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The Heart of the Matter7 Heart Smart Health Tips pg. 6 Just do it … for your heart. pg. 4

HEART SURVIVOR

pg. 7

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Advertising DirectorDennis Anderson

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Valley Health is a publication of the Montrose Daily Press. It publishes monthly on the first Friday.

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Hospital Happenings

Year in review and moreAs we re-

flect on our New Year’s resolutions, take time to remember that good health is the foundation for a happy life and know that we at Montrose Memorial Hospital are dedicated to our commu-

nity’s wellbeing. We emerge from 2015 with a record of success and are strategically planning for the coming years. A few highlights from 2015 include:

• Reducing existing debt through increased cash reserves

• Proceeding with updates to our facilities

• Initiating new philanthropy, community partnership and engagement strategies

• Successful recruitment of physicians and advanced practitioners for our region

While we have much to feel good about, it’s important to keep an eye on the future so we continue to meet the upcoming challenges as we live in a time of great transition for healthcare. A local, independent nonprofit hospital is a treasure worth pre-serving and the Board of Direc-tors and executive leadership of Montrose Memorial takes this stewardship responsibility seri-ously.

The hospital recognizes that community and regional collabo-ration are essential to keep the healthcare system vibrant for our region in the current health-care climate. We have actively built, and continue to strengthen and expand a network of profes-sional and organized partner-ships. This network bolsters not

only Montrose Memorial, but also focuses on strengthening the regional healthcare providers by providing additional resources while allowing us all the indepen-dence to better meet the needs of local populations.

We are one of 29 owner mem-bers of the Western Healthcare Alliance (WHA), and also a member of WHA’s Community Care Alliance (CCA) for rural and community hospitals. WHA membership benefits Montrose staff with access to an active peer-exchange and to state-of-the-art WHA programs on cost-reduction and quality care. Through our work and leadership role in WHA and CCA, we have recently formed an additional collaboration with neighboring hospitals in Delta, Gunnison and Aspen, and physi-cian clinics in order to increase communication and care in a patient-centered approach. This approach has demonstrated to be very effective in rural communi-ties which have unique challenges based on how and where we live. Our participation with our neighboring healthcare provid-ers represents a commitment to greater communication between providers in the care continuum, especially for our patients with chronic illnesses. By improv-ing how we work together with other hospitals and care providers across the spectrum of care, we hope to improve care, reduce the likelihood of duplicated services, and reduce costs for our patients.

Montrose Memorial is more than just a hospital. We are a com-munity-based integrated health system that is well positioned for 2016 and the years to come. We believe it is important to continue developing mutual-benefit allianc-es with other quality providers to ensure the future of healthcare for our region.

Steve Hannah, MHA is the CEO of Montrose Memorial Hospital. To learn more, visit http://www.montrosehospital.com. l

Dear pharmacist

Protect yourself from heart attack

Dear Pharmacist,My brother, father, and uncle

all died of a heart attack in their early 50s so I’m getting nervous. How can I help myself now? – G.H., Decatur, Ill.

I commend you for your enthu-siastic quest for wellness. After writing this column for 14 years, one point I cannot stress enough: Inflammation is the primary underlying factor contributing to cardiometabolic risk.

When I say “inflammation,” I’m not referring to swollen fingers – I mean full body (systemic) inflam-mation. Think of it as a fire driv-ing up your insulin (bad), messing your hormone balance (bad), in-creasing pain-causing compounds called cytokines (bad) and squeez-ing off blood flow to your major organs like the brain and heart.

Health care today emphasizes medications to treat symptoms of heart disease rather than trying to put the fire out.

One example is with cholesterol reducing drugs. Fine by me, but medication alone doesn’t put out your smoldering systemic fire. Same thing with insulin resis-tance, detected easily in a blood test. Take all the blood sugar reducing medications you want to, they won’t put out the fire (inflam-mation) either.

This is covered entirely in my “Diabetes WIthout Drugs” book, where I help you avoid becoming a “number junkie,” a person who chases down numbers with medi-cations. The assumption is that it equals good health! It doesn’t.

To adequately reduce your risks, I recommend proper diagnostic test-ing first. The way we measure blood pressure is wrong. The British are ahead of us. They do 24-hour moni-toring as standard procedure.

That’s excellent because one of-fice pressure won’t tell you what’s going on centrally, in the brain and heart, it only measures peripheral pressure. You never want your CRP to go over 3 mcg/ml because this

blocks the angiotensin II receptor, cranking out enormous amounts of oxidative stress (think fire).

The B vitamins reduce CRP so a B-complex is a good idea. Addi-tionally, consider potassium, 3 to 5 grams per day (absolutely ask your doctor). Physicians sometimes pre-scribe beta blockers. As a general rule they don’t do anyone a favor, and are known to increase diabetes by about 5 percent a year.

