PEAK NV - Spring/Summer 2019 by SNMG Interactive

Spring/Summer | 2019

Volume 3 | Issue 1

The time of your life.

Don’t skip a beat

Why making little changes now can have a big impact on your heart’s health Get up, stand up

You are what you eat

Planning makes perfect

Top 5 ways to get your blood flowing

Don’t be fooled by ‘natural’ food labels

Why you should review your estate plan

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| The time of your life.

Get your peak on this spring and summer!

reetings, readers, and welcome to the Spring/Summer 2019 edition of Peak NV magazine! This marks our fifth edition of Peak NV, and while much has changed in the world over the past couple of years, I’d like to think that we’ve kept things pretty simple since our inaugural magazine launched in April 2017. We’re still publishing twice a year, and for the most part, the quality of content hasn’t swayed — we’re dedicated to working with a strong stable of doctors, attorneys, medical professionals and other experts throughout the greater Reno-Tahoe-Carson region to share top-notch advice and information. Our overarching goal remains to let those experts discuss various angles and trends relative to health and wellness for our region’s active adult population — i.e., those in the age range of 50-70 years — in addition to fun features about recreation and outdoor-friendly lifestyles. After all, the tagline of Peak NV is, simply, “The time of your life,” and many would say there’s no better time of your life than one’s later years. This newest edition of Peak NV is no different when it comes to celebrating that tagline. Whether you’re looking for tips from the cardiology experts at Renown Health on how to reduce risk of heart disease (page 10); ideas from the Carson City Senior Center of fun activities to try out this summer (page 14); or advice from a Carson Valley law firm on the importance of keeping your living trust and estate plan up to snuff (page 28) — along with plenty more intriguing content areas — the Spring/Summer 2019 edition should keep you well-informed. With all that said, a little change never hurts anyone, right? With a few editions under our belt (and with five being such a nice, round number), now is as good a time as any to ask for feedback. How are we doing? Are there any areas of content lacking that you feel would be beneficial to our region’s active adult population? Would you like to see different experts featured or quoted? And what about the advertisements sprinkled throughout the magazine — are we missing anything? I’d love to hear your feedback and ideas — and, frankly, your constructive criticism if we’re blatantly missing anything. Feel free to email any time at kmacmillan@swiftcom.com, or call 775-850-2145. I look forward to engaging! — Kevin MacMillan is editor of Peak NV magazine, in addition to Tahoe Magazine and other specialty products published by the Sierra Nevada Media Group. Have questions about Peak NV? Email him at kmacmillan@swiftcom.com.

Volume 3 | Issue 1 | Spring/Summer 2019 |

The time of your life. Publisher Rob Galloway | rgalloway@swiftcom.com Editor Kevin MacMillan | kmacmillan@swiftcom.com Contributing Editors Rick Hoover Charles Whisnand Advertising Executives Tara Addeo Carolan LaCroix Robert Glenn Jessica Rackley Melissa Saavedra Ryan Shepherd Design & Layout Rob Fair

The pulse of the community Carson Tahoe Health readies for next Community Health Needs Assessment

Food safety for older adults

Contributing Writers Dustin Boothe Danielle L. Christenson Dr. Samanda Durand Margi A. Grein Daniel W. Heller Juliee Morrison Cate Neal Dr. Richard Seher Cassandra Walker Courtney Warner

Why it’s important to be vigilant when handling, preparing and consuming

SNMG Publishing Operations Director Brad Bancroft

SNMG Editorial Director Adam Trumble Cover Photo Shutterstock Peak NV magazine is a product of the Sierra Nevada Media Group (SNMG) and its affiliated media organizations: Nevada Appeal, The Record-Courier, Lahontan Valley News and Northern Nevada Business View. All content is copyrighted, April 2019. Peak NV strives for accuracy and is not responsible if event details or other information changes after publication. Unless otherwise indicated, all photography in this publication is property of Swift Communications, the parent company of Sierra Nevada Media Group and Peak NV.

peaknv

| The time of your life.

Is it simply aging — or is it Alzheimer’s? Mid-life preventive care can help delay the onset of Alzheimer’s

Be prepared Safety tips for swimming in Lake Tahoe or other Sierra Nevada bodies of water

8 26

Volume 3 | Issue 1 | Spring/Summer 2019 |

The latest buzz

By Carson Tahoe Health t’s not easy ‘beeing’ green. Or is it? Three Carson City entities have teamed up to ensure pollinators have an extra cozy place to land this spring — the Carson City Chamber Leadership class has chosen the development (from the planning to the populating) of a bee habitat at Carson Tahoe Health’s Foothill Garden. “Bee populations are declining at an alarming rate,” says Christopher Gray, Carson City Leadership team member. “Since 1 in every 3 bites of food we eat is courtesy of insect pollination, our class decided on a project that would reflect Carson City’s important commitment to the health of bee populations and therefore, the health of our community.” In addition to the newly established bee hotel, Foothill Garden, whose theme is “Bee Well and Thrive,” will soon be home to a planned pollinator garden. Carson City Parks, Recreation and Open Space is working with regional experts to plan drought-resistant flora to help attract pollinators and truly enrich the area.

“The bee hotel and the associated pollinator garden will assist us in continuing to nurture a healthy ecosystem onsite.” — Will Pierz, Assistant Manager at The Greenhouse Project

“Carson Tahoe is happy to be the site for this innovative community project,” says Michelle Joy, Vice President and Chief Operating Officer at Carson Tahoe Health. “We’re in the business of healthcare, but wellness, prevention through nutrition, and the sustainability of natural foods should be a part of that conversation. We think healthcare is also about giving people the tools to maintain good health.” It takes a village The Foothill Garden, nestled among the foothills behind the Carson Tahoe Cancer Center, was established in 2017 as a model for sustainability in growing organic produce and educating future gardeners; allowing us to donate the bounty to the food insecure in our community. The site also serves as host to community garden classes, yearround. The Greenhouse Project, an agriculture/education-based nonprofit and another key player in the Foothill Garden, will manage the habitat, primarily observing the colonization and health of the pollinator residents. “The bee hotel and the associated pollinator garden will assist us in continuing to nurture a healthy ecosystem onsite,” says Will Pierz, Assistant Manager at The Greenhouse Project. “In addition to providing pollination services for the garden, many pollinator species also prey upon common garden pests (often in the larval or nymph stages). We rely heavily on these insect allies to allow us to grow healthy produce without pesticides.” Although there are nearly 4,000 species of bees in North America, only 1,000 are native to Nevada, and of that 1,000 the leadership class chose a gentle leaf cutter bee (genus Megachile) to occupy its new bee sanctuary.

peaknv

| The time of your life.

This particular species serves the crucial role of pollinator, but acts solitarily so each bee individually builds a small nest in the different holes (or rooms) of the house. The leaf cutter bee was also chosen because it does not exhibit signs of aggression, making it more suitable for a community space. Looking forward Once complete, the bee hotel will act as one cog in the “well-nurtured” machine that is the Foothill Garden. All the organizations involved hope the space will serve the community in a multitude of ways. “Increased pollinator health benefits a community’s food supply, ecological resources, and furthermore, its people,” says Kelsey Stalker, Community Education Coordinator with Carson City Parks, Recreation, and Open Space. “This site will also be able to host many different educational events for gardening, pollinator education, and interpretive hikes for people of all ages. “Members of the community will be able to learn about the importance of pollination, enjoy

Carson City was recently named a Bee City USA by the Xerces Society. Photo: Wendy Hanson Mazet

the beauty of the garden, and be able to recreate in one of Carson City’s most beautiful outdoor spaces.” Mark your calendar Part of the impetus for this project was a recent designation — Carson City was named the 76th Bee City USA by the Xerces Society, the only city with that designation in Nevada. To celebrate this and the completion of their project, Carson City Leadership will work with involved parties to host an “open garden” during the week of June 16, in honor of Pollinator Week. ● — This article was provided by Carson Tahoe Health. Go to www.carsontahoe.com/garden to learn more about the event, the Foothill Garden, bee hotel and upcoming garden classes.

