Category: Health

Meet Joan Packet at 94

She works on her health and fitness every day with Diane Cadinha.

Our friend Joanie Packer says she doesn’t worry about things she can’t do anything about — so she lives in the present, works at being as healthy as possible and tries to show appreciation to those around her.

At 94, how is your life different than when you first retired?

(left) Joan Packer at 49 yrs. and (right) at 94 yrs.

Joan: Back in Missouri, I used to rise at six a.m., spend my days teaching high school English and dream about a life of leisure when I could sleep late. But when I did retire, I was bored and depressed. In my 70s I moved from my farm to a condo in Waikiki. When I saw how physically fit and healthy everyone looked walking around Kapiolani park, I decided I wanted to be like that, too. Now, 28 years later, I exercise six days a week and I’m no longer bored and depressed.

Six days a week sounds like a lot. What kind of exercise classes are you taking?

Joan: It didn’t happen overnight. At age 77, I started an exercise plan. We began with tubing and light weights, and worked up to the stability ball and balance work to prevent falls. Strength training keeps my muscle mass and bone density, so I don’t get frail and weak. The better I feel, the more I want to try other classes like Pilates and Yoga. In class we all encourage each other.

Believe me, I am inherently lazy and do not really relish working out. So going to classes and having a trainer to ride herd on me and hold me accountable is important. I figure my health and independence are worth the effort.

What else you do to stay fit?

Joan: I think walking is really important. On the days I don’t walk to class, I walk around the park, the zoo and sometimes up Diamond Head Road. That 40- to 60-minute trek never fails to make me feel better than when I started out. Socializing is also healthy and fun. Two days a week, my group does tai chi in Kapiolani Park.

Besides exercise — do you have any other recommendations?

Joan: Food! I gave up my starchy Midwestern farm fare for fruits, vegetables, fish and poultry, soups and lentils. Now I crave healthy foods. I also recommend a positive mental outlook — that makes life fulfilling at any age.

Shaping Up Fitness Studios
Mililani and Downtown: 250 Ward Ave., Suite 206
808-221-3905 | shapingup@hawaii.rr.com
www.shapingup808.com

Our friend Joanie Packer says she doesn’t worry about things she can’t do anything about — so she lives in the present, works at being as healthy as possible and tries to show appreciation to those around her. At 94, how is your life different than when you first retired? Joan: Back in Missouri, I…
Metal-Free Biocompatible Restorations
Conservative Restoration

Dental toxicity can occur when materials placed in a patient’s mouth cause that person’s immune system to react and “reject” the restoration. Serum compatibility testing provides dentists with one way to help determine which materials will react in a test tube with a patient’s serum proteins. Today’s dental patients have the opportunity to select:

Highly aesthetic, tooth-colored fillings — created and placed during a single dental appointment, with no temporary crown.

Metal-free, bio-compatible materials for restorations that will not cause an allergic reaction with the body.

CEREC Restoration

The CEREC procedure was developed at Zurich University 25 years ago. The CEREC system uses restorative material and the conservative removal of dental enamel to restore the diseased tooth.

In the past crowns were made for teeth requiring removal of a lot of tooth structure. With the new materials, the dentist can preserve precious tooth enamel and effectively restore the tooth. Enamel is the only tissue in the body that once removed, will not regenerate.

Hawaii Center for Cosmetic & Laser Dentistry
808-526-0670 | www.smilepower.net
Dental toxicity can occur when materials placed in a patient’s mouth cause that person’s immune system to react and “reject” the restoration. Serum compatibility testing provides dentists with one way to help determine which materials will react in a test tube with a patient’s serum proteins. Today’s dental patients have the opportunity to select: Highly…
Total Knee Rehab and Recovery

The knee is the most often replaced joint in the body. Usually, total knee replacement (TKR) surgery is performed when people have knee damage and pain caused by osteoarthritis, rheumatoid arthritis or alignment problems in the leg that make walking or performing daily activities difficult. Successful recovery requires a considerable investment of time and energy in rehabilitation following surgery. A strict timetable of exercise, rest and medication is crucial to heal muscles and tendons. Your physical therapist can speed up your return to normal activity and help make your new knee better than the old one! A rehab program tailored to your specific needs may include land or aquatic range of-motion and muscle-strengthening exercises, activity-specific training, and body awareness with balance training. You may also receive manual therapy and pain modalities to minimize swelling, as well as a custom home exercise program. Prepare for surgery by losing weight. Staying active, even beyond your home exercise program, will help hasten your recovery — but activities should never be done to the point where they cause more pain. Follow your physical therapist’s instructions and take care to protect your new knee and your general health. These are ways you can contribute to the success of your total knee replacement.