More simple stuff. Vitamin B6 is a natural calcium channel blocker, mild diuretic and it improves insu-lin resistance. Awesome, consider-ing it’s 10 dollars a month if you take 100-200 mg per day.

Also alpha lipoic acid, about 200mg three times daily. It improves endothelial dysfunction, and in-sulin resistance; used with Acetyl L-carnitine, it’s a one-two punch. You’ll need a little biotin on board to prevent depletion from the alpha lipoic acid.

My suggestions are intended to shine a flashlight of hope. I hate when people are told “Let’s wait and see.” Wait for what? A heart attack?

If you like how I think, it’s be-cause I attend medical seminars of-fered by the Institute for Functional Medicine. Find a doctor at their website (functionalmedicine.org) where they “speak this language.” Just click on “Find a Practitioner” or call 800-228-0622 for more infor-mation.

Suzy Cohen has been a licensed pharmacist for 25 years and is a functional medicine practitioner for the last 15. She devotes time to educating people about the benefits of natural vitamins, herbs and minerals. In addition to writing a syndicated health column, “Dear Pharmacist,” Suzy Cohen is the author of many different books on natural health. All of the opinions expressed in this column are those of the author and do not necessar-ily represent the viewpoint of the Montrose Daily Press. l

Steve HannaMontrose Memorial Hospital

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Mindfulness and heart healthBY KENDRA DORR

Taking a few minutes to relax each day could help you lower your risk of heart disease. Mindfulness is a practice — often using deep breathing, quiet thought or long moments to focus on something simple such as a color, phrase or sound that helps you let go of stress, feel peaceful and maintain a relaxed state of mind – think of it as a 20- or 30-minute vaca-tion from the stress in your life.

For some people, being present and mindful is a natural part of their personality. Fortunately, for the rest of us, mindfulness is a skill which can be learned by focusing on ‘‘the now.’’

Most of the research regarding mindfulness centers on the connection between the power of present thinking and the positive effects it can have on the body. This research shows us that being attuned to our present feel-ings allows us to better manage various cravings for salty or sugary foods, cigarettes or even laziness — all of which undermine our physical health.

“People who are more mindful tend to have more awareness of their mind and body. By increasing our awareness, we might become more aware of the impact of what we are doing to ourselves,” said Eric Loucks, an assistant professor at Brown University.

For instance, if a mindful person is less physically active, they might notice that they have less energy.

Researchers asked 382 people to evaluate statements that measure their level of mindfulness on a six-point scale ranging from, “almost always” to, “almost never.” Participants responded to statements like, “I find it difficult to stay focused on what’s happening in the present.”

The participants who scored highest in mindfulness, also had very healthy scores when it came to the seven American Heart Association indi-cators for heart health.

Those indicators include avoiding smoking, being physically active, hav-ing a healthy body mass index, consuming decent amounts of fruits and vegetables and maintaining good cholesterol, blood pressure and fasting blood glucose levels.

This study is one of the first to provide real evidence suggesting that, “dispositional mindfulness,” (someone’s awareness and attention to what they are thinking and feeling in the moment) can, in fact, have a positive impact on four of the seven heart health indicators.

Those who practice mindfulness for two 20-minute periods a day have a 66 percent less chance of heart attack and stroke than those who do not practice mindfulness.

While mindfulness can be a tool for lowering stress and the risk for heart disease, it can’t replace other important lifestyle changes like eating healthier, losing or managing weight, reducing sodium intake or engaging in regular physical activity.

Mindfulness can be done simply, every day. It doesn’t require seminars, long hours or yoga. Mindfulness is whatever you want it to be, whatever way works best for you.

It’s not one-size-fits-all, but rather it can be an individualized approach based on personality, so that you feel comfortable. Take advantage of the opportunity to take a vacation from stress each day by learning and using mindfulness techniques — your heart might just thank you for it.

Kendra Dorr is the assistant marketing manager for the Center for Mental Health in Montrose.l

MMH cardiologist uses new stent

Dr. Matthew Smolin, Cardiologist at Montrose Memorial Hospital, recently treated a patient with the newly approved SYNERGY Everolimus-Eluting Platinum Chromium Coronary Stent from Boston Scientific, making her one of the first patients in Colorado to benefit from this new technology.

The SYNERGY Stent was approved for use by the FDA Oct. 2, 2015. Stents are tiny mesh tubes doctors use to prop open clogged arteries, allowing blood to flow freely to the heart.

“Bringing the most advanced medical technologies to our community directly supports our mission to provide outstanding patient care,” said Dr. Smolin. “Early adoption of the SYNERGY Stent, the first and only bioabsorbable polymer drug-eluting stent in the U.S., reinforces our com-mitment to deliver advanced treatment to patients in Montrose and the surrounding communities.”

