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Health Matters Observer

AUGUST 2020

KNOW YOUR FUTURE Genetic testing can tell you what conditions you and your children might face — and possibly the best ways to stay healthy. PAGE 2

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What to expect as your eyes age with you.

E-bikes are the future of transit — for everyone.

Push yourself for the next generation.

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AUGUST 2020

Nicole Wood offers genetic counseling to people in need.

THROUGH DIVORCE By Freya Robbins, CDFA™

Peace is something that seems to be in short supply these days. It feels like there is an argument waiting for each of us at every turn. Any expression of what we believe or feel seems like an invitation for someone to disagree. Of course, everyone has a right to their opinion! But a disagreement doesn’t have to be an argument and the decision to part ways doesn’t have to affect your peace. This sense of walking on eggshells is something many of us experience before and during a divorce. It can feel as if any misstep creates an explosion of emotion and words that can’t be unsaid. Over time this can really wear on your well being and it is important to realize there is an alternative. You can end things positively and without the added stress and financial strain of a contentious, litigated divorce. As a CDFA™, Certified Divorce Financial Analyst, I specialize in helping people see clearly both for the present and for the future. I understand that when we get to the end of a relationship, we just want it over. However, what you agree upon now will affect you and your family years down the line. As a Florida Supreme Court Certified Family Mediator, I have guided divorcing couples through the process for over 15 years. Drawing from my own life experiences in marriage, parenting, divorce and step-parenting, I understand the intensity of the head vs. heart battle and do my best to help couples understand that keeping Peace is the best option. Our goal is to help create a settlement that fully addresses the divorcing couple’s long term financial and strategic needs. My role includes providing you both with expert financial guidance, enhancing communication with your spouse and other professionals and, most importantly, creating amicable solutions. We help divorcing couples understand the reality of their situation and reach beyond an emotional reaction to what’s truly in everyone’s rational best interest,

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ABCs DNA

with the result being a better, more peaceful resolution. I like to use the acronym P.E.A.C.E. P is for Perspective. If we can try to see and understand things through each other’s eyes, it helps us find the middle ground for a compromise. I may never agree with you, but if I am willing to understand your perspective we can continue a discussion.

E is for Equitable Distribution. The law mandates a fair and equitable distribution of your assets and liabilities. That looks different for every couple. I use my expertise to help you determine what is fair given your unique circumstances. A is for Analysis. After the emotional component is settled, divorce is often the largest financial transaction you will ever make. It is important to have a fair and thorough understanding of your financial situation.

Local health professionals weigh in on the benefits of genetic testing for everyday people.

C is for Conversations. The ability to discuss these things calmly, honestly and thoroughly is the key to the mediation process. Don’t worry if that doesn’t feel like something you can do right now! It’s my job to help you do this!

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E is for everything else, which can cover a wide range of details, from refinancing, alimony, child support, credit card debt, making sure liabilities and deeds are changed, as well as how to operate emotionally and financially while in the divorce process.

s anyone in the medical field can tell you, the human body is incredibly complex. Beyond the thousands upon thousands of variations in height, eye color, skin color, hair color and athletic ability are the millions of variables that make up our genetic structures. For decades, medical professionals and scientists have learned more about our bodies through genetic testing, a procedure in which we examine our DNA structure. It looks at whether your body has changes — mutations — in its genes that point to a specific illness or condition. Some changes

The first step is a complimentary 15 minute call with you, followed by a call with your spouse. Then, if we are all comfortable, we will proceed with an initial consultation where we begin to discuss specifics. Mediation is typically the least expensive and most rewarding alternative to a litigated divorce. Couples always have the opportunity to have an attorney assist in the mediation process if they prefer. I hope to have the opportunity to help you and your family.

