RSVP Health | Spring 2011

Spring 2011 | Volume 2, Issue 2

www.rsvphealth.com

sleep disorder quiz and sleep study sample

You Have More Power THan You THink! ParT 3

IndIvIdualIty; habIts of a lIfetIme

Bridging The Gap Between Patients And Providers

WAKE UP!How do sleep disorders affect you and where to find answers to correct them.

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4 RSVP Health | www.rsvphealth.com

RSVP Health is a focused group of individuals, interested in bringing consistent and understandable health care, health and wellness education and services.

It is who we are that dictates what we do.

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Credits

PublisherRSVP Marketing Group

Executive EditorsBenjamin A. MossRodney D. Gross, Ph.D.Kevin Russell

Creative DirectorProduction ManagerBenjamin A. Moss

WritersRodney D. Gross, Ph.D.Dr. Charles Willey, M.D.Lola AuBuchon GrossWayne Meyer, M.D.Jane WilkeSusan HutchinsonLuke SmithDr. Arturo C, Taca, FABAM, FABPNBenjamin A. MossRev. Darryl Anderson

Production CoordinatorKevin Russell

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RSVP Health124 N. Jackson St.,Farmington, MO [email protected]

RSVP Health is provided for information and education purposes and is in no way to take the place of a health care professional’s advice. Please consult a health care professional with any health related questions. Not all information within is the opinion of RSVP Marketing Group or RSVP Health.

RSVP Health is not liable for any decisions made as a result of information received from the RSVP Health Magazine.

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RSVP Health | www.rsvphealth.com 5

Readers compliment me on the way I write and present “relative” content along with how the said information is explained for their understanding. Additionally, the readers are astounded by the artwork and pictures associated with the articles. That is a direct result of my partner Benjamin A. Moss (Ben). Ben is able to take my and other’s articles/ads and develop/design a picture/theme that sometimes sums up that article into one visual. By that, I mean that he can literally sum up the relevancy of the message into one powerful graphic. This publication is no exception, as you will experience. Our collaboration is where RSVP Health LLC ensures the professionalism, relevancy, connection and pride in and of our vision.

My purpose as always is to empower individuals in taking interest in “their” own health. My goal for this issue is the same, well maybe just a little different. I hope to hear after the reading of this issue, that I “put you to sleep”. If I hear those words, then I have accomplished what I have set out to do.

Sleep is supposed to be natural occurring and something that the majority of us have attempted to manipulate throughout our lives. We never liked our parents telling us to go to bed at a certain time, people saying lights out, saying we are fine as long as I get six hours of sleep and we will catch up on our sleep this weekend. I am here to tell you and others will throughout this issue, that our parents were right. You will also see it is not just sleeping; it is the quality and actual hours.

Receiving request from readers and researching on some of the most requested medical conditions, I started seeing a common denominator and that was sleep. If you spent as many years as I have in the medical field, you hear of all kinds of things (facts, myths, etc) that are associated with certain medical conditions. However, I am here to tell you that you need to take notice of this information given to you within this issue and the experts/entities/resources that are available for you. The research I have put into this issue along with the other contributors and experts, shows the importance that the government, doctors and other leading health and wellness experts are placing on sleep and sleep

medicine towards all of us and at all ages (infants, adolescents, early adulthood, adults and seniors), all genders and all races.

Never are my intentions for you to self diagnose, but only to make you aware of possible signs that “may” be leading to a certain condition you already have or one that with the help of detection, “may” be prevented. Who knows your loved ones, child’s and or your body best? “YOU”! I say it over and over, educate yourself, it is your body and your life, invest in it. If you see a relation between symptoms and or information in this publication or just want to find out more information, please contact the specialist/experts/resources listed within this publication. They are in here for you. If you do not feel comfortable contacting them directly, contact me anytime.

As always, I would like to thank all health care and wellness entities and contributors that have participated in this guide and for seeing the importance to communicate and educate you. In addition, I would like to thank my other partners who make up RSVP Health LLC and their support on the importance of health care and wellness education, communication and awareness.

In closing, RSVP Health LLC will strive to bring health care and wellness education, awareness and access to you with one goal in mind, your well-being.

Rodney D. Gross, Ph.D.

RSVP Health | Community Health Care and Wellness Resource Guide

“The most pathetic person in the world is someone who has sight, but has no vision.”

-Helen Keller


Looking for answers on health care?Check out rsvphealth.com

Updated ArticlesExpert Answers to Health Care Questions

Health Care NewsAudio and Video of Radio Show and Forums

Connect to us through Facebook or Twitter.Facebook.com/rsvphealth

Twitter.com/rsvphealth

We are LIVE on the air, 8:20 A.M. Friday Mornings on KREI, 800 AM. Listen live or hear the shows on RSVPHealth.com.

Click on the media button for the most recent show, or select media > audio for the show archives.


Page 17 A Window to Your Health

Page 21Sleep Disorder Quiz

Page 25Sleep Study Sample

Page 28Sweet Dreams Baby

Pages 34, 48, 66Preserving Life and Limb (3 Part Series)

Page 36 Fun Programs Like ‘Get Active, Get fit’ Help Children in Battle Against Bulge

Page 41Does Where You Go For Rehab Matter

Page 45Retirement on a Shoestring

Page 46Latest Advances in Treating Addiction

Page 60Individuality; Habits of a Lifetime

Your Internal Clock Affects Your Health - Page 38, Concerned About Coffee? - Page 56, Gather Together: Staying Connected on the Spiritual Path of Aging - Page 58, Can We Prevent Alzheimer’s - Page 68

Table of Contents | RSVP Health

The Latest Advances in

Treating AddictionPage 50

Health and Wellness Resource List

2

Sleep Apnea: What is all the

buzz?

Page 18

You Have More Power Than You Think.

Page 8

Looking for answers on health care?Check out rsvphealth.com

Updated ArticlesExpert Answers to Health Care Questions

Health Care NewsAudio and Video of Radio Show and Forums

Connect to us through Facebook or Twitter.Facebook.com/rsvphealth

Twitter.com/rsvphealth

We are LIVE on the air, 8:20 A.M. Friday Mornings on KREI, 800 AM. Listen live or hear the shows on RSVPHealth.com.

Click on the media button for the most recent show, or select media > audio for the show archives.


By Dr. Rodney Gross, Ph.D. Benjamin A. Moss


Part 3


Many readers and listeners of the RSVP Health Publication and RSVP Health Radio Show made requests for definitions and information of certain medical conditions. I compiled the requests and came up with the ones that had the most requests and I added some others because after researching some of your top requests, I

and our contributors started seeing a relationship to some common denominators backed by research and professional studies. I have answered them to the best of my knowledge and experience as a health care executive and my said responsibilities within the health care arena. The definitions are basic and not drawn out, though some may have quoted definitions that were deemed appropriate. Many of these subjects will have articles associated with them throughout this publication that will go into more detail. This by no means is advice on medical treatment, just educational definitions, descriptions, examples, etc, to help you understand and empower yourself to take charge of your health and wellness. Another point I want to make as you will see, is the relationship that some of these medical conditions may have with something that seems so basic, your sleep.

You Have The Power!

“Individuals like you now more than any point in the past has to “empower” themselves and involve their families...”

Article Contents:What are some common definitions?

Depression

Diabetes

Epilepsy

Heart Attack (Myocardial Infarction/MI)

Hypertension

Insomnia

Narcolepsy

Sleep Apnea

Stroke

Seizure

Become Your Own Health and Wellness Expert



DepressionA very confusing word to not only most people, but to health care professionals alike. Many experts feel that it needs to be separated into two definitions.

Unhappiness Depression- When referring to this type of depression, one has feelings that may include sadness, boredom, dissatisfaction and the blues. These feelings occur when our lives are facing difficult things and or we are making mistakes. One can become demoralized and the strength of these feelings intensified. One of the strongest feelings of “unhappiness” is natural, the loss of a loved one or someone very close to us. For those who have these prolonged or increasingly intensifying feelings, professional help is recommended. Some of the most effective ways to handle these feelings are turning the negative feelings into positive feelings, using those positive feelings to help someone else, do not become isolated and communicate with someone.

Clinical Depression- A whole other matter, this type of depression is a medical condition that may not have any specific “origin” of events, could, can recur through one’s life, and is not grief and or demoralization. Individuals describe their feelings

What are some common definitions?

Individuals like you now more than any point in the past has to “empower” themselves and involve their families, not only in their own health and wellness but also in the understanding and definition of healthcare providers and entities that provide healthcare geared towards them and definitions of medical terminology to include medical conditions. The empowerment comes from knowledge one can access from things like word of mouth to searching on the web. There is so much free, professional, detailed information right at ones fingertips.

Doctors, Pharmacies, Insurance Companies, Hospitals, Nursing Homes, etc, also are realizing this and some are taking steps to build personalized relationships with their patients/customers. They are accepting things such as education, preventative medicine, technology and resources as part of their overall care with their patients/customers. This only benefits you more along with you continuing your health and wellness knowledge. However, be aware, that you need to call them out by asking questions, researching and being the most educated individual on your well-being. In many instances, some of the entities/people are not the experts nor have your well-being in the forefront of their overall goals.

Again, the following pages in the section are a basic guide for to empower your own health and wellness. Ask questions, research the web, go to the library, spend a day at the bookstore, most of this cost little to nothing in return for the knowledge you will receive. Your health and wellness is your “Return on Investment”.

Where to start when going to empower yourself to make health care decisions.

National Institute of Healthhttp://www.nih.gov

News In Healthhttp://newsinhealth.nih.gov

National Institute of Healthhttp://www.nih.gov

Health and Human Serviceshttp://www.health.gov

Mayo Clinichttp://www.mayoclinic.com

American Diabetes Associationhttp:// www.diabetes.org

There are numerous sources for information when it comes to making decisions about your health care and health and wellness. Here are a few of the sources we use and trust on a regular basis.

rsvpHealth.com



as much more severe as the ones stated above, stating it is like heaviness such as a weight, black cloud and or fog. Guilt, self-blame, loss of pleasure in activities that were once enjoyable, body discomfort, fatigue, erratic eating patterns (overeating or loss of appetite) and insomnia, are all some of the sufferings one experiences. The most severe feelings accompanying this type of depression are hopelessness, despair, panic and suicidal thoughts. Know that this type of depression is a physical disorder caused by chemical imbalances in the brain and that it is not your fault.Please remember that “depressions” are highly treatable and there is always hope, no matter how hopeless it feels and that you can try to be as positive as you can, but the way you feel may

not entirely be something you can control and or your fault.

Diabetes(American Diabetes Association) – “Diabetes Mellitus, or simply, diabetes, is a group of diseases characterized by high blood glucose levels that result from defects in the body’s ability to produce and/or use insulin”.

As with the previous definition, diabetes needs to be separated into four basic definitions.

Type 1 Diabetes- (American Diabetes Association) “is usually diagnosed in children and young adults, and was previously known as juvenile diabetes. In type 1 diabetes, the body does not produce insulin. Insulin is a hormone that is needed to convert sugar, starches and other food into energy needed for daily life. Only 5% of people with diabetes have this form of the disease”. Type 2 Diabetes- (American Diabetes Association) “is the most common form of diabetes. Millions of Americans have been diagnosed with type 2 diabetes, and many more are unaware they are at high risk. Some groups have a higher risk for developing type 2 diabetes than others. Type 2 diabetes is more common in

African Americans, Latinos, Native Americans, and Asian Americans, Native Hawaiians and other Pacific Islanders, as well as the aged population. In type 2 diabetes, either the body does not produce enough insulin or the cells ignore the insulin. Insulin is necessary for the body to be able to use glucose for energy. When you eat food, the body breaks down all of the sugars and starches into glucose, which is the basic fuel for the cells in the body. Insulin takes the sugar from the blood into the cells. When glucose builds up in the blood instead of going into cells, it can lead to diabetes complications”.

Gestational Diabetes- (American Diabetes Association) “During pregnancy, usually at around 28 weeks or later, many women are diagnosed with gestational diabetes. A diagnosis of gestational diabetes does not mean that you had diabetes before you conceived, or that you will have diabetes after giving birth. But it’s important to follow your doctor’s advice regarding blood glucose (blood sugar) levels while you’re planning your pregnancy, so you and your baby both remain healthy”.

Pre-diabetes - (American Diabetes Association) “Blood glucose levels that are higher than normal but not yet high enough to be diagnosed as diabetes. 79 million people in the United States have pre-diabetes. Recent research has shown that some long-term damage to the body, especially the heart and circulatory system, may already be occurring during pre-diabetes”.

Epilepsy Generically, a chronic neurological disorder that is characterized by seizures.

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Heart Attack (Myocardial Infarction/MI)The death of heart muscle tissue resulting from obstructed blood flow, usually by a clot in a coronary artery. Unlike Cardiac Arrest, that is caused by the heart’s electrical system.

HypertensionOften called the “silent killer” because it may not cause symptoms for years, it is another name for high blood pressure. It has to do with high pressure of the blood, not with tension or stress in the individual.

InsomniaBecause people need a varying amount of sleep, Insomnia should not be defined by the failure to sleep a specific number of hours. It should however, be defined as not getting “enough” sleep. Actually, some people with insomnia may actually sleep more than they perceive; but for reasons associated to the quality and nature of their sleep cycle, their sleep is inadequate, resulting in daytime fatigue and lethargic. Symptoms associated with insomnia are difficulty falling asleep, frequent awakening with the difficulty returning to sleep and waking up earlier than desired. Depression can occur because of insomnia.

NarcolepsyA chronic sleep disorder identified by excessive and overwhelming daytime sleepiness that leads to ones falling asleep at inappropriate times and places. It may occur without warning and repeatedly occurring throughout the day.

Sleep ApneaBrief interruptions of breathing during sleep. Two types of apnea are central sleep apnea and obstructive sleep apnea.

Central Sleep Apnea- Less common than the two types, it occurs when the brain fails to send appropriate signals to the respiratory muscles that initiate breathing.

Obstructive Sleep Apnea- Occurs when air cannot flow in or out of the individual’s nose or mouth (as a result of the throat muscles and tongue relaxing during sleep and partially blocking the opening of one’s airway) although efforts to breathe continue.

StrokeThe interruption of blood flow to any part of the brain, sometimes called a “Brain Attack”. Strokes result when blood vessels in the brain are blocked or they burst open and when a blood clot or material fragment that breaks free from elsewhere in the body, wanders through the bloodstream, eventually lodging in one of the brain’s blood vessels. Additionally, stokes occur when an artery in or leading to the brain bursts, due to high blood pressure or a weakened artery wall (aneurysm).

SeizurePhysical effects of unusual electrical energy bursts in the brain. When seizures recur and or become chronic, it is described as epilepsy.

Hypertension -

“The Silent Killer”


Tonic-Clonic Seizure- Also known as Grand Mal seizures, is a seizure that involves the whole body. Characteristics are loss of consciousness, whole body spasms and muscular convulsions, tongue biting, incontinence and inability to breathe. This seizure may be triggered by external stimuli such as certain sounds, patterns of light, stress, missed meals and altered sleep cycles.

Absence Seizure- Also known as Petit Mal seizures, a seizure with brief (10-30 second) loss of consciousness with eye and or muscle fluttering. Most commonly referred to as “blanking out”.

Partial Seizure- We know from above that seizures in general are electrical disturbances in the brain and partial seizure (also known as focal seizures) occur when this electrical disturbance maintains in a specific area of the brain. Symptoms that occur are a result of where in the brain this type of seizure occurs. May include aimless wandering, glassy stare, tugging at clothes, lip smacking, chewing motions, slurred/unintelligible speech, forced turning of the eyes and abnormal head movements.

Two types of partial seizures are:

Complex (Temporal Lobe) - The individual will briefly lose touch with reality/abnormal consciousness and will not remember what happened during the seizure.

Simple (Jacksonian) - The individual remains conscious and aware, but loses control of some body motion.

Febrile Seizure- Are convulsions in a child that is a result of fever. They occur when their temperature is rising rapidly but may also take place as their temperature is going down. The most common type of seizure encountered in infants and young children.

Become Your Own Health and Wellness Expert

Never enough can I express the importance of educating yourself on even the basics of healthcare. This section along with other definitions from previous versions of the RSVP Health Publication www.rsvphealth.com, gives you a start to some basic and detailed definitions, explanations and facts on who, what and where your health and wellness experiences may begin and include. However, even before that, educate yourself; know which providers specialize in what, Know what test they can and cannot actually perform, know credentials to ask for and their meaning, research inspections, know your own family history, etc, these will enhance your “Return on Investment” for your own health. There are wonderful health & wellness providers and entities that should be given respect, but demand the same with your own health and wellness. Be the leader and take charge of your health and wellness.

Healthy Connections

EMERGENCY FIRST AID FOR SEIZURES

• Call 911

• Do not attempt to force a hard object (such as a spoon or a tongue depressor) between the teeth. You can cause more damage than you can prevent.

• Do not try to hold the person down during the seizure.

• Turn the person to the side if vomiting occurs. Keep the person on his or her side while sleeping after the seizure is over.

• If the person having a seizure turns blue or stops breathing, try to position their head to prevent their tongue from blocking their airways. Breathing usually starts on its own once the seizure is over.

• CPR or mouth-to-mouth breathing is rarely needed after seizures and cannot be performed during the seizure.

If a person has repeated or prolonged seizures without regaining consciousness or returning to normal behavior, the body may develop a severe lack of oxygen. This is an emergency situation. Seek immediate medical help.

AFTER THE SEIZURE

Treat any injuries from bumps or falls. Record details of the seizure to report to the person’s primary health care provider. You should note the following details:

How long it lasted

What body parts were affected

Type of movements or other symptoms

Possible causes

How the person behaved after the seizure

Seizures of all types are caused by disorganized and sudden electrical activity in the brain. Here is some first-aid tips if someone around you has a seizure.


Your vision seems great. Your eyes feel completely fine. So you may be putting off that visit to the eye doctor. But if you haven’t seen your eye care professional in a while, you might have an eye problem that you don’t know about.

“Many eye diseases have no early warning signs,” says Dr. Janine Austin Clayton, an ophthalmologist and deputy director of NIH’s Office of Research on Women’s Health. “You may not notice anything. So it’s critical to have your eyes examined on a regular basis.”

A comprehensive dilated eye exam involves looking at all the parts of your eye. It also tests eye movement, the reaction of your pupil to light and the fluid pressure inside your eyes.

“It’s critical to pay attention to your eye health, because eye health actually is a reflection of overall health,” Clayton says. Changes in the eyes, for example, can tip a doctor off that you have diabetes.

Comprehensive dilated eye exams can catch problems that could lead to blindness and visual impairment while they can still be halted or reversed. If you have glaucoma or diabetic eye disease (a group of eye problems that can accompany diabetes), you may notice a problem only when it’s too late to regain your lost vision.

Glaucoma, for example, first affects your side, or peripheral, vision, which can be hard to notice. If left untreated, the vision loss will continue to move toward the center of your vision. “It’s a painless process,” Clayton says, “much like hypertension or high blood pressure can be painless.”

Having regular eye exams can help detect eye diseases in their early stages, when they can still be treated. Regular eye exams are important for everyone, but especially for African Americans

over age 40, those with a family history of eye disease, people with diabetes and everyone over 60.

An eye exam can also spot uncorrected refractive errors, meaning your eye is out of focus. Uncorrected refractive errors affect more than 11 million Americans, according to a recent study by NIH’s National Eye Institute. Eye care professionals usually prescribe eyeglasses or contact lenses to solve the problem. More than 150 million Americans now use corrective eyewear.

How often you should have your eyes examined depends on your age, family history and other risk factors. Your eye care professional can tell you when your next exam should be.

If you haven’t had an eye exam for a while, now’s the time. Your eyes are an important part of your health. Healthy vision can help keep you safe while you’re driving, participating in sports and taking part in recreational activities. It can also help you maintain a healthy and active lifestyle well into your golden years.

Source: National Institute of Health, NIH.gov

A Window to Your Health

A Window to Your Health | National Institute of Health


Sleep Apnea: What is all the Buzz

By Dr. Rodney Gross, Ph.D.



Sleep Apnea in the past ten years is rapidly increasing to the forefront of discussion, studies, funding, treatment, access, standards and most importantly, awareness, within the health and wellness communities and government levels. There are some health and wellness professionals out there who may not agree and not even be aware with all of this “Buzz” and may even question its importance in “consideration” of a relationship/causing contributor to a medical condition and or obtaining a diagnosis (this is very simple, lack of current education and credentials, for themselves). However, I want you to be aware of some of the “buzz” (facts, figures, discussions, statements, etc.) that is and has been going on and who is saying it besides sleep medicine professionals and me.

American Academy of NeurologyHeadaches upon awakening are particularly common in the people with obstructive sleep apnea (OSA). People who complain of headaches have a disproportionately high rate of sleep disorders, and managing or improving the sleep disorder may relieve the headache. Experts think that the dilation of blood vessels in the brain and increased blood pressure in the head, along with metabolic changes produced by the fluctuating oxygen levels in the blood and the overall effects of OSA on sleep quality, may all play a role.

Every time you stop breathing, the oxygen in your blood goes down a lot. When you re-breathe, your body tries to refresh itself with the new oxygen. That cycle is very hard on the brain: cells die, nerve fibers die, and you lose connections between different brain structures. The affected parts of the brain include structures that influence blood pressure, mood, and memory, which helps explain why high blood pressure, irritability, and memory problems are so often associated with OSA. This absolutely helps explain the association between sleep apnea and neurological conditions such as stroke.