Manufactured by Boston Scientific, the SYNERGY Stent, with its bioab-sorbable polymer, offers simultaneous drug and polymer absorption. De-signed for faster healing, the SYNERGY Stent offers what you need when you need it; medicine, which inhibits coronary blockages from recurring, and freedom from permanent polymer exposure, which has been associ-ated with complications such as vessel re-narrowing and blood clots.

“We are pleased to be working closely with Dr. Smolin and Montrose Memorial Hospital to ensure patients can access this innovative technol-ogy,” said Kevin Ballinger, President, Interventional Cardiology, Boston Scientific. “In development for over 10 years, the SYNERGY Stent reflects our commitment to bringing meaningful change to interventional cardi-ologists with the most complete portfolio of clinical solutions to best treat their patients.

“We are excited to bring this transformative technology to U.S. facilities that provide best-in-class patient care,” he added.

Special to the Daily Press. l

Montrose Memorial Hospital Cardiologist Dr. Matthew Smolin shows the Platinum Chromium Coronary Stent he recently used for the first time in Colorado.

Submitted photo

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TWYLA RIGHTER

Just do it … for your heart.This month Valley Health is

focusing on heart health. I hate to disappoint you dear

readers … but … I am not a cardi-ologist.

Sorry.But, I’ve done some excellent

research. I went to Google, and I googled a bunch of stuff – about hearts and cardio vascular systems. I googled about strokes and DNA links, and then I asked a few medical people I know … followed by a few fun TED talks – they may or may not have been completely unrelated.

Here’s what I found: No. 1. A decent chunk of heart health is related to DNA. You may have certain pre-disposition to a bad

heart. You can’t do anything about that.No. 2. There are some more obvious lifestyle factors.

If you are overweight, your heart and circulation are taking a beating on behalf of your stomach. Quit being a jerk to your heart. It’s not nice.

But, there is something else – that is actually a huge factor in your cardio-vascular health.

No. 3. Your attitude and ability to manage stress. Example: When a car cuts you off in the overwhelm-

ing traffic of Montrose. (That’s a joke – if you are stressed out in Montrose traffic, then you are a weenie and need to go spend a week on the 405 in Los Angeles at 6 p.m. before you are allowed back into the city lim-its. I’m serious.)

Back to you getting cut off … A car has cut you off while you’re cruising down Rio Grande and you get mad. Really mad.

“What the heck?!?” you think. You give them a gesture that your mom would slap

you for. You think dark, evil, thoughts toward their bumper sticker, which, of course, represents a political party you despise.

Then you wander into that Montrose High School basketball game while muttering exotic curses worthy of great Irish men of yore … “May the wind be ever in your face and may your brake pads wear early and uneven!”

This situation, you may be shocked to discover, is not great for your heart. It may be even more shocking to discover that the problem is not actually the guy who pulled out in front of you. The problem is … wait for it. You! You are the big, fat, problem here.

This in no way applies to me by the way. I never get mad at other drivers … I am a Zen master capable of blessing those who curse me. Much like Mother The-resa, my mentor in all situations road rage related.

But you … you have an issue. You are killing your poor heart by being so incapable of coping with stress. Fortunately for you there are solu-tions.

The first one is to get involved in a faith community. People who prac-tice faith live longer, healthier, happier lives. They spend a significant amount of time learning to see the positive in life and support one an-other in difficult times.

I won’t tell you which community you should join … I will simply let you know that I am part of the good one and all the other ones are really bad. (That’s a joke – if it offended you, then that was bad for your heart, too.)

You also should spend more time giving hugs. When people hug, (and not just other people, hugging your cat or dog works, too), their stress hormones dissipate and their blood pressure drops immediately. The other great thing about hugging is that it establishes bonds that last even longer. So a hug today means more hugs down the line, and all hugs are heart medicine! Did you get that? Heart medicine – hugs. Do it!

Another thing you need to do more of – laugh. Laughter has an immediate impact on vasoconstriction. A laugh will

immediately relieve many symptoms of stress; it releases feel-good hor-mones and builds the immune system.

How do you go about laughing? Well, I have a few suggestions. I was recently advised that you can ask Siri to beatbox for you. I found it

affective. My teenager also thinks Siri is amusing to ask questions regarding

mixing of dog breeds like Shitzu with … well … pretty much any breed. Example: What do you call a Shitzu bred with a Poodle… and so on and so forth.

In order to do good thorough research in the area of laughter and heart health, I recognized that I must self-experiment. (The things I do for you!)

I made myself sit down and watch as much funny stuff as I could on the Internet. It had to be done.

I suffered through clips of people falling a lot. I found a car imbedded in the side of a building. (Can you picture that? It’s just a car sticking halfway out of the wall of a building …)

There were the always funny people coming out of anesthesia.

