Contents of the Winter, 2009 issue Meet a couple of...Grandmas on the Go! Hoopla! 2009 Stroke: Are you at Risk? Caring for the Alzheimer's Patient Experience the Virtual Dementia Tour Covenant HomeCare Hospice Offers Monthly Grief Support Groups Step Right Up! - Passport Announces Confidence and Assertiveness Training for Women Bleeding After Menopause: Is it Normal? Seniors that EXCEL - Covenant offers computer class New Knee Gives Patient Her Mobility Back Saving Your Sight Got a Few Minutes? New Year News from 50+ Fitness: Arthritis Advice Spring Allergies Sage Advice Emergency Room Visit Calendar of Events Healthy Living The Breakfast Club On the Cutting Edge - Clinton Athletic Director Has Big Win Against Severe Wound

Meet a couple of...Grandmas on the Go!    Donna Strowd(left) and Carolyn White became fast friends with training for the Knoxville Marathon This year's Covenant Health Knoxville Marathon Team includes two ladies who are proud grandmothers. Donna Strowd and Carolyn White are now in training with hopes of running 13.1 miles on March 29. Both women have remained physically active and are out to prove that age is just a number. Follow their journey to the finish line and get training tips from experts at Covenant Health by logging onto www.knoxvillemarathon.com. Carolyn White, 70 Knoxville Grandkids: Sarah - age 14, Caroline - 11, Newlon - 1 Why did you decide to apply for the Covenant Health Marathon Team Challenge? Actually my daughter, Dana, sent in the application. She and her sister, DeAnna, thought that I would be a good candidate. Dana did not tell me about the challenge until after she had mailed the application. She said, “Now mom if they call you, I did send in your application so don’t hang up on them.” Tell us about the responses you’ve had from family members and friends? Have they encouraged you? All of my family members think it is wonderful. A couple of people have said that is a long way to walk or run. Most have been very encouraging saying they have no doubt that I can do it. They know that I have a very positive attitude and can accomplish anything that I set my mind to do. I am a goal-oriented person. How do you find time to exercise? I try to think of my exercise time as a daily appointment that I have. I don’t cancel it unless something very important comes up. What’s the secret to personal success after age 50? I think it is very important to take care of yourself by eating properly and exercising. Don’t dwell on how old you are…your age is just a number. Also, keep up with regular check-ups. My breast cancer was detected in a mammogram. I could not feel the lump and neither could my surgeon, oncologist, or plastic surgeon. I am a firm believer that the mammogram saved my life. What’s going through your mind as you think about the months and weeks between now and March 29? Right now when I think about it, I get a little tired. Then, my adrenaline starts pumping just thinking about all of the people that will be cheering me on at the finish line, and then I start thinking who needs to wait until March 29? I could do it today! Who do you hope to inspire by being a part of the Covenant Health Marathon Team Challenge? I hope to inspire folks my age to get up off the couch and start moving. You can accomplish anything that you set out to do as long as you are committed, dedicated, and determined. Being a breast cancer survivor, I hope to inspire others battling cancer that there is light at the end of the tunnel. I know there are days when chemo can have you feeling rough. Just hang in there, and you can make it! I did!!! Donna Strowd, 54 Kodak, TN Grandkids: Elijah - age 9, Maddie - age 7, Weston - age 3 Why did you decide to apply for the Covenant Health Marathon Team Challenge? I needed something to get me back on the road to a healthy and more active lifestyle. I have not paid enough attention to myself this past year, and I just felt it was time for me. Tell us about the responses you’ve had from family members or friends - were they surprised? My family was surprised and a little dumbfounded that I would even attempt this (I assured them the 1/2 marathon was my limit this year!!). But they and my friends have been very supportive and some have even offered to help me train. And yes, I've had a few to tell me I was too old. So, I guess I'll just have to show them. What are your biggest challenges in your race to personal fitness? I work full-time, so finding the time is one challenge. Also, sometimes I push myself too hard, so I have to really get a handle on that. I'm not a very patient person (with myself). What’s going through your mind as you think about the months and weeks between now and March 29? To be honest, I'm a little apprehensive and hope that I won't let anyone down. I know it will take commitment, but I am determined to finish (before sundown!!). Have you always been athletic? I was not an athlete at school. Sports was not even in my vocabulary.But as I grew older, I realized what I had missed. I love watching sports on TV and attending events when I can. I have participated in several 5K (and longer) walks, but have not tried running in any of them. I try to walk several times a week. Also, during the last year, I took horseback riding classes and thoroughly enjoyed them. My body got a really good workout during that time. I have always been able to walk for long distances and hope that I can condition myself to at least run most of the race. Who do you hope to inspire by being a part of the Covenant Health Marathon Team Challenge? I hope to inspire other "baby-boomers" that we can "grow old gracefully" and continue to be active into our senior years. I have no intention of slowing down, and I want to be an inspiration to my children and grandchildren and make them proud of me. For information on participating in the Covenant Health Marathon, call 541-4500. Passport Pacers 5K team at the Covenant Health Knoxville Marathon Join the Covenant Health Passport Pacers as we run, walk, and jog our way across the finish line at the covenant Health Knoxville Marathon on March 29, 2009. Passport members receive a $5 discount on registration and a free Passport Pacers team t-shirt. Register online at www.knoxvillemarathon.com/registration. Choose “search for a team name”, enter Passport Pacers, and follow the directions from there. Join us as we set the pace for health in 2009!

