gaz health 032615

2 Gazette Health | Spring 2015 A GAZETTE AND GAZETTE-STAR PUBLICATION

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GAZETTE.NET Spring 2015 | Gazette Health 3

A publication of The Gazette and Gazette-Star | Spring 2015

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Content is for informational purposes only and should not be construed as medicaladvice, nor as a substitute for seeing your own medical professional(s).

COVER PHOTO: BOWIE RESIDENT DEON MERENE BY DAN GROSS/THE GAZETTE

Editor

Designer

Contributing Writers

Prepress

Tiffany Arnold

Anna Joyce

Karen Finucan ClarksonScott HarrisKate McDermott

Matt Getz

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This Resource Guide will include:- Adult Daycare- Legal & Financial- Home Healthcare- Housing for Seniors- Rehabilitation Centers- Assisted Living- And much more

The Resource Guide will be delivered to TheDept. of Aging as well as many senior centers,senior apartments, hospitals, libraries, countygovernment, and other strategic locationsthroughout the county.Circulation: 35,000

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Call Chauka Reidto Reserve Your Space Today!

240-473-7588

THE 2015 PRINCE GEORGE’S COUNTY

Resource Guide for Seniors& Family Caregivers

Space Deadlineis June 30th

Publication Date:July 16th

Internet Included

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As we get older, webegin to lose morebone thanwe build.

The tiny holes within bonesget bigger, and the solid outerlayer becomes thinner. Inother words, our bones getless dense. Hard bones turnspongy, and spongy bonesturn spongier. If this loss ofbone density goes too far, it’scalled osteoporosis.

More than 10 millionpeople nationwide are esti-

mated to have osteoporosis.It’s normal for bones to

break in bad accidents. But ifyour bones are dense enough,they should be able to standup tomost falls. Bonesweak-enedbyosteoporosis, though,are more likely to break.“It’s just like any other engi-neering material,” said Dr.JoanMcGowan, an expert onosteoporosis at the NationalInstitutes ofHealth. If you falland slam your weight onto

a fragile bone, “it reaches apoint where the structuresaren’t adequate to supportthe weight you’re putting onthem.” If the bone breaks,it’s amajor hint that an olderperson has osteoporosis.

–NIH News in Health


About two-thirds of those over 60 who have high blood pressure have isolated systolic hypertension,in which only the top number, the systolic pressure, is high. –NIH Senior Health

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he U.S. SurgeonGeneral has anonline tool, My

Family Health Portrait atfamilyhistory.hhs.gov, thatcan help you gather andrecord your family healthhistory. The tool lets yousave family information toyour own computer andshare health histories withother familymembers, and isavailable in English, Spanish,Italian and Portuguese.

Before you begin usingthis tool, talk with familymembers to gather detailsabout their health histories.Conditions such as cancer,heart disease and diabetesoften run in families. Tracingthe illnesses of your par-ents, grandparents and otherblood relatives can help yourhealth care practitioner pre-dict your risk for specificdisorders. It could suggest

vital screening tests and treat-ments before any disease isevident. That’s why it’s soimportant to discuss yourfamily’s health history.

In the future, tests maymake it possible to identifyand possibly fix the geneglitches that raise a person’srisk fordiseases.TheNational

Institutes of Health is nowworking on technology thatwill help doctors quicklycreate a health plan basedon a person’s unique geneticblueprint. In the meantime,family health history is ano-cost way to help doctorspersonalize your health care.


Chocolate for the WinResearchers have been able to reverse

age-related memory loss by boostingactivity in a region a part of the brainknownas thedentate gyrus, according toastudypublished inNatureNeuroscience.What led to the boost in activity? Aspecially formulated drink packed withflavanols, a group of antioxidant com-pounds found in cocoa beans—yetanother reason to be a chocolate lover.

Battling Parkinson’sScientists have identified more than

two dozen genetic risk factors involvedin Parkinson’s disease, including six thathad not been previously reported. Theyhope such researchwill one day lead tosuccessful therapies. Parkinson’s diseasebelongs to a group of motor systemdisorders, which are the result of theloss of dopamine-producing brain cells.

–National Institutes of Health

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Create a Health

FAMILY TREE

Down to the Bone

1/3of all hip fractures

occur in men.

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Runners live an average of three years longer than non-runners.–Journal of the American College of Cardiology

senior FITNESS

M aybe there’s no sport as literalin its metaphors as running.

