BOOMERSF a l l 2 0 1 4

PRSRTSTDU.S.Postage

PAIDPermitNo.440

Sterling,IL61081

P.O.Box498Sterling,IL61081

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2 Boomers 2014

Boomers 2014 3

Become a better boomer ....................................... Page 5

Managing your IRA ..... Page 9

The importance of sharingyour health history .... Page 10

New treatment regenerates,produces collagen ...... Page 12

Is your diet making you sick? .................................... Page 13

High-tech ways to keep an eyeon aging parents ........ Page 15

New treatments, gettingscreened for Hepatitis C ..................................... Page 17

Treating chronic pain withspinal cord stimulation ..................................... Page 21

Many Americans in denial overlong-term care needs . Page 22

Articles and advertisements are the property of Sauk Valley Media, P.O. Box 498, Sterling, IL 61081, 815-625-3600. No portion of this publication may be reproduced without the written consent of the publisher. Ad content is not the responsibility of Sauk Valley Media. The information in this guide is believed to be accurate; however, Sauk Valley Media cannot and does not guarantee its accuracy. Sauk Valley Media cannot and will not be held liable for the quality or performance of goods and services provided by advertisers listed in any portion of this magazine.

What’s insidePublisher:

Sam R Fisher

Advertising Director:

Jennifer Baratta

Advertising Sales:

Jill ReynaKelly Shroyer

Editors: Larry LoughMarla Seidell

Page Design: Marla Seidell

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Avonlea Cottage of Dixon503 Countryside Lane ! Dixon, IL 61021District Administrator: Marge CornejoDirector of Nursing: Diane Hawkins

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Avonlea CottageWhere loved ones feel at home.

We are pleased to announce that AvonleaCottage of Dixon will begin accepting residentsas a dedicated Memory Care Community inOctober 2014, pending licensure.

We are a Person Centered Care Communitycaring for each person in a positive environment.We do our best to provide a supportiveenvironment because people with dementia arejust like you and me, with the same emotionaland social needs.

Avonlea Cottage is dedicated to helping thosewith memory loss find security and fulfillmentin everyday life. Our dedicated licensed staffcaters to each individual resident’s needs.

Our mission is to create a community thatrespects each resident’s dignity andindividuality, and to promote quality of life inall aspects of our care and services.

Our warm, home like surroundings create acalm environment, and our staff iscompassionate and encouraging. Here theresidents participate in a variety of memorybased activities that are thoughtfully planned byour caregivers, who provide close supervisionand gentle support to our residents.

Life is challenging for the family who cares forthe individual with Alzheimer's or otherdementia disorders. Families can be at peaceknowing their loved one is cared for here atAvonlea Cottage.

Avonlea Cottage Services &Amenities “Senior friendly” private bathrooms with easy access showers 24-hour protective care by an attentive staff of licensed and certified nursing personnel Medical Director services onsite Personal emergency response system 3 nutritious home cooked meals per day, plus snacks Memory based planned activities and special events Music therapy twice per month by a licensed therapist Housekeeping and laundry service Beauty Salon TV and phone hookups available Month to month rent; No leases or hidden commitments Respite and short term care available at a daily rate

Avonlea Cotta503 Countryside Lane ! DixoDistrict Administrator: Mar

Boomers 2014 5

Become a better boomer

BY LUCINDA HALLSpecial to Boomers

R eady to ramp up your metabo-lism?It’s no surprise that baby boom-

ers are lacing up their sneakers and heading to the gym, but it’s not just about the treadmill anymore.

And, if you don’t have a fitness regi-ment, consider this: regular exercise can reduce the effects of aging, ease anxiety, boost your immune system, preserve lean body mass, maintain healthy joints, promote better sleep, and increase your energy.

The Sterling Park District and Dixon Family YMCA have programs that can

help boomers add a spring to their step and tone to their tummies.

Take, for example, the Silversneakers program offered by Dixon Family YMCA. The classes are designed to increase strength, flexibility, muscular endurance, balance, coordination, agility, speed, and power. Whew! The 45-minute sessions gently work all parts of the body.

The Sterling Park District offers a fit-ness class just for people 60 and older at the Westwood Fitness and Sports Center. The program includes the use of Dyna-bands: wide, flat elastic bands that are used for strength training, replacing the need for heavier weights. The bands work with the body to create

resistance to strengthen muscles. The 45-minute classes are held three times a week.

Yoga, the ancient art of using body positions to achieve a state of physical and emotional tranquility, is offered at Dixon Family YMCA and the Sterling Park District’s Duis Recreation Center. Yoga has been praised as a way to lower blood pressure and improve digestion, posture and sleep, while helping to maintain an overall youthful feeling by slowing the aging process. Beginner to advanced programs are offered at both facilities.

Regular exercise can reduce effects of aging, help to maintain healthy joints

Alex T. Paschal/apaschal@saukvalley.comSeniors work up a sweat during a recent exercise class at the Dixon Family YMCA. The Y has many different classes and equipment for seniors to use.

EXERCISE CONTINUED ON 7�

6 Boomers 2014

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Boomers 2014 7

Alex T. Paschal/apaschal@saukvalley.comDixon Family YMCA has a water Zumba class on Tuesday and Thursday mornings.