Hoopla! 2009 Our annual event is back and better than ever! This year's outing has been kicked up a notch with better seating and a fabulous hot lunch. After winning the national championship in 2008, Pat Summit is back with a group that includes a little experience and a lot of rookies. You will feel like part of the action in Level 200 seating! Register early, seating is limited to the first 100 Passport members that call. Registration is $25 and includes tour of the Women’s Basketball Hall of Fame (exhibits change regularly), hot soup and sandwich bar, private pep rally with UT cheerleaders, transportation to and from the game, and game tickets.

Stroke: Are you at Risk? After the age of 55, your risk of stroke doubles every decade. If you are male or have a family history of stroke, your risk is higher. These factors you cannot control. But you can have an effect on some of your risk factors: control high blood pressure and cholesterol, stop smoking, limit fats in your diet, and try to be active for 30 minute. You can also find out more at Covenant Health’s Stroke Risk Assessment at the South Knoxville Senior Center. The free event will be held on January 6 from 1 – 3 p.m and will include a carotid artery screening, an atrial fibrillation screening and blood pressure checks. Call 541-4500 to learn more.

Caring for the Alzheimer's Patient Calming an intense situation When the diagnosis is Alzheimer's Disease (AD), fear and anxiety begin immediately. This anxiety is partially driven by the unknown. To complicate matters, there isn't a medical evaluation that can specifically identify the disease. And since no two people experience the disease the same way, there isn’t one approach to caregiving. Stress is high for the patient and the caregiver. "I fell into it, then I fell in love with it," says Sabrina Trollinger of caring for patients at the Riverstone Senior Behavioral Center at Parkwest. Trollinger is the clinical educator and manager of the Riverstone Center. Working with Alzheimer’s and dementia patients for almost four years, Trollinger has had plenty of experience helping patients and families learn to cope with the behavioral changes caused by the disease. Alzheimer’s is a progressive disease effecting almost 5 million Americans. Changes in the brain cause memory loss, difficulty communicating and eventually loss of ability to care for oneself. These changes cause frustration in the patient that can lead to anger and aggressive behaviors. Dealing with the outburst is a skill that a family member can learn. A caregiver can watch for signs that their loved one is becoming agitated so that they can intervene before the situation escalates. Warning signs may include clinched fists, deliberate pacing, and a "wild eyed" appearance. This agitation can be caused by a number of things: a change in the environment, such as too much light or noise; frustration at not being able to perform tasks that they could do previously; fear of what is happening around them; or pain that they are unable to communicate. If you can identify that someone is becoming restless, you can remove the source of frustration or move the loved one to a calmer environment. Trollinger also suggests backing off the situation and giving the patient some space and letting them have their way as long as it isn’t dangerous. According to Trollinger, a person is most dangerous during the early stage of the disease when they can’t admit there is a problem. A person in denial may continue to drive. She advises families to pay close attention to "what happened right before the outburst". At Riverstone, treatment teams use this information to help evaluate the patient. Keeping a journal may help you determine what triggers to avoid. If you would like more information on the evaluation and treatment of Alzheimer’s, dementia, or depression in seniors, call 373-1745. If you would like to learn more, join us on January 7, noon, at the Frank Strang Senior Center as Sabrina Trollinger, RNC, BSN, shares more information about managing aggressive behaviors. Registration is required by calling 541-4500. The program is $5 and includes a boxed lunch.

Experience the Virtual Dementia Tour Caring for a loved with Alzheimer’s is a life changing job. Both the caregiver and the Alzheimer’s patient experience frustration. Changes in the behavior of their loved one leaves the caregiver wondering “Why are you behaving this way?” The Virtual Dementia Tour is designed to give caregivers and health care professionals exposure to what it feels like to have AD. Participants are fitted with distortion glasses, movement of the hands is limited. and there is constant background noise. The individual is then asked to complete certain tasks. After completing the experience, participants have a greater understanding and sensitivity to the frustrations experienced by a confused family member. On January 21, you will have a chance to learn more and experience the world of dementia. Call 483-1318 for more details.

