p e c ia li z e
Scheduled Trips Branson, Missouri - June 12-18
7 days, 6 nights; $599 db. Includes Motor Coach, 6 nights lodging,10 meals, admission to 7 shows.
by Kevin & Linda Pillow
he purple martin is perhaps the first backyard bird in North America. Ornithologist Alexander Wilson observed martins nesting in gourds near Native American dwellings in the early 1800’s. It was known by the Native Americans that the martins would give an alarm call at the sign of danger and they drove off hawks, crows and vultures. There is no bird that is more universally loved than the purple martin. Their stunning dark purple color and cheerful calls and chirps as they circle and dive overhead are a delightful aspect to any yard. Folklore states that the martins devour great numbers of mosquitoes. In fact, they prefer much larger insects like dragonflies. Martins forage at heights above 100 feet, where large insects are found, but not many mosquitoes. Seems they might be more aesthetic than practical! Since they only eat flying insects, martins are, of course, migratory. In the Hill Country, we can count on their return in the early part of February—a sign that spring is near. If you already have a house up, it is recommended to have it open by February 1. Of course, you can always attract a colony throughout the nesting season. Being a landlord requires a small amount of work. You should purchase a home or gourds that are attached to a telescoping pole with a ground socket that will allow you to raise and lower the home for cleaning and monitoring. Your housing should be 10 to 15 feet above the ground. Martins prefer broad, open areas located within 100 feet of your home. One of the many attractions to the purple martin is that they return to the same place, to the same nesting colony and often to the same nest compartment. If you have a colony return, it means that you have everything they need to successfully raise their young. Once you have a colony of martins, you’ll understand why they are so loved in yards across the country. Happy Birding!
Tunica & Memphis - Sept 25-Oct 1
7 days, 6 nights; $475/person db. Includes Motor Coach, 6 nights lodging (4@ Casino Resort), 10 meals, guided tours, admission to Graceland and much more.
Call for details on these or any of our tours.
Liz Farris. Tour Director 830-285-1027 email@example.com
Kevin & Linda Pillow are the proud owners of Wilds Birds Unlimited Nature Shop located at 855 Junction Hwy in Kerrville. Each staﬀ member is a Certified Bird Feeding Specialist and can help you discover a refuge in your own backyard. 830-895-7393.
wbu.com/Kerrville. 16 │ KCP │ Mar-Apr 2011
by Regan Land
What is the Cost of Comfort?
How a proactive approach can save you money!
is finally here! It’s time to put away the winter coats, turn off the heaters, and open the windows to let some warm, fresh air enter our homes. It’s the perfect time to get some spring cleaning done inside the home, clean up outdoors in anticipation of the green grass and plant all the colorful flowers to help lighten things up. Well, spring is also the perfect time for preventative maintenance on your “out of sight, out of mind” air conditioning system. Preventative maintenance agreements (PMAs) are agreements between you and your heating, ventilation, and air conditioning (HVAC) contractor for scheduled inspections and maintenance on your HVAC system. PMAs are designed to maintain peak efficiency, prevent utility overpayment, avert system failures, and prolong the life of the system. The key word in PMA is preventative. PMAs are a great way of preparing your system for the upcoming season in a proactive approach—before system failure and prior to overpaying your utility company.
What’s the bottom line for you? Savings: According to the Department of Energy (DOE), an average 56% of your utility bill goes towards heating and air conditioning your home. If not maintained, the system will consume more energy the older it gets. Keeping the system maintained will save money in the long run. In fact, according to the Air Conditioning Contractors of America (ACCA), having your system maintained can save you up to 50% of electric consumption over the life of the system. In addition, most
contractors will also provide a discount on parts and services performed during the year.
Preventative Maintenance Agreements (PMAs) prolong the life of your HVAC system. Piece of Mind: Preventative maintenance will mean fewer system failures and longer life for your HVAC system. According to multiple studies, including one by the Arizona Public Service, as many as 82% of HVAC systems have an improper amount of refrigerant. This can lead to premature breakdown of the compressor and other components. Weak capacitors, burnt contactors, loose wire connections, etc., can all also lead to problems. You can rest easy knowing that all these potential problems are checked.
Continuity: Many contractors are often able to assign technicians to specific customers. That way, you get to see and know the same service technician, and he or she becomes more familiar with you and your equipment. So, keep this in mind: Just like changing the oil in your car every 3,000 miles will help prevent you from having to buy a $3,000 engine, having your HVAC system maintained twice a year can prevent thousands of dollars worth of repairs and hundreds of dollars in additional costs to your utility company. Regan Land was born and raised in Kerrville. He is the General Manager at Hardin Heating and Cooling where he helps customers get the most out of their indoor comfort system through energy audits, education, design, and repair. Regan holds a Texas HVAC Contractors license (TACLA27542E) and is a Certified Indoor Environmentalist (CIE). You can reach him at regan@ hardinheatingandcooling.com or (830) 7923993.You can also visit the website at www. HardinHeatingAndCooling.com.