Local organizations collaborate to build bee hotel in Carson City

A New Way to Feel and Live Better Prominence Health Plan offers a Medicare Plan that can make your healthcare cost more predictable and save you money. And now, we’ve opened our own care centers to change the way our members get care in Carson City! The care center team works with our Medicare members to create customized health plans with providers who take extra time and provide empathetic listening. At a Prominence Care Center, you can access: • Preventive care, screenings and assessments • Chronic disease management, including diabetes, hypertension and depression. • Same or next day appointments for minor illnesses or injuries. • Health coaching, on-site labs, provider-dispensed medications and more!

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Prominence Health Plan is an HMO with a Medicare contract. Enrollment in Prominence Health Plan depends on contract renewal. Prominence Health plan complies with federal civil rights laws and does not discriminate on the basis of race, color, national origin, age, disability or sex. ATENCIÓN: si habla español, tiene a su disposición servicios gratuitos de asistencia lingüística. Llame al 1-855-969-5882 (TTY: 711). PAUNAWA: Kung nagsasalita ka ng Tagalog, maaari kang gumamit ng mga serbisyo ng tulong sa wika nang walang bayad. Tumawag sa 1-855-969-5882 (TTY: 711). Y0109_PEAKNVSPRING19_M_CMS Accepted Volume 3 | Issue 1 | Spring/Summer 2019 |

Courtesy photo

— Diane Rush, Director of Marketing and Public Information at Carson Tahoe Health

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“The only way we can find out the health of our community is if you tell us — and we want to know.”

magine a world where you were asked your opinion on local healthcare. Now imagine a scenario where that input actually made a difference in your community. Good news, it’s real. Every three years Carson Tahoe Health conducts a Community Health Needs Assessment (CHNA); a tri-county survey to learn what the major healthcare obstacles and concerns are within the community. “Our survey extends to every aspect of community health,” says Diane Rush, Director of Marketing and Public Information at Carson Tahoe Health. “We survey a crosssection of 800 people within Carson, Douglas, and Lyon counties, as well

as solicit participation from over 300 businesses and community stakeholders.” The information gathered helps Carson Tahoe determine where to focus their efforts in managing the critical needs of the community. Once all the data is collected, a strategic plan is developed to address the issues that bubbled to the top, and can include things like new services, increasing education and prevention opportunities, or expanding programs to aide access to care. Although a CHNA survey is now required every three years by the Federal Government for not-forprofit hospitals, Carson Tahoe has been conducting them to better serve their patients since 1999.

By Carson Tahoe Health

The Community Health Needs Assessment helps medical professionals learn what the major healthcare obstacles and concerns are within the community.

Carson Tahoe Health readies for next Community Health Needs Assessment

The pulse of the community

“Carson Tahoe has also formed great community partnerships to help address the identified needs,” Rush says. “When we learned access to wholesome food was a concern in the community, we partnered with The Greenhouse Project to add a garden on our campus. Now, we are able to grow fresh, organic produce and donate it to community members who are food insecure.” The garden also provides opportunities to teach sustainability through community classes and education. Not only that, but upon hearing mental health and substance use was a major concern to the community in its last CHNA survey, Carson Tahoe invested heavily in its Mallory Behavioral Health Crisis Center. Since opening in January 2017, the crisis center has served as a safety net for the community, by providing immediate psychiatric help and paving a pathway for patients’ recovery. Thanks to an $800,000 donation from the Mallory Foundation, Carson Tahoe will be expanding its crisis center over the next several years. None of these expansions and much-needed innovations would be possible without examining the pulse of the community. E B R AT I NG E L of this The most importantCpart survey, however, may come from you. “If you’re local to this region, you may receive a call asking you to participate in a survey.” IYEARS encourageE O W you to take part,” RushV Isays. N G W“The H AT only way we can find out the health of our community is if you tell us — and we want to know.” ●

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By Dr. Richard Seher

s we get older, our risk for heart attacks and heart disease increases. But even as we enter our 50s, 60s, 70s and 80s, there are things we can do to lower our risk, prevent heart disease and live a healthier life. It’s a statistic we hear frequently: Heart disease is the leading cause of death for both men and women in the U.S. According to the CDC, 735,000 Americans have a heart attack each year.

Live heart healthy

Know the signs and symptoms First and foremost, everyone needs to know the symptoms of heart attack. For a third of people, a heart attack is their first warning sign. For another third, it’s sudden death. Because the nerve supply to the heart is not as well developed as other parts of the body, identifying heart pain can be tricky but it can also be a lifesaver. Symptoms include: • Chest discomfort: pressure, tightness, fullness or pain • Upper body discomfort: pain in one or both arms, back, neck, shoulders, jaw or teeth • Arm heaviness • Pain that may be mistaken for heartburn • Shortness of breath • Breaking out in a cold sweat • Nausea or vomiting • Extreme, unexplained fatigue • Chest pain that occurs at rest or with activity Have symptoms? Call 9-1-1 In the case of a heart attack, minutes can mean all the difference. Many patients

experience denial or simply don’t want to scare their loved ones and go to the hospital unnecessarily; but it’s critical to call 9-1-1 as soon as you spot any symptoms. Within minutes of an artery blockage, your cardiac muscle cells are losing oxygen and start to die. In just a few hours of a blockage, the part of the heart losing oxygen can’t recover. For that reason, taking an ambulance and getting medical care immediately is key to prevent permanent damage. You should

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It’s the little changes that can reduce your risk as you age never drive yourself if you think you’re experiencing a heart attack. Reducing your risk Heart health is made up of a variety of factors — some you can control and some you can’t. Age, gender and genetics/family history are all things outside your control. But they’re important to remember because they play a big role in your overall risk. On the other side, 80 percent of chronic illnesses — including heart disease — are the result of unhealthy lifestyle choices according to the World Health Organization. Tobacco use, high cholesterol, high blood pressure, inactivity/sedentary lifestyle, obesity and diabetes all increase your risk. Fortunately, making little changes can have a big impact on your health.

Little changes, big impact Start with some easy hearthealthy changes such as using the Mediterranean diet as your daily guide. Skinless poultry and fish, fruits and vegetables, whole grains and low-fat dairy are all a step in the right direction. New studies have also shown eating legumes like beans, lentils and peas can reduce your heart attack risk by 20 percent. Keep in mind, if you’re taking a statin to lower your cholesterol, you should closely watch your saturated fats. As we age, back and hip problems can make staying active difficult but it’s important to keep moving even with simple exercises like walking. The American College of Cardiology recommends at least two hours of moderate activity each week. If you aren’t active, it’s important to watch your diet very strictly.

Little changes to your diet can go a long way to helping ensure you have a healthy heart for years to come.