Here’s a funny one. Google “sticky floor prank.” It’s a guy dressed in a business suit. He enters a building in which somehow they have managed to lay a huge carpet made of fly paper across a floor. The whole thing takes less than a second. His hair gets stuck. It’s hilarious.

I found Pinterest had images of people getting frightened in haunted houses. Teenage boys with their legs wrapped around their screaming mothers …

I also heard some fun real world suggestions to get laughter going. One was to get into an elevator full of people and start doing tai chi… (this would probably help your heart in two ways.)

The other suggestion was to face the rest of your fellow elevator mates instead of facing the door.

I can’t decide if it would be funnier to just do this with a straight face or to plaster a big creepy smile on your face?

It might be even better to quote something you memorized while a kid. The preamble to the constitution or the “rap” you used to memories the Pythagorean theorem.

I really hope I’m in the elevator with you when you try this out. I will be standing in that weird moment facing the door with a box full of strang-ers … you will be ready to go big for your heart.

You will turn slowly around – everyone in the elevator will immediately become painfully uncomfortable. Then suddenly you will burst into a song about the states and their capitals… complete with hand gestures and perhaps an impromptu box step.

Please – somebody do this for me! It will be so awesome I can’t even stand thinking about it.

I also really love videos of infants cracking up when paper is ripped, or … ok … I admit it – I love watching children totally eat it on America’s funniest home videos.

Don’t judge. I’m doing this for you. And here’s the thing: you need to go and laugh

at the falling children! Not because you are heartless schadenfreude and find humor in their pain … you are doing this for your health. And hey … put the oxygen mask on yourself first – right?

Twyla Righter lives the distinguished drama of stay at home motherhood. Before taking on a career in motherhood she was a flight attendant with a history and poly-sci degree and minors in theology and religions. l

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Take heart — mind your cardiovascular health.BY KATHARHYNN HEIDELBERG

Heart disease is the leading cause of deaths for Americans, but while nothing is failsafe, there are practical, meaningful steps you can take to increase your ticker’s health.

Myriad conditions can contribute to heart disease, and advice is not necessarily one-size-fits-all, but the simple, preventative measures boil down to balanced nutrition, adequate exercise, and not smoking.

“If (people) smoke, they should stop smoking immediately,” said Dr. Riley Foreman, a cardiologist with Montrose Memorial Hospital’s cardi-ology clinic.

“Smoking is one of the major causes of atherosclerotic heart disease, and it’s the major preventable cause.”

Atherosclerotic refers to the progressive narrowing and hardening of the arteries. Medical experts say it is the most common culprit behind heart attacks, strokes and vascular disease.

Regular exercise can help prevent constrictive build-up in the arter-ies, because it improves conditions that can lead to atherosclerosis.

“Regular exercise improves blood pressure control, control of things like diabetes and cholesterol, but more importantly, it improves your cardiac functional status — how your body and your heart function together — and improves cardiovascular fitness,” Foreman said. “Ex-ercise has benefits for virtually all cardiac patients. We do recommend that people get some type of exercise 20 to 40 minutes a day, three to four times a week, at least.”

Nutritional recommendations vary by individual. In general, heart-healthy nutrition emphasizes lower-fat foods and fewer fried foods.

“In general, our diet can affect our weight, our cholesterol levels and the incidences of diabetes. Cholesterol levels and diabetes development are very important (factors) in developing heart disease,” Foreman said.

Routine cholesterol checks are recommended for most people. Testing should break down the levels of both LDL and HDL cholesterols. The LDL, or low-density lipoprotein, is more commonly known as “bad” cholesterol. High-density lipoprotein, or HDL, is considered “good” cholesterol.

“We believe that higher levels of HDL decrease the level of atheroscle-rosis and have a cardio-protective benefit, Foreman said.

“Exercise and nutrition can have an effect, not just on total choles-terol, but the good and bad cholesterol.”

Blood pressure should also be routinely checked by health care pro-viders. The recommended systolic pressure (when the heart contracts) is below 140 and the recommended diastolic pressure (relaxation of ventricles as they fill with blood) is below 85.

You might be having a heart attack if …

The symptoms of a heart attack are not uniform among individuals, but can include pressure sensation and tightness in the chest, and the radiation of that discomfort into the right or left arm.

Tightness or pressure in the neck or jaw are also possible symptoms, as is extreme shortness of breath with sudden onset.

“Any acute symptoms that arise should be evaluated at the emergency room, because not everyone has the classic symptoms,” Foreman said.

People who think they are having a heart attack should call 911 immediately.

If a person has lost consciousness, CPR can be performed.“If someone does lose consciousness and they have no pulse, routine

CPR should be initiated and 911 should be called,” Foreman said.For more information, visit the American Heart Association at www.

heart.org. For information tailored to your needs and for specific treat-ment regimens, visit your doctor. l

Cholesterol screenings will be available as part of a total chemistry profile test at the upcoming MMH health fair, from 6:30 a.m. to noon, Feb. 27.