American Diabetes AssociationYour family or partner may make jokes about snoring at your expense but sleep apnea is no laughing matter. Sleep apnea can be dangerous to your health. Untreated sleep apnea can increase your risk of having high blood pressure and even having a heart attack or stroke. Sleep apnea can also increase the risk of diabetes and the risk for work-related accidents and driving accidents.

American Heart Association / American Stroke AssociationSleep apnea is not just snoring. Left untreated, the condition can lead to serious cardiovascular problems.

Obstructive Sleep Apnea (OSA) related heart failure’s have contributing factors of lack of oxygen and rising blood pressure.

Sleep apnea is a risk factor for such medical problems as high blood pressure, heart failure, diabetes and stroke.

Until recently, the only known consequence of snoring was frayed nerves for the spouse who could not sleep. However, new evidence shows that snoring may lead to something far more serious, cardiovascular complications including stroke.

Stanford University School of Medicine, Department of Psychiatry and Behavioral Sciences

Sleep problems and specifically obstructive sleep apnea (OSA) are rarely assessed on a regular basis in patients with a depressive disorder. However, OSA might not only be associated with a depressive syndrome, but its presence may also be responsible for failure to respond to appropriate pharmacological treatment. Furthermore, an undiagnosed OSA might be exacerbated by adjunct treatments to antidepressant medications, such as benzodiazepines.

Increased awareness of the relationship between depression and OSA might significantly improve diagnostic accuracy as well as treatment outcome for both disorders.

U.S. Dept of Health & Human Services - National Institute of Health

Obstructive sleep apnea (OSA) is associated with an increased risk of stroke in middle-aged and older adults, especially men.

Overall, sleep apnea more than doubles the risk of stroke in men.

Men with moderate to severe sleep apnea were nearly three times more likely to have a stroke than men without sleep apnea or with mild sleep apnea.

“This is the largest study to date to link sleep apnea with an increased risk of stroke. The time is right for researchers to study whether treating sleep apnea could prevent or delay stroke in some individuals. “- NHLBI Acting Director Susan B. Shurin, M.D.Sleep apnea often goes undiagnosed. Doctors usually cannot detect the condition during routine office visits. Undiagnosed and untreated sleep apnea can:

Increase the risk of high blood pressure, heart attack, stroke, obesity, and diabetes.

Increase the risk of, or worsen, heart failure.

Make arrhythmias (ah-RITH-me-ahs), or irregular heartbeats, more likely.

Sleep Apnea: What is all the Buzz

Sleep Apnea: What is all the buzz? | By Dr. Rodney Gross, Ph.D.


Increase the chance of having work-related or driving accidents.

Web MDUntreated sleep apnea can cause hypertension, stroke or heart failure.

Patients with obstructed sleep apnea (OSA) had reductions of gray matter volume and an associated decrease in neuropsychological performance. “According to the National Institute of Neurological Disorders and Stroke, gray matter refers to the cerebral cortex, where the brain does most of its processing of information”.

People with obstructive sleep apnea (OSA) may be able to increase the volume of gray matter in their brains by undergoing continuous positive airway pressure therapy, also known as CPAP, new research indicates.

I am confident that you get my point. No one is saying that it is the “smoking gun” for all medical conditions; it just needs to be taken serious and considered. Communication on your sleep between you and your provider needs to be a part of your overall care. If you have questions or think you may have a sleep disorder, I have given you some of the most respected, professional entities/names above for further research. Additionally, you may contact your nearest Sleep Institute/Professionals around your area. Please make sure the Sleep Institute/Sleep Professionals have physicians that are Board Certified in Sleep Medicine and that they have certified sleep technologists.

Sleep Apnea: What is all the buzz?

Healthy Connections

When you’re awake, throat muscles help keep your airway stiff and open so air can flow into your lungs. When you sleep, these muscles are more relaxed. Normally, the relaxed throat muscles don’t prevent your airway from staying open to allow air into your lungs.

But if you have obstructive sleep apnea, your airway can be blocked or narrowed during sleep because:

Your throat muscles and tongue relax more than normal.

Your tongue and tonsils (tissue masses in the back of your mouth) are large compared to the opening into your windpipe.

You’re overweight. The extra soft fat tissue can thicken the wall of the windpipe. This causes the inside opening to narrow, which makes it harder to keep open.

The shape of your head and neck (bony structure) may cause a smaller airway size in the mouth and throat area.

The aging process limits your brain signals’ ability to keep your throat muscles stiff during sleep. This makes it more likely that the airway will narrow or collapse.

Not enough air flows into your lungs if your airway is fully or partly blocked during sleep. This can cause loud snoring and a drop in your blood oxygen level.

If the oxygen drops to a dangerous level, it triggers your brain to disturb your sleep. This helps tighten the upper airway muscles and open your windpipe. Normal breaths then start again, often with a loud snort or choking sound.

The frequent drops in oxygen level and reduced sleep quality trigger the release of stress hormones. These compounds raise your heart rate and increase your risk of high blood pressure, heart attack, stroke, and arrhythmias (irregular heartbeats). The hormones also raise the risk of, or worsen, heart failure.

Untreated sleep apnea also can lead to changes in how your body uses energy. These changes increase your risk of obesity and diabetes.

What causes sleep apnea?


Restless Legs Syndrome or Periodic Limb Movement Disorder

Other than when exercising, I experience muscle tension in my legs.

I have noticed (or others have commented) that parts of my body jerk during sleep.

I have been told that I kick at night.

When trying to go to sleep, I experience an aching or crawling sensation in my legs.

I experience leg pain or cramps during the night.

Totals (2 or more)

Acid Reflux Section:

I wake up at night with an acid/sour taste in my mouth.

I wake up at night coughing or wheezing.

I have frequent sore throats.

During the night I suddenly wake up feeling like I am choking.

Totals (2 or more)

Narcolepsy Section:

When I am angry or surprised, I feel like my muscles are going limp.

I have fallen asleep while driving.

I have experienced vivid dreamlike scenes upon falling asleep or awakening.

I feel like I am hallucinating when I fall asleep.

Naps are refreshing to me.

I have fallen asleep in social settings such as movies or at a party.

I have trouble at work because of sleepiness.

I have dreams soon after falling asleep or during naps.

I have “sleep attacks” during the day no matter how hard I try to stay awake.

I have had episodes of feeling paralyzed during my sleep.

Totals (3 or more)

Insomnia Section:

I have difficulty falling asleep.

Thoughts race through my mind and prevent me from falling asleep.

I anticipate a problem with sleep almost every night.

I wake up during the night and cannot go back to sleep.

I worry about things and have trouble relaxing.

I wake up earlier in the morning than I would like.

I lie awake for half an hour or more before I fall asleep.

I often feel sad and depressed

I have trouble concentrating at work or at school.

Totals (3 or more)

Sleep Apnea Section:

I have been told I snore.

I have been told that I stop breathing while I sleep

I have high blood pressure.

I sweat excessively during the night.

I have noticed my heart pounding or beating irregularly during the night.

I get morning headaches.

I suddenly wake up gasping for breath during the night.

I am overweight.

I seem to be losing my sex drive.

I often feel sleepy and struggle to remain alert.

I frequently wake up with a dry mouth.

Totals (3 or more)

Sleep disorder quiz:

Sleep disorder quiz:

If the number of “Yes” answers equals the number in the parenthesis, you may want to talk to you doctor about the topic in that section.

Skagzzz Sleep Institute1269 Doctors Dr.Farmington, MO 63640 573-760-1501Find us on Facebook

Sleep is essential to good health. However, over 40 million Americans suffer from some type of sleep disorder that prevents them from having a good night’s sleep. Often, the symptoms of a sleep disorder go unrecognized and untreated. Without help, an individual’s quality of life can suffer, possibly leading to other medical conditions such as heart attack, stroke or an injury.

Skaggzzz Sleep Institute is composed of registered sleep technologists with years of experi-ence in the field of sleep disorders. Come see our Board Certified Specialists at no cost to discuss your sleep problems and see if a sleep test is the answer.

Here are some sleep disorders and symptoms.

SLEEP APNEASleep apnea is a serious medical disorder in which breathing is repeatedly obstructed for periods of time.

Symptoms:Habitual snoring, daytime sleepiness and irritability.

NARCOLEPSYNarcolepsy is a disorder of the central nervous system that causes excessive daytime sleepiness, cataplexy (sudden muscle weakness) or sleep paralysis when falling asleep or awakening from sleep.

RESTLESS LEG SYNDROMERestless legs syndrome involves a “creepy crawly” sensation in the legs resulting in a frequent need to move the legs for comfort.

PERIODIC LIMB MOVEMENT DISORDERPeriodic limb movement disorder is the rhythmic moving or kicking of the limbs while asleep.

INSOMNIAInsomnia is a condition characterized by difficulty falling asleep or maintaining sleep.

Sleep.


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P937135.pdf 12/28/10 12:55:20 PM


Approximately 2 Minutes and 30 Seconds of not breathing.

Snoring

Abdominal

Blood/Oxygen Levels

Brain Activity

Breathing

Breathing

30 sec. interval

Abdominal

You can see where in the first minutes the patient is breathing, snores at about the 20 seconds and then stops breathing. They stop breathing for nearly 2 minutes and 30 seconds. At the 3:30 mark you can see their body startle, wake themselves up as they gasp to catch their breath.

This a 4 minute sample of a 7 hour sleep study that was performed on a patient. This shows what is checked during a sleep study and problem areas. This patient stopped breathing twice during the study for extended periods of time, this show is for a nearly 2 minutes and 30 seconds time span. Imagine being under water for over 2 minutes, and the reaction that happens when coming out of the water to catch your breath and that will give you somewhat the idea of what this patient was experiencing.

This measures the movement in the abdominal section during your sleep. At the beginning, at the 30 second mark you can see movement associated with the snoring and then no movement for the time when the patient stops breathing and then the violent movement as they try to catch their breath.

Snoring

In this segment, their are two fairly abrupt snores. The first coming right before the patient stops breathing and then the violent one as they catch their breath at the 3:30 mark.

Brain Activity

The brain activity is measured during a sleep study. Here you can see the activity before, during and after the period where the patient wasn’t breathing.

Blood/Oxygen LevelsThe oxygen levels in the blood are normal at the beginning of the segment in the 90’s, but as the patient stops breathing, they drop to very low levels in the 60’s.

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“Approximately 40 percent of all women and 25 percent of all men have varicose veins,”

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Many times after a good night’s sleep, we use the saying “Last night I slept like a baby.” While this analogy rings true most of the time, we tend to think of sleep disorders as an adults only problem. Pediatric sleep disorders can and do occur in infants, toddlers, preschoolers, school age and adolescents. According to the National Institute of Health, pediatric sleep disorders are responsible for a host of problems ranging from pulmonary, neurological, family problems, as well as psychological and psychiatric problems. By learning to recognize the signs of these pediatric sleep disorders throughout a child’s life stages, we can ward off potential problems in the future.

First off, let us begin with infants and how they are affected by sleep disturbances. Although the gestational age of the baby and the environment they are in are factors, the anatomy and central nervous system of the infant can be where the most serious issues originate. Sleep apnea in premature babies, apnea in infants, and SIDS (Sudden Infant Death Syndrome) are all examples of sleep disordered breathing that can be life threatening. The word “apnea” comes from the Greek meaning “without wind”. Brief pauses in breathing are considered normal, however a prolonged pause in breathing can cause oxygen levels to drop and disturb sleep. In a long cessation of breathing,

an infant may have to be resuscitated. Apnea affects premature infants because they do not have a fully developed central nervous system and cannot yet control their breathing reflex. It stands to reason that the more premature a baby is and the smaller size it is, the greater the chances of apnea increases. Small babies only store tiny amounts of oxygen so the effects of oxygen being deprived are more severe. Heart rate and breathing are monitored while keeping

the baby in an incubator. Most premature infants outgrow the apnea as time goes on, although they are at a higher risk of late apnea. Late apnea occurs in babies over six weeks and can affect full term infants with signs that could signify underlying problems such as congenital heart disease, infection, anemia, meningitis, or seizures. By around a year old if there is not, a cause found, the baby usually outgrows the apnea. If apnea persists, the parent may want to be trained in infant first aid and use a home monitor. Undiagnosed late apnea can lead to sudden infant death syndrome due to lapses in breathing depriving the brain and central

nervous system of oxygen. SIDS is the leading cause of death in infants one month to one year old. The National Institute of Heath recommends always putting the baby to sleep on its back, only in a crib, in the parent’s room not sharing the parent’s bed, and on a firm mattress. Do not use heavy comforters, quilts, or pillows. A light sheet is fine. Provide a fresh smoke free environment as cigarette smoke has been linked to SIDS. Although an infant is out

of danger after a year old, the peak for sleep apnea is between two and five years.

Next, let us look at toddlers through preschool age and the types of sleep disorders that can affect them. As stated before, sleep apnea is a problem that also happens to this age group. Snoring can be a sign of obstructive sleep apnea. This occurs

when there is a prolonged partial blockage or sporadic breathing in a sleeping child. Enlarged tonsils or adenoids are quite often the cause of obstructive sleep apnea. Sometimes surgical removal is necessary to help the child to breathe normally. Medications for the respiratory system, supplemental oxygen, and the use of a CPAP, are just some of the treatments for obstructive sleep apnea. CPAP stands for continuous positive airway pressure. This is a mask worn on the face that delivers a steady stream of air pressure through the nose allowing the child to breathe normally while sleeping. CPAP can be used

Sweet Dreams BabyBy Lola AuBuchon Gross

The National Institute of Health recommends always putting the baby to sleep on it’s back, only in a crib, in the parent’s room not sharing the parent’s bed...


Where Joy is DeliveredIN TINY BUNDLES

At Mineral Area Regional Medical Center, there’s nothing we love more than the sweet cry

of a newborn baby. That’s why our Women’s Center features a host of amenities designed for

the well-being of both mother and baby, including all private rooms, and 24-hour anesthesia

coverage. And our spacious nursery and modern security system reassure new parents that

their babies are safe and sound. Because for us, even the tiniest baby is a great big bundle of joy.

To learn more, or to schedule a personal tour, visit our website or call 573-701-7246.

573-756-4581www.marmc.net1212 Weber Road

Farmington, MO 63640

©2010 BCI

MIN049_womensAd.indd 1 12/10/10 3:03 PM

Where Joy is DeliveredIN TINY BUNDLES

At Mineral Area Regional Medical Center, there’s nothing we love more than the sweet cry

of a newborn baby. That’s why our Women’s Center features a host of amenities designed for

the well-being of both mother and baby, including all private rooms, and 24-hour anesthesia

coverage. And our spacious nursery and modern security system reassure new parents that

their babies are safe and sound. Because for us, even the tiniest baby is a great big bundle of joy.

To learn more, or to schedule a personal tour, visit our website or call 573-701-7246.

573-756-4581www.marmc.net1212 Weber Road

Farmington, MO 63640

©2010 BCI

MIN049_womensAd.indd 1 12/10/10 3:03 PM

after adenoid and tonsillectomy if further treatment is required, or if surgery is not an option. CPAP can also be helpful for overweight children with apnea, also. Many times the CPAP can be discontinued once the weight is lost as the apnea improves. Sleep apnea is higher in those children born with medical conditions such as cerebral palsy, down’s syndrome, and craniofacial (skull and face) abnormalities. Mouth breathing with choking and gasping for air can be other signs of apnea, as well as disrupted, fitful sleep. Children with apnea can never seem to get a good, sound night’s sleep. This is not a normal state to be in, as sleeping, is the main activity of the brain during the early developmental years. The sleep-wake cycle (circadian rhythms) takes time to develop. Newborns have irregular sleep cycles until their circadian rhythms start to develop starting at six weeks and regulate at six months. A good night’s sleep is extremely important for a child’s mental and physical development. During non-rapid eye movement sleep (NREM), which is where the child is sleeping quietly and deeply, a number of restorative processes take place. Hormones important for their

growth and development are released, as well as the restoration of energy and tissue repair and growth. By contrast, rapid eye movement sleep (REM), is when our brains are active and dreaming takes place. It is no wonder night fears and nightmares become more prevalent, as toddlers and preschoolers develop active imaginations. During preschool years sleepwalking and sleep terrors can occur. Signs of sleep disorders can manifest during the daytime, becoming more noticeable as the child starts school.

At last, from school age to adolescence children are often faced with their sleep disorder symptoms showing up during the day as well as night. The first time a parent may become aware of this is when they are contacted by the schoolteacher concerning behavioral problems. There are strong links between sleep apnea and poor sleep in general, tied to problem behavior. Hyperactivity, inability to pay attention, and daytime sleepiness cause difficulty in school. The parent or the teacher may not realize a child’s performance in school is related to the quality of sleep. The parent

is then usually told the child is probably ADD (attention deficit disorder), or ADHD (attention deficit hyperactivity disorder) and the sleep aspect does not even come into play. Dr. Ronald Chervin a University of Michigan neurologist and sleep researcher is quoted as saying, “Inattention and hyperactivity among general pediatric patients are associated with increased daytime sleepiness and -especially in young boys- snoring and other symptoms of SDB (sleep disordered breathing).” As the study showed, children between the ages of two through thirteen who frequently snore or have sleep disorders are twice as likely to suffer from ADHD as those who have a restful sleep. As one of the possible contributing factors to ADD and ADHD, the sleep disorder link should not be ignored. Left untreated the child sometimes carries over sleep problems on into the adolescence years. A teen’s circadian rhythms may be affected by hormonal changes and continual physical growth. Unlike younger children, these changes affect adolescents by keeping them from getting sleepy until later at night. Melatonin (a hormone linked to sleep) is produced later on in the evening in teens


compared to children and adults. By not getting tired until much later, and teens having to get up early, the shorter sleep cycles of six hours instead of the required nine can cause obvious problems. Depression, mood swings, irritability, and falling asleep in class can be the result of just not getting enough quality sleep. New research suggests that teens were 71% more likely to report depression when the sleep cycle was five hours or less. To quote study researcher James E. Gangswisch, PhD, of Columbia University Medical Center in New York, “Our results are consistent with the theory that inadequate sleep is a risk factor for depression.“ Aside from the mental aspect of lack of sleep, slow response times and poor concentration can lead to physical accidents such as car wrecks. Some of the causes of lack of sleep could again be sleep apnea or side effects of certain medications or an illness itself. Of course, too much caffeine in the afternoon or evening does not help sleep either. Obesity is also a factor as the teen stays up late snacking on junk food with shorter sleep cycles. Getting rid of sleep apnea might be as simple as a teen losing weight. Having a structured sleep routine and environment can help your teen to stabilize their sleep-wake cycle.

Finally, what can you do if you suspect your child has a sleep disorder? Contact your pediatrician who most likely will recommend a sleep study called a polysomnogram. Usually an overnight stay at a sleep center, hospital or major medical center is where the polysomnogram is conducted. The child sleeps in a quiet, comfortable environment while professional medical staff observes them. Sensors attached to the child monitor breathing, oxygenation, and brain waves electroencephalogram (EEG). The results will show whether your child has a sleep disorder. Specialists such as pulmonologists, neurologists, otolaryngolists, cardiologists, psychiatrists, and psychologists are just some of the specialists that may help your pediatrician diagnose your child’s results. If you do not suspect a serious sleep problem there are ways you can still improve your child’s sleep time. Begin by enforcing a regular and consistent sleep schedule no matter what age the child is. Also, help them wind down with a relaxing bedtime routine in a cool, quiet, dark room free of TV, computer and other electronics. Do not forget to limit their sugar and caffeine. Remember, from babies to adolescents a good night’s sleep is conducive to good health. SWEET DREAMS BABY!

Healthy Connections

Where a child lives—the greenery of the landscape and the distance to supermarkets—is related to the risk for excess pounds, according to a recent study.

In a study of more than 7,000 children, NIH-funded researchers found that children living in urban areas were less likely to be overweight if their neighborhood had more greenery. Children in suburban regions had less risk for excess weight if they lived closer to major supermarkets.

The findings suggest that access to green spaces may encourage physical activity and that access to major food stores may enable healthier diets.

Although previous studies have found that adults living closer to fast-food chains and convenience stores are at greater risk for being overweight, the current study found no evidence that the same holds true for children.

“As a pediatrician, I hope this study will encourage neighborhood organizations, community activists and others to bring more opportunities for physical activities and healthy food choices to the places where children live,” said the study’s lead investigator, Dr. Gilbert C. Liu of Indiana University School of Medicine.

National Institute of Health - NIH.govhttp://newsinhealth.nih.gov/2007/April/docs/02capsules.htm

Greenery, Groceries and Children’s Weight


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“...the great majority of you can prevent diabetes or at least put it into remission and do it for free.”



We are presently embroiled in a great national debate about healthcare. It is actually a debate about the cost and financing of our healthcare. That debate all too often ignores the very personal, individual calamity and cost of healthcare. It is no small wonder that the best solutions to the national healthcare debate will be found with the personal responsibility and accountability of the individual patient and his or her doctor.