Programs provide positive motivation

If you’d like to make a splash, water aerobics is a great way to go. Offered at the YMCA and the Duis Center, water aerobics are especially beneficial for individuals who are looking for low-impact exercise. Classes include a car-diovascular workout and movements to improve muscle tone, as well as exercises to increase flexibility and circulation.

The YMCA also offers a water Pilates Stretches and Strength class. Held in the shallow end of the pool, Pilates exercises are used to improve breathing, coordina-tion and mental well being.

Both locations also offer scheduled lap and open swimming.

No boomer fitness program would be complete without a cardio component. Westwood offers a Saturday Cardio Trio class as a great way to start the weekend. The workout, which is different each week, incorporates many different types of cardiovascular activities to improve heart and circulation health.

Aerobic classes, which pair cardio and strength training, are offered at both the Duis Center and YMCA. Aerobics help to increase oxygen to muscles through physical activity while supporting cardio and circulation health. Classes range from step aerobics – focusing on the lower body for firmer bottoms, hips and thighs, to spinning – a high-energy work-out that can burn up to 700 calories per

class using stationary cycles.Becoming increasing popular at West-

wood is weekend adult competitive tennis with an increase in the number of baby boomers taking to the courts. Singles competition is held on Satur-days and couples competition on Sun-days.

Dixon Family YMCA is particularly proud of the Operation Move to Win program, which has been popular with boomers. Operation Move to Win is a 12-week health improvement partner-ship with KSB Hospital, which resulted in the Y’s new KSB Wellness Center.

The goal of the program is to provide positive motivation for participants to lose weight and make healthy lifestyle changes. While the program is primar-ily made up of business and corporate employee teams, individuals who want to participate can join the YMCA team. More information on the program can be found on the Y’s website.

Like it or not, your body is changing. Become a better boomer. Break away from the treadmill and discover all the fitness fun that’s out there!

Where it’s at, babyDixon Family YMCA

110 N. Galena Ave., Dixon815-288-9622

www.dixonymca.org

Sterling Park DistrictWestwood Fitness and Sports Center

1900 Westwood Drive, Sterling815-622-6201

Duis Recreation Center211 E. St. Mary’s Road, Sterling

815-622-6200www.sterlingparks.org

EXERCISECONTINUED FROM 5

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8 Boomers 2014

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Boomers 2014 9

Are you a savvy IRA manager?Many individuals missing out on long-term savings benefits

BY MARK JEWELLThe Associated Press

BOSTON – When it comes to retirement planning, most of the focus is placed on 401(k)s. The reality is that individual retirement accounts represent the larg-est share of America’s savings.

At the end of last year, IRAs had $5.4 trillion in assets compared with $5.1 trillion in 401(k)s and other defined contribution plans. Some 40 percent of U.S. households own at least one type of IRA, which offer tax incentives to save for retirement.

Many of these IRA holders are left to their own devices to manage their accounts. Of course, some investors are take-charge types with the ability to maximize savings without taking on too much risk. But in many other instances, portfolio management is hit-or-miss, with little attention to selecting an appropriate mix of mutual funds or other investments.

“Many individuals are still missing out on the long-term savings benefits of IRAs, simply because they don’t under-stand what they are and how they work,” says Dan Keady, director of financial planning for TIAA-CREF, a financial services company. In a recent telephone survey of 1,008 adults, his company found that nearly half of the respondents lacked a basic knowledge.

IRAs provide individuals not covered by workplace retirement plans with an opportunity to save on a tax-advantaged basis on their own. The money put into a traditional IRA can be deducted from the accountholder’s taxable income for that year, and the money isn’t taxed until it’s withdrawn at retirement. Also, work-ers who are leaving jobs can use IRAs to preserve the tax benefits that employer-sponsored plans offer.

Haphazard managementWith so many IRA holders managing

accounts on their own, approaches vary widely, often to the detriment of long-term savings.

For example, surveys by the fund industry’s trade organization, the Invest-ment Company Institute, found that low-yielding money-market mutual funds make up a far larger proportion of IRA portfolios than is typically considered appropriate. For example, the ICI found that IRA holders in their 60s had invested

nearly 25 percent of their portfolios in low-yielding money funds. That’s four times larger than the average alloca-tion to money funds in 401(k) accounts owned by people in their 60s.

Perhaps even more surprising, IRAs held by people in their 20s had an aver-age 22 percent in money funds.

Among the reasons cited for the unusu-ally high weighting: Money funds are often a default investment for small roll-overs into IRAs from other investment accounts, and IRA holders may be more likely than other investors to keep invest-ed savings readily available for conver-sion to cash.

Most investors use money funds as parking places for cash that’s temporar-ily kept out of higher-yielding invest-ments. But it’s no way to build retire-ment savings because money funds have offered returns barely above zero for the past 4 years.

David Schehr, who follows investment industry trends for research firm Gartner Inc., says it appears that people “are a little better at investing for the long-term with their 401(k)s than they are with their IRAs.”

He believes there’s a growing need for products to help IRA owners manage accounts on their own. Among the start-up firms that have launched in recent years to address this need are online-based services such as Wealthfront, ShareBuilder, Betterment and Motif Investing.

New optionThe latest entrant into this niche is

Rebalance IRA, which launched in Janu-ary. Its advisory board includes Burton Malkiel, a Princeton University econo-mist and author of the investing classic,

“A Random Walk Down Wall Street”; and Charles Ellis, founder of the investment consultancy Greenwich Associates and author of another renowned investing book, “Winning the Loser’s Game.” Both are advocates of low-cost index mutual funds and exchange-traded funds, which seek to match market performance rath-er than beat it.