Priority Service: Should a system failure occur during the heat of summer or cold of winter, PMA customers will generally receive priority service. KCP │ Mar-Apr 2011 │17
by Derek Meier & John Merritt
Where does one begin?
here are many reasons why people decide to start conserving energy. Some do it to save money, some to help save the planet. Regardless of why they decide to do it, the fact of the matter is they all have to figure out where to begin. With so many products and practices available to choose from, deciding where to begin is no easy chore! As experts in the residential energy conservation market, we at Meier Custom Built Homes can help you find a great place to start! With very few exceptions, we like to have our clients start their energy conservation practices by putting them in hot water— literally! On average, consumers spend 30% of their energy bill in one place…their water heater. Think about it…you can take your
monthly utility bill, divide it by three, and that number is (on average) what your water heater is costing you. So with that in mind, we offer a solar water heating system that reduces the 30% figure you come up with by up to (on average) 80%! Our systems are designed to be installed in both existing homes and in the new homes we design and build. They have a back-up system that ensures hot water regardless of sunshine, which means if you need hot water at night you will have it. And the best thing about it that is our systems are very affordable. So if you are wondering where to begin in regard to conserving energy in your home, give us a call and we will be happy to guide you through the process!
Shower Yourself in
with the hottest shower enclosure trends.
Custom Glass & Mirror Kerrville Showroom 3110 Junction Hwy
Meier Custom Built Homes is owned by Derek Meier whose family came to the Kerrville area in the mid-1800’s. John Merritt is the company’s Project Manager and between the two they have almost 50 years experience in the construction trade. As members of the National Association of Homebuilders, they are certified as Design and Build Professionals and also as Green Building Professionals to name just a few fields. 961 Water Street, Suite C, Kerrville. For more information visit them at www.meiercustombuilt.com or call 830.370.1558.
Hill Country Mexican Imports • Iron Works • Pottery Rustic Furniture • Western Decor Crosses • Jewelry
Shower Doors Mirrors Plate Glass Tub Enclosures Tabletops Windows Cabinet Glass
Bandera 830.460.7728 Boerne 830.249.2747 18 │ KCP │Mar-Apr 2011
John & Lynn Palmer
3951 Bandera Hwy
(between Kerrville & Camp Verde)
Title Talk by Diane Green
Common Consumer's Q&A
here is good news on the economic horizon. Signs are pointing to sustained improvement in the real estate market. December home sales were up 12% nationwide. Lawrence Yun, the National Association of Realtors chief economist, predicts that sales will continue to strengthen as job growth gains momentum and affordable housing conditions are present.When you are ready to buy or sell real estate, it helps to know what to expect. The following questions are often asked of title company professionals.
When can you tell me the amount of funds required to close? After receiving all loan documents and preparing the settlement statement, the title company will let you know the amount of funds you will need to close.
Can I give the title company a personal check? The title company requires you to bring “good funds” to closing. When the amount is $1500 or greater, good funds may include cash, wire transfers, cashier’s checks, certified checks, or teller’s checks. Uncertified funds, including personal checks, traveler’s checks, and money orders can be used when the amount due is less than $1500.
What will the escrow oﬃcer explain to me at my closing? Your escrow officer will explain loan documents along with other closing documents.The escrow officer will also provide you a copy of all documents you have signed.
Ta s t e Of Ol d M e x ico Bistro Style
When you dine at Francisco’s, whether inside or out, you are warmed to the soul. There’s a hint of history, a concoction of traditions going back for centuries. A Taste of Old Mexico in the Heart of Downtown Kerrville!
R E S T A U R A N T
Lunch 11 - 3 Mon - Sat Dinner 5:30 - 9 Thurs - Sat
201 Earl Garrett ● Kerrville ● 257-2995
y f s i t a s o t e r u S man ’s appetite! any
What will I need to take to the Title Company when I go in to sign my papers?
You will need to take good funds payable to your title company in the amount given by your escrow officer. Take a valid driver’s license, Texas ID card, valid passport, or Military ID as well.
When will I get my deed showing proof of ownership?
The deed is recorded when the transaction is funded by the lender.
Fresh Breads and More
It will take approximately 45 days from the funding date for the title company to mail the original signed, recorded deed, along with your owner’s title policy.
And yes, we still have the freshest salads!
Diane Green moved to Kerrville in 1972 with husband, Bob, and immediately began her title insurance career at Kerr County Abstract & Title Co. Diane and Bob enjoyed raising their children in the beautiful Texas Hill Country. Diane has spent 39 years in the title business and now owns Kerr County Abstract.To learn more, call 257-5151 or visit www.kerrtitle.com.