At 20% of Gross Domestic Product (GDP), healthcare costs are crushing our businesses’ competitiveness, jobs and our government’s ability to serve. In 2007, Diabetes and its complications were responsible for $174 billion of direct and indirect costs. Given the 25.6 million diabetics over age 20, that is $6,797 per year on average for each diabetic. Over an average of 30 years of a life with diabetes, the per person average cost is $203,910. Among U.S. residents ages 65 years and older, 10.9 million, or 26.9 percent, had diabetes in 2010. 1

The good news is that in most cases Type 2 diabetes is a self-inflicted problem. Good news? Yes! You can un-inflict it. Though there is usually a requisite, familial predisposition, it most often also requires fat to become a Type 2 diabetic. Apparently some people can so severely overuse their pancreas with poor diet for a long enough time to become diabetic without being fat.

What Is Diabetes? Eventually, all food we eat turns to sugar, a basic fuel for our organs. The pancreas produces insulin to drive the sugar from the blood into the organs. The more sugar you eat, or carbohydrate that turns into sugar, the more insulin the pancreas must produce. It is becoming apparent that our pancreas’ have their lifetime limits. When fat is present it requires additional insulin to serve it. In addition, abdominal fat, sometimes called brown fat, impairs the effectiveness of insulin. Both require your pancreas to work overtime, day in, day out, year after year to produce extra insulin. Eventually the pancreas wears out and insulin is insufficient for the carbohydrate load at hand. When insulin lags, the sugar remains in the blood where at abnormal levels, it is literally poison that hardens and clogs the arteries. What can happen next? Clogged arteries to the eye is blindness, to the brain is stroke or dementia, to the heart it is

an attack or failure, to the kidneys dialysis and to the legs painful neuropathy or amputation. All are quite miserable and all are very expensive to you, your employer, insurer or government. Unfortunately the long term uncontrolled diabetic does not often achieve the comfort of dying in his or her sleep. They are serially disabled and most often end up on dialysis and or living in nursing homes both of which can have a fairly high misery index and are very expensive.

The great news is that the great majority of you can prevent diabetes or at least put it into remission and do it for free. How? Don’t become fat or if you have already become so, lose the fat and lose the diabetes. Ouch! Sorry, candor is

good medicine. If you don’t admit it you won’t fix it. Losing the diabetes definitely prevents those miserable and expensive complications. It is free because walking for exercise is free and though you can’t stop eating all together it costs less to eat less. It costs less to eat correctly as well. Those manufactured foods aren’t inexpensive.

Type 2 Diabetes is definitely self-inflicted. You are quite literally making yourself miserable with your adverse lifestyle. The ball is in your court. It is up to you to decide to establish the habit of a new lifestyle. I challenge that it is not only your duty to yourself but given the cost of diabetes to your insurance pool and or government it is also your civic duty to achieve that new lifestyle for health. It is easier said than done, but more good news, there is help and it doesn’t have to cost too much either. See page 48 for part 2.

Preserving Life and Limb, Part 1 | By Dr. Charles Willey, M.D.

This is part one of a three part article on Diabetes. Find parts two and three on pages 48 and 66.

‘Preserving Life and Limb’ Literally, Your Life, Your Limbs, Your Organs and Your DollarsPreventing the Misery and Cost of Diabetes By Dr. Charles Willey, M.D.Innovare Health Advocates


Fun Programs Like ‘Get Active, Get Fit’ Help Children in Battle Against Bulge

Anthem Blue Cross and Blue Shield in Missouri recently awarded 25 Missouri elementary schools prizes from the “Get Active, Get Fit” School Challenge hosted by Radio Disney AM 1260.

The school challenge helped educate more than 26,000 students throughout Missouri about the importance of a healthy and active lifestyle. The 20 schools that completed the “Get Active, Get Fit” School Challenge with the highest percentage of participation and received a Radio Disney Dance Party at their school to celebrate their accomplishment are:

· Manes R-5, Manes R-5 District· St. George Catholic School, Private, Linn, MO· Taneyville K-8, Taneyville R-2· Novinger Elementary, Adair County R-1· Kelly Elementary, Scott County R-IV· Skyline Elementary, Hickory County R-1· Fair Grove R-10 Elementary, Fair Grove R-10· Fair Grove Middle School, Fair Grove R-10· Senath-Honersville Elementary, Senath-Honersville District· Montgomery City Elementary, Montgomery County R-11· West Elementary, Central R-111· Gratz Brown Elementary, Moberly School District· Harrisburg Elementary, Harrisburg R-VIII· Litzsinger Elementary, Special School District· Humansville Elementary, Humansville R-IV· Orchard Farm Middle School, Orchard Farm R-V School District· Jonesburg Elementary, Montgomery County R-11

· Westview School, Westview School District· Lesterville Elementary, Lesterville R-IV· Bourbon Elementary, Crawford County School District

Five schools who signed up first and completed the challenge received gym equipment packages worth $500 each:

· Novinger Elementary, Adair County R2· Fair Grove Elementary, Fair Grove R10· Humansville Elementary, Humansville R-IV· Central Elementary, Central R-111· Halfway R-III

Close to 500,000 students are participating in the “Get Active, Get Fit” School Challenge across the country. States include California, Georgia, Indiana, Kentucky, Ohio, Missouri, upstate New York, Virginia, and Wisconsin. For Radio Disney, the network’s involvement in the program demonstrates its commitment to inspiring healthier lifestyles for kids and families supporting Disney’s Magic of Healthy Living effort.

For Anthem Blue Cross and Blue Shield, it demonstrates our commitment to educate our members and the community, especially our kids, on ways to be healthy. According to the 2007 National Survey of Children’s Health, 31 percent of Missouri’s children are considered overweight or obese. Missouri ranks near the middle of the nation, 27th, in the number of overweight and obese children.

By Dr. Wayne Meyer, M.D.Medical Director, Anthem Blue Cross and Blue Shield in Missouri


Fun Programs Like ‘Get Active, Get Fit’ Help Children in Battle Against Bulge | By Wayne Meyer, M.D.

Based on current overweight and obesity trends, one-third of children today will develop diabetes over their lifetime.(1) Statistics also show overweight adolescents have a 70 percent chance of becoming overweight or obese adults.(2)

Our youngest citizens are tipping the scales in a huge way toward a lifetime of unhealthy lifestyles. Today’s generation may be the first in history to have a shorter life expectancy than their parents.

Obesity in children may lead to serious health problems like:

Heart disease – Obese children and teens have more risk factors for cardiovascular disease, including high cholesterol levels, high blood pressure and abnormal glucose tolerance. Being overweight or out of shape makes the heart work harder.(3)

Type 2 diabetes – Every day, more than 30 children are newly diagnosed with diabetes according to the Juvenile Diabetes Research Foundation. The most common form, type 2 diabetes, a.k.a. “adult-onset” diabetes, now often strikes teenagers and even children. Unhealthy behavior is the prime cause of these tragic statistics. Approximately 80 percent of diabetic youth are also overweight. In other words, their diabetes was preventable. If current trends continue, adolescents with type 2 diabetes may experience heart troubles beginning as young as 30 or 40 years old.(4)

Digestive problems – One in four obese children may have digestive troubles such as constipation.(5)

Asthma and/or sleep apnea – Extra weight can make it harder to breathe and can inflame the respiratory tract. Children with serious asthma are more likely to be overweight.(6)

Emotional and behavioral problems – Overweight and obese children often suffer from serious emotional and behavioral problems. Severely obese children may have a similar health-related quality of life as children who have been diagnosed with cancer.(7) Overweight and obese children often suffer from low self-esteem, experience bullying, teasing and depression.

Obese children are more likely to be obese as adults. One study found that approximately 80 percent of

children who were overweight at age 10-15 were obese adults at age 25.(8) Another study found that 25 percent of obese adults were overweight as children.(9) The latter study also found that if overweight begins before 8 years of age, obesity in adulthood is likely to be more severe.

To protect our children from obesity, collaboration is needed among every adult who impacts a child’s life – parents, healthcare professionals, policymakers, and teachers – to promote exercise and teach kids the importance of choosing healthy, nutritious foods and an active lifestyle.

As a society we are learning that fitness through programs such as ‘Get Active, Get Fit’ can be fun and can enhance the lives of our members and the health of our communities.

1 Narayan, KM. Boyle, JP. Thompson, TJ. Sorensen, SW. and Williamson, DF. (2003). Lifetime Risk for Diabetes Mellitus in the United States. JAMA, 290(14):1884-1890.

2 Office of the Surgeon General. (2007). The Surgeon General’s Call To Action To Prevent and Decrease Overweight and Obesity. U.S. Department of Health and Human Services Web site. Obtained 1/20/09 from: http://www.surgeongeneral.gov/topics/obesity/calltoaction/fact_adolescents.htm

3 Li X, Li S, Ulusoy E, Chen W, Srinivasan SR, Berenson, GS. Childhood adiposity as a predictor of cardiac mass in adulthood: The Bogalusa Heart Study. Circulation 2004; 110:3488-92

4Obesity and Disability. Santa Monica, California: Rand Health; 2004.

5 http://www.mercola.com/2004/sep/15/obese_children.htm

6 http://www.hsph.harvard.edu/press/releases/press05102005.html

7 Yanovski JA, Yanovski SZ. Treatment of Pediatric and adolescent obesity. JAMA. April 9, 2003; 289 (14): 1851-1853

8 Swartz MB and Puhl R. Childhood obesity: a societal problem to solve. Obesity Reviews 2003; 4(1):57–71.

9 Luder E, Melnik TA, Dimaio M. Association of being overweight with greater asthma symptoms in inner city black and Hispanic children. J Pediatr 1998;132:699–703.


Do you live by the clock, checking your watch so you’re not late for work, school or appointments? While you struggle to stay on time for your daily activities, your body has its own internal clock. This biological clock helps you feel alert at work, hungry at mealtime and drowsy at night. When your internal clock is out of whack, your health can suffer.

Scientists have long known that the human body has daily rhythms, called circadian rhythms (circadian is Latin for “around a day”). These natural rhythms are coordinated by a tiny region in your brain. This “master clock” generally operates on a 24-hour cycle, and it adjusts to several cues in your surroundings. The most important cue is light and darkness.

During the day, when it’s light outside, the brain’s master clock sends out signals to other brain regions to make hormones that will help keep you awake, boost your heart rate and give you energy. In the evening, when less light enters your eyes, the master clock triggers production of a hormone called melatonin. Melatonin makes you feel drowsy and helps you stay asleep.

The brain’s clock affects various body functions, including body temperature, hormone levels, urine production and blood pressure.

“Many processes are patterned around a 24-hour cycle: sleeping, eating, waking, drinking and even health-related events,” says Dr. Martha Gillette, a scientist at the University of Illinois at Urbana-Champaign. For instance, she notes, heart attacks

are more likely to occur early in the morning, when the level of a hormone called cortisol starts its daily rise. Time of day has also been shown to influence the effectiveness and side-effects of certain drugs.

When you fight against your circadian clock and your activities take you out of sync with day and night, your health may suffer. The schedules of shift workers who must be on the job after the sun goes down are at odds with their biological clocks. These people often find themselves sleepy at work. They may also have trouble falling or staying asleep during daylight hours after work. Studies show that shift workers have increased risk for heart disease, digestive disturbances, cancer and other health problems.

Another less severe disruption of the circadian clock is jet lag. It’s caused by traveling across time zones. Jet lag is usually more severe for eastbound travelers, because their days are shortened and the brain has more trouble adjusting to a shorter day than a longer one. Some studies suggest that taking melatonin pills just before bedtime may help jet-lagged travelers adjust to new time zones. But the scientific evidence for using melatonin to treat sleep disorders is still unclear.

In recent years, researchers have discovered that circadian activities are far more complicated than they’d ever expected. Inside our cells, clock genes and proteins keep each cell running on a near-24-hour schedule. “Every single cell that we’ve looked at in the body has a clock inside of it,” says Gillette. “Cellular timekeeping is a molecular dance, and it’s very complicated.”

Researchers continue to explore exactly what makes our biological clocks tick. The answers they find may eventually lead to new treatments for sleep disorders, jet lag and other health problems.

Source: Nathional Institute of Health, NIH.gov

Your Internal Clock Affects Your Health | National Institute for Health

Keep Your Inner Clock On Track

• Stick to a regular sleeping schedule.

• Avoid caffeine and cigarettes late in the day, and don’t drink alcohol to help you sleep.

• Get rid of light and sound distractions in your bedroom.

• Don’t exercise within 2 hours of bedtime. It may delay the release of melatonin.

Your Internal Clock Affects Your Health

Our health connects us.

When one of your employees does something healthy, others will

too. We all infl uence the health of those around us, especially in the

workplace. At Anthem, we’re committed to encouraging this. That’s

why we offer a wide range of affordable plans and one of the largest

networks of doctors. It’s good for your employees. It’s good for your

bottom line.

Want to see how your employees’ overall health can infl uence your

bottom line? Go to http://connects.anthem.com and calculate your

company’s potential savings.

Life and disability products are underwritten by Anthem Life Insurance Company. In Missouri (excluding 30 counties in the Kansas City area): Anthem Blue Cross and Blue Shield is the trade name for RightCHOICE® Managed Care, Inc. (RIT), Healthy Alliance® Life Insurance Company (HALIC), and HMO Missouri, Inc. RIT and certain affi liates administer non-HMO benefi ts underwritten by HALIC and HMO benefi ts underwritten by HMO Missouri, Inc. RIT and certain affi liates only provide administrative services for self-funded plans and do not underwrite benefi ts. Independent licensees of the Blue Cross and Blue Shield Association. ® ANTHEM is a registered trademark of Anthem Insurance Companies, Inc. The Blue Cross and Blue Shield names and symbols are registered marks of the Blue Cross and Blue Shield Association.

19333MOEENABS 1/11

REACH Short Stay —Rehabilitation After a Hospital Stay

You Have a Choice.

REhabilitation through ACHievement. Your smart choice is right here in St. Louis. In the comfort of our senior living communities, you’ll find a comprehensive approach to recovery and rehabilitation. Our team is dedicated to maximizing your ability. Our Specialized Approach Includes:< Interdisciplinary expertise from a team that includes licensed therapy, nursing,

nutritional management, social services, and spiritual care< Physical, occupational, and speech therapy< Improvement to your highest potential

Call today to find the location nearest you!

Independent Living < Assisted Living < Memory Care Assisted Living < Skilled Nursing

314.968.9313 g LSSLiving.org

®


You’ve been out of surgery for 24 hours now. You’re feeling a world better, but it’s going to take a while before you’re really back on your feet. And your doctor is telling you you’re going to need additional rehabilitation before you can go home.

Chances are, your doctor will suggest a particular skilled nursing facility for you to enter for short term rehab. But this isn’t a time to make a rushed decision. By taking the time to do a little research beforehand, you may find that there are other providers who can better serve your particular tastes and needs.

As the old saying goes, all rehabs are not created equal, and a little advance planning can make all the difference when it comes to getting the most out of your stay.

“You do have a choice when it comes to short-term care,” says Joan Devine, who helped design the new REACH Short Stay rehabilitation program for Lutheran Senior Services (LSS). “So often after surgery or acute illness, people feel that they need to take their doctor’s first suggestion for rehab, but if you take some time to look at the different possibilities out there, you may find there’s a program that better fits your needs. And that’s okay — it’s your choice, so make the most of it.”

For that reason, in creating REACH Devine’s team wanted to make a radical departure from the traditional model of care used in most skilled nursing facilities’ rehab programs. In REACH Short Stay, staff members focus on learning the personal habits and routines of each individual guest, and then create a daily plan of care that supports their individual choices and goals.

“For some people, the most productive hours of the day are first thing in the morning,” says Devine. “Doesn’t it make more sense for them to spend their time in the therapy room just after breakfast, rather than whenever we can schedule them in?”

This flexibility and emphasis on personal choice extends to all aspects of life in LSS’ REACH

Short Stay program, from longer mealtimes to individualized care plans to consistent staffing methods that keep caregivers working with the same guest for the duration of his or her stay. Even the surroundings are designed to promote a feeling of personal freedom; the REACH team places a high priority on creating warm, welcoming, home-style environments for guests to relax as they continue to work hard toward their rehabilitation goals.

Lutheran Senior Services currently offers REACH Short Stay at its five continuing care retirement communities in the St. Louis area. On the Missouri side of the river, this program is coupled with REACH At Home, an in-home health care program that offers a seamless continuation of skilled medical services as guests make the transition back to home life.

“We’ve worked hard to provide a truly seamless transition for our guests from a hospital stay to returning to their own home,” says Devine. “We want our guests to be able to say that LSS Reach Short Stay was the best health care decision they ever made.”

Jane Wilke is Administrator of Communications for Lutheran Senior Services. REACH Short Stay is just one part of the full continuum of services and living options Lutheran Senior Services offers to older adults in Missouri and Illinois. To find an LSS location in your area, visit www.LSSLiving.org or call 1-888-LSS LIVING.

Does Where You Go For Rehab Matter?

Does Where You Go For Rehab Matter? | By Jane Wilke

By Jane Wilke

More than 40 million Americans suffer from some sort of sleep disorder. Thirty million people—suffer from chronic insomnia, resulting in an estimated annual economic cost of $30 billion in lost productivity, as well as profound loss of quality of life. Insomnia can create extreme stress at home and at work, as well as impaired mood and physical problems.

Better Sleep.Better Life.


Do You... • Have difficulty falling asleep? • Have difficulty staying asleep? • Awake many times during the night? • Wake up too soon? • Wake up feeling unrefreshed? • Notice unexplained increases in your weight?

Are you feeling... • Fatigue? • Decreased concentration? • Impaired memory and mood? • Poor judgment and physical coordination? • Irritability? • Noticeable anxiety?

If you have one or more of these symptoms, talk to your physician about The Insomnia Center at Clayton Sleep Institute, or call us directly for more information. Respecting what your mind and body are telling you, acknowledging the serious nature of insomnia and asking for help are the first steps toward better sleep and better health!

It’s what kind of insomnia?In general, there are three main types of insomnia, and properly identifying the type is a critical element in creating the right individual treatment plan.

Acute InsomniaAcute insomnia is relatively short term, usually lasting up to one month—which may feel like an eternity! Life changes, persistent stress, physical illness or emotional strain are often the sources of acute insomnia. When the cause is eliminated or resolved, good sleep will likely return, so addressing the source is key.

Co-Related or Co-Morbid InsomniaThis insomnia occurs at the same time as another health issue—it is associated with that health issue and is often marked by impairment during waking hours. Common health risks and disease states associated with co-morbid insomnia include: • Sleep apnea • Restless leg syndrome • Chronic pain • Heart disease • Heartburn (“GERD”—gastroesophogeal reflux disease) • Depression and anxiety • Dementia • Multiple sclerosisFor successful diagnosis and treatment, these compound physical and mental conditions require complete, careful compilation of data about, and thorough evaluation of, each individual patient’s health and disease states.

Primary or Chronic InsomniaPrimary insomnia lasts longer than one month and has no connection to another issue or condition. Causes of primary insomnia are specific to the individual and often a composite of biological, behavioral and cognitive factors. Symptoms form primary insomnia frequently become most apparent in the middle adulthood , when an individual’s traits, behaviors and mental patterns have been established for some time. Particularly with primary insomnia the key to successful treatment is accurate diagnosis.

Take Your Insomnia Seriously. We Do!If you have insomnia, or even think you have insomnia, do not ignore it. Talk to your doctor. Ask about The Insomnia Center at Clayton Sleep Institute or call (314) 645-5585 to speak with one of our insomnia patient specialists. We are dedicated to unraveling the mystery and the frustration of insomnia for you!

What is the Clayton Sleep Institute?Sleep affects every aspect of health; it is vital to our sense of well-being. With more than 40 million Americans suffering from some sort of sleep disorder, you can’t afford another bad night’s sleep.Clayton Sleep Institute (CSI) is a leading independent organization founded, directed and managed by expert medical, research and technology professionals dedicated to all aspects of sleep medicine and healthy sleep.

So What Is Insomnia?

Insomnia is, simply, persistent problems in falling or staying asleep. People with insomnia typically complain about poor or unrefreshing sleep and often suffer from consequences such as drowsiness and lack of focus during waking hours.



Kathy BeavenAuthorized AgentIndividual, Family and Small Business

Licence number: PR34420Anthem Blue Cross and Blue Shield1831 Chestnut Street, St. Louis, MO 63103

(314)923-5532 - office(314)923-4746 - [email protected]

When I say the words “health coverage,” what’s your first reaction? Concern? Elation that you have it? Confusion? All of the above? It’s true that health coverage can be confusing, frustrating and overwhelming. However, by spending time understanding the intricacies of your health coverage, you ensure that you will receive the best healthcare “bang for your buck.”

Another benefit of understanding your plan is being able to act decisively and quickly should a medical emergency strike. During an emergency is not the time to research which hospitals you can be taken to for treatment. So just what are the key things to understand your health coverage? To help you, I’ve prepared a list of health coverage terms to look for while you read through your coverage. While there are differences between health coverage plans and providers, this terminology will likely apply to most, if not all, providers and plans.

Cost-Sharing: With most health care coverage, you pay a monthly premium, then you share some of the cost of covered medical care with the company that provides your health care coverage. The level of cost-sharing you choose directly impacts your premium amount. The more you are willing to share in the costs, the lower your premium. With Anthem Blue Cross and Blue Shield you can choose your level of protection and the level of cost-sharing that works best for your health care needs and budget.