Like life, becoming a runner is not a sprint,but a marathon. And for seasoned athletesas well as those who have never laced a pairof sneakers, it happens one step at a time.

ForDeonMerene, 55, a resident of Bowie,completing those 26marathonmileswas theculmination of a lifetime of work. “I hadwanted to do a marathon for many years,”she said. “I started running in high school… .Running amarathonwas onmybucket list.”

Running takes a commitment, especiallyfor first-timers and people older than 50.But competition can be a strongmotivator.According to Running USA, a nationalnonprofit, more than 19 million peoplefinished a running event in 2013. Runninghas been shown to prevent obesity and ahost of diseases, as well as build strengthand elevate mood.

And there are all sorts of race lengths,from the humble 5K all the way up tomarathons and ultramarathons,which gener-ally are defined as any run longer than themarathon’s 26miles. And sometimes beingolder can actually be helpful, as people findthey have more time to spend training. Inpreparation for her first marathon,Mereneran 40miles per week, a workload that canbe just as taxingmentally as it is physically.

“The kids were a little older and it waseasier to commit,” she said. “It gets to be amental thing. Can I really stick to this thing?”

Merene has completed a handful ofmarathons. Nick Panebianco, 51, has byhis own estimate completed 67. And thatdoesn’t take ultramarathons into account.The Beltsville systems engineer once ran40 miles, which took him about 12 hours.

“It’s hard at first, but it does get easier.

It does feed on itself,” Panebianco said. “Irun myself to exhaustion. But I still can’twait to get back out. I just love to run.”

INJURY RISKS GO UP FOR OLDER PEOPLE,but perhaps not asmuch as onemightthink. Mark Peterson, M.D., anorthopedic surgeonwho operates atAdventist HealthCare Shady GroveMedical Center in Rockville, said thechances of injury—and the path to stayinghealthy—are generally similar for all run-ners, regardless of age or experience level.

“A lot of it is based on genetics,” Petersonsaid. “Injuries are usually a matter of over-doing it, whether you’re older or younger… . A 50-year-old may need six months,and a 20-year-old might need six weeks,but either way the risk is there when you’regetting up to speed.”

Peterson,who identified stress fractures inthe lower body as themost common injuriesfor runners, said older people should visittheir primary care doctor and get their heartschecked out before beginning any rigorousprogram.Andwhilemany products, such asdifferent shoes or nutritional supplements,claim to help improve health or strengthin athletes, nothing has been scientificallyproven to prevent injuries or optimize fitness,Peterson said, though he did acknowledgeanecdotally hearing from patients that cer-tain items can be helpful.

Runners chase down life one step at a time

STORY BY SCOTT HARRISPHOTOS BY DAN GROSS

Deon Merene, 55, trainsalong Annapolis Road inBowie earlier this month.

| continued on 14

aid. “Ican’tun.”

LE,tntethestayingall run-e level.etersonof over-ounger

months,weeks,n you’re

tures ininjuriesuld visitr heartsigoroussuch asements,trengthtificallyfitness,wledgehat cer-

ime

Deon Merene, 55, trainsalong Annapolis Road inBowie earlier this month.

ed on 14


“Injuries are usuallya matter of

OVERDOING IT,whether you’re older

or younger.”


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Swim for Your Life!BY SHARON NAYLOR

Swimming has numeroushealth and fitness benefits,especially as you age. Thefun of the backstroke,

breaststroke, butterfly and free-style can add a fresh kick to yourexercise regimen.

According to the Centers forDisease Control and Prevention,swimming is the fourth-most pop-ular sports activity in the UnitedStates, a top way to get regularaerobicexercise.TheCDCreportedthat just two-and-a-half hours ofswimming per week can helpdecrease the risk of chronic illness.

Swimming laps is a low-impactaerobic exercise that works outyour heart and puts minimal stress onjoints while building endurance and helpingto reduce blood pressure and cholesterollevels. Plus, the resistance of the water (12percent to 14 percent more resistance thanair) forces your body towork harder, toningbiceps, triceps and back, chest, stomach andleg muscles for all-over toning.

Exercising in thewater has several benefitsthat exercising on land lacks. When youswim, according to the United StatesWaterFitness Association, 90 percent of your bodyis buoyant in the water, “so you are nothitting the floor as hard as you would onland.” No pounding or jarring. Also, yourflexibility improves, circulation increases,bone strength stays strong (importantfor post-menopausal women), and yourendurance grows. You get the confidencecharge of beating your prior lap times asyou continue your swimming regimen. Also,the cooling effect of water disperses yourbody heatmore effectively, which canmakeexercising more comfortable than on landin a hot gym or workout room.