Sandwiches Baked Potatoes
Taco Bar Mon-Fri 7am - 3pm Sat-Sun 11am - 2pm
225 Earl Garrett Kerrville
KCP │ Mar-Apr 2011 │19
by Ode Young, MD and Kathy Dietert, RN, BSN
and your skin
It's a fact:
every woman will go through menopause, usually in her early to mid 50’s. In addition to triggering common symptoms such as hot flashes and mood swings, menopause can greatly affect your skin too, causing dryness, adult acne, and thin, translucent skin that’s less elastic.
excessively dry skin Drier than normal skin is a common symptom of menopause, due in part to estrogen decrease coupled with declining collagen production. Once hormone levels begin to dip, the oil glands are not stimulated as before, causing less oil to be produced and the skin becomes drier. the solution. In order to deliver moisture to the skin, it’s imperative to get rid of any dead surface skin cells, which can interfere with the absorption of your moisturizer. Regular exfoliation and prescription strength topicals, like retinoids and tretinoins, stimulate cell turnover. When selecting a moisturizer, make choose a cream that hydrates without clogging the pores. Look for ones that contain glycerin as well as hyaluronic acid to restore moisture. the power of hyaluronic acid. When it comes to replenishing moisture, hands down the best choice is hyaluronic acid, which is naturally produced by the body. Many skin care companies are incorporating hyaluronic acid into daily-use products. Topically, hyaluronic acid is unable to penetrate the epidermis, and can trap some moisture on the surface of the skin, but it must be combined with an oil, glycerin or another ingredient to be effective. Hyaluronic acid in injectible fillers has a large molecular weight and binds 1,000 times its weight in water. It is used to rejuvenate and smooth away unwanted wrinkles such as the smile lines or marionette lines.
Solutions that will help regain healther looking skin. wrinkles Dry skin and wrinkles go hand-in-hand. Since there is a decrease in estrogen and collagen production, which leads to dry and dehydrated skin, it’s no surprise that wrinkles begin to form, or get worse, around the time of menopause. When skin is dry, it thins out because collagen levels are depleted and there is less moisture to keep it plump. There is also loss of elastin and fat that causes them too. While there are different types of wrinkles—superficial ones that sit on the surface of the skin, and deep fold and wrinkles that are deeply etched in—each can be corrected. the solution for ﬁne lines. Wrinkles can be treated with hyaluronic acid fillers such as Juvederm, which delivers moisture directly into the wrinkle, plumping it up and smoothing the skin. A technique called volumetric enhancement, in which the tissue above the fold is injected with a filler to lift it, as well as injecting the filler directly into the fold itself. for mild to moderate wrinkles. Laser technology has come a long way. In particular, Sublative Rejuvenation offers a non-surgical option for improving the appearance of the skin. This treatment offers a unique combination of ablation and skin resurfacing, leading to wrinkle reduction, skin tightening and lifting with less down time. The procedure uses bi-polar radio frequency to penetrate through the skin, sending more energy beneath the surface of the skin, to significantly stimulate collagen, and even more importantly, elastin production, which gives the skin that snapback firmness.
translucent, thinning skin Once the skin is less able to retain moisture and produce an adequate amount
of skin-lubricating oil, the underlying fat layers begin to thin out. As facial fat starts to diminish, thinning of the skin can occur, which may cause it to take on a bluish tint and look translucent, thus calling attention to changes in the mid-face like dark circles and sunken cheeks. In addition, more mature skin tends to be pale, bruises more easily and may be more prone to allergic reactions and irritations. the solution. To address translucent and thinning skin, a retinoid should be used to help rebuild the skin’s thickness by stimulating collagen production. Sometimes your plastic surgeon may suggest fat transfer to areas of the face where the skin appears thinner and has lost fat and volume. Whatever your menopausal skin issues, there are products and treatments that can give you significantly younger, healthier looking skin.
Kathy Dietert, RN, BSN, has been a nurse for over thirty years with an extensive background in aesthetic medicine. Dr. Ode Young, MD, has been a physician for over twenty years with a concentration in aesthetic medicine for the past four and a half years. Kathy, Dr. Ode and their trained staﬀ provide a full range of aesthetic services at their state-of-theart and beautifully appointed spa, Bella Luz. 1411 Water Street, Kerrville. Call 792-3552 today to schedule your complimentary and completely confidential consultation.
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Engagement k Jessica Lea Tinsley & Michiel J. Bridges Mr. Jack Tinsley of Huntington, Texas and Ms. Laura Placker of Lufkin, Texas are pleased to announce the engagement of their
daughter, Jessica Lea Tinsley of Cypress to Michiel J. Bridges of Cypress, son of Mike and Yolanda Bridges of Hunt, Texas. The Bride-Elect is a 2003 graduate of Huntington High School. Jessica earned her Bachelor of Science Degree in Fashion Merchandising and a minor in Business from Stephen F. Austin Sate University in 2007. Jessica is currently an Analyst at Stage Stores in Houston, Texas. The Groom-Elect is a 1998 graduate of Ingram Tom Moore High School in Ingram, Texas. Michiel graduated in 2003 with a Bachelor of Arts in Business Administration with an emphasis in International Business from Benedictine College in Atchison, Kansas where he received a football scholarship. Michiel is currently employed as a Business Development manager at KTI-Technip, USA, Inc. in Houston, Texas. A beautiful outdoor wedding is planned for May 7, 2011 in Hunt, Texas at Mo-Ranch.