“Heart disease

Photo: Getty Images

is the leading

Mental health is another critical piece. Studies have shown heart patients with a history of depression have a poor prognosis; while people with heart problems who are in control of their stress have a better prognosis. Try taking steps to lower your stress at work and at home, and if you need additional help, talk to your provider. Watching your blood pressure, total cholesterol, blood sugar and body mass index numbers are all quick ways to gauge your heart health. Of course, it’s even more important to get regular screenings with your doctor to fully understand your risk and what changes will improve your heart health today and in the years to come. ●

cause of death for both men and women in the U.S. According to the

— Dr. Richard Seher is a cardiologist with the Renown Institute for Heart & Vascular Health. DR. JAMES THE DENTIST Go to www.bestmedicinenews.org to learn more.

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Volume 3 | Issue 1 | Spring/Summer 2019 |

Just because a loved one is suffering from dementia or Alzheimer’s disease doesn’t mean you can’t work with him or her to live a healthy lifestyle. Photo: Shutterstock

Working for wellness

By Juliee Morrison f you have a loved one who has been diagnosed with dementia or Alzheimer’s disease, you likely are aware that these types of diseases progressively attack the brain, causing confusion and cognitive decline — decline in our ability to think, reason and communicate. But have you considered how a memory disorder might impact your loved one’s physical wellbeing? Just because someone is living with a memory disorder doesn’t mean his or her physical health has to suffer. Caregivers can help their loved ones maintain physical wellness, while taking into consideration the unique challenges that seniors with Alzheimer’s may be facing. Here are some examples of these challenges and how you, as a caregiver, can help your loved one continue to live a healthy lifestyle. Exercise Older adults already experience changes to their bodies associated with normal aging such as diminished vision, hearing loss and being more susceptible to falls. However, people with memory disorders are at even higher risk of falling down due to decreased coordination and spatial awareness. Encourage your loved one to maintain regular exercise to build muscle strength, improve balance and endurance, and ultimately, decrease the risk of falling and injuring themselves. Nutrition People with Alzheimer’s may not drink enough water or eat enough food to stay healthy as a result of confusion and memory loss. Support your loved one by offering juice, water and nutritious snacks throughout the day to keep them nourished. Consider asking them or keeping track of the foods they like and dislike and offer them their favorite meals or snacks to ensure they maintain a regular eating schedule.

Help your loved ones with memory disorders practice healthy living

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| The time of your life.

Communication Memory disorders make it harder for people to communicate when they are sick, or if something has changed in their bodies. If you notice sudden changes in mood or behavior in a loved one, it could be a sign of a discomfort or a physical health issue like a UTI, sinus infection or dental problem. Don’t assume a change in temperament is part of the disease, and check for sources of pain that might not be as obvious, such as the feet. If you’re concerned, don’t hesitate to schedule a visit with their doctor. Emotional health Aging adults with memory disorders are frequently diagnosed with depression and can experience sadness and loneliness. To support emotional health, caregivers can plan activities and outings for their loved ones to help keep them engaged. Remember to check in frequently to see how they’re doing — even a quick phone call can help brighten their day! Also, encourage them to take short “sunshine breaks,” as going outside for just 10 minutes on a

sunny day will provide a sufficient dose of Vitamin D while helping to boost their mood.

Chances are… YOU NEED AN ESTATE PLAN

Personal care and hygiene Maintaining self-hygiene can be challenging for individuals with Alzheimer’s, so they often rely on caregivers for assistance with bathing, changing clothes, brushing teeth and hair, and other acts of personal care. Support your loved one by approaching the topic of self-care with a positive attitude; providing simple choices; using life stories to make a connection; and being kind and supportive while protecting their dignity and privacy. At the end of the day, older adults with memory disorders often need support and encouragement to maintain a healthy lifestyle. By being aware of the key factors above, and you will be wellequipped to help your loved one continue healthy living habits. ●

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Volume 3 | Issue 1 | Spring/Summer 2019 |

By Courtney Warner

e live in an area lush with hiking trails, biking trails and water sports — whether in the valleys or near Lake Tahoe. Sometimes, these activities can be daunting to older adults who might not have the joint strength or wherewithal like they used to. What are some easy-to-learn activities or simpler exercise ideas for active adults to participate in the warmer summer months to ensure they are getting ample exercise and blood flow outdoors?

Get your blood pumping

Top five activities — indoors and outdoors — to try this summer Here is our top five: Guided walks, hikes and bike rides in Carson City “Muscle Powered” is a Carson City-based organization dedicated to making the area “healthier for all citizens and safer, more accessible for cycling and walking through education and advocacy, the promotion of bicycle and pedestrian friendly infrastructure, and developing and maintaining recreational trails throughout the city.” Weekly bike rides are offered on Sunday mornings at 9 a.m., and a variety of cycling activities, maps and trails are offered throughout the year. Muscle Powered also offers morning walks on Tuesday and Friday mornings at 9 a.m., evening hikes on Tuesdays at 5:30 p.m., an afternoon hike on Thursdays at 3 p.m., and easy Saturday hikes sprinkled throughout the month. Walks and hikes can vary in intensity and elevation, so check out their calendar at www. musclepowered.com/calendar to find the best one for you. Swimming and water exercise The Carson City Aquatic Center houses an indoor pool, an outdoor pool and a therapeutic warm pool, as well as a weight room facility. The center offers lap swimming and open swim Monday through Saturday.

peaknv

Lap swimming not your thing? Try an Aquacise class, a lowimpact, improve-as-you-go class to tone the muscles without soreness; or, try deep-water exercise, which provides a cardiovascular workout wearing a flotation belt with no impact on the joints. Need a gentle way to start your day? Try the Range of Motion class to increase mobility in stiff or sore joints, which is offered in the therapy pool five days a week. For more information, call the Swim Center at 775-887-2242. Indoor walking, jogging and running The Carson City MAC (MultiPurpose Athletic Center) boasts an indoor 1/8th-mile walking/jogging/ running track that is open seven days a week, except for certain holidays. Stay protected from the elements and still hit your steps for the day! Downstairs from the track, pickleball and basketball are available most mornings, and in the afternoon the courts are available for volleyball, futsal, dodgeball and basketball. For information on the MAC, call 775887-2339.

| The time of your life.

Health and wellness activities Carson City Parks and Recreation offers a wide variety of programming for health and wellness — from adaptive recreation for people of all abilities and their families to aerobics, stretching, muscle resistance training and Tai Chi C’huan and Qi Gong. They also offer outdoor excursions and hiking, as well as learning opportunities through the Carson City Library. For more information, visit www.carsoncity.org, or pick up the Carson City Parks and Recreation activity guide at grocery stores and other outlets around town. Senior-focused activities and dining The Carson City Senior Center provides a variety of programs that encompass physical health, intellect and learning, social activities and lunch options. Serving Carson City residents age 60 and up, the Center is open Monday through Friday from 9 a.m. to 4 p.m., with scheduled activities each day such as exercise, bunco, bingo, line dancing, lapidary, bridge, yoga and many other senior-focused activities.

Swimming can be one of the most effective forms of exercise for older adults. Photo: Shutterstock

A hot, nutritious meal is served in the Senior Center dining room every weekday from 11 a.m. to 12:30 p.m. for a suggested donation of $2.25 for seniors (age 60 and older) and $6 for guests under age 60. The Senior Center also provides services including Meals on Wheels service, Medicare counseling, tax preparation service, blood pressure clinics, AARP driving services and senior support groups, along with a Social Work Program Manager who can help our seniors connect with the services that they need. The Center also has a bilingual Case Manager. ● — Courtney Warner is executive director of the Carson City Senior Center. For more information, visit www.carsoncityseniorcenter.org or call 775-883-0703.