Additional benefits of swimming include:l Fitness. A swimming regimen can

help strengthen your body and, of course,

provides a great cardiovascular workout,provided you’re swimming at a good paceand not just gliding or floating.

l Therapeutic effects. If you’ve had aback or other bodily injury, your doctormight suggest swimming as a low-impactworkout to help keep you in shape andhelp rehabilitate your injured body parts.

l Stress release. Fitness creates calminghormones and is an important element of awellness plan.When you’re swimming, youcan forget about work, home and moneypressures in your daily life.

Youmayhaveheard that swimmingdoesn’tburnmany calories comparedwith running,biking and other exercises. But at a briskpace, you canoftenburn the samenumberofcalories aswith abriskwalk, amedium-level

intensity aerobics class or a slowrun. Everything you do for yourhealth addsup.You’ll findonlinecalculators projectinghowmanycalories you’ll burn doing spe-cific kinds of exercises, but keepin mind that calculators aren’talways accurate, and thenumberof calories you burn depends onyour weight and gender and theintensity and duration of yourworkouts.

In addition to lap swimming,youmight alsowant to give thesein-water workouts a try:

l Water walking. Movingforward, backward or sidewaystowork yourmuscles differently.

l Water aerobics. If yourknees can’t take on-land aerobics, do thesefun exercises in water. Water’s buoyancymakes them easier. And some people claimthat if no one can see their feet clearlybeneath thewater, any lack of coordinationisn’t noticeable.

l Water toning. If you use floatable handweights and other in-water fitness equip-ment, muscles get strengthened and firmed.

l Flexibility classes. In-water classes ledby a trained and licensed instructor can helpyou improve your flexibility, important asyou age, and also help you heal from injuries.

l Water yoga. Relaxing yoga classes arenow offered at many pools.

l Water running. Flotation devices areused to lift you, and you canmake runningmovements with your legs to get in a runwithout any jarring impact on your legs,knees, feet, hips or back.

Consider pairing your lap swimmingwithone ormore of the above in-water exercisesto keep your interest level high, add varietyto yourworkouts and keep your enthusiasmup. Keep a journal of your lap times andother fitness goals to further motivate youto improve your fitness level.

–Creators.com

senior FITNESS Just 2.5 hours of swimming a week reduces the risk of chronic illness.

At a brisk pace, swimmerscan burn the same numberof calories as a brisk walk,a medium-level intensity

aerobics class or a slow run.

common CONDITIONS

Understanding themost misdiagnosedtype of dementia

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What isLewy BodyDisease?

BY KATE MCDERMOTT

Aggressive public information campaignsover the last 30 years have been highly suc-cessful in raising awareness of Alzheimer’sdisease,withmanyAmericansnowbelieving

the illness is synonymous with what used to be simplyknown as dementia. Yet neurologists are quick to pointout that dementia, like cancer, can takemany forms andhave many different origins.

In particular, some families of patients who have pre-viously been diagnosedwith Alzheimer’s or Parkinson’sdiseases are learning that another formofdementiamaybe the cause of their loved ones’ cognitive decline: Lewybody dementia.

According to the Lewy Body Dementia Association,LBD is the most misdiagnosed form of dementia,affecting nearly 1.4 million Americans. Named afterscientist Friedrich H. Lewy who discovered abnormalprotein deposits that disrupt the brain’s functioning,LBD remains a difficult condition to diagnose becauseits symptoms—at least initially—cancloselymirror thoseof Alzheimer’s and Parkinson’s diseases.

“UNFORTUNATELY, NOT MANY CLINICIANS ARE ABLE TOdiagnose this disease because its presentation is subtle,”saidAnneE.A.Constantino,M.D., apracticingneurolo-gist with Comprehensive Neurology Services of SilverSpring. Symptoms suchasa slowingof cognitive abilities,difficulty assessing spatial relationships and fluctuationsin alertness canbe present in all three | continued on 13

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Due to the quick action of hiswife, Iris Wilson, George Wilsonpromptly got the treatment heneeded to recover from a stroketwo years ago.