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can point to cancer, while others can suggest if your family has a history of certain conditions. It’s an immensely complicated topic, one that isn’t always clear to discover health conditions. Finding a gene mutation through genetic testing, for example, has a fairly direct association with some form of cancer. For a different health issue, such as diabetes, there are other environmental and genetic factors at play that can make an association more ambiguous. “Our understanding of genetics has become a lot better, and the application of genetics has become more relevant to patients,” said Nicole Wood, a certified genetic counselor with Sarasota Memorial Cancer Institute. “It’s become less of a theorized ‘This is how these results may impact you at some point’ and more practical ‘These are the results.’ And these are what we can do with that information and have a direct impact on their health and their well-being.” Finding that balance between

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your body and nature and nurture is an ongoing craft, and scientists and health professionals are relying on genetic testing more every day. Sarasota Sports Medicine, a medical clinic founded in 2012 by Orioles chiropractor Ken Kaufman, has started utilizing genetic testing to create more specialized nutrition and exercise routines for its members. The hope is that instead of trying different diets and programs that might not be right for certain people, genetic testing can show the best breakdown proteins, micronutrients, carbs and other factors for individual people. “The genetic testing gives us a tool and gives the client the tool to know, ‘OK, this is what I need to do,’” Kaufman said. “Somebody follows a certain diet and invariably runs into a brick wall and won’t progress as fast as they had hoped. And so they abandon it because they think, ‘Maybe this isn’t for me.’ Whereas now with a genetic test, they know psychologically, this is the one for me.” The hope is that the more precise nutrient and exercise regimens can result in faster and more noticeable improvements, through knowing what food groups and nutrients you’re deficient in and understanding what types of exercise are more productive. Sarasota Sports Medicine has partnered with Nutrigenomix, a genetic test provider, for the fitness and nutrition tests. The test gauges nutrient metabolism, weight management, body composition, eating habits and more. Genetic testing remains a complicated subject, so we asked local health professionals to share insight on the topic.

What is the test like? Although the genetic information the tests parse through is complicated, the actual way they are administered is not. Genetic testing is done most frequently through blood samples and cheek swabs, two relatively safe practices. The collected DNA is delivered to a laboratory where technicians look for a specified criteria, be it a possibility of cancer, autism or other conditions. Wood said results then take typically two to three weeks to come back. “The genes that we would evaluate are different, but we’re still measuring the DNA from the white blood cells in your blood or the lymphocytes in your cheek,” Wood said. “We have 20,000 genes in each of ourselves. So when we send off a sample, regardless of what it is — blood, skin, saliva — all of that information is contained in every single one of the cells. So we just tell the lab what we want them to focus on.” A common mistake Wood recommends patients avoid is eating or drinking before a cheek swab test. Technicians are looking to parse through your DNA, not so much burger genes. What are the benefits? Being aware of your body gives you more ability to take care of yourself. Knowing you’re susceptible or positive for certain conditions can push you toward treatment and prevention plans. A negative result likewise can offer peace of mind. Knowing if you are, or are not, susceptible for genetic conditions can also be an important part of family planning. Having an idea of what diseases you have a higher risk of, especially when cross-referencing it with a family history, can give some-

one repose or push them to making changes in their lives to avoid developing illnesses in the future. People at risk for an inherited cancer gene often have family members diagnosed with cancer before the age of 50, so Wood recommends being tested before that age. What are the risks? It should be noted that the procedure for prenatal testing has a small but real risk of miscarriage. There are also limitations. Although a test can show the possibility of having a condition, it has no way of telling you if you will show symptoms, the severity of those symptoms or whether it will worsen over time. How much does it cost? Genetic testing can be covered by health insurance plans, though some customers pay out-ofpocket to avoid their coverage

being affected. Sarasota Sports Medicine offers the genetic test with a consultation and a report of findings for $549. Can you figure it out yourself using at-home DNA tests? At-home DNA tests, also known as direct-to-consumer tests, are something of a different breed than the testing done at health institutions. Rather than visiting a hospital or clinic and having the test be done by a medical professional, these tests are sold to consumers directly — you might have seen them advertised online and can buy them in stores. There, you send in a DNA sample and have the results sent back to you. A particularly popular subset of at-home kits are ancestry tests, which track your genetic lineage. It’s easier, but Wood said the evidence from those tests is more anecdotal. “It’s not used for med-

Harry Sayer

Sarasota Sports Medicine Founder Ken Kaufman has started incorporated nutrition and workouts based off his genetic test result.