By Barton Health

regory Burkard Jr., DO, is an interventional pain and sports medicine physiatrist who recently joined Tahoe Orthopedics & Sports Medicine, a division of Barton Health. Dr. Burkard took time recently to answer some questions about his medical specialty, as well as the services available to help people living with pain. Peak NV: What exactly does a physiatrist do? Dr. Burkard: I see and treat people living with pain. Pain can be caused by one or several factors. Most patients I see have pain from sports injuries, overuse injuries and accidents that unfortunately resulted in functional disabilities. Peak NV: Why did you decide to become a physiatrist? Dr. Burkard: I like how a physiatrist considers the whole body in addressing a patient’s pain and injuries. For example, if someone experiences knee pain when they run or walk, it may be more than the knee joint. It could also be the patient’s biomechanics, low back, hips, ankles, IT bands, leg muscles, or other underlying issues. I have the training to help diagnose the pain generator and develop a comprehensive approach to overcome the pain and ailment.

Physiatry your questions (and answers) for pain

one year fellowship that focused on interventional pain and sports medicine to help cultivate my skills to take care of any patient who walks in to my clinic searching for treatment. Peak NV: How did your training prepare you? Dr. Burkard: Training in interventional pain and sports medicine gave me the skillset to take care of patients with all kinds of injuries to the musculoskeletal system, including the back, neck, knees, shoulders and any other painful joints.

Peak NV: What is your philosophy on treating pain? Dr. Burkard: I want to decrease my patients’ pain, help restore muscle

Peak NV: What kind of training did you do to become a physiatrist? Dr. Burkard: A physiatrist is a physician who completes training in a residency program called physical medicine and rehabilitation (PM&R). Like other physicians, I earned my medical degree and completed a specialized residency training program. My physical medicine and rehabilitation (PM&R) residency was a total of four years long where I gained a wide set of skills in treating patients with multiple issues, injuries and disabilities that stem from the musculoskeletal or nervous system. Afterward, I further concentrated and specialized in a

and skeletal function, and improve their quality of life. I do this by making an accurate diagnosis and a comprehensive treatment plan individualized for each patient. Peak NV: What kinds of treatment plans do you recommend? Dr. Burkard: There are lots of non-surgical plans and strategies I use to help diagnose and treat patients. This may include use of medications as well as managing therapies, such as physical therapy, occupational therapy, acupuncture, chiropractic care, cognitive behavioral therapy, or aquatic therapy. In addition, I have training in nerve conduction studies and musculoskeletal ultrasound to help diagnose nerve and soft tissue injuries as well as a variety of ultrasound and x-ray guided injections to help patients manage their pain. Peak NV: Can a physiatrist do surgery? Dr. Burkard: As a physiatrist, I do not perform any major surgeries, but I do consider all treatment and procedure options. Some examples of procedure options I perform are musculoskeletal ultrasounds, x-ray procedures for spines and joints, radiofrequency ablations/neurotomy for spine arthritis, spinal cord stimulators, joint and tendon injections, and nerve conduction studies. If surgery is the best option for the patient, I will refer to a surgeon who can address that patient’s specific medical needs. Peak NV: How can I see a physiatrist? Dr. Burkard: A physiatrist appointment requires a referral from your primary care provider. If you are experiencing muscle, joint, nerve or skeletal pain, talk with your primary care provider about your symptoms and request a referral. ●

A physiatrist performs electronic therapy on a knee to treat pain. Photo: Shutterstock

— Dr. Burkard sees patients at Tahoe Orthopedics & Sports Medicine in Carson City and the Barton Center for Orthopedics and Wellness in South Lake Tahoe. Go to www.bartonorthopedicsandwellness.com learn more about orthopedic and physiatry services available to address pain.

Volume 3 | Issue 1 | Spring/Summer 2019 |

ccording to the U.S. Food and Drug Administration, the term “natural” displayed on food packaging is to mean that: “Nothing artificial or synthetic (including all color additives regardless of source) has been included in, or has been added to, a food that would not normally be expected to be in that food. “However, this policy was not intended to address food production methods such as the use of pesticides, nor did it explicitly address food processing or manufacturing methods, such as thermal technologies, pasteurization, or irradiation. The FDA also did not consider whether the term “natural” should describe any nutritional or other health benefit.” What this boils down to is clever marketing strategies that lead consumers to believe foods they are purchasing are more nutritious than they are. “Most consumers, when they see ‘natural,’ are led to assume it probably means it is probably not genetically modified, doesn’t have hormones or pesticides, or artificial ingredients — which is false,” Kim Mason, nutrition care manager at Carson Tahoe Health, said in an interview this past summer. “It leads to a ton of confusion to

the point where now there are a number of lawsuits and the FDA is being petitioned to better reflect what ‘natural’ means.” Previous FDA regulations are dated back to the 1990s and don’t properly reflect manufacturing procedures used today, Mason said; as such, manufacturers are not necessarily violating regulations because GMOs and certain food treatments — even artificial ingredients — are considered “natural.” The FDA has petitioned the public to get a sense of what consumers understand the term “natural” to mean. And now more than ever, people are concerned with what they’re eating, where it came from and how it was treated before ending up on their plate. “If you’re a person who is opposed to having GMOs and artificial ingredients, the most important thing would be to have additives and processing transparently labeled on the food,” Mason said. “From there, there hasn’t been any real conclusive research that says if you eat GMOs, ‘this will happen’ … (if you eat) hormones, ‘this will happen.’” Without conclusive research telling us one way or another, Mason says the ultimate decision is a personal one — “do I want to put this in my body, or not?”

On the positive side, there is absolutely a realm of companies that are doing the right thing to offer responsibly sourced, nutritious food. Mainstream labels are adding healthy ingredients to their packaged goods and looking for ways to make their products better. The key, experts say, is to be diligent in reading the label, researching the company and finding knowledgeable and trustworthy food sources in your area. New Moon Natural Foods in North Lake Tahoe is among many regional companies that source 100 percent organic produce. “We offer local, responsibly produced products that do not use any of a list of certain ingredients,” said Andrea Shaw, data manager,

You are what you eat

Just because that package says ‘natural’ doesn’t mean you shouldn’t do research By Cassandra Walker

When buying produce, experts recommend always buying organic. Photo: Cassandra Walker

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| The time of your life.

wine buyer and procurement manager at New Moon. “Even our wine is organically grown and bio-dynamic, it’s not just an ingredient list we look at. When people shop here they can trust that we’ve vetted that the products and produce are being responsibly sourced, we even have healthy candy and chips that are responsibly produced.”

Just because a label suggests one thing, your research might suggest otherwise. Photo: Shutterstock

Shaw said that product knowledge drives New Moon as it does many health-conscious shopping destinations. They research who owns the company of the products they carry, visit the farms where their produce is grown, and have even gotten feet on the ground at the ranches where their ethical grass-fed meats are sourced. As a parent, Shaw said she wants to feed her son the best foods available, but certainly understands that not everyone has access to affordable, nutrient-dense foods.