Covenant HomeCare Hospice Offers Monthly Grief Support Groups Grief is a complex process that continues long after a significant person has died. Covenant HomeCare Hospice offers ongoing monthly grief support groups in Knoxville, Oak Ridge, and Sevierville. It is a safe environment where those who have experienced the death of a loved one can find comfort, support, and hope. The groups are informal. You may attend meetings as you wish, for as long as you want. The grief support group meetings are open to the community and are free of charge, but registration is required. For more information on dates and locations, please call (865) 541-4500 or (877) 334-4500.

Step Right Up! - Passport Announces Confidence and Assertiveness Training for Women 30th Anniversary for Pioneers Have you ever wanted to speak out during a group meeting, but didn’t have the nerve? Wish you knew how to negotiate a car deal or complain effectively if you receive poor customer service? Wanted to ask your physician a question, but were too modest to do so? Or thought of the perfect comment...after the conversation was over? The ability to speak up confidently in different settings is a learned skill, especially for many older women. Covenant Health’s Learning and Leadership Development program is pleased to announce a special class just for women that will help you communicate more effectively and have fun at the same time. "Confidence and Assertiveness Skills for Women" is a half-day class for Passport members only that will be held on March 3. The class will meet from 8:30 a.m. – 12:30 p.m. at the Covenant Health Learning Center, 9041 Executive Park Blvd. off Cedar Bluff Rd. in West Knoxville. "This class is a great opportunity to learn about personal communication styles," said instructor Barbara Edwards, Covenant Health’s director of employee development. "We include some interesting personal assessments to help participants learn how their communication styles developed. For instance, we’ve discovered that for some older women, speaking out or asserting themselves was considered impolite when they were growing up. Others come from backgrounds where discussions, debates and even arguments were more frequent." Edwards said the class teaches women the difference between passive, assertive, and aggressive behavior. "An assertive approach is usually the most effective way to communicate," she said. "Passive people are often frustrated and feel like others are taking advantage of them. On the other hand, aggressive people can be rude and confrontational. An assertive person can make a point, take a stand for her values, or get what she needs without alienating others." Edwards said participants in previous classes have found that the relatively small size of the group makes for a relaxed environment and enjoyable discussions. The group shares a lot of insights and a lot of laughter," she said. "We build confidence – and we have a great time doing it." Cost for the class is $30 lunch and materials are included. To register call 541-4500.

Bleeding After Menopause: Is it Normal? Bleeding after menopause may not seem serious, but should be discussed with your physician. The first thing a doctor will do take a detailed history,” says OB/GYN Holly Noonan Talley, M.D of Great Expectations. “If a patient recently had a change in hormone medication, the bleeding may be simply caused by a hormonal fluctuation. However, if she’s been in menopause for years with no problems, that’s another story.” Vaginal bleeding can sometimes be triggered by polyps and fibroids, infection, and in some cases it can be a sign of something more serious. Unfortunately for many women, it is the one and only sign of uterine cancer,” emphasized Dr. Talley. “There are several tests we can do in the office to make sure the bleeding is not a sign of cancer.” One of these tests is an endometrial biopsy. During this test, your doctor takes a small sample of the lining of your uterus. The tissue is analyzed under a microscope for abnormal cells. An ultrasound may also be used to detect polyps and to help rule out cancer. Unusual vaginal discharge, changes in bowel habits, bloating, and weight changes should also make your antennae go up. “Don’t wait for symptoms to get worse,” says Dr. Talley. “It’s always best to check with your physician if you notice something unusual going on with your body. Uterine cancer is the most common gynecological cancer, but also the most curable.” “How To Stay Marvelous After Menopause” Women’s Lunch & Learn Featuring Dr. Holly Noonan Talley of Great Expectations OB/GYN A frank discussion about the special gynecological issues women face as they age. Noon, Monday, March 2, 2009 South Knox Senior Center Please call 541-4500 for more information.

Seniors that EXCEL - Covenant offers computer class Covenant Health’s Learning and Leadership Development department is excited to offer Introduction to Microsoft Excel just for Passport members. These fun and exciting classes taught by Rod Collins will teach you to get the most out of your computer. You will learn the basics of using spreadsheets, working with calculations and formulas, creating a personal budget, and producing other financial worksheets. The class will be taught on Jan. 26. Registration is $30 and includes materials and lunch. Call 541-4500. Class size is limited.