Moon Physical Therapy,
320 Ward Avenue, Suite 107, Honolulu, HI 9681
Aquatic, Land-based and Manual Therapy and
Cardiopulmonary Rehab Programs
808-597-1005 | Moon Physical Therapy, www.moonpt.com

The knee is the most often replaced joint in the body. Usually, total knee replacement (TKR) surgery is performed when people have knee damage and pain caused by osteoarthritis, rheumatoid arthritis or alignment problems in the leg that make walking or performing daily activities difficult. Successful recovery requires a considerable investment of time and energy…
Smile! Rejuvenate Your Life!
Before

Nothing can start your day off better than seeing a beautiful, genuine smile in your mirror. Have you ever thought, “I don’t like my smile?” With today’s dental advancements you can significantly improve your smile.

You may consider smile rejuvenation if you have any of the following:

crooked teeth

missing teeth

misaligned teeth

stained teeth

gapped teeth

uneven length teeth

gums that are too noticeable

After

There are many ways to make your teeth straight, fill in gaps and improve their overall appearance. Orthodontics such as clear aligner therapy align teeth for health, function and beauty. Porcelain veneers can help to enhance your smile. You may have a tooth missing — a dental implant topped with a crown, may resolve that problem.

A person with a malocclusion or “bad bite,” prematurely wears down the teeth. Severe wear collapses the space between the chin and nose, creating a very aged facial appearance. Correcting the bite gives the patient an “instant face-lift”.

Whether you want to change the shape, color or alignment of your teeth, consult a dentist who specializes in smile rejuvenation to discuss the best option for you.
Nothing can start your day off better than seeing a beautiful, genuine smile in your mirror. Have you ever thought, “I don’t like my smile?” With today’s dental advancements you can significantly improve your smile. You may consider smile rejuvenation if you have any of the following: crooked teeth missing teeth misaligned teeth stained teeth…
High Intensity Training for Arthritic Relief

According to the U.S. Centers for Disease Control and Prevention, approximately 33 percent of adults 65 and older suffer from osteoarthritis (OA). Mayo Clinic reports that OA is the most common form of arthritis, when protective cartilage wears down, creating “wear-and- tear” pain, discomfort and fatigue.

Aquatic therapy is an effective treatment for OA, giving patients improved mobility, reduced pain and greater flexibility. You might think exercise at a high intensity level would exacerbate the pain. Not so. A recent groundbreaking study published in The Journal of Strength and Conditioning Research, demonstrated the benefits of high-intensity interval training (HIIT) on an underwater treadmill. For six weeks, subjects with OA walked in water, against alternating high and low resistance. Training resulted in significantly less joint pain, improved balance, better mobility. Walking speed was nearly as fast as control subjects without arthritis. Aquatic exercise gave benefits and relief that individuals with OA would not be able to achieve on land.

A growing body of clinical research proves aquatic therapy for osteoarthritis may be more effective than alternative land-based exercise.

Moon Physical Therapy, LLC
320 Ward Avenue, Ste. 107, Honolulu, HI 96814
Aquatic, Land-based and Manual Therapy and
Cardiopulmonary Rehab Programs
808-597-1005 | www.moonpt.com

According to the U.S. Centers for Disease Control and Prevention, approximately 33 percent of adults 65 and older suffer from osteoarthritis (OA). Mayo Clinic reports that OA is the most common form of arthritis, when protective cartilage wears down, creating “wear-and- tear” pain, discomfort and fatigue. Aquatic therapy is an effective treatment for OA, giving…
Round ‘em Up!

O’ahu Seniors rehearse for an exhibition dance.

Line Dancing — it’s not just country, or confined to local Honky Tonk. Heck! Seniors are line dancing to all their favorite tunes!

A number of studies extoll the benefits of line dancing for seniors: low impact exercise that can improve cardio-vascular health, muscle tone and strength is one. I just learned that it also lowers risk of osteoporosis!

Dancing also exercises our minds. Learning new dance steps, patterns and musical rhythms keep our brains and attention sharp — to ward off dementia. It also provides essential social benefits: meeting new people, sharing common interests. We see dancing seniors building new confidence and self-expression. Line dancing is a wonder drug for seniors! And FUN!