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KCP │ Mar-Apr 2011 │23
Love Parents of the Bride Rocky & Teri Hawkins
A Celebration of
Mr. and Mrs. David Sab (Kathryn Hawkins)
Wedding Party 24 │ KCP KCP │ │ Mar-Apr Mar-Apr 2011 2011 24│
January 29, 2011 Ingram, Texas
Jaret Hawkins & Kathryn Sab
Robert, Raemon & Mercee Davis
Bride's Mother and Brother, Teri & Jaret Hawkins
David Sab Rocky Hawkins
Mindy Moll and Kathryn
Robert Lever, Jaret Hawkins, Kathryn & David Sab, Rocky Hawkins Kathryn with Freddie & Chaille Hawkins
Kathryn with Greg Walton & Poole Family
Hair by Christi O'Brien, Tin Star Salon, Kerrville. Flowers by Showers of Flowers, Ingram. Bridal shots were taken at Copper Cactus Ingram, by the wedding photographer, Mia Church. KCPKCP │ Mar-Apr 20112011 │25 │ Mar-Apr
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Glenn Coggins, Penni Carr, Kacy & David Smith
hometown events KERR ARTS AND CULTURAL CENTER
Wine Seminars and Cooking Demos Delectable Desires Food and Wine Tasting Event
Rick Smith, Judy Gausnell
Mike & Charlotte Huff
Suzanne & Debbie Roberts
Tess Noland, Karen Vaucher
Music by Larry Miniard
Judy Davis, Geri Magnell, Amber Thomason, KACC Executive Director Debbie Minns, Iris Huchton, Laura Fore, Misty Moseley, Chelsea Kunkler KCP │ Mar-Apr 2011 │27
continued from page 11
The Art Of Landscaping Another job required Kerrville Landscaping to create an oasis in the desert near Laredo, to surround a 10,000-square-foot “hunting cabin” that Zack describes as a cross between a castle and the Alamo. The company emphasizes water conservation and strives to work with an area’s natural environmental conditions. “We’re not trying to bring Houston to Kerrville.” However, Zack also points out, “Xeriscaping doesn’t mean a lot of white gravel and three cacti. It’s about the intelligent use of water, choosing native plants that are adapted to this soil and climate.” But lest you think Kerrville Landscaping only handles large-scale projects, Zack quickly points out that the company also does plenty of small jobs. “We’ll plant a single shrub or simply oﬀer consultation if customers want to do their own work.”
slow, steady growth
Like the trees and shrubs they plant, Kerrville Landscaping continues growing slowly and steadily. Zack credits his hardworking and devoted staﬀ for the company’s success. All the crew leaders rose through the ranks and were chosen not only for their skills, but also their intelligence, loyalty, and leadership ability. Perhaps one day, Zack’s children Gavin, Garrett, and Taya, and Mike’s sons Andrew, Preston, and Keaton will join the ﬁrm. Due to increased demand for their services, Kerrville Landscaping is considering expanding and opening another branch in Boerne. “We plan to keep growing a little every year,” Zack says, but not so rapidly that they forget their roots here. “I like to have a continued relationship with customers.
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28│ KCP │ Mar-Apr 2011
I want them to know if they run into problems, we’re here to help out.” Helping clients bring their dreams to fruition and seeing homeowners’ joy when the ﬁnished product is even better than they’d hoped for is what the “green team” love most about their work. “The best part of my job,” Zack says, “is when we’ve exceeded the customers’ expectations and done something they couldn’t even have imagined.” For more information, call 830-896-6981 or visit www.kerrvillelandscaping.com. Check out Zack’s articles in past and future issues of Kerr County People for practical landscaping tips and advice.
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Selling to sell again at by Mary Lee Gowland
the Ford Motor Company, Ken Stoepel Ford-Lincoln is a family-owned business. Founder Ken Stoepel began working at Ford Motor Company in the 1940s. One of his coworkers was Lee Iacocca, who later became an American business icon by emphasizing customer satisfaction above all else. Likewise, for Ken Stoepel Ford-Lincoln customer satisfaction is paramount––which is why Ken Stoepel Ford - Lincoln is the number one volume new car dealership in the Texas Hill Country. Ken Stoepel opened his Kerrville dealership in 1966, when Iacocca’s “brain child” the Ford Mustang reached its height of popularity. A few years later he moved the business to its current location at 400 Sidney Baker South, which in those days was considered “way on the other side of the river.” Today his sons, Ron and Gerry, carry on the family tradition of striving to exceed the expectations of every customer.
