June 2010 Healthwisc

JUNE 2010 Est. 1992

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F R E E P U B L I C A T I O N

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By Kalpana (Rose) M. Kumar, MDIn the decades I have worked with women

in midlife, I have come to a much deeper understanding of the sacred process of women’s cycles, and the powerful transition that women make in their forties and fifties, that has the potential to deeply heal unhealed aspects of their bodies and their lives.

Carl Jung said that the window between the unconscious and conscious is thin during adolescence and in midlife. We get a second chance in midlife to reinvent ourselves from the inside out. The process is transformational and with precise guidance from those who have traversed this sacred territory one can orient themselves at all levels of body, mind and Soul as one explores who they truly are and what they are here to contribute.

Since Christiane Northrup, MD, published her landmark book entitled, The Wisdom of Menopause, a much deeper understanding of women’s health has emerged. Although it has not yet made its way into the traditional medical system, which continues to pathologize women’s bodies and processes, a stirring and an awakening has begun in unprecedented numbers of women. In my practice I see multitudes of women who have a keen insight into their process and an understanding of where their healing is needed.

As recently as a decade ago, women would come to my practice asking me for advice and relied on my knowledge and wisdom about their process. I find myself now offering them a framework with which they can journey through the changes in their mind, body and soul that are occurring, as well as provide validation and understanding for the process they bring with them to help them integrate balance at physiological and emotional levels through integrative medicine.

Times have changed and there is a deeper longing for a healthy framework in our society to replace the victim/persecutor/rescuer framework that women have been imprinted to live out by our society. Moreover, traditional medical practice promotes fear and dependency which disempowers women. They are asking for a more empowering form of health care in which they can work collaboratively with their health care practitioner to understand and identify the areas of imbalance in their life that may be causing their conditions.

Women’s health has been one of the least understood and most neglected areas of medicine.

In a woman’s late thirties, her hormones begin to shift subtly. In our American society, the synthetic estrogen load from the estrogen in meat and dairy, oral contraceptives, by-products of plastics and pesticides, in excess body fat stores, as well as higher concentrations of synthetic estrogen in the groundwater (from the hormones animals and women excrete due to higher intake of

synthetic hormones) creates a state of estrogen dominance in a woman’s body. In order to have a healthy cycle and a healthy peri-menopausal transition, progesterone needs to be balanced with estrogen. At this age, progesterone levels begin to drop gently, stimulating stress hormones that are produced with this imbalance. She begins to experience the imbalance around two weeks before her menses and it becomes more exaggerated right before menses. She feels more irritable, experiences early morning awakening as well as restless sleep, hair thinning, emotional lability and sensitivity, heavier periods, skin changes including more acne, increased abdominal girth, breast tenderness, memory changes, bowel sensitivity or irritable bowel symptoms and sensitivity to various foods particularly dairy and gluten. She simultaneously finds her Soul becoming restless and begins asking a series of questions about her life and her relationships from a deeper newer level. She begins to want more Truth in her life and finds herself intolerant of anything less. She also begins to ask questions like ‘why am I here?’. She finds herself being awoken by this question in the middle of the night with relentless fervor.

I have seen diabetic women develop difficulty with blood sugar control before their periods, as well as women with ulcerative colitis and lupus with worsening of their symptoms before their periods. These have been correlated with lower blood progesterone levels and improve with natural progesterone.

When I received my training in internal medicine at Stanford University in the late 1980’s, women’s health was a novel subject with little passion or interest from the medical community. The answer to most issues that women came in with was addressed with oral contraceptives, hormone replacement therapy, antidepressants or hysterectomies. Women would leave the Medical Center feeling disempowered and broken. Not much has changed in the medical field of women’s health since the eighties. This form of medicine did not resonate with me at all. It felt disempowering and women felt broken and betrayed by their bodies. It certainly did not educate them or address their issues. As a woman myself, I felt deeply betrayed by the medical system on behalf of my gender with the pathology oriented framework that diagnosed the natural transition of menopause as an estrogen deficiency and premenstrual syndrome as a psychiatric condition.

When I first began hearing about natural hormones, I intuitively felt that they had promise. As a clinician and a scientist, I waited patiently for research that could demonstrate credibility and legitimacy for standard-of-practice so I could safely prescribe natural hormones. In the last twenty years, no large scale studies have been done. This is mostly due to the fact that the pharmaceutical industry and the research industry do not see any legitimacy in conducting studies on what are not synthetic pharmaceuticals. Despite that, I began seeing women who came to me on natural hormones themselves and were experiencing great results. Their symptoms of the hormone imbalance and estrogen dominance were dissipating. As I approached my late thirties, and began experiencing the estrogen dominance symptoms, I tried natural progesterone, and within one cycle of taking it, felt significantly more balanced with more vitality and energy. I began prescribing the natural hormones, but felt it was important to objectify the treatment with blood levels of hormones, including a thyroid panel which is also imbalanced during this transition process in over 25% of American women. The results were unprecedented and mostly (90% of the time) positive when combined with lifestyle change that introduced healthy nutrition and exercise into the therapeutic process. I also read most of what was published on natural hormones to be able to understand the mechanisms, risks and benefits of them in order to help my patients take them safely.

Although estrogen replacement has been touted by the traditional medical model as the key ‘woman’s hormone’, in my experience with thousands of women over twenty years, I have experienced more positive effects of natural progesterone on symptoms of chronic illness including fibromyalgia, irritable bowel syndrome, ulcerative colitis, as well as mild anxiety and depression. In many cases, fibromyalgia patients who developed their symptoms during their menopausal transition were symptom free after beginning the correct therapeutic dose of natural progesterone.

Progesterone has a profound effect on reducing tendon and muscle injury in active

FOR WOMEN

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June 2010 Note

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June 2010 EDITION

Summer officially arrives this month and I can’t wait! We had a beautiful May and I took advantage of the warm weather by taking long walks with my family, working in the yard and cleaning up

the barbecue grill in anticipation of the summer grilling season. I love the easy preparation of summertime foods and I really appreciate the fruits and vegetables that are available at this time. The flavors are incredible and they give me a lot of kitchen inspiration. I truly feel healthier after increasing the amount of fresh veggies in my diet. I encourage people to try their hand at gardening because it gets you out of the house and into the sunshine (use sunscreen!). It gives you a good workout and nothing beats fresh fruit and vegetables! If you don’t have time or space for a garden, try visiting many of the local farmer’s markets. It can be fun for your whole family and hopefully it will get your kids interested in better eating habits.

We have lined up a lot of great health articles for you. We are very interested in staying healthy and we know you are, too. We have current health information for you and those you love. Every month we talk to local health care professionals and we try to get that information to you. You need to remember there are regional health issues and by contacting the health professionals here we can provide you with information that is pertinent to your health. We encourage you to contact us with your suggestions so we can make HealthWisc a better paper for you. Stay healthy!

-Amanda Lewis


After a cold Wisconsin winter, many of us look forward this time of year to warm temperatures and sunshine. There are some, however, who also can look forward to intense headaches – that sometimes can be debilitating at work, while driving, or even at the pool.

CONTROLLING SUMMERTIME HEADACHES

By Traci Purath, MD, Neurologist Medical Director, Wheaton Franciscan Medical Group Comprehensive Headache Care

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Enjoy the summer...and don’t let headaches get in the way of your fun! The best advice if you are a headache sufferer is to BE PREPARED!

Traci Purath, MD, is a Neurologist and Medical Director of Wheaton Franciscan Medical Group’s Comprehensive Headache Care Program, located at Wheaton Franciscan Healthcare-Franklin, 10101 S. 27th Street. For more information, please call (414) 325-4710.

HERE ARE SOME TIPS TO KEEP HEADACHES UNDER CONTROL DURING THE SUMMER MONTHS:

Avoid Dehydration. 01

In the summer, it is easy to become overheated and not drink plenty of fluids. It is important to continue drinking – especially water—throughout the day during the hot summer months. Headaches are a clue that your body may not be getting enough water, and by the time you “feel thirsty” you are already lacking proper fluid intake. Avoid caffeine and alcohol when you are thirsty, as caffeine actually works as its own diuretic, making you more dehydrated. Alcohol also dehydrates the body. Water and juice are good choices during the summer.

In the summer, it is easy to stay up later. The warm summer air and the longer days of sunlight can disrupt our sleep cycles. Lack of sleep is a common trigger for developing headaches. Backyard barbeques and, perhaps, the greater likelihood of drinking alcohol can also lead to disrupted sleep. Alcohol tends to make people fall asleep faster, but awaken throughout the night- therefore people tend to not feel refreshed in the morning.

02 Get Plentyof Sleep.

Many headache sufferers will say that extreme heat will trigger their headaches. It is important to stay in the shade, avoid being out in extreme temperatures. If you know that heat is a trigger for your headaches, try to stay indoors in a cool area of your home during the extreme temperatures of the day, which usually occur between noon and 4pm.

StayCool.03

Eat. 04Low blood sugar can also trigger headaches. The brain requires glucose for energy

and not eating causes our blood sugar to lower which puts many people at risk for headache. Sometimes in the summer fun, we forget to stop and eat. It is important to always have a snack with you. Fresh fruit is a good option because of its natural sugars.

Be Aware ofWeather Changes.05

There isn’t much that we can do to prevent changes in the weather, but if you’re a headache sufferer, you can be prepared. Research has shown that sudden changes in barometric pressures can trigger headaches for certain sufferers. If you know that weather changes are a trigger for your headaches and you see that there are some changes in the weather brewing. Make sure that you have your medications available. There are many medications available for the treatment of headache, and if your health care provider has prescribed something for you always make sure that you have it available. Being prepared is probably the most important thing we can do to help with our headaches.

Many headache sufferers are extremely sensitive to strong smells. If you are that person, and you know that strong smells can provoke a headache avoid sunscreens with perfumes. There are sunscreens and bug sprays available without scent.

Summertime means eating a few more hot dogs and brats. For many headache sufferers, the nitrates (preservatives) in processed meats can cause a headache. Again, being prepared is the key: if you know that you have had problems with nitrates causing headaches (and hot dogs and brats are full of nitrates)...then consider bringing chicken or another non-preserved item to the barbeque. Your friends would rather that you have a good time instead of having to leave early because of a headache.

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Cellulite

UC Berkeley Wellness LetterNearly all women, even skinny ones, have some cellulite. Cellulite is the non

medical term for pockets of fat, separated by bands of connective tissue that protrude into the skin layer. There’s nothing unique about this fat, except that it gives the overlying skin a waffled, dimpled appearance. Women are more prone to it than men because they have thinner skin (cellulite shows less with thicker skin) and a less-even fat distribution under the skin; they also tend to accumulate more fat on their thighs and buttocks, where cellulite typically occurs.

Anti-cellulite treatments—creams, supplements, injections, seaweed wraps, and laser procedures—are big business. Many promise “sleeker” thighs in just a few weeks. What’s lacking is credibility—the small studies cited are usually poorly designed, unpublished, and/or done by researchers with financial ties to the manufacturers.

Anti-cellulite creams and gels (such as Revitol Cellulite Solution and Nivea’s Goodbye Cellulite) contain caffeine, retinol, amino acids, green tea, herbs, and other substances that supposedly increase fat burning, stimulate circulation, and decrease water retention, among other effects. Some compounds may improve the appearance of cellulite slightly—for example, by making the area swell. But there are few published studies on them and no evidence of significant or lasting benefits. As a 2005 review in Dermatologic Surgery pointed out, the ingredients must be able to penetrate the skin and reach the targeted tissue in high enough concentrations to have any effect, and it’s not known if these products do that. There are also reports of allergic reactions from some ingredients. Our take: Probably safe, but likely a waste of money—some cost more than $50 for a small tube.

NOW YOU STILL SEE

NOW YOU SEE IT . . .

Nearly all women, even skinny ones, have some cellulite.

JUNE �010 HEALTHWISC �

Dietary supplements (such as Cell-U-Loss and Cellu-science) contain vitamins, minerals, herbs, fish oil, lecithin, vinegar, and other ingredients, and claim to boost fat burning and circulation, reduce fluid accumulation, and have other skin-smoothing effects. But there’s no evidence that any pill can reduce cellulite—and supplements may contain ingredients of questionable safety. At best, some have a mild diuretic effect that may temporarily reduce cellulite appearance. Our take: Don’t take.

Endermologie is a massage therapy, administered by a doctor or trained professional, that uses a high-powered hand-held roller and suction device. It is approved by the FDA for the temporary reduction in the appearance of cellulite. The key words are “temporary” and “appearance.” The rollers can help redistribute the fat if used regularly but do not get rid of cellulite. In a small Turkish study in the International Journal of Dermatology in 2009, Endermologie was reported to reduce the circumference of treated areas but was only mildly effective in improving cellulite appearance. Our take: May temporarily help, but is costly; may be painful.