West Maui Seniors have fun at Kaunoa Center.

On O‘ahu, Palama Settlement offers a variety of line dance programs for the first-timers and intermediate level dancers. Kick up your heels with us at Ward Warehouse on Tuesday nights. Many County Department of Parks and Recreation senior clubs have open classes. Our annual Senior Line Dance Round-up is O‘ahu June 4 and 5.

For more information about the Senior Line Dance Round-up or line dance classes and programs on all islands, call 808-228-0390 on O‘ahu, or email AlohaLinedancer@outlook.com.

The counties of Honolulu and Maui present
THE ANNUAL SENIOR LINE DANCE ROUND-UP
hosted by the West Oahu Line Dancers and
the Aloha Line Dancers Association
June 4–5, 2015
Ala Wai Golf Course Clubhouse, Waikiki
2 days of workshops, dancing and exhibitions.
Costs only $5 per person.

Line Dancing — it’s not just country, or confined to local Honky Tonk. Heck! Seniors are line dancing to all their favorite tunes! A number of studies extoll the benefits of line dancing for seniors: low impact exercise that can improve cardio-vascular health, muscle tone and strength is one. I just learned that it also…
Hiking for Health, or Just For Pure Joy

Hiking is a great activity for seniors! I’m 72 and really enjoy it. Several of my fellow hikers are in their upper 70’s and are still going strong. One, at 83, still hikes five miles on the beach several times a week.

Some people hike mainly for exercise and walk vigorously hoping to work up a good sweat. Others prefer a more leisurely pace and stop often to take pictures, enjoying their commune with nature. While you can see much from your car as you drive along the highways, you can only see the finer details of nature while walking. And there are many sights not available from your car, such as hidden waterfalls, moss covered trees, and the colorful hills in the center of Haleakala Crater.

You can choose from a wide variety of hikes ranging from easy to difficult. On the easy end of the scale are simple beach walks or strolls along scenic country roads. My favorite Maui hike, moderately strenuous, is the Pipiwai Trail within Haleakala National Park. It has a wonderful stretch of bamboo forest with three-inch thick stalks, 50 feet high. The 11 mile Haleakala Crater hike may be difficult, but well worth the effort. Scenery within the crater is wonderful and truly otherworldly. While 20-somethings may do this hike in four hours, I myself plan on at least eight hours.

Bob Chang, Bev Brill, Ginny Kiick and Diana Douglas of Mauna Ala Hiking Club take a welcome rest in Haleakala Crater.

There are several books that list hikes in Hawai‘i, but it is even better to find local groups to hike with that can provide guidance and companionship.

You can join meetup.com on the internet to find hiking groups in your area. Sierra Club, www.sierraclubhawaii.com/groups.php, leads hikes on all four main islands. Contact the hike leader to make sure the hike is right for you.

Never hike alone on isolated trails; if you slip and injure yourself, you could be in serious trouble. Wear proper shoes and clothing, hat and sunscreen. Bring a snack and lots of water. While cell phones won’t work in some areas, they can help you out of trouble in others.

Hiking is a great activity for seniors! I’m 72 and really enjoy it. Several of my fellow hikers are in their upper 70’s and are still going strong. One, at 83, still hikes five miles on the beach several times a week. Some people hike mainly for exercise and walk vigorously hoping to work up…
Constipation in Seniors
Constipation affects approximately 2 percent of the population in the US; the elderly are more commonly affected. Constipation refers to bowel movements that are infrequent or hard to pass. According to the National Institutes of Health (NIH), constipation is defined as having a bowel movement less than 3 times a week.

Laxatives can help relieve constipation. Overuse of certain laxatives can lead to dependency and decreased bowel function. In general bulkforming laxatives, also referred to as fiber supplements, are the gentlest on the body and safest to use long term. However, seniors must remember to drink adequate amounts of water when taking fiber supplements like Metamucil.

Seniors need to call their physicians immediately if they have sudden constipation with abdominal cramps and are unable to pass gas. It is important to seek help if seniors have blood in the stools, constipation lasting more than 2 weeks, require use of laxatives for several weeks, experience rectal pain, unexplained weight loss, or severe abdominal pain–these may be signs of a serious underlying medical condition.

What causes constipation?