Turning Hard Times into Good Times
Long-time customer, Beneﬁt Solutions owner, Todd Peter with Stoepel’s top salesman, Mike Hebert. Chris Bynum, Cheryl Howard 30│ KCP │ Mar-Apr 2011
Just as Ken Stoepel learned from his mentor, Lee Iacocca, Terry Massey, Ken Stoepel Ford-Lincoln’s General Sales Manager, is inspired by Ford’s current C.E.O. Alan Mullaly, who has marshaled Ford through tough times. Unlike many U.S. companies that relied on federal bailouts when the economy faltered, Ford obtained $23.4 billion in private loans in 2006, securing those loans with assets that included their headquarters and their famous blue oval logo. Much of that debt has now been paid back. “Mullaly’s intuitive foresight has led to great new products, eﬃciency, and safety,” says Terry. Louise & Tony Larson, Bea Bode
Ken Stoepel Ford-Lincoln in kerrville Today, Ford has more cars and trucks rated a coveted 5 Stars for safety by the National Highway General Manager Terry Massey, Capricia Stoepel, Ron and Gerry Stoepel Traffic Safety Administration than any other manufacturer, and sales are good. Not only is the Ford F-150 truck the most popular model in the Hill Country, warrantees, service, finance, and more. At twice-weekly it has been the best-selling vehicle in the U.S. for thirty-four meetings, employees in Ken Stoepel’s sales, maintenance, and years in a row. And in 2011, the legendary Ford Mustang once parts departments update themselves about new products, again made Car and Driver’s Top Ten list. technological advancements, industry changes, customer “I am so proud that the American public rewarded Ford with service issues, and more. As Terry explains, “If you’re not their loyalty and business,” states Terry. “It’s heartwarming. And learning, you’re going backwards.” because of Ford’s resurgence, resale values are tremendous.”
A Team Effort Terry Massey began selling cars at Ken Stoepel Ford-Lincoln when he was only twenty years old. He liked cars and he liked people, and he wanted to educate buyers so they had peace of mind when they drove away in the cars of their dreams. Like many young men, however, he got a little restless and took a sales position at a dealership in San Antonio where he was able to gain valuable experience. After several years of commuting, he missed the friendlier atmosphere of his hometown, so he returned to Kerrville and Ken Stoepel Ford, where he became Sales Manager in 1997. Terry says “ I’m very grateful that Ron and Gerry Stoepel welcomed me home.” In the highly competitive automotive industry, Terry wants to make sure Ken Stoepel’s tradition of providing quality products and customer satisfaction continues. With that objective in mind, Ken Stoepel’s dedicated staff took the company to its best year ever in 2010. “When I tell people that, they are surprised that our best year came about during this economy. I respond that our dedicated people and superior products were two of the biggest reasons,” Terry says. “No one person is more important than any other,” Terry points out. “It’s a team effort. We have great owners and leadership, founded on sound business practices. We have a great parts and service department, run by Bobby Richardson and Dan Mendez. We have an excellent staff of ethical and knowledgeable salespeople. Our product quality is second to none.” But because technology is changing so rapidly, staying up to date is imperative and education is an ongoing process. Staff members must pass an online test that covers products,
The Key to Customer Satisfaction The staff at Ken Stoepel Ford-Lincoln realizes that some people get very confused and frustrated with the car-buying process. “Previous misunderstandings and deals gone bad can leave a bad taste in their mouths,” Terry says. “It can get absolutely maddening with all the fine print, hidden fees, and one-of-akind offers.” A car deal, he explains, requires four basic elements to make it successful: (1) giving customers a fair trade-in value on their vehicles; (2) offering good prices on the vehicles they purchase; (3) working with customers to obtain the financing package that best meets their needs; (4) providing reliable service and maintenance in the future. By emphasizing these four elements and constantly striving to reach a higher level of customer satisfaction, Ken Stoepel Ford – Lincoln has established a loyal customer base, not only in the Hill Country but nationwide. Repeat business is the key to any company’s health and longevity, and for forty-five years Ken Stoepel’s motto has been “We sell to sell again.” Owners Ron and Gerry Stoepel also believe in giving back to the community. To that end, they support and participate in dozens of civic endeavors and charities throughout the Hill Country. Terry says, “We treat you like neighbors, because you are our neighbors!” For more information, contact Ken Stoepel Ford –Lincoln’s friendly staff at 830-257-5553 or 877-237-FORD. Or visit their website www.stoepelford.com to browse their inventory of new and pre-owned vehicles and learn about the many services available.
KCP │ Mar-Apr 2011 │31
health awareness by Dr. John Bilderback, Chiropractor
R E C N A C Strategy #1 T
he cells in our bodies are aerobic, meaning they use oxygen to function properly. In 1931 Dr. Otto Warburg won his ﬁrst Nobel Prize for proving cancer is caused by a lack of oxygen respiration in cells. In an article titled “The Prime Cause and Prevention of Cancer” he stated that “the cause of cancer is no longer a mystery, we know it occurs whenever any cell is denied 60 percent of its oxygen requirements.” Dr. Warburg found that respiratory enzymes in cells, which make energy by using oxygen, die when cellular oxygen levels drop. When this happens the cell can no longer produce energy anaerobically. If the cell is to live, it has to ferment sugars to produce energy. But cells that produce energy by fermenting sugars may turn cancerous.