Deductible: The amount you have to pay each calendar year for covered services before your health care plan starts paying. For some services, the plan will even begin to pay before the deductible is met. Usually, the higher a plan’s deductible, the lower the premium. In some cases, you may also have a separate deductible for certain services such as prescription drugs.Coinsurance: The percentage of the cost of covered services that you will be responsible for, after your annual deductible is met. With some plans, you have a choice of coinsurance levels. Much like your deductible, selecting a higher coinsurance typically lowers your monthly premium because it increases your share of the cost.

Copayment: A specific dollar amount you have to pay for certain covered services.

Out-Of-Pocket Maximum: The most that you would pay in a calendar year for deductible

and coinsurance for network covered services. Once you reach this maximum, the plan pays at 100% for most covered services for the rest of the calendar year.

Formulary: A list of prescription drugs our health care plans cover. They include generic and preferred brand name drugs that have been rigorously reviewed and selected by a committee of practicing doctors and clinical pharmacists for their quality and effectiveness. We’ve negotiated lower prices on these formulary drugs, so you’ll save when your doctor prescribes medication from our formularies. There can be different formularies for different health care plans. Formulary lists can be found at www.anthem.com.

Health Savings Account (HSA): A special bank account that can be set up by a member enrolled in a qualified HSA-compatible high-deductible health plan. Contributions to this account can be made with certain tax advantages and funds from the account can be used for qualified health care expenses.

Network Discounts: With Anthem, you have access to some of the largest provider networks in the state. These network (or participating) providers have agreed to accept lower costs for their covered services to Anthem members — similar to volume discounts. These negotiated costs help reduce the overall cost of covered medical services, including your share of those costs. This is true whether you are paying the entire cost for covered services (such as while you are meeting your deductible), or whether we are sharing the cost. With over 10,500 doctors and more than 125 hospitals, chances are your provider already participates. Just visit a network provider to take advantage of the savings. With our PPO plans, you can always choose to receive services outside the network, but your share of the cost will be greater.

For your convenience, I have created a page of questions you can use to help you review your current plan or to help when you are shopping for coverage. You can also use this page to record all the components of your plan so you have them in one place. I’m happy to forward this to you via email. Call me to today to learn how Anthem Blue Cross and Blue Shield can help you with your individual or business health care coverage needs.

In Missouri (excluding 30 counties in the Kansas City area) Anthem Blue Cross and Blue Shield is the trade name for RightCHOICE® Managed Care, Inc. (RIT), Healthy Alliance® Life Insurance Company (HALIC), and HMO Missouri, Inc. RIT and certain affiliates administer non-HMO benefits underwritten by HALIC and HMO benefits underwritten by HMO Missouri, Inc. RIT and certain affiliates only provide administrative services for self-funded plans and do not underwrite benefits. Independent licensees of the Blue Cross and Blue Shield Association. ®ANTHEM is a registered trademark of Anthem Insurance Companies, Inc. The Blue Cross and Blue Shield names and symbols are registered marks of the Blue Cross Blue Shield Association. Additional information about Anthem Blue Cross and Blue Shield in Missouri is available at anthem.com.

Understanding Your Health Coverage



As you may have heard, everything’s awful.

At least, that’s what the news says. The economy. The housing market. Interest rates. The deficit. Spin the radio dial and you’ll find any number of pundits proclaiming the end of the financial world. But while no one’s going to claim that times aren’t tight – here come higher gas prices again! – people still find jobs, buy houses, and, yes, even retire in this economy.

Even if our dollars aren’t stretching as far as they used to, we still have a lot of options when it comes to retirement. Between private, state, and federally sponsored programs, there’s a lot of help for older adults out there, provided you know where to look.

First, let’s talk about housing. If you’ve reached the end of your financial rope, you can’t afford to keep up with the bills, or it’s just getting too hard physically to maintain your house, it might be time to consider rent-subsidized housing. There are nearly 4,500 Department of Housing and Urban Development properties in the St. Louis area alone, so odds are, there’s a HUD 202 affordable housing community in your neighborhood.

I’m happy to tell you that “rent-subsidized housing” does not have to equal “low quality housing”. There are safe, well-run, well-maintained affordable housing communities available for seniors in just about every part of the St. Louis area.

For example, Lutheran Senior Services – the organization I work for – operates nine such communities. Time after time, I’ve heard from our residents that making the move to one of our locations was the best move they’d ever made. And considering the cost savings at stake, taking an hour to tour one of these communities might just be a very smart investment on your part.

But there are a lot more resources for seniors in our area besides low-cost housing. Home health care, housekeeping assistance, handyman services, and personal aid are just a few programs offered by private and government-sponsored agencies around the St. Louis area. Some work with Medicaid, some are private pay only. And finding the resources that

are the right fit for you can be daunting at the best of times. If you’re suffering from health problems, it can seem downright overwhelming.

Fortunately, there are services out there that can help you navigate the senior health care maze. One such program is the Aging Answers Line from Lutheran Senior Services. Funded in part by the United Way, this free hotline helps seniors find the help they need through consultations provided in person or over the phone.

The Aging Answers Line can also help you set up a geriatric care management program, which can take a more active role in helping you plan, implement, and schedule payments for a whole range of services.

To reach the Aging Answers Line about HUD 202 affordable housing or other senior services in your area, call 314.446.2475.

So contrary to popular belief, everything is not awful. Even in a down economy, retirement can still be some of the best years of your life. But it sure helps to have the right people in your corner.

Susan Hutchinson is Executive Director of Affordable Housing for Lutheran Senior Services. As part of its Christian mission of caring service, Lutheran Senior Services (LSS) maintains nine beautifully appointed HUD 202 affordable housing locations in the St. Louis area, as well as eight in-home services to help seniors maintain their independence. To learn more, visit www.LSSLiving.org or call 1-888-LSS LIVING.

Retirement on a Shoestring

Retirement on a Shoestring | By Susan Hutchinson

By Susan Hutchinson


An Outside Perspective on Life at a Senior Living Community

A Lust for LifeBy Luke Smith



Luke Smith is Media & Communications Director for Lutheran Senior Services. Want to know more about senior living communities in your area? Lutheran Senior Services (LSS) is a great place to start. With 15 locations in the St. Louis area (including five continuing care retirement communities), LSS offers some of the most comprehensive retirement living options in the region. To learn more, visit www.LSSLiving.org or call 1-888-LSS LIVING.

The joke was a cheap one. The first time I told my friend I work as a photographer for a retirement community, he replied without so much as a pause, “Well, at least you don’t have to spend a lot of money on high speed film.”

Oh, if only he knew.

In the years since my friend’s ill-advised quip, I’ve met gold medal swimmers, hikers closing in on 1,000-mile distinction, Wii Fit leagues, cross-country motorcyclists, and fleet-footed 86-year-old tap dancers. I’ve come close to ruining expensive cameras by getting splashed on the sidelines of water volleyball tournaments, and on more than one occasion I’ve gotten winded following retirees around their communities while they barely broke a sweat.

After five years as a photographer of older adults, I can say with some authority that the residents of senior living communities — individually and as a whole — are some of the most active people you’re likely to meet. While the health magazines cajole seniors to stay active to stave off heart disease and this, that, and the other, they’re preaching to the choir when it comes to the friends I’ve made through my job.

What is it about life at a senior living community that inspires this kind of lifestyle? For one, I think it’s the Planners – those residents who are always thinking ahead, always trying to get the most for their money, and always making sure the future is taken care of. They’re the ones who move in when they’re “young enough to enjoy it”, as they frequently put it.

Planners seem to gravitate toward senior living communities because they’re a perfect fit for the way they approach life. Many such places – especially Continuing Care Retirement Communities – offer onsite assisted living and skilled nursing care, which appeals to the Planners’ desire to make sure their future needs are met.

But more than that, Planners are always in motion, whether they’re consciously staying active for health reasons or just

because they never learned how to slow down. They crave social interaction and new experiences. And senior living communities – with their fitness facilities, wellness programs, day trips, and easy access to quality health care — are a great place to meet all those needs.

And the best part of having the Planners around? They’re great inspiration for the rest of us. Within a senior living community, they help build a culture of active, joyful living. And the best senior living communities do their best to foster that culture, welcoming residents to help build diverse, exciting activities calendars and other aspects of community life.

The swimmers and hikers and video gamers and motorcyclists and tap dancers I’ve met weren’t all Planners when they arrived. Some still aren’t. Some were devout, lifelong couch potatoes whose schedules’ most pressing priorities involved catching The Young and the Restless. But there’s something about being surrounded by people who are living life to the fullest that makes you want to see what all the fuss is about.

What they discover is the real benefit of life in a senior living community – the idea that a lust for life is 100% contagious, provided you’re in the right place at the right time of your life. And it’s never too early to start planning for a happy, healthy future.

As a photographer who’s chiefly interested in getting people to smile, I tell a lot of jokes. But the joke I hear most often from my “models” is, “You want to take my picture? Are you sure I won’t break your camera?”

And while I’ve never had a camera malfunction because of someone’s perceived unattractiveness, I have, on occasion, had to ask our residents, “Can you slow down? I didn’t bring fast enough film.”



The goals of treating Type 2 diabetes have to be preventing complications and preserving the pancreas’ ability to produce insulin. Eventually the pancreas can wear out enough to require that even the Type 2 diabetic will need to inject insulin. With the average life expectancy for a man almost 80 and a woman nearly 85, we need to plan for the long term preservation of the pancreas. Some people are becoming diabetic simply because they are outliving their pancreas.

Establish a Healthy LifestyleAs stated in Part 1, establishing a habitual lifestyle of correct eating and daily exercise are always the most important aspect of treatment. Whereas in cholesterol treatment the medications are so effective some can ignore diet and just take a stronger dose of medication and still achieve control, it’s important to understand this is not true with diabetes. Indeed, poor diet and exercise combined with some of the diabetes medications, especially insulin, conspire to accelerate your fattening which in turn makes the diabetes control worse and worse in the long run.

Exercise That’s Fun and FreeRemember, walking for exercise is free and it’s always 72 degrees and never rains or snows inside the Mall, Wal-Mart, Home Depot and other big stores that are delighted to have you walk for exercise in their stores. A regular Jack LaLanne-type regimen can be done for free in your home as well. Some health plans like Essence Healthcare will pay your membership fee to the YMCA and certain other fitness facilities. Oh, and remember: never use an elevator and please walk up the escalator.

Guidelines for Great Food for LifeThe proper diet is simple to understand but often a difficult habit to establish. Think of it this way, ‘If you can’t catch it, pick it, shoot it or milk it, don’t eat it’. That is fish; vegetables and a little fruit; chicken, pork tenderloin, lean beef, game; and low fat dairy. Another approach is to shop the perimeter of the grocery store where is found the produce, meat/fish and dairy sections. Avoid the center of the store where is found the manufactured items generally pumped full of that irresistible but destructive salt, fat, carbs and sugar. Eat before you shop and don’t bring your favorite cravings into your home. e. If you must, drive to the ice-cream parlor, park a mile away, walk in, eat it and walk the mile back to your car.

Inexpensive Medication OptionsSome diabetics will need medication but most do so because they have not mastered the habit for healthy lifestyle. All can minimize their need for medication with proper lifestyle. Medications do have a cost but the best are what I like to call ‘Dirt Cheap Generics’ and are available most everywhere for $10 per 90 day supply. That is a mere $40 per year.

The hands down best and favorite Type 2 diabetes medication is Metformin because it is the only diabetes medication that does not promote weight gain. Remember fat/weight is the cause of diabetes so a treatment that increases fat, though beneficial in the short term, is a prescription for disaster in the long run. Glipizide is also very inexpensive and useful at low dose but at higher dose adds little benefit and may drive appetite. Unfortunately, the newer oral medications are ridiculously expensive to the tune of thousands of dollars per year, are not all that effective and all but maybe one promote weight gain.

Using insulin in Type 2 diabetes before you are truly insulin deficient is a real catch 22. If you would eat and exercise correctly you wouldn’t need insulin. If you start insulin when not insulin deficient and don’t eat and exercise correctly, it will temporarily bring down your sugar and A1c but will shortly make you even fatter and your sugar and A1c worse. If you are tested and truly insulin deficient, you can minimize your insulin use by eating and exercising correctly. Insulin is expensive so minimizing will save money as well. See Part 3 on page 66 for more methods and results in care of Type 2 diabetes.


‘Preserving Life and Limb’ Literally, Your Life, Your Limbs, Your Organs and Your Dollars

Preventing the Misery and Cost of Diabetes

This is part two of a three part article on

Diabetes. Find parts one and three on pages

34 and 66.

By Dr. Charles Willey, M.D.Innovare Health Advocates

RSVP Health | www.rsvphealth.com 49RSVP Health | www.rsvphealth.com 49

Remember the good old days when your family doctor really

spent time with you? Wouldn’t it be great to have that same levelof service now from your primary care physician as your healthcareneeds increase?

At Innovare Health Advocates, we practice“Old School” Internal Medicine that means we spendall the time necessary to help you enjoy a healthier life.“Old School” medicine means you receive the mostup-to-date medical treatment available while gettingall the time you deserve from our top medical team.We are your coach and advocate, and wherever yougo in the healthcare system, we’re with you everystep of the way. We work closely with you to educate,motivate and lead you to better long term health. “Old

School” means truly responsive InternalMedicine that delivers high quality patientcare with specific attention to low cost for you.We appreciate the two Medicare Advantage plansin which we participate, Essence Healthcare andGold Advantage, that truly enable Old SchoolInternal Medicine. Ask for us when you callEssence 866-597-9560 or TTY:711 or GoldAdvantage 800-533-0362 (both plans Mon-Frifrom 9 am to 5 pm). The Innovare style of medicineis Healthcare the Way It Ought to Be. Come see ussoon and experience the difference.

Health Care the Way It Ought to Be

Call Dr. Charles Willey and the team at Innovare Health Advocatesfor an appointment. Our offices are in:

South St. Louis County—314-843-4794Jefferson County—636-931-5112

Visit us online at www.innovarehealth.com. ©Copyright 2010 CJW Enterprises Inc.

*Source:2009 Patient Satisfaction Study

Dr. Charles Willey, MDAs heard on RSVP Healthradio & Bob Hardcastle’sMoney Talk TV and radio

Quality CareSpeaks for Itself

91% of Patients AreSatisfied & Happy

with Our HealthcarePractices*

Dr. Charles Willey, MD; Terry McQuaide, APRN-BC;Barbara Menke, APRN-BC; and Christine Grissum, APRN-BC

RSVPadlayout2:Layout 1 3/2/11 3:07 PM Page 1


Latest Advances in Treating Addiction

By Arturo C. Taca, Jr., M.D. FABAMMedical Director – The Institute of Neuro-Synergy (INSynergy)


Finally, developments in the field of addiction medicine has allowed clinicians to effectively treat once deadly addictions such as alcoholism, heroin and pain pill addiction, and nicotine dependence. Better understanding of the brain and its circuits help us understand that addiction is really what we have been saying for decades, “Addiction is a medical illness”. It only makes sense to offer medical options to help reduce the risk of dying from these addictions. Now, there are several medical options available to help eliminate cravings and disarm the effects of illicit drugs by blocking their euphoric effects.

Recovery is now guided by research and science. Some persons are genetically programmed to have addiction

run in families, just like diabetes or high blood pressure. That’s why not everyone who has drank alcohol or tried to smoke cigarettes become addicted to them. Some people have alcoholism run through families. This is confirmed with twin and adoption studies. We now know that our genes can determine whether using a drug will cause a very euphoric feeling that

can lead to addiction. We also know that changes in the brain occur with constant exposure of an illicit drug and may need to be addressed when someone requires detox. For example, someone using heroin for several years will have more opiate receptors growing in the brain (up regulation) and will have a harder time quitting cold turkey as compared to someone who has just started using heroin.

Regardless of the drug used, the field of addiction medicine is taking a more sophisticated look at the brain and how we can re-adjust the changes through medications such as Suboxone, Vivitrol, and Chantix. All of these new molecules pay attention to the receptors of the brain and either block, stimulate, or block and stimulate at the same time. It promotes long lasting results because of decreased cravings and does not allow illicit drugs of abuse to activate certain receptors. These advances in the treatment of chemical dependency and alcoholism go beyond the traditional 12-Step, Alcoholics Anonymous approach to treatment, which has been helpful but not enough for many.

What a wonderful time to have these options available when studies report a remarkable increase of certain addictions such as heroin and pain pill dependence. I have seen in the last 5-6 years how heroin has become a middle class drug oftentimes starting in high school students from good families with good upbringing. What is equally alarming is

the growing addiction to pain pills like oxycontin, Percocet, vicoden. Many are professionals like doctors, lawyer, pharmacists, nurses, businessmen and women who are offered these powerful pain meds for legitimate pain issues but quickly become addicted to them, not because they are bad people, but because changes in their brain make them crave more of the drug.

Nicotine addiction can be effectively treated with several medical options that certainly have fewer side effects that the tobacco itself. The new drug, Vivitrol (naltrexone) is non addicting, not habit forming, very well tolerated, and is the first monthly injection for the treatment of alcoholism and recently got FDA approval for opiate addiction. My clinic has several hundred experiences with these medications since the FDA approved them for these conditions and has seen lives turn around at a rate never imagined before. Many of the clients report that their “cravings just go away and don’t think about drinking as much”.

INSynergy offers a modern-day solution to drug addiction and alcoholism that combines of medical pharmaceutical therapy with counseling. My practice incorporates Cognitive Behavioral Therapy, which identifies automatic negative thoughts, cognitive distortions, and combines it with anti-craving medications and treatment of any co-morbid mood disorders such as depression, anxiety, bipolar disorder, and ADHD.

Latest Advances in Treating Addiction | By Arturo C. Taca, MD, FABAM, FABPN

“Regardless of the drug used, the field of addiction medicine is taking a more sophisticated look at the brain and how we can re-adjust the changes through medications...”


Dual Disorders refers to the presence of both a mood disorder and a substance abuse disorder occurring in the individual at the same time. Co-occuring mental health and substance abuse disorders are very common and oftentimes overlooked. Mental health issues often predate substance abuse problems by 4-6 years.

Often, these patients use drugs and alcohol to self-medicate, which reinforces the downward-spiral. In some cases, substance abuse precedes the development of mental health issues. For instance, anxiety and depression may be brought on as a response to stressors from broken relationships, lost employment, and other situations directly related to a drug-using lifestyle.

Often the psychiatric problem occurs first. In an attempt to feel better, the individual self-medicates with alcohol or drugs which can lead to chemical dependency. Depression, anxiety, bipolar depression, ADHD,

and even schizophrenia are all implicated in increased risk to drink or use drugs to help them with their emotional tone. In other cases, the alcohol or drug dependency is the primary condition that over time can lead to depression, anxiety and more severe emotional and mental problems.

Regardless of the cause, the first step in living a more healthy life is to form healthy habits. Sleep, exercise, diet, is essential for non-medical approaches to improvement in mood. Sleep hygiene is an important, non-chemical approach to helping the brain respond in a predictable fashion. Exercise can lift and regulate mood by stimulating natural endorphin release. A good healthy diet is crucial to helping the body and brain heal itself.

Addiction does not have to be a life sentence, when treated like other chronic diseases, it can be managed successfully. Treatment enables patients to decrease relapses and regain control of

their lives. Treatment, however, should be integrated. Specialists, including psychiatrists like myself, along with psychologists, therapists, social workers, physical health and fitness professionals should work in tandem to make a specific treatment plan for each person.

I advise patients to find the treatment center that is right for them. There are a variety of options available that can offer the recent advancements in the field of addiction treatment. Request your doctors to offer you medical options that were not available a generation ago. Supplement this treatment with good supportive resources such as therapy, a healthy lifestyle, and a supportive family network. Invest in your health!


“...find the treatment center that is right for [you]. There are a variety of options available that can offer the recent advancements in the field of addiction treatment”

Arturo C. Taca, Jr., MD, FABAMMedical Director – The Institute of Neuro-Synergy (INSynergy)

Founded by Arturo C. Taca, Jr., MD, FABAM, INSynergy was created in response for a dire need to provide effective and affordable treatment for motivated persons struggling with addictions.

Dr. Taca brings to the Institute of Neuro-Synergy (INSynergy) a wealth of experience in addiction medicine. Dr. Taca is a Diplomate and Board Certified by the American Board of Addiction Medicine as well as the American Board of Psychiatry and Neurology.

Dr. Taca has been the force behind setting the benchmark in addiction treatment locally. He has established medically assisted recovery programs locally and founded the very popular and highly effective Integrated Neuro-Science program protocol. Before this, he was the former Medical Director of Assisted Recovery Centers of America (ARCA) and led this program to develop higher standards in treating addictions.

Before INSynergy, Dr. Taca completed his psychiatric residency training at St. Louis University where he was the Chief Resident of the Department of Psychiatry. He is currently a clinical instructor and continues to teach and supervise residents at the St. Louis University School of Medicine Department of Psychiatry and St. John’s Mercy Medical Center.