People who had early blood draws can bring in their results to discuss with a provider; others can have blood drawn at the fair and the results will be provided later. The chemistry profile costs $40; insurance is not billed and credit/bank cards are not accepted. A 12-hour fast is recommended, except for diabetics, and when not recommended by a doctor.

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BY REBECCA WEITZEL

Heart disease is the leading cause of death in both men in women in the United States. Al-though these statistics are alarming, there are many ways to reduce your heart disease risk.

“Caring for your heart is one of the kindest things you can do for yourself and for your loved ones,” said Rebecca Weitzel, Wellness Coordinator for Hilltop’s Health Top Wellness Solutions.

Weitzel encourages patients to follow these seven heart smart health tips:

NO. 1 DRINK MORE WATERDid you know that drinking plenty water has

been shown to reduce the risk of coronary heart disease? You don’t necessarily have to drink “eight glasses per day”, but choosing water over other sugary or chemical-laden drinks improves health in many ways.

NO. 2 EAT MORE FRUITS AND VEGGIESNumerous studies have found that even mod-

erate consumption of fruits and vegetables can reduce your risk of dying of a heart attack or stroke by around 30 percent. Fruits and veggies are a good source of fiber and micronutrients that help eliminate heart-sabotaging chemicals from your body. Ideally, you should aim for at least five servings of fruit/veggies per day.

No. 3 Stop and take a deep breathWhen stress becomes high, it becomes a prob-

lem. You know your stress level is high when you begin trying to solve problems in irrational ways: eating too much, tensing your body, mak-ing erratic decisions, having emotional out-bursts, etc. When you feel this happening, stop and take a few deep breaths. This simple trick can do wonders in reducing your heart rate and decreasing your rising blood pressure.

NO. 4 TAKE A DAILY WALKHippocrates is credited for saying, “Walking

is a man’s best medicine.” Walking supports a healthy heart by lowering blood pressure, raising good cholesterol (HDL), lowering bad cholesterol (LDL) and increasing blood flow. And it doesn’t take much! Try just 10 minutes twice per day to get started.

NO. 5 CUT BACK ON SALTWhile sodium is a necessary part of our diet,

most Americans consume too much. A surpris-

ing amount of salt is hiding in many of the foods we eat every day. In fact, many people consume twice the recommended amount. Too much sodium in your diet contributes to high blood pressure and heart disease.

The U.S. Department of Health and Human Services recommends that individuals eat no more than 2,300 milligrams of sodium per day, the amount found in just one teaspoon. You can see how shaking salt onto all of your food can add up fast. Choose fresh foods, read labels and ask restaurants for lower-sodium options.

NO. 6 GET ENOUGH SLEEPSleep is often looked at as a luxury in our

country — or even something only lazy people need. However, sufficient sleep is vital not only for our ability to perform at our best, but also to protect our health.If you sleep less than 6 hours each night, you are at an increased risk of developing heart disease. People who sleep at least seven hours per night are more likely to live longer.

NO. 7 BE KIND.Did you know that the health of the “figu-

rative” heart can influence the health of the physical heart? Oxytocin is a chemical that is released in our brains when we bond with other people. Oxytocin has a powerful effect on reducing free radicals and inflammation in our bodies, improving cardiac functioning and reducing one’s risk of developing heart disease.

Since oxytocin has been shown to be re-leased when we perform acts of kindness for others, it follows that seeking these opportuni-ties is good for our health. The kinder we are, the better we feel and the healthier our hearts will be!

In 2015, Hilltop Community Resources was recognized as one of the five healthiest workplaces in the nation by the American Psychological Association. Since then, Hilltop saw the opportunity to expand its workplace wellness success. Rebecca continues to work with Hilltop and other community partners to support healthy habits and behaviors. For more information about Hilltop’s Health Top Wellness Solutions contact Rebecca Weitzel at (970) 244- 0698.l

The last couple of weeks have brought unexpected and unwel-come news to millions of seniors and disabled people on Medicare. Their already high out-of-pocket costs are going to get higher.

For some, premi-ums for Medicare Part B coverage that pays for doctor and outpatient services will go up as much as 52 percent.

For everyone Part D premiums, which cover drug benefits, will increase an av-erage of 13 percent, and everyone will see their annual Part B deductible rise from $147 to $223.

These are not trivial amounts considering that half of all people on Medicare are living on annual incomes of $24,150 or less. In 2010 about 7 million people covered by the program lacked supplemental insurance such as Medigap poli-cies, which cover what Medicare doesn’t.

By 2013 the number of people without the additional coverage had more than doubled, most likely because they couldn’t afford to buy it.

What’s going on here? Weren’t Medicare’s costs supposed to go down thanks to the Affordable Care Act?