BY KATE MCDERMOTT

By the timeyou finish readingthis article, nine people inAmerica will have had astroke and at least one of

themwill die as a result.TheAmericanHeartAssociation

reports that strokes will kill morethan 129,000 people this year,making burst or blocked blood ves-sels in the brain the fourth leadingcause of death in the United States.Although stroke death rates havedropped nearly 36 percent over thelast decade, the sobering factremains that almost 800,000 peoplewill have a stroke before the year isover andmanyof thosewho survivewill be left disabled by the inter-rupted blood supply to their brains.

Given those statistics, GeorgeWilson of Hyattsville knows he’sincredibly lucky to be alive follow-ing his stroke in December 2012.Thanks to the quick decision by hiswife, IrisWilson, to call 911 imme-diatelyafterhe collapsed,he receivedessentialmedical treatmentwithin thecritical first fewhoursafterhis stroke.That treatmentnotonly savedhis life,but also markedly reduced lastingdamage to his brain. Today,GeorgeWilson has no significant physicalchallenges other than some slightspeech impairment thathe continuesto overcome through therapy.

AmirZangiabadi,M.D.,aneurolo-gistatWashingtonAdventistHospitalin Takoma Park, was waiting forGeorgeWilsonwhenhearrived in theemergency room.Zangiabadi imme-diately evaluatedWilson’s condition

andorderedaCTscan todeterminethe locationand typeofbloodvesselinjury in his brain.

The scan revealed Wilson had ablockedvessel, soZangiabadiadmin-isteredadrugknownas recombinanttissue plasminogen activator (tPA)to try to break up the clot that wascausing the stroke. “The use of tPAhas become more popular over thelast 10 years, but timing is every-thing,” Zangiabadi explained. “Itmust be administered within fourto four and half hours followingstroke symptoms’ onset, and soonerfor diabetics and those who havesuffered stroke before.”

Zangiabadi also cautioned thattPA is not appropriate for everyonewho has a stroke. “There is only a40 percent to 45 percent chance themedicinewillwork,”he said, notingthat patients whose strokes are dueto burst blood vessels (hemorrhagicstroke) are not candidates for tPA.Even those whose CT scans revealblockages are not guaranteed itsuse either, since factors such as thelocation of the clot and its thicknessplay significant roles inhoweffectivetPAwill be.

The best thing anyone can do tohelp a stroke victim is to act FAST(see box on page 12). “If you suspectsomeoneishavingastroke,youshouldnot try to transport them to the hos-pitalyourself,”Zangiabadisaid.“Call911 immediatelybecause if theycomebyambulance, theywill be seen rightaway [in theER]since theparamedicswill call us in advance to let usknowthe situation.”

‘MinutesarePrecious’

During a Stroke,

| continued on 12

commonCONDITIONS

Strokecauses1out of every 19deathsin the United States. –CDC

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BY KAREN FINUCAN CLARKSON

They are known to be painful and tointerferewith themovement of a joint.But bone spurs—common in olderadults—often are benign. If you are

over 60, chances are good that you have a bonespur, though youmaynot yet realize it, accordingto local orthopedic surgeons.

Abonespur—thecreationofextrabone—is theresultof inflammation, stress,pressureordamage.“It’s the body’s response to wear and tear on thejoints,” said Loiy Mustafa, M.D., an orthopedicsurgeon at Capital Orthopaedic Specialists, P.A.with privileges at Doctors Community Hospitalin Lanham.Bone spurs are found in joints aswellas in places where tendons and ligaments attachtobone. In seniors, a bone spurmost oftenoccurswhen there is degeneration of a joint due to osteo-arthritis,Mustafa said.

“What happens is that over time the cartilagebreaksdownina joint,andthebodydealswiththatbygrowingbone inorder toprovidemore stabilityand surface area,” said Sridhar M. Durbhakula,M.D., an orthopedic surgeon at OrthoBethesdain Bethesda, and co-medical director of the JointCenter at Adventist HealthCare Shady GroveMedical Center.

OSTEOARTHRITIS MAY ACCOUNT FOR THE GREATESTnumberofbonespurs,butthereareotherfactorsthatcontribute to their creation. “Occasionally peopleget bone spurs from running,” said Anthony S.Unger,M.D.,anorthopedicsurgeonatWashingtonOrthopaedics&SportsMedicine inChevyChase.

“Theyalsoresult frompressure, likewhenashoerubs on the side of a foot,” said Unger, who hasprivilegesatSuburbanHospital inBethesda.Bonespurshavebeenassociatedwithplantar fasciitis, acondition inwhicha ligamentonthebottomof thefoot becomes stressed and inflamed, andAchillestendonitis, where the tendon in the back of theheelbecomes irritated, according to theAmericanAcademy ofOrthopaedic Surgeons.

commonCONDITIONS While bone spurs can be found throughout the body, they’re most common in the knees.