“Personally, I think you’re paying on the front end for good foods, and saving on doctor’s bills on the back end,” she said. “When you’re younger, you don’t realize how your food makes you feel.” When reading labels, Mason says the most important information should be called out. If the manufacturer is trying to do things right, they will indicate, “non-GMO, no pesticides, or no sodium nitrate used in manufacturing” on the label. Whenever possible, shop organic — it further eliminates things in question as organic foods are more controlled through a set of regulations; it is actually quite difficult to become a certified organic producer. Further, the more you can eat fresh or non-convenience foods, the healthier you will be. ●

Be careful what you drink — soda might taste great, but it is loaded with chemicals and sugar. Photo: Shutterstock

— Cassandra Walker is a Truckee-based writer and contributor to Peak NV magazine.

Get healthier: Experts suggest adopting more diligent consumer habits to ensure that you and your loved ones are eating the best foods possible. By researching labels, knowing what to look for, and building a good food foundation to add fresh items to, you can also stick to a budget while putting nutrition your highest priority. Below are a few important tips to keep in mind:

Read Between the Lines

• Just because it’s labeled “natural” doesn’t mean it’s been sourced, processed or manufactured the way you’d like. • Be cognizant while reading the product label of your food and steer clear of high fructose corn syrup, artificial colorings, artificial sweeteners, parabens, refined grains, trans fats, sodium sulphite, sulphur dioxide, monosodium glutamate, butylate hydroxanisole and butylate bydrozyttolune, to name a few. • Whenever possible shop organic, and take care in reading packaging to see companies who point out the good work they’re doing. The more diligent we are in the food we eat the more companies will keep up with demand for quality.

Establish a Solid Pantry

• By planning weekly menus in advance and keeping a well-stocked pantry of staple items you can easily add fresh ingredients to make nutritious meals while being smart, financially. Items to have on-hand: olive oil, bean products, oatmeal, whole grain bread, brown rice. • By adding fresh fruits, vegetables and meat to the items you already have on-hand you won’t need to continuously purchase large bulk products for one meal. Make your own salad dressing: one of the most over produced pantry staples is salad dressing. In order to give consumers good flavor and a long shelf life dressings are filled with unnecessary ingredients and preservatives. • Stick with a basic recipe of three parts oil, one part vinegar and an emulsifier like Dijon mustard. Add rosemary, oregano and garlic, give it your own taste and enjoy. This recipe can be easily changed, for example, use rice vinegar and peanut butter for an Asian twist.

Inconspicuous Culprits

• Drinks are one of the biggest contributors to weight gain in our country because people are unconsciously hydrating throughout the day, grabbing a soda or fruit juice, which is loaded with chemicals and sugar. • We can all do ourselves a favor by creating our own flavored water using natural fruits, even a cinnamon stick, just to stay away from prepackaged beverages which have 23g of carbs and added sugar on top of that. • Another important part of nourishing your body is consciously eating — if your brain perceives your food as being good quality and you have a positive outlook, if the eating experience isn’t rushed or stressed out, it is a comfortable and rewarding kind of experience. • As you select ingredients make sure they are good quality — go to a farmer’s market rather than a supermarket. Prepare your food lovingly and consciously, be in a positive frame of mind as you cook your meal — you are going to get more nutrition out of food that was lovingly put together.

Volume 3 | Issue 1 | Spring/Summer 2019 |

By Dustin Boothe

s we age, it is normal for our bodies not to work as well as they did when we were younger. Changes in our organs and body systems are expected as we grow older. These changes often make us more susceptible to contracting a foodborne illness. By the age of 65, many of us have been diagnosed with one or more chronic conditions, such as diabetes, arthritis, cancer or cardiovascular disease, and many are taking at least one medication. The side effects of some medications or the chronic disease process may weaken the immune system, causing older adults to be more susceptible to contracting a foodborne illness. After the age of 75, many adults often have a weakened immune system and are at an increased risk for contracting a foodborne illness. Should older adults contract a foodborne illness, you are more likely to have a lengthier illness, undergo hospitalization or even die. To avoid contracting a foodborne illness, older adults must be especially vigilant when handling, preparing, and consuming foods. Follow these safe food-handling practices while you shop: • Carefully read food labels while in the store to make sure food is not past its “sell by” date. • Put raw packaged meat, poultry or seafood into a plastic bag before placing it in the shopping cart, so that its juices will not drip on —

and contaminate — other foods. If the meat counter does not offer plastic bags, pick some up from the produce section before you select your meat, poultry and seafood. • Buy only pasteurized milk, cheese and other dairy products from the refrigerated section. When buying fruit juice from the refrigerated section of the store, be sure that the juice label says it is pasteurized. • Purchase eggs in the shell from the refrigerated section of the store. (Note: store the eggs in their original carton in the main part of your refrigerator once you are home.) When consuming raw eggs, using pasteurized eggs is the safer choice. • Never buy food that is displayed in unsafe or unclean conditions. • When purchasing canned goods, make sure that they are free of dents, cracks, or bulging lids — and, once you are home, remember to clean each lid before opening the can. • Purchase produce that is not bruised or damaged. Follow these tips for safe transporting of your groceries: • Pick up perishable foods last, and plan to go directly home from the grocery store. • Always refrigerate perishable foods within 2 hours of cooking or purchasing. • Refrigerate within 1 hour if the temperature outside is above 90 degrees. • In hot weather, take a cooler with ice or another cold source to transport foods safely.

An example from the USDA of where to find the “Sell By” date.

Always read the USDA’s Safe Handling Instructions label.

Food Product Dating It’s important to read the USDA’s “Safe Handling Instructions” label for food safety information on raw foods. When it comes to open dating, these notices are found primarily on perishable foods such as meat, poultry, eggs, and dairy products: • A “Sell-By” date tells the store how long to display the product for sale. You should buy the product before the date expires. • A “Best If Used By (or Before)” date is recommended for best flavor or quality. It is not a purchase or safety date.

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| The time of your life.

• A “Use-By” date — which is determined by the manufacturer of the product — is the last date recommended for the use of the product while at peak quality. • “Closed or coded dates” are packing numbers for use by the manufacturer. Closed or coded dating might appear on shelfstable products such as cans and boxes of food. Except for “use-by” dates, product dates don’t always pertain to home storage and use after purchase. “Use-by” dates usually refer to best quality and are not safety dates.

An example from the USDA of a “Best If Used By” date.

It’s recommended to use gloves when handling meat to avoid spreading foodborne bacteria. Photo: Shutterstock

Food safety for older adults Why it’s important to be vigilant when handling, preparing and consuming

Even if the date expires during home storage, a product should be safe, wholesome and of good quality if handled properly. If foods are mishandled, however, foodborne bacteria can grow and, if pathogens are present, cause foodborne illness — before or after the date on the package. The handling and preparation on the label should be followed to ensure top quality and safety. ● — Dustin Boothe, MPH, REHS, is the Disease Control and Prevention Manager for Carson City Health and Human Services. Visit gethealthycarsoncity.org to learn more. This article has been adapted from the USDA publication “Food Safety for Older Adults.” Go to bit.ly/2tTzbTp to read it in full.

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Volume 3 | Issue 1 | Spring/Summer 2019 |

Nutritious foods can do your body good —

Salmon and other fish are foods rich in nutrients — and low in fats. Photo: Shutterstock

By Juliee Morrison t’s important to eat well at any age, but older adults especially require plenty of vitamin-rich foods to stay healthy. Eating well helps keep your body strong, your mind sharp and your energy level up as you age.