Laser/light treatments include TriActive and VelaSmooth, which are cleared by the FDA for the temporary reduction in cellulite appearance (other laser systems do not have FDA clearance for use on cellulite). These treatments heat up and “release” the fat and tighten skin, and then use roller suction massage to smooth the areas. A 2006 paper in Lasers in Surgery and Medicine noted that these laser procedures “yield better and more prolonged clinical results than other therapies” for cellulite, though the benefits are still limited. And you’d have to be treated regularly—twice weekly at first and then monthly—to maintain any benefit, at a cost of several thousand dollars. Mild side effects may include redness and swelling. It’s not recommended if you have certain circulatory or heart problems or are pregnant. Our take: Promising and safe for most people, but expensive.

try to learn to accept your body as it is.

Mesotherapy involves injecting a mixture of drugs, plant extracts, vitamins, and other substances into the skin supposedly to increase blood and lymph flow in the tissues and break up fat cells. Studies in people are scarce, and mesotherapy has not been proven safe or effective. Though some doctors offer it, none of the drugs are FDA-approved for use against cellulite, and there are no standard formulas or doses. It can cause extreme swelling, allergic reactions, and skin lesions, and there are reports of serious infections. If done incorrectly it can cause scarring; long-term consequences are unknown. Our take: steer clear.

Liposuction removes excess fat from under the skin, but it won’t get rid of cellulite because it doesn’t affect the underlying connective tissue structure. In fact, it may cause additional dimpling and thus worsen the appearance of cellulite. A procedure called Laser-Lipo may have better results as the fat is removed and then a laser is used to tighten the skin. Our take: Not recommended.

Seaweed wraps, massage therapy, aromatherapy and other anti-cellulite spa treatments. None are proven to have more than temporary benefits, at most. Vigorous rubbing or compression may make the skin look better briefly. Our take: Can be relaxing, but pricey.

Bottom line: Cellulite is normal and there is no permanent solution. No special diets target cellulite, either. The best advice is to lose weight if you are overweight (weight gain doesn’t cause cellulite but makes it more obvious), get more exercise (aerobic activities to burn fat and strength-training to tone muscles), and try to learn to accept your body as it is.

Reprinted with permission from the University of California at Berkeley Wellness Letter Copyright Health Letter Associates, 2010. To order a one year subscription, call 1-386-447-6328.


DON’T GET BURNED With summertime approaching, it’s tempting to spend more time outdoors, especially under the sun. Between trips to the beach, lounging by the pool and barbecues in the backyard, the increased time spent in the sun could mean problems later on.

While some exposure to the sun helps your body make Vitamin D, which is important for your health, too much sun exposure can be very harmful.

The sun’s ultraviolet (UV) radiation is believed to help cause wrinkles, loss of elasticity in the skin, age spots and skin cancer, among other things. In fact, according to the American Cancer Society, skin cancer is the most common of all cancer types.

The American Academy of Ophthalmology states that long-term exposure to UV rays may also contribute to the development of various eye disorders, such as age-related macular degeneration and cataracts.

If you do decide to spend time in the sun, here are some tips from the American Cancer Society and the Environmental Protection Agency to help protect you against the damaging UV rays:

• Limit the time you spend in the sun between 10 a.m. and 4 p.m. when the sun’s rays are the strongest.

• Spend your time outdoors in the shade or wear protective clothing, such as long-sleeved shirts, pants and hats.

• Always wear a sunscreen with a minimum 15 sun protection factor (SPF). Be sure to reapply the sunscreen throughout your time in the sun, especially when spending time in water.

• Wear sunglasses that block 99 to 100 percent of the sun’s two types of rays, UVA and UVB, to protect your vision.

And if you think tanning beds are the way to go for a harmless tan, think again: Tanning lamps have been found, by the American Cancer Society, to give out UVA and frequently UVB rays as well.

If you notice anything changing, growing or bleeding on your skin, see a dermatologist to have it checked out. According to the American Academy of Dermatology, skin cancer is very treatable when caught early.

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DON’T ALLOW YOUR PAIN TO DEFINE YOUR LIFE!

The picture with the woman in the harness is a 70+ year old that came to us after years of de-bilitating pain in her spine. Her Medical Doctor told her on one of her office visits, “Marcia, I don’t know how stand up with this spine of yours.” She not only got back to standing but she is now on stage acting in a musical production and doing all the things she had thought were over, like traveling and playing with her grandchildren. Yes, that is her lumbar spine x-ray. (How did she stand up with that back?)

At HealthWise, we have a team of experts who will evaluate your problem and, if you are accepted as a patient, we will design a program of care that will help you reach your goals.

ProAdjuster Chiropractic Technology(Acuwave S. M. A. R. T. Adjuster& Joint Mobilization Instrument)Science verifies that our nervous sys-tem controls or influences the function of every cell in our body. We promote the healing process by minimizing nerve interference.Therefore, the Chi-ropractic model of health is centered on the philosophy that, given the right opportunity and circumstances, the human body will heal itself.

PneuBack InstituteA non-surgical, seven-step program designed to address low back pain associated with sciatica, radiculopa-thy, herniated discs and other condi-tions of the back, neck and shoulder. Designed to break the pain cycle, strengthen your back and alleviate future pain through a combination of functional un-weighing, vibration therapy and clinical strengthening, the Pneu-Back Program can help get you on your way to a healthy, more active lifestyle.

Sandy started as a new patient in April of this year. She had a stroke in her 50s, which made her unable to perform her job as a business manager. Sandy’s pain forced her to take numerous powerful painkillers and yet she still was home bound. She told us just recently that she is getting better and she is sure of it! She invited her family over for her grand daughter’s “taco” birthday party Saturday evening. She had to shop for the food, clean her house, prepare the food and be the host all night long. Sandy could not believe how good she felt on Sunday even after working all day Saturday. Her relatives all commented on how good she looked. She told me “You are giving me my life back.”

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Let my great team of professionals show you the new technology that is giving people their lives back. (Please mention that you saw this advertisement in HealthWisc Monthly Magazine when you call.)

Just one year ago, the woman pictured in pink was taking a hand-ful of medications just to keep going. She is a high achiever who teaches Zumba, plays competitive tennis and participates in the Se-nior Olympics.

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FOODS IN FOCUS

Victoria Shanta Retelny, R.D., L.D.N.Environmental NutritionIn our aging nation, it is not surprising that age-related deteriorating eye conditions

are increasing. From birth, our eyes filter light—from sunlight to the more damaging blue light (light waves that make the sky look blue) with detrimental effects over time. Age-related macular degeneration (AMD), a disease associated with aging that gradually destroys one’s central vision, is the largest cause of vision loss in the U.S., affecting five percent of people aged 65 and older. AMD is debilitating; it can obstruct your ability to see the details of someone’s face, or read a book or road sign. And once AMD progresses, there’s no turning back.

Eye health is contingent upon multiple factors. According to the National Eye Institute (NEI), the greatest risk factor for AMD is age (over 60), followed by smoking, obesity, race (Caucasians are more prone than African-Americans), family history (an immediate relative with AMD), and gender (women are more susceptible than men). But AMD is preventable. Just like your skin, your eyes need “sunscreen,” too. Eating wisely can be a protective salve for your eyes. New research suggests that key foods and nutrients might be a simple, inexpensive treatment option to help protect vision.

Enter the Age-Related Eye Disease Study. The last two decades of research have generated vital data on eye health and nutrition. Specifically, the Age-Related Eye Disease Study (AREDS), a 2001 clinical trial led by researchers at the Tufts University Jean Mayer USDA Human Nutrition Research Center for Aging, shed light on nutrients that fend off vision loss from advanced AMD. AREDS found that

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in 3,640 people with intermediate signs of AMD, high doses of zinc oxide, copper (to balance out zinc supplementation), and the antioxidants vitamin C, vitamin E and beta-carotene (vitamin A) significantly reduced the risk for developing advanced AMD. In fact, high potency antioxidant and/or zinc supplementation taken daily reduced the risk of advanced AMD by 25%, according to the study findings, published in the Archives of Ophthalmology in December 2003. Scientists believe that one explanation for the benefits behind the antioxidant formulation might be the reduction of oxidative stress.

The next generation study, AREDS2 (scheduled for completion in 2012), takes the formula a step further by adding the carotenoids (naturally-occurring plant pigments) lutein and zeaxanthin, and/or the omega-3 fatty acids, docosahexaenoic acid (DHA) and eicosapentaenoic acid (EPA) to the AREDS formula to see if it slows the progression of AMD among 4,000 participants aged 50 to 85 years. In addition, the study will look at the effects of eliminating beta-carotene and reducing zinc in the original AREDS supplement.

“AMD is a complicated scenario. The interaction of a number of genes and lifestyle factors may come into play,” explains Emily Chew, M.D., Deputy Director, Division of Epidemiology and Clinical Applications at NEI. “AREDS2 is looking at people who are already at high-risk for advanced AMD and evaluating whether high dose supplementation of lutein and zeaxanthin or omega-3 fatty acids is beneficial. If not, why use it?”

Colorful carotenoids for eye health. Looking for another reason to eat leafy greens like kale and spinach? These vegetables are high in two eye-protective carotenoids, lutein and zeaxanthin, which earned the attention of AREDS2 researchers. Yellow foods like corn and egg yolks also contain high levels. (Hens eat carotenoid-rich corn and marigold petals and pass those nutrients into their eggs’ yolks.) Deposits of these carotenoids form the macular pigment in your eye’s retina. According to research in the July 2006 Journal of Nutrition, macular pigment may reduce oxidation and free-radical damage in the central retina by absorbing harmful wavelengths of light. That’s why eye health experts advise people to consume at least six milligrams (mg) per day of lutein and zeaxanthin from foods to reduce the risk of AMD and cataract formation. The AREDS2 supplement contains 10 mg of lutein and two mg of zeaxanthin.

Eying omega-3 fatty acids. Researchers have also homed in on omega-3 fatty acids for potential eye health benefits. DHA is largely present in the eye’s retina. And, omega-3 fatty acids’ powerful anti-inflammatory properties hold promise for fending off eye disease like AMD, which is believed to be rooted in inflammation. In the December 2009 issue of the American Journal of Clinical Nutrition, researchers followed 1,837 AREDS participants with moderate to high risk for AMD, concluding that those who consumed the most omega-3 fatty acids (primarily from fish and seafood) were 30% less likely to progress to advanced AMD. This explains why AREDS2 is examining the potential for 1,000 mg per day of the omega-3 fatty acids, DHA and EPA to halt the progression of AMD.

Reprinted with permission from Environmental Nutrition, 52 Riverside Dr., Suite 15-A, New York, NY 10024.

Food labels can help you choose foods lower in sodium, as well as calories, satu-rated fat, total fat, and cholesterol. The label tells you:

Number Of ServingsThe serving size is cup. The package contains about 3 servings.Amount Per ServingNutrient amounts are given for one serving. If you eat more or less than a serving,

add or subtract amounts. For example, if you eat 1 cup of peas, you need to double the nutrient amounts on the label.

Percent Daily ValuePercent Daily Value helps you compare products and tells you if the food is high

or low in sodium. Choose products with the lowest Percent Daily Value for sodium.NutrientsYou’ll find the milligrams of sodium in one serving.

news brief

READ THE FOOD LABEL

1� HEALTHWISC JUNE �010

EXER

CISE

Bert ParkerAnd Arlene Becker Diabetes can be a very threatening disease. It manifests itself on many levels of the

body. It can cause heart disease, kidney problems, blindness, and limb amputations. It is not a disease to take lightly. Obviously diabetics should be careful of their nutrition, but along with this it’s important that they get exercise into their lives as well, as it’s been shown in studies over and over that exercise can actually ameliorate

the diabetic condition.The shocking fact is that currently diabetes is the seventh leading cause of death

in the U.S., From 1980-2004 the number of American diagnosed has gone up form 5.8 million to 14.6 million. Increasingly, sedentary life style, poor nutrition, a rise in obesity, and the aging of the population are some of the causes. The estimated cost of treatment for diabetics is 174 billion dollars a year.

Bert Parker, fitness supervisor at the Elite Sports Club’s West Brookfield facility, knows the importance of exercise for a diabetic personally. “It’s one of the reasons I have fought so hard in the battle against diabetes. My father’s a diabetic. It runs in my family. At Carroll College where I majored in exercise science, where I studied the relationship of exercise on special populations and diabetes was one of the diseases that we covered.”