New Knee Gives Patient Her Mobility Back Mary Ann Larson, 75, is a modern day mover and shaker. Having six children and 13 grandchildren keeps her young at heart, but her knee became an obstacle. Before she realized it, her only mobility was a walk to the mailbox. Larson had been able to swim a mile a day and keep her day full of activities. After an arthroscopic knee surgery she was advised that she would need to have a total knee replacement within ten years. Although she was able to prolong the surgery with temporary relief from cortisone shots, her knee got the best of her one day while she was shopping. It gave out on her and caused her to fall and severely injure her shoulder. Her shoulder required surgery and extensive physical therapy before she could have her knee replaced. “My advice to others is to not put things off. I wish I would have gotten my knee replaced before it caused my shoulder injury,” said Larson. She was one of the first patients to go through Parkwest Medical Center’s new Joint Center – The Retreat. This new program provides patients quicker recoveries and a shorter hospital stay. In an average of three days, total joint replacement patients participate in group therapy sessions and activities. Larson says, “Determination and exercise are essential. I’m so glad that I found this program. It has given me the opportunity to return to the things that I enjoy most.” At her total knee replacement follow up appointment, her physician, Dr. Hal Cates with Tennessee Othopaedic Clinics, encouraged her to return to The Retreat as a volunteer so she could motivate others during their hospital stay. During her professional career, Larson worked with children who were mentally impaired and handicapped which gave her a special understanding for others. Now, she enjoys helping total joint replacement patients begin their recovery to resume an active lifestyle like she did. Those who suffer from chronic hip or knee joint pain and/or arthritis may benefit from the Center. If you want to enjoy a quicker recovery in an atmosphere that treats you well each step of the way – you are an ideal candidate. To become a part of the Parkwest Joint Center – Retreat, you must be a patient of an orthopedic physician who has privileges with Parkwest Medical Center. For a listing of physicians visit either www.TreatedWell.com or call (865) 374-PARK

Saving Your Sight Passport offers program on Vision Loss You have looked forward to retirement. You finally have a chance pursue all those things you didn’t have time to do when you were working and raising children. It could all end with a diagnosis of age- related macular degeneration. Macular degeneration is a chronic disease of the eye that causes a blind spot in your central vision. It is the leading cause of blindness in people over 65. There are two forms of macular degeneration – wet and dry. The dry form is the most common affecting nearly ninety percent of those diagnosed with AMD. The wet form usually leads to more serious vision loss. The onset of AMD is usually slow and painless. Symptoms may include shadowy, fuzzy or slightly distorted central vision. Risk factors are higher for those with a family history of AMD, females and Caucasians. Incidence is greater for those that smoke, have high blood pressure, are overweight, or have lighter eye color. There is no cure for AMD but if diagnosis is made early, some treatments may slow the vision loss. Some studies also indicate that nutrients - zinc, lutein and vitamins A, C and E – help lower the risk for AMD or slow the progression of the dry form. If you want to learn more, join Bruce Gilliland, OD, as he discussion risk factors, symptoms and treatments on March 4 at the Frank Strang Senior Center. Reservations can be made by calling 541-4500.

Got a Few Minutes? For some of us, thinking we have to exercise 60 minutes every day sounds overwhelming and leaves us thinking “Why bother? I don’t have the time!” "The same goes for me." says Missy Kane often does “mini workouts” during the week. "I find that 20 minutes is better than zero minutes." New research is confirming the fact that shorter workout sessions do have benefits. In the a recent newsletter published by the Mayo Clinic talked about all that just 30 minutes of exercise can do for you. • Reduced chances of heart attack and stroke • Control existing diabetes and reduce chances of developing Type II Diabetes • Lower body fat • Increase flexibility and range of motion • Increase muscle mass and prevent injuries and falls • Increases bone mass with weight bearing exercises • Improves emotional health • Reduced chances of many types of cancer If you’ve just started exercising and even 30 minutes seems like too much, split the half hour up with 15 minutes of brisk walking in the morning and 15 minutes of household chores like mopping or sweeping. If you are really busy one day and maybe only get in a 15 minute walk around the block, just try to increase the next workout by a few minutes. Here’s another tip. Try to set aside one day per week or every other week when you build up to a much longer workout. Like for hikers, they may walk or do an exercise class 3-4 days per week then on the weekend go for a 5 mile hike. You can start by adding on a half mile or 10 minutes every other weekend until you can handle an hour to two of hiking, biking etc. This for many is the key to keeping down their weight and maintaining good stamina. So even if you can’t get in that hour workout class today, walk the dog for 20-30 minutes and you are still benefiting your health. Try new activities like 50Plus Fitness classes, or watch my 30-minute “Fit and Fun w/ Missy Kane” exercise show weekdays at 7 a.m. on ETPtv. Learn more at covenanthealth.com or by calling (865) 541-4500. A journey of a thousand miles begins with a single step. - Confucius