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Causes and consequences of the body’s response to wear and tear

BONE SPURSBattling


While bone spurs are found throughout thebody—in the feet, hips, spine, neck, shoulder andhands—they aremost common in the knees, saidDurbhakula. The extra bone canmake it painfulto move the knee and can interfere with a joint’srange of motion. “The knee is where bone spurscommonly break off and become loose bodies,”he said.As loosebodies float in theknee, they cancause intermittent lockingorasensationthat some-thing ispreventing the joint frommovingproperly.

THE GROWTH OF EXTRA BONE IS AN UNCONTROLLABLEnatural response that canhaveunintended conse-quences. In the shoulder, for example, bone spurscanpinch rotator cuff tendons. Pain, stiffness andreduced rangeofmotion canoccur, saidMustafa,noting that persistent impingement of rotatorcuff tendons can lead to tears, which exacerbatethe condition.

In thespine,bonespurscanpinchthespinalcordor its nerve roots. “When a bone spur presses onthe nerves, which extend into the body, you canget pain running up and down your arms andlegs,” said Unger. Weakness or numbness in theextremities alsomay result.

AnX-ray ismost commonlyused todiagnoseabonespur,according toDurbhakula.“Because it isbone and calcified, it is readily seen on anX-ray,”he said.Treatmentmayvaryby the locationof thebone spur, although there are some approachesthat are generally applicable.

“We usually start with conservative measuresto reduce pain, such as oral anti-inflammatorymedicationsor cortisone injections into the joint,”saidMustafa.Physical therapycan increasea joint’srange of motion. “When a joint becomes stiff orhard to move, the soft tissue structures around itbecome tight. Stretching and strengthening exer-cises canbehelpful.” Improved functioningof thejoint along with a reduction in painmay delay oreliminate the need for surgery, he said.

According to Durbhakula, other nonsur-gical treatments include a supplement known asTripleFlex, which contributes to joint comfort,mobility and flexibility, and Synvisc injections,which supplement fluid in the knee and helplubricate and cushion the joint.

“Synvisc gives the knee more ‘hydraulic sus-pension’ so that bones are not rubbing againsteach other as much,” he said. Lifestyle changes,including weight loss and stress reduction, alsocan be beneficial, relieving pressure and tensionon joints andmuscles.

“Whenconservativemeasuresarenot successfuland a patient’s quality of life is adversely affected,then surgical intervention may be indicated,”said Mustafa. “In the hip and knee, we can dojoint replacement surgery. In the spine, we candecompress the pinched nerve. It all depends onthe location of the bone spur.”

Earlydiagnosisofabonespur iscritical topreventadditional damage to a joint andmaintaining orregainingone’s quality of life, theorthopedic sur-geons said.“Thebest treatment takes intoaccountmany factors and is theone that thephysicianandpatient come upwith together,” saidMustafa.

If you’re over 60, chances are good you have a bone spur, although you might not realize it.

In seniors, a bone spur mostoften occurs when there is

DEGENERATION OF A JOINTdue to osteoarthritis.

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Zangiabadi said that whilewaiting for the ambulance to arrive,those tending to a stroke victimshould help the person lie down.Donot offer medicine, food or liquid,since the personmay aspirate giventheir inability to swallow correctly.Do not give aspirin since it mightcause additional bleeding in thosewhose strokes are caused by a burstblood vessel.

Zangiabadi said the odds ofsurviving a stroke and avoidingpermanent disability are improvingthanks to advances in both publicawareness of what to do if strokeis suspected, as well as medicalinterventions. Aggressive publiceducation campaigns about the riskfactors for stroke are also makinga difference.He encouraged peopleto follow the Heart Association’s“Life’s Simple 7” steps to reducethe risk of heart disease and stroke:• Manage your blood pressure• Control cholesterol• Reduce blood sugar• Lose weight• Stop smoking• Eat better• Get active

But he also added an eighth step:Reducealcoholuse sincesomestudiesindicate that having more than twodrinks per day may increase strokerisk by as much as 50 percent.

Although only a small portion ofthe population is at a higher risk forstroke because of specific geneticdiseases, many, many Americanshave a genetic tendency for risk fac-tors such as high cholesterol or highbloodpressure thatput themathigherrisk of stroke.