Dr. Taca also was voted one of the Best Doctors of America in Psychiatry. This distinction is only offered to those physicians who have been selected by consensus of their peers to be included in Best Doctors. Only about 5% of all doctors in the U.S. are honored in this way by their colleagues as the result of a nationwide survey in which doctors cast more than one million votes


How do drugs work in the brain?Drugs are chemicals. They work in the brain by tapping into the brain’s communication system and interfering with the way nerve cells normally send, receive, and process information. Some drugs, such as marijuana and heroin, can activate neurons because their chemical structure mimics that of a natural neurotransmitter. This similarity in structure “fools” receptors and allows the drugs to lock onto and activate the nerve cells. Although these drugs mimic brain chemicals, they don’t activate nerve cells in the same way as a natural neurotransmitter, and they lead to abnormal messages being transmitted through the network.

Other drugs, such as amphetamine or cocaine, can cause the nerve cells to release abnormally large amounts of natural neurotransmitters or prevent the normal recycling of these brain chemicals. This disruption produces a greatly amplified message, ultimately disrupting communication channels. The difference in effect can be described as the difference between someone whispering into your ear and someone shouting into a microphone.

How do drugs work in the brain to produce pleasure?All drugs of abuse directly or indirectly target the brain’s reward system by flooding the circuit with dopamine. Dopamine is a

neurotransmitter present in regions of the brain that regulate movement, emotion, cognition, motivation, and feelings of pleasure. The overstimulation of this system, which rewards our natural behaviors, produces the euphoric effects sought by people who abuse drugs and teaches them to repeat the behavior.

How does stimulation of the brain’s pleasure circuit teach us to keep taking drugs?Our brains are wired to ensure that we will repeat life-sustaining activities by associating those activities with pleasure or reward. Whenever this reward circuit is activated, the brain notes that something important is happening that needs to be remembered, and teaches us to do it again and again, without thinking about it. Because drugs of abuse stimulate the same circuit, we learn to abuse drugs in the same way.

Why are drugs more addictive than natural rewards?When some drugs of abuse are taken, they can release 2 to 10 times the amount of dopamine that natural rewards do. In some cases, this occurs almost immediately (as when drugs are smoked or injected), and the effects can last much longer than those produced by natural rewards. The resulting effects on the brain’s pleasure circuit dwarfs those produced by naturally rewarding behaviors such as eating and

All drugs of abuse target the brain’s reward system by flooding the circuit with dopamine.

NucleusAccumbens

TVentralegmental

Area

DRUGS OF ABUSE TARGET THE BRAIN’S PLEASURE CENTER

These brain circuits are important for natural rewards such as food, music, and sex.

Typically, dopamine increases in response to natural rewards such as food. When cocaine is taken, dopamine increases are exaggerated, and communication is altered.

FOOD COCAINE

Brain reward (dopamine) pathway Drugs of abuse increase dopamine

Frontal CortexDopamine

Transporter

DopamineDopamineReceptor Cocaine Dopamine

DopamineTransporter



DRUGS OF ABUSE TARGET THE BRAIN’S PLEASURE CENTER


sex. The effect of such a powerful reward strongly motivates people to take drugs again and again. This is why scientists sometimes say that drug abuse is something we learn to do very, very well.

Long-term drug abuse impairs brain functioning.

What happens to your brain if you keep taking drugs?Just as we turn down the volume on a radio that is too loud, the brain adjusts to the overwhelming surges in dopamine (and other neurotransmitters) by producing less dopamine or by reducing the number of receptors that can receive and transmit signals. As a result, dopamine’s impact on the reward circuit of a drug abuser’s brain can become abnormally low, and the ability to experience any pleasure is reduced. This is why the abuser eventually feels flat, lifeless, and depressed, and is unable to enjoy things that previously brought them pleasure. Now, they need to take drugs just to bring their dopamine function back up to normal. And, they must take larger amounts of the drug than they first did to create the dopamine high - an effect known as tolerance.

How does long-term drug taking affect brain circuits?We know that the same sort of mechanisms involved in the development of tolerance can eventually lead to profound changes in neurons and brain circuits, with the potential to severely compromise the long-term health of the brain. For example, glutamate is another neurotransmitter that influences the reward circuit and the ability to learn. When the optimal concentration of glutamate is altered by drug abuse, the brain attempts to compensate for this change, which can cause impairment in cognitive function. Similarly, long-term drug abuse can trigger adaptations in habit or nonconscious memory systems. Conditioning is one example of this type of learning, whereby environmental cues become associated with the drug experience and can trigger uncontrollable cravings if the individual is later exposed to these cues, even without the drug itself

being available. This learned “reflex” is extremely robust and can emerge even after many years of abstinence.

What other brain changes occur with abuse?Chronic exposure to drugs of abuse disrupts the way critical brain structures interact to control behavior - behavior specifically related to drug abuse. Just as continued abuse may lead to tolerance or the need for higher drug dosages to produce effective control and ability to make sound decisions, while sending intense impulses to take drugs, it may also lead to addiction, which can drive an abuser to seek out and take drugs compulsively. Drug addiction erodes a person’s self-worth.

ABOUT THE INSTITUTE FOR NEURO-SYNERGY (INSYNERGY):

INSynergy is committed to implementing scientific advancements and discoveries in the field of addiction medicine.

Advancements in anti-craving medications for alcohol, opiates, and nicotine, along with Cognitive Behavioral Therapy allow INSynergy to treat persons as outpatients without disrupting busy lifestyles.

INSynergy believes that treatment does not have to be a painful, humiliating, disruptive

experience. One doesn’t have to ‘disappear’ for 28 days and have employers, family, friends, wonder what happened.

Treatment is local, practical, highly effective and affordable.

World Class Substance Abuse Treatmentin the Heart of Creve Coeur, Missouri.

This Corridor of Ballas Road is epicenter of superior medical care in St. Louis County home to several medical buildings stretching several miles and sandwiched between two major hospitals, St. John’s Mercy Medical Center,

which is the only suburban trauma center in St. Louis, and Missouri Baptist Hospital just a few blocks down. Barnes West Country Hospital and St. Luke’s Hospital are also within a few miles from INS.

INSynergy11477 Olde Cabin RoadSuite 210Creve Coeur, MO 63141Phone: 314.997.2296www.insynergytc.com

Decreased Brain Function in Methamphetamine Abuser

Healthy Control Drug Abuser

Methamphetamine abusers have significant reductions in dopamine transporters. Source: Am J Psychiatry 158:377-382. 2001.



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Because it tastes so good, you may assume coffee is bad for you. Maybe you’ve heard rumors that your morning brew causes everything from heart disease to cancer. But researchers are finding that coffee poses little to no health risk for most people. Not only that, coffee drinking might have some health benefits.

Early research hinted that coffee might have some harmful effects. But most of those studies searched for links between people’s habits and their overall health. In such studies, it’s hard to know which effects come from coffee and which just show up by coincidence. Heavy coffee drinking sometimes goes hand

in hand with unhealthy habits, like smoking and a less active lifestyle.

Coffee beans are seeds and, like all seeds, they’re loaded with compounds to protect the plant’s next generation. “Coffee is an amazingly potent collection of biologically active compounds,” says Dr. Walter C. Willett of the Harvard School of Public Health.

Caffeine is probably the most well-known compound in coffee. It can make you feel more awake and alert, which is why most people drink coffee in the first place. But too much can be



harmful. In fact, according to Willett, caffeine causes the most common problem reported by coffee drinkers: trouble sleeping. Caffeine can also blunt your appetite and cause headaches, dizziness, nervousness and irritability.

If you’re sensitive to caffeine, Willett says, simply drink less of it. If you have trouble falling asleep at night, make sure to avoid it later in the day.

Caffeine is mildly addictive, so you might get headaches, drowsiness, irritability, nausea and other symptoms if you suddenly cut back. You can avoid these effects, though, by gradually reducing your caffeine intake.

“There’s some evidence that high amounts of caffeine during pregnancy may cause problems with the pregnancy,” says Dr. Jared Reis of NIH’s National Heart, Lung and Blood Institute. That’s why doctors recommend that pregnant women cut back on coffee and other caffeinated beverages.

Studies also suggest that caffeine may interfere with calcium absorption. Calcium is an important nutrient for growing and maintaining strong bones. Make sure you get enough calcium in your diet to help reverse this effect.

Overall, says Dr. Rob M. van Dam of Brigham and Women’s Hospital and Harvard Medical School, “Caffeine doesn’t seem to have the wide array of detrimental health effects we first thought it had.”

At one time, many doctors worried that coffee might cause cancer. That’s largely because caffeine damages DNA in the test tube, Willett explains, and DNA damage is linked to cancer. However, that doesn’t mean that coffee causes cancer in people. Coffee also has high levels of compounds, called antioxidants, that protect DNA.

“Coffee’s been looked at in detail in relation to many cancers, and there’s really not been any good evidence that any type of cancer is increased by coffee consumption,” Willett says. “I think we can say quite confidently that there’s no increased risk of cancer with coffee consumption.”

Some evidence even suggests that coffee may help reduce the risk of liver cancer, Willett says. NIH’s National Cancer Institute is now organizing a new effort to put together data from many studies and look into this question, among many others.

Some doctors thought coffee might cause heart attacks or strokes, because caffeine can raise blood pressure. But Reis says that a cup of coffee won’t lead to a dramatic increase in blood pressure for regular coffee drinkers. “In long-term studies, higher levels of caffeine have not led to a higher risk of cardiovascular disease,” he says.

Some types of coffee can cause cardiovascular problems for another reason, however. Coffee can contain compounds that lead to a rise in LDL cholesterol. That’s the “bad” kind of cholesterol that’s been linked to cardiovascular disease.

“A lot depends on the way in which coffee is brewed,” Reis explains. “When coffee is brewed with a paper filter, it removes a lot of the components that lead to higher LDL.” So it’s a good idea to drink filtered coffee to avoid this problem.

Coffee may even have some positive effects. Some studies have linked coffee intake with a lower risk of developing Parkinson’s disease. “When looking at Parkinson’s disease patients, they may be up to 4-8 times less likely to have been heavy coffee drinkers,” says Dr. Wendy R. Galpern of NIH’s National Institute of Neurological Disorders and Stroke. However, she points out, the studies in this area have been limited. “It’s hard to know if this is just an association or if this is cause and effect,” she says.

Some studies suggest coffee may have other positive effects on the mind. Galpern says that researchers are now looking into the potential effects of caffeine on memory and Alzheimer’s disease.

Perhaps the strongest research showing a health benefit from coffee relates to type 2 diabetes. In a 2002 study, van Dam’s team reported that people drinking 7 or more cups per day had a 50% lower risk of type 2 diabetes than those drinking 2 or less cups. About 20 studies have now looked into the effect in various populations. “The great majority of studies confirm that coffee is associated with a lower risk for type 2 diabetes,” van Dam says.

Researchers aren’t sure why coffee has this effect, but some compound other than caffeine is responsible. “We did a study of decaffeinated coffee and essentially found the same association as caffeinated coffee,” van Dam says.

Another potential benefit from coffee is that it can keep you from drinking less healthy things. “We think that coffee is actually quite a good beverage compared to other beverages,” van Dam says. “It can be a reasonable beverage choice if you don’t add a lot of cream and sugar.”

Coffee can also help your social life, if you meet good friends to talk over coffee. Studies have clearly shown that people who have more social relationships have less stress and live longer. Research also suggests they’re less likely to show mental declines as they age.

So go enjoy that cup of coffee. It’s not the guilty pleasure you may have thought.


Concerned About Coffee? | National Institute of Health



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Our communities serve older adults of all faiths, regardless of race, color, sex, national origin, age or handicap, except as limited by state and federal law.

At one of the senior living communities where I serve, there’s a woman named Dorothy. Dorothy ‘s father was a preacher. Her grandfather was a preacher. She had brothers and uncles and cousins who were preachers. She ended up marrying a preacher (who, himself, was the son of a preacher), and she had a son of her own who grew up to be – that’s right! – a preacher.

To say that Dorothy has always been surrounded by a strong faith community is something of an understatement. As a result, she has a very clear understanding of her personal spiritual journey, and that’s something that has brought her a great deal of peace.

When you work with seniors, you learn that not everyone is as fortunate as Dorothy. And you learn that even the Dorothys of the world can sometimes find themselves fearful of the road ahead. The key, I’ve found, is to understand that you don’t have to face that fear alone – there are others who will walk this road with you.

That’s why I’m such a big proponent of senior living communities. There, people from a multitude of faith traditions come together to share their journey. While their religious practices may differ, many of their spiritual needs are very much the same – finding meaning and purpose. Resolving lingering doubts and questions. And especially continuing to grow in their faith. And I have the privilege of helping them pursue those goals.

The staff at senior living communities — especially those with spiritual care as a core value — work very hard to keep their residents from falling into isolation. We all feel the need to be alone with our thoughts from time to time, but a long-term pattern of isolation can

be one of the most harmful traps that older adults can fall into. It can lead to depression, ill health, and thoughts of suicide.

As a chaplain, I draw strength from my own faith, and I’ve made it my life’s work to guide others in doing the same. But there’s a reason why every major tradition emphasizes the need to gather together. We are inspired and sustained by our beliefs, but we are nurtured and supported by the people we surround ourselves with.

As the daughter of a minister, and later as a minister’s wife, Dorothy has had a lot of homes. “When I was teaching,” Dorothy says, “the kids wanted to know about my childhood. So I counted it up. I’ve had 25 different mailing addresses over the years.”

But, surrounded by her fellow travelers, her current home is turning out to be one of the best. “There’s a spirit of friendship and fellowship that prevails here,” she says. “I love it here.”

Rev. Darryl Anderson is Director of Care for Lutheran Senior Services. Spiritual care is an essential aspect of life at every Lutheran Senior Services community. Our full-time chaplains offer onsite spiritual programs and 24-hour pastoral care services for individuals of all faith traditions. To learn more about LSS’ 150-year-old ministry of caring service, or to find an LSS location in your area, visit www.LSSLiving.org or call 1-888-LSS LIVING.

Gather Together:Staying Connected on the Spiritual Path of Aging

By Rev. Darryl Anderson


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Call today to find the community nearest you!

Our communities serve older adults of all faiths, regardless of race, color, sex, national origin, age or handicap, except as limited by state and federal law.


All of us have habits we have developed because of our own comfort, convenience, demand and most importantly our individuality. Whether the habits are good or bad, they are ours

There is a difference in changing, manipulating and transitioning someone’s habits and the majority of us know the bad ones we need to change. Adaptation is a word I always use in the realm of my professional experiences, especially in health care. I cannot express enough about the importance of understanding and respecting someone’s individuality. Nowhere else is this more prevalent, than inside senior care entities and involving one’s habits.

As a young and new Nursing Home Administrator, I was as guilty as the next in taking for granted the individuals who came into the facility. Once inside our doors, they were placed where we suggested (wanted), told when to eat and told when to sleep. The disconnection from respecting and understanding one’s individuality was obvious. The basic individualities of eating and sleeping were ignored and the individuals were expected to conform to generic schedules of eating at 7 a.m., noon and 5 p.m. and going

to bed/lights out at 9 p.m. Now, many senior care entities will read this and say “we have to have these schedules so everyone will eat, get bathed, medications and sleep”. This is exactly my point; the individuals are expected to conform to the “entity’s” convenience.

After years of going with “doing what has always been done”, I started listening and watching both, the staff and the individuals. Two instances in particular always stand out:

The staff always complained about an individual not taking medications, not eating and not sleeping through the night. Collectively the entity (staff, physician) and the individual’s family met several times discussing the “problems”. Medications where used to “calm” the individual so they would sleep and not be combative with the staff while trying to administer medications, bathing and eating. All this really did was take away their individuality and put them in a state of what I believe was depression. Finally, I met with the family members of the individual alone and just by listening, the whole situation became clear; “the individual had worked in the mines their whole career since a child

Individuality; Habits of a Lifetime

By Dr. Rodney Gross, Ph.D.


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An EMR Could Help Save Your Life. So, Why Isn't

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on the night shift”. Though some changes were attempted, the old mentality of “this is how it has always been done” and “they have to conform to our needs”, created an ongoing struggle.

An individual with similar struggles identified by staff was coming to a head. The individual was always tired and always seemed to be sleeping. You could not get them to eat, do physical therapy or activity. When staff would try to wake them for medications, to eat, etc, they would become combative. They even went through a couple of roommates who complained about them snoring and jerking at night. Again, the first answer from the staff and physician was to “calm” the individual by medication. Now remember, I said all this individual seemed to do was sleep, but sleeping was actually not the problem, it was the quality of sleep. As a young Administrator who was by now a little more enlightened, I met with the family (which I found out that the individual, for as long as they recalled, never slept more than six hours) and remembered that we had access to a Sleep Institute whom on the Hospital side we had just signed a contract for their services. We got them involved and they suggested to the individual’s physician that a sleep study be ordered/performed. The first response from the physician was that “I am not ordering a sleep study on someone of that age”. Remember, as I said a few sentences ago, “I was a little older and little more enlightened”. I came back and said, “what do you mean you won’t order the test on someone of that age”? To make a long story short, the physician was an employed physician, the family demanded it and the test was performed. The Sleep Institute experts confirmed that the individual had multiple sleep disorders.

Steps were taken with CPAP machines and sleep habit counseling with not only the individual, but also the “staff” and the “calming” medications were dismissed that actually attributed to forced sleep. The individual almost simultaneously improved in their overall sleep habits and overall quality of life. They were alert, participated in activities and for as long as I was there, never again combative.

Look, there are great senior living facilities and many have changed their thinking of how one’s individualities and habits are recognized. Sadly, there are those who still plainly “do not get it” and refuse to adapt to the individual. Some say I speak/write too bluntly, but how else do you get the point across. Those entities with vision and the understanding that without you, they do not have a facility, “get it”. More and more, I see facilities being remodeled and or built around individuality and habits. By that, I mean things like having enough room/areas where people who worked different shifts their whole life can be together and eat according to those same shifts. Many have developed actual meal menus so at least there is “choice”. All of us that choose and or help a loved one choose a facility, needs to make sure that the entity under consideration can adapt to your or your loved one’s individuality and habits that you have formed. Last but not least, is to ensure that the quality of your life is respected especially when medical conditions arise and or identified, it has “nothing” to do with age, that is your are your loved ones choice. Even before you seek out a facility or just have a question on what to expect or questions to ask, I recommend that you use resources like those at Lutheran Senior Services. Organizations like this “get it” and they understand “individuality and habits”.

Individuality; Habits of a Lifetime | By Dr. Rodney Gross Ph.D.

Healthy ConnectionsLong-term care is a variety of services that includes medical and non-medical care to people who have a chronic illness or disability. When researching and looking for a long term care facility there are many resources available to help. The power resides with you and your family to ask the right questions and get the information needed to make an informed decision. Here is some information to get you started.

1. Assess your needs.There are many different kinds of long-term care. Long-term care can take place at home, in senior centers, at community centers, in assisted living or special retirement communities, as well as in nursing homes. Long-term care service is not only nursing home care.

2. Research financing and care choices.The cost of long-term care can vary quite a bit depending on what kind of care you need, where you get the care, and where you live.

3. Find what is right for you.Quality care means doing the right thing, at the right time, in the right way for the right person and producing the best possible results. Medicare enforces standards, however quality of care will vary at every facility.

4. Visit your options.Before you make a final decision about long-term care, visit each of the facilities you are interested in. Make appointments to talk to the program coordinators or care supervisors.

Steps to choosing the appropriate long term care facility.

This information and much more in-depth information on choosing the right facility can be found at http://www.medicare.gov/LongTermCare/Static/Home.asp

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Ways to Control DiabetesIf you are overweight or are an uncontrolled diabetic, you may be frustrated or even feel hopeless that you can ever lose weight or achieve control of your diabetes. The good news is that many people have been successful with both and you can do it too.

Many of the techniques discussed in these articles are in use in our diabetes treatment methodology at Innovare Health Advocates. We don’t contend that ours is the only successful method but we are somewhat unique.

In national surveys of diabetics, it is discovered that less than 50% even know what an A1c is and even fewer know what their own A1c result is. The A1c test measures the sugar/glucose attached to hemoglobin.. The sugar does not come off during the 90 day life of the hemoglobin molecule. . A1c is a 24 hour/day, 7 day/week, 12 week running average of diabetes control. Minimum or standard goal is that it should be less than 7.0. Excess insulin production likely begins at A1c’s over 6.0 which would be the super goal. At Innovare, 70% of our Type 2 diabetics have an A1c less than 7.0. We use very little insulin with our patients and very few of the newer expensive medications. We have a special Diabetes Coaching Program for our diabetics who are most severely out of control. We spend a minimum of 30 minutes with our patients on average and even longer

with our diabetics. We have 4 clinicians, 3 of who are very highly trained Advanced Practice Registered Nurses. We emphasize diet, exercise and judicious use of medication. When quality is equal we aggressively seek the lower cost methods.

We enroll those diabetics not under control in the coaching program led by our Nurse Educator Debbie Schroeder, RN. She teaches, motivates and facilitates our uncontrolled diabetics to establish a habit for a new healthy lifestyle. She meets these patients one on one in the office, develops a treatment plan for them, and then calls them twice a week to help further teach, remind, encourage and monitor for glucose testing and results. Treating diabetes requires our involvement in the very personal issues of diet and exercise. It takes a strong relationship to have standing in discussion of these matters. The regular weekly contact helps patients want to improve before the next call. We set expectations for behavior and performance and coach patients to achieve the lifestyle modification. Ms. Schroeder uses positive reinforcement along with high expectations and frequent contact to establish the new habit for healthy lifestyle. The table on the opposite page lists some of our early results on the most difficult of our patients who previously experienced severely uncontrolled diabetes. (See chart on page 67)

We work closely with Essence Healthcare’s Diabetes Special Needs Plan. This is a benefit plan exclusively for diabetics and it is designed to make some of the critical resources for diabetics more affordable. The home glucose testing system is available at no cost to the patient. The medication benefit is richer to help increase the probability that our diabetics can afford the very important care we recommend. Several fitness centers are available free to Essence members and we strongly encourage participation, especially among the diabetics. We are planning cooking and shopping classes for those with diabetes as well.

