by Bobby Anderson
Staff Writer

Karen Ritchie, RN, has seen the looks come across the faces of new patients walking into the Norman Regional Oklahoma Wound Center.
There’s the understandable fear, anxiety and trepidation that comes with a process that has the possibility of unthinkable outcomes – the loss of limb and possibly life.
As Norman Regional Health System’s diabetic limb salvage nurse navigator, Ritchie always has a smile, caring word and a message for those patients: There’s hope.
That was just one of the messages stressed by Dr. Desmond Bell, DPM, CWS, president and founder of the Save a Leg, Save a Life Foundation (SalSal) during his presentation “The Gift of a Second Chance.”
Bell’s presentation capped a month-long awareness campaign spearheaded by Dr. TaySha Howell and staff at the Oklahoma Wound Center.
“SalSal is about creating awareness in the community and educating patients as well as the medical community,” said NRHS cardiologist Dr. Archana Gautam. “For many years everyone knew about peripheral vascular diseases but nobody was aggressive at treating it.”
Ritchie says that in any given year Oklahoma is No. 1 or No. 2 in the nation in total amputations.
The statistics Bell shared are alarming with more than 65,000 major amputations performed annually for crucial limb ischemia (CLI) alone.
Within five years nearly 70 percent of those patients are dead.
FAILURE IS NOT AN OPTION
“Amputation should not be seen as a treatment option, but a treatment failure,” Bell said, quoting one of his colleagues.
The five-year mortality rate for a non-healing neuropathic ulcer is 45 percent.
Bell singled out the Oklahoma Wound Center as a national leader in promoting wound care awareness.
“Your group here has done a phenomenal job and I just can’t thank you enough,” he said. “You may not realize this but Norman … you all have been the model for what is to come and I’m sure what we’re going to accomplish you’ll look back on this day and be very, very proud in the next few years.”
After Bell addressed the group, patient after patient shared stories about their treatment journey at Oklahoma Wound Center.
“I drive a truck for a living and I was worried about not being able to do what I did,” said Eldon P., who presented with a diabetic toe. “I didn’t want to be in a wheelchair. It’s pretty scary and I went through some pretty rough times emotionally thinking I might lose a limb.”
The therapies, including hyperbaric oxygen dives, helped save his foot.
“It was a long journey, but well worth it,” said Carol T., beginning to tear up while sharing her diabetic ulcer story. “I definitely got the second chance message. There are things you take for granted until you could be missing it. I just thank Dr. Howell and her whole team.”
Bell said the SalSal Foundation is in its infancy, much like the Breast Cancer Awareness group Susan G. Komen Foundation was years ago.
That group started with a promise from one sister to another.
“Imagine what we could do if we had a dollar from every single person with diabetes in this country. It’s mindboggling but it’s achievable,” Bell said. “Five years from now we’ll look back and the things you all have done for our organization will be among the most impactful.”
Bell pointed out that the underlying factors such as diabetes and peripheral artery disease and obesity are more universal than cancer.
“If someone gets the word cancer thrown at them then all the wheels are set in motion and they become their own best advocate,” Bell said. “Yet our patients don’t understand what’s happening. They don’t understand the pain that’s ahead of them. It’s probably one of the most undignified ways to leave this world.”
“We have to do better, simply stated.”
Howell, wholeheartedly agrees and has a message for patients and clinicians.
“It’s so vital because either the patient doesn’t realize how serious it is … but also sometimes to primary care doctors the wound doesn’t look really infected, big or the patient doesn’t complain it hurts,” Howell said. “So a month goes by and another … and they get bone infection or no blood flow and it just blows up into some disaster where if they come when they first have a wound it’s so much easier to turn around.”
That’s why Ritchie loves her job, because she understands she truly saves lives. “It’s awesome. Wound care is very different than being a staff nurse or floor nurse,” Ritchie said. “With those patients they come in and you make them feel a little bit better and they are discharged and go on their way. With wound care they come in with wounds they know are going to take time to heal and you see them for weeks.”
“Once you know they’ve been successful – that’s the most awesome, most fulfilling feeling.”
“That’s what you went to nursing school for.”