Wilson is one of those people. A

vegetarian for most of his life, heexercised regularly andwas in verygood health prior to his stroke. Buta genetic predisposition for highblood pressure was a risk factor hecouldn’t avoid. He is also African-American,which almost doubles hisrisk of stroke as compared towhites.

Atrial fibrillation (irregularheart-beat) also increases the riskof stroke,especially in thoseover75,because itcanproducewhatZangiabadi called“micro-clots” that, although small,candosignificantdamage.These tinyclots form in the upper chambers ofthe heart and can travel throughoutthebody, including to thebrainwherethey can block blood vessels andcause stroke.

Zangiabadi encourages all olderpatients to maintain a regularrelationship with their health careproviders—andheencourages thoseproviders to communicatewith eachother as to the best course of treat-ment for their patients.

“I especially urgedentists to speakto the patient’s primary care doctorat least three days before performingany treatment,” Zangiabadi said.He has seen several patients who,under the advice of their dentists,stopped taking their blood pressureand cholesterolmedications prior totheir dental procedures and subse-quently suffered strokes.

Today, Wilson is working hardto return to the radio talk showhe has hosted on Sirius XMRadiofor many years. And although IrisWilson doesn’t take to the airwaveslike her husband, she ismaking surethat she broadcasts to anyonewhowill listen the importance of actingquickly when dealing with stroke.“Time counts,” she said. “Minutesare precious.”

STROKE, from 9

If you notice symptoms such as weakness in extremities, numbness on oneside of the body, excruciating headache, sudden dimness or loss of sight orinability to speak, the National Stroke Association says you need to act FASTby asking these questions:

H O W T O I D E N T I F Y A S T R O K E

FACE – Does the smile droop on one side?

ARMS – Is the person unable to raise both arms?

SPEECH – Is the speech slurred?

TIME – If the answer to any of these is yes, call 911 immediately.

FAST

Emergency Services atBowie Health Center

Emergency medical services for adults and children

Quicker than a traditional Emergency Room

Board certified doctors, with a reputation forexcellence

Caring and highly skilled nursing staff

15001 Health Center Drive(Off Northview Drive across from Bowie Town Center)

Open 24 hours,Seven days a week

301-262-5511www.bowiehealthcampus.org

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diseases, but often what tips practi-tioners off to a LBDdiagnosis is thepresence of hallucinations or actingout during sleep.

“If a patient presents withParkinsoniansymptomsandis treatedwith medications for Parkinson’sdisease, they have a lower thresholdfor developing hallucinations,”Constantino explained. “So if theybegin to experience hallucinations,this suggests that it is LBD morethan Parkinson’s disease.”

Another clue toadiagnosisofLBDversus Alzheimer’s or Parkinson’sdisease is the order in which symp-toms begin to present themselves.“Not everyonewhohasParkinson’sdisease will get dementia,” said JimBicksel, M.D., medical director ofInovaHospital’sMemoryCenter inFalls Church, Va. “So if movementproblems (a slow gait, shuffling offeet, etc.) present themselves first, itcouldbeParkinson’s. But if dementiaoccurs first andmovementproblemsensue, we tend to suspect LBD.”

SOME PATIENTS WHO ARE DIAGNOSEDwith LBD may live with the condi-tion for some time, andwith proper

treatment, canmanage tocopeeffec-tively with the symptoms, even thehallucinations, according toBicksel.“Sometimes they simply learn toignore them,” he said.

Unfortunately, however,LBD is aprogressivedisorderwithnoknowncure, soover time, the symptomswillget worse.

Doctors often treat it with manyof the same medications used forAlzheimer’s and Parkinson’s dis-eases—including drugs designed toincrease the level of chemical mes-sengers in the brain—known underbrand names such as Exelon andAricept. These may help improvememory,butBickselpointedout thatunlikeAlzheimer’s patients, patientswith LBD often do not have short-term memory issues. “If you askthem what month it is, it may takethem a long time

LBD, from 7

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WANT TO KNOW MORE?The Lewy Body DementiaAssociation (lbda.org) offersnumerous educational materialsas well as information on clini-cal trials and support forums forpatients and families who sufferfrom the complexities of LBD.

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LIVE YOUR BEST LIFEbarryfletcher com.

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In end-of-life situations, the role of SeasonsHospice is to engender hope in the lives ofits patients and their family members. Weare here for you 24 hours every day byproviding:

• Regular visits by registered hospice nurseswith specialized training and expertise inpain and symptom management.