In summary, Type 2 Diabetes is both awful and expensive if uncontrolled but there are effective ways to achieve control and prevent misery at little or no cost.


‘Preserving Life and Limb’ Literally, Your Life, Your Limbs, Your Organs and Your Dollars

Preventing the Misery and Cost of Diabetes

This is part three of a three part article on

Diabetes. Find parts one and two on pages

34 and 48.

By Dr. Charles Willey, M.D.Innovare Health Advocates


This chart shows the strong progress by many of the most challenged patients in reduction of A1c in just the first 3 months of coaching with Innovare. A1c tests are given at the start of treatment and on average every 3 months afterward to track progress in controlling diabetes.

A for the A1C testThe A1C Test shows you what your blood glucose has been over the last three months. The A1C goal for most people is below 7. High blood glucose levels can harm your heart and blood vessels, kidneys, feet, and eyes.

B for Blood pressure.The goal for most people is 130/80.

High blood pressure makes your heart work too hard. It can cause heart attack, stroke, and kidney disease.

C for Cholesterol.The LDL goal for most people is less than 100.The HDL goal for most people is above 40.

LDL or “bad” cholesterol can build up and clog your blood vessels. It can cause a heart attack or a stroke. HDL or “good” cholesterol helps remove cholesterol from your blood vessels.

Actions you could take:Ask your health care team: What your A1C, blood pressure, and Cholesterol numbers are What should your ABC numbers should be What you can do to reach your targets

Write down all your numbers and keep a track record of them.Stay on top of your health and research out the best health care team to have on your side of your Diabetes fight.Source: National Institute of Health, NIH.gov


Dr. Charles Willey, M.D., is an internist and chief executive officer of Innovare Health Advocates. You may contact Dr. Willey at the Innovare South St. Louis County office by calling 314.843.4794, or the Jefferson County office by calling 636.931.5112. For additional information, please visit www.innovarehealth.com.

Healthy ConnectionsKnow Your Diabetes ABC’s


Can We Prevent Alzheimer’s Disease?

“Research so far has offered good leads about preventing Alzheimer’s disease and

age-related cognitive decline.”


Will doing crossword puzzles prevent memory loss as we age? Does exercise delay or prevent Alzheimer’s disease? Will adding fish oil to a diet help keep our brains healthy as we age? NIH recently convened a conference to answer these and other questions. The conclusion? Research so far has offered good leads about preventing Alzheimer’s disease and age-related cognitive decline. Still, more research is needed before we can be sure what’s effective.

“Scientists are actively investigating a wide range of strategies,” says Dr. Richard J. Hodes, director of NIH’s National Institute on Aging (NIA). “Before we can tell the public that something will prevent Alzheimer’s disease or cognitive decline, we want to make sure that the intervention is tested as rigorously as possible.”

Alzheimer’s disease usually affects people 60 and older, but people with a rare form of the illness can develop the disease in their 30s or 40s.

“The biggest risk factor for Alzheimer’s disease is age, and the number of Americans over the age of 65 is expected to double to 70 million by 2050,” Hodes says. “We must find ways to prevent or delay this terrible disease.”

While aging brains may not store memories or recall information as easily as they once did, many older people function well despite these changes. In fact, experience can help some older people perform certain tasks as well or better than younger ones. Alzheimer’s disease and other dementias are definitely not, as people once thought, a normal part of aging.

The science of Alzheimer’s disease has come a long way since 1906, when a German neurologist and psychiatrist named Dr. Alois Alzheimer first described the key features of the disease now named after him. He noticed abnormal deposits in the brain of a 51-year old woman who had dementia. Researchers now know that Alzheimer’s disease is characterized by brain abnormalities called plaques and tangles. Plaques are clumps of protein in the spaces between the brain’s nerve cells. Tangles are masses of twisted protein threads found inside nerve cells. Scientists know what these plaques and tangles are made of. But they still don’t know what causes them to form, or how to stop the process.

During the 3-day meeting—called the State-of-the-Science Conference on Preventing Alzheimer’s Disease and Cognitive

Decline—an independent panel of 15 medical, science and health care experts heard talks from leading scientists and reviewed the available evidence.

The panel noted the challenges in diagnosing and treating these complex disorders. It’s hard to measure them in their earliest stages. There are no agreed-upon tests that doctors can use in their offices. Scientists are continuing to investigate methods for early detection.

A handful of approved medications are available to help treat the symptoms of Alzheimer’s disease. One, donepezil (Aricept), was found to delay the development of Alzheimer’s disease for about a year in people with mild impairment. None of the approved medications, however, appears to affect the underlying causes of the disease.

The panel reviewed a range of observational studies and a few short-term clinical trials looking at different prevention strategies. For example, these studies have suggested that physical activity, social engagement and intellectual activity all may help prevent Alzheimer’s disease and cognitive decline. Controlling high blood pressure and diabetes may help. So may omega 3 fatty acids, which are found in salmon and other fish. Many of these strategies have already been shown to promote healthy aging and reduce the risk for other diseases.

However, none of the studies to date has given conclusive answers when it comes to preventing Alzheimer’s or cognitive decline. These strategies and many others are under further study. In addition, many drugs are now being tested in clinical trials.

“We wish we could tell people that taking a pill or doing a puzzle every day would prevent this terrible disease, but current evidence doesn’t support this,” says Dr. Martha L. Daviglus, panel chair and professor of preventive medicine at Northwestern University in Chicago.

Still, many of the healthy habits under study, like exercise, usually do no harm and likely benefit overall health. Smoking has been linked to a greater risk for dementia and cognitive decline, so if you smoke, try to quit. Chronic diseases, such as diabetes and depression, may also raise your risk, so be sure to address any long-term health problems.

Can we prevent Alzheimer’s Disease? | National Institute of Health


SAM RIDGEWAY

(314) 558-1644 ext. 10014575 Manchester RoadManchester, MO 63011

[email protected]

Authorized Independent Agent

Don’t put your family at risk by trying to get by without health care coverage. Get reliable benefits that match your busy life. We can help you choose a plan that makes good sense for your health, and your wallet.

Health coverage as individual as your family.

Sam Ridgeway is an independent authorized agent in Missouri for Anthem Blue Cross and Blue Shield.In Missouri, (excluding 30 counties in the Kansas City area) Anthem Blue Cross and Blue Shield is the trade name of RightCHOICE® Managed Care, Inc. (RIT), Healthy Alliance® Life Insurance Company (HALIC), and HMO Missouri, Inc. RIT and certain affiliates administer non-HMO benefits underwritten by HALIC and HMO benefits underwritten by HMO Missouri, Inc. RIT and certain affiliates only provide administrative services for self-funded plans and do not underwrite benefits. Independent licensees of the Blue Cross and Blue Shield Association. ® ANTHEM is a registered trademark of Anthem Insurance Companies, Inc. The Blue Cross and Blue Shield names and symbols are registered marks of the Blue Cross and Blue Shield Association.

Despite all the challenges, Hodes says, there are reasons to be optimistic. “Technology is advancing our ability to identify the gene mutations that may place some people at greater risk for developing Alzheimer’s disease. Scientists are developing new imaging tools to allow us to map the changes taking place in living brains. And we are moving closer to identifying the markers in blood that may signal disease onset, track its progress and test whether or not a medicine is working.”

Whether you have memory problems or not, you can take an important step: You can volunteer to participate in research. NIA is now funding 6 clinical trials to examine the effects of exercise or other lifestyle changes on people with mild to severe Alzheimer’s disease. Another 14 clinical trials are testing ways to prevent cognitive decline in healthy older adults.


Forgetfulness: When To Seek Help

People who have a sudden loss of memory or become very confused should get medical help right away. Make an appointment to see a doctor if you notice these symptoms:

Asking the same question or repeating the same story over and over.

Becoming lost in familiar places.

Not being able to follow directions.

Getting confused about time, people and places.

Not taking care of yourself—eating poorly, not bathing or being unsafe.

Having memory or concentration problems that concern you.

Healthy Connections

Chances are you’ve walked into a room and forgotten why you went there. And misplaced your keys or eyeglasses at least a few times. Many people worry about these memory lapses. They fear they’re heading toward a serious condition like Alzheimer’s disease, an irreversible brain illness.

Occasional forgetfulness is a normal part of life that becomes more common as we grow older. In most cases, it’s no cause for alarm—unless it begins to hamper daily activities. Forgetting where you left the car keys is one thing; forgetting what they do is quite another.

Over the past few years, scientists have learned a lot about memory and why some memory problems are serious but others are not. As we age, changes occur throughout the body, including the brain. As a result, you may begin to notice that it takes longer to learn new things. Perhaps you can’t remember information as well as before, or you may misplace things. These memory lapses may be signs of normal aging. But if increasing forgetfulness begins to worry you, it’s a good idea to check with your doctor. If a medical problem exists, it’s best to start treatment as early as possible.

No matter what your age, several underlying causes can bring about memory problems. Forgetfulness can arise from stress, depression, lack of sleep or thyroid problems. Other causes include side effects from certain medicines, an unhealthy diet or not having enough fluids in your body (dehydration). Taking care of these underlying causes may help resolve your memory problems.

For some older people, though, episodes of memory loss may be a sign of a more serious problem called dementia. Two of the most common forms of dementia in older people are Alzheimer’s disease and multi-infarct dementia (or vascular dementia).

In Alzheimer’s disease, memory loss begins slowly and gets worse over time. People with Alzheimer’s disease have trouble thinking clearly. They find it hard to do everyday things like shopping, driving, cooking or having a conversation. Medications can help during the early or middle stages. As the illness progresses, though, patients may need someone to take care of all their needs (like feeding and bathing) at home or in a nursing home.

Vascular dementia also causes serious memory problems. But unlike Alzheimer’s disease, the signs of vascular dementia may appear suddenly. This is because the memory loss and confusion are caused by small strokes or changes in the blood supply to the brain. Further strokes can make the situation worse. Taking care of your high blood pressure can lower your chances of getting this illness.

See your doctor if you’re concerned that you or someone you know has a memory problem. Your doctor may be able to diagnose the problem or refer you to an expert who specializes in memory problems. Source: National Institute of Health

Things Forgotten Simple Lapse or Serious Problem?

Can we prevent Alzheimer’s Disease?


SAM RIDGEWAY

(314) 558-1644 ext. 10014575 Manchester RoadManchester, MO 63011

[email protected]

Authorized Independent Agent

Don’t put your family at risk by trying to get by without health care coverage. Get reliable benefits that match your busy life. We can help you choose a plan that makes good sense for your health, and your wallet.

Health coverage as individual as your family.

Sam Ridgeway is an independent authorized agent in Missouri for Anthem Blue Cross and Blue Shield.In Missouri, (excluding 30 counties in the Kansas City area) Anthem Blue Cross and Blue Shield is the trade name of RightCHOICE® Managed Care, Inc. (RIT), Healthy Alliance® Life Insurance Company (HALIC), and HMO Missouri, Inc. RIT and certain affiliates administer non-HMO benefits underwritten by HALIC and HMO benefits underwritten by HMO Missouri, Inc. RIT and certain affiliates only provide administrative services for self-funded plans and do not underwrite benefits. Independent licensees of the Blue Cross and Blue Shield Association. ® ANTHEM is a registered trademark of Anthem Insurance Companies, Inc. The Blue Cross and Blue Shield names and symbols are registered marks of the Blue Cross and Blue Shield Association.


Health & WellnessResource List

AARP 601 E Street, NW Washington DC 20049 P. 1-888-OUR-AARP (687-2277) www.aarp.org

ABILITY Awareness 1440 E. 1st St., Suite 107 Santa Ana CA 92701P. 714-277-4330F. 714-277-3743www.ABILITYAwareness.org

Administration on Aging (AoA) Department of Health and Human Services (DHHS) Administration on AgingWashington DC 20201 P. 202-619-0724Eldercare Locator: 1-800-677-1116F. 202-357-3555www.aoa.gov

Ageless Design3197 Trout Place Road Cumming, GA 30041P. 1-800-752-3238www.agelessdesign.com

Agency for Health care Research & Quality (AHRQ) Office of Communications & Knowledge Transfer540 Gaither Rd., Suite 2000Rockville MD 20850P. 1-800-358-9295www.ahrq.gov

AIDS Community Research Initiative of America (ACRIA) Center on HIV and Aging 230 West 38th Street, 17th Floor New York NY 10018 P. 212-924-3934F. 212-924-3936www.acria.org/center/introduction

AIDSinfo PO Box 6303 Rockville MD 20849-6303P. 1-800-HIV-0440 (448-0440)F. 301-315-2818www.aidsinfo.nih.gov

Alcoholics Anonymous (AA) A.A. World Services, Inc. New York NY 10163 P. 212-870-3400 www.aa.org

Alliance for Aging Research 2021 K Street, NW, Suite 305 Washington DC 20006 P. 202-293-2856 F. 202-785-8574www.agingresearch.org

Alzheimer’s Association 225 N. Michigan Avenue, Floor 17 Chicago IL 60601-7633P. 1-800-272-3900F. 1-866-699-1246www.alz.org

Alzheimer’s Disease Cooperative Study University of California, San DiegoLa Jolla CA 92093-0949 P. 858-622-5880 adcs.ucsd.edu

Alzheimer’s Disease Education and Referral (ADEAR) Center PO Box 8250 Silver Spring MD 20907-8250P. 1-800-438-4380F. 301-495-3334www.nia.nih.gov/Alzheimers

Alzheimer’s Foundation of America (AFA) 322 Eighth Avenue, 7th Floor New York NY 10001 P. 1-866-AFA-8484 (232-8484)F. 646-638-1546www.alzfdn.org

America’s Health Insurance Plans 601 Pennsylvania Ave., NW South building, Suite 500 Washington DC 20004 P. 202-778-3200 F. 202-331-7487www.hiaa.org

American Academy of Audiology 11730 Plaza America Drive, Suite 300 Reston VA 20190P. 800-AAA-2336 (800-222-2336)F. 703-790-8631www.audiology.org

American Academy of Dermatology (AAD) PO Box 4014 Schaumburg IL 60168-4014P. 886-503-SKIN (7546)F. 847-240-1859www.aad.org

American Academy of Family Physicians (AAFP) P.O. Box 11210 Shawnee Mission, KS 66207-1210P. 1-800-274-2237F. 913-906-6075www.aafp.org

American Academy of Hospice and Palliative Medicine (AAHPM) 4700 W. Lake Ave.Glenview IL 60025 P. 847-375-4712F. 847-375-6475 www.aahpm.org www.palliativedoctors.org

American Academy of Neurology (AAN) 1080 Montreal Avenue St. Paul MN 55116 P. 1-800-879-1960F. 651-695-2791www.aan.com

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American Academy of Ophthalmology (AAO) PO Box 7424 San Francisco CA 94120-7424 P. 1-800-222-3937F. 415-561-8533www.aao.org

American Academy of Orthopaedic Surgeons (AAOS) 6300 North River Road Rosemont, IL 60018-4262P. 800-346-AAOS F. 847-823-8125www.aaos.org

American Academy of Otolaryngology Head and Neck Surgery, Inc. (AAO) 1650 Diagonal Road, Alexandria VA 22314 P. 703-836-4444 F. 703-683-5100www.entnet.org

American Academy of Physical Medicine and Rehabilitation (AAPMR) 970 West Bryn Mawr Avenue., Suite 200, Rosemont IL 60018-5701P. 847-737-6000 F. 847-737-6001www.aapmr.org

American Association for Geriatric Psychiatry (AAGP) 7910 Woodmont Avenue, Suite 1050,Bethesda MD 20814-3004P. 301-654-7850 F. 301-654-4137www.aagpgpa.org

American Association for Marriage and Family Therapy (AAMFT) 112 South Alfred St., Alexandria VA 22314P. 703-838-9808 F. 703-838-9805www.aamft.org

American Association of Cardiovascular and Pulmonary Rehabilitation (AACVPR) 401 North Michigan Ave., Suite 2200, Chicago IL 60611P. 312-321-5146 F. 312-673-6924www.aacvpr.org

American Association of Critical-Care Nurses (AACN) 101 Columbia Aliso Viejo CA 92656-4109P. 1-800-899-AACN (2226)F. 949-362-2020www.aacn.org

American Association of Homes and Services for the Aging (AAHSA) 2519 Connecticut Avenue, NW, Washington DC 20008-1520P. 202-783-2242 F. 202-783-2255www.aahsa.org

American Bar Association (ABA) American Bar Association Commission on Law and Aging;740 15th Street, NW, Washington DC 20005-1022P. 202-662-8690 F. 202-662-8698www.abanet.org/aging

American Brain Tumor Association (ABTA) 2720 River Road Des Plaines IL 60018P. 1-800-886-2282F. 847-827-9918www.abta.org

American Cancer Society (ACS)Heart Health CenterCheck the ACS website for your local office’s address. P. 1-800-ACS-2345 (227-2345)www.cancer.org

American Chiropractic Association (ACA) 1701 Clarendon Boulevard Arlington VA 22209P. 1-800-986-4636F. 703-243-2593www.amerchiro.org

American Chronic Pain Association P.O. Box 850 Rocklin CA 95677P. 1-800-533-3231F. 916-632-3208www.theacpa.org

American College of Foot and Ankle Surgeons 8725 West Higgins Rd. Ste. 555 Chicago IL 60631-2724P. 1-800-421-2237F. 773-693-9304www.footphysicians.comwww.acfas.org

American College of Health Care Administrators1321 Duke St, Suite 400 Alexandria VA 22314P. 202-536-5120F. 888-874-1585www.achca.org

American College of Obstetricians and Gynecologists (ACOG) 409 12th Street, SW ; PO Box 96920 Washington DC 20090-6920P. 202-638-5577www.acog.org

American College of Physicians (ACP) 190 North Independence Mall WestPhiladelphia PA 19106-1572 P. 1-800-523-1546www.acponline.org

American College of Rheumatology Association of Rheumatology Health Professionals 2200 Lake Boulevard NE Atlanta GA 30319 P. 404-633-3777 F. 404-633-1870www.rheumatology.org

American College of Sports Medicine (ACSM) 401 West Michigan Street, PO Box 1440,Indianapolis IN 46206-1440 P. 317-637-9200F. 317-634-7817www.acsm.org

American College of Surgeons (ACS) 633 North Saint Clair Street Chicago IL 60611-3211P. 312-202-5000F. 312-202-5001www.facs.org

American Council of the Blind (ACB) 2200 Wilson Boulevard, Suite 650 Arlington VA 22201P. 1-800-424-8666F. 703-465-5085www.acb.org

American Counseling Association (ACA) 5999 Stevenson Avenue, Alexandria VA 22304P. 1-800-347-6647F. 703-823-0252www.counseling.org

American Dental Association (ADA) 211 East Chicago Avenue, Chicago IL 60611-2678P. 312-440-2500 Ext: 2593 www.ada.org

American Diabetes Association (ADA) 1701 North Beauregard Street Alexandria VA 22311P. 1-800-DIABETES (342-2383)www.diabetes.org

American Dietetic Association (ADA) 120 South Riverside Plaza, Suite 2000 Chicago IL 60606-6995P. 1-800-877-1600www.eatright.org

American Federation for Aging Research (AFAR) 55 West 39th Street, 16th Floor New York NY 10018P. 1-888-582-2327F. 212-997-0330www.afar.org

American Foundation for the Blind (AFB) 2 Penn Plaza, Suite 1102 New York NY 10121 P. 1-800-AFB-LINE (232-5463)F. 818-545-8331www.afb.org

American Geriatric Society Foundation for Health in Aging The Empire State Building350 Fifth Avenue, Suite 801, New York NY 10118P. 1-800-563-4916 (toll-free) F. 212-832-8646www.healthinaging.org

American Health Assistance Foundation (AHAF) 22512 Gateway Center Drive, Clarksburg MD 20871P. 1-800-437-AHAF (437-2423)F. 301-258-9454www.ahaf.org/alzheimers

American Health Care Association (AHCA) 1201 L Street, NW, Washington DC 20005 P. 202-842-4444 F. 202-842-3860www.ahca.org

American Heart Association (AHA) National Center, 7272 Greenville Avenue Dallas TX 75231P. 1-800-AHA-USA1 (242-8721)www.americanheart.org

American Horticultural Therapy Association (AHTA) 150 South Warner Road, Suite 156 King of Prussia PA 19406P. 484-654-0357F. 610-225-2364www.ahta.org

American Hospital Association (AHA) 155 N. Wacker Dr., Chicago IL 60606-3421 P. 312-422-3000 F. 312-422-4591www.hospitalconnect.com

American Liver Foundation 75 Maiden Lane, Suite 603 New York NY 10038P. 1-800-GO-LIVER (465-4837)F. 212-483-8179www.liverfoundation.org

Health

care Providers List



American Lung Association (ALA) 1301 Pennsylvania Ave., NW, Suite 800 Washington DC 20004P. 1-800-LUNG-USA (586-4872)www.lungusa.org