New Year News from 50+ Fitness: Our bodies love fat! Those holiday pounds will not come off on their on. Now is the time to get moving with the best deal in town: 50+ fitness classes. The classes are convenient, affordable, and efficient ways to burn those Holiday pounds! We pledge to follow the most current science to provide both a safe and effective workout for middle aged and beyond. If you have never tried a class, now is the time! Go to www.covenanthealth.com and click on the 50+ logo to find the nearest location to you. Classes are $2/class for Passport members and Covenant Health employees. All others pay $3/class. Beginning in 2009, 50+Fitness will have a new name 2009: Body Works 50+. Covenant Health will deliver a community fitness program for all ages. The overall program will be called Covenant Body Works. Under this program, 50+ will continue stronger than ever as well as offering non-age specific classes such as “Body Works after work” and “Body Works at work”. Over the years, we have received increasing requests to offer our community classes in the evenings and at worksites. We hope to reach more of the community by this expansion as well as serve the needs of seniors. Seniors will pay the Passport price at any classes we offer under Body Works, not just the 50+ classes! So, as 2009 marches on, you can keep pace with Covenant Body Works.

Arthritis Advice by Christopher Norris, Pharm. D., Fort Sanders Regional Medical Center The word arthritis means joint inflammation, but is often used to describe the more than 100 diseases that cause joint pain, stiffness, and swelling. More than 40 million Americans have some form of arthritis, with most suffering from either osteoarthritis or rheumatoid arthritis. Osteoarthritis is the most common form and usually comes with age as the cartilage covering the end of the bones gradually wears away. Without the protection of cartilage, the bones begin to rub against each other and the resulting friction leads to pain and swelling. It most often affects the hands, knees, and hips. Rheumatoid arthritis can occur at any age when the body’s own defense system doesn’t work properly and mistakenly attacks itself. It affects joints and bones, usually of the hands, wrists, and knees, and may also affect internal organs. Rheumatoid arthritis can make those affected feel sick or tired and may cause fever. You might have some form of arthritis if you have lasting joint pain, joint swelling, joint stiffness, tenderness or pain when touching a joint, problems using or moving a joint normally, or warmth and redness in a joint. If any of these symptoms lasts longer than two weeks, see your doctor. Each kind of arthritis is treated a little differently, but there are some common treatment choices. Weight control and injury protection measures can lower a person’s risk for developing arthritis. Physical activity has been shown to have significant benefits for people with arthritis, including reductions in pain and improvements in physical function, mental health, and quality of life. Eating a healthy, well-balanced diet can help strengthen bones and muscles. Medications can help control arthritis pain. Because people with osteoarthritis have very little inflammation, pain relievers such as acetaminophen (Tylenol) may be effective. Patients with rheumatoid arthritis generally have pain caused by inflammation and often benefit from nonsteroidal anti-inflammatory drugs (NSAIDs) such as over-the-counter ibuprofen, naproxen, and others. Some NSAIDs are also available by prescription. Talk with your doctor about if and how you should use acetaminophen or NSAIDs for your arthritis pain. Corticosteroids are very effective in treating arthritis and can be taken by mouth or given by injection. Prednisone is the corticosteroid that is most commonly given by mouth to decrease the inflammation of rheumatoid arthritis. In both osteoarthritis and rheumatoid arthritis, a corticosteroid may be injected into the affected joint to stop the pain. Because frequent injections may cause damage to cartilage, they should be done only once or twice a year. There’s continued debate about whether glucosamine and chondroitin are effective at repairing cartilage and treating osteoarthritis. In September 2008, the Glucosamine/Chondroitin Arthritis Intervention Trial, funded by the National Institutes of Health, found that the drugs weren’t very effective in treating knee arthritis. However, experts argue that the trial was flawed because it studied glucosamine hydrochloride, a relatively ineffective form of glucosamine. Glucosamine sulfate appears to work better than the hydrochloride form and has been shown to be beneficial in the past. Regardless of the arguments over effectiveness, glucosamine sulfate, with or without chondroitin (some believe that glucosamine works better without chondroitin) is safe enough to try. If you don’t see any improvement after two or three months (your pain may not be due to damaged cartilage), stop the drug(s) and save the money. Additional medications for rheumatoid arthritis Disease-modifying anti-rheumatic drugs (DMARDs) are used to treat people with rheumatoid arthritis who have not responded to NSAIDs. DMARDs such as methotrexate, hydroxychloroquine, penicillamine, and gold injections are thought to correct abnormalities of the immune system. Treatment with these medications requires careful monitoring by a doctor to avoid side effects. Biologic response modifiers are injectable drugs used to block the complex cascade of cellular events that lead to inflammation in rheumatoid arthritis. They may be added to other rheumatoid arthritis treatments following an inadequate response to DMARD therapy. These medications also require careful monitoring for serious side effects and are very expensive. They include adalimumab (Humira), etanercept (Enbrel), infliximab (Remicade), anakinra (Kineret), rituximab (Rituxan), and abatacept (Orencia).

