Category: Articles

Don’t Be That Lazy Guy

The boomers grew up listening to the Beatles, the Rolling Stones and the Who. My Generation — remember that? When I’m 64 — I know you remember that song. We joked about getting older — and now, here we are. We are the age our parents warned us about. Linda and I just celebrated a milestone. We were born on the same day, in the same year. Yet, amazingly, she is ten years younger than I am. How does that happen? The other amazing thing and something I am so grateful for, my mother sent us a birthday card. My point here is that all of us are living longer and have to plan for all the eventualities.

And there are many.

There are financial considerations. Many experts contribute to this magazine who have wonderful information regarding plans for the future — what you will need for the years after retirement [and there may be many years]. Other experts can provide advice on caregiving, emotional and physical help to get through some of the tough times.

Our main focus in Generations Magazine is to let you know you are not alone. Help abounds. You merely have to ask. Here’s my joke for this column:

Two lazy guys are laying down against a tree, one on one side, the other on the other. Suddenly one of the guys says, “There’s a huge procession headed down the road. There’s limousines, beautiful girls, a giraffe, an elephant and a marching band. It’s incredible.” The other fellow says, “Gosh, I wish I was on your side of the tree.”

Don’t be that lazy guy.

The boomers grew up listening to the Beatles, the Rolling Stones and the Who. My Generation — remember that? When I’m 64 — I know you remember that song. We joked about getting older — and now, here we are. We are the age our parents warned us about. Linda and I just celebrated a milestone. We were born on the…
Hawai’i Family Caregiver Coalition

What is the Hawai‘i Family Caregiver Coalition? How did they get started? Why are they here? Good questions!

The Hawai‘i Family Caregiver Coalition, or HFCC, is a group of organizations, including government agencies, non-profit organizations, and private businesses concerned with the needs of unpaid family caregivers. Friends and neighbors are often caregivers, in addition to family members. Most people don’t realize that on any given day in Hawai‘i, about 169,000 adults are caring for frail or impaired adults, and about 247,000 are caregivers at some time during the year. These caregivers provide an astounding 162 million hours of unpaid service during the year! The estimated dollar value of this service is $1.990 Billion per year.1 This potentially saves a tremendous amount of money for insurance companies, family members, and the state, which might otherwise have to pay for care through the Medicaid program or other sources.

HFCC started when Hawai‘i was selected in 2004 to participate in a project designed to create coalitions such as theirs at the state and local levels. This project was funded by the US Administration on Aging and conducted by the AARP Foundation. The Coalition emerged following a two-day training period, in which 27 organizations participated.

Most importantly, why is HFCC here?

HFCC exists because family caregivers often face great challenges, yet they are not represented by supporting organizations; and their needs are not known to most policymakers or by the community. HFCC’s member organizations support caregivers and their families either through providing direct services or by other means. They have joined together in order to achieve two goals: first, to identify gaps in service and advocate for service expansion which will need caregiver needs; and, second, to promote education to caregivers, professionals in the field of aging, policymakers, and the public regarding caregiver needs.

What does HFCC do?

Here are a few examples: During Family Caregiver Day at the Capitol, advocates and caregivers visit legislative offices to discuss legislative priorities and have family members share their personal experiences with caregiving. They also distribute copies of their annual Aging and Disabilities Issues report to lawmakers, senior organizations and the public. The Coalition’s Educational Symposiums offers members valuable information and a chance to learn new skills. The Speakers Bureau and educational materials are available at no charge.

Organizations interested in joining HFCC can contact Anthony Lenzer via email Tlenzer@hawaii.rr.com or call 808-261-2095. Mailing address is P.O. Box 3088, Honolulu, HI 96802.

(1) Lynn Feinberg, Susan C. Reinhard, Ari Houser, and Rita Choula. Valuing the Invaluable: 2011 Update The Growing Contributions and Costs of Family Caregiving. Washington, DC: AARP Public Policy Institute

What is the Hawai‘i Family Caregiver Coalition? How did they get started? Why are they here? Good questions! The Hawai‘i Family Caregiver Coalition, or HFCC, is a group of organizations, including government agencies, non-profit organizations, and private businesses concerned with the needs of unpaid family caregivers. Friends and neighbors are often caregivers, in addition to…
Building Senior Resilience
Most of us in Hawai‘i understand that the island chain we call home is particularly vulnerable to hurricanes, earthquakes and tsunamis. And we’ve definitely all heard how wise we’d be to plan ahead and prepare for these types of emergencies and natural disasters. The good news for you and your family is that now you’ve got a capable partner who is willing and eager to help you when you’re ready to take on this necessary and difficult challenge.

The National Disaster Preparedness Training Center (NDPTC) offers many workshops to community members free of charge. One of our latest courses targets a broad cross section of seniors, senior caregivers, family members, friends, home health providers, and medical personnel to help them better understand the actions that might be required of them during a natural disaster. Seniors are frequently the most vulnerable population during a natural disaster because they often require additional support or have special needs. This 4-hour hands-on workshop focuses specifically on planning and preparedness actions that caregivers of seniors can take to help ensure the continued health, safety, and security of the senior(s) in their care.

Natural disasters can happen with little or no warning, but that doesn’t mean that we are completely powerless to protect ourselves or that we must depend entirely on emergency management personnel to rescue us. Did you know that individuals, families and businesses in Hawai‘i should expect to be on their own for at least 7 days after a disaster? The goal of this workshop is to empower you and help minimize risks and ultimately to reduce the impact of the natural disaster on the people you love and care for.

Here’s a list of some of the topics we explore in this course:

Identifying types of hazards and their potentials to cause fatalities, injuries, property damage, infrastructure damage, damage to the environment, interruption of business, or other types of harm or loss (FEMA, 1997)

Preparing caregivers in advance to reduce vulnerabilities of seniors in emergencies

Assessing and managing constraints and vulnerabilities of older persons such as mobility issues, medical conditions, disabilities, social and economic constraints

Developing a plan of action (e.g. evacuation, sheltering, feeding, transportation, accommodating persons with disabilities, ongoing and emergency care, etc.)

Organizing an extended support system

Amassing critical equipment, resources, food and water provisions

Building resilience and attending to the overall well-being of seniors during and
after disaster

Resilience is key in dealing with any of life’s difficulties, especially in natural disasters. It means being able to rebound or recover so that you can get on with your life. For seniors, knowing that there is a specific emergency plan in place will encourage confidence and peace of mind. For caregivers, being trained and prepared to deal with natural disasters will help to reduce anxieties about their caregiving duties and
responsibilities so that they can perform them with confidence.

We hope to see you at this workshop and encourage you to contact us by phone or visit online for more information, as well as for more training opportunities and resources that we offer.

Natural Disaster Preparedness Training Center
p: 808-956-0600 | f: 808-536-9110 | ndptc.hawaii.edu
Most of us in Hawai‘i understand that the island chain we call home is particularly vulnerable to hurricanes, earthquakes and tsunamis. And we’ve definitely all heard how wise we’d be to plan ahead and prepare for these types of emergencies and natural disasters. The good news for you and your family is that now you’ve…
Better Business Bureau: Tax and Scams
This time of year, fliers, yard signs, emails and other advertisements offering tax preparation assistance and promising bigger, faster refunds are popping up everywhere. When you alone are ultimately responsible for the information on
your tax returns, how do you separate the professionals from the scammers? Over the past few years seniors have become prime targets of the tax scammers.

One popular scheme works by convincing seniors that they qualify for reimbursement through the American Opportunity Tax Credit (AOTC). The AOTC allows people paying for college to reduce their taxable income by as much as $2,500.

A key requirement of the AOTC is that a person be currently enrolled in an institute of higher education — a condition that most seniors do not meet. But, scammers lie, telling seniors that they can collect benefits even if they went to school many years ago or even if they helped pay for their children’s schooling.

Here is a list of some of other recent tax related scams:

Fictitious claims for refunds or rebates based on excess or withheld Social Security benefits.

Claims that Treasury Form 1080 can be used to transfer funds from the Social Security Administration to the IRS enabling an IRS-payout.

Unfamiliar for-profit tax services teaming with local churches.

Homemade fliers or brochures implying credits or refunds available without proof of eligibility.

Offers of free money with no documentation required.

Promises of refunds for “Low Income — No Documents Tax Returns.”

Claims for the expired Economic Recovery Credit Program or for the Recovery Rebate Credit.

Senior stimulus payment. Retirees and other Social Security beneficiaries are eligible for a senior stimulus payment — $250 for individuals and $500 for couples — as part of the new stimulus plan. Some scams claim seniors can get a second, much larger payment by calling a telephone number and surrendering personal information.

Hawaii’s BBB offers the following tips for avoiding tax preparation scams:

Be cautious of tax preparers who claim they can get larger refunds than other preparers, or who base their fee on a percentage of your refund.
Consider whether the individual or firm will be around to answer questions about the preparation of the tax return months, or even years, after the return has been filed.

Check the preparer`s credentials. Only attorneys, certified public accountants (CPAs) and enrolled agents can represent taxpayers before the IRS
in all matters including audits, collections and appeals.

Find out if the preparer is affiliated with a professional organization that provides its members with continuing educational resources and holds them to a code of ethics.

Ask friends and family if they know of people who has used the tax preparer before, and whether they were satisfied with their service.

Check out the firm with Hawaii’s Better Business Bureau at Hawaii.bbb.org

Keep your money and your identity safe this tax season. And remember the IRS provides free telephone assistance for people who have questions at 1-800-829-1040.
This time of year, fliers, yard signs, emails and other advertisements offering tax preparation assistance and promising bigger, faster refunds are popping up everywhere. When you alone are ultimately responsible for the information on your tax returns, how do you separate the professionals from the scammers? Over the past few years seniors have become prime…
Financial: Home Exemptions for Seniors

Many have told us that their Real Property Taxes seem to be going up. This may be true since our property taxes are a direct relation with the City’s value of the property. The higher the assessed value of your property, the higher your property taxes will be..

We have clients from all over the world. And believe it or not, our property taxes are not as high as some states. As of the 2008 U.S. Census, the state of New Jersey holds the #1 position for the highest median property tax paid per year at $6,320. The lowest median property tax paid was Louisiana at just $188.

Home exemptions reduce the net taxable assessed value of the property used in determining your property tax and apply only to your primary residence. You can only have one primary residence which is tracked by your Social Security number. The current basic home exemption is $80,000. This means that $80,000 is deducted from the assessed value of the property and the homeowner is taxed on the balance. If you’re 65 years and older, the home exemption is $120,000. To qualify for the higher exemption you must be 65 years or older on or before June 30 preceding the tax year for which the exemption is claimed. Your exemption amounts will automatically increase depending on the age of the homeowner. The current property tax rate is $3.50 per $1,000 of assessed value. This rate is set in May or June by the City Council and may be adjusted for the July statement of this year.

If you believe your property taxes are too high, there is a way you can file for an appeal. These are what you need to know:

You’ll need to complete the Notice of Real Property Assessment Appeal form and submit a $25.00 deposit. This form as well as other valuable information can be found online at www.realpropertyhonolulu.com.

There are 4 ways to appeal. The most common is based on your belief that the assessment of the property exceeds more than 10% the market value of the property.

Once the form is completed a hearing is scheduled before the Board of Review. This board is made up of private citizens in an informal setting. You’ll want to bring documentation to validate your statement and then they’ll remedy a decision.

If you purchase a property, remember to file for the exemption immediately, so you don’t forget later. Ownership must be recorded at the Bureau of Conveyances on or before September 30 preceding the tax year.

We’ve known seniors who have lived in their home for years and never took advantage of their home exemptions and they’ve paid more property taxes than needed — imagine the extra savings.

Dan Ihara (RA) & Julie Ihara (RA)
Dani@iharateam.com, juliei@iharateam.com
808-256-7873
www.oahuhomes.biz

Many have told us that their Real Property Taxes seem to be going up. This may be true since our property taxes are a direct relation with the City’s value of the property. The higher the assessed value of your property, the higher your property taxes will be.. We have clients from all over the…
Medicare: Staying Healthy

February is “Heart Healthy Month” (and for all of you sweethearts out there, don’t forget Valentine’s Day on February 14th). Taking care of your heart is very important and there are some easy things that each of us can do.

Ask your physician what your “healthy weight” is and make an effort to eat lots of color: purple (eggplants), red (radishes), blue (blueberries), green (broccoli), white (cauliflower) and orange (tangerines). Try some grains like quinoa, instead of white rice.

Quit smoking and stay away from second-hand smoke.

Exercise — don’t let this scare you. One of the best things is walking. You don’t need equipment; and if you have a dog, you both benefit. A 30 minute walk each day will have you signing up for the Honolulu Marathon in no time.

March is “Colorectal Cancer Awareness Month” and the same three things are suggested to lower your risks — healthy eating, exercising, and quitting smoking.

Medicare’s benefits include a yearly “Wellness” visit where you will fill out a Health Risk Assessment form and then you and your physician will develop a personalized prevention plan to help you stay healthy.

Other preventive services include: bone mass measurement, mammograms, cardiovascular screenings, diabetes screenings, flu shots and glaucoma tests, just to name a few. Some of the new preventive benefits in 2013 are:

Cardiovascular Disease — Behavioral Therapy. Medicare will pay for one visit per year with your primary care doctor to help you lower your risks for cardiovascular disease.

Alcohol Misuse Counseling. One screening per year for adults with Medicare who use alcohol and don’t meet the medical criteria for alcohol dependency. Your primary care doctor can recommend up to four brief face to face counseling sessions per year and Medicare will pay for those.

Depression Screening. One screening per year. The screening must be done in a primary care setting (like a doctor’s office) that can provide follow-up treatment and referrals.

Obesity Screening and Counseling. If you have a BMI (body mass index) of more than 30 you may be eligible for intensive counseling to help you lose weight.

Sexually Transmitted Infections Screening and Counseling. These screenings are covered by Medicare for those that are pregnant and/or for certain people who are at an increased risk for STIs. Medicare will also pay for up to two individual 20-30 minute face to face counseling sessions each year for those at risk.

For more information about these preventive benefits and other Medicare benefits, the Hawai‘i SHIP (State Health Insurance Assistance Program) is available by calling 1-888-875-9229.

February is “Heart Healthy Month” (and for all of you sweethearts out there, don’t forget Valentine’s Day on February 14th). Taking care of your heart is very important and there are some easy things that each of us can do. Ask your physician what your “healthy weight” is and make an effort to eat lots…
Financial: Selecting Your Financial Advisor
Speaking from experience, the relationship between financial advisors and their clients is incredibly important. Whether you rely on your advisor to help with retirement planning, saving for college, or meeting other goals, this individual will help determine how you approach some of life’s biggest financial decisions. Here are a few things to keep in mind when choosing an advisor.

Find someone who shares an interest in your future. Your financial advisor should ask questions about your hopes, dreams and concerns. Your advisor should not be someone who only talks at you, but also listens to you.

Your advisor should know the marketplace. A good advisor should offer a tailored plan based on your goals — whether it’s building cash reserves, protecting your income against death or disability, or creating a balanced portfolio.

Financial advisors shouldn’t be know-it-alls. A smart advisor knows when it’s time to gather input from other experts, such as tax and legal professionals. Find an advisor who is willing to use a team approach to help you reach your goals.

Select an advisor with a solid reputation. When interviewing advisors, ask for references and specific examples of how they helped clients reach their goals. Check the advisor’s educational background and note any professional designations they have earned. You may find this infor-mation and on websites like FINRA.org.

Once you choose an advisor, you can start customizing a financial plan that fits you. Here’s what to expect during the planning process:

Set Goals: Your advisor will ask questions to help you identify your financial needs and dreams. These might include:

Envisioning your future — what’s next for you?

Where do you see yourself living?

What lifestyle goals are important to you?

Providing for your children’s education?

How do you envision your retirement?

Do you want help to reduce the effect of taxes on your assets?

Don’t worry if you can’t provide detailed answers. As you go through the financial planning process, your responses will become clearer to both you and your advisor.

Determine the Facts. After setting goals, assess your current financial picture. This includes gathering information and materials for your advisor to get a clear picture of your present situation.

Create the Plan. Your financial advisor will work with you to establish a course of action designed to help you achieve your goals. This strategy may cover things like:

Your needs, goals and values.

Current assets and liabilities.

Investment portfolio recommendations.

Retirement plan.

Insurance audit and needs analysis.

Estate planning analysis.

Product recommendations and action items.

Implement the Plan. After reviewing your strategy and consulting with your financial, tax and legal professionals, you and your advisor will implement the plan.

Meet and Review. Now that your plan is in motion, you will want to meet once or twice a year to review progress and make updates.

Selecting an advisor and creating a financial plan does take some time and effort. Once you take action to achieve your goals, you’ll likely discover life’s challenges can be better managed with the security of having a plan in place.

For info, contact Michael W.K. Yee at (808) 952-1240.

1 The Money Across Generations IISM study was commissioned by Ameriprise Financial, Inc. and conducted by telephone by GfK in December 2011 among 1,006 affluent baby boomers (those with $100,000 or more in investable assets); 300 parents of baby boomers; and 300 children of baby boomers at least 18 years old. The margin of error is +/- three percentage points for the affluent boomers segment and +/- six percentage points for the parents and children of boomers segments.

Ameriprise Financial and its representatives do not provide tax or legal advice. Consult with your tax advisor or attorney regarding specific tax issues.

Brokerage, investment and financial advisory services are made available through Ameriprise Financial Services, Inc. Member FINRA and SIPC. Some products and services may not be available in all jurisdictions or to all clients. ©2012 Ameriprise Financial,Inc. All rights reserved. File # 143286
Speaking from experience, the relationship between financial advisors and their clients is incredibly important. Whether you rely on your advisor to help with retirement planning, saving for college, or meeting other goals, this individual will help determine how you approach some of life’s biggest financial decisions. Here are a few things to keep in mind…
Arthritis, Diet and Dietary Supplement

“Arthritis” means “inflamed joints.” About 100 different types exist, and each has its own treatment. On top of this list are osteoarthritis (OA) and rheumatoid arthritis (RA). In medicine, the conventional treatments for any disease are provided under “clinical practice guidelines.” For arthritis, these and “patient resources” are listed at www.rheumatology.org. However, each patient responds differently so the treatment is carefully determined by the physician.

Although many conventional medical diets exist, some diets and supplements fall under “complementary” medicine, a method of health care sought by up to 90 percent of adults with arthritis. Does diet help? Researchers suggest that vegetarian diets may help people with RA. An elimination may help because grains (gluten), dairy, meats and citrus were among the top 10 common foods that worsen RA symptoms. Not all people with arthritis have food sensitivities. For those that do, an elimination diet under the guidance of a registered dietitian may help find the offending foods. Losing excess weight may very well alleviate OA pain, especially in the knees where the protective pad wears out between the two bones pressing against each other. Avoiding obesity is the best preventative measure against OA that affects 1/3 of the people over 65.

Numerous dietary supplements have been touted to help arthritis, and those with some limited clinical research support in humans, are now briefly listed below:

Avocado/Soybean unsaponifiables (ASU) — A Cochrane review of two OA studies show improvement in function, pain, and reduced medications.

Bromelain — This enzyme found in pineapples has been traditionally used by boxers to reduce their hand inflammation. One OA study found it was as beneficial as anti-inflammatory drugs in relieving pain.

Cat’s Claw — Three studies support the use of cat’s claw for OA. This vine native to the Amazon has been used for centuries.

Chondroitin Sulphate — Although it takes two months to show an effect, if any because results are mixed, this supplement may relieve OA pain.

Collagen — Polymerized collagen reduces inflammation in OA.

Devil’s Claw — A few studies show that pain, stiffness, and function improve in OA.

Fish Oil — Strong research support exists for treating RA pain.

GLA (gamma linolenic acid) — About 7 studies suggest that this omega-6 fatty acid found in evening primrose oil, black currant oil, and barrage oil, may reduce the stiffness, pain, and amount of required medication for RA.

Ginger — Reduced knee pain was observed in one OA study (possibly RA).

Glucosamine — Some, but not all, people with OA respond after about two months on this natural substance. Diabetics should monitor their blood glucose when taking glucosamine-containing supplements.

Glucosamine Chondroitin — A National Institutes of Health study (GAIT) supported its use in OA patients where it provided significant knee pain relief, but only for moderate or severe pain.

Hyaluronic Acid — Found naturally in the body and used on horses, studies show it helps people too.

Rose Hips — Two studies show that rose hips reduced the pain of OA and RA.

SAM-e — Many studies support S-adenosylmethionine use for joint pain, but it is also used for depression.

Stinging Nettle — Several studies show that this supplement taken orally or applied to the skin as a cream may be helpful in reducing OA inflammation and pain.

Tumeric — Curcumin, a yellow coloring agent extracted from tumeric, may reduce inflammation in the body, including that caused by arthritis.

“Arthritis” means “inflamed joints.” About 100 different types exist, and each has its own treatment. On top of this list are osteoarthritis (OA) and rheumatoid arthritis (RA). In medicine, the conventional treatments for any disease are provided under “clinical practice guidelines.” For arthritis, these and “patient resources” are listed at www.rheumatology.org. However, each patient responds…
Legal: Review Your Estate Plan Often

As we turn the page from 2012 to 2013, it is not a bad time to focus on your Rule Book (the set of documents in which you lay out your estate plan) and make sure that the rules you have in place are still consistent with your wishes and your needs. How often you review your Rule Book is up to you, but it is important to appreciate that things change. As they do, your Rule Book can gradually become obsolete, and if you fail to update it, it may do more harm than good.

What kinds of changes impact your estate plan?

Changes in your health. Like it or not, your health will change over time, and the general trend will not be for the better. Your doctors can do a lot to keep you going, but they have not discovered the Fountain of Youth yet. If you ever lose the capacity to update your estate plan, your family may be stuck with a Rule Book that does not meet your needs, and there may be little that can be done about it, short of taking an expensive foray through the court system.

Changes in your assets. Values go up, values go down. Those fluctuations can affect how your estate plan works. More importantly, it is important to take periodic stock of your assets and make sure they are all properly titled. If you have a revocable living trust, you probably should have all or most of your assets in the name of your trust. If you sell an asset that belongs to your trust, make sure the proceeds go into an account owned by your trust, and when the proceeds are reinvested, make sure the new assets are properly titled.

Changes in your family situation. Any time your family experiences a marriage, a divorce, a birth, or a death, you should have a look at your Rule Book. Other changes might impact what you want to say in your Rule Book as well. Those changes might be good, such as a child heading off to college, or not so good, such as the discovery that a family member has a drug problem or a debt problem.

Changes in the law. There have been some dramatic changes in the Federal and Hawai‘i estate tax laws over the past several years, and you can expect those kinds of changes to continue for the foreseeable future. Though the changes have caused uncertainty, they have also given rise to opportunities. Over the past two years, Hawai‘i laws relating to trusts and tenancy by the entirety have changed in some very positive ways that open the door to enhanced asset protection. Don’t miss out on what those new laws have to offer.

If you review your Rule Book at least once per year, you will probably be able to stay on top of all of these changes and be able to make appro-priate updates to your estate plan.

You should also sign a new durable power of attorney and advance health-care directive each year, even if there are no changes. The reason to update your power of attorney is that once it is more than a year old, many financial institutions will not honor it, and once it is five years old, nobody will honor it. The reason to update your advance directive is to force you to focus on it and make sure that it accurately reflects your wishes. It will not be called upon until you are unable to speak for yourself, so you need to get it right while you still have the capacity to do so.

Scott Makuakane, Attorney at Law
Specializing in estate planning and trust law.
www.est8planning.com
O‘ahu: 808-587-8227, Maui: 808-891-8881
Email: maku@est8planning.com

As we turn the page from 2012 to 2013, it is not a bad time to focus on your Rule Book (the set of documents in which you lay out your estate plan) and make sure that the rules you have in place are still consistent with your wishes and your needs. How often you…
A Story to Tell of Life and Love

Taking good care of ourselves and helping others who suffer from disease is important not only for ourselves but for others who may be impacted by disease. In the context of Chronic Kidney Disease and kidney transplantation even young children can learn much and be shaped by the experience they share with adult members of the family. Consider the following story.

My Big Surprise
By Trevor Toma

“I have been surprised many times in my life, but the absolute greatest surprise was in March 2012 when my mother told me she was going to give away her kidney. When my mother came home from work, she looked way happier than usual. So I asked her, “Why are you so happy?” Then she told me the story of how uncle Gregg’s kidneys were running at 11% efficiency and how he was on the National Kidney Foundation Donor’s list. She told me that it would be a long time for him to get a kidney and maybe he wouldn’t even get one. He would die without a kidney transplant. Then she told me, “I have decided to give uncle Gregg one of my kidneys. Don’t worry because I can live just fine with only one. I am going to have surgery in San Francisco when it is time.” Then she asked me if I had any questions or suspicions about the transplant but I wasn’t worried at all. She decided to give her kidney away because it made her sad to think that he would die and his kids wouldn’t have a father and his wife wouldn’t have a husband. He was shocked, excited, and grateful because he didn’t even know that his wife and my mom were talking about it. He was surprised because he didn’t think that a friend would risk their life to give him a kidney. He was grateful because he knew that this kidney would give him a new life.

During the tests, my mom took x-rays, blood tests, urine tests, and an IV. Sometimes she was gone for hours then came back with some news – sometimes good, sometimes bad. But my mother knew it was all worth it. Then one day she had to go to San Francisco for 3 days with her co-worker’s family to get more tests. She had a very good time. When she got back, she gave me a baseball cap and showed me pictures of the house she stayed at. After, she told me that there would be only a few more tests to take and then they would have to wait for a kidney match to swap.

Well, now it’s only a matter of time before my mother and uncle Gregg are ready to swap. Now I see how much love and effort was put into this transplant. I hope to save lives like her one-day. Even now — this very minute — I see how much she cares for uncle Gregg and his family.”

The decision to donate a kidney so that another person may live is one that is made with much planning, testing, and care. Those who donate one of their kidneys profoundly affect lives besides the life of the recipient.

National Kidney Foundation of Hawaii
1314 South King St., #304, Honolulu, Hawai‘i 96814

808.589.5976 info@kidneyhi.org www.kidneyhi.org

Taking good care of ourselves and helping others who suffer from disease is important not only for ourselves but for others who may be impacted by disease. In the context of Chronic Kidney Disease and kidney transplantation even young children can learn much and be shaped by the experience they share with adult members of…
Your Mind & Body: Disease of the Kings
An estimated 6 million people in the United States have experienced gout at some point in their lives. Known as “the disease of kings and the king of diseases,” gout has been studied by physicians and has caused suffering in many people for centuries. Gout is a type of arthritis that occurs when uric acid builds up in the blood and causes joint inflammation. Men aged 40 to 50 are most commonly affected.

What causes Gout?

Gout is one of the few types of arthritis where the cause is known. It results from deposits of needle-like crystals of uric acid in the connective tissue, joint spaces, or both. Uric acid is a byproduct of the breakdown of purines or waste products in the body. Normally uric acid breaks down in the blood and is eliminated in urine. When the body increases its production of uric acid or if the kidneys do not eliminate enough uric acid from the body, levels build up. This is called hyperuricemia. If excess uric acid crystals form as a result of hyperuricemia, gout can develop.

What are the symptoms?

Sudden, severe attacks of pain

Tenderness

Redness

Warmth

Swelling in some joints

It usually affects one joint at a time, especially the joint of the big toe, but can also affect the knee, ankle, foot, hand, wrist and elbow.

Deposits of uric acid, called tophi, can appear as lumps under the skin around the joints and at the rim of the ear.

In addition, uric acid crystals can also collect in the kidneys and cause kidney stones.

How is it diagnosed?

Standard diagnostic tools for gout may include a medical history and physical examination, blood test for uric acid, and urine sample for uric acid. For a definitive diagnosis of gout, a sample of synovial fluid from the affected joint is required. X-rays may be helpful. Not everyone with high uric acid levels in the blood has gout.

How is Gout treated?

Indomethacin is the usual choice for pain relief during an acute attack of gout. Colchicine (Colcrys), a derivative of the autumn crocus, has been used to treat gout for hundreds of years. This drug relieves the pain and swelling and can help prevent future attacks. Corticosteroids such as Prednisone can also be very effective for short term relief of joint inflammation and pain.

Allopurinol blocks uric acid production and is the standard drug used in long-term treatment of gout. Probenecid is another maintenance drug that increases uric acid excretion in the urine. Febuxostat (Uloric) is the newest drug available to lower uric acid in the blood and has greatly improved the quality of life for persons with gout.

Lifestyle and Dietary Recommendations

Weight loss can help reduce uric acid levels in those people that are overweight.

Drinking plenty of water also helps remove uric acid from the body.

Avoid alcohol.

Limit the amount of meat at each meal.

Avoid purine rich foods – anchovies, sardines, fish roes, herring, yeast, organ meats (e.g., liver, kidneys), legumes (e.g., dried beans, peas, and soybeans), meat extracts, consommé, gravies, mushrooms, spinach, asparagus, cauliflower, and poultry.
An estimated 6 million people in the United States have experienced gout at some point in their lives. Known as “the disease of kings and the king of diseases,” gout has been studied by physicians and has caused suffering in many people for centuries. Gout is a type of arthritis that occurs when uric acid…
Stretch to Better Health and Well Being
Quad Stretch (Front of thigh) — Stand up straight and tilt pelvis forward. Keep the knee down and lean only as far back as you can still relax.

We all know exercise and staying active plays a big role on how we age, but a lot of us forget about the importance of stretching and staying flexible. Tight short muscles create muscle imbalances, which leads to loss of function and range of joint motion. Not to forget the aches and pains that goes along with it. Tasks that used to be simple like reaching for something in the cabinet, putting on your seat belt, or even putting on a sock become extremely difficult or impossible. A regular stretching program can help lengthen your muscles and make daily activities so much easier and manageable.

Hip Flexor (Front of hip) — Kneel on a pad or pillow. Bring one leg forward; enough to keep your knee behind your toes. Press the opposite hip to the floor.

Anyone can learn to stretch regardless of age or flexibility. There are simple stretches you can do on a daily basis while watching television at the computer or before you get out of bed. It feels good and doesn’t have to involve a huge time commitment, but can deliver huge results!

Here are just a few of the benefits of stretching you can expect.

Increased flexibility, improves function, balance and coordination, lowering your risk for falls.

Improved circulation increases blood flow to your muscles and arteries to give you more energy and lower blood pressure.

Reduced muscle tension reduces stress so you feel more relaxed.

Less prone to injury and muscle strains.

Better posture helps to minimize discomfort of aches and pains.

Develops body awareness. As you stretch you focus on that particular part of your body you become more in touch with yourself. It is a form of active meditation for a better sense of well being.

Calf / Achilles Tendon — Only step as far back as you can. Keep your back heel on the floor.Stretching your calves keeps your ankle joint functioning.

Muscles stretch easier if you warm up first. You can do a 5 minute walk making sure to move your arms, or even taking a warm shower. If you do strength training, stretch between sets. It is particularly important not to sit for more than an hour at a time without getting up and stretching!

Hamstring (Back of leg) —Keep your chest up and reach forward. You can also lay on your back and wrap a towel or rubber tubing around your foot and hold.

Begin a stretch by holding it for 10–30 seconds to where you feel a mild tension. More is not better when comes to stretching. Find the degree of comfortability, then relax into it. Slight discomfort is okay, providing it starts to subside as you hold your pose. Don’t bounce, that can cause tears which can lead to scar tissue and tighter muscles.

Your breathing should be slow and controlled. Deep breathe in through the nose and out through the mouth. That sends a signal to the brain to relax and to allow your muscles to lengthen.

If you cannot relax then you’re trying to hard. Ease up slow and start again. Breath and relax.

Make stretching part of your daily activities, you’ll feel better and your body will love it!

Hip and Low Back — On your back and pull your bent knee across your body. Look the opposite direction. Keep your arm on the floor. Repeat with otherside.

Sissor Inner Thigh — Sit up tall and sissor your legs. With your hands behind your back you will also feel a stretch in your forearms and chest.

Photos by Kathy Boast
We all know exercise and staying active plays a big role on how we age, but a lot of us forget about the importance of stretching and staying flexible. Tight short muscles create muscle imbalances, which leads to loss of function and range of joint motion. Not to forget the aches and pains that goes…