American Medical Association (AMA) 515 North State Street, Chicago IL 60610 P. 1-800-621-8335www.ama-assn.org

American Medical Directors Association (AMDA) 11000 Broken Land Parkway, Suite 400 Columbia MD 21044P. 1-800-876-2632F. 410-740-4572www.amda.com

American Menopause Foundation (AMF) 866 United Nations Plaza, Suite 508 New York NY 10017P. 212-714-2398 www.americanmenopause.org

American Music Therapy Association (AMTA) 8455 Colesville Road, Suite 1000, Silver Spring MD 20910P. 301-589-3300 F. 301-589-5175www.musictherapy.org

American Nurses Association (ANA) 8515 Georgia Ave., Suite 400 Silver Spring MD 20910-3492P. 1-800-274-4ANA (4262)F. 301-628-5001www.nursingworld.org

American Occupational Therapy Association, Inc. (AOTA) 4720 Montgomery Lane, Bethesda MD 20824-1220P. 301-652-2682 F. 301-652-7711www.aota.org

American Optometric Association (AOA) 243 North Lindbergh Boulevard St. Louis MO 63141P. 1-800-365-2219F. 314-991-4101www.aoanet.org

American Orthopaedic Foot and Ankle Society 6300 North River Rd., Suite 510Rosemont IL 60018P. 1-800-235-4855F. 847-692-3315www.aofas.org

American Osteopathic Association 142 East Ontario Street, Chicago IL 60611P. 1-800-621-1773F. 312-202-8200www.osteopathic.org

American Parkinson’s Disease Association (APDA) 135 Parkinson Ave., Staten Island NY 10305P. 1-800-223-2732F. 718-981-4399www.apdaparkinson.org

American Pharmacists Association (APhA) 2215 Constitution Avenue NW Washington DC 20037P. 1-800-237-APhA( 2742)F. 202-783-2351www.pharmacist.comwww.pharmacyandyou.org

American Physical Therapy Association (APTA) 1111 North Fairfax Street Alexandria VA 22314-1488P. 1-800-999-APTA (2782)F. 703-684-7343www.apta.org

American Podiatric Medical Association (APMA) 9312 Old Georgetown Road Bethesda MD 20814-1621P. 1-800-FOOT-CARE (366-8227)F. 301-530-2752www.apma.org

American Psychiatric Association (APA) 1000 Wilson Blvd., Suite 1825, Arlington VA 22209-3901P. 1-888-35-PSYCH (357-7924)F. 703-907-1085www.psych.org

American Psychological Association (APA) 750 First Street, NE Washington DC 20002-4242P. 1-800-374-2721www.apa.org

American Red Cross 2025 E Street, NW Washington DC 20006P. 202-303-5000www.redcross.org

American Self-help Group Clearinghouse 375 E. McFarlan St. Dover NJ 07801-3638P. 1-800-367-6274F. 973-989-1159www.mentalhelp.net/selfhelp

American Sleep Apnea Association (ASAA) 6856 Eastern Avenue, NW, Suite 203, Washington DC 20012P. 202-293-3650 F. 202-293-3656www.sleepapnea.org

American Social Health Association P.O. Box 13827 Research Triangle Park NC 27709P. 919-361-8400F. 919-361-8425www.ashastd.org

American Society on Aging (ASA) 71 Stevenson Street, Suite 1450San Francisco CA 94105-2938 P. 1-800-537-9728F. 415-974-0300www.asaging.org

American Speech-Language-Hearing Association (ASHA) 2200 Research Boulevard, Rockville MD 20850-3289P. 301-296-5700 F. 301-296-8580www.asha.org

American Stroke Association (ASA) American Heart Association National Center Dallas TX 75231 P. 1-888-4STROKE (478-7653)F. 214-570-5930www.strokeassociation.org

American Tinnitus Association (ATA) PO Box 5 Portland OR 97207-0005P. 1-800-634-8978F. 503-248-0024www.ata.org

American Urological Association Foundation, Inc. 1000 Corporate Blvd., Suite 410,Linthicum MD 21090 P. 410-689-3700F. 410-689-3800www.urologyhealth.orgwww.auanet.org

Americans for Better Care of the Dying 1700 Diagonal Road, Suite 635Alexandria VA 22314 P. 703-647-8505 F. 703-837-1233www.abcd-caring.org

Aplastic Anemia And MDS International Foundation, Inc. 100 Park Avenue, Suite 108P.O. Box 610Rockville MD 20850 P. 1-800-747-2820 F. 301-279-7205www.aamds.org

ARCH National Respite Network and Resource Center 800 Eastowne Drive, Suite 105Chapel Hill NC 27514 P. 919-490-5577 F. 919-490-4905www.archrespite.org

Arthritis Foundation (AF) P.O. Box 7669 Atlanta GA 30357-0669P. 1-800-283-7800F. 404-872-0457www.arthritis.org

Assisted Living Directory www.assisted-living-directory.com

Assisted Living Federation of America (ALFA) 1650 King St., Suite 602 Alexandria VA 22314-2747P. 703-894-1805 F. 703-894-1831www.alfa.org

AssistedLivingFacilities.org www.assistedlivingfacilities.org

Association for Gerontology in Higher Education (AGHE) 1220 L Street, NW, Suite 901Washington DC 20005-4018 P. 202-289-9806 F. 202-289-9824www.aghe.org

Asthma and Allergy Foundation of America 1233 20th Street, NW, Suite 402Washington DC 20036 P. 1-800-7-ASTHMA (727-8462)www.aafa.org

B’nai B’rith2020 K St, NW, 7th FloorWashington DC 20006 P. 202-857-6600 F. 202-857-1099www.bnaibrith.org

BenefitsCheckUp www.benefitscheckup.org

Best of the Web Senior Housing Directory seniorhousing.botw.org

Better Hearing Institute 515 King St., suite 420Alexandria VA 22314 P. 1-800-EAR-WELL (327-9355)F. 703-684-6048www.betterhearing.orgBetter Sleep Council 501 Wythe StreetAlexandria VA 22314 P. 703-683-8371F. 703-683-4503www.bettersleep.org

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Beverly Foundation 566 El Dorado St., #100Pasadena CA 91101 P. 626-792-2292 www.beverlyfoundation.org

Brookdale Center on Aging (BCOA) of Hunter College 425 East 25th St., 13th Floor North,New York NY 10010-2590 P. 212-481-3780 F. 212-481-3791www.brookdale.org

Care Planner Clinical Tools, Inc. Chapel Hill NC 27516 P. 919-960-8118 F. 919-960-7745www.careplanner.org

Caring.com 2600 South El Camino Real, Suite 220 San Mateo CA 94403www.caring.com

Catholic Charities USA (CCUSA) 1731 King StreetAlexandria VA 22314 P. 703-549-1390 F. 703-549-1656www.catholiccharitiesusa.org

Catholic Golden Age (CGA) Olyphant PA 18447 P. 1-800-836-5699F. 570-586-7721www.catholicgoldenage.org

The Center for Social Gerontology (TCSG) 2307 Shelby AvenueAnn Arbor MI 48103 P. 734-665-1126 F. 734-665-2071www.tcsg.org

Center for the Advancement of State Community Services Programs (CASCSP) National Association of State Units on Aging (NASUA)1201 15th St., NW, Suite 350Washington DC 20005P. 202-898-2578 F. 202-898-2583www.nasua.org

Centers for Disease Control and Prevention (CDC) 1600 Clifton RoadAtlanta GA 30333 P. 1-800-311-3435www.cdc.gov

Centers for Medicare and Medicaid Services (CMS) 7500 Security BoulevardBaltimore MD 21244 P. 1-800-MEDICARE (633-4227)F. 202-690-7675www.cms.hhs.gov www.medicare.gov

Children of Aging Parents (CAPS) P.O. Box 167Richboro PA 18954 P. 1-800-227-7294www.caps4caregivers.org

Clearinghouse on Abuse and Neglect of the Elderly (CANE) University of Delaware, Department of Consumer Studies, Newark DE 19716 P. 302-831-3525 F. 302-831-6081www.cane.udel.edu/cane/

Community Transportation Association of America (CTAA) 1341 G Street, NW, 10th FloorWashington DC 20005 P. 1-800-891-0590 F. 202-737-9197www.ctaa.org

ConsumerReportsHealth.org www.ConsumerReportsHealth.org

Continuing Care Accreditation Commission (CCAC) 1730 Rhode Island Avenue, NW, Suite 209Washington DC 20036 P. 1-866-888-1122F. 202-587-5009www.carf.org

Corporation for National & Community Service (CNS) 1201 New York Avenue, NWWashington DC 20525 P. 1-800-424-8867F. 202-565-2791www.nationalservice.orgwww.seniorcorps.org

The Dana Alliance for Brain Initiatives 745 Fifth Avenue, Suite 900New York NY 10151P. 212-223-4040 F. 212-317-8721www.dana.org

Delta Society 875 124th Ave. NE, Ste 101Bellevue WA 98055 P. 425-679-5500 F. 425-679-5539www.deltasociety.org

Department of Veterans Affairs (VA) Office of Public AffairsWashington DC 20420 P. 1-800-827-1000www.va.gov

Depression and Bipolar Support Alliance (DBSA) 730 North Franklin St., Suite 501Chicago IL 60654-7225 P. 1-800-826-3632 F. 312-642-7243www.dbsalliance.org

DES Action P. O. Box 7296, 187 Via CatalunhaJupiter FL 33468 P. 1-800-DES-9288 (338-9288)www.desaction.org

Described and Captioned Media Program (DCMP) National Association of the Deaf (NAD)1447 E. Main StreetSpartanburg SC 29307 P. 1-800-237-6213F. 1-800-538-5636www.dcmp.org

Diabetic Connect 224 South 200 West, Suite 250Salt Lake City UT 84101 P. 801-355-6002F. 801.355.5198www.diabeticconnect.com

Disabled American Veterans (DAV) PO BOX 14301Cincinnati OH 45250-0301 P. 1-877- I AM A VET (426-2838)www.dav.org

Elder Care Online www.ec-online.net

Elder Craftsmen (EC) 307 Seventh Avenue, Suite 1401New York NY 10001 P. 212-319-8128F. 212-319-8141www.eldercraftsmen.org

Eldercare Initiative in Consumer Law (EICL) National Consumer Law Center, Inc. (NCLC) Boston MA 02110 P. 617-542-8010 F. 617-542-8028www.consumerlaw.org

Eldercare Locator National Association of Area Agencies on Aging1730 Rhode Island Avenue, NW, Suite 1200Washington DC 20036 P. 1-800-677-1116F. 202-872-0057www.eldercare.gov

Elderhostel 11 Avenue de LafayetteBoston MA 02111 P. 1-877-426-8056F. 1-877-426-2166www.elderhostel.org

Elderweb 1305 Chadwick DriveNormal IL 61761 P. 309-451-3319 www.elderweb.com

Employee Benefits Security Administration (EBSA) Department of Labor200 Constitution Avenue, NWWashington DC 20210 P. 1-866-444-3272www.dol.gov/ebsa

Epilepsy Foundation 8301 Professional PlaceLandover MD 20785 P. 1-800-332-1000F. 301-577-2684www.epilepsyfoundation.org

Family Caregiver Alliance 180 Montgomery Street, Suite 1100San Francisco CA 94104 P. 1-800-445-8106www.caregiver.org

Federal Citizen Information Center (FCIC) Room G-142, (XCC), 1800 F Street, NWWashington DC 20405 P. 1-888-878-3256F. 719-948-9724www.pueblo.gsa.gov

Fifty-Plus Lifelong Fitness 2483 East Bayshore Road, Suite 202Palo Alto CA 94303 P. 650-843-1750 F. 650-843-1758www.50plus.org

Food and Drug Administration (FDA) 10903 New Hampshire Ave.Silver Spring MD 20993-0002 P. 1-888-INFO-FDA (463-6332)www.fda.gov

Food and Nutrition Information Center (FNIC), Department of Agriculture Beltsville MD 20705-2351 P. 301-504-5414F. 301-504-6409www.nalusda.gov/fnic

Foundation for Biomedical Research (FBR) 818 Connecticut Avenue, NW, Suite 900Washington DC 20006 P. 202-457-0654 F. 202-457-0659www.fbresearch.org

Health

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Generations Online 108 Ralston HousePhiladelphia PA 19104 P. 215-222-6400 F. 215-222-6401www.generationsonline.com

Generations Together (GT) Pittsburgh PA 15260 P. 412-648-7155 F. 412-624-4810www.gt.pitt.edu

Gerontological Society of America (GSA) 1220 L Street, NW, Suite 901Washington DC 20005 P. 202-842-1275 F. 202-842-1150www.geron.org

Glaucoma Research Foundation (GRF) 251 Post St., Suite 600San Francisco CA 94108 P. 1-800-826-6693F. 415-986-3763www.glaucoma.org

The Hartford Alzheimer’s Disease Driving Guide Southington CT 06489 P. 860-547-5000www.thehartford.com/alzheimers

Health Services Research (HSR) Information Central 8600 Rockville Pike, Building 38A, Room 4S-410, Mail Stop Code 3833Bethesda MD 20894 P. 301-496-0176F. 301-402-3193www.nlm.nih.gov/hsrinfo/

Hill-Burton Free Care Program 5600 Fishers Lane, Room 10-105Rockville MD 20857P. 1-800-638-0742F. 301-443-0619www.hrsa.gov/hillburton/

Huntington’s Disease Society of America (HDSA) 505 Eighth Ave., Suite 902New York NY 10018 P. 1-800-345-HDSA (4372)F. 212-239-3430www.hdsa.org

Hysterectomy Educational Resources and Services Foundation (HERS) 422 Bryn Mawr AvenueBala Cynwyd PA 19004 P. 1-888-750-HERS (4377)F. 610-667-8096www.hersfoundation.com

Indian Health Service (IHS) Rockville MD 20852-1627 P. 301-443-3593 F. 301-443-0507www.ihs.gov

Institute for Cancer Prevention (IFCP) 1 Dana RoadValhalla NY 10595 P. 914-592-2600 F. 914-592-6317www.ahf.org

International Essential Tremor Foundation (IETF) PO Box 14005Lenexa KS 66285-4005 P. 1-888-387-3667F. 913-341-1296www.essentialtremor.org

International Hearing Society (IHS) 16880 Middlebelt Road, Suite 4Livonia MI 48154 P. 1-800-521-5247F. 734-522-0200www.ihsinfo.org

John Douglas French Alzheimer’s Foundation 11620 Wilshire Boulevard, Suite 270Los Angeles CA 90025 P. 1-800-477-2243F. 310-479-0516www.jdfaf.org

Kansas Geriatric Education Center (KS-GEC) Center on Aging Kansas City KS 66160-7177P. 913-588-1549 F. 913-588-1201coa.kumc.edu/gec

Laurent Clerc National Deaf Education Center Gallaudet University 800 Florida Avenue, NEWashington DC 20002 P. 202-651-5000 clerccenter.gallaudet.edu

Leukemia and Lymphoma Society, Inc. (LLS) 1311 Mamaroneck AvenueWhite Plains NY 10605 P. 1-800-955-4572F. 914-949-6691www.leukemia.org

Lewy Body Dementia Association (LBDA) 912 Killian Hill Road, S. W.Liburn GA 30047 P. 404-935-6444 F. 480-422-5434www.lbda.org

Lighthouse National Center for Vision and Aging (LNCVA) 111 East 59th StreetNew York NY 10022-120 P. 1-800-829-0500F. 212-821-9707www.lighthouse.org

Lupus Foundation of America (LFA) 2000 L Street, NW, Suite 710Washington DC 20036 P. 1-800-558-0121F. 202-349-1156www.lupus.org

Mayo Clinic200 First St. S.W.Rochester MN 55905 P. 507-284-2511 F. 507-284-0161www.mayoclinic.com

Meals On Wheels Association of America (MOWAA) 203 S. Union St.Alexandria VA 22314 P. 703-548-5558F. 703-548-8024www.mowaa.org

MedicAlert Foundation 2323 Colorado AvenueTurlock CA 95382P. 1-888-633-4298F. 209-669-2450www.medicalert.org

Medicare Rights Center (MRC) 1460 Broadway, 17th FloorNew York NY 10036 P. 212-869-3850 F. 212-869-3532www.medicarerights.org

Meso Foundation PO Box 91840Santa Barbara CA 93190-1840 P. 877-END-MESO (877-363-6376)F. 805-563-8411www.curemeso.org

MySeniorCare.com 32605 W. 12 Mile Road, Suite 275Farmington Hills MI 48334 www.MySeniorCare.com

Narcolepsy Network, Inc. P.O. Box 294Pleasantville NY 10570 P. 1-888-292-6522F. 401-633-6567www.narcolepsynetwork.org

National Academy of Elder Law Attorneys, Inc. (NAELA) 1577 Spring Hill Rd., Ste. 220Vienna VA 22182 P. 703-942-5711F. 703-563-9504www.naela.org

National Adult Day Services Association, Inc. 85 South Washington, Suite 316Seattle WA 98104 P. 1-877-745-1440F. 206-461-3218www.nadsa.org

National Alliance for Caregiving 4720 Montgomery Lane, 5th FloorBethesda MD 20814 www.caregiving.org

National Alliance for Hispanic Health 1501 16th Street, NWWashington DC 20036 P. 202-387-5000F. 202-797-4353www.hispanichealth.org

National Alliance for the Mentally Ill (NAMI) 3803 N. Fairfax Dr., Ste. 100Arlington VA 22203 P. 1-800-950-NAMI (950-6264)www.nami.org

National Asian Pacific Center on Aging (NAPCA) 1511 3rd Avenue, Suite 914Seattle WA 98101 P. 1-800-33-NAPCA (366-2722)F. 206-624-1023www.napca.org

National Association for Continence (NAFC) PO Box 1019Charleston SC 29402-1019 P. 1-800-BLADDER (252-3337)www.nafc.org

National Association for Health & Fitness (NAHF) 65 Niagra Square, Room 607Buffalo NY 14202 P. 716-583-0521 F. 716-851-4309www.physicalfitness.org

National Association for Hispanic Elderly (Asociacion Nacional Por Personas Mayores) 234 East Colorado Boulevard, Suite 300Pasadena CA 91101 P. 626-564-1988 F. 626-564-2659www.anppm.org

National Association for Home Care (NAHC) 228 7th Street, SEWashington DC 20003 P. 202-547-7424 F. 202-547-3540www.nahc.org

National Association for Human Development (NAHD) 1424-16th St., NW, Suite 102Washington DC 20036 P. 202-328-2191F. 202-265-6682www.health.gov/nhic

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National Association for Practical Nurse Education and Services (NAPNES) PO BOX 25647, 1940 Duke St., Suite 200Alexandria VA 22313, 22314 P. 703-933-1003 F. 703-940-4089www.napnes.org

National Association of Activity Professionals (NAAP) PO Box 5530Sevierville TN 37864 P. 865-429-0717 F. 865-453-9914www.thenaap.com

National Association of Area Agencies on Aging (N4A) 1730 Rhode Island Ave. NW, Suite 1200Washington DC 20036 P. 1-800-677-1116F. 202-872-0057www.n4a.org

National Association of Community Health Centers (NACHC) 7200 Wisconsin Avenue, Suite 210Bethesda MD 20814P. 301-347-0400F. 301-347-0459www.nachc.com

National Association of Nutrition and Aging Services Programs (NANASP) 1612 K Street, NW, Suite 400Washington DC 20006 P. 202-682-6899F. 202-223-2099www.nanasp.org

National Association of Professional Geriatric Care Managers (NAPGCM) 3275 West Ina Road, Suite 130Tucson AZ 85741-2198P. 520-881-8008F. 520-325-7925www.caremanager.org

National Association of Social Workers (NASW) 750 First Street, NE, Suite 700Washington DC 20002-4241P. 1-800-638-8799 F. 202-336-8310www.naswdc.org

National Association of State Units on Aging (NASUA) 1201 15th St, NW, Suite 350Washington DC 20005 P. 202-898-2578 F. 202-898-2583www.nasua.org

National Association of the Deaf (NAD) 8630 Fenton St., Suite 820Silver Spring MD 20910-3819 P. 301-587-1788 F. 301-587-1791www.nad.org

National Association on HIV Over Fifty (NAHOF) 23 Miner St., Ground LevelBoston MA 02215-3319 P. 617-233-7107 F. 617-262-5667www.hivoverfifty.org

National Cancer Institute (NCI) 6116 Executive Blvd.Bethesda MD 20892 P. 1-800-4-CANCER (422-6237)www.nci.nih.gov

National Caucus and Center on Black Aged, Inc. (NCBA) 1220 L Street, NW, Suite 800Washington DC 20005P. 202-637-8400 F. 202-347-0895www.ncba-aged.org

National Center for Assisted Living 1201 L Street, NWWashington DC 20005 P. 202-824-4444 F. 202-842-3860www.ncal.org

National Center for Complementary and Alternative Medicine Clearinghouse (NCCAM)National Institutes of Health (NIH)Gaithersburg MD 20898 P. 1-888-644-6226F. 1-866-464-3616www.nccam.nih.gov

National Center for Health Statistics (NCHS) Centers for Disease Control and Prevention (CDC) Hyattsville MD 20782P. 1-866-441-NCHS (441-6247) www.cdc.gov/nchs/