Customers can set up portfolios invest-ed exclusively in ETFs, after a free phone consultation with Rebalance IRA’s pro-fessional financial advisers to assess their goals and existing investment accounts. Initial calls usually last around an hour.

For a $250 initial fee, a customized account is established and the adviser maintains periodic contact with the cus-tomer. A fee of 0.5 percent of the total assets invested is charged annually for portfolio management, with a minimum fee of $500. An accountholder also pays management expenses of the ETFs. Those expense ratios vary depending on which ETFs are selected, and average less than 0.20 percent.

Because Rebalance IRA’s $500 mini-mum annual management charge per account is steep for someone with a small IRA, it’s not recommended for an account with less than $75,000.

Systematic approachThe service includes automatic port-

folio rebalancing to help IRA holders become more disciplined investors.

“People tend to buy when everybody is optimistic and the stock market is up, and sell when everybody is pes-simistic and the market is down,” Mal-kiel says. “Rebalancing makes you do the opposite of what your emotions tell you to do.”

He cited findings that systematic rebalancing over the past 15 years added 1.5 percentage points to an aver-age annual return of a portfolio invest-ed in stocks and bonds, while reducing volatility.

Schehr, the Gartner analyst, sees significant potential for start-ups like Rebalance IRA if they can mar-ket themselves effectively. “A lot of boomers really haven’t dealt with how they’re managing their IRAs,” he says. “And with retirement around the cor-ner, they’re finding out they’re late in the game to start taking charge of their accounts.”

’’‘‘

A lot of boomers really haven’t dealt with how

they’re managing their IRAs. And with retirement around the

corner, they’re finding out they’re late in the game to start taking

charge of their accounts.Burton Malkiel, Princeton University

economist and author

10 Boomers 2014

Share your health history

Photo courtesy of Getty ImagesMany health conditions run in the family, so knowing the health history can help you or your loved ones take the right steps to stay well and get tested if you or they are at risk.

Start a new tradition at your family reunionFAMILY FEATURES

F amily reunions are a great oppor-tunity to reconnect and turn relationships into strong, eternal

ties. This year, try starting a new tradi-tion – share your health history with your family.

Passing down family health history can be as important as sharing that heirloom recipe your great grandmother shared with your grandmother. Many health conditions run in the family, so know-ing the health history can help you or your loved ones take the right steps to stay well and get tested if you or they are at risk. Sharing a health history means having a conversation about your health conditions or those experienced by another family member. These conver-

sations can transform a simple update about a loved one’s wellbeing into a piece of prevention.

Why is sharing a health history impor-tant?

Though marked with stories and laugh-ter, family reunions are also a perfect time to talk about important matters that affect the health of your family members. As the number of those with common ailments such as obesity, heart disease and cancer continues to rise, other major conditions should not be overlooked, especially kidney disease.

According to the U.S. Renal Data Sys-tem, nearly one in six African American adults (or 6.2 million) has signs of kidney disease. There are usually no symptoms for early kidney disease, which is why it

is sometimes called a “silent disease.” The two primary causes of kidney dis-ease are diabetes and high blood pres-sure.

The National Kidney Disease Education Program is encouraging relatives at fam-ily reunions to talk about the connection between diabetes, high blood pressure and kidney disease. The Program’s Fam-ily Reunion Health Guide can help you plan large group or one-on-one conver-sations about kidney disease. You do not need to be a healthcare professional or expert to start these important conver-sations – the guide has everything you need.

To download or order a free copy, visit http://nkdep.nih.gov/get-involved/talk-with-family.shtml?ref=MAT.

Boomers 2014 11

Five tips for starting the conversationTalking about health history at family reunions can be chal-

lenging. Having a strategy for difficult conversations can help guide the discussion and make it a meaningful and productive experience.

Here are some tips for getting a one-on-one conversation started at your next family reunion:

1. Ask permission to have the conversation and try to choose a convenient time and comfortable environment. Look for a quiet, private place that is free from distractions.

2. Acknowledge that it is not always easy to face personal health problems. Try to be supportive and listen to their con-cerns.

3. Include personal stories in your health discussion. Try sharing your story on how you manage diabetes or high blood pressure to help put them at ease.

4. Offer to go with family members to their health care pro-vider and encourage them to bring information about kidney disease, diabetes and high blood pressure to appointments.

5. Follow up with family members in ways that work for them. Some relatives may prefer a phone call to an email or text mes-sage. Make the kidney connection with a loved one and start a new, healthy tradition at your next family reunion.

For more information, visit https://www.facebook.com/MaketheKidneyConnection. Photo courtesy of Getty Images #12194 Source: NKDEP

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12 Boomers 2014

Fresh approachFamily Features

A woman’s face and hands can be tell-tale signs of years creeping by, but there is another area of the

body that is often overlooked and can be one of the best indicators of a woman’s true age – her dÈcolletage.

The chest is one of the most-exposed and least-cared-for areas of the body. Sun dam-age conspires with the passage of time to thin the skin and create wrinkles, sunspots and crepe paper-like texture. Even side-sleeping, which chronically compresses the skin, contributes to vertical wrinkling pat-terns on the chest.