“We learned about the very real and important benefits of exercise on diabetics. Here, at Elite, we usually work more with type II diabetics, which is the more common form of diabetes in the US population. Ninety to ninety five percent of all diabetics have type II diabetes. The normal person’s body produces the insulin that the body needs, however, with type II, the body doesn’t recognize the insulin, and in type I the body doesn’t produce it all. One of the reasons I went into this field is because I realized the value of exercise for diabetics. Certainly exercise is a lot cheaper than going to the hospital or taking medications.”

“Diabetics that we see usually have a weight problem, and are heavy set or even obese individuals, and basically their main goal is to either loose weight and to delay or reverse the effects that diabetes has on their bodies. There is no cure for diabetes, but with exercise we can help the body out. Exercise can improve insulin resistance so that it doesn’t jus pass through the body, but rather the body recognizes and utilizes it the way it’s supposed to.”

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Parker explained, “Type II diabetes is often seen in obese people and also in people over the age of forty, both of whom have a higher risk. If you see it in juveniles, most of the time these children haven’t had proper nutrition of exercise. Exercise helps lose weight and body fat. When we strength train, slowly see over time, we build more and new muscle. It’s not enough, or even the best thing, to just loose weight by diet alone. It helps, but we need to build up muscle mass at the same time, so with my obese, pre-diabetic or diabetic clients, I encourage them to weight train as well.”

If we get a sedentary person to participate in moderate to intense exercise, we’re able to prevent diseases

that are often associated with diabetes, such as heart disease, high cholesterol, or high blood pressure.

“When a new member joins Elite, or inquires about personal training, we put them through a general health assessment and that’s when we find out that we may be dealing with a diabetic. Part of the general health assessment question is called Park-Q, which is a set of five questions, one is, “are you taking any medications, or have you ever been prescribed with diabetes.” If all the answers are no, then we move on to the next screening with is more in depth. If all

these are answered with a no then we go into an intensive family history background, including the history of any grand parents and sometimes we’ll find that even though the new member isn’t himself or herself a diabetic, it may be in their family. We would note that this person is a potential diabetic and once we know that we take the precautionary steps that we know if there are any physical limitations. We also ask that the person get a physical if they haven’t had any in the past three years. Knowing your health background is important to diabetics and non diabetics as well, as often a grandparent, not a parent may have had the disease.”

Parker extolled the virtues of exercise, “You do see increased overall health such as lower blood pressure, better body composition, and body fat percentages that are optimal for the diabetic’s age group. All this is important everybody, but especially to a diabetic.”

He went on to describe the best exercise program. “We get someone on a regimen of two times a week on weight training, using free weights and machines. We also do functional training that is training for day to day activities, and improving core strength which we do with medicine balls, or the TRX suspension training system which uses the persons own body weight for resistance. The TRX can be used for anyone from the person walking into the gym for the first time to the Olympic athlete.”

“We recommend aerobic training”, he said, “ranging from a walk on the treadmill to a fast paced jog on treadmill or bike along with weight training, of a half hour to an hour, and aerobics, ranging from twenty minutes to ninety minutes. If there are times that you can’t make it to the gym, many work-outs can be done at home as well.” Parker cautioned,”It’s best that a diabetic, because of the situation of high or low insulin levels, and their risk of hypoglycemia, which is a lowering of the blood sugar, which can cause them to pass out, never engage in any exercise without someone being nearby.”

“At Elite, we require that diabetics take blood glucose levels before their workout, with us and every twenty minutes during the workout. These are recommended standards. .If you’re a diabetic and would rather walk outside on nice days, you should always walk with a non diabetic partner in case something was to happen.”

“The studies of exercise and diabetes are out there and so many physicians are now prescribing exercise for their patients.”

“Diabetics could probably lower dosage if they work out five to six times for six to eight weeks if they follow the program, if they’re consistent. Consistency is the key.”

Even for those diabetics who may have lost a leg, we have a bicycle which is an all body exercise they can do with there hands.”

Parker recommended an Elite class for diabetics, “New Energy, which is a low to moderately intense class, which utilizes bands and stability balls that’s good for diabetics of all ages. It’s a class that’s easier on the body.”

“For young diabetics our junior strength classes and open gym, and parent’s night out are good. I had a diabetic kid and we had to make sure that he kept an eye on his blood sugar.”

Exercise will benefit Type I and type II diabetics, Parker summed up. “ “With exercise, good nutrition, and monitoring glucose levels, whatever their age or prior fitness levels, diabetics will add years to their lives and better health.”

Parker can be reached at Elite’s West Brookfield Sport’s Club at 1-262-786-3330.

“The studies of exercise and diabetes are out there and so many physicians are now prescribing exercise for their patients.”

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By Monica Maroney Ear infections are one of the most common diagnoses in children. It is estimated

that over five million episodes occur each year at a cost of approximately $3 billion. In the United States it has been routine to prescribe antibiotics for ear infections, although current research raises doubts about the effectiveness of this treatment and even concerns about the overuse of antibiotics. Statistics are now showing that repeated use of antibiotics is a contributing factor to future infections by creating drug-resistant strains.

New recommendations by the American Academy of Pediatrics encourage the watch and wait approach instead of antibiotics at the first sign of ear infection. Watching and waiting is not always easy for parents to do when their child is in pain. An alternative approach to alleviate the symptoms associated with ear infections includes a visit to the pediatric chiropractor.

Chiropractic adjustments allow the fluid to drain from the middle ear and take pressure off the tympanic membrane and that decreases the pain associated with ear infections. There are numerous studies supporting the efficacy of chiropractic adjustments and the resolution of ear infections. A study published in the Journal of Physiologic and Manipulative Therapies examined 46 children under the age of five with ear infections. The author states that 93% of episodes improved with chiropractic care and 75% of the cases responded in less than 10 days. Currently, a large research project is being conducted by David Eisenberg, MD and the National Institutes of Health (NIH) to examine whether chiropractic care will reduce the persistence of middle ear fluid in children with ear infections. This will be the first study of its kind involving children and chiropractic at the NIH and it reflects the large numbers of parents seeking chiropractic care as an alternative for their children with ear infections.

All parents need to be aware of chiropractic care as an alternative approach for ear infections. Doctors of Chiropractic take a detailed case history and perform a careful examination of the ears as well as the head and neck to determine if the child is a good candidate for chiropractic care. The adjustments are safe and gentle and encourage the body to heal itself through increased function of the nervous system. Next time your child displays the symptoms of ear pain consider a visit to the chiropractor as a safe and effective way to ease the pain.

For more information about pediatric chiropractic care visit the International Chiropractic Pediatric Association (ICPA) website at www.icpa4kids.org.

EARCHIROPRACTIC CARE CAN HELP

INFECTIONS

JUNE �010 HEALTHWISC 1�

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UNDER RATED

Nutrition Action Health LetterSome foods get all the attention and don’t deserve it. Others are gems that go

largely unnoticed.It’s not just a coincidence. Some high-profile foods are backed by hefty ad

budgets, while other foods have nothing but your grandmother’s (long-forgotten) endorsement.

It’s time to set the record straight.

Sunflower SeedsAlmonds, walnuts, pecans. You often hear about their virtues. But sunflower seeds

are rarely in the spotlight. (That’s partly because there’s no seed-industry group that sponsors research and plugs sunflower seeds like the International Tree Nut Council Nutrition Research & Education Foundation does for almonds, Brazil nuts, pistachios, and walnuts.)

That’s a shame, because sunflower seeds are at least as good as most nuts…and they’re cheaper. A quarter cup of sunflower seeds has 3 grams of fiber and 6 grams of protein plus 25 to 75 percent of a day’s copper, vitamin E, selenium, and manganese and roughly 10 percent of a day’s zinc, magnesium, and vitamin B-6.

For a snack, buy sunflower seeds in the shell (it will slow down your munching). For tossing on salads or yogurt, buy them raw, unsalted, and shell-free. (You can easily roast them in a toaster oven for richer flavor.) There’s only one catch: every ¼ cup contains 180 calories…and it’s tough to stop there.

Garbanzo BeansAll beans are good beans. They’re rich in protein, fiber, iron, magnesium,

potassium, and zinc. And they’re dirt cheap in cans, and cheaper if you buy them dried. What’s more, Eden Organic has a line of no-salt-added beans that come in cans with liners that are free of BPA. (Some animal studies have suggested that BPA increases the risk of cancer, diabetes, and heart disease and that it may alter some behaviors that are influenced by hormones.)

But garbanzos (chickpeas) stand out because they’re so versatile. Just drain, rinse, and toss a handful on your green salad.

If you have an extra few minutes, dress them up with chopped scallions, olive oil, and lemon juice. Or coat with olive oil, balsamic vinegar, and fresh chopped garlic and serve as is or roast (stirring occasionally) until they’re crunchy.

You can also throw garbanzo beans into vegetable stews, curries, and soups; mix them with brown rice, whole wheat couscous, bulgur, or other whole grains; stir them into your chili; or add them to a pot of simmering greens.

They’re the easiest beans around.

Unsweetened YogurtAmericans eat plenty of yogurt, but one look in the dairy case tells you that most

of it is sweetened. You have to hunt to find “plain” (unsweetened) yogurt. That’s too bad.

A typical 6 oz. Dannon Vanilla, Coffee, or Fruit-on-the-Bottom yogurt (like Peach or Strawberry) has about 4 teaspoons of added sugar. “Light” yogurts swap the sugar for artificial sweeteners. (The two major brands—Yoplait and Dannon—use the questionable sweeteners acesulfame potassium and/or aspartame.)

Unsweetened yogurt has a pleasant tartness that’s a perfect foil for the natural

Foods

FOODS SEE PAGE 16

INFECTIONS


sweetness of strawberries, bananas, or peaches, or for your favorite breakfast cereal. Greek yogurts (by companies like Fage, Dannon, Yoplait, and Chobani) add a creaminess that makes even the fat-free versions seem luxurious.

And plain yogurt has more protein, potassium, calcium, zinc, and vitamins B-6 and B-12 because it doesn’t have to share a container with the sugary fruit preserves or the sugar that’s in many flavored yogurts.

If unsweetened yogurt is still too tart for you, try mixing it with some vanilla (or other sweetened) yogurt. But why start out with all the sugar in sweetened yogurts if you don’t need to?

WatermelonIt’s hard to find a soul, from toddler to senior, who doesn’t love the juicy sweet

taste explosion set off by a bite of crisp watermelon. The next time someone tells you that they don’t like fruit, ask about watermelon.

Contrary to what most people think, watermelon is no lightweight in the nutrient department. A standard serving (about 2 cups) has 38 percent of a day’s vitamin C, 32 percent of a day’s vitamin A, and 7 percent of a day’s potassium for only 85 fat-free, salt-free calories. You won’t find two cups of many foods that go that easy on your waistline.

Bonus: watermelon is one of the “Clean 15,” the fruits and vegetables with the fewest pesticide residues, according to the Environmental Working Group. (That’s partly because the thick rind keeps out both bugs and pesticides.) And when they’re in season, watermelons are often locally grown, which means they may have a smaller carbon footprint than some other fruits.

So the next time you walk past the watermelon to get to those petite plastic containers of expensive raspberries or blueberries, don’t forget the filling, economical fruit that comes in its own container.

Leafy greensYes, you’ve heard that leafy greens are nutritional superstars. But if you’re a

typical American, the only greens in your grocery cart are likely to be lettuce and (maybe) spinach.

Nothing wrong with that, except that you’re missing out on power-house greens like kale, collards, turnip greens, mustard greens, and Swiss chard.

Why do you skip them? If you’re like most people, you don’t have the foggiest idea how to cook them. Our advice: Start with kale, which is one of the milder greens, and follow one of the simple tips in the “Greens by any Means” box.

Leafy greens are jam-packed with vitamins A, C, and K, folate, magnesium potassium, calcium, iron, lutein, and fiber. And people who eat them have a lower risk of diabetes, stroke, colon cancer, cataracts, bone loss, and memory loss. (Though it’s also possible that healthy people are more likely to eat greens.)

Either way, you’ve got a delicious new side dish that’s cheap, even if you buy it pre-cut in a bag.

Don’t pass greens by.

Greens by and MeansIf you’re new to leafy greens, start with a mild variety like kale or collards. Mustard

greens (which can be quite peppery) and beet greens and Swiss chard (with their earthy taste) have their charms, but they’re an acquired taste that can come later.

It’s easiest to buy your greens washed, chopped, and bagged. If you don’t, you’ll need to remove and discard any tough stems and center ribs, wash the leaves thoroughly to remove any sand or soil, and chop. (You should also wash the bagged greens.)

The simplest way to cook leafy greens: sauté some garlic in olive oil for a minute or two, then add the greens (still wet from washing) and cook until soft—anywhere from 5 to 20 minutes—stirring occasionally. (If you cover the pan, they’ll steam a little and cook more quickly.) Then squeeze on some lemon juice or add a splash of wine vinegar. Absolutely delish.