Spring Allergies It’s that time of year again, the grass will be growing, the flowers blooming, and many of us find ourselves suffering from runny noses and itchy, watery eyes. Sound familiar? If so, join Bryan Tigner, MD, at Parkwest Presents at the Strang Senior Center on Wednesday, March 25 at noon to learn more about spring allergy symptoms and the different treatment options available. Attendance is $5.00, and complimentary boxed lunches will be available to all attendees who RSVP by March 20. Call 374-PARK to reserve your spot today!

Sage Advice    Rachel Peterson, Program Director at the Peninsula Senior Day Hospital My mother has been to every doctor in town for her numerous physical health complaints. The doctors have been unable to find anything physically wrong with her and are telling us her complaints are caused from anxiety. She has been diagnosed with panic disorder and we don’t really understand what that means. Could you help? Sincerely, Clueless Son Dear Clueless, Panic attacks are a rather common form of anxiety but can be very debilitating when left untreated. A panic attack is defined by the DSM -IV-TR as a “discrete period in which there is the sudden onset of intense apprehension, fearfulness, or terror, often associated with feelings of impending doom”. Common physical symptoms experienced during a panic attack are: shortness of breath, pounding heart, accelerated heart rate, sweating, trembling, nausea, abdominal distress, numbness or tingling sensation, chills or hot flashes, chest pain or discomfort, choking or smothering sensation, and fear of “going crazy” or losing control. A common response is to flee the situation, seek medical help or be fearful to be left alone. A panic attack exhibits all the symptoms of the body’s normal reaction to fear but it is happening with no external trigger. The body’s normal fear reaction has become oversensitive and has become easily triggered. One of my clients explained a panic attack this way, “it is as if you were lying in bed at night and heard someone breaking into your home you would be terrified, want to flee to situation, your heart would race, and you would sweat and shake. A panic attack is just like the reaction you would have to a terribly fearful event but there is no event present.” Often times individuals are reluctant to believe a diagnosis of panic disorder because they feel that a doctor is telling them these symptoms they are experiencing are “all in their head” and that they should be able to control them. Individuals who experience panic attacks are often reluctant to get the treatment they need to overcome the attacks. If left untreated panic disorder can lead to agoraphobia. goraphobia is the fear of leaving ones home due to anticipatory panic (the fear of having another panic attack). Panic attacks can be controlled with medication and/or therapy. Research shows that the highest success rate for treatment is a combination of medication and therapy. There are a wide variety of medications that are helpful. I would suggest that you request a non-addictive medication. Therapist can teach individuals to recognize their symptoms as a panic attacks and not a life threatening problem. Individuals are taught with therapy to restructure their thought process decrease length and intensity of panic attacks. Relaxation therapy is also very helpful for individuals with panic attacks. Panic attacks do subside and are not life threatening but they can feel very miserable for the person having them and can be very exhausting for family and friends who are trying to help. If you of someone you love are struggling with panic attacks please contact the Senior Day Hospital for helpful advice. Sage Advice features straight-talk from experts about issues of concern to seniors and their loved ones. Please feel free to call me, Rachel Peterson, program director at the Peninsula Senior Day Hospital at (865) 374-7158 to schedule a free, confidential assessment.

Emergency Room Visit Every year millions of people find themselves in an emergency room. Most of these people hadn’t planned to go – but they can be prepared. Planning ahead can reduce stress and save valuable time. The following items can help your visit to the ER go smoother: A list of contacts and phone numbers – your primary care doctor and specialists, family members, neighbors Any medical records that clarify your medical condition(s) A list of your medications and doses, this includes any over the counter medications, vitamins and herbals supplements A record of any known allergies Health insurance cards – Medicare, HMO, supplements Legal documents such as living will, health care proxy, power of attorney. Keep these documents in an easy to find place so that you, a family member or emergency medical technician can locate them. On Feb. 18, Roger Brooksbank, MD, will share more information on preparing for an ER visit, including when to go, and whether you should drive or call 9-1-1. You can register by calling 483-1318.