These increases have nothing to do with Obamacare and every-thing to do with the laws govern-ing Medicare and Social Security.

Each year the Secretary of Health and Human Services exam-ines the spending for Part B ser-vices which actually has risen this past year. By law premiums paid by everyone on Medicare must cover 25 percent of the program’s cost. (General tax revenues cover 75 percent.)

And each year the Social Secu-rity Administration determines the cost-of-living increases (COLA) for seniors based on the Consumer Price Index. There will be no in-crease for the coming year.

All this means about 30 percent of beneficiaries will see increases for Part B. Most people have their

premiums deducted from their Social Security checks, but the law prohibits any Part B premium increase that would result in a

reduction in their Social Security benefits. Without a COLA increase, a higher premium means a smaller Social Security check.

Because Medicare premiums must cover 25 percent of Part B costs, the government has to find the money somewhere. So four groups of people will have to shoulder the added financial burden.

They include those who begin receiving Medicare benefits in 2016, those over age 65 who are on Medicare but who have not taken their Social

Security benefits yet; wealthier beneficiaries (individuals with incomes above $85,000 and couples with $170,000) and low-income people eligible for both Medicare and Medicaid. State Medicaid programs pay those increases and they, too, are grumbling.

Increases in Part D premiums stem from higher costs for both brand and generic prescriptions and particularly for specialty drugs like Sovaldi to treat hepati-tis C.

Will Congress fix these inequi-ties and find other funds to protect everyone from these increases? “It’s very hard to predict what Congress will do,” says Tricia Newman, senior vice president at the Kaiser Family Foundation. Newman points out this year’s higher premiums and deductibles may be temporary and are expect-ed to come down in 2017.

The other day, I explained all this on a New York City radio show along with Joe Baker who heads the Medicare Rights Center, which helps beneficiaries from all over the country understand their op-tions.

Callers on fixed incomes and tight budgets drove home the point: The increases will pinch. One woman told of a $300 rent increase she had to absorb along with higher prices for food and medicines.

Another said her husband had cancer, and the family had

been socked with high medical costs. She said they had to pay a $3,000 deductible before insur-ance kicked in. Most likely she meant the requirement to pay $3,000 out of pocket before her Medicare Advantage plan pays benefits. That’s a common out-of-pocket limit for these types of plans. Even if she didn’t label the source of the problem correctly, she knew the family budget was in trouble.

That led to a discussion of the how the COLA adjustment is calculated and whether it is fair to seniors because they spend money on a different market basket of goods than younger Americans do. They spend more on healthcare, for example, and less on gasoline, which is heav-ily factored into the cost-of-living calculations. But despite years of talk and experiments with a more accurate cost of living index for seniors, the government has yet to implement one.

Years ago healthcare expert Mari-lyn Moon, who served as a public trustee of the Social Security and

Medicare Trust Funds, urged Americans to save their money be-cause they were going to need it for medical care when they got older. This year’s situation shows how right she was.

How much do you pay for healthcare even with Medicare? Write to Trudy at trudy.lieberman@gmail.com.l

7 heart smart health tips

Seniors face higher medicare premiums, deductibles next yearThinking about health

Trudy LiebermanRural Health News Service

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BY RICHARD REEDER

Most people probably don’t think about their doctor’s need for medical care. Orthopedist Dr. Lou Winkler found himself a patient at Montrose Memorial Hospital late last year, and he is grateful for the care.

Winkler was in the hospital last November for a bout of gastroin-testinal bleeding. He was prepar-ing to check out when the unex-pected happened.

“I was sitting in my hospital room when I had a heart attack, so I called my nurse and she called the doctor in,” Winkler said. “They ordered some medica-tion and oxygen. Within 15 min-utes it was determined I had an acute heart episode.”

The staff performed a cardio-gram and the then his doctor consulted with a cardiologist. After a couple more tests, it was determined Winkler had suffered a heart attack but his heart was still functioning.

“They performed a cardiac categorization to look at my ar-teries,” he said. “I had two par-tially blocked arteries, and they performed an operation and put two stents in place to improve the blood flow.”

Winkler said the operation was performed at the hospital’s lab and he was impressed with the equipment and staff at the hospital.

He said before this lab was built, he would have had to have gone to Grand Junction to St. Mary’s for the procedure.

“I am critical of health care, and I have to say I was impressed with the staff, the care was excel-lent,” he said. “I can’t think of

anything better. My care would not have been any better at St. Mary’s.”

Since his release after the stents were installed, Winkler has been in rehab and taking medication to prevent anymore problems. He said he started cardiac rehab two weeks later.

Rehab is an exercise program with two nurses and two exer-cise physiologists. They closely monitor heart activity including heart rate and oxygen levels. The class is one hour long three times a week.

“It’s important to get into an exercise program with supervi-sion after a heart attack or heart surgery,” Winkler said. “Hope-fully people graduate and keep exercising with the supervision.”