AUGUST 2020

ical purposes, but it is interesting for a lot of people,” she said. The validity of genetic tests sold directly to customers can be harder to ascertain. Laboratories that have healthbased testing fall under federal regulations known as the Clinical Laboratory Improvement Amendments, as well as state restrictions. The CLIA rules are meant to control quality of testing procedures and personnel to ensure proper validity. Wood does note there are labcreated hereditary cancer tests you can purchase online that are useful if you don’t have a genetic counselor nearby. The U.S. National Library of Medicine states many direct-toconsumer tests are not CLIAcertified and currently have little regulation, and it might be best to consult with a health professional before ordering one. Why is genetic testing more beneficial than just knowing your family history? It’s hard to know everything about your family’s health. Wood said it’s far safer to deal with science. “We walk through their personal risk factors for cancers and talk about their family history and as much detail as we can,” Wood said. “Nobody knows everything about their relatives. So we work [with what] we have, but we try and get as much detail there as possible.” For those trying to start a family and wanting to know what diseases or conditions their children could carry, Wood recommends getting tested. For more ambiguous maladies, such as diabetes or Alzheimer’s disease, knowing the family history might end up being the most beneficial.

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AUGUST 2020

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Everyone knows your eyes change as you age, but did you realize some conditions can be prevented or slowed while others are simply inevitable? Signs of common eye conditions — glaucoma, cataracts or presbyopia — often begin in an individual’s 40s or 50s because eyes physically change as you age. For example, the eye’s lens begins to harden, and the retina becomes cluttered with “cellular trash” that impacts vision. Local optometrists Dr. Ashley Masuga, of InFocus Family Eyecare, and Dr. Troy Bedinghaus, of Vision Source Signature Eye Care, share some of the most common conditions you are likely to experience as you age.

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PRESBYOPIA

Presbyopia is a fancy way of saying you lose your close-up vision. Generally, this type of vision loss begins around age 40 and progresses through age 55. “That’s the biggest one we asso-

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ciate with age,” Bedinghaus said. “The lens inside the eye stops flexing, and the muscle that makes it flex just isn’t working as [well].” Individuals experiencing presbyopia might initially think they need more light to see well or feel eye strain and fatigue. They’ll begin to hold things at a distance, gradually farther and farther away. It might also take longer to shift focus from one object to another. Reading glasses are helpful, and it’s best for individuals to be checked by an optometrist to determine if the vision loss is similar in both eyes. If the difference is too drastic, reading glasses are not always recommended. Masuga said for those who wish to avoid reading glasses, there now are multifocal contact lenses available. Masuga and Bedinghaus noted presbyopia is not preventable.

Dr. Ashley Masuga, of InFocus Family Eyecare, says natural changes in the eye lead to certain vision conditions.

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Even your dog can get cataracts, but what does it mean? As you age, the internal lens of the eye becomes cloudy and gets thicker each year. That means less light gets into the eye as well. Cataracts increase in your 50s and 60s until, typically, in your 70s, you simply can barely see at all. Early signs are a halo effect — much like when you look at the sun, look away and see circles — and trouble with night vision. Masuga said UV light can speed up development of cataracts, so protecting your eyes is important. “We’re all going to have one,” Masuga said. “It’s a natural change of the eye.” Fortunately, cataracts can be corrected with surgery, and once a surgery is completed, you won’t have to have it repeated, she said. GLAUCOMA

Masuga calls glaucoma the “silent blinder” because many people do not realize they have a problem until their vision is gone permanently. The eye essentially is a circular shell filled with fluid and gel. Fluid is pumped in and out of the eye, and when the pump stops working correctly, pressure begins to build. This can damage the nerve connecting the eye to the brain. “The pressure has to be awful high for you to feel it,” Bedinghaus said. “You really have to depend on the doctor [for diagnosis]. It happens so slowly you don’t notice it.” In the early stages, there are no symptoms, but gradually, individuals begin to lose their peripheral vision. Masuga said catching glaucoma early is critical for slowing its progression. Treatment typically

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DERMATOCHALASIS

Dermatochalasis sounds complicated, but it’s a simple condition. It’s when the hooding of your upper eyelid begins to droop, thus pushing down on your eyelid and impacting vision. If you always seem to be lifting your eyebrows up, or if your eyelids look uneven when you look into the mirror, you might have dermatochalasis. Typically, the condition is seen in individuals 60 and older.