Calendar of Events January 6 is Cuddle Up Day. Hugs lower blood pressure and ward off depression. Jan. 6, 1 – 3 p.m. Stroke Risk Assessment South Knoxville Senior Center Jan. 7, Noon Crisis Intervention Skills for the Alzheimer’s Patient Lunch & Learn Sabrina Trollinger RNC, BSN, TCI Frank Strang Senior Center Jan. 13, 9 a.m. “Re-vamp Your Exercise” Routine Breakfast Club Karen Milligan Knoxville Center Mall Jan. 15, 9 a.m. “Re-vamp Your Exercise” Routine Breakfast Club Karen Milligan West Town Mall Jan. 20, Noon New Treatment for Atrial Fibrillation Lunch & Learn William Hall, MD Oak Ridge Senior Center Jan. 21, Noon Alzheimers and Dementia Jill Baker First Presbyterian Church, Oak Ridge Call 483-1318 for information on program and the Virtual Dementia Tour Jan. 21, Noon Stressed Out? Using Food for Comfort? Improve your Health while Coping with Cravings! Lunch & Learn Covenant Weight Loss Management Staff Frank Strang Senior Center Jan. 23, 9 a.m. – Noon Covenant Senior Health & Wellness Fair Loudon County Senior Center Call for a list of screenings. Jan. 26, 8 a.m. – 3:30 p.m. Intro to Excel Covenant Health Learning and Leadership Development $30 for registration and materials February 3 is Take a Cruise Day. Check out MoeFaye’s travel schedule for 2009. Feb. 2 & 3, 9 a.m. – 1 p.m. AARP Driver Safety Training Cedar Springs Presbyterian Church $10 for registration and materials February 6, 9am -Noon Go Red Free Cholesterol, Blood Pressure and BMI Screenings at the Knoxille Center and West Town Covenant Health at the Mall kiosks Feb. 10, 9 a.m. “Love Your Heart” Breakfast Club David Wood, MD Knoxville Center Mall Feb. 12, 9 a.m. “Love Your Heart” Routine Breakfast Club Jaan Anne Kelly, PA West Town Mall Feb. 18, Noon Emergency Care Roger Brooksbank, MD First Presbyterian Church, Oak Ridge Call 483-1318 Feb. 22, 11:30 a.m. Hoopla 2009! Women’s Basketball Hall of Fame & Lady Vols vs. Lady Bulldogs $26 all inclusive ticket Heart Score and More Screening Tuesdays and Thursdays in February by appointment Fort Sanders Sevier Medical Center $125.00 Call 453-WELL for an appointment March 3 is Open Wide Day. Schedule a check up with your dentist. March 2, Noon Marvelous After Menopause Lunch & Learn Holly Noonan Talley, MD South Knoxville Senior Center March 3, 8:30 a.m. – 12:30 p.m. Confidence & Assertiveness Skills for Women Barbara Edwards $30 for registration March 4, Noon Updates on Macular Degeneration Lunch & Learn Bruce Gilliland, OD Frank Strang Senior Center March 10, 9 a.m. Nutrition Breakfast Club Knoxville Centre Mall Kayla Matrunick, MD, RD March 12, 9 a.m. Nutrition Breakfast Club West Town Mall Kayla Matrunick, MS, RD March 18, Noon Surviving the Loss of a Loved One Steve Herbes First Presbyterian Church, Oak Ridge Call 483-1318 for information March 20, 8 a.m. – Noon Covenant Health Check Fort Sanders Sevier Senior Center Stroke Score and More Screening March 18 & 25 by appointment Fort Sanders Sevier Medical Center $100 Call 453-WELL for an appointment For Information or registration for any of these programs, call 541-4500 unless otherwise indicated. All Lunch & Learns are $5 to attend and include a boxed lunch.