• Visits by hospice aides to provideadditional personal care and attention.

• Psychosocial support for patients andfamilies, as well as for the nursing homestaff and care givers.

• Spiritual support, as requested, forpatients and families.

• Trained volunteers who providecompanionship, assistance, and support.

• Bereavement counseling and support for family members and significant othersthroughout the patient’s illness and for a minimum of 13 months (more, ifneeded) following the death.

• Consultation and emergency care 24 hours a day, every day of the year.• Coordination of medical equipment and medications related to the terminal

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to respond, but they often are ableto give the right answer,” he said.

Carbidopa-levodopamedicationssuchasSinemet,whichareoftenusedto treat Parkinsonian movementsymptoms, may also provide somerelief. And although anti-psychoticmedications, known tomanyunderbrand names such as Seroquel orZyprexa, can help some patientsreduce their delusions, other LBDpatientsmayhavea severe sensitivityto them that can actually triggerpronounced hallucinations.

AGE AND GENDER SEEM TO PLAY Asignificant role in the onset ofLBD. Most cases occur after age60, although some cases have beenreported much earlier. A 15-yearstudy funded by the NationalInstitute on Aging published in2013 revealed that the incidence ofLBDwas twice as common inmenas in women.

There are currently no tests todefinitively diagnose LBD. Only

an autopsy of the brain after deathcan confirm with certainty that aperson had the disease. But thanksto patients and families who arewilling to donate suspected LBDbrains to scienceafterdeath,Bickselsaid researchers are learning thatLewybodyproteins areoften foundin the deep part of the brain thatcontrols movement and that theyaffect thinking by interfering withthe brain’s ability to send signals todifferentareas involved incognition.

Armed with this knowledge,researchers can now attempt toanswer questions such as how andwhy theLewybodyproteinsdepositin those areas.

Even thoughwe knowLBD is the

secondmost common cause of pro-gressive dementia after Alzheimer’sdisease, Constantino said that thereis still much to be learned about it.

“There are several papers thatsuggest a genetic predisposition, butthis has never been conclusive,” shesaid. “Environmental toxins havealso been implicated.”

UNTIL A CURE IS FOUND, NEUROLOGISTSencourage LBD patients to followmanyof the samerecommendationsgiven toAlzheimer’s andParkinson’sdisease patients.

“It is important to continue toengage in mental, physical andsocial activities,” Bicksel stressed.

Because of its similarities to

Alzheimer’s and Parkinson’s dis-eases, families who suspect theirloved ones may have LBD shouldshare their concernswith their pri-mary care physicians and request areferral for evaluation by a neurolo-gistwho is familiarwith thedisorderand the subtleties that distinguish itfrom Alzheimer’s and Parkinson’sdiseases.

“Anytime you see movementsymptoms, things like the shuf-fling of feet, muscle rigidity, amasked face, et cetera, you shouldrequest referral to a neurologist,”Bicksel said.

Despite uncertainty about howthe disease forms or why somemedications affect some patientsmore negatively than others, theexperts are sure of one thing: Earlyidentificationand earlymanagementprovide the best hope for patients,since the LBD Association reportsthat a diagnosis by specialists whoare very familiar with the diseasecan be accurate in 90 percent ofcases, leading tomore targeted andeffective treatment.


THE PRIMARY KEYS TO HEALTH FORany runner, Peterson said, are “lis-tening to your body” and settingamethodical pace. “Increase youractivity by 10 percent a week, be itbased on speed or distance. Start offsmallwithwalking and then slowlyincrease… .People get injuredwhenthey don’t give themselves enoughtime to train … . Take it easy.”

While thehealthbenefitsmightbeevident, less so might be the socialaspectof thepursuit. “When it’s earlyin themorning and it’s cold outside,it helps to know there’s someonewaiting for you,”Merene said.

Running clubs are a commonway to foster community, and thesegroups exist all around the area.The PrinceGeorge’s RunningClub(pgrc.org) offers training andmem-berships to runners of all experiencelevels. Panebianco himself helpstrain runners.

In a nutshell, the key for anybeginner, Panebianco said, is tostart slow.

“Get out there three times aweek and do some walking,” headvised. “Try to cover one mile,then two miles, then three miles.Then you start to walk and jog atthe same time. It’s hard at first, butit gets easier.”

RUNNING, from 5

LBD, from 13 “Anytime you seemovement symptoms,things like shuffling of the feet,

muscle rigidity, amasked face, et cetera,

YOU SHOULD REQUEST A REFERRALTO A NEUROLOGIST.”