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Macular degeneration is a severe loss of central vision caused by the buildup of a protein, called drusen, in the retinal lining of the eye. Early signs are distorted vision or skipping letters while reading. The most common form, called “dry” macular degeneration, is the thinning of the retina, while the more severe, less common form (20%) is “wet.” It refers to the leaking of blood vessels or new growth of blood vessels in the eye. Studies have found the condition is largely genetic but also that a healthy diet can have a significant impact in development and progression of the disease. Masuga said it’s best to eat a healthy diet rich in dark leafy greens and colorful vegetables.

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AUGUST 2020

RIDING HIGH

Rory Dowdell says he uses an e-bike for “90%-95%” of trips within 8 miles.

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Isaac Sierra wants to educate people about electric bikes and their uses.

E-bikes can be an option for everyone, including older riders. RYAN KOHN SPORTS REPORTER

wo years ago, the Dowdell family had two cars, which they used to take themselves everywhere. Rory and Krista Dowdell simply drove their children — then two in number, now three — around town as needed. The system was fine, but something was lacking. Rory Dowdell said he and Krista

both enjoy CrossFit workouts and, at the time, were thinking about training for a triathlon. A onehour session wasn’t enough. They were craving more of a workout, he said, and started to think about creative ways to do that while still being around their kids. “We thought, ‘What if we biked to the workout?’” Dowdell said. “Our gym is about 5 miles away. Driving, it takes us 12-14 minutes. We looked, and on a normal bike it would take us 25 to get there. That was too long. But on an electric bike, it would only take 14-16 minutes. Since we could do the commute in about the same time and get that extra workout in, it

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became worth the investment.” In October 2018, the Dowdells traded in one of their vehicles and purchased two Riese & Muller electric bikes, becoming the latest family to make the switch. The U.S. is late on the trend. According to the Verge, electric bikes, or e-bikes, account for just 4% of total bike sales here. In some European countries like the Netherlands (68%), there are more e-bikes sold than regular bikes. But it is growing here: According to research firm NPD, e-bike sales jumped 91% from 2016 to 2017 and 72% from 2017 to 2018. In simple terms, an e-bike is a bike with a motor, battery and controller built into it, allowing riders to increase their speed while pedaling less frequently or with less vigor. There are three classes of them. Isaac Sierra, of Sarasota’s Shoreline Ebikes, said Class 1 bikes feature a technology called “pedal assist,” which gives you assistance based on the cadence of your pedaling. Riders can choose to have more or less assis-

tance. These bikes are capped at 20 mph. Class 3 bikes feature the same technology but can reach speeds of 28 mph. It is the Class 2 bikes, Sierra said, where things change. These bikes do not trigger their assistance through pedaling but rather through a throttle, similar to a moped. These bikes can reach speeds of 20 mph. “We don’t recommend [Class 2s],” Sierra said. “They are not easy to pedal. If you have an injury, it is hard to control your speed. People end up just using the throttle and not getting a lot of exercise.” The benefits of switching to an e-bike are numerous, Sierra said. For older riders who don’t think they have the strength to ride a bike, an e-bike can handle the majority of the load. Sierra said it’s easy to pedal them, even for those with weak or injured legs. Because the bikes take less of a toll on your muscles, Sierra said, riders feel better afterward and are more likely to ride frequently as a result. The one drawback is cost. A