Finding the right solution: While there are a number of products that target this area – from topical skin care creams and serums to structural devices worn on the chest for side sleepers – the options are still relatively limited. The available options require ongoing use, offer a preventive focus, and are limited in their ability to repair damage.

Those looking to find a cure in a bottle can pick from a number of creams at their local department stores, pharmacies and salons.

Yet, these over-the-counter treatments are not regulated by the Food and Drug Administration, potentially offering false hope to consumers. Lasers can be effective, but must be used at low levels over several treatments, and the patient must avoid any sun exposure throughout the multi-month treatment regimen.

Fresh approach to an age-old problem: With a recent FDA clearance, for the first

time, there is now an option specifically indicated to non-invasively treat the chest to improve lines and wrinkles of the dÈcol-letage. The Ultherapy(r) DÈcolletage Treat-ment utilizes imaging and micro-focused ultrasound therapy capabilities, only takes about 30 minutes to administer and boasts no downtime after the procedure.

Unlike lasers, radio frequency, surgery and other technologies, non-surgical Ulthe-rapy bypasses superficial skin to deliver the right amount of ultrasound energy at the right depths and the right temperature. This energy triggers a natural response under the skin, jumpstarting the regenerative process that strengthens weak collagen and produc-es fresh, new collagen. The treatment also uses traditional ultrasound imaging, which allows practitioners to see the layers of tissue they are treating, ensuring the treat-ment energy is delivered to where it will be most beneficial.

For those ready to don V-neck blouses again without the risk of revealing their real age, Ultherapy may be a simple solu-tion to supplement a cabinet full of miracle creams. To learn more, visit NewUltherapy.com.

Treatment regenerates weak, and produces new collagen

Photo courtesy of Getty ImagesSun damage conspires with the pas-sage of time to thin the skin and create wrinkles.

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Boomers 2014 13

StatePoint Media Service

F eeling under the weather? Many common ailments, as well as seri-ous life-threatening conditions,

are caused by what you are and aren’t putting into your body, experts say.

“Even if you stick to a well-balanced diet, you may not be getting sufficient nutrients,” says Dr. Michael A. Smith M.D., author of the new book and educa-tional tool, “The Supplement Pyramid” and host of Healthy Talk on RadioMD.com.

In fact, nearly all Americans have an inadequate intake of Vitamin E and nearly a third do not get enough Vitamin C according to government statistics.

“It doesn’t matter how many fruits and vegetables you’re eating if they’re grown in nutrient-poor soil,” Smith says. “The unfortunate truth is that the nutrient content of our soil – and thus our crops – has been steadily declining for decades.”

While organic produce may reduce your exposure to pesticides, it doesn’t necessarily mean it will be more nutri-ent-rich. So in addition to a healthy diet, what can you do to ensure you’re getting sufficient nutrition? Smith offers a few tips:Q Take an ideally dosed multi-

vitamin/mineral. From Vitamin A to zinc, your body is dependent on these nutrients for optimal health. But not all multivitamins are the same. Skip the bare-bones variety that provide mini-mal doses of some essential nutrients, and opt for a robust multivitamin that delivers ideal doses of a full spectrum of essentials.Q Omega-3 fatty acids are healthy fats

that your body can’t live without, sup-porting mental and cognitive health, decreasing cardiovascular disease risk, and lowering systemic inflammation. But because your body can’t make them, you either have to get omega-3 fatty acids through your diet or supplementa-tion.

Is your diet making you sick?Many ailments can be caused by what we eat

StatePoint Media ServiceIt doesn’t matter how healthy your diet is. If your gut is compromised, it can’t extract the protein, carbohydrates, fats, vitamins and minerals you need to sur-vive.DIETCONTINUED ON 14�

’’‘‘Even if you stick to a

well-balanced diet, you may not be getting sufficient nutrients.

Dr. Michael A. Smith, M.D.

EndocrinologyRheumatology

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14 Boomers 2014

Q All of your cells need ener-gy to function, particularly your heart and brain cells. You may have never heard of coenzyme Q10, but it plays a critical role in cellular energy production. Look for this sup-plement in ubiquinol form, which is absorbed much bet-ter by the body.Q It doesn’t matter how

healthy your diet is. If your gut is compromised, it can’t extract the protein, carbo-hydrates, fats, vitamins and minerals you need to survive. Not only that, but about 70 percent of your immune sys-tem is actually located in your gut. Since so many factors diminish levels of beneficial bacteria in the gastrointes-

tinal tract, it’s essential to replenish their numbers with daily probiotic supplementa-tion.Q When seeking out supple-

ments, stick with a company that has an established track record of selling high-quality products and uses only pure, potent raw materials. They should also include dos-ages of key ingredients high enough to impact your health. Find out if your supplements make the grade by doing your research.

For free tools to build your personal supplement regimen and for more information about Smith’s new book, visit MySupplementPyramid.com or call 855-870-0687.

Don’t assume a healthy diet is sufficient. Key supple-ments can improve the way you feel.

Taking supplements can improve the way you feel

DIETCONTINUED FROM 13

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Call us to learn more 815-772-4031403 Scenic Street • Morrison, Illinois 61270Windsor-Manor.com

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Boomers 2014 15

Peace of mind High-tech ways to keep an eye on aging parents

BY TROY WOLVERTONMCT News Service

A fter her 75-year-old mother suf-fered a severe health problem last fall that required surgery,

Colleen Sturvidant needed a way to bet-ter keep an eye on her.