Not drinking enough liquids

Low-fiber diet

Lack of physical activity

Ignoring the urge to have a bowel movement

Stress

Travel

Medical conditions — affecting the gastrointestinal, endocrine, or nervous system

Medications — iron or calcium supplements, narcotics, antidepressants, anticonvulsants, and certain medications to lower blood pressure.

Which tests may help diagnose the cause of constipation?

Based on history and physical examination, a physician may order some of the following tests:

Blood tests including a complete blood count and basic metabolic profile

Colonoscopy

Proctosigmoidoscopy

Barium enema

Stool studies

X-rays of the abdomen

Anorectal manometry (pressure measurements of the anus and rectum)

What are the complications of chronic constipation?

Hemorrhoids

Anal fissures

Fecal impaction

Bowel obstruction

Rectal prolapse

How can seniors prevent constipation?

Drink at least 8 glasses of water each day

Eat lots of fiber

Exercise regularly

Do not ignore the urge to use the restroom

Eat foods that promote bowel movement: prunes, apples, papaya, banana and cabbage
Constipation affects approximately 2 percent of the population in the US; the elderly are more commonly affected. Constipation refers to bowel movements that are infrequent or hard to pass. According to the National Institutes of Health (NIH), constipation is defined as having a bowel movement less than 3 times a week. Laxatives can help relieve…
Know Your Numbers

You may have seen a report late last year explaining that Hawai‘i was the healthiest state in the nation. While good health is certainly good news, the story involved a summary of limited information, and did not reflect the current state of kidney disease in America.

Unfortunately, incidence of the disease has more than doubled in the past decade and is projected to double again in the next 10 years. Here in Hawai‘i, the incidence of kidney disease is approximately 30 percent higher than the national average: 1 in 7 people have the disease — often without realizing it during the early stages.

Chances are, unless you are already diagnosed with kidney disease, you do not “know your numbers” for healthy kidneys. Results from a simple blood test and urine analysis requested by your doctor will help you know if your numbers are good. One way to know your kidneys are healthy is to “know your numbers”— so ask your doctor. If you haven’t seen your doctor for a while, now is a good time to get a checkup. Ask your doctor about your glomerular filtration rate (GFR). Your GFR number tells you how much kidney function you have. As kidney disease worsens, kidney function declines and the GFR number decreases. Early detection can allow you to slow down or even stop the disease from worsening, by changing your lifestyle and following your doctor’s advice.

Help us reverse the trends associated with kidney disease by helping yourself. “Know your numbers.”

National Kidney Foundation of Hawaii
808-589-5976 | jeff@kidneyhi.org
For Planned Giving: www.kidneyhawaii.org
Main: www.kidneyhi.org | www.kidney.org

You may have seen a report late last year explaining that Hawai‘i was the healthiest state in the nation. While good health is certainly good news, the story involved a summary of limited information, and did not reflect the current state of kidney disease in America. Unfortunately, incidence of the disease has more than doubled…
All-On-4: The Modern Solution
Many patients today with missing teeth have opted for the All-on-4 treatment as a viable solution to permanently replace missing teeth.

All-on-4 dental implants offer you many important advantages:

A cost effective solution. Your new replacement teeth require only four implants for each jaw. Reducing the number of implants means lowering the cost of tooth replacement.
Reduced need for bone grafting. The special tilting of two of the implants ensures a secure and stable anchorage for the replaced arch, typically making bone grafting unnecessary.

Faster treatment and healing time. Your replacement arch can be attached to your implants immediately. There is no need to wait for healing time between surgery and tooth replacement. Prosthesis options. You can choose fixed (one with highest durability and chewing function, but cannot be removed) or removable (one you can remove for easy cleaning).

Scientifically proven and documented. All-on-4 is supported by good clinical outcomes in studies where four implants were proven to support a full replacement arch.
If you feel that your dentures make chewing difficult and prevent you from enjoying the foods you love, you may want to explore the possibility of implants — in particular, an All-on-4, option.

Hawaii Center for Cosmetic & Laser Dentistry
808-526-0670 | www.smilepower.net
Many patients today with missing teeth have opted for the All-on-4 treatment as a viable solution to permanently replace missing teeth. All-on-4 dental implants offer you many important advantages: A cost effective solution. Your new replacement teeth require only four implants for each jaw. Reducing the number of implants means lowering the cost of tooth…
Hospice and Palliative Care
Dame Cicely Saunders (founder of the first modern hospice in London in 1968) summed up the hospice philosophy best when she told her patients:“You matter to the last moment of your life, and we will do all we can, not only to help you die peacefully, but to live until you die.” Hospice care is a model for quality compassionate care for people facing a life-limiting illness. It is a team approach to expert medical care, pain management, and emotional and spiritual support tailored to the patient’s needs and wishes.