For variety, try sautéing them with garlic, diced tomato, chickpeas, and a pinch of red pepper flakes.

You can also steam your greens (10-15 minutes for most kinds; about half that for Swiss chard). Once they’re steamed, you can: stir into a pan with an onion that you’ve sautéed in olive oil until well browned (about 10 minutes, or stir into a pan with sliced shiitake mushroom caps that you’ve sautéed in toasted sesame oil until browned (3-5 minutes), then season with a splash of reduced-sodium soy sauce and rice or cider vinegar and a sprinkling of sesame seeds.

For a more traditional taste, simmer raw greens in low-sodium chicken stock with chunks of smoked turkey sausage until the greens are soft. You can also toss raw greens into the pot as your lentil or bean soup simmers.

Or throw away the rule book and make Crispy Kale: Toss raw kale with a little olive oil to lightly coat the leaves, spread on baking sheets, and pop in a 350 degree oven until crisp, about 15 minutes.

Copyright 2010 SPI, Reprinted/Adapted from Nutrition Action Health Letter, 1875 Connecticut Ave., N.W., Suite 300, Washington, D.C. 20009-5728.

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FOODS FROM PAGE 15


Choose gardening tools that have padded handles to protect the joints in your hands and fingers from excess pressure. Keep your tools light weight and use long-handled shovels or spades to reduce back strain. Use spring-action shears or clippers if you have a weaker grasp.

Spring is here and summer is approaching! According to the National Gardening Association, about 40 million U.S. households have a garden. Gardening is one of the best physical activities for preventing and improving chronic health conditions. Gardening can also help relieve stress from watching something grow, to breathing in the scent of flowers and picking that tomato to eat from your own backyard, gardening is a great hobby! It’s also an intense exercise, using all the major muscle groups in your body. The key is not to overdo it or do it wrong!

Like any exercise, gardening requires stretching as a warm up and use of proper form while shoveling, raking, digging, lifting or pulling weeds. Here are some tips to help you when you are gardening:

HEALTHIER GARDENING 01Stretch for 5 minutes before heading out to the garden: Focus on your hamstrings, back and arms. When buying and preparing soil, choose smaller, lighter bags or divide large bags of mulch, dirt and fertilizer into smaller, more manageable loads and use a cart or wagon to move materials.

When lifting, use the muscles in your legs, not your back! Keep your back straight when lifting and bend at your knees.

Do not stay in a bent over position too long. Stand up, stretch and walk around every 10 minutes or so. Kneel instead of bending for prolonged periods. Use knee pads to protect your knees, or use a garden bench and sit to garden.

Vary your tasks so that you avoid stressing any one part of your body. For example, don’t spend the entire day stooping and pulling weeds, instead tackle one section of your garden one day and save the rest for the next day.

0�

03

0�

0�Don’t forget to wear your sunscreen!

0�

0� Keep your smaller tools in a small bag or backpack that you can carry as you move from bed to bed to avoid making several trips back and forth.

0� Keep your garden manageable. That may even mean container gardening. If you take on too much, too soon, you will find yourself sore the next morning, or even risk a more serious injury.

09 As with any exercise, drink plenty of water to prevent dehydration.

10For more information on Healthier Gardening call Advance Therapy Services, LLC at 414-422-4678.


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You may have heard the term sustainable used when it comes to landscape design.

It sounds “green” and trendy, but in fact it’s a very practical and cost-effective approach to creating beautiful and functional outdoor spaces.

Sustainability means keeping in mind our impact on the world. Will the plants chosen need a lot of fertilizing, watering and pampering? How can you manage the run-off from your roof and driveway to minimize pollution and your need to water? These choices can mean the difference between an expensive, high-maintenance landscape or one that works beautifully and effectively with nature.

Smart design balances sustainability, beauty and function. It takes into consideration issues such as:

• Properly placing trees for shade and wind breaks• Using lawn grass in areas for play, walking, gathering or transition from one

space to another• Incorporating walls and patios for needed functional space• Cohesively working natural areas into the overall design• Planting disease-resistant cultivars to reduce the need for chemicals• Minimizing the use of plants that require consistent wateringRain is an element of designWith the increasing problems of urban run-off, including wet basements and soggy

yards, smart landscape design harnesses the vital and creative qualities of rainwater. It makes water central by planning for proper drainage to protect structures. It replenishes groundwater by slowing and infiltrating rainwater. It employs devices such as rain barrels and harvesting systems to reuse rainwater when there’s not a cloud in sight.

The decisions we make for our yards impact our neighbors, the community and the world at large. A well-designed landscape will bring joy for decades as it grows, matures and weaves itself into your life. In coming months, we’ll explore in greater detail the elements that create beautiful, smart and sustainable outdoor spaces.

John LaPointe is the owner of Greener Roofs and Gardens, a landscape company dedicated to creating signature outdoor spaces that blend beauty with smart, sustainable design. He can be reached at 262-844-2397 .

Creating An Outdoor SpaceThat Works


Everything from classic herb gardens to urban chicken coops are popping up all over America! Today we feel apprehensive about the future and in the garden, the old adage “you reap what you sow” finds life. This revival is borne from that sense of self-sufficiency and the touch-it-feel-it kind of independence that comes from growing home grown! Victory gardens were planted during WWI and WWII to support war efforts and to grow vegetables, fruits and herbs for families so that commercial resources could be used to nourish our soldiers overseas. Today, in the United States and abroad, there are many socioeconomic and cultural factors that “ripen the vine” for this revival. In America…

- We again have many men and women serving overseas. The original victory gardens, also called war gardens or food gardens for defense, appeared during times of war.

- We are more focused than ever on health and nutrition. We want to eat organically and are either skeptical of the true nature of the available products or don’t want to pay for them.

- Again due to our commitment to good health, we aren’t afraid to roll up our sleeves, get a little dirty and work up a sweat! Heck, gardening can save a trip to or a bill from the gym. After an hour in the garden, we’re likely to have burned off around 300 calories.

- We have an increased awareness of pesticide use and contaminants in commercially grown produce and the use of antibiotics in the poultry, dairy and livestock industries.

- We are concerned about the amount and affects of fossil fuels required to transport food. Did you know that the average piece of produce travels 1500 miles before it lands on your plate?!

- We have the desire to buy American. Better yet, we’d like to utilize local resources, support neighborhood businesses and farms and be involved in community activities.

- We would like to provide assistance to the large number of hungry Americans and donate our harvests to food banks and shelters.

- We want to share this renewed sense of self-sufficiency and show our kids what really matters most in life! Through this recession, our collective obsession with material things and the concept of “money buying happiness” has diminished.

- We remember that old, disfigured pear tree growing over the swing-set at Grandma’s and the garden we spent so much time weeding in our folks’ backyard. During difficult times, we long for those that were more carefree and simple. In this regard, although our carrots might be crooked and our apples blemished, the garden doesn’t disappoint!

At Lied’s, we see this trend gaining steam through our clients’ requests and in the types of projects we are partnering on together. More and more frequently, we have the opportunity to help our clients design and establish plots, build and maintain coops, protect crops by adding fencing, responsibly manage insect and disease problems, and even install devices to collect rainwater for use in the patch. Our reward? Well, besides the obvious, our clients always share! Just to name a few, we’ve enjoyed vine-ripe tomatoes, super-sized zucchinis, homemade pickles and even fresh brown eggs! Here at Lied’s, we find ourselves doing a little of the heavy lifting to get our clients ready to reap and sow. But, usually our clients save most of the “work” for themselves...but wouldn’t you too?!

Gardens come in all shapes and sizes. Edibles can coexist with traditional plants in landscape beds – the integrated herb garden shown here is a nice example.

Growing Home Grown in the Contemporary Victory Garden

Gardening Trend:

�0 HEALTHWISC JUNE �010

WHAT ARE SPORTS INJURIES?The term sports injury, in the broadest

sense, refers to the kinds of injuries that most commonly occur during sports or exercise. Some sports injuries result from accidents; others are due to poor training practices, improper equipment, lack of conditioning, or insufficient warmup and stretching.

Although virtually any part of your body can be injured during sports or exercise, the term is usually reserved for injuries that involve the musculoskeletal system, which includes the muscles, bones, and associated tissues like cartilage. Traumatic brain and spinal cord injuries, (relatively rare during sports or exercise) and bruises are considered briefly in the appendix. Following are some of the most common sports injuries.

SPRAINS AND STRAINSA sprain is a stretch or tear of a

ligament, the band of connective tissues that joins the end of one bone with

SPORTS

.

In recent years, increasing numbers of people of all ages have been heeding their health professionals’ advice to get active for all of the health benefits exercise has to offer. But for some people—particularly those who overdo or who don’t properly train or warm up—these benefits can come at a price: sports injuries.

Fortunately, most sports injuries can be treated effectively, and most people who suffer injuries can return to a satisfying level of physical activity after an injury. Even better, many sports injuries can be prevented if people take the proper precautions.

INJURIESanother. Sprains are caused by trauma such as a fall or blow to the body that knocks a joint out of position and, in the worst case, ruptures the supporting ligaments. Sprains can range from first degree (minimally stretched ligament) to third degree (a complete tear). Areas of the body most vulnerable to sprains are ankles, knees, and wrists. Signs of a sprain include varying degrees of tenderness or pain; bruising; inflammation; swelling; inability to move a limb or joint; or joint looseness, laxity, or instability.

A strain is a twist, pull, or tear of a muscle or tendon, a cord of tissue connecting muscle to bone. It is an acute, noncontact injury that results from overstretching or overcontraction. Symptoms of a strain include pain, muscle spasm, and loss of strength. Although it’s hard to tell the difference between mild and moderate strains, severe strains not treated professionally can cause damage and loss of function.

KNEE INJURIES

Because of its complex structure and weight-bearing capacity, the knee is the most commonly injured joint. Each year, more than 5.5 million people visit doctors for knee problems.

Knee injuries can range from mild to severe. Some of the less severe, yet still painful and functionally limiting, knee problems are runner’s knee (pain or tenderness close to or under the knee cap at the front or side of the knee), iliotibial band syndrome (pain on the outer side of the knee), and tendinitis, also called tendinosis (marked by degeneration within a tendon, usually where it joins the bone).

More severe injuries include bone bruises or damage to the cartilage or ligaments. There are two types of cartilage in the knee. One is the meniscus, a crescent-shaped disc that absorbs shock between the thigh (femur) and lower leg bones (tibia and fibula). The other is a surface-coating (or articular) cartilage. It covers the ends of the bones where they

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JUNE �010 HEALTHWISC �1

meet, allowing them to glide against one another. Knee injuries can result from a blow to or twist of the knee; from improper landing after a jump; or from running too hard, too much, or without proper warmup.

COMPARTMENT SYNDROMEIn many parts of the body, muscles (along with the nerves and blood vessels

that run alongside and through them) are enclosed in a “compartment” formed of a tough membrane called fascia. When muscles become swollen, they can fill the compartment to capacity, causing interference with nerves and blood vessels as well as damage to the muscles themselves. The resulting painful condition is referred to as compartment syndrome.

Compartment syndrome may be caused by a one-time traumatic injury (acute compartment syndrome), such as a fractured bone or a hard blow to the thigh, by repeated hard blows (depending upon the sport), or by ongoing overuse (chronic exertional compartment syndrome), which may occur, for example, in long-distance running.

SHIN SPLINTSAlthough the term “shin splints” has been widely used to describe any sort of leg

pain associated with exercise, the term actually refers to pain along the tibia or shin bone, the large bone in the front of the lower leg. This pain can occur at the front outside part of the lower leg, including the foot and ankle (anterior shin splints) or at the inner edge of the bone where it meets the calf muscles (medial shin splints).

Shin splints are primarily seen in runners, particularly those just starting a running program. Risk factors for shin splints include overuse or incorrect use of the lower leg; improper stretching, warmup, or exercise technique; overtraining; running or jumping on hard surfaces; and running in shoes that don’t have enough support. These injuries are often associated with flat (overpronated) feet.

ACHILLES TENDON INJURIESAn Achilles tendon injury results from a stretch, tear, or irritation to the tendon

connecting the calf muscle to the back of the heel. These injuries can be so sudden and agonizing that they have been known to bring down charging professional football players in shocking fashion.

The most common cause of Achilles tendon tears is a problem called tendinitis, a degenerative condition caused by aging or overuse. When a tendon is weakened, trauma can cause it to rupture.

Achilles tendon injuries are common in middle-aged “weekend warriors” who may not exercise regularly or take time to stretch properly before an activity. Among professional athletes, most Achilles injuries seem to occur in quick-acceleration, jumping sports like football and basketball, and almost always end the season’s competition for the athlete.