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What your body needs now According to the modified food pyramid for older adults, brightlycolored, antioxidant-rich vegetables are necessary for a healthy metabolism, which can slow with age, causing weight gain. You should also eat highnutrient, low-fat foods, like fish. This protein-rich food keeps muscles strong, and a report from the Annals of Rheumatic Diseases found that individuals who eat fish regularly are less likely to develop arthritis as they age.

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from your head to your heart

Calcium-heavy dairy and Vitamin D are especially vital for healthy bones. Losing bone density is a normal part of aging, but medical conditions like osteoporosis can further weaken musculoskeletal strength. For women especially, it’s important to pair at least 1,500 mg of calcium a day with low-intensity activity, like walking to stay strong. Aging adults may also find that food tastes differently, and may be less flavorful. Instead of reaching for the saltshaker, try adding other, healthier seasonings to your plate like basil, cumin or fennel. Sodium is a necessary nutrient for our bodies, but it can be harmful in excessive amounts. The importance of soul food Especially during the holidays, food is a sentimental part of our lives — aiding in reliving cherished moments and allowing us to enjoy

family traditions all over again. We understand the importance of eating familiar foods and we incorporate family favorites into the menu for our residents, to give them a sense of home. Eating foods from your past can bring back fond memories and help those with dementia and Alzheimer’s disease recall experiences that they may have otherwise forgotten. That’s why food is part of Prestige Care’s award-winning memory care program, Expressions. Our food-focused component, Tasty Expressions, draws from individual residents’ lifelong experiences with food, aiding in memory recovery and rehabilitation. Nutritious food does your whole body good — from your head to your heart. Next time you fill up your plate, remember to give your body what it needs at this stage in your life. ●

It’s Your Choice... • • • • • •

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— Juliee Morrison, BSN, RN, is the Expressions Director for Carson Tahoe Expressions Memory Care at Carson Tahoe Care Center. Go to www.PrestigeCare.com/CarsonTahoe to learn more.

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Volume 3 | Issue 1 | Spring/Summer 2019 |

Is it simply aging — or is it Alzheimer’s?

Exercising to get the heart pumping, including yoga, can help keep the brain fed with a healthy supply of blood and oxygen. Photo: Shutterstock

Mid-life preventive care can help delay the onset of Alzheimer’s

By Carson Valley Medical Center

ou’ve misplaced your car keys — again. Or you can’t remember a word you’ve used many times, yet it’s right there on the tip of your tongue. The older you get, the more likely you’re apt to wonder: Are memory slips like this early signs of Alzheimer’s disease? The first thing to know is that mild forgetfulness can be a normal part of aging. The concern is when memory problems become serious — you can’t retrace your steps and find those car keys, for instance. Or you don’t eventually come up with the right word. Know the signs Alzheimer’s is a disorder of the brain that affects memory, thinking and reasoning. It gets worse over time. Most people display their first signs and symptoms when they’re in their mid-60s. Those signs and symptoms can include:

Learn more: 22

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• • • • • • • • •

Getting lost in familiar places. Having trouble paying bills or managing money. Misplacing things in odd places. For example, putting mail in the freezer. Repeating questions. Taking longer to complete normal daily tasks. Losing track of the day or year. Having trouble following a conversation or recognizing familiar people. Having difficulties carrying out multi-step tasks, such as getting dressed. Engaging in impulsive behavior, such as undressing at inappropriate times or places or using vulgar language.

Get help If you or a loved one has memory problems, or you’re concerned about changes in memory and behavior, your first step is to talk to a doctor. It’s important to know that these signs

and symptoms may be caused by problems other than Alzheimer’s, and the right care could improve or reverse them. There is no cure for Alzheimer’s. But there are medications that might delay progression of the disease. Acting quickly is to your advantage. You can also practice the following mid-life preventative care tips that might help you in your later years: •

Head outside for some hiking or biking — aerobic exercise gets the heart pumping. And that helps keep the brain fed with a healthy supply of blood and oxygen. Physical activity is associated with a lower risk of cognitive decline. One large study linked fitness in midlife with a reduced risk for dementia in older age. Just make sure all bike riders wear a helmet — it helps protect the brain from trauma in case of an accident or fall.

Some of the information included in this article comes from the Alzheimer’s Association and the National Institute on Aging. Go to www.alz.org or www.nia.nih.gov to learn more.

| The time of your life.

•

Read a book or break out word games for family game night. Challenging your mind may have immediate and lasting benefits for your brain.

•

Diets high in fruits and vegetables are brain pleasers. Stock up on a rainbow of colors, including: dark-colored vegetables, like kale, spinach, broccoli and beets; berries — blue, black and red; and cherries and plums.

•

When firing up the grill, throw on some salmon, trout, mackerel or other fish high in omega-3 fatty acids, which are good for the brain.

• Heart-healthy diets that limit saturated fat and sodium may also protect against dementia. ● — Carson Valley Medical Center offers a Caregivers of Alzheimer’s & Dementia support group at 10:30 a.m. on the fourth Wednesday of every month at the Douglas County Community & Senior Center, 1329 Waterloo Lane in Gardnerville. Call 775-782-1599 or go to cvmchospital.org for more information.

By Courtney Warner he secret to happiness just may be in growing older. By the time we hit our mid-50s, we’ve learned a thing or two about life. We have the tools to make good decisions and the wisdom to know when we should. While you may no longer play tennis or run 10k races, ice skate or shoot hoops, you may still walk, cycle, play with your dog or have lunch with friends. The trick is to approach each day with creativity — it’s not what I can’t do, it’s what can I do? Creativity extends to trying new things. Opportunities for people age 60 and up abound — local senior centers offer a wide variety of activities from arts and crafts to exercise, dance lessons and card games. Travel companies and restaurants often offer specials for older adults, and local service

Happiness as you age organizations offer many ways to volunteer, whether at a museum, an animal shelter or for children’s organizations. A 2012 University of California San Francisco study concluded that loneliness is a common source of stress and suffering in the lives of older people, which can lead to medical issues such as depression, cognitive decline and cardiovascular diseases. Loneliness has been defined as a state of mind, which can cause feelings of emptiness and aloneness. While lonely people need and often crave contact with other people, their state of mind may increase their difficulty in reaching out and connecting with others.

Low self-esteem may also contribute to loneliness. Learning a new skill or polishing up an old one can help improve your self-esteem and give you more confidence to join group activities.

“There is no room for regret in happy aging.” — Jane E. Brody Getting active in your community is one way to ward off

loneliness and isolation, and to rejuvenate your mind and body. Here are some ways to stave off loneliness: • Join an exercise class to gain more energy. • Find social groups where you find and interact with people who have interests in common with you. • Play games to stimulate your brain and memory. • Develop an interest or hobby in arts and crafts. Take care of your health. Free yourself to try new things. And most of all, have fun. ● — Courtney Warner is executive director of the Carson City Senior Center. For more information, visit www.carsoncityseniorcenter.org or call 775-883-0703.