Because Sturdivant lives in Oakland, California, and her mom lives by herself in Sacramento, California, it wasn’t easy for Sturdivant to check on her, and there was little chance she could respond quickly in an emergency. So when a friend of her husband suggested she try out a new device his company had designed for just such situations, Sturdi-vant, 45, decided to give it a try.

The product, from a San Francisco startup called Lively, is built around a system of network-connected sensors that can tell Sturdivant when her mom gets something out of the fridge, when she opens her front or back door, when she takes her medicine and even when she leaves the house.

It may sound creepy to those con-cerned about privacy, but Lively’s system

has been reassuring to both Sturdivant and her mom. The system can’t directly notify Sturdivant when there’s an emer-gency, but by keeping track of her mom’s regular patterns, it can indicate when something might be wrong.

“I talk to my mom often, practically daily,” said Sturdivant, who works in the information technology department of a local retailer. “But I want that conversa-tion to be about what’s going on in her life and not about, ‘Are you OK?’ ”

That kind of peace of mind is precisely what Lively’s founders wanted to offer customers, said David Glickman, the com-

pany’s co-founder and chief operating offi-cer, who is a college friend of Sturdivant’s husband. When Glickman and his col-leagues founded the company 2 years ago, they set out to create a product that would help seniors live independently for as long as possible while helping their families keep an eye on them.

Lively is just one of a growing number of companies offering senior monitoring devices and systems. Among its competi-tors are startups such as BeClose and GrandCare Systems as well as Care Inno-vations, a joint venture formed by Intel and General Electric.

Their products are meant to address some of the implications of the aging of the Amer-ican population. The U.S. government’s Administration on Aging forecasts that the number of Americans age 65 or older will grow from 40 million, or 13 percent of the population, in 2010 to 72 million, or 19 per-cent of the population, in 2030. People are living longer, and are contending for longer periods with chronic illness.

’’‘‘I talk to my mom often,

practically daily. But I want that conversation to be about what’s going on

in her life and not about, ‘Are you OK?’Colleen Sturdivant

HIGH-TECH CONTINUED ON 16�

Lee County Council on AgingAssisting seniors to better quality of life

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16 Boomers 2014

The number of seniors suffering from Alzheimer’s disease alone is expected to grow from about 5 million today to more than 7 million in 2025. At the same time, there’s a dearth of assisted-living facili-ties and lack of trained health givers, noted BeClose CEO Liddy Manson.

“We’re definitely going to have a human resources crunch,” Manson said. “So technology is going to have to bridge the gap.”

While the potential demand for prod-ucts such as those offered by BeClose and Lively is huge, the market is still nascent, industry analysts say. Greg Caressi, an analyst who focuses on health care technology for research firm Frost & Sullivan, estimates that only about $15 million worth of senior monitoring products were sold in the United States last year. He forecasts the market will grow to about $25 mil-lion in 2017.

Many consumers simply aren’t

aware that such products are avail-able, Caressi and other analysts say. In many cases, the costs have been prohibitive to consumers and health insurers often don’t pick up the costs.

Glickman and his colleagues hope they can expand the market by addressing some of the flaws they saw in earlier senior monitoring systems. They were expensive; complicated, sometimes requiring professional installations; or invasive, some includ-ing video cameras or requiring seniors to wear something around their neck at all times.

By contrast, Lively’s service is designed to be simple. The kit comes with six sensors and a hub device that are already paired when users open

the box. The hub includes a built-in cellular data connection, so users don’t have to worry about connect-ing it to their home network or to the Internet. Basically, all they have to do to set it up is attach the sensors to refrigerator doors or medicine cabi-nets and plug in the hub.

Glickman and his colleagues inten-tionally left out a camera and designed the system so that it doesn’t provide fine-grained details of seniors’ activi-ties. It can’t tell what they’re eating or what pills they’re taking, and it doesn’t keep track of their movements outside the home.

Perhaps most importantly, Glickman and his colleagues priced the service relatively cheaply. The system costs $149 plus a $20 monthly subscription fee. By contrast, similar systems can cost $400 or more with monthly charg-es starting at $50.

For Sturdivant, the system has been well worth its cost.

“The monthly service price is fine for the peace of mind that it gives me,” she said.

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Boomers 2014 17

The medical roller coasterof Hepatis C treatment

MCT News Service Barbara Walter, 67, of Fairview, Pennsylvania, poses for a portrait on Sept. 18, 2014. Walter was cured of hepatitis C. She con-tracted it from a blood transfusion in 1976, was diagnosed in 2000, and cured with expensive drugs this past summer.

CDC recommends everyone born between 1945 and 1965 get tested

BY DAVID TEMPLETONMCT News Service

PITTSBURGH – Barbara Walter has experienced the full medical odyssey of chronic hepatitis C infection, hav-ing faced its every major challenge while benefiting from all of the mod-ern breakthrough treatments.

She is one of the lucky few. She is cured, with no detectable virus in her blood since July.

But it is a medical roller coaster ride for the 4 million Americans and 180 million people worldwide with

hepatitis C.The latest issue involves two new

antiviral medications that can cure a patient in 12 weeks and one expect-ed soon to be available once the U.S. Food and Drug Administration finalizes approval. But those break-throughs are tempered by the drugs’ price of $1,000 a pill, limiting their use to only those with the sever-est complications or biggest bank accounts.