COMMON TYPES OF SPORTS INJURIES• Muscle sprains and strains • Tears of the ligaments that hold joints together • Tears of the tendons that support joints and allow them to move • Dislocated joints • Fractured bones, including vertebrae. FRACTURESA fracture is a break in the bone that can occur from either a quick, one-time injury

to the bone (acute fracture) or from repeated stress to the bone over time (stress fracture).

Acute fractures: Acute fractures can be simple (a clean break with little damage to the surrounding tissue) or compound (a break in which the bone pierces the skin with little damage to the surrounding tissue). Most acute fractures are emergencies. One that breaks the skin is especially dangerous because there is a high risk of infection.

Stress fractures: Stress fractures occur largely in the feet and legs and are common in sports that require repetitive impact, primarily running/jumping sports such as gymnastics or track and field. Running creates forces two to three times a person’s body weight on the lower limbs.

The most common symptom of a stress fracture is pain at the site that worsens with weight-bearing activity. Tenderness and swelling often accompany the pain.

DISLOCATIONSWhen the two bones that come together to form a joint become separated, the joint

is described as being dislocated. Contact sports such as football and basketball, as well as high-impact sports and sports that can result in excessive stretching or falling, cause the majority of dislocations. A dislocated joint is an emergency situation that requires medical treatment.

The joints most likely to be dislocated are some of the hand joints. Aside from these joints, the joint most frequently dislocated is the shoulder. Dislocations of the knees, hips, and elbows are uncommon.

WHAT’S THE DIFFERENCE BETWEEN ACUTE AND CHRONIC INJURIES?Regardless of the specific structure affected, sports injuries can generally be

classified in one of two ways: acute or chronic.ACUTE INJURIESAcute injuries, such as a sprained ankle, strained back, or fractured hand, occur

suddenly during activity. Signs of an acute injury include the following:• sudden, severe pain

SPORT INJURIES SEE PAGE 38

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Health and LivingSenior Senior

A special section dedicated to helping senior’s plan the next phase of their life.


By Stephen P. Rudolph, CSACertified Senior Advisor If there is one thing in this life that we can be sure of, it’s the fact that we all get older and reach a point

where we need assistance with our every day activities. For the lucky ones among us, loved ones and family members will be around to help. But in a fast evolving and ever strenuous society counting on the help of our loved ones in old age is a luxury we can not afford.

While back in the day, old parents used to live in their children’s homes but things have changed. This is not because children no longer care about their old parents but in fact it has to do with the fact that we live in a society where both the husband and wife have to work to earn a decent living. Therefore, taking care of one’s aging parent is ever more challenging.

WHAT ARE THE OPTIONS AVAILABLE FOR SENIOR CARE Traditionally most children or parents themselves have opted for Nursing homes or Assisted living facili-

ties when independent living is no longer possible. While this has been the choice for many people, a great number of seniors prefer the comfort of their home. This has led to the need for In Home Care services. In-home care service is similar to assisted living with one exception. Instead of going to a senior living facility, care is provided by a professional caregiver inside the residence of the client.

It is important for seniors to start talking to loved ones about preferences for care so that everyone is prepared when the time comes. An important factor to consider in this decision is whether or not it will be possible to continue living in the comfort of ones own home with the help of a professional caregiver or moving to a Nursing home is absolutely necessary.

Stephen P. Rudolph has a Masters Degree in Health Care Administration and is the owner of Comfort Keepers, a nonmedical, in-home service that provides personal cares and other non-medical services for aging adults, those with disabilities and others needing assistance. Rudolph is Board Certified in health care management, a Fellow in the American College of Healthcare Executives (FACHE), a Certified Senior Advisor (CSA) and a member of the Society of Certified Senior Advisors (SCSA).

For local information contact Comfort Keepers at414.858.9400 or 262.376.7510 or go to www.comfortkeepers.com.

PERSONAL HYGIENE

FOOD PREPARATION

MEDICATION REMINDERS

TRANSPORTATION

DRESSING

RANGE OF MOTION EXERCISES

COMPANIONSHIP

HELP WITH MAIL

READING

AND MANY OTHER QUALITY SERVICES…

A PROFESSIONAL CARE GIVER WILL ENHANCE THE QUALITY OF LIFE BY PROVIDING THE FOLLOWING SERVICES:

HOME CAREA BETTER ALTERNATIVE TO NURSING HOMES


By Karyl RichsonSocial Security Public Affairs Specialist in Milwaukee, WIWho says you can’t teach an old dad new twists? All across the nation this

Father’s Day weekend, people are telling their fathers, grandfathers, and other special men in their lives about a new “twist” in the law that may help them qualify for extra help paying for costs associated with their prescription drugs.

When you’re spending time with Dad this weekend, ask him if he can use some help paying for his prescription drugs. If so, tell him about the Medicare Prescription Drug Plan and the extra help available through Social Security.

If Dad is covered by Medicare and has limited income and resources, he might be eligible for extra help to pay for his monthly premiums, annual deductibles, and prescription co-payments. The extra help is worth an average of $3,900 per year.

If you’re met with a resistant, “No, I’ve looked into it before and I don’t qualify,” then let him know the law changed in January 2010. As volunteer spokesman Chubby Checker will tell you, a new “twist” in the law makes it easier than ever to qualify for the extra help.

Thanks to this new “twist” in the law, we no longer count any life insurance policy he has as a resource, and we no longer count as income any financial assistance he receives regularly from someone else to pay his household expenses like food, mortgage or rent, utilities or property taxes.Don’t take our word for it, see Chubby Checker’s rocking message at www.socialsecurity.gov/prescriptionhelp.

You can help Dad fill out an easy-to-use online application at www.socialsecurity.gov/prescriptionhelp. To apply by phone or have an application mailed to you, call Social Security at 1-800-772-1213 (TTY 1-800-325-0778) and ask for the Application for Help with Medicare Prescription Drug Plan Costs (SSA-1020). Or go to the nearest Social Security office.

You and your dad can learn more about the Medicare prescription drug plans and special enrollment periods. Visit www.medicare.gov or call 1-800-MEDICARE (1-800-633-4227; TTY 1-877-486-2048).

Maybe it’s been a few years since Dad did the Twist. But saving an extra $3,900 a year on prescription drugs may help put a new spring in his step.

TEACH AN OLD DAD A NEW TWISTThis Father’s Day

When you’re spending time with Dad this weekend, ask him if he can use some help paying for his prescription drugs. If so, tell him about the Medicare Prescription Drug Plan and the extra help available through Social Security.

JUNE �010 HEALTHWISC ��

Provided by Timothy M. Stasinoulias, RFC

More options. On January 1, 2010, owners of nonqualified annuities were allowed some new tax benefits. On that date, the Pension Protection Act (PPA) of 2006 was fully implemented and brought about dramatic and interesting changes for those who had started annuities with after-tax dollars. At the start of 2010:

• Non-qualified deferred annuities with added long term care insurance riders

were now characterized as tax-qualified LTC insurance plans.1

• As a result, all withdrawals from these “hybrid annuities” are income tax free so long as they are used for qualified long term care. So you can use the cash value of the annuity to cover the cost of LTC insurance premiums without triggering a taxable event.1

• Annuity owners were now allowed to make tax-free 1035 exchanges into appropriate hybrid annuities with long term care riders.2

• Additionally, an annuity owner can do a 1035 exchange for the cash value from any annuity into a single-premium qualified LTC insurance policy without incurring any gains.2

Now these annuities are even more attractive. Hybrid annuities with LTC insurance riders already offer their owners tax-deferred growth - and sometimes, a return-of-premium option that gives back the investment to an owner’s estate if no LTC claim is made. These linked-benefit annuities (and linked-benefit life insurance policies) can provide something like a “money-back guarantee”, as well as

the capability to multiply the benefit value of idle cash sitting on the sidelines. The new allowance of what could be sizable tax-free withdrawals makes them look even better.

In addition, the new freedom to make a tax-free exchange means that an annuity owner can now leave a current contract for a hybrid annuity that may provide a much greater pool of money someday to cover LTC costs.

Are they for you? These hybrid annuities are certainly worth a look. If you can’t qualify medically for LTC insurance but still need to be protected, a hybrid annuity may be an excellent option. Many people fund these annuities by redirecting cash from a bank CD or an annuity they already own. You might want to talk to an independent Registered Financial Consultant so you can assess your financial/estate plan, its risk to Long Term Care spend-down, and the viability of owning one of these products to help protect you from that risk. An Independent planner also can shop the market for you to find the best company, product design, and benefits.

Timothy M. Stasinoulias is the Founder and Managing Partner of Aegis Wealth Advisors, LLC, a Wisconsin Registered Investment Advisor firm based in Delafield, WI. Approved Affiliate Member of CFLCW (Collabdivorce.com). Call 262-646-5450 for more info or visit www.aegiswealthadvisors.com

These are the views of Independent Sources, not the named Financial Advisor or RIA firm, and should not be construed as investment advice. Neither the named Financial Advisor or RIA firm gives tax or legal advice. All information is believed to be from reliable sources; however, we make no representation as to its completeness or accuracy.

Citations. 1 thecompletelawyer.com/financial-matters/retirement-planning-financial-matters/

new-laws-mean-important-changes-for-long-term-care-4333.html?nomobile [4/20/09]

You can thank the Pension Protection Act.

New Tax Perks FOR NONQUALIFIED ANNUITY OWNERS


By Gina BrathLasata Care Center has added several new pieces

of therapy equipment to enhance the already high level, personalized care provided both to residents and members of the community on an outpatient basis.Lasata Care Center has Physical Therapy, Occupational Therapy and Speech Therapy services. Physical therapy services focus on improving strength, mobility, balance, coordination, endurance and pain management. Occupational therapy services retrain clients in daily care management, safety, and compensatory methods for improving daily function. Speech therapy services address all aspects of communication and swallowing. This includes speaking, listening, reading and writing, language and expression to help with daily communication.

All staff are licensed and recieve continued education to assure current , evidence based treatment, including ongoing training for the specialized equipment.Those people seen by Lasata Care Center’s experienced therapy staff are now being treated with the same therapeutic equipment used by professional sports teams and Olympians to improve recovery and performance. The equipment, known as physical agent modalities, is supported by extensive research and has demonstrated its ability to manage pain, inflammation and edema in athletes as well as patients of all ages. The equipment also enables clinicians to treat more complex medical conditions, while increasing strength and neuromuscular control in patients with a variety of diagnoses.

Used for decades among elite athletes, the new equipment at Lasata Care Center has been engineered and calibrated specifically for use with aging adults, including the elderly. The small unit makes use of Patterned Electrical Neuromuscular Stimulation (PENS), using four electrodes placed where necessary to help numb pain and/or re-educate muscles by providing feedback to the brain while “firing” muscles.

“Providing great patient care is the guiding principle for all that we do,” said Jen Drumm, Rehab Manager of Lasata Care Center. “Our residents may not be chasing Olympic medals, but we think it’s important that they have the opportunity to participate in the activities they enjoy for as long as possible. We believe this equipment, and the skills of our therapists will help that cause and, as a result, allow our residents to maintain quality of life.”Also at Lasata Care Center’s therapy department is new equipment for providing Pulsed Shortwave Diathermy. Diathermy is applied as a pulsed electromagnetic field to treat tissue. It has subthermal and thermal effects. Subthermal is used for post-operative pain, swelling, osteoarthritis and ligament pain. Thermal is for pain reduction, decreasing muscle spasms (such as back pain), circulation problems and increasing range of motion.

The equipment (PENS, electrical stimulation, ultrasound and diathermy) will be used in conjunction with several specialized treatment programs for conditions commonly found among the geriatric population. The therapists are calling this their ACE Programs—Advancements in Clinical Excellence. The

skilled physical and occupational therapists at Lasata Care Center have received advanced training for these programs, as well as the equipment itself.

Lasata Care Center will be promoting the ACE Programs throughout the course of the year. These programs address a variety of conditions including stroke, arthritis, joint replacements, contractures, wounds, fall prevention, pain management, bladder control, self care management, as well as areas of communication and cognition.

Our Speech Therapy services also have specialized equipment and services called Vital Stimulation. Vital stim is a specific treatment that focuses on dysphagia or a swallowing disorder. It is an active rehab program that is painless and non-invasive, combining the use of electrical simulation to the neck region while eating and/or drinking. This is FDA approved and is provided only by certified Speech Language Pathologist. This can help the person regain the fellowship of friends and family through the socialization that surrounds eating, prevents aspiration pneumonia, chronic malnutrition, and improves quality of life.