Winkler said there is also diet counseling, but changing the diet is up to the patient, though the staff will monitor weight.

“This never crossed my mind because I have always taken care of myself,” Winkler said. “There was no prior warning of this, so I am grateful to the hospital and staff.”

Winkler said his good care wasn’t because he has been on the staff for 40 years, he said that is the way all patients are treated. He said the staff and equipment are unlike any other hospital of comparable size anywhere.

“They have a dedication to the community, no one is ever turned away based on ability to pay,” he said. “Everyone gets the same care no matter their situation. Not many places can say that about their care.”

Richard Reeder is a News Editor at the Montrose Daily Press l

Heart survivor

Dr. Lou Winkler suffered a heart attack last November and has be rehabbing through programs with Montrose Memorial Hospital.

Richard Reeder/Daily Press

8

Choosing to cook healthy foods is important whether you have a heart condition or are susceptible to heart conditions. But what does it mean ex-actly to cook healthy?

Clearly fruit and veggies and items that aren’t processed are a good place to start. But much like the Biblical in-junction regarding bread, man cannot live on fruits and veggies alone. At least most of us can’t.

So there are a huge number of substi-tutions that can be made in recipes to make your favorite “bad for you” meal not so bad for you.

My first introduction to this idea was in 1991 when Graham Kerr published

his “Smart Cooking” cookbook. You remember him … he was the Galloping Gourmet. I think I paid $18 for the cookbook. I noted recently it’s available for $2 online.

Such are the fortunates of the book-publishing business.Most of the time, reducing the amount of fat in a recipe

is generally offset with increasing the amount of herbs and spices. As I recall, Kerr’s book was big on this concept.

And that works fine unless you have a sensitive stomach. Overly spiced food then becomes the problem instead of fat content.

Some substitutions are – to put it plainly – horrible. For instance, fat-free yogurt for sour cream. I can’t think of any-thing worse than a beef stroganoff made with yogurt. It’s just not right. And cottage cheese is not a substitute for cream in my book either.

So with some help from my friends at the American Heart Association and Mayo Clinic, I came up with common-sense substitutions that won’t make you gag.

There’s a constant argument regarding cream, half-and-half, two percent milk, one percent milk, nonfat milk and now toss in soy milk, almond milk and a couple dozen other contenders. Most of us don’t have a problem using nonfat milk for cereal, although I have never been able to drink it straight out of a cup without benefit of chocolate being added.

I use nonfat milk when mashing potatoes, but generally up the amount of butter, so it’s a wash. If you’re cooking anything where texture is an issue, don’t substitute nonfat milk. Homemade pudding is one example. Stick with two percent or even half-and-half or you will be drinking your pudding.

I have read that adding a tablespoon of liquid vegetable oil to nonfat milk helps somewhat with the texture issue, but adding oil adds fat, so you might as well stick with a higher fat content dairy product to begin with.

Butter versus margarine. We could argue that until the cows come home.Again, whether you can substitute one for the other – or

whether you should – is dependent to some degree on what you’re cooking.If you’re making toasted cheese sandwiches, use butter.

Margarine soaks into the bread and leaves it soggy. In bak-ing, margarine can often be substituted for butter without too much damage. I wouldn’t recommend it as a substitute in your croissant recipe, however.Some things just have to contain good old-fashioned “bad

for you” butter.Substituting prune puree for applesauce for some of the

butter or shortening has never had good results in my book. There once were a couple off-the-shelf fat substitute products you could purchase, but they were expensive and gave foods a weird texture.

Bacon also takes a hit – the old-fashioned made-from-pork kind. The anti-bacon people are really taking a smashing these days. I had a friend post on Facebook recently a photo of a plate full of full-fat bacon with a strip of lettuce in the middle.“Look, I made a salad,” the caption read.The logical substitution, of course, is turkey bacon. I like

turkey bacon; probably not as much as pork bacon, but it’s tolerable, particularly made in the microwave. I have substituted it in calico beans with good results and enjoy it in bacon, lettuce and tomato sandwiches.Making pork bacon in the microwave with a specially

designed device that helps drain off the fat is the best bet if you just can’t give up the real thing. You could also consid-er cutting your bacon intake to one or twice a month.

Ground turkey for ground beef has been debated for years. Turns out some of the ground turkey that was being marketed initially actually had more fat in it than ground beef since there were no federal regulations requiring fat labeling for turkey.After a number of tryouts, I decided that a lower fat con-

tent ground beef drained thoroughly and served in limited quantities worked better than ground turkey. One adven-ture with ground turkey breast substituted into a favorite casserole proved to be the end. I guess there’s a reason they call it “hamburger” noodle hotdish.