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When you face surgery,you might have manyconcerns. One commonworry is about going

under anesthesia. Will you lose con-sciousness?Howwill you feel afterward?Is it safe?

Every day about 60,000 peoplenationwide have surgery under generalanesthesia. It’s a combination of drugsthat’s made surgery more bearable forpatients and doctors alike. Generalanesthesia dampens pain, knocks youunconsciousandkeepsyou frommovingduring the operation.

“Prior to general anesthesia, the bestideas for killing pain during surgerywere biting on a stick or taking a swigofwhiskey,” saidDr. Emery Brown, ananesthesiologist atMassachusetts Gen-eralHospital inBoston.Things improvedmore than150years ago,whenadentistinMassachusettspubliclydemonstratedthat theanestheticdrugethercouldblockpain during surgery. Within just a fewmonths, anesthesia was being used inAustralia, Europeand thenaround theworld.

“General anesthesia changed medicinepracticallyovernight,” saidBrown.Life-savingprocedures such as open-heart surgery, brainsurgery or organ transplantation would beimpossible without general anesthesia.

GENERAL ANESTHESIA AFFECTS YOUR ENTIREbody.Other types of anesthesia affect specificregions. Local anesthesia—such as a shot ofnovocaine from the dentist—numbs only asmall part of your body for a short periodof time. Regional anesthesia numbs a largerarea—suchaseverythingbelowthewaist—fora few hours. Most people are awake duringoperationswith localor regionalanesthesia.Butgeneralanesthesia isused formajor surgeryandwhen it’s important that you be unconsciousduring a procedure.

General anesthesia has three main stages:going under (induction), staying under (main-tenance) and recovery (emergence).

The drugs that help you gounder are eitherbreathed in as a gas or delivered directly intoyour bloodstream. Most of these drugs actquicklyanddisappearrapidly fromyoursystem,so theyneed tobegiven throughout the surgery.A specially trained anesthesiologist or nurseanesthetist gives you the proper doses andcontinuouslymonitors your vital signs—suchasheart rate,body temperature,bloodpressureand breathing.

“WHEN PATIENTS ARE GOING UNDER, THEYexperienceaseriesofdeficits,” saidDr.HowardNash, a scientist at the National Institute ofMental Health. “The first is an inability toremember things. A patient may be able torepeat words you say, but can’t recall themafter waking up.”

Next, patients lose the ability to respond.“Theywon’t squeeze your fingers or give theirname when asked,” Nash said. “Finally, theygo into deep sedation.”

Althoughdoctorsoften say thatyou’llbe asleep during surgery, research hasshown that going under anesthesia isnothing like sleep. “Even in the deepeststagesof sleep,withproddingandpokingwecanwakeyouup,” saidBrown.“Butthat’snot thecasewithgeneralanesthesia.General anesthesia looks more like acoma—a reversible coma.” You loseawareness and the ability to feel pain,formmemories andmove.

Once you’ve become unconscious,the anesthesiologist uses monitors andmedications tokeepyouthatway. In rarecases, though, somethingcangowrong.About once in every 1,000 to 2,000surgeries,patientsmaygainsomeaware-ness when they should be unconscious.Theymay hear the doctors talking andremember it afterward.Worse yet, theymay feel pain but be unable tomove ortell the doctors.

“It’s a realproblem,although it’squiterare,” said Dr. Alex Evers, an anesthe-siologist at Washington University inSt. Louis.

AFTER SURGERY, WHEN ANESTHESIA WEARSoff, you may feel some pain and discomfort.How quickly you recover will depend on themedicationsyoureceivedandother factors likeyour age. About 40 percent of elderly patientshave lingeringconfusionandthinkingproblemsfor several days after surgery and anesthesia.Right now, the best cure for these side effectsis time.Brownandhis colleagues areworkingtodevelopdrugs tohelppatientsmorequicklyemerge and recover from general anesthesia.

Anesthesia is generally consideredquite safefor most patients. “Anesthetics have gottenmuchsaferover theyears in termsof the thingswe’remostworriedabout, like thepatientdyingor having dangerously low blood pressure,”Evers said. By some estimates, the death ratefromgeneral anesthesia is about 1 in 250,000patients. Sideeffectshavebecome less commonandareusuallynotas seriousas theyoncewere.


Waking Up to Anesthesia

from the EXPERTS Every day, 60,000 people in the U.S. have surgery under general anesthesia.

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