National Center on Elder Abuse (NCEA) Center for Community Research and ServicesUniversity of Delaware, 297 Graham HallNewark DE 19716 P. 302-831-3525F. 302-831-422www.ncea.aoa.gov

National Center on Minority Health and Health Disparities (NCMHD) National Institutes of Health (NIH)6707 Democracy Boulevard, Suite 800,MSC 5465Bethesda MD 20892-5465P. 301-402-1366F. 301-480-4049www.ncmhd.nih.gov

National Citizen’s Coalition for Nursing Home Reform (NCCNHR) 1828 L Street, NW, Suite 801Washington DC 20036-2211P. 202-332-2275 F. 202-332-2949www.nccnhr.org

National Coalition for Adult Immunization (NCAI) National Foundation for Infectious Diseases4733 Bethesda Avenue, Suite 750Bethesda MD 20814 P. 301-656-0003 F. 301-907-0878www.nfid.org

National Committee to Preserve Social Security and Medicare (NCPSSM) 10 G Street, NE, Suite 600Washington DC 20004 P. 1-800-966-1935F. 202-216-0451www.ncpssm.org

National Consumer’s League (NCL) 1701 K Street, NW, Suite 1200Washington DC 20006 P. 1-800-876-7060www.natlconsumersleague.org/

National Council of La Raza (NCLR) Raul Yzaguirre Building 1126 16th St., NWWashington DC 20036 P. 202-785-1670F. 202-776-1794www.nclr.org

National Council on Aging (NCOA) 1901 L Street, NW, 4th floor,Washington DC 20036 P. 202-479-1200 F. 202-479-0735www.ncoa.org

National Council on Alcoholism and Drug Dependence (NCADD) 244 East 58th Street, 4th FloorNew York NY 10022 P. 1-800-NCA-CALL (622-2255)F. 212-269-7510www.ncadd.org

National Council on Patient Information and Education (NCPIE) 4915 Saint Elmo Avenue, Suite 505Bethesda MD 20814-6082 P. 301-656-8565 F. 301-656-4464www.talkaboutrx.org

National Diabetes Information Clearinghouse (NDIC) Bethesda MD 20892-3560P. 1-800-860-8747F. 703-738-4029www.diabetes.niddk.nih.gov/

National Digestive Diseases Information Clearinghouse (NDDIC) Bethesda MD 20892-3570 P. 1-800-891-5389F. 703-738-4929www.digestive.niddk.nih.gov

National Eye Health Education Program (NEHEP) National Eye Institute Information Center (NEIIC) Bethesda MD 20892-3655 P. 301-496-5248 F. 301-402-1065www.nei.nih.gov/nehep

National Eye Institute National Institutes of Health Bethesda MD 20892 P. 301-496-5248 www.nei.nih.gov

National Family Caregivers Association (NFCA) 10400 Connecticut Avenue, #500,Kensington MD 20895-3944 P. 1-800-896-3650F. 301-942-2302www.nfcacares.org

National Foundation for the Treatment of Pain P.O. Box 70045Houston TX 77270 P. 713-862-9332F. 713-862-9346www.paincare.org

National Gerontological Nursing Association (NGNA) 1020 Monarch St.Lexington KY 40513 P. 1-800-723-0560F. 859-977-7441www.ngna.org

National Health Information Center (NHIC) Office of Disease Prevention and Health Promotion (ODPHP) Washington DC 20013-1133 P. 1-800-336-4797F. 301-984-4256www.health.gov/NHIC

Health

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National Heart, Lung, and Blood Institute (NHLBI) Information Center PO Box 30105Bethesda MD 20824-0105 P. 1-800-575-WELL (9355)F. 240-629-3246www.nhlbi.nih.gov

National Hispanic Council on Aging (NHCoA) The Walker Building, 734 15th Street NW Suite 1050,Washington DC 20005 P. 202-347-9733 F. 202-347-9735www.nhcoa.org/

National Hospice and Palliative Care Organization (NHPCO) National Hospice Foundation (NHF)1700 Diagonal Road, Suite 625Alexandria VA 22314 P. 1-800-658-8898F. 703-837-1233www.nhpco.org

National Hospice Foundation (NHF) 1700 Diagonal Road, Suite 625Alexandria VA 22314 P. 1-800-658-8898F. 703-837-1233www.hospiceinfo.org

National Human Genome Research Institute (NHGRI) National Institutes of Health (NIH) Bethesda MD 20892 P. 301-402-0911 F. 301-402-2218www.nhgri.nih.gov

National Indian Council on Aging, Inc. (NICOA) 10501 Montgomery Boulevard, NE, Suite 210Albuquerque NM 87111-3846 P. 505-292-2001 F. 505-292-1922www.nicoa.org

National Information and Referral Support Center (NIRSC) 1225 I Street, NW, Suite 725Washington DC 20005-3914 P. 202-898-2578 F. 202-898-2583www.nasua.org

National Institute Arthritis and Musculoskeletal and Skin Diseases Information Clearinghouse National Institute of Arthritis and Musculoskeletal and Skin Diseases (NIAMS) Bethesda MD 20892-3675 P. 1-877-22-NIAMS (226-4267)F. 301-718-6366www.nih.gov/niams

National Institute of Allergy and Infectious Diseases (NIAID) NIAID Office of Communications and Government Relations,Bethesda MD 20892-6612 P. 866-284-4107www.niaid.nih.gov

National Institute of Child Health and Human Development (NICHD) Information Clearinghouse PO Box 3006Rockville MD 20847 P. 1-800-370-2943 F. 301-984-1473www.nichd.nih.gov

National Institute of Dental and Craniofacial Research (NIDCR) National Institutes of Health (NIH) Bethesda MD 20892-2290 P. 301-496-4261F. 301-408-4098www.nidcr.nih.gov

National Institute of Environmental Health Sciences (NIEHS) National Institutes of Health (NIH) Research Triangle Park NC 27709 P. 919-541-3345 www.niehs.nih.gov/home.htm

National Institute of General Medical Sciences (NIGMS) 45 Center Drive, MSC 6200Bethesda MD 20892-6200 P. 636-937-8883F. 301-402-0224www.nigms.nih.gov

National Institute of Mental Health (NIMH) Bethesda MD 20892-9663 P. 1-866-615-6464F. 301-443-4279www.nimh.nih.gov

National Institute of Neurological Disorders and Stroke (NINDS) NIH Neurological Institute Bethesda MD 20824P. 1-800-352-9424F. 301-402-2186 www.ninds.nih.gov

National Institute of Nursing Research (NINR) Office of Science Policy and Public Liaison Bethesda MD 20892-2178 P. 301-496-0207 F. 301-480-8845www.nih.gov/ninr

National Institute on Aging (NIA) National Institutes of Health (NIH) Bethesda MD 20892-2292 P. 1-800-222-2225F. 301-496-1072www.nia.nih.gov

National Institute on Alcohol Abuse and Alcoholism (NIAAA) 5635 Fishers Lane, MSC 9304,Bethesda MD 20892-9304 P. 301-443-3860 F. 301-443-6077www.niaaa.nih.gov

National Institute on Deafness and Other Communication Disorders (NIDCD) National Institutes of Health (NIH)31 Center Drive, MSC 2320Bethesda MD 20892-2320 P. 1-800-241-1044F. 301-402-0018www.nidcd.nih.gov

National Institute on Drug Abuse (NIDA) National Institutes of Health (NIH)Bethesda MD 20892-9561 P. 1-800-729-6686F. 1-888-644-6432www.nida.nih.gov

National Interfaith Coalition on Aging (NICA) National Council on Aging (NCOA) Washington DC 20036 P. 1-800-424-9046F. 202-479-0735www.ncoa.org

National Kidney and Urological Diseases Information Clearinghouse (NKUDIC) National Institute of Diabetes and Digestive and Kidney Diseases (NIDDK) Bethesda MD 20892-3580 P. 1-800-891-5390F. 703-738-4929www.kidney.niddk.nih.gov/

National Kidney Foundation (NKF) 30 East 33rd StreetNew York NY 10016 P. 1-800-622-9010F. 212-689-9261 www.kidney.org

National Library of Medicine (NLM) National Institutes of Health (NIH)8600 Rockville PikeBethesda MD 20894 P. 1-888-FIND-NLM (346-3656)F. 301-402-1384www.nlm.nih.gov

National Library Service for the Blind and Physically Handicapped (NLSBPH) Library of Congress Washington DC 20011 P. 1-800-NLS-READ (657-7323)F. 202-707-0712www.lcweb.loc.gov/nls/

National Long-Term Care Ombudsman Resource Center (NLTCORC) ORC Office 1828 L Street, NW, Suite 801Washington DC 20036 P. 202-332-2275 F. 202-332-2949www.ltcombudsman.org

National Long-Term Care Resource Center (NLTCRC) Division of Health Services, Research and Policy Minneapolis MN 55455 P. 612-624-5171F. 612-624-8448www.hsr.umn.edu

National Medical Association (NMA) 8403 Colesville Road, Suite 920, Executive OfficesSilver Spring MD 20910 P. 202-347-1895F. 202-347-0722www.nmanet.org

National Mental Health Association (NMHA) 2000 N. Beauregard Street, 6th FloorAlexandria VA 22311 P. 1-800-969-NMHA (6642)F. 703-684-5968www.nmha.org

National Multiple Sclerosis Society (NMSS) 733 3rd Avenue, 6th FloorNew York NY 10017-3288 P. 1-800-FIGHT-MS (344-4867)F. 212-986-7981 www.nmss.org

National Organization for Rare Disorders (NORD) 55 Kenosia AvenueDanbury CT 06813-1968 P. 1-800-999-6673F. 203-798-2291www.rarediseases.org

National Osteoporosis Foundation (NOF) 1232 22nd Street, NWWashington DC 20037-1292 P. 202-223-2226 F. 202-223-2237www.nof.org

National Policy and Resource Center on Nutrition and Aging National Resource Center on Nutrition, Physical Activity & AgingMiami FL 33199 P. 305-348-1517 F. 305-348-1518nutritionandaging.fiu.edu

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National Psoriasis Foundation (NPF) 6600 SW 92nd Avenue, Suite 300Portland OR 97223-7195 P. 1-800-723-9166F. 503-245-0626www.psoriasis.org

National Rehabilitation Information Center (NARIC) 4200 Forbes Boulevard, Suite 202Lanham MD 20706 P. 1-800-346-2742F. 301-459-4263www.naric.com

National Resource Center: Diversity and Long-Term Care (NRCDLTC) Schneider Institute for Health Policy The Heller School for Social Policy & Management Waltham MA 02454-9110 P. 781-736-3900 F. 781-736-3905www.sihp.brandeis.edu

National Resource Center on Native American Aging (NRCNAA) University of North Dakota, School of Medicine & Health Sciences Room 4909, 501 North Columbia Road Stop 9037Grand Forks ND 58202-9037 P. 701-777-3848 F. 701-777-6779www.med.und.nodak.edu/depts/rural/nrcnaa

National Resource Center on Supportive Housing & Home Modifications USC Andrus Gerontology Center Los Angeles CA 90089-0191 P. 213-740-1364 F. 213-740-7069www.jefferswww.homemods.org

National Rural Health Association (NRHA) 521 E. 63rd St.,Kansas City MO 64111-3329P. 816-756-3140 F. 816-756-3144www.ruralhealthweb.org

National Self-Help Clearinghouse (NSHC) Graduate Shcool and University Center of the City University of New York New York NY 10016-4309 P. 212-817-1822F. 212-817-1561 www.selfhelpweb.org

National Senior Games Association (NSGA) P.O. Box 82059Baton Rouge LA 70884-2059 P. 225-766-6800 F. 225-766-9115www.nationalseniorgames.org

National Sleep Foundation (NSF) 1522 K Street, NW, Suite 500Washington DC 20005 P. 202-347-3471 F. 202-347-3472www.sleepfoundation.org

National STD and AIDS Hotlines P.O. Box 13827Research Triangle Park NC 27709 P. 919-361-8400 F. 919-361-8425www.ashastd.org

National Stroke Association (NSA) 9707 East Easter Lane, Building B,Centennial CO 80112 P. 1-800-STROKES (787-6537)F. 303-649-1328www.stroke.org

National Women’s Health Information Center (NWHIC) 8550 Arlington Blvd., Suite 300Fairfax VA 22031 P. 1-800-994-WOMAN (96626)www.4woman.gov

National Women’s Health Network (NWHN) 514 10th Street, NW, Suite 400Washington DC 20004 P. 202-347-1140 F. 202-347-1168www.nwhn.org

Native Elder Health Care Resource Center (NEHCRC) P.O. Box 6508Aurora CO 80045 P. 303-724-1414F. 303-724-1474www.uchsc.edu/ai/nehcrc/nehcrc_index.htm

NIH Osteoporosis and Related Bone Diseases National Resource Center (NIH-ORBD- NRC) 2 AMS CircleBethesda MD 20892 P. 1-800-624-BONE (2663)F. 202-293-2356www.osteo.org

North American Menopause Society (NAMS) 5900 Landerbrook Drive, Suite 390,Mayfield Heights OH 44124 P. 1-800-774-5342F. 440-442-2660www.menopause.org

Office of Dietary Supplements National Institutes of Health Bethesda MD 20892 P. 301-435-2920 F. 301-480-1845dietary-supplements.info.nih.gov

The Office of Minority HealthU.S Department of Health and Human Services P.O. Box 37337Washington DC 20013 P. 1-800-444-6472www.omhrc.gov

Office of Research on Women’s Health 900 Rockville Pike, Building 1, Room 201Bethesda MD 20892 P. 301-402-1770 F. 301-402-1798orwh.od.nih.gov

Office on Smoking and Health (OSH) Centers for Disease Control and Prevention Atlanta GA 30341 P. 1-800-CDC-INFO (232-4636)www.cdc.gov/tobacco

Older Women’s League (OWL) 1828 L Street NW, Suite 801Washington DC 20036 P. 1-800-TAKE-OWL (825-3695)F. 703-812-0687www.owl-national.org

Opticians Association of America (OAA) 4064 E Fir Hill Drive,Lakeland TN 38002 P. 901.388.2423 F. 901.388.2348www.oaa.org

Paget Foundation for Paget’s Disease of Bone and Related Disorders 120 Wall Street, Suite 1602New York NY 10005-4001 P. 1-800-23-PAGET (23-72438)F. 212-509-8492www.paget.org

Parkinson’s Disease Foundation (PDF) 1359 Broadway, Suite 1509New York NY 10018 P. 1-800-457-6676F. 212-923-4778www.pdf.org

Partnership for Prescription Assistance P. 1-888-477-2669www.pparx.org

PayingForSeniorCare.com The American Elder Care Research Organization736 Cole StreetSan Francisco CA 94117 P. 641-715-3900 Ext. 606151www.payingforseniorcare.com/

President’s Council on Physical Fitness and Sports (PCPFS) Department WWashington DC 20201 P. 202-690-9000 F. 202-690-5211www.fitness.gov

Prevent Blindness America (PBA) 211 West Wacker Drive, Suite 1700,Chicago IL 60606 P. 1-800-331-2020www.preventblindness.org

Project AlientoNational Association for Hispanic Elderly (Asociación Nacional Pro Personas Mayores)Pasadena CA 91101 P. 626-564-1988 F. 626-564-2659anppm.org

Pulmonary Fibrosis Foundation (PFF) 1332 North Halsted St., Suite 201Chicago IL 60622 P. 312-587-9272F. 312-587-9273www.pulmonaryfibrosis.org

Restless Legs Syndrome Foundation 819 Second Street, SWRochester MN 55902 P. 507-287-6465 F. 507-287-6312www.rls.org

Screening for Mental Health, Inc. (SMH) One Washington Street, Suite 304Wellesley Hills MA 02481 P. 781-239-0071F. 781-431-7447 www.mentalhealthscreening.org

Self Help for Hard of Hearing People, Inc. (SHHH) 7910 Woodmont Avenue, Suite 1200Bethesda MD 20814 P. 301-657-2248 F. 301-913-9413www.shhh.org

SeniorNet (SN) 900 Lafayette St., Suite 604Santa Clara CA 95050 P. 408-615-0699 F. 408-615-0928www.seniornet.org

Simon Foundation for Continence PO Box 815Wilmette IL 60091 P. 1-800-23-SIMON (237-4666)F. 847-864-9758www.simonfoundation.org

Health

care Providers List


The Skin Cancer Foundation 245 Fifth Avenue, Suite 1403New York NY 10016 P. 1-800-SKIN-490 (754-6490)F. 212-725-5751www.skincancer.org

Social Security Administration Office of Public InquiriesBaltimore MD 21235 P. 1-800-772-1213www.socialsecurity.gov

Society for Neuroscience 1121 14th St., Suite 1010Washington DC 20005 P. 202-962-4000 F. 202-962-4941www.sfn.org

SPRY Foundation 10 G Street, NE, Suite 600Washington DC 20002 P. 202-216-8466 F. 202-216-0779www.spry.org

Substance Abuse and Mental Health Services Administration (SAMHSA) 1 Choke Cherry Rd.,Rockville MD 20857 P. 1-877-726-4727 F. 240-221-4292www.samhsa.gov

Technology for Long-Term Care I.D.E.A.S., Inc.; 8055 Chardon RoadKirtland OH 44094www.techforltc.org

Undertaken With Love: A Home Funeral Guide for Congregations and Communities www.undertakenwithlove.org

United Way of America 701 North Fairfax StreetAlexandria VA 22314 P. 1-800-892-2757F. 703-683-7840www.unitedway.org

Vestibular Disorders Association (VEDA) PO Box 13305Portland OR 97213-0305 P. 1-800-837-8428F. 503-229-8064www.vestibular.org

Vision Council of America (VCA)/Better Vision Institute (BVI) 1700 Diagonal Road, Suite 500Alexandria VA 22314 P. 1-866-826-0290F. 703-548-4580www.visionsite.orgwww.checkyearly.com

Visiting Nurse Associations of America (VNAA) 900 19th Street, NW, Suite 200Washington DC 20006 P. 202-384-1420 F. 202-384-1444www.vnaa.org

Volunteers of America 1660 Duke StreetAlexandria VA 22314 P. 1-800-899-0089 F. 703-341-7000www.volunteersofamerica.org

VZV Research Foundation 24 E. 64th St., FL 2New York NY 10021 P. 1-800-472-8478F. 212-371-7277www.vzvfoundation.org

Well Spouse Foundation (WSF) 63 West Main Street, Suite HFreehold NJ 07728 P. 1-800-838-0879F. 732-577-8644www.wellspouse.org

Women’s Health Initiative 2 Rockledge Centre, Suite 8093, MS 7935Bethesda MD 20892 P. 301-402-2900 F. 301-480-5158www.nhlbi.nih.gov/whi

Young Men’s Christian Association (YMCA) 101 North Wacker Drive,Chicago IL 60606 P. 1-800-USA-YMCA (872-9622)F. 312-279-0416www.ymca.net

Young Women’s Christian Association (YWCA) 2025 M St., NW, Suite 550Washington DC 20036 P. 1-800-YWCA-US1 (992-2871)F. 202-467-0802www.ywca.org

RSVP Health Sponsors

Lutheran Senior ServicesP. 314-968-9313www.lssliving.org

Anthem Blue Cross Blue Shieldwww.anthem.com

Miracle MethodP. 573-358-7228P. 314-293-0074www.miraclemethod.com

Mineral Area Regional Medical CenterP. 573-756-4581www.marmc.net

Innovare HealthP. 314-843-4794P. 636-931-5112www.innovarehealth.com

Midwest CardiovascularP. 636-931-7107P. 573-701-0090www.midwestcardio.com

HBD Construction Inc.P. 314-781-8000www.HBDgc.com

Midwest Health Group Convenient CareP. 573-454-2466www.midwestconvenientcare.com

Thurman, Shinn & CompanyP. 573-760-9400www.ThurmanShinnCo.com

GloStream/Something CoolP. 573-436-2665www.somethingcool.com Clayton Sleep InstituteP. 314-645-5855www.claytonsleepinstitute.com

Skaggzzz Sleep InstituteP. 573-760-1501

Supertalk Radio KREI-800 AMP. 800-842-2330www.mymoinfo.com

Hea

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List


A Fresh StartTHE PERFECT TIME FOR

Lap Band Surgery

at Mineral Area

Regional Medical Center

573-756-4581 • www.marmc.net • 1212 Weber Road • Farmington, MO 63640

©2010 BCI

Laparosccopic Adjustable Gastric Banding is a safe

and effective weight loss procedure that helps

you eat less, control hunger and lose weight

gradually and permanently, as much as 1-2

pounds per week and 50 percent of

excess weight within two years.

So why wait? Contact your personal

physician or call the Weight Loss Center at

Mineral Area Regional Medical Center today, and

begin looking forward to a healthier and happier tomorrow!

Gregg Ginsburg, M.D.,General Surgery

Member of the American Society for Metabolic & Bariatric Surgery

covered by most insurance companies

MIN031_lapBandAd2_resize.indd 1 12/10/10 3:05 PM


Catch us LIVE every Friday at 8:20 A.M. on KREI 800 AM.

R A D I O S H O W

If you can’t get KREI, then listen to the latest episode on rsvphealth.com/media. The archives from our previous shows are at rsvphealth.com/media/audio

RSVP Health | Spring 2011

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Transcript of RSVP Health | Spring 2011