Developing an arts-and-crafts hobby like knitting, pottery or painting is one fun way to get creative as you age. Photo: Shutterstock

Get creative — there are plenty of new things for you to try

Volume 3 | Issue 1 | Spring/Summer 2019 |

By Dr. Samanda Durand

ou’ve likely heard of primary care and family medicine. But have you heard of integrative medicine? Better yet, do you know what integrative medicine is and how it differs from primary care? Integrative medicine is a blended approach to healthcare combining traditional Western medicine with well-studied alternative treatments. To determine the best care for each patient, integrative medicine providers look at best practices and supplemental therapies from around the world. The goal of this type of blended care is for patients to focus on preventive care and be more

Combining traditional and alternative medicine to fit your needs

Integrative medicine — is it right for you? proactive in their own health. As a patient, you should be ready to commit to the role you must take in your own life to stay healthy because you know yourself, your habits and your health goals better than anyone else. Central to integrative medicine is a focus on treating the person as a whole. Rather than treating specific symptoms of a condition; physical, mental and social health are all considered and treated together to find the best results for each patient. To help provide well-rounded care, complementary holistic therapies are often used for pain relief, healing, stress relief and maintaining a healthy lifestyle. What therapies are offered? Integrative medicine often leans on acupuncture and/or traditional Chinese medicine for pain management. Acupuncture is often known for treating chronic pain in the back, neck and shoulders, but it can also help with osteoarthritis and chronic headaches as well as stress, anxiety and insomnia.

All Renown acupuncturists are licensed by the Nevada State Board of Oriental Medicine and are also medical doctors (MD) or doctors of osteopathy (DO). Photo: Jamie Kingman

Additionally, it can reduce nausea and vomiting associated with cancer treatment; and has shown relief for victims of stroke as well as digestive and respiratory disorders. Acupuncture is available in one-on-one private appointments and group settings. Meditation, mindful movement and chair yoga may be prescribed to reduce stress and the effects on your body. Mindful movement focuses on increasing mobility while strengthening your mindbody connection. Similarly, yoga improves cardiovascular health, balance and coordination; increases strength and flexibility; and may result in weight loss. Chair yoga makes yoga accessible to everyone, no matter his or her fitness level and offers modifications to fit your individual needs. Integrative providers also provide diet and nutrition guidance and work alongside other care providers including dietitians, health coaches and yoga instructors to further your healthy lifestyle.

Is integrative medicine the right fit for you? The most important thing to remember is integrative medicine uses a patient-centered model. This means you are invested in your health and wellbeing and are committed to making the necessary changes to reach your goals together. The integrative medicine model is also more individualized and allows for more one-on-one time with your provider to discuss your treatment and therapy options in addition to the lifestyle changes you’re committed to making at home. Because the patient is at the center of integrative medicine, the type of care and treatment changes based on a patient’s evolving needs and goals. For example, when a patient becomes a grandparent for the first time or begins to care for an aging parent, their health focus and priorities may change. The goal of integrative medicine is to support the person in coordination with their goals. Those goals may be different for someone looking to manage knee pain so they can go grocery shopping on their own versus someone with knee pain looking to complete a marathon. What does the first appointment look like? Much like establishing care with a new primary care provider, you’ll meet with your new doctor to talk about your health. You’ll also talk about your health goals and concerns to create an individualized plan for your care. Together with your provider, you’ll discuss both traditional treatments and alternative therapies to fit your personal needs for mind-body care. ● — Samanda Durand, DO, works in the Renown Medical GroupIntegrative Primary Care department. To learn more, go to bit.ly/2EOPuHF or call 775-982-8255.

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| The time of your life.

Hydrate, hydrate, hydrate

Protect yourself against the dangers of heat exhaustion One question that I am continually asked is how much water a person should drink on average. There really isn’t a certain amount to look for and it varies among adults, children and seniors. A good indicator of satisfactory water intake is urine. Light, clear urine is good and means that you are keeping your body properly hydrated; dark urine, or the absence of urinating regularly throughout the day, means the body is holding on to whatever fluid it has to try and prevent dehydration and a sign that you need to drink more water to help replenish needs and remain healthy. Preventive measures The best form of treatment, of course, is taking preventative measures so that you or your family won’t fall victim to heat exhaustion in the first place:

Staying properly hydrated is one of the most important ways to avoid falling victim to heat exhaustion. Photo: Shutterstock

By Daniel W. Heller t’s that time of year again — summertime in Reno. With high temperatures assaulting residents on a daily basis, we see several pharmacy customers with heat-related illnesses and questions about treatment as the pharmacy is usually the first line of defense before seeing a doctor or visiting a quick care/emergency department. It’s important to know not only the proper forms of treatment, but what steps that can be taken to prevent yourself and your family from falling victim to heat exhaustion. Heat exhaustion is simply when the body experiences prolonged exposure in high temperatures and can no longer handle heat, leading to dehydration and other complications. This doesn’t just happen because of prolonged exposure to sunlight

and the natural environment — it can also stem from intense exercising in heavy clothing, spending too much time in a spa or sauna, etc. Symptoms include, but are not limited to, fatigue and overall body weakness, nausea, profuse sweating, confusion, headaches, dizziness and possible fainting. The person may also experience a rapidly beating heart, called heart palpitations. Heat exhaustion is the most common form of heat-related illness, with heat stroke being the most extreme, leading to hospitalization and, in some cases, death. Young children and the elderly are highly susceptible to heatrelated illnesses. Take note if you look overly flushed and sweaty, feel weak and/or confused, or complains of intense thirst or nausea to seek medical attention.

How do we treat it? The good news is, in most cases the body can recover fairly quickly with a few simple steps: Go indoors. As easy as it sounds, quickly remove yourself from the heat and get back inside to a cool environment. Try taking a cool bath or shower to help lower body temperature. Cool down and calm down. Try lying flat on your back with both legs raised; you can also help cool your body temperature down by using ice packs or wet towels, sitting directly in front of a cooling source, etc. Hydrate, hydrate, hydrate. Dehydration is the lack of water that exists in the body, so it is crucial to replace it as quickly as possible by drinking plenty of fluids.

Morning time is the best time. For any planned outdoor activity, try to schedule it during the early morning hours. Even in the evening, temperatures can be brutal so it’s best to exercise, walk the dog, do the gardening, etc. before the heat becomes too intense. Once again, hydrate, hydrate, hydrate. If time outdoors can’t be avoided, try to drink plenty of water before heading out (10-20 ounces), and drink even more if strenuous activity is on the agenda. It’s much tougher to replace fluids when suffering, so drinking plenty of water beforehand will help tremendously. Protect your skin. Our skin is our protective barrier, so remember to wear loose fitting clothing and hats, and don’t forget the SPF. ● — Daniel W. Heller, Pharm. D., is a Patient Care Coordinator for Smith’s Food & Drug Stores, with several locations throughout Northern Nevada. Visit www.smithsfoodanddrug.com to learn more.

Volume 3 | Issue 1 | Spring/Summer 2019 |

esides its spectacular natural beauty, a plunge into Lake Tahoe can literally take your breath away. It may be warm outside, but the lake can be dangerously cold. Lake Tahoe’s average surface temperature in the summer is 63 degrees, and can drop to 53 degrees just 18 inches below the surface. And many other regional water bodies have colder-thanyou-might-think temperatures during the summer months. One of the most dangerous consequences of submerging suddenly into cold water is a “coldshock response.” This response is an uncontrollable gasp for air, followed by a prolonged period of rapid breathing. Taking a couple gasps of air underwater is all it takes to drown. Another “cold-shock response” when temperature of the blood cools down and returns to the heart is a heart attack. So what can we learn from others who take a dangerous plunge? Here are few tips for a fun and safe day at the lake. Ease in Slowly: Take your time getting in the water. Give your body time to adjust to the cooler temperature. Follow the Rules: Swimmers should stay in designated areas. If you are paddling, wear a PFD (personal flotation device). Non-motorized crafts have the right of way, but be aware of power boats.