Study: Hepatitis C will be rare by 2036

MCT News Service

PITTSBURGH – Hepatitis C, a major infectious disease in the United States with 180 million cases worldwide, will likely become a rare disease by about 2036, according to a University of Pittsburgh Graduate School of Public Health analysis.

But that time period could be short-ened by a decade to about 2026, according to computer modeling of factors and trends involved in infection rates.

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18 Boomers 2014

A single-drug regimen awaits FDA approval

A 12-week treatment regimen with one of two drugs costs $60,000 and $80,000, respectively, with a full regimen of both drugs costing $144,000, which is a prohibi-tive cost for public and private health plans for most people with the disease.

The major step forward in treating the infection must be weighed against the drugs’ costs that pose a “potential threat to the viability of the U.S. health-care sys-tem,” states proposed guidelines for use of the drugs outlined last week in the Journal of the American Medical Association. The controversy involves the drugs sofosbuvir (sold as Sovaldi) and simeprevir (sold as Olysio), often prescribed along with other drugs. A single-drug regimen awaiting FDA approval could cure the disease in as little as 8 weeks.

Gilead Sciences Inc., the manufacturer of sofosbuvir, raised the bar of contro-versy recently with its announcement that it would license generic versions of sofosbuvir to be manufactured by various drug companies to be sold for a fraction of

the American price in India and 90 other nations whose citizens cannot afford full-market price. A full round of treatment in India could cost less than $1,800, about a penny on the dollar when compared with the American price.

One in 100 Americans has hepatitis C, with 80 percent of the cases infecting baby boomers. Many contracted the disease decades ago when blood transfusions were not screened for the virus. The infection also can be transmitted through intrave-nous drug use and sexual transmission.

The National Medical Association says of every 100 people with the infection, 75 per-cent to 85 percent develop chronic hepa-titis, with 60 percent to 70 percent of those developing chronic liver disease. As many as 20 will develop cirrhosis of the liver (liver scarring), and as many as five will die from cirrhosis or liver failure.

Walter, 67, of Fairview, Pennsylvania, received a blood transfusion in 1976 during a medical procedure. This eventually led to her diagnosis of hepatitis C in 2000 after a routine blood test. Most people with the virus often don’t know they have it until they begin experiencing the symptoms of cirrhosis or liver cancer.

“Actually, I felt good,” she said. “A lot of patients get discoloration, but I wasn’t yel-low. I did not lose weight. I really looked healthy.”

Soon after diagnosis, she was placed on the traditional course of peginterferon and ribavirin, which requires about a year of treatment to produce a cure about 50 percent of the time but with adverse side effects. The drugs did not work for Walter, and the side effects required medication.

But back pain in December 2011 led to discovery of a cancerous liver tumor, which University of Pittsburgh Medical Center physicians removed. That led to her being listed for a liver transplant due to advancing cirrhosis. She underwent a successful trans-plant in April 2013 at UPMC Montefiore. Then, last April, the liver began showing signs of rejection once hepatitis had infect-ed the new liver.

So she received insurance approval for the expensive dual-drug combination of sofos-buvir and simeprevir, which she took May through July, with a $10,000 copay and a total medication cost of $144,000, she said. And it worked. Since her blood test in July, she has had no signs of infection.

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Boomers 2014 19

“We picked an ideal scenario – one that really is ideal – that assumes that all unaware patients get screening once and everyone who is infected is treated,” said Mina Kabiri, a doctoral student in health ser-vices research and policy and the study’s lead author. “We wanted to show what would be the difference if you had the most optimal situation and illustrate how it changes the time before it would become a rare disease. It would be a 10-year difference.”

The analysis and computer-modeling methodology used to reach the conclusions was published recently in the Annals of Internal Medicine. The predictive model, devel-oped with assistance from the M.D. Anderson Cancer Center

at the University of Texas, was funded through the National Institutes of Health.

Hepatitis C causes about 15,000 deaths annually in the United States. Prevalence of a rare disease is fewer than one of every 1,500 people. Currently, hepatitis C infects about one in 100, although the rate has been declining steadily in recent years due to treatment advances.

“We compared the base case – the current trend – with the very ideal to show the range,” Kabiri said. “There are new drugs and changes in physicians’ reactions to new drugs. It is pretty hard to pick a year between 2026 and 2036 because everything is chang-ing so fast.”

The model was run with data and trends from recent eras, and the outcomes compared favorably with what actually did occur, she said.

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20 Boomers 2014

“If you already went through a transplant, you don’t want anything to happen to the new liver,” Walter said. “Life depends on it. So my husband said, ‘Whatever the cost, it’s worth it.’”

The liver is the body’s largest organ, with more than 500 functions, said Vinod K. Rustgi, the UPMC medical director of liver transplantation.

The U.S. Centers for Disease Control now recommends people born between 1945 and 1965 be screened with a blood test for the hepatitis C infection. Symptoms don’t typically appear until liver function declines to less than 30 percent, with typical symp-toms of jaundice, a swollen abdomen, con-fusion and bleeding, Dr. Rustgi said. People who reach this stage of infection face a 50 percent death rate within 5 years, which points to the need for drug treatments and liver transplants.