Lasata Care Center provides inpatient and outpatient services for Physical Therapy, Occupational Therapy and Speech Therapy. Therapy services are available by appointment by calling Lasata Care Center at 262-376-9504. If you would like to see the equipment or learn more on how therapy services at Lasata can help you or a loved one, please contact our therapy department. Lasata Therapy Department is open to the community on an outpatient basis and will verify insurance coverage. It is a covered provider by Medicare.

Learn How PENS Can Help With Rehabilitation.PAID ADVERTISEMENT

JUNE �010 HEALTHWISC ��

Independent Retirement Communities are for active adults who want to live life to the fullest. Community living provides the opportunity to enjoy maintenance free living, financial security, fitness programs, healthy dining, socialization and educational sessions. Mowing the grass, shoveling the snow, repairing the kitchen faucet or paying real estate taxes can become a thing of the past. Before you can make a decision it is important to understand what senior community life is all about.

Some seniors have been misinformed and believe that Independent Retirement Communities are for “old folks” who belong in nursing homes, or need daily care. This is certainly not true. Independent Retirement Communities offer the best in senior living options and keep seniors young at heart. Research shows that the more active and social you are, the longer you live, and the healthier you remain.

Independent Retirement Communities are more affordable than you ever imagined! If you add up the cost of annual repair and maintenance on your home, along with taxes, lawn care costs, utilities, etc, you might find that living in an Independent Retirement Community is the same cost or less! Retirement communities offer wide range of amenities to enhance your lifestyle. Indoor/outdoor swimming pools, recreation centers, exercise rooms, libraries, craft rooms, laundry services,

THEindependent

RETIREMENT COMMUNITY LIFESTYLE

housekeeping, and transportation are all possible options. On campus restaurant style dining, cafés and bistros can take the work out of meal preparation as well as offer a chance to dine with friends. Independent Retirement Communities increase socialization and offer the opportunity to make new friends! From the moment you arrive, the sense of community and togetherness is apparent. Although there is plenty of time for relaxation in your own apartment there are also many activities designed to bring residents together -- women’s groups, men’s groups, bridge clubs, fitness groups, craft classes, book discussion groups, and many more options…you name it, it’s probably available!

Another benefit is transportation. Some seniors enjoy driving for many years, and others prefer not to drive especially during inclement weather. Either way, you will feel right at home using your own car or enjoying the luxury of door to door service. Transportation to the grocery store, doctor appointments, and local shopping malls is available.

Adult children feel great about their parents choice to live in an Independent Retirement Community. They love knowing that if anything happens, help is not far away. The fact that so many people are looking out for their parents safety and health gives great peace of mind. The level of activity and sense of community is

second to none. A Continuing Care Retirement Community (CCRC)

like Tudor Oaks offers multiple levels of care. This type of retirement community gives active seniors the ability to enjoy an independent lifestyle with the knowledge that all of their needs will be met should their health care situation change.

A Senior Apartment Complex offers senior apartments with few if any amenities. Seniors in this community will need to move again if their needs change. It is interesting to note that the monthly rent over a period of time could use the saved funds that would have allowed the senior to enter a CCRC and have a continuum of care available.

Choosing the correct senior living community ensures that you or your loved one will have every opportunity to fully enjoy retirement, amidst a community of peers, with a full-range of activities in a safe environment. One of the most important things you can do when considering your retirement years is to plan ahead. Addressing financial and health issues early keeps families from having to deal with a crisis later.Current residents of Tudor Oaks and other Independent Retirement Communities will tell you the same thing over and over again. “I should have done this many years ago, it was the best decision I ever made!”

Independent Retirement Communities increase socialization and offer the opportunity to make new friends!


By Karyl RichsonSocial Security Public Affairs Specialist in Milwaukee, WI There’s good news for Americans who want help getting a handle on their finances.

The official government website dedicated to teaching all Americans the basics of financial education,www.mymoney.gov is now loaded with more information and is even easier to use.

The new site has enhanced interactive features and provides more resources to Americans seeking information that can help with their personal financial decisions.

The new, www.mymoney.gov website creates an online point of access to financial information from the 21 federal agencies, departments, and bureaus -- including Social Security -- that comprise the Financial Literacy and Education Commission. Visitors to the site can find information about how to plan, financially, for a host of life events, such as the birth or adoption of a child, home ownership, or retirement. Users also can find information targeted to their personal or professional situation. For instance, the site offers resources for teachers, military service members, women, parents, youth, and employers. The site also provides money management tools including a financial savings calculator, worksheets for establishing a household budget, and a college preparation checklist. The site also is available in Spanish. The effort to make the website as helpful and useful to Americans will be ongoing, with improvements expected to continue.

In addition to being a member of the commission responsible for this site, Social Security offers other ways to help you with your finances. For example, you can use the online Retirement Estimator to get a personalized, instant estimate of what your future retirement benefits will be in different situations. The estimator is available at www.socialsecurity.gov/estimator.

Learn more about Social Security at www.socialsecurity.gov.For more about the basics of financial education, whether you’re buying a house

or balancing your checkbook, visit,www.mymoney.gov#

NEW “MYMONEY” WEBSITE Can Help You With Your Money


Join us for fun, education, socializing and good information at Alexian Village. Alexian Village of Milwaukee, 9225 N. 76 Street, Milwaukee, WI. 53223

Superior Senior Liv ing www.clubalex ian.com

Check Out Alexian’s newest Adult Day Center

J u n e C l u b A l e x i a n E v e n t s Wednesday June 2 Noon Lunch, $4.00 1:00 p.m. Bingo Free

Lunch and Bingo - AB Pavilion Enjoy a great lunch catered by Alexian Village Dining Services followed by a “Hip and Knee Pain” informational seminar sponsored by Columbia St. Mary’s Hospital. Then enjoy a fun game of bingo with cash prizes. If you cannot make it to lunch; come for Bingo. No charge to play Bingo. Win Cash Prizes in Bingo!! Please RSVP to (414) 371-7811 by May 30.

Wednesday June 9 Noon, $4.00

Healthy Cooking & Luncheon Series - AB Pavilion “Diabetic Diets” Receive information and recipes on foods low in carbohydrates and sugar for diabetics or those watching their diets with Amanda Masmela and Robin Rateau, Alexian Village’s Certified Nutritionists. Enjoy a great lunch and receive the recipes. Please RSVP to 414-371-7811 by June 7.

Wednesday June 16 Noon Lunch, $4.00 1:00 p.m. Bingo Free

Lunch and Bingo - AB Pavilion Karri Sears, Director of Wellness, presents the beautiful Living Well Day Spa while you enjoy a great lunch catered the Alexian Village Dining Services. Bingo with Cash prizes follows lunch. If you cannot make it to the lunch; come for Bingo. No charge to play Bingo and Win Cash Prizes!! Please RSVP to (414) 371-7811 by June 14.

Wednesday June 23 Noon, $4.00

Lunch and Learn - AB Pavilion Donna Hellan from Comfort Keepers discusses what non medical in-home care is and how to chose the right one for you if and when you need it. Enjoy the information while you enjoy a delicious hot lunch prepared by the Alexian Catering Department. Please RSVP by June 21 to (414) 371-7811.

Wednesday June 23 1:00 p.m., Free

Movie Day with Free Popcorn & Soda - AB Pavilion “Up In The Air” carries you through the travels of George Clooney. A humorous and moving film about the loneliness of air travel and its adventure.

Wednesday June 30 11:30 a.m., Free

Bonus Wednesday - “See It For Yourself!” You have heard so much about the beautiful Alexian Village facility and all of the amenities that we offer. Now you can see it for yourself. A private tour will be given to Club Alexian members that include the Living Well Day Spa, Woodworking Shop, Library, Fitness Center, Beautiful Apartments and much more. Following the tour enjoy a delicious four-course meal in the Milwaukee Dining Room compliments of Alexian Village. Each Club member also will receive a gift. Tours begin at 11:30 a.m. with Lunch at 12:30 p.m. Please RSVP by June 28 to (414) 371-7811.

Many people delay the decision to move to a retirement community due to misconceptions or fear. They often regret not making the decision to move sooner; when they were healthier, more involved, or did not realize how lonely they were and the reasons go on and on. Regret is undesirable in all times of life; retirement decisions are no different.

The many activities and daily interactions with friends and neighbors offer a dynamic and stimulating environment. A.V. of Milwaukee residents freely share their thoughts about retirement living in general and the choices available to them. As you read through this article, look for the comfort, freedom and peace of mind that come from making informed choices.

“Statistics show that retirement community residents live healthier and longer lives than those living alone.” That doesn’t sound like rocket science; we need people. A resident commented, “If I knew how many of my friends lived here, I would have moved in years ago.” As one resident says, “I have to admit, it was lonely sometimes at home, now there is always something enjoyable to do.” Whether you want to participate in all of the social activities and outings or read a good book in the quiet of your apartment, the choice is yours.

“I love telling stories and reminiscing but it’s not always easy when they’re thirty years younger than me,” remarks a resident. A retirement community, by its very nature, allows people to interact with people their own age affording greater empathy and identification. Memories and recollections are complimented when

CONTINUING CARE RETIREMENT COMMUNITIES: It’s all about Choices

two people can truly share the depth and breathe of events. Somewhat tongue-in-cheek yet true, is the adage that retirement communities provide a “constant reservoir of friends.”

“I never have to worry about home upkeep or shoveling again,” said a smiling resident. Now you can choose what you would like to spend time doing: cooking in your apartment, patio gardening, traveling, learning to paint or play the piano; all of the things you never felt you had time to do before. The choice is yours.

Keeping the mind, body and spirit healthy is the goal of many retirement communities. “When I moved here, it was very impressive to see how many care about my wellbeing,” a resident reported. Your choice of personal wellness goals are supported by a retirement community’s team who are all rooting for you. “Wellness programs” are growing initiatives in retirement communities to ensure balance, increased strength and awareness of changes.

Many retirement communities provide a spiritual component through pastoral visits or Sunday services that keep your hope and faith strong through all times of life.

Retirement communities offer various forms of financial protections like “life care” or “endowments” that protect your financial future regardless of your health. A “life care” type contract also provides the potential for tax deductions for prepaid medical expenses. If you don’t feel the need for long term health care coverage,

SENIOR COMMUNITY SEE PAGE 39

30 HEALTHWISC JUNE �010

1400 N. Prospect AvenueMilwaukee

1414 N. Prospect AvenueMilwaukee

414-276-2627 414-289-9600

www.jewishseniorliving.org

Diabetes is a serious disease. People get diabetes when their blood glucose level, sometimes called blood sugar, is too high. Diabetes can lead to dangerous health problems, such as having a heart attack or a stroke. The good news is that there are things you can do to take con-trol of diabetes and prevent its problems. And, if you are worried about getting diabetes, there are things you can do to lower your risk.

What is Diabetes?Our bodies change the food we eat

into glucose. Insulin helps turn glucose into energy that “fuels” our cells. If you have diabetes, your body does not make insulin, does not use insulin the right way, or both. That means there is too much glucose in the blood. Doctors who specialize in taking care of people with

A Disease You Can Manage

diabetes are called endocrinologists.Managing DiabetesWhen you have diabetes, your body

does not use or make insulin properly. Your doctor may prescribe pills, insulin, other injectable medicines, or a combina-tion of these to help control your blood glucose levels. Insulin can be taken by shots/injections, with an insulin pump, or even inhaled.

In addition, you can keep control of your diabetes by:

•Tracking your glucose levels.Very high glucose levels or very low glucose levels (called hypoglycemia) are dan-gerous health emergencies. Talk to your doctor about how you can check your glucose levels at home.

•Making healthy food choices. Learn how different foods affect your glucose

levels. Think about foods you like that will also help you lose weight. Let your doctor know if you want help with meal planning.

•Getting exercise. Daily exercise can help improve glucose levels in older people with diabetes. Ask your doctor to help you plan an exercise program.

•Keeping track of how you are doing. Talk to your doctor about how well your diabetes care plan is working. Make sure you know how often you need to check your glucose levels.

Your doctor may want you to see other health care providers who can help you manage some of the extra problems caused by diabetes. He or she can also give you a schedule for tests you may need. Talk to your doctor about what you can do to stay healthy. Here are some

things to keep in mind: •Have yearly eye exams. Finding and

treating eye problems early may keep your eyes healthy.

•Check your kidneys yearly. Diabetes can be hard on your kidneys. A urine and blood test will show if your kidneys are okay.

•Get flu shots and a pneumonia vac-cine. A yearly flu shot will help keep you healthy. If you’re over 65, make sure you have had a pneumonia shot. Talk with your doctor to see if you should get an-other one.

•Check your cholesterol. At least once a year, get a blood test to check your cholesterol as well as your triglyceride levels. High levels may increase your risk for heart problems.