sturdy e-bike intended for frequent use can cost between $1,000-$3,000. For bikes meant to be car replacements, like the Dowdell family’s bikes, that price can jump to $5,000-$6,000. But Sierra said the cost is worth it. If you buy a cheaper bike, he said, it’s likely to be a “one-time use” bike, meaning that if part of it breaks or malfunctions, it cannot be fixed, and a new bike must be purchased. Bikes from leading companies like Riese & Muller are more likely to last a long time, and if something does go wrong, they use parts from trusted companies like Bosch and Shimano that are easily replaced. In addition to brick-and-mortar stores, there are various retailers selling e-bikes online. Sierra said he urges his customers to do their research and determine which bike would be the best fit for them. The nonprofit People for Bikes, he said, is a good place for riders to begin. “We do more education than we do sales,” Sierra said. “I truly do think e-bikes will be a big component of transportation in the future, especially in urban areas. They are good for the environment. They lessen traffic on the roads. There are people here already living that life.” Rory Dowdell is one of them. Dowdell said he has no regrets about trading in a car for his family’s e-bikes, and he has since purchased another e-bike to accommodate his growing family. “It was a little challenging in the beginning,” Dowdell said. “We had to plan out our trips more. Now, 90%-95% of trips within an 8-mile radius, we’re doing on our bikes. I even went to jury duty on my bike.”

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Sabal Harbour’s Lesley Aulds ran alongside his 8-year-old son, Emmett, during Bridge of Life’s Superhero 5K in February. Together they crossed the finish line, which is something Aulds thought he wouldn’t be able to do because of his weight. “You can’t take things like [running in a race together] away,” Aulds said. “[He and I] will both have that forever, of being able to do that and finish together and everything.” Before having gastric sleeve surgery in December 2018, Aulds weighed 322 pounds. Gastric sleeve surgery removes 75%-80% of the stomach. He was on nine medications and just wanted to be healthier, so he could play with his son without running out of breath easily. After surgery, he weighed 202 pounds, and he didn’t want to stop there. In addition to weekly workouts with an F3 group through Bayside Community Church, Aulds finds ways during the week to exercise on his own, whether it’s running around his neighborhood or doing boot-camp-type exercises at home or at the park. “I use whatever I have,” he said. “I don’t go to a gym or anything like that.” He’ll even take a walk during his lunch break at Mobydick North America to keep himself active throughout the day. “I just feel great after getting a good workout, whether it’s run-

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1231 N. TUTTLE AVE. SARASOTA, FL 34237 941- 366-0134

14243 TAMIAMI TRAIL NORTH PORT, FL 34287 941-888-2144

408 7TH STREET WEST PALMETTO, FL 34221 941-803-7939

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Welcome Call now, our friendly team is ready to help you SAVE. SAVE up to 80% on your prescription needs | 941.927.3600

Sarasota Chamber Business of the Year - Wellness Award Winner - 2018

Our prescription service can help when... MEDICATION NOT ON YOUR CURRENT INSURANCE PLAN HIGH CO-PAYS / DEDUCTIBLES AVOIDING THE DONUT HOLE SAVING ON EMPLOYEE’S PRESCRIPTION NEEDS

Affordable Convenience to Your Doorstep For over 15 years, many in our community have turned to Discount Prescription Services to help.

THE PROCESS: With a valid Doctors prescription your medication will be billed, filled and shipped to you direct from the pharmacy.

REFILL SYSTEM: Once you have placed an order with us, you will be included in our refill system. We will contact you when it’s time to place your next order, allowing enough time for the new order to be delivered. Refills will not be ordered without your consent.

WE WORK WITH DOCTORS: We work with many of the area

CALL NOW FOR SAVINGS

UP TO

80% ON PRESCRIPTION MEDICATIONS COMPARED TO US PRICES.

Doctors who are familiar with our service. Locally Owned and Serving Customers all over the US since 2003 Drop by or Call Monday-Friday 9am-5pm; Saturday 9am-2pm 4113 Bee Ridge Road, Sarasota 34233 | 941.927.3600 * Fax 941.927.0027

We give back to the community through our Charity of Choice - Each time you place an order, a donation is made on your behalf to a local charity like All Faiths Food Bank, Boys & Girls Club, SPARCC, Tidewell Hospice and others. 337197_V13

*Narcotic and refrigerated medication not available.