In 2007, the death rate from hepatitis C began exceeding that of human immuno-deficiency virus infections in the United States. “HIV has received a lot of publicity, and it is incumbent upon us to make peo-

ple aware that hepatitis C is more common than HIV and it is curable.”

Screening allows for earlier recognition of symptoms and allows for lifestyle changes, including dietary changes and abstinence from alcohol, Dr. Rustgi said.

“When you look at an area like Pittsburgh, where there are 2.4 million people (in the metropolitan area), we may have 50,000 people with hepatitis C, with only 10,000 identified as having it,” he said. “That is why screening is so important.

“It is important that the average person not be afraid or ashamed to be screened because there is better recognition of the problem, and we can address it before we get to a point where the situation is irre-trievable,” Dr. Rustgi said.

Walid F. Gellad, co-director of the Center for Pharmaceutical Policy and Prescribing at the University of Pittsburgh, said the hep-atitis debate “may be a harbinger of what’s to come” with expensive drugs to treat vari-ous illnesses.

“A lot of drugs are really expensive, but they are not used for conditions as com-mon as hepatitis C,” he said. “These deci-sions about what drugs to cover and what to screen for are extremely difficult deci-sions.”

For now, many of those decisions are made by Medicare and private health insur-ance providers. Treating people early to prevent huge costs in 20 years might seem like a no-brainer in terms of cost and con-science.

“But not everyone who has hepatitis C will end up with a transplant or cirrhosis, and we don’t know how to exactly predict who those people will be,” Dr. Gellad said. “I don’t want to minimize it. This is an impor-tant cause of death and liver transplants, and a very important disease, but not every-one who gets the infection ends up with these advanced conditions.”

One issue being debated is the cost to research, develop, test and manufacture the drugs. That question arose in recent weeks when the pharmaceutical company Gil-ead announced agreements to sell generic sofosbuvir overseas at the dramatically reduced price.

Gilead is seeking FDA approval for yet another revolutionary hepatitis C medica-tion – a fixed-dose pill that combines sofos-buvir with the experimental drug ledipasvir that has been shown to cure hepatitis C in just 8 weeks in most cases. “Everyone will be waiting with bated breath to see how it will be priced,” Dr. Gellad said.

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Boomers 2014 21

Going beyond medicationSpinal cord stimulation helps treat chronic pain

StatePoint Media Service

N early 100 million Americans suffer from chronic pain – that’s more than the number of peo-

ple living with heart disease, cancer and diabetes combined. Often experienced as pain that lasts over 3 to 6 months, chronic pain is a serious and debilitating condition that, if left unmanaged, can negatively impact nearly every aspect of your life.

Chronic pain is the leading cause of long-term disability in U.S. and is a sig-nificant burden to the health care econ-omy and society as a whole. It costs as much as $635 million annually in direct medical treatment costs and low produc-tivity, according to government statistics. Surprisingly, 40 percent of work absenc-es are due to back pain, second only to the common cold.

Zac Cover, a former firefighter and tri-athlete, knows the devastating impact of chronic pain. In 2006, the Floridian was hit by a car while cycling and suffered multiple injuries, including broken ribs, a badly injured leg, fractured arm and severed nerve in his broken collarbone.

He underwent seven operations and was bedridden for nearly 6 months. While the surgeries corrected the physi-cal damage to his body, Cover was left with excruciating pain that lasted for years. His doctor prescribed medication that helped ease the pain but left him foggy-headed, with a poor memory and unable to enjoy activities he loved.

After months of trying other unsuccess-ful treatments, Cover’s doctor recom-mended neurostimulation, also known as spinal cord stimulation – an advanced therapy option used to manage chronic pain in the arms, legs and trunk, and pain caused by failed back surgery. SCS involves implanting a small device (the size of a silver dollar) along the spinal cord where it emits low intensity elec-trical pulses that intercept the body’s pain signals before they reach the brain, replacing feelings of pain with a more pleasant tingling sensation.

Dr. Timothy Deer, president-elect of the International Neuromodulation Society, says he has seen an increase in the number of people receiving SCS. “Spinal cord stimulation is an important therapy option for patients who have not been able to alleviate their chronic

pain through traditional methods, such as back surgery or pharmacological options,” Deer said. “Studies have shown SCS can reduce pain by 50 percent or more, and patients have the option to try a temporary implant to see if they’re comfortable with the therapy.”

Over time, Cover was able to resume almost all his normal activities – like biking, swimming and running – because he can now better manage his pain. In fact, he was able to draw from this experience and began working as a clinical specialist at St. Jude Medi-cal, the company that manufactured his device. He now works with patients also suffering from chronic pain who have or are about to receive SCS sys-tems.

Cover urges others suffering from chronic pain to talk to their doctor about the best treatment option for them. “Spinal cord stimulation has given me back a life I didn’t think I would have again,” he said. “My pain level is much lower and I’ve been able to stop taking pain medication. It’s dramatically transformed my quality of life.”

StatePoint Media ServiceZac Cover, a former firefighter and triathlete, knows the devastating impact of chronic pain. In 2006, the Floridian was hit by a car while cycling and suffered mul-tiple injuries, including broken ribs, a badly injured leg, fractured arm and severed nerve in his broken collarbone.