DIABETES IN OLDER PEOPLE


Being able to continue to function is key to maintaining or regaining indepen-dence and quality of life, particularly after an illness or injury. Starting rehabilitation early can help you maintain function and increase your chances of returning to your previous level of function as much as possible.

In restorative rehabilitation, the goal is to restore a function that you have lost. It is often funded by Medicare or other payers. Examples include short-term rehabili-tation that usually follows a stroke or a hip fracture. In maintenance rehabilitation, the goal is to maintain and strengthen a function. Maintenance rehabilitation is less intense, with physical therapy or occupational therapy continued three times a week as an outpatient. With longer-term therapy, possibly more function can be gained or more functional loss can be prevented.

WHO BENEFITS FROM REHABILITATION?When evaluating a disability, your health care provider will focus on understand-

ing how the loss of function developed and progressed over time. Other vital factors in predicting whether function can be regained are how severe the loss of function is, what caused it, and the potential for recovery.

The level of function you had before a disability is an important consideration in the level of function you can expect to regain after rehabilitation. For example, if a healthy older person who walks without a cane falls and fractures a hip, he or she will likely be able to walk again after several months of a rehabilitation program. However, the same goal is not as realistic for someone of the same age who was al-ready having a hard time walking (possibly due to arthritis or bad circulation) before suffering a hip fracture.

If a person has additional medical conditions, such as heart, lung, or joint diseases, his or her participation in an intense rehabilitation program may be limited. How-ever, many people can still improve their ability to exercise gradually even if they have moderate to severe heart and lung disease.

Another important factor in successful rehabilitation is commitment to an ongoing program. Commitment is important not only for the person who has lost some func-tion, but also for family members (or other caregivers) when he or she returns home after the rehabilitation program. What the older adult and his or her family expects and prefers should also be considered, because rehabilitation programs usually re-quire everyone’s participation. Another reason why everyone should be involved in the decision-making process is because many disabilities of older adults are chronic (eg, arthritis, diabetes, hypertension, heart disease). For older adults to be able to best control their chronic diseases, they should understand the disease or injury, feel confident that they understand and can perform the activities needed to manage their disease and prevent new problems, and be able to monitor their disease status as much as possible.

The type of disability and how severe it is, as well as what the person actually needs to do at home as well as what others can do for the person are important con-siderations in the decision of whether a person can safely return home after rehabili-tation. People living at home should, at the very least, be able to move safely from a bed to a chair, and from walking or a wheelchair to the toilet. For people who have difficulty thinking things through or who have problems with vision, 24-hour super-vision may be necessary. Often, the critical factor for discharge from a rehabilitation unit is whether 24-hour support is available at home for those who need it.

SETTINGS FOR REHABILITATION PROGRAMSRehabilitation can take place in many types of settings:special units in acute care hospitals or rehabilitation hospitals nursing facilities outpatient centers homes private officesIf you have a new disability and are a good candidate for 4—12 weeks of restor-

REHABILITATION

F O C U S E S O N F U N C T I O N

REHAB SEE PAGE 32


ative rehabilitation, you may benefit from an intensive rehabilitation program involv-ing a multidisciplinary team of health care professionals. Such programs are usually done in a rehabilitation unit, whether within a hospital, in a separate rehabilitation hospital or building, or in a nursing facility with a designated rehabilitation program. Other people may not require or be able to do such intensive rehabilitation and may be better suited to outpatient or home rehabilitation.

SPECIAL REHABILITATION UNITSRehabilitation programs within hospitals or special rehabilitation hospitals use

a multidisciplinary team approach, which involves the combined efforts of many specialists. The members of the rehabilitation team focus on different parts of health and manage different rehabilitation activities. The specific team members will vary significantly depending on the specific disability and situation.

In general, to qualify for Medicare or other insurance coverage of comprehensive rehabilitation at the hospital level, the person must need the following:

close medical supervision and care by a rehabilitation physician rehabilitation nursing on a 24-hour basis participation in more than one discipline, such as physical therapy, occupational

therapy, and speech therapy a team approach to therapy, with a coordinated rehabilitation program clear, realistic goals in rehabilitation, with the expectation of significant improve-

ment during the rehabilitation programIn general, rehabilitation programs in these settings are for a short time. Depend-

ing on the person’s needs and anticipated improvement, inpatient rehabilitation pro-grams usually last about 6—8 weeks for someone who has had a stroke, and about

2 weeks for someone who has had a hip fracture. A longer time is generally need-ed for those who have had more a severe injury, and a shorter time for those who have less complicated problems and were in good shape before becoming sick. Medicare reimbursement depends on documented progress as a result of thera-py. The maximal length of stay is 90 days per illness.If you cannot tolerate or do not need an intense therapy program, you may receive services at a nursing facility, in your home, or as an outpatient. These programs may also be more appropriate for ongoing maintenance therapy after an inpatient rehabilitation program.

NURSING FACILITIESIn this setting, maintaining function

may be the goal of care. In contrast to the Medicare requirements for the hospital level of rehabilitation, the requirements for insurance coverage at the nursing level of rehabilitation do not include oc-cupational therapy, a multidisciplinary approach, or the services of a rehabili-tation physician. However, the require-ments do specify that a person must need daily physical therapy and skilled nursing care and that continued, significant func-tional improvement must be documented. To be eligible for skilled nursing benefits through Medicare, the person must have had a hospital stay of at least 3 days in the past 30 days. The length of Medicare cov-erage for rehabilitation in nursing homes is limited.

OUTPATIENT REHABILITATIONOutpatient rehabilitation offers a wide

range of services from private practitio-ners’ offices that offer fee-for-service care, to outpatient rehabilitation facili-ties that provide the same comprehensive team efforts as in hospital rehabilitation units. Generally, these outpatient units are appropriate for people with short-term illnesses, such as low back pain or mi-nor trauma. Reprint permission from the American Geriatrics Society (www.amer-icangeriatrics.org). For more information visit the AGS online at www.americange-riatrics.org.

REHAB FROM PAGE 31

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Presbyobia is the loss of the focusing ability of the eye, taking away our ability to see things close or read without the help of glasses. In those who already have needed glasses, this often means their first pair of bifocals. As frustrating as this change in vision may be, fortunately, it does not mean a loss in our central vision. Quite often, with a little coping, most of us do just fine with our new bifocal glasses, or for the lucky ones, over-the-counter reading glasses are a great help.

Another nearly unavoidable consequence of the aging eye usually takes much longer to develop. A cataract is a clouding or opacity of the normally transparent lens inside the eye. It prevents the light rays passing onto the retina. The picture that the retina receives becomes dull and fuzzy. The normal process of aging causes the lens to harden and become cloudy. This is called age-related cataract and it is the most common type. It can occur anytime after the age of 45 years, although rarely, this may occur earlier in the setting of other diseases, such as diabetes. Aging and change of the lens within the eye may also bring a change in how we perceive color. The most common color vision changes are a reduction of ability to discriminate blues and blue-greens. The yellowing of the lens is believed to be responsible for this effect. The aging lens and cornea causes glare by light scattering, especially for shorter wavelengths. Aberrations of cornea also increase with age, leading to poor vision especially when the pupil dilates as in the dark. One of the more aggravating aspects of vision in an older person seems to be the feeling that it does not work as effortlessly or as quickly as it did in younger days. They must concentrate harder and require higher levels of illumination than they formerly did in order to have the same perceptual results. Fortunately, cataracts are removable, and with the most modern techniques, patients often do quite well with their removal along with implantation of an artificial lens implant.

Glaucoma is a serious condition that most commonly involves an elevation in pressure inside the eye caused by a build-up of excess fluid. Our risk for this condition also increases as we age. Those with family members who have glaucoma are also at increased risk for the disease. Left untreated, this pressure can impair vision by causing irreversible damage to the optic nerve and, eventually, blindness. Visual loss, however, can be stabilized by lowering the pressure in the eye. This is most commonly done with eyedrops, but occasionally, laser procedures or surgery are required.

One of the more devastating causes of severe loss of central vision is macular degeneration. Macular degeneration may be considered a “wearing out” of the center part of the retina, the macula. The

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There are several common eye diseases that affect our vision in different ways as the body ages. Some of the most common conditions affecting the eye include cataract, macular degeneration, and glaucoma, and one that all of us experience sometime after the age of 40 or 45, presbyopia. Routine eye care allows your eye doctor to diagnose these conditions, and in many cases, prevent visual loss from occurring.

aging eye

macula is the part of the retina that provides us with central vision and allows us to see fine detail, such as recognizing a face, reading, or watching television. It is often related to aging, and is commonly referred to as Age-Related Macular Degeneration. Macular degeneration is divided into two forms, the dry type, and the more advanced wet type. A special formulation of antioxidant vitamins can reduce by 25% the risk of progression from dry macular degeneration to the worse wet form.

With aging, the quality of vision may worsen due to reasons independent of aging eye diseases. The area of the pupil governs the amount of light that can reach the retina. The pupil also may dilate slightly less with age. Because of this smaller pupil size, older eyes may receive less light at the retina. In comparison to younger people, it may be as though older persons are wearing medium-density sunglasses in bright light and dark glasses in dim light. Everyone’s vision deteriorates with age, but there are ways to lessen its impact. Good lighting can make the difference between seeing and not seeing for older adults, especially in your homes, stairways, kitchen, and living rooms. Many of the severe consequences of these conditions, cataract, glaucoma, and macular degeneration, can be prevented by early detection by your eye doctor.

If you are experiencing the symptoms of cataracts or other vision problems, you should obtain a complete eye examination. To schedule an appointment with Aaron Holtebeck, M.D. please call Milwaukee Eye Care Associates, S.C. at 414-271-2020.

C O N D I T I O N S O F T H E


KEEP IT COOL

Older people are at high risk for developing heated-related illness because the ability to respond to summer heat can become less efficient with advancing years. Fortunately, the summer can remain safe and enjoyable for everyone who uses good, sound judgment.

Heat stress, heat fatigue, heat syncope (sudden dizziness after exercising in the heat, heat cramps and heat exhaustion are all forms of “hyperthermia,” the general name given to a variety of heat-related illnesses. Symptoms may include headache, nausea, muscle spasms and fatigue after exposure to heat. If you suspect someone is suffering from a heat-related illness:

• Get the victim out of the sun and into a cool place, preferably one that is air- conditioned. • Offer fluids but avoid alcohol and caffeine. Water, fruit and vegetable juices are best. • Encourage the individual to shower, bathe or sponge off with cool water. • Urge the person to lie down and rest, preferably in a cool place. Heat stroke is especially dangerous for older people and requires emergency

medical attention. A person with heat stroke has a body temperature above 104 and may have symptoms such as confusion, combativeness, bizarre behavior, faintness, staggering, strong rapid pulse, dry flushed skin, lack of sweating, possible delirium or coma.

The temperature does not have to hit 100 for a person to be at risk for hyperthermia. Both an individual’s general health and/or lifestyle may increase the threat of a heat-related illness. Health factors which may increase risk include:

• Age-related changes to the skin such as poor blood circulation and inefficient sweat glands. • Heart, lung and kidney diseases, as well as any illness that causes general weakness or fever. • High blood pressure or other conditions that require changes in diet. For example, people on salt restricted diets may increase their risk. However, salt pills should not be used without first asking a consulting doctor. • The inability to perspire caused by medications including diuretics, sedatives, tranquilizers and certain heart and blood pressure drugs. • Taking several drugs for various conditions. It is important, however, to continue to take prescribed medication and discuss possible problems with a physician. • Being substantially overweight or underweight. • Drinking alcoholic beverages. Lifestyle factors also can increase risk, including extremely hot living quarters, lack

of transportation, overdressing, visiting overcrowded places and not understanding weather conditions. Older people, particularly those at special risk, should stay indoors on especially hot and humid days, particularly when there is an air pollution alert in effect. People without fans or air conditioners should go to shopping malls, movie houses and libraries. Friends or relatives might be asked to supply transportation on particularly hot days. Many communities, area agencies, religious groups and senior citizen centers also provide such services as cooling centers.

For a free copy of the National Institute on Aging’s AgePage on hyperthermia and other important health information, please contact the NIA Information Center at 1-800-222-2225 or go to http://www.niapublications.org/agepages/hyperther.asp.

The NIA is part of the Department of Health and Human Services’ National Institutes of Health. The NIA is the lead federal agency supporting and conducting biomedical, social, and behavioral research and training related to aging and the diseases and special needs of older people.

with Hot Weather

Advice for Older People

The summer can remain safe and enjoyable for everyone who uses good, sound judgment.