Watch for Obstacles: With the heavy amount of snow we had this winter, you may notice extra vegetation and debris near and along the shoreline. Before jumping into the water, scout out any obstacles and jump in feet first. Whether you are swimming or paddling, know how to look for and avoid obstacles.

Be prepared Swimming at Sand Harbor at Lake Tahoe can be a wonderful summer activity. Just make sure you’re prepared for cold water temperatures.

By Cate Neal

Photo: Ming Poon Photography

Be Weather Aware: On Lake Tahoe, especially, weather varies by the hour. Don’t wait for the weather to change. Be aware of your surroundings and know the easiest way to shore. Skip Swimming and Drinking: Alcohol impairs judgment and increases risk-taking, a dangerous combination. Even experienced swimmers may venture out farther than they should. A leg cramp can make it challenging to get back to shore, and even a chill can develop into hypothermia. Bring a Buddy: Never swim alone. If you haven’t seen your buddy for a couple of minutes, he or she may need your help. Supervise your Children: Keep an eye on your children, especially if they are inexperienced swimmers. If possible, teach your little ones to swim at a young age. In short, summer at Lake Tahoe is a treasurable time with family and friends. Do your best to keep it that way — swim with caution and enjoy this magnificent body of water. ● — Cate Neal, RN, is the Trauma Program Manager at Barton Memorial Hospital’s Level III Trauma Center. Go to www.bartonhealth.org to learn more.

Safety tips for swimming in Lake Tahoe or other Sierra Nevada bodies of water 26

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Volume 3 | Issue 1 | Spring/Summer 2019 |

16388ROPA

Start now Estate plan maintenance can be similar to health maintenance

By Danielle L. Christenson any residents of our community age 60 and over are relatively “new” residents to the great state of Nevada, having purposed to retire here to avail themselves of the exceptional quality of life that only Northern Nevada offers — and that is particularly evident and available in picturesque Douglas County. If you are one of those “newer” members of our community, know that you are welcomed to Douglas County with enthusiasm and energy, and that your “new” community shares in your belief that you made the right choice. In retirement, one is often focused on health and how best to maintain it since, as we age, life takes its natural course and our aging bodies too soon become less nimble, less flexible, less capable, less steady — even slower

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— and require regular checkups and maintenance in one form or another to allow us to maintain the level of activity that corresponds to our physical health. The same evolving maintenance requirements occur over the lifetime of an estate plan: an estate plan requires regular checkups and maintenance to keep each component strong, impenetrable, functional, and moving forward. This applies to all forms of an estate plan, including a trust plan; a will plan; a “pay-on-death” plan; and powers of attorney. If you have, indeed, recently relocated to Douglas County from another state, the estate plan that you designed in the state of your prior residence should be reviewed within six months of your relocation. Nevada estate planning laws are not distinctly different from estate planning laws in other states, but, particularly since 2015,

| The time of your life.

our Nevada State Legislature has made many changes to Nevada’s estate planning laws — mostly positive; some controversial — that your estate plan should contemplate if not also address head-on; particularly in the area of guardianship. Even if you are a long-standing resident of Douglas County, but your estate plan has not been reviewed for some time — say, in more than three years — your estate plan is in need of a regular checkup. Another reason to have your estate plan reviewed is to ensure that the people that you previously nominated to take care of you — who likely DO NOT reside in Nevada — are still the right people to take care of you. Beyond your relocation, perhaps circumstances have changed, and the people you nominated to manage your finances and make healthcare decisions on your behalf

may not be the best choice for you: perhaps they have moved away, as well; perhaps you have grown apart; perhaps a divorce or marriage has occurred that has given you concern. If your nominations are no longer the people you would want making decisions, you need to have your estate plan reviewed. As we age, our health depends on ongoing and regular maintenance. Your estate plan is not any different. If ignored, your estate plan can fail you miserably. Just like your health. Maintain your estate plan with the same commitment and interest in which you maintain your health. Start now. ● — Danielle L. Christenson, Esq., is an attorney licensed in Nevada and California who practices primarily in areas of estate planning, trust, wills, probate, trust administration, guardianship, elder law and family law. Mrs. Christenson is the owner of Heritage Law Group, P.C., in Minden, Nevada. Call her at 775-782-0040 or go to heritagenevada.com to learn more.

By Margi A. Grien

glance out the window may not confirm it, but spring is little more than a month away. As spring home upkeep and repair season nears, online ads, bulletinboard posts and solicitations from unlicensed contractors interested in performing a variety of services on your home are likely to pop up just as quickly as the weeds in your yard. The Nevada State Contractors Board warns everyone — especially older adults — to be on the lookout for unsolicited offers from door-todoor salesmen or other individuals advertising inexpensive services on Craigslist, Facebook, community newsletters or other related mediums. It is always in homeowners’ best interest to hire licensed contractors for any work in or around their homes. Licensees have passed criminal and financial background checks; are required to carry workers’ compensation insurance; and have passed necessary trade and law exams demonstrating their competence and awareness of their responsibilities as licensees. Referrals are always a great place to start, but it’s important to still verify a contractor is properly licensed, regardless of how great their work has been in the past. A contractor’s license contains five significant digits: 98765 or 0098765, and is not the same as a business license. Ensure your contractor has an “active” license status with the Contractors Board using the Board’s mobile application, verifying the license number on the Board’s website, www.nscb.nv.gov, or by calling our office at 775-6881141. When licensed contractors are hired, homeowners receive protections, such as the ability to file a complaint with our office up to four years from the date the work was performed should any workmanship issues arise.

Closing view The Board investigates the complaint and may order your contractor to remedy the issues found to be valid. Owners of single-family residences may also be eligible to file a claim with the Board’s Residential Recovery Fund, which can afford owners up to $35,000 in financial recourse when damages are incurred. Whether you are seeking assistance for a large or small home repair project, the Contractors Board discourages hiring unlicensed contractors due to the added risks and liabilities homeowners assume, including the likelihood that the unlicensed individual is not carrying workers’ compensation insurance. Although the board will investigate complaints into unlicensed contracting, these cases are sent to the local district attorney for criminal prosecution, which may or may not include an order for restitution. Most homeowners in this situation find themselves seeking recourse

through civil litigation, and/ or hiring a properly licensed contractor to make the necessary repairs. Protecting yourself from construction related scams requires awareness of some of the main warning signs: • “Today only” offers using excess material from a recently completed job in the neighborhood. • Only accepts cash payments or offers discounted rates when using cash; requests a large down payment to purchase materials, and refuses to put the terms of your project in writing.

It is important to note that contractors must be licensed in Nevada — those living in communities along the state’s border may find themselves being solicited from out of state contractors. These contractors must obtain a Nevada contractor’s license in order for you to receive the full protections of the Board. The Contractors Board is a FREE public resource, and we welcome the opportunity to serve you whether hiring a contractor, filing a complaint, or answering your construction-related questions. Please call us any time: 775-6881141. ● — Margi Grein is Executive Officer of the Nevada State Contractors Board. Visit www.nvcontractorsboard.com to learn more.

• High-pressure sales tactics that include “free inspections” or an insistence to enter your home, which can lead to crimes of theft or burglary. • Claiming to be “licensed, bonded, and insured,” but only has a Nevada business license.

Scammers are everywhere, and many will strike via an oddly worded email or a sketchy request via phone to obtain your information. Photo: Shutterstock

Don’t get ‘swept up’ in spring, summer home repair scams Volume 3 | Issue 1 | Spring/Summer 2019 |

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