’’‘‘

Studies have shown that SCS can reduce pain

by 50 percent or more, and patients have the option to try a temporary implant to see if they’re comfortable

with the therapy.Dr. Timothy Deer, president-elect of the International Neuromodulation Society

22 Boomers 2014

Long-term care needsTwo-thirds of Americans over 40 are in denial

BY LAURAN NEERGARED and JENNIFER AGIESTA

The Associated Press

WASHINGTON – We’re in denial: Americans underestimate their chances of needing long-term care as they get older – and are taking few steps to get ready.

A new poll examined how people 40 and over are preparing for this difficult and often pricey reality of aging and found two-thirds say they’ve done little to no planning.

In fact, 3 in 10 would rather not think about getting older at all. Only a quarter predict it’s very likely that they’ll person-ally need help getting around or caring for themselves during their senior years, according to the poll by the AP-NORC Center for Public Affairs Research.

That’s a surprise considering the poll found more than half of the 40-plus crowd already have been caregivers for an impaired relative or friend – seeing from the other side the kind of assistance

they, too, are likely to need later on.“I didn’t think I was old. I still don’t

think I’m old,” explained retired school-teacher Malinda Bowman, 60, of Laura, Ohio.

Bowman has been a caregiver twice, first for her grandmother. Then after her father died in 2006, Bowman moved in with her mother, caring for her until her death in January. Yet Bowman has made few plans for herself.

“I guess I was focused on caring for my grandmother and mom and dad, so I didn’t really think about myself,” she said. “Everything we had was devoted to taking care of them.”

The poll found most people expect

family to step up if they need long-term care – even though 6 in 10 haven’t talked with loved ones about the possibility and how they’d like it to work.

Bowman said she’s healthy now but expects to need help someday from her two grown sons. Last month, prompted by a brother’s fall and blood clot, she began the conversation by telling her youngest son about her living will and life insurance policy.

“I need to plan eventually,” she acknowledged.

Those family conversations are cru-cial: Even if they want to help, do your relatives have the time, money and knowhow? What starts as driving Dad to the doctor or picking up his grocer-ies gradually can turn into feeding and bathing him, maybe even doing tasks once left to nurses such as giving injec-tions or cleaning open wounds. If loved ones can’t do all that, can they afford to hire help? What if you no longer can live alone?

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Boomers 2014 23

“The expectation that your family is going to be there when you need them often doesn’t mean they understand the full extent of what the job of caregiving will be,” said Susan Reinhard, a nurse who directs AARP’s Public Policy Institute. “Your sur-vey is pointing out a problem for not just people approaching the need for long-term care, but for family members who will be expected to take on the huge responsibility of providing care.”

Most people who have been caregivers called the work both worthwhile and stress-ful. And on the other end, those who have received care are less apt to say they can rely on their families in times of need, the poll found.

With a rapidly aging population, more families will be facing those responsibilities. Government figures show nearly 7 in 10 Americans will need long-term care at some point after they reach age 65, whether it’s from a relative, a home health aide, assisted living or a nursing home. On average, they’ll need that care for 3 years.

Despite the “it won’t happen to me” reac-tion, the AP-NORC Center poll found half of those surveyed think just about everyone will need some assistance at some point. There are widespread misperceptions about how much care costs and who will pay for it. Nearly 60 percent of those sur-veyed underestimated the cost of a nursing

home, which averages more than $6,700 a month.

Medicare doesn’t pay for the most com-mon types of long-term care. Yet 37 percent of those surveyed mistakenly think it will pay for a nursing home and even more expect it to cover a home health aide when that’s only approved under certain condi-tions.

The harsh reality: Medicaid, the federal-state program for the poor, is the main payer of long-term care in the U.S., and to qualify seniors must have spent most of their savings and assets. But fewer than half of those polled think they’ll ever need Med-icaid – even though only a third are setting aside money for later care, and just 27 per-cent are confident they’ll have the financial resources they’ll need.

In Cottage Grove, Oregon, Police Chief Mike Grover, 64, says his retirement plan means he could afford a nursing home. And like 47 percent of those polled, he’s created an advance directive, a legal document outlining what medical care he’d want if he couldn’t communicate.

Otherwise, Grover said he hasn’t thought much about his future care needs. He knows caregiving is difficult, as he and his brother are caring for their 85-year-old mother.

Still, “until I cross that bridge, I don’t know what I would do. I hope that my kids and

wife will pick the right thing,” he said. “It depends on my physical condition, because I do not want to be a burden to my chil-dren.”

The AP-NORC Center poll found wide-spread support for tax breaks to encourage saving for long-term care, and about half favor the government establishing a volun-tary long-term care insurance program. An Obama administration attempt to create such a program ended in 2011 because it was too costly.

The older they get, the more prepara-tions people take. Just 8 percent of 40- to 54-year-olds have done much planning for long-term care, compared with 30 percent of those 65 or older, the poll found.

Mary Pastrano, 74, of Port Orchard, Washington, has planned extensively for her future health care. She has lupus, heart problems and other conditions, and now uses a wheelchair. She also remembers her family’s financial struggles after her own father died when she was a child.

“I don’t want people to stand around and wring their hands and wonder, `What would Mom think was the best?’” said Pas-trano, who has discussed her insurance policies, living will and care preferences with her husband and children.

Still, Pastrano wishes she and her hus-band had started saving earlier, during their working years.

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