The easiest way to cook healthy with sugar is simply to use less. I generally use half the sugar called for in any given recipe, and the only time anyone has ever comment-ed was in the cranberry sauce at Thanksgiving. “You can actually taste the cranberries instead of just sugar,” was a common response. Sugar substitutes are a mixed bag. Some take on a strange taste if heated, not good options for baking.High fructose corn syrup has a great many critics. The

jury is out on whether it’s more sweet or “bad for you” than any other sugar. It’s easy to avoid in your own cooking, but it’s in an amazing number of processed foods. A number of yogurt varieties contain high fructose corn syrup. Natural sweetness from fruit should be sufficient to make yogurt edible.

At least we refrigerate our yogurt, unlike many Europe-ans, who eat it at room temperature.

Paul Wahl is the Managing Editor at the Montrose Daily Press l

Paul WahlMontrose Daily Press Managing Editor

No substitute for healthy cooking

Here’s a heart-healthy recipe that definitely kicks up the spice level from livewellcolorado.com

INGREDIENTS• 1 cup pearl barley• 4 cups water• 2 whole bay leaves• 2 medium celery stalks• 1 medium green bell pepper• 3 medium onions• 2 medium cloves garlic• 4 ounces turkey ham• 1 Tbsp. canola oil• 2 (14½ ounce) cans diced tomatoes, no salt added• 1 tsp. salt• ½ tsp. cayenne pepper• 1½ tsp. dried oregano• 1 tsp. ground black pepper

INSTRUCTIONSPlace barley in a colander and rinse under cold water. Bring

water, bay leaves, and barley to a boil in medium saucepan over high heat. Reduce heat to low, cover saucepan and cook barley until tender and water is absorbed, about 45 minutes. Place bar-ley in a colander, draining any excess water, and set aside.

Rinse celery and green pepper. Peel onions and garlic and rinse onions. Dice onions, celery, and green pepper and mince garlic. Dice turkey ham into 1⁄4-inch pieces. Add oil to large soup pot and heat over medium-high heat. Add meat, onions, celery, peppers, and garlic to the soup pot. Mix well.

Sauté 5-10 minutes, scraping bottom of pan periodically. Add tomatoes. Turn heat to high and bring to boil. Add the 4 spices and stir to combine. Cover, reduce heat, and simmer for 15 min-utes. Add cooked barley to the meat and vegetable mixture, stir to combine. Add more liquid, if necessary. Cook over low heat for an additional 5-10 minutes to blend flavors together. Remove bay leaves before serving.

Yield: 6, 1¼ cups per servingTurkey sausage may be used instead of the turkey ham. To

save time, the barley can be cooked up to two days in advance, refrigerated, and then added to the soup pot toward the end of the process. Additional black pepper also helps boost the flavors.

Barley Jambalaya

Folks either love bread pudding or hate it. If you make it with whole-grain or multigrain bread, it’s healthier, but it’s likely to

have a texture that’s a bit different from “normal” bread pudding.

INGREDIENTS• Cooking spray• 1 whole egg• 1 egg white• 1 cup skim milk• 2 Tbsp. brown sugar• 1 tsp. vanilla extract• 1 tsp. cinnamon• 1/2 tsp. cloves or allspice• 6 slices light, whole-grain or multigrain bread, cubed• 3 medium apples, cored, cored, cut into 1/2-inch cubes• 1/2 cup of any one of the following: raisins, dried cranber-

ries, fresh or dried blueberries, chopped walnuts, pecans or almonds

INSTRUCTIONSPre-heat oven to 350. Spray 9x9-inch baking dish with cooking

spray. In large bowl, whisk together egg, egg white, milk, sugar blend, vanilla, cinnamon, and cloves. Add bread and apple cubes. Add fruit or nuts if desired. Mix well. Pour mixture in to prepared baking dish and bake in preheated oven for 40-45 minutes.

Do you have suggestions for future food columns? Send them to paulw@montrosepress.com.

Apple Bread Pudding

Cauliflower has become the hero of the health cooking scene in the past few years. Here’s a recipe from American Heart Associa-tion that might even disguise it enough to get past those who are

confirmed cauliflower-haters.

INGREDIENTS• 1 1/2 cups cauliflower florets (about 6 ounces)• 2 tsp. grated reduced-fat Parmesan cheese• 1 tsp. chopped fresh parsley leaves• 1/4 tsp. garlic powder• 1/4 tsp. ground black pepper• salt to taste• 1 tsp. extra virgin olive oil

INSTRUCTIONSPreheat the oven to 425°F. In a medium bowl, combine the

cauliflower, cheese, parsley, garlic powder and pepper. Season with salt. Toss to mix. Drizzle on the oil and toss again. Transfer the mixture to a small nonstick baking dish. Bake for 15 to 17 minutes, tossing once, or until lightly browned and crisp-tender. Serve immediately.

Parmesan Roasted Cauliflower