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“After walking on a treadmill at the local community center, I knew I’d be hap-pier outside. So, I got a step counter and started walking in my neighborhood. Since then, I’ve seen yellow tulips bloom in spring and red dogwood leaves drop in fall. I always come home with more energy and happy to go on with the rest of the day.” Marian (age 77)

“Both my wife and I have heart problems. About 2 years ago, we joined our local health club, where we do both endurance and strength training exercises. On the off days, we walk near our house. It’s been life-saving for us.” Bob (age 78)

These older adults are living proof that exercise and physical activity are good for you, no matter how old you are. In fact, staying active can help you:

•Keep and improve your strength so you can stay independent. •Have more energy to do the things you want to do. •Improve your balance. •Prevent or delay some diseases like heart disease, diabetes, breast and colon can-

cer, and osteoporosis. •Perk up your mood and reduce depression.You don’t need to buy special clothes or belong to a gym to become more active.

Physical activity can and should be part of your everyday life. Find things you like to do. Go for brisk walks. Ride a bike. Dance. Work around the house. Garden. Climb stairs. Swim. Rake leaves. Try different kinds of activities that keep you moving. Look for new ways to build physical activity into your daily routine.

Four Ways to Be ActiveTo get all of the benefits of physical activity, try all four types of exercise – 1)

endurance, 2) strength, 3) balance, and 4) flexibility.1.Try to build up to at least 30 minutes of activity that makes you breathe hard on

most or all days of the week. Every day is best. That’s called an endurance activity because it builds your energy or “staying power.” You don’t have to be active for 30 minutes all at once. Ten minutes at a time is fine.

How hard do you need to push yourself? If you can talk without any trouble at all, you are not working hard enough. If you can’t talk at all, it’s too hard.

2.Keep using your muscles. Strength exercises build muscles. When you have strong muscles, you can get up from a chair by yourself, you can lift your grandchil-dren, and you can walk through the park.

Keeping your muscles in shape helps prevent falls that cause problems like broken hips. You are less likely to fall when your leg and hip muscles are strong.

3.Do things to help your balance. Try standing on one foot, then the other. If you can, don’t hold on to anything for support. Get up from a chair without using your hands or arms. Every now and then walk heel-to-toe. As you walk, put the heel of one foot just in front of the toes of your other foot. Your heel and toes should touch or almost touch.

4.Stretch. Stretching can help you be more flexible. Moving more freely will make it easier for you to reach down to tie your shoes or look over your shoulder when you back the car out of your driveway. Stretch when your muscles are warmed up. Don’t stretch so far that it hurts.

Who Should Exercise?Almost anyone, at any age, can do some type of physical activity. You can still

exercise even if you have a health condition like heart disease or diabetes. In fact, physical activity may help. For most older adults, brisk walking, riding a bike, swim-ming, weight lifting, and gardening are safe, especially if you build up slowly. But, check with your doctor if you are over 50 and you aren’t used to energetic activity. Other reasons to check with your doctor before you exercise include:

•any new symptom you haven’t discussed with your doctor •dizziness or shortness of breath •chest pain or pressure, or the feeling that your heart is skipping, racing, or flut-

Exercise and Physical Activity:

Getting FITFor Life

FIT SEE PAGE 37


It’s not too soon to begin thinking about your golf game for spring and summer of 2006. As a physical therapist specializing in golf fitness, I know that a great golf game begins with great overall physical readiness. This is a good time of year to give some thought to your conditioning and to ask yourself: Am I ready to start swinging? What can I do to improve my posture, balance, flexibility, strength and control?

Start SlowlyWhile the first nice day of late spring may tempt you to a full day’s game, it is wise to start slowly and expand your golfing activities gradually. For example, you may begin with a few trips to the driving range. It is beneficial to start with a few wedges and work your way through the middle irons and then on to your woods. This will help maintain a good tempo before gripping and ripping it with the driver. Think 85%!

Take Stock of Injuries, LimitationsIf you have sustained injuries, physical limitations or changes in posture over

the long winter months, be sure that these situations have been addressed and are fully resolved before the start of the golfing season. Remember that a golf swing is a complicated physical action, which requires proper posture and neck, shoulder, back and hip joints which work well with no restrictions.

Warm Up with ExerciseOn the day of a game, you can warm up using any routine you’re comfortable

with. But be sure to include a few stretches to prepare your body for the swing. Stretch arms and shoulders, wrists, rotate the trunk, stretch hips, hamstrings, calves and lower back.

Watch Your BackAs you play the game, be kind to your back! When lifting your clubs, be sure

to use good posture and bend your knees. If you carry your clubs on the course, switch shoulders frequently. If you are still carrying a bag with one strap, it might be beneficial to invest in a bag with a dual strap. This will allow for less strain on the shoulders and lower back. When you pick up a flagstick, tee a ball or remove a ball from the hole, be sure to squat and bend your knees. Bending straight from the waist can hurt your back.

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tering •blood clots •an infection or fever with muscle aches •unplanned weight loss •foot or ankle sores that won’t heal •joint swelling •a bleeding or detached retina, eye surgery, or laser treatment •a hernia •recent hip or back surgery Safety TipsHere are some things you can do to make sure you are exercising safely:•Start slowly, especially if you haven’t been active for a long time. Little by

little build up your activities and how hard you work at them. •Don’t hold your breath during strength exercises. That could cause changes

in your blood pressure. It may seem strange at first, but you should breathe out as you lift something, and breathe in as you relax.

•Use safety equipment. For example, wear a helmet for bike riding or the right shoes for walking or jogging.

•Unless your doctor has asked you to limit fluids, be sure to drink plenty when you are doing activities. Many older adults don’t feel thirsty even if their body needs fluids.

•Always bend forward from the hips, not the waist. If you keep your back straight, you’re probably bending the right way. If your back “humps,” that’s probably wrong.

•Warm up your muscles before you stretch. Try walking and light arm pump-ing first.

Exercise should not hurt or make you feel really tired. You might feel some soreness, a little discomfort, or a bit weary, but you should not feel pain. In fact, in many ways, being active will probably make you feel better.

How to Find Out MoreLocal fitness centers or hospitals might be able to help you find a physical activ-

ity program that works for you. You also can check with nearby religious groups, senior and civic centers, parks, recreation associations, YMCAs, YWCAs, or even shopping malls for exercise, wellness, or walking programs.

Looking for more information on how to exercise safely? Exercise and Physi-cal Activity: Your Everyday Guide from the National Institute on Aging has strength, balance, and stretching exercises you can do at home. You can order the free Guide from the National Institute on Aging Information Center.

Many groups have information about physical activity and exercise for older adults. The following list of resources will help you get started:

For more information on health and aging, contact: National Institute on Ag-ing. www.nia.nih.gov

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• swelling • inability to place weight on a lower limb • extreme tenderness in an upper limb • inability to move a joint through its full range of motion • extreme limb weakness • visible dislocation or break of a bone. CHRONIC INJURIESChronic injuries usually result from overusing one area of the body while playing

a sport or exercising over a long period. The following are signs of a chronic injury:• pain when performing an activity • a dull ache when at rest • swelling. WHAT SHOULD I DO IF I SUFFER AN INJURY?Whether an injury is acute or chronic, there is never a good reason to try to “work

through” the pain of an injury. When you have pain from a particular movement or activity, STOP! Continuing the activity only causes further harm.

Some injuries require prompt medical attention (see “Who Should I See for My Injury?”), while others can be self-treated. Here’s what you need to know about both types:

WHEN TO SEEK MEDICAL TREATMENTYou should call a health professional if:• The injury causes severe pain, swelling, or numbness. • You can't tolerate any weight on the area. • The pain or dull ache of an old injury is accompanied by increased swelling or

joint abnormality or instability. For updates and for any questions about any medications you are taking, please

contact U.S. Food and Drug Administration, Toll Free: 888-INFO-FDA (888-463-6332) Website: http://www.fda.gov/ For updates and questions about statistics, please contact Centers for Disease Control and Prevention’s National Center for Health Statistics Toll Free: 800–232–4636 Website: http://www.cdc.gov/nchs

SPORT INJURIES FROM PAGE 21

SPORT INJURIES SEE PAGE 39

Let us help youwith the next step.

Independence

Walk through the doors of one of our Senior Living Communities and you will immediately sense the home-like and friendly atmosphere. Compassionate staff has been specially selected and carefully trained to serve with an open heart and friendly smile. Our Memory Care Neighborhoods offer specialized care for the unique needs of residents with Alzheimer’s or related dementias.

For tours and information, please contact us at (262) 432-0222.

Assisted Living and Memory Care Communities

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Assisted Living and Memory Care Communities

Linda Emmer from Health Quest Massage will share benets of massage for pain management and post operative and post injury treatment in healing. Massage therapy is a wonderful tool to maintain optimal health. Benets include increased circulation and decreased blood pressure.

San Camillo offering a series of informal and informative talks. Grab a cup of coffee and learn from one of our experts. Bring your questions!


many communities offer rental programs, so again the choice is yours as to which option works best for you.

“When my wife had her stroke, it was so convenient to visit her several times a day. I couldn’t do that if I had to drive each way,” commented a resident. Should a care need arise, retirement communities can provide professional and caring services, all in the comfort of your “community.”

The choice is yours regarding your lifestyle and many elements need to be considered in making your decision. Should you decide that a retirement community is right for you, there are many elements, such as the ones listed here, that need to be considered and weighed, so that you can feel confident about your choice.

For more information contact Alexian Village of Milwaukee at 414-357-5105.

SENIOR COMMUNITY FROM PAGE 29

women, restores the sleep cycle, lifts mild depression, improves cognition and the mild short term memory loss that occurs in most women in peri-menopause and restores a sense of balance in the majority of women who use it for symptomatic relief of peri-menopausal symptoms. In addition, it has a profound effect on building bone density. Estrogen only reduces the breakdown of bone density, and not significantly.

The same results do not occur with synthetic progesterone.As women seek balance for their midlife process it’s important to keep sight of the

deeper levels of balance that are needed to restore health and equanimity. Part 2 of this article will address some of the other ways this can be done, coming in July.

©Kalpana(Rose)M.Kumar,MD March2010Kalpana (Rose) M. Kumar, MD is board certified in Internal Medicine and the

founder and Medical Director of The Ommani Center for Integrative Medicine in Pewaukee, WI. She received her medical training at UCSF and Stanford University. She has been in practice for more than 20 years and focuses her practice on integrative medicine and women’s health. She can be reached at www.ommanicenter.com or telephone 262.695.5311.

MENOPAUSE ROM PAGE 2

By Christine EbertWhen you set out to evaluate a specific independent living, assisted living, or

memory care residence, how do you know you are seeing the everyday ‘face’ of the facility? Below are some basic suggestions on how to proceed.

GO UNANNOUNCED -Visit a residence on the weekend and observe what is happening. Caregivers should be engaged with the residents. Is there life in the community? What do you see, smell, and hear? Try to avoid scheduling a tour of the facility where they put on a show instead of letting you know what’s really going on.

TALK TO THE RESIDENTS – Learn what residents are thinking about their community. Naturally you will hear both glowing reports as well as minor complaints, but are there any themes that repeatedly run through their comments? Are they uncomfortable, not sleeping well, bored, or unable to find anyone to listen? Dig a little deeper into complaints you hear repeatedly.

TALK TO THE STAFF – The caregivers deliver what the senior needs, so ask to be introduced and visit directly with the people ‘in the trenches.’ Ask about the rate of caregiver turnover and make certain staff is trained to handle special care needs.

REVIEW RECORDS – Senior facilities are inspected on a regular basis. You have the right to see any reports from those inspections.

When you help to make a decision affecting the most precious people in your life, remember to ask the best question of all: Would you enjoy living there?

HOW TO EVALUATE A senior living facility

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Then You are One of ManySu�erers from Plantar Fasciitis But do you know where it comes from? The Plantar Fascia is like a bowstring across the bottom of yourarch that helps hold it up. Whenever you stand, walk orrun, that bowstring gets pulled. If your arches collapsemuch, and most do, that bowstring gets yanked withevery step. Eventually, the place where the bowstringattaches to the heel bone can get very sore. So soreyou can hardly tolerate walking on it. So sore you mayeven let the doctor give you a shot right where it hurts.But shots can only give you temporary relief at best, becausethat bowstring is still getting yanked every time you areon your feet. Someone might tell you it’s a heel spur.And that sounds right because it sure feels likesomething is stabbing you down there. Buta heel spur can’t stab you. It is just a thingthat shows up on an X-ray that proves thebowstring is being yanked. So the soft padwith the hollow center you got for it at thedrugstore does not help, either.

There are many “sounds good” solutions out there, butuntil you do something that actually stops the yanking youare going to keep on hurting. The pain can get so bad thatonly sitting feels good - and there goes your day. It can getso bad you will pay a surgeon to cut it. Then your arch losesall kind of support and other things happen with the extraarch collapse. Things like bunion, metatarsalgia and big toearthritis, to name a few.

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