Who is eligible for hospice care?

When the goal of treatment begins to shift from cure to providing comfort, it may be time to consider hospice for persons facing terminal cancer: end-stage heart, lung, kidney or liver disease; severe dementia; severe Parkinson’s disease; or stroke. A physician must certify that the person is in the last stages of a terminal illness.

Where is hospice care provided?

Most hospice care is provided in a person’s own home. Hospitals, nursing homes, assisted living, care or foster homes are other possible settings.

What services are covered under hospice care?

Nursing: pain and symptom management

Personal care/home health aide

Social services

Spiritual counseling

Volunteers

Respite care

Bereavement support

Who pays for hospice?

Medicare, Medicaid and all medical insurances offer hospice benefit. Durable medical equipment and medications related to the terminal diagnosis are covered. Little or no co-payment is required.

What is palliative care?

According to the World Health Organization (WHO), palliative care is an approach that improves the quality of life of patients and their families facing the problem associated with life-threatening illness, through the prevention and relief of suffering by means of early identification and assessment and treatment of pain and other problems, physical, psychosocial and spiritual.

How is hospice different from palliative care?

Palliative care is specialized care for persons with life-threatening illness, regardless of life expectancy. Hospice is a type of palliative care that occurs at the very end of a person’s life.

What is supportive or concurrent care?

“Supportive” or “concurrent” care is a type of palliative care that encompasses all the extra care provided in addition to regular medical care by a full team of physicians, nurses, social workers, chaplains, and aides who specialize in caring for people facing serious illness. This means that somebody with a serious illness can have all the benefits of comfort care and still receive life prolonging treatments.

Who pays for Supportive or Concurrent Care?

Hawaii Medical Service Association (HSMA) offers supportive care services for homebound members who have advanced cancer, advanced heart failure or emphysema. University Health Alliance (UHA) offers concurrent care services to persons with any serious illness. HSMA and UHA have partnered with local hospices to offer this innovative program.
Dame Cicely Saunders (founder of the first modern hospice in London in 1968) summed up the hospice philosophy best when she told her patients:“You matter to the last moment of your life, and we will do all we can, not only to help you die peacefully, but to live until you die.” Hospice care is…
The Hawai’i Neurotrauma Registry

We’ve had lots of positive feedback on our first article about the Hawai‘i Neurotrauma Registry. In the last two years, we’ve given out information on neurotrauma injuries (stroke, traumatic brain injury, spinal cord injury) at 60 events and presentations to approximately 6,500 people.

There is a lot of information on patients with stroke, spinal cord injury or traumatic brain injury while they are in the hospital or rehabilitation facility.But what happens once they get home? What problems are they having? What kind of help do they need?

The Hawai‘i Neurotrauma Registry wants to know so the Hawai‘i Department of Health, Developmental Disabilities Division can make appropriate plans and policies.

We currently have 81 individuals with neurotrauma injuries who have registered. They took more people — especially from the Neighbor Islands — and younger people. The registry is voluntary and open to any resident of Hawai‘i, any age, who has had a neurotrauma injury at any point in his or her lifetime.

You can fill out the confidential survey online at www.svy.mk/1qybSHZ.Call us (there’s a tollfree number for Neighbor Islands) to receive a copy by mail or to schedule assistance completing the survey. Email us with any questions, as well. With your help, the registry will be a success. Mahalo.

University of Hawaii at Manoa
John A. Burns School of Medicine, Pacific Basin RRTC
677 Ala Moana, Suite 202, Honolulu, HI 96813
808-692-1375/1372 | 1-866-447-9023
HawaiiNT@hawaii.edu

We’ve had lots of positive feedback on our first article about the Hawai‘i Neurotrauma Registry. In the last two years, we’ve given out information on neurotrauma injuries (stroke, traumatic brain injury, spinal cord injury) at 60 events and presentations to approximately 6,500 people. There is a lot of information on patients with stroke, spinal cord…

Category: Health

What causes constipation?

Which tests may help diagnose the cause of constipation?

What are the complications of chronic constipation?

How can seniors prevent constipation?