Experiments were done to examine the diﬀerences between how normal cells and cancer cells reacted to changes in the oxygen environment. High oxygen tension was lethal to cancer tissue, but not harmful to normal tissues. Low oxygen levels in cells may be a fundamental cause of cancer. Cells become poorly oxygenated for several reasons: poor circulation; toxins clogging up cells; poor quality cell walls that don’t allow nutrients into the cell; and the lack of nutrients necessary for respiration. Fortunately, you can increase oxygen levels in your cells in order to kill cancer cells and prevent them from spreading. Here are some products that can help: Co Enzyme Q10 helps repair mitochondria, enabling the body to utilize oxygen better.
MSM is a cellular oxygenator, making it a cancerﬁghting supplement. OXY E creates oxygen in your cells. OXY DHQ is a powerful free-radical scavenger. Flax oil provides the Omega 3 fatty acids the cell walls need so that oxygen can enter. To your health! Mention this article to receive your initial consultation free. Dr. Bilderback received his degree from Western States Chiropractic College in Portland, Oregon in 1985. He has chosen to serve the folks of Kerr County and surrounding area for more than twenty years. 1416 Sidney Baker, Kerrville. 257-2323.
WHAT'S AT THE CENTER FOR YOU?
32│ KCP │ Mar-Apr 2011
· Spring & Summer Camps · Kroc Kid’s Theater · Youth Soccer · Water Slide · Fitness Center · Aquatic Center · RJ’s Café
by Georgette Robbins, RN
How Hospice Should Be Hospice1
is a compassionate, patient-centered approach to medical care and support for people with a life-limiting illness and their families. It’s care focused on maintaining dignity, increasing quality of life, and providing comfort, including pain and symptom control. Hospice recognizes that every person’s experience is diﬀerent and the hospice team creates a plan of care according to the individual needs and wishes of each patient.
The hospice staff mission is to walk side-by-side with patients, to offer support, not only for physical symptoms, but emotional and spiritual needs as well.
Hospice staﬀ members are available at all times, 24 hours a day, 365 days a year. It is the mission of hospice staﬀ to walk side-by-side with patients and oﬀer support, not only for physical symptoms, but for emotional and spiritual needs as well. This support extends to family members, and hospice helps them cope with their own unique emotional and spiritual concerns.
Through a team of healthcare professionals, hospice provides: Medications and other methods of pain and symptom control related to the life-limiting illness. Medical care focused on maintaining patient comfort, including frequent assessment and help for family members. Assistance with personal care and activities of daily living. Coordination of community resources and help to the patient and family with non-medical concerns.
The assistance helps family members plan for the future and ease emotional diﬃculties.
Help coping with spiritual questions and concerns at the end of life, either directly or by coordinating services with the patient’s and family’s spiritual counselors.
Hospice is primarily a concept of care, rather than a speciﬁc place. A fully covered beneﬁt through Medicare, Medicaid and most commercial insurances, services are provided wherever you call home—your family residence, a nursing home, an assisted living community, an inpatient unit, or a hospital. It’s truly about meeting patients where they are—with the care that’s right for them. To ﬁnd out if you or a loved one may need hospice services, take the “Is Hospice the Answer?” quiz at www.VistaCare.com or contact us at 830-792-6200. Georgette Robbins, a 30 year resident of Kerrville, is Executive Director of VistaCare. VistaCare is located at 1001 Water Street, Suite B-100, Kerrville.
Bereavement services to help patients and families deal with grief. Grief support services continue for 13 months after the loss of a loved one. Volunteers to provide companionship and emotional support and oﬀer help in many diﬀerent ways. KCP │ Mar-Apr 2011 │33
health and wellness by Mirellé Foster, MD
Surviving A Stroke Fighting back after a stroke takes patience, strength and help. Strokes occur when blood ﬂow to the brain is blocked.
The Stroke Rehab Team
Signs of Stroke
The team is made up of specially trained healthcare professionals including physical therapists, occupational therapists and speech therapists.
Common stroke symptoms seen in both men and women:
Surviving A Stroke The most common type of stroke is ischemic, caused by a blood clot. Less common, but far more often fatal, is a hemorrhagic stroke, which occurs when a blood vessel in the brain ruptures. People who suﬀer a stroke are aﬀected in diﬀerent ways depending on the type of stroke, the area of the brain aﬀected and the extent of brain injury.
The Rehabilitation Process Fighting back after a stroke takes patience, strength and help. It means facing challenges ranging from partial paralysis to communicating and understanding to performing everyday tasks. Fortunately, there are many aggressive rehabilitation therapies designed to help stroke survivors recover more completely than ever before. Stroke rehabilitation requires a team of specialists who understand the needs of the stroke patient. One such team can be found in the ARU (Acute Rehab Unit) at Peterson Regional Medical Center. The ARU is a special 24-bed unit with a talented team of physical and occupational therapists, speech therapists, nurses, case managers and physicians working together for optimal outcomes. Regardless of where a stroke patient was initially treated, when they are transferred to the ARU the goal is to provide a strong recovery foundation that can be built upon once the patient is discharged. 34│ KCP │Mar-Apr 2011
A physical therapist prompts the patient to change positions frequently while lying in bed, and engages them in range-of-motion exercises to build strength. Using exercises, they help patients’ correct balance and improve walking skills. An occupational therapist helps the patient relearn everyday living skills such as eating, dressing and using the bathroom. The occupational therapist may also recommend braces or adaptive devices to help with regaining independence. A speech therapist works with stroke patients who have aphasia—diﬃculty speaking, ﬁnding the correct words or understanding language. Through language-therapy exercises and constraint-induced aphasia therapy, patients can progress from using gestures to more complex language skills.