Healthy Living Delicious Crab Chowder: by Brett Johnson Director of Food & Nutrition Ft. Sanders Sevier Medical Center Ingredients: 2 tablespoons extra-virgin olive oil 1 cup finely diced onion 1 cup finely diced cored fennel bulb (can substitute celery here if desired) 2 tablespoons minced garlic 2 teaspoons Italian seasoning blend 1/8 teaspoon salt ½ teaspoon ground pepper 1 14-ounce can reduced-sodium chicken broth or vegetable broth 1 ½ cups water 2 cups precooked diced potatoes 2 cups canned crushed tomatoes 1 pound pasteurized crabmeat, drain if necessary Instructions: 1. Heat oil in a large saucepan over medium heat. Add onion, diced fennel, garlic, Italian seasoning, salt and pepper and cook, stirring often, until the vegetables are just starting to brown, 6 to 8 minutes. 2. Add broth, water and potatoes; bring to a boil. Reduce heat to a simmer and cook until the vegetables are tender, 3 to 5 minutes. Stir in tomatoes and crabmeat. Return to a boil, stirring often; immediately remove from heat. Nutrition information: Per serving: 210 calories 5 g fat (1g salt, 4g mono); 88 mg cholesterol; 21 g carbohydrate; 19 g protein; 3 g fiber; 515 mg potassium Nutrition bonus: Iron (35% daily value), Vitamin C (30% daily value), Calcium (15% daily value) 1 ½ carbohydrate servings Exchanges: 1 starch, 1 vegetable, 2 very lean meat, 1 fat Makes 6 servings, about 1 ½ Cups each

The Breakfast Club New health education series begins in 2009 If your New Year’s Resolution includes taking better care of your health, Covenant Health has just the opportunity for you. We will offer cover topics from exercise to heart health and nutrition at our Knoxville Center and West Town Mall kiosks. Coffee and a light breakfast provided by Chick-Fil-A and Passport. Tuesday, January 13 at the Knoxville Center Mall kiosk and Thursday, January 15 at the West Town Mall kiosk: Start the New Year with a New You. Learn safe & effective ways to shed those holiday pounds and update your exercise routine from Karen Milligan, the director of 50 Plus Fitness. Tuesday, February 10 at the Knoxville Center Mall Classroom and Thursday, February 12 at the West Town Mall kiosk: The newest information on heart disease and prevention by David Wood, MD and Jaan Anne Kelly, PA. Tuesday, March 10 at the Knoxville Center Mall kiosk and Thursday, March 12 at the West town Mall kiosk: Kayla Matrunick, RD, Fort Sanders Health and Fitness Center, will be speaking on the importance of good nutrition morning, noon and night. All programs begin at 9 a.m. For more information, please visit us at www.covenanthealth.com or call 541-4500.

On the Cutting Edge - Clinton Athletic Director Has Big Win Against Severe Wound With a successful high school football season behind him and a basketball season on the horizon, Clinton High School athletic director Jim Davis, 59, is ready for the challenge. He would not have been a few months ago. Davis has diabetes, which puts him at higher risk than other people for developing non-healing wounds. He had elective surgery to remove a cyst from his right ankle in December 2007. By early January, complications had developed in the form of a diabetic ulcer at the incision site. "My wound was open to the bone," he explained. "The worst case scenario was that I could lose my leg." His surgeon referred him to the MMC Wound Treatment Center, which is a service of Methodist Medical Center in Oak Ridge. The wound center is the most experienced provider of hyperbaric oxygen treatment in this area, and it made all the difference for Davis. During hyperbaric treatment, patients rest in a special chamber and breathe pure, pressurized oxygen. Pressurizing the oxygen enables them to dissolve more oxygen in their red blood cells and plasma. The oxygen circulates throughout the body, reaching tissues that are not receiving enough oxygen under normal circumstances. This action promotes angiogenesis, the formation of new blood vessels. "You get into the chamber; watch television or take a nap; and breathe the oxygen for about 90 minutes," Davis explained. "It feels normal even though the oxygen is pressurized. It’s called a ‘dive’." Davis had 39 treatments over eight weeks. Dr. David Stanley, medical director of the MMC Wound Treatment Center, was Davis’s primary wound care doctor. "There are several reasons wounds will not heal, including diabetes and peripheral artery disease," said Dr Stanley. "People with these conditions have poor blood circulation that deprives cells of the oxygen and nutrients they need. "The tissue may become infected, the infection may spread to the muscles and bones in the foot, and the tissue may eventually die. These wounds can be extremely painful and can rob you of your independence," Stanley noted. Davis also received several traditional wound treatments including debridement to remove dead tissue, antibiotics, removal of the dressing and cleaning of the wound every day, and constant monitoring. "It was mind-boggling how my foot ulcer healed," he said. "The wound center is a remarkable organization. The treatment and the people were fantastic." Because of hyperbaric treatment, Davis has been able to keep up with the 15 sports teams he oversees as athletic director, play a major role in the recent renovation of his school’s football stadium, and play with his two-year-old grandson. "I’ve lived in this area all of my life, and it’s amazing the technology we have in this valley." He said. "The wound has closed, and I’m working now to rebuild the muscles." The timing could not be better!