Photography and Text by Terry “Travels with Terry” Zinn  t4z@aol.com

Preceding the Red Earth Festival in Oklahoma City is the informative, entertaining and thought provoking Sovereignty Symposium. Being established in 1988 the Symposium is about to celebrate its thirtieth anniversary in the historic Skiving Hotel. For two days, June 7 and 8 the most prestigious speakers from the Judicial and Native American Leaders and artist gather to share their knowledge and expertise.
The mission statement of the Sovereignty Symposium states: “The Sovereignty Symposium was established to provide a forum in which ideas concerning common legal issues can be exchanged in a scholarly, non-adversarial environment. “
Oklahoma Supreme Court Justice Yvonne Kauger has coordinated the Sovereignty Symposium since its inception. About its formation Justice Kauger says, “We did it because John Doolin kept going to the National Association of Chief Justices and they have an Indian law committee, but he went three times and came back and said, “They’re never going to do anything. They talk about it, they say they’re going to
have a seminar, they say they’re going to do this. They haven’t done anything and they’re not going to do anything.” And they still haven’t.
So he said, “We’ll just do our own.”
“Governor Bellmon was very instrumental in helping us, and Ed Edmondson, and we did it. And now we’ve been doing it, and no one gets anything for doing this, they pay
their own way. We have the best legal scholars in the world and they pay their own way and they get a T-shirt for coming and our thanks.”
Of particular interest and creativity is: SIGNS, SYMBOLS AND SOUNDS, moderated by the talented, WINSTON SCAMBLER, Student of Native American Art, who has gathered for his seminar: FRITZ KIERSCH, Assistant Vice President, Point Park University, Pennsylvania; ERIC TIPPECONNIC, (Comanche), Historian, Artist, and Professor, California State University, Fullerton; JASON MURRAY, (Chickasaw), Independent Scholar & Professor, Formerly of the University of South Dakota; POTEET VICTORY, (Cherokee/Choctaw), Artist; BRENT GREENWOOD, (Ponca/Chickasaw), Artist and Musician; JOSHUA HINSON, (Chickasaw), Chickasaw Language Revitalization Program and GORDON YELLOWMAN, (Cheyenne), Peace Chief, Assistant Executive Director of Education, Cheyenne and Arapaho Tribes.
Winston Scambler is the youngest moderator, as he is an upcoming senior at Heritage Hall and wise beyond his years. Scambler continues the seminar “Signs, Symbols and Sounds,” he began last year.
“I attribute my initial interest to my grandmother, Justice Kauger. She was adopted into the Cheyenne and Arapaho tribe and is called the Mother of the Red Earth Powwow.,” Scambler proclaims. “Through her Influence I’ve grown up with Native American Art and really love it.”
With the guidance of photograph Neil Chapman, Scambler educated himself in art with assistance from the archives at the Oklahoma History Center, before forming his seminars.
One of his favorite artists and speakers this year is Eric Tippeconnic. “Eric likes to talk about the symbols he uses, as it means something different to everyone. You’ll see a lot of hand prints and horses,” says Scambler. “This year he is doing something really contemporary with his series called, Briefcase Warriors.”

Other sessions with their moderators include:
ECONOMIC DEVELOPMENT with JAMES C. COLLARD, Director of Planning and Economic Development, Citizen Potawatomi Nation;
LAND, WIND AND WATER with PATRICK WYRICK, Justice, Oklahoma Supreme Court;
TRUTH AND RECONCILIATION: GENERATIONAL/HISTORICAL TRAUMA AND HEALING with NOMA GURICH, Vice Chief Justice, Oklahoma Supreme Court;
ROUNDTABLE DISCUSSION WITH FORMER ASSISTANT SECRETARIES OF THE INTERIOR FOR INDIAN AFFAIRS, with JOHN REIF, Justice, Oklahoma Supreme Court.
Since its inception in 1988, the Sovereignty Symposium has award the status of “Honored One” to unique individuals whose life time contribution to the world, the United States, the State of Oklahoma and their personal communities are without peer. Past recipients include Justice Sandra Day O’Connor, the first woman appointed to the United States Supreme Court; former Attorney General Janet Reno, Astronaut Commander John Harrington and Cherokee Chief Wilma Mankiller.
This years Honored Ones, are Former Assistant Secretaries of the Interior for Indian Affairs: Thomas W. Fredricks, Ada E. Deer, Neal McCaleb, Carl Artman and Larry Echo Hawk..
The Friend of the Court for this year goes to Kris Steele. The Ralph B. Hodges-Robert E Lavender Award for Judicial Excellence Award goes to Oklahoma Supreme Court Justice Seven Taylor (Retired).
Benjamin Harjo, Jr. (Seminole & Shawnee), designed and donated the logo for the Sovereignty Symposium. The Lighthorseman depicts an Indian policeman framed in a star. In Indian Territory, the Five Civilized Tribes had a body of men, the Lighthorsemen, who served as a mounted police force. The Lighthorsemen helped the United States Army to keep peace in Indian Territory and to drive out white intruders. Considerable latitude was given to the Lighthorsemen in enforcing the judgments of the courts. Harjo has won many awards in major Native American art shows in the United States. His generosity is appreciated in designing and in donating the logo.
General Admission of $300 for both days may be found with your registration at, www.thesovereigntysymposium.com or sovereignty.symposium@oscn.net
You may want to add on to your cultural entertainment, the Red Earth Festival and Powwow June 8 and 9th at the Cox Convention Center near the Skirvin Hotel in downtown Oklahoma City The festival includes dance competitions and a high quality Native American art show and sale. https://www.redearth.org/

Picnics, campouts and going to the lake. Kathy Swan

Staying in the AC and watching the birds and squirrels. Margaret Salter

The flowers, watching people jog and exercise and getting my little puppy and playing with him. Barbara Gossett

It ain’t cold. I can’t ride my scooter wherever I want in the winter.

Mike Davis

Dear Savvy Senior, My husband and I are interested in getting a couple of bicycles for leisurely exercise and fun, and would like to get your recommendation. We’re both approaching 60 and are a little overweight, and it’s been a while since we rode. Easy Riders

Dear Easy,
If you’re interested in leisurely, recreational riding for fitness and fun, a great option is a “comfort bike,” which is very popular among baby boomers. Here’s what you should know about this option, along with some tips to help you shop and choose.
Comfort Bikes
A comfort bike is a style of bicycle that’s easy on an aging body because it lets you ride in a more comfortable upright position. These bikes have high handlebars so you don’t have to hunch over, which eases lower-back strain and reduces pressure on the wrists and hands. They also come with wide tires for a smooth ride, offer fewer gears, and have soft, wide seats to eliminate saddle soreness.
Most comfort bikes also come with shock-absorbing forks and seat posts for additional comfort. And some offer unique design features like an ultra low step-over bar that makes getting on and off easy for people with limited flexibility (like the Biria Easy Boarding at Biria.com), or the “flat-foot” design offered by many manufacturers where the pedals are moved forward, away from the seat. This allows you to get a full-leg extension when you pedal, but keeps the seat in a lower position so when you’re stopped, you can put your feet down flat on the ground while seated, which is a great safety feature for older riders.
Most major manufacturers including Electra, Sun, Raleigh, GT, Giant, and Trek all make a line of comfort bikes that costs between $300 and $800 or more depending on its features.
Shopping Tips
To find a quality comfort bike, your best option is to find a good bike shop in your area. Bikes from big box stores, like Walmart and Target, are mass-market bikes that may be less expensive, but the quality isn’t as good and they’re typically seven to eight pounds heaver. They also come in only one size, so you’re not likely to get a great fit.
Before you buy any bike, be sure you take it for a test ride first to ensure that the seat and fit of the bike is comfortable, the brakes and shifters are easy to use, the gears can go low enough for climbing hills, and the frame and suspension adequately smooth the bumps.
Recumbent Bikes
If the comfort bikes don’t meet your needs, another popular style among older riders is a recumbent bike. These are the low-to-the-ground, stretched-out frame bikes with La-Z-Boy style seats that allow you to recline with your legs positioned in front of you.
Recumbent bikes are very comfy, easy on the back, arms and shoulders, and aerodynamic which make them ideal for long rides. The disadvantages, because they are low-to-the-ground, they can be harder to balance and maneuver, and are more difficult for other vehicles to see.
If you worry about falling or want more stability when you ride consider a three-wheel recumbