Contents of the Summer, 2008 issue Testing 1-2-3 Give a Hoot n' Holler Treating Hand Arthritis to Maximize Quality of Life Mini-Maze - New Treatment for Atrial Fibrillation Creating 'Moments to Remember' When Pain Won't End A Dozen Dollar Savers Covenant Health Organizations Win National Awards Word Up! Keep it Safe This Summer Say What? Physical Therapy Gets You in the Swing of Things Love Your Aging Skin! When Disaster Strikes, Will You be Ready? Medication-Related Falls in Seniors Because We Care . . . SAGE ADVICE Creative Estate Planning Course Helps You Map Your Future Calendar of Events Summer Veggie Tart If You’re About to Celebrate Number 65, Now is the Time to Join Cariten Senior Health Destination – Fun! Burn that Fat!

Testing 1-2-3 Has your doctor ever ordered tests for you and left you wondering what to expect? You might be asking yourself, "What's the difference between an MRI, a PET scan and a good old-fashioned X-Ray?" Technology has come a long way in helping physicians diagnose and treat patients. We now have more options to capture images than ever before. "We are privileged to provide our community with the latest and best technology available. Our images are all digital, so our physicians can access them from anywhere within our system," said Jason Raiford-Davis, administrative supervisor of imaging services at Parkwest Medical Center. A radiology department, which is often called "imaging," includes many different types of procedures. These include X-Ray, MRI, CT, ultrasound, nuclear medicine, mammography, and interventional radiology. Images obtained during these procedures are interpreted by a radiologist, a physician who is specially trained to read images. In some cases a substance which causes a visual contrast may be used during the radiology exam to bring out more details in an area of interest. Contrast makes it easier to see internal structures in the body. It can be given orally, through an I.V., or as an enema, depending on the test. Patients are usually encouraged to wear comfortable clothing and minimal jewelry for imaging procedures. Some exams will require the removal of any metallic objects and dentures since they can interfere with an image's quality. If your physician has requested a copy of the exam, a CD will be provided to you. Once your results have been dictated by the radiologist and transcribed, they will immediately be faxed to your physician. Here is some basic information about each procedure: • During an X-Ray, individual particles pass through the body and are interpreted by a computer to display the images. This technology is a change from the traditional processed films that used to be viewed in front of a "light box;" all Covenant Health facilities now produce digital x-rays. Solid structures such as bones appear white, while areas containing air (such as lungs) appear black. Soft tissues appear as shades of gray. X-Rays are often used to determine if there is a broken bone, fluid in the lungs, or joint deterioration. • Computed Tomography (CT) uses X-Rays to create cross-sectional images of the body. A computer takes the information from the scan and uses it to create individual images which are referred to as "slices." A CT can be used to diagnose many conditions or occurrences. Some of the most common uses are identifying stroke, pulmonary embolism, kidney stones, trauma, and signs of heart disease. A CT patient will be asked to lie on a narrow table that slides into the center of a tubular scanner. • Magnetic Resonance Imaging (MRI) uses powerful magnets and radio waves to non-invasively produce pictures of the body. MRI scans see fine details in both tissues and organs, and are commonly used for the brain, joints, ligaments, nerves, blood vessels, and distinguishing cancerous tissue. Like a CT scan, patients are asked to lie on a narrow table that slides into the scanner, and the patient must remain still during the exam. • Ultrasound uses sound waves to make images of organs and structures. Unlike other radiology procedures, no ionizing radiation is used. A water-based gel is placed on the patient's skin over the area of interest to help conduct sound waves. Ultrasounds are useful in diagnosing a wide range of conditions, and are often used to visualize soft structures such as arteries, veins, glands, and abdominal organs. • Nuclear Medicine injects the patient with radioactive substances called isotopes. As the substance flows into the organs, the patient lies on a table under a camera, which takes images of the organ or tissues being studied. A distinct difference between nuclear medicine and other areas of radiology is that nuclear medicine is often used to assess how an organ functions, while other modalities focus on the organ's anatomy. • Mammography is a special low-dose X-Ray that is calibrated to specifically read breast tissue. It is used as a screening tool to detect breast cancer. The American College of Radiology recommends that women over age 40 receive annual mammograms. • Interventional radiologists conduct procedures which not only diagnose patients, but treat them as well. Interventional procedures are sometimes the only viable therapeutic option for critically ill patients unable to tolerate surgery. Source: National Institute of Health

Give a Hoot n' Holler Passport Plans Day at Pigeon Forge Dinner Theater With a name like "Hoot n' Holler," you might think you're headed for a barn dance. But don't let the name fool you. It's been called the funniest show in the Smokies - and for good reason. Writers of the show have also written scripts for Disney Theme parks, and the show's star trained with Ringling Bros. circus. While enjoying lively entertainment, you'll dine on a three-course Italian Feast. Come share the fun at noon on Friday, Sept. 12. Tickets are $15. Round trip transportation is available for an additional $10. This fun show is housed inside WonderWorks, the upside-down building on the Parkway in Pigeon Forge. If you'd also like to enjoy the incredible exhibits, we've got a special half-price rate of $10 to upgrade your ticket. Reservations must be made by Aug. 31.

Treating Hand Arthritis to Maximize Quality of Life C. Sanford Carlson, Jr., M.D. Throughout much of my career in medicine, I've taken a special interest in treating senior citizens, and I continue to find treating and caring for seniors to be a very rewarding and gratifying experience. As I talk with my patients, answer their questions and address their concerns, I try to learn as much as I can about their lives and the activities they enjoy. This helps me discern what I can do to maximize their quality of life and participation in daily activities. We're fortunate to live in an age of incredible innovation in healthcare, but technology is no substitute for personal attention, a listening ear, and true devotion to knowing what's important to my patients. One issue I deal with frequently, especially among female patients, is basal joint arthritis, or inflammation of the joint at the base of the thumb. This common complaint is actually the result of decades of wear and tear on the joint. Complicating matters is the high degree of stress that daily activities put on the base of the thumb. In fact, research has shown that stress at the base of the thumb is as much as 12 times greater than at the tip of the thumb. It's funny, but many of my patients don't realize that years of doing everything from opening tightly sealed jars to buttoning a button might one day “catch up to them” and impede their ability to do hobbies they enjoy, such as gardening, sewing or quilting. Fortunately, one of the ways this common complaint is easily and quickly treated is through a surgical procedure known as basal joint arthroplasty. In this procedure, the surgeon actually performs a joint replacement. The procedure is relatively simple, side effects and complications minor, and most importantly, the benefits are numerous. (I've even had people ask for the same procedure on the other hand after the first surgery!) Patients tell me they feel almost immediate pain relief (after the swelling and effects of surgery subside, of course), increased range of motion, improved function – and most of all – the ability to return to the activities that bring them enjoyment and fulfillment. To me, that's the most important benefit of all. About Dr. C. Sanford Carlson, Jr., M.D. Dr. C. Sanford Carlson, Jr., is a Knoxville native who has spent much of his career caring for patients from East Tennessee and Southeastern Kentucky. He is a 1972 graduate of Yale University, and received his doctor of medicine degree in 1975 from the University of Tennessee medical school in Memphis. He completed surgery and orthopedic surgery internships at McGill University-affiliated hospitals in Montreal, Canada, and a hand surgery fellowship at Union Memorial Hospital in Baltimore, Md. He is board certified by the American Academy of Orthopedic Surgeons and by the American Society for Surgery of the Hand (ASSH 1989, 1998). His office is conveniently located on the Fort Sanders West complex, and can be reached at (865) 693-7155

Mini-Maze - New Treatment for Atrial Fibrillation Atrial fibrillation (AF) is a type of cardiac arrhythmia, or irregular heartbeat, that affects about 2.2 million Americans. When an episode of AF occurs, the heart quivers irregularly instead of beating efficiently. Blood isn't pumped completely out of the chambers, allowing it to pool and possibly clot. This increases the risk of stroke from a dislodged lot. About 15 percent of strokes occur in people with AF. Traditional treatment options have included medical management, catheter ablation, and open-heart surgery. Now a minimally invasive procedure called the "mini-Maze" is providing new hope for patients with AF. The procedure isolates tissue from surrounding trigger sites which start the abnormal electrical activities. "With an approximate curative rate of 90 percent, the mini-Maze can safely restore and maintain normal cardiac rhythm. It potentially eliminates the need for lifelong medical therapy and its associated risks," explains Dr. William Hall, cardiovascular surgeon at Methodist Medical Center. You're invited to learn more about the mini-Maze procedure with Dr. Bill Hall: Wednesday, Sept. 3 Noon Frank Strang Senior Center Screening for atrial fibrillation will be provided by Covenant Senior Health beginning at 11 a.m.

Creating 'Moments to Remember' Covenant Passport Welcomes the Four Lads Though summer turns to winter And the present disappears The laughter we were glad to share Will echo through the years When other nights and other days May find us gone our separate ways We will have these moments to remember. The older we get, the more wonderful memories we have to keep us company. It's easy to settle into those memories and stay awhile. But making memories doesn't stop when we hit our senior years. We are making new memories every day, and that's why it's important to live life to the fullest, no matter what age and stage we may currently be in. One senior doing just that is Frank Busseri, an original member of the Four Lads, whose hits include "Istanbul," "Standin' on the Corner," and "Moments to Remember." At 75 years of age, Frank is still touring and performing, making sweet music and memories for a new generation. The Four Lads will be the featured entertainers at the 2008 Covenant Platinum Awards Gala Luncheon and Awards Ceremony on Thursday, Aug. 7, at the Knoxville Convention Center. For over 55 years Busseri has been the group's leader, manager, mainstay, and "keeper of the flame." He's always on guard to maintain the original sound and musical standards of the Lads as new members have taken the place of the three men he started out with in 1950. The Lads initially sang in clubs around Toronto. They were signed to a recording contract and received their first Gold record in 1953 for "Istanbul." Their success story includes the sale of some 50 million singles and albums to date. Busseri was inducted into the Group Singers Hall of Fame in 2003. Today the Four Lads continue their musical story, bringing exciting and truly "platinum" performances to receptive audiences everywhere. To their audiences, they still provide many wonderful "Moments to Remember." The Covenant Platinum Awards honor seniors who put the plus in 65 plus, the gold in golden years, and the citizen in senior citizen. Covenant Passport is a sponsor of the event. The gala luncheon is open to the public. Tickets are $25 and may be reserved by calling (865) 541-4500. To learn more about the Covenant Platinum Awards, log on to www.covenanthealth.com. The 2008 Covenant Platinum Awards Gala Luncheon and Awards Ceremony Noon - 2 p.m., Thursday, Aug. 7, 2008 Knoxville Convention Center Featuring entertainment by The Four Lads Tickets are $25. Call (865) 541-4500 to find out more.

When Pain Won't End We all feel pain occasionally – a headache, backache, or even a sprained ankle. After a week or so, it goes away and we don’t think about it again. But as we age, we have more injuries and more wear and tear on every part of the body. When pain lasts for six months or longer it becomes known as chronic pain. When pain won’t go away, a cycle begins. Many people become depressed and feel guilty. You don’t have to feel guilty. According to Denise Tope, Ph.D., who specializes in treating patients with chronic pain, “Developing coping skills is an important part of the pain management process. There are steps individuals can take to end the negative cycle. Sometimes making just a small change gives someone a degree of control they didn’t have previously. Many people are reluctant to take pain relievers for fear they will become addicted to their medications or they are afraid of side effects. Every individual has to learn what works to improve his or her quality of life.” Join Dr. Tope as she talks about how pain and emotions work together. You can have a renewed sense of hope. This informative program will be at the Frank Strang Senior Center on Wednesday, Aug. 6. See Calendar of Events for details.

A Dozen Dollar Savers If you're feeling a bit of a pinch at the pump and at the grocery store, here are 12 ways to stretch your dollars farther: 1. Stay in season—Never buy fruits and vegetables out of season, when the price is highest. Support the local economy and enjoy fresh local food when possible. When the average person in North America sits down to eat, each ingredient has typically traveled at least 1600 miles. That’s like traveling from Knoxville to the Grand Canyon to get your peas and carrots! The transportation of this food emits tons of carbon dioxide, not to mention increasing the cost to the consumer. 2. End aisles—Pay attention to the supermarket end aisles, where sale items are usually placed. 3. Look up, look down—The brands that dominate the market are placed at eye level; look at the top and bottom shelves for lesser known but more affordable brands. 4. Don't be shy—Ask about senior discounts. Some stores offer them on certain days, some restaurants during certain early dinner hours. Adjusting your schedule a little may save you a lot. 5. Use coupons—But only for things you were planning to buy anyway. 6. Check out books, videos, and CDs from the library—Only purchase those that you plan to read, watch, or listen to again. 7. Shop thrift or resale stores—Use online sites such as www.craigslist.org or local exchange or recycle lists to find products you're looking for or to sell things you no longer need. 8. Buy food in quantity with friends or family—No matter how good a deal it is, food that's thrown out is no bargain. Store brands are less expensive than name brands and are of similar or equal quality. 9. Share a meal—A decrease in physical activity as we age may also decrease our need for calories. When eating out, consider sharing a meal with your spouse or a friend. 10. Lights out—It’s obvious, but turning off lights at night can save you money and help the environment. A computer left running 24 hours a day can increase the electricity bill by $75 to $120 yearly. By putting the computer into standby mode, this amount is reduced to only $15 per year. 11. Look for ways to save gas—In the “old days” car engines needed to warm up before driving. For today’s engines, 30-40 seconds is enough, even on cold mornings. 12. Direct deposit—Stop unnecessary waste and expense by having your Social Security and other government checks sent directly to your financial institution. It saves trees, transportation costs, and the need to rush to deposit your funds, as well as reducing the risk of theft. Don’t forget to take advantage of Passport discounts in the gift shops, cafeterias, and parking lots when you are using a Covenant Health hospital.

Covenant Health Organizations Win National Awards Covenant Health has been named one of the “Top 100 Integrated Healthcare Networks” for 2008 because of the organization’s outstanding performance as an integrated healthcare network (IHN). The honor comes from Verispan, a healthcare data and consulting firm whose annual report is the nation’s premier rating system for healthcare networks. It is the second consecutive year that the health system has been ranked in the Top 100. Fort Sanders Sevier Medical Center has been named one of the nation’s 100 Top Hospitals® by Thomson Healthcare, a leading provider of information and solutions to improve the cost and quality of healthcare. The award recognizes hospitals that have achieved excellence in clinical outcomes, patient safety, financial performance, and efficiency. This is the first time Fort Sanders Sevier Medical Center has been recognized with the honor. Parkwest Medical Center has been named to “The 100 Club,” by QSource, Tennessee’s quality improvement organization. The 100 Club recognizes hospitals that achieve a perfect data validation score for at least two of four designated quarters, as measured by the Centers for Medicare/Medicaid Services (CMS). Parkwest achieved a perfect score for four consecutive quarter in 2006 and 2007.

Word Up! Passport offers Microsoft Word Improve your computer skills! Do all the things you dreamed of when you got your computer. Organize recipes, write better letters, record your family history! Covenant Health Learning and Organization Development will offer this one-day class just for Passport members. Mark your calendars for Monday, Aug. 4. Registration is $30 and includes lunch. Call 541-4500 to register. Class size is limited, so call early.

Keep it Safe This Summer Take an AARP Driver Safety Course As the weather begins to warm, our desire to get out and about increases. Make sure you’re prepared by taking an AARP Driver Safety Course. Covenant Passport will sponsor a class on Aug. 4 & 5 at Cedar Springs Presbyterian Church on Kingston Pike. As a Passport member, you’ll receive a special rate of $5 at this site only. To register or to find other times and locations, call 541-4500.

Say What? Tips for Communicating with People Who are Hearing Impaired “We frequently associate hearing impairment with aging, and it is a problem for some seniors,” said Ann Ross, director of Methodist Therapy Centers and certified licensed speech-language pathologist. “But hearing loss can occur at any age.” Communication between hearing and hearing-impaired people is often difficult. Those of us who have good hearing may become frustrated, while those with a hearing problem may feel isolated, lonely and depressed because of diminished social interaction. If you have family members or friends who have difficulty hearing, keep them involved in family and social activities as much as possible. Ross offers the following tips to help improve communication: • Find quiet places to have conversations, especially when the topic is important. Turn off the television, radio or other distracting noise-makers. Any remaining background noise should be behind the person who is hearing impaired. • Get the person’s attention by saying his or her name. Look directly at the person and maintain good eye contact at all times. • Speak loudly and clearly, but don’t shout or exaggerate sounds. Exaggeration can cause speech distortion. • Stop talking when you turn away from the person, and don’t expect hard-of-hearing people to hear you when they turn away from you. • Keep the distance between you and the hearing-impaired person to a minimum of three to six feet. Don’t talk from another room. Remember, a hearing impaired person needs to see your face. • Tell people with hearing problems when you are going to change the subject. • Be sensitive to signs that the person is confused. Ask hearing-impaired people if they understand what you said, and if they don’t, rephrase but don’t necessarily repeat it. Some speech sounds, such as “s, f, t,” and “sh,” are harder to hear and understand than other sounds no matter how many times you say them. • Don’t eat, drink, smoke or chew gum during conversations. • Use visual aids as needed. People who are hearing impaired rely on their sight to help them understand you. Facial expressions, gestures, and body language can help you make your point.

Physical Therapy Gets You in the Swing of Things Would you enjoy golf more if it hurt less? Has an injury or medical condition affected your play? Is your game inconsistent? Then you could benefit from the experts at Covenant Therapy Centers, who can help you find more consistency and distance in your golf game while reducing your risk of injury. More seniors than ever are enjoying the sport of golf. Along with surge of popularity has been an increase in the number of golf-related injuries, particularly among seniors who have decreased flexibility and strength. The typical golfer takes over 100 swings, leans over 30-40 putts, and bends down 40-50 times in a single round. That is a significant amount of bending and twisting, which creates stress and strain on the spine and other body joints. Back problems are most prevalent, but golf-related injuries may also occur in shoulders, elbows, hips and knees. The same factors that increase risk for injury also affect quality of play. Overuse, poor posture, poor flexibility and weakness lead to poor swing technique, mechanics and inefficiency. Helping area golfers through Parkwest Therapy Center’s golf program is both a passion and a privilege for physical therapist Pam Ollard. “I love what I do as a physical therapist and I love the game of golf. I’m fortunate to combine the two and help others play a better and safer game” she says. A certified McKenzie therapist, Ollard is also a certified golf fitness instructor through Titleist Performance Institute and brings the latest expertise in golf swing biomechanics, physical screening techniques and treatments. Covenant Therapy Centers’ specially trained physical therapists have advanced certifications in spine care (McKenzie), orthopedics (OCS), and sports (SCS). These professionals use their unique knowledge and skills to develop an individualized program for injury treatment, prevention, and improved golf performance. For more information about Parkwest Therapy Center’s golf program, call (865) 531-5710. To learn more about any of the other Covenant Therapy Center locations visit www.covenanttherapy.com or call (865) 541-4500.

Love Your Aging Skin! By Anne Marie Rodgers, RNC, BSN, CWOCN Fort Sanders Regional Inpatient Wound Care Coordinator Skin trivia: Did you know that: • The skin is the largest human organ, covering nearly 25 square feet? • Skin makes up about 15 percent of our body weight? • Humans shed and replace outer skin cells every 27 days? • With aging, this replacement of the outer skin cells takes longer? • By the age of 70 an average person will have lost 105 lbs. of skin? As we get older, understanding our skin care becomes more important. Skin care is not all about looking younger. The goal is to make sure your skin has all the nutrients it needs to be healthy. With age, our body produces less of what our skin needs to keep from getting flaky and brittle. We have to compensate for that loss. For example, your current soap may cleanse well, but do nothing to replenish necessary nutrients your skin needs. It may actually remove essential elements that older skin no longer produces in excess. Changing to a gentler soap may be part of your skin care regimen. It’s also important to avoid the use of hot water and excessive friction. Environmental factors such as low humidity and cold air lead to dry skin. Moisturizing dry skin helps keep the skin more supple, lessening the chance of the skin cracking and reducing possible injury from trauma. Apply moisturizers twice a day to slightly moist skin to get the most benefit. What you eat may also help your skin age better. Our skin, like any of our organs, needs vitamins and nutrients to be healthy. As we age, we need more of certain elements found in fruits and vegetables to keep skin supple and healthy. Eat a balanced diet, and always remember to talk with your physician before adding supplements or changing your diet. You have the ability to protect and maintain your skin. Recognize that it’s a dynamic organ throughout your life span – and love the skin you’re in!

When Disaster Strikes, Will You be Ready? Being ready for a disaster makes good sense. A disaster, whether natural or man-made, can occur at any time without warning. Having a plan helps us protect ourselves, our families, and our property from all types of hazards by knowing what to do before, during, and after an event. Being prepared also provides peace of mind. The first step in a disaster plan is to be informed. What kinds of emergencies are typical in your community? If you’re new to the area, call the American Red Cross. They can also tell you about the community’s warning signals — what do they sound like and what should be done if you hear them? Follow any instructions you hear from the National Weather Service, your local radio and television stations. Your personal disaster plan begins with a communication plan. If family members live outside of your community, talk about how you will contact one another when disaster strikes. Let other family members know who the primary contact person is. Important documents, such as insurance policies, deeds, and other vital papers, need to be stored in a safe place, preferably away from your home. If you have a disability or a special need, create a network of neighbors, relatives, and friends to aid you in an emergency. Find out about special assistance that may be available to you in your area. Animals are also affected by disasters so be sure to include the care of pets when preparing your plan. Contact your local veterinarian or www.vet.utk.edu/dart/ for more information. Depending on the nature of the disaster, you may need to survive on your own after a catastrophic event. Although local officials and emergency responders will be on the scene, they cannot reach everyone immediately. This means having your own food, water, medications and other supplies in sufficient quantity to last for at least three days. Disasters can strike without warning. It’s not a matter of “if,” but rather, a matter of “when.” Be ready. Be prepared.

Medication-Related Falls in Seniors By Christopher Norris, Pharm. D., Fort Sanders Regional Medical Center Approximately one-third of persons aged 65 years and older have one or more falls each year. Many medications have been implicated as risk factors for falls, but falls among seniors rarely have a single cause or risk factor. A fall is usually caused by a complex interaction among intrinsic factors (age-related decline in function, diseases, and adverse drug effects), extrinsic factors (environmental hazards), and situational factors (related to the activity being done). High blood pressure medications, antipsychotics, antidepressants, sleep aids (benzodiazepines and Benadryl®), anti-seizure medications, heart antiarrhythmic drugs, and narcotics are some of the types of medications that can contribute to falls in seniors. For example, certain medications can cause dizziness and may result in a fall if a person is not instructed to stand and walk slowly. Other medications can affect coordination or balance, or cause visual disturbances, confusion or sleepiness. Certain medications can even cause frequent urination, which might result in a fall during a nighttime trip to the bathroom. Taking four or more medications also increases the risk of a fall. Sometimes the increased risk is because of the health problems for which the person takes the medications. In other cases, medication side effects or interactions are the cause. How can I prevent a medication-related fall? ► Ask your doctor or pharmacist if any of your medications or over-the-counter products (including vitamins, minerals, and herbal products) increase your risk of falling. If specific medications are identified, ask your doctor if you need to continue to take them or if the doses can be decreased. Never stop taking your medications unless you talk with your doctor first. ► Any time you get a new prescription ask your doctor or pharmacist about side effects that could increase your risk of a fall. ► If you fall, be sure and tell your doctor, even if you aren’t hurt. Many underlying causes of falls can be treated or corrected. Problems with medications can be corrected and a manageable disease or other problem can be treated. ► Help prevent fractures resulting from a fall by improving your bone health. Be sure to consume adequate amounts of calcium and vitamin D.

Because We Care . . . Classes for the Family Caregiver -- Setting Up a Medication Safety System Aug. 11, 6 p.m., Fort Sanders Sevier Senior Center Sept. 25, 3 p.m., Strang Senior Center If you are taking care of an elderly loved one, you may be surprised by all that caregiving encompasses. Making sure medical, financial and emotional needs are met for your family member can be a full-time job. One of the most important tasks you are responsible for is developing an organized medication system. An average senior citizen takes about eight prescriptions on a regular basis. It can be overwhelming to remember what time of day the medicines should be taken, if they should be taken with meals or on an empty stomach, etc. (The absorption of some medications may be reduced if taken with other medicines, either prescription or over the counter.) Since medication errors can be deadly, it’s important to make sure you get it right. There are different medication systems, from simple pill organizer boxes to more complicated electronic systems. Deciding which is right depends on the individual. • Can your family member take the medications with minor supervision? • Are there other factors to consider such as vision loss or arthritis that would prevent the medicine from being taken accurately? • Does the patient understand what each medication is for? If you would like to learn more about how to manage medications for a loved one or for yourself, join us at one of the Classes for Caregivers on Aug. 11 at Fort Sanders Sevier Senior Center or Sept. 25 at the Frank Strang Senior Center.

SAGE ADVICE Emotional Eating Comes with a Heavy Price Since retiring four years ago, I have gained 20 pounds. I am unhappy with the way I look, but I don’t have the motivation to lose the weight or keep it off. Diets have helped me lose some of the weight, but then I regain it, plus a few more pounds. I don’t want to face another failure! Sincerely, Not So Pleasantly Plump Dear Plump: First, know that maintaining an ideal weight is important to helping us age healthily. Being overweight or obese can negatively contribute to existing medical conditions and cause other medical conditions to develop. Weight gain can also cause loss of self-esteem because of how we perceive our physical appearance. The reality is, aging affects weight. Changes in hormones, slowing metabolism and loss of muscle mass all come into play, making it harder to lose weight or keep it off. These changes result in reduced need for calorie intake. Eating less and exercising more is the key to success, but those of us with weight problems know it isn’t as easy as it sounds. It can be very frustrating. I’ve consulted experts at the Covenant Weight Management Center to make sure your question is addressed fully and accurately. To be successful in weight loss, they say you must understand the difference between physical and emotional hunger. Physical hunger develops slowly, is patient and will wait for food. This type of hunger starts with a small rumble in the stomach and gradually leads to a deliberate choice of food you would like to eat. Physical hunger stops when the stomach is full. You’re more likely to make healthy food choices when you are physically hungry. Conversely, emotional hunger presents itself suddenly and demands food immediately. When you are emotionally hungry there is little regard for what is eaten, and you will continue to eat even when your stomach is full. Our emotional hunger craves our favorite foods (sweets, carbs, etc.). Although emotional eating fills our need for comfort at the moment, it often leaves us feeling guilty and ashamed. Emotional eating is a coping mechanism. While it may feel good, it has the side effect of weight gain. Diets do not get to the root cause of emotional eating. Until this happens, you will likely fail at keeping the weight off. What can you do? • Make an appointment with your physician to make sure your weight gain isn’t caused by hypothyroidism or side effects of medication. • Address the emotions underlying your need to comfort yourself with food. If needed, consult a therapist to guide you in this process. • Review the characteristics of physical and emotional hunger and keep a daily log of events, thoughts and emotions prior to an emotional hunger pang. This will help you identify the cause of the emotional discomfort. • Contact the Covenant Weight Management Center at (865) 531-5243. They offer a six-month program that is medically supervised with an individualized plan for healthy eating and healthy living. • With your doctor’s approval, consider participating in a Fifty Plus Fitness classes available through Covenant Health – they’ll help you lose weight, and you might gain some new friends along the way! To find out more about senior fitness classes in your community, call (865) 541-4500. Sage Advice feature straight talk from experts about issues of concern to seniors and their loved ones. Please feel free to call me, Rachel Peterson, program director of the Peninsula Senior Day Hospital at (865) 374-7158.

Creative Estate Planning Course Helps You Map Your Future Do you have a will? Regardless of the size of your estate, an up-to-date will is vital. Once you’ve taken that step, what’s next for your estate planning? How about – knowledge? Covenant Health’s Office of Philanthropy offers a confidential and complimentary Creative Estate Planning Course for Passport members. The home-study course iscomposed of five different lessons, each consisting of four pages of easy-to-read information and a multiple-choice quiz to test your understanding of the information covered. Lessons are mailed once a week. Topics include: How You Can Shape the Future, How to Make a Better Will, How to Cope with Estate Tax Uncertainty, How Trusts can Improve Your Estate Plan, How to Boost Income and Cut Taxes Now. After completing the course, you’ll receive a copy of the book Your Personal Estate Planning Record for recording your personal data. Register by calling Jeff Elliott at 531-5197 or by e-mail to jelliott@covhlth.com This course is limited to 30 students. Sign up today!

Calendar of Events July 3 is Eat Beans Day – You know they are good for you- full of fiber and protein! July 4 – Happy Independence Day! July 23, Noon Lunch & Learn Maintaining Good Health Roxie Anderson, APNP Frank Strang Senior Center August 2 is Watermelon Lover’s Day – Indulge in something sweet without the guilt! August 4 & 5, 9 a.m. -1 p.m. AARP Driver Safety Training Cedar Springs Presbyterian Church Cost for Passport members is $5 at this location only. August 4, 8:30 a.m. – 4:00 p.m. Introduction to Word Covenant Health Learning and Organization Development $30 for registration and materials August 6, 8:30 a.m. – 10:30 a.m. (by appointment) Cholesterol Screening Fort Sanders Sevier Senior Center $20 – Call 453-WELL August 6, Noon Lunch & Learn Dealing with Chronic Pain Denise Tope, Ph.D. Frank Strang Senior Center August 11, 6 p.m. Caregiver Class Setting Up a Medication System Claudia Ogburn, Pharm. D., and Eric Lee, Pharm. D. Fort Sanders Sevier Senior Center Call 453-WELL August 26, 7 p.m. Health Night on the Town Palliative Care Michael Thompson, MD Methodist Medical Center Call 835-3370 August 27, Noon Lunch & Learn Peripheral Vascular Disease Frank Strang Senior Center September 2 is Pop Top Day. The pop top was introduced in 1963 by the Schlitz Brewing Company. Prior to that, you needed a “church key” to open a can. September 3, Noon Lunch & Learn New Treatment for Atrial Fibrillation William Hall, MD Frank Strang Senior Center EKG screenings will be provided for those registered at no cost beginning at 11 a.m. September 11, 9 a.m. – noon Senior Health Fair Fort Sanders Sevier Senior Center Various Free Screenings; Lipid Profile - $20 September 12, Noon Hoot n’ Holler Dinner Theater $15 – tickets for show $10 – transportation Call 541-4500 before August 31 September 25, 3 p.m. Caregiver Class Setting Up a Medication System Christopher Norris, Pharm. D. Frank Strang Senior Center September 30, 7 p.m. Health Night on the Town Glaucoma Vic Khemsara, MD Methodist Medical Center Call 835-3370

Summer Veggie Tart Ingredients: 1 Pepperidge Farm pastry shell (thawed) 1 cup mozzarella or provolone cheese (can use low-fat) 2 cups fresh mixed veggies (suggestions: asparagus, bell peppers, squash, zucchini, onions) 2 TBSP olive oil Salt, pepper, and any other favorite spice (suggestions: garlic, basil, thyme, oregano) • Preheat oven to 400 degrees • In a bowl, mix the veggies with the olive oil, salt, pepper, and optional spices • Roast the veggie mix on a baking sheet @ 400 for 15 minutes. • Roll pastry shell onto another baking sheet that you have lightly sprayed with oil • Sprinkle the cheese over the pastry shell • Then spread roasted veggies on the pastry shell/cheese and bake another 15 minutes. Enjoy! Recipe from Gary Young, Center for Community Health

If You’re About to Celebrate Number 65, Now is the Time to Join Cariten Senior Health There’s good news for East Tennesseans who have just turned 65 or who are turning 65 this year. Folks in this age bracket can now join Cariten Senior Health – the area’s only locally owned and operated Medicare Advantage plan. Cariten Senior Health members have access to more than 6,000 doctors and healthcare providers, as well as almost every local hospital. Benefits for most plans include: • 100% hospitalization for inpatient and outpatient hospitalization • Worldwide emergency coverage • Prescription drug coverage that can fill in the coverage gap • Direct access to most in-network physicians – including specialists • Substantial preventive care benefits including screenings, check-ups and immunizations • Transportation to healthcare appointments Special plans are available for those who qualify for both Medicare and Medicaid. And Cariten offers $0 to low monthly premium plans. Plans are offered that fit any need and budget. For a list of free Cariten Senior Health seminars in your area or to learn more about any of Cariten’s Medicare Advantage plans, call: In Knoxville: 865-670-7780 (TDD/TTY 865-470-8409) Outside Knoxville: Toll Free 888-285-2599 (TDD/TTY Toll Free 800-396-2150) Seven days a week, 8 a.m. to 8 p.m. www.caritenseniorhealth.com Cariten Senior Health has a Medicare Advantage contract with the Centers for Medicare and Medicaid Services. Anyone with Medicare and who lives in the plan service area may apply. You must be enrolled in Medicare Part B, remain entitled to Medicare Part A, and continue to pay your Medicare premiums.

Destination – Fun! Check MoeFaye’s Latest Trips July 24, Franklin, N.C. & Dillard, Ga. – Call immediately to join this gem mining expedition! Gemboree and lunch at Dillard House. Aug. 7-9, Mystery Trip -- Need a little excitement? This mystery trip includes two-night lodging, some meals, and an unknown destination. Aug. 26, Lynchburg, Tenn. -- Back by popular demand! Tour the Jack Daniels distillery and have lunch at Miss Mary Bobo’s. Aug. 28-29, Mt. Airy, N.C. & Hillsville, Va. – A day in ‘Mayberry,’ plus the Labor Day weekend Flea Market in Hillsville. Sept. 8-13, Branson, Mo. – Shows, food, fun, lodging. Sept. 18, Cumberland County Playhouse – “South Pacific,’ lunch, and a few surprises. Sept. 25-26, Lexington, Ky. – Harness racing, sight seeing, great food and more. Oct. 9-25, Australia/New Zealand/Fiji – Too many sites to mention – call for brochure. Oct. 12, Townsend – ‘Passion Play in the Smokies;’ dinner with backstage tour. Dec. 31-Jan. 1, 2009; New Year’s Eve Party -- Let MoeFaye be your designated driver with pick-ups in Knoxville, Oak Ridge, and Sevierville. Dinner, riverboat cruise, champagne, party favors, and breakfast. Make the evening special without having to do the planning. May 23 – June 2, 2010 – Oberammergau, Germany, “The Passion of Christ.” Reservations must be made by early July! This production has been presented once every 10 years since 1634. Stops include Switzerland, Austria, and Southern Germany. Looking ahead: Apr/May 2009—Holland River cruise during tulip time! July/August, 2009—Canadian Rockies (We just got back from a site visit. It is awesome!) Sept/Oct 2009—Southern Italy/Sicily Others trips being considered: S. Africa, Iceland, Egypt, Israel, China & many coach trips. Want to Cruise through Next Winter? Plan Now! Jan 16-24, 2009, the Bahamas - Motor coach to/from Charleston, S.C. Ports of call include Grand Bahamas Island, Nassau, Great Stirrup Cay, and Port Canaveral, Fla. You asked for it! You’ve Got it! Jan. 28-Feb. 9, 2009, The Panama Canal - Motor coach to Miami, Fla. Ports of call at Labadee, Haiti; Cartagena, Colombia; Panama Canal; Cristobal Pier, Panama; Puerto Limon, Costa Rica; and Georgetown, Grand Cayman. For additional Information or reservations call: Katie at 865-429-2404, or Faye & ‘Moe’ at 865-577-4643, or E-mail us at: moefayetravel@aol.com or kmoefayetravel@aol.com Check the web at: www.covenantpassport.com

Burn that Fat! It’s that time of year when the weather gets warmer and the winter clothes finally get put away. At this same time many people ask, “What’s the best way to burn fat off my ________?” (choose a body part to place in the blank!). The answer is not simple, because the body is a complex and efficient machine. It uses both fat and glucose for energy, but primarily relies on glucose. Glucose is a readily available energy source – so the body uses it first, rather than breaking down the fat from your thighs, hips or waist. This is simplifying complex physiological chemistry, but here are the essentials: To burn fat for fuel, you need to participate in aerobic activities, because the body needs lots of oxygen to burn fat. The exercise intensity (the level we push ourselves) needs to be “somewhat hard” if you are rating how the exercise feels to you. Exercise science has proven that pushing oneself at the “somewhat hard” intensity generally corresponds to 60-80% of target heart rates. At this intensity the body uses fat as well as glucose. So, if your goal is to burn fat, you need to make sure that when you are walking, biking, or in a class, you are exercising at a rate that is not too easy or too hard. We can help at 50+ Fitness. Check out locations/classes at covenanthealth.com and click on the 50+Fitness logo or call 541-4500.