• • • • •
sudden numbness or weakness of face, arm or leg—especially on one side of the body sudden confusion, trouble speaking or understanding sudden trouble seeing in one or both eyes sudden trouble walking, dizziness, loss of balance or coordination sudden severe headache with no known cause
Women may report unique stroke symptoms: • • • • • • •
sudden face and limb pain sudden hiccups sudden nausea sudden general weakness sudden chest pain sudden shortness of breath sudden palpitations
Many times the person having the stroke is not aware it’s happening. Knowing these signs and acting fast by calling 911, is imperative! When it comes to a stroke, every second counts so act quickly.
What’s Next? Researchers have found patients, who continue their exercises into outpatient therapy make signiﬁcant progress and have a greater chance of becoming independent again. What’s more, studies show patients over age 75 who receive both in-patient and out-patient stroke rehabilitation continue to improve.
Mirellé Foster, M.D., specializes in rehabilitation medicine and is the Medical Director at Peterson Regional Medical Center's Acute Rehab Unit in Kerrville, Texas.
551 Hill Country Drive, Kerrville www.petersonrmc.com
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errville Drug Co.
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women’s health by Annette Jone, RN, CNM
"The practice of compounding hormones is becoming more standardized. Perhaps in the near future, we will be able to custom formulate relief for women."
enopause is deﬁned as a woman’s ﬁnal menstrual period but does not become an oﬃcial date until there is no period for one year. Unfortunately there can be ﬁve or more miserable years of irregular bleeding, hot ﬂashes, body aches, irritability and other symptoms. Most symptoms seem to be related to decreases in estrogen and progesterone and their aﬀects on all parts of the body. In the past, our only defense has been to supplement these hormones by trial and error until we found the right combination. This or alternative remedies work for most women. A few however, will continue to have symptoms that aﬀect their day-to-day life. I am happy to report that research related to aging is starting to oﬀer more information and options for managing the peri-menopausal time frame. A few of the older medications are now being recognized as potentially harmful and we are trying to move away from prescribing them. Lab tests are becoming more sensitive in recognizing speciﬁc deﬁciencies. Frequently blood spot tests and saliva tests can be done in the privacy of your own home. As a problem is identiﬁed, a targeted plan can be developed and individualized. Some bioidentical hormones are FDA approved and are being used with good results. The practice of compounding hormones is becoming more standardized and several local pharmacists are able to oﬀer this option. Perhaps in the near future, we will be able to custom formulate relief for women. 36│ KCP │ Mar-Apr 2011
There are several challenges to putting this exciting information into practice. First, providers need to attend special education seminars, most of which are out of state, last several days and are very expensive. Mainstream medicine still has not recognized this as valuable, so few will be interested. Second, individualizing a patient’s therapy requires a lot of time and energy to develop and teach. I heard one woman say she had spent 3 hours in her provider’s oﬃce! Third, not all laboratories are equipped to do the screening and the tests are expensive. This is not yet considered “standard of care” so most insurance companies will not pay for the laboratory or compounded bioidentical hormones if recommended. In addition, the Endocrine Society (hormone specialists) warns against the use of compounded bioidentical hormones. There are a few obstacles, but if you are a woman who is not helped by standard therapies, this may oﬀer hope for relief. Hopefully, all of us will eventually beneﬁt from these advances. Talk to your health care provider if you have any concerns in this area.
Wo m e n ’ s H e a l t h c a r e Specialists Melissa G. Wampler, MD M. Elizabeth Ruiz Wilfong, DO Annette Jones, RN, CNM, MSN Kathy Bogie, RN, WHNP Niessa Meier, RN, CNM Mary E. Prentice, MD, MSN
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HOME HEALTH SERVICES
by Kathy Dietert, RN, BSN & Annabelle Lindner, RHIT
Home health service is a category of healthcare beneﬁts. Other categories are hospitalization, out-patient lab/x-ray, out-patient rehab, out-patient day surgery, physician services, durable medical equipment, skilled nursing in a nursing home, and ambulance service. Each category has speciﬁc guidelines and criteria for reimbursement from Medicare or insurance companies. Home health services are provided by licensed home health agencies which are certiﬁed by Medicare to provide such services to Medicare patients.
here are speciﬁc criteria a patient must meet in order to be eligible for home health beneﬁts through the Medicare program.
or 30 days after the start of care date. The physician must document the reason for home health services and certify the patient meets the homebound criteria.
Patient must be homebound – it must be taxing and diﬃcult for the patient to leave their home and absences from the home should be infrequent and not for long durations.
Is solicitation of patients allowed?
There must be a need for a skilled service – the patient’s condition is one that requires a skilled nurse to
assess and evaluate the patient and report to the physician any changes in the patient’s condition, and/or provide teaching/instruction, or direct skill such as catheter care, wound care, injections/IV’s, etc. the skilled service can also be that of a physical therapist for strengthening and endurance, home exercise program, etc. or for speech therapy for treatment of stroke, etc.
The care must be medically necessary and intermittent, with an end in sight. The attending physician must see the patient up to 90 days prior to admission Locally Owned & Operated
Absolutely not! Solicitation of patients by home health agencies is against state and federal law. Agencies cannot oﬀer to take you to appointments for free or provide any like kind of free service as an inducement to sign up for home health services. If you or your family members believe you or a loved one could beneﬁt from receiving home health services, you should discuss such with your attending physician. Your physician will evaluate the circumstances and if appropriate, make a referral to home health services.
Do you have a choice in selecting your home health care provider? Absolutely, federal law guarantees freedom of choice when you need home health services. In fact, federal law says you should be given all the options available to you. You can select the home health care provider of your choice. Discuss your option with your physician as home health care is a multidisciplinary approach to healthcare.
When can home health services be beneﬁcial? Home health services may be beneﬁcial to you if you have experienced one of the following.
Onset of a new illness or exacerbation of a current illness that requires changes in your treatment. New medications have been started for a disease process or acute illness. You were recently in the hospital or nursing home for an acute illness or surgery.
Who pays for home health services? Home health services are a beneﬁt of the Medicare program. Medicare pays 100% for home health services at this time. Most other major insurance companies also pay for home health services. Medicare does not pay for any custodial type services such as housekeeping, shopping, transportation, or companion type services.
“The Hill Country Leader In Home Health” Call 830. 895.3100 or toll free 800-506-5557 117 Hugo St, Kerrville
“Over 40 skilled nurses, therapists, home health aides & other professionals provide personalized quality care to our Hill Country neighbors.”
Serving Bandera, Bexar, Edwards, Gillespie, Kendall, Kerr, Kimble, Medina and Real Counties for more than a decade.
a Special Day for PRMC Volunteers by Martha Kies Volunteer Auxiliary Coordinator Peterson Regional Medical Center
One of Jack's many deliveries of the day, Angela Moreno in the PRMC business oﬃce.
addition to making lives of patients more comfortable and enriching their own lives, Peterson RMC volunteers have a lot of fun. While taking care of the day-to-day needs of patients and visitors is their main goal, there are special occasions throughout the year where they get to do something entirely diﬀerent.
Around Valentine’s Day, Cupid sprinkled all of his stardust on the volunteers— Jack (our own Rock Hudson) Spencer donned a black tux, red cummerbund and red bowtie to bring smiles on faces in every corner of the hospital as he hand-delivered Valentine gifts purchased from the auxiliary. Other volunteers, including Beverly Bond and Doris Stallings were busy keeping fresh ﬂower arrangements available for visitors to the hospital gift shop. They keep a nice selection of ﬂowers, at a very reasonable price, for visitors to purchase for their hospital-ridden friends and relatives.
The opportunities for volunteers are very varied, something for everyone. If you’re looking for a way to spend some of your time in a worthwhile endeavor and have some fun at the same time, stop by to visit us—you might just want to stay a spell. Martha Kies, Volunteer Auxiliary Coordinator for Peterson Regional Medical Center, brings to PRMC her love of helping people, as well as expertise in volunteer coordination from serving 11 years as Asst. Volunteer Coordinator of Community Relations with Kerrville State Hospital. You may call Martha at 258-7495 or email her at firstname.lastname@example.org.
38│ KCP │ Mar-Apr 2011
Volunteers Doris Stallings and Beverly Bond make ﬂower arrangements for the gift shop.
Aurora Winn, a member of the PRMC food service receives her hand-deliverd gift.
Take Years Off Your Face
William R. Thornton, MD, FACS 210.633.6106
244 Wesley Drive, Kerrville
Plastic and Reconstructive Eye Surgery
A step above the rest, Dr. Thornton oﬀers a unique type of plastic surgery—giving patients the beneﬁts of expertise, comprehensive focus, and individualized care. Dr. Thornton is committed to providing the highest standards of professional care to his patients to ensure the best possible outcome. Dr. Thornton is a Board Certiﬁed Ophthalmologist and University Fellowship trained in the subspeciality of ophthalmic (eye) plastic and reconstructive surgery. He has been in private practice and university academic practice for 30 years. To serve you better, Dr. Thornton has two oﬃces— 15316 Huebner Road, Suite 101, San Antonio and 244 Wesley Drive, Kerrville.
Speak with Dr. Thornton personally by calling 210-633-6106. KCP │Mar-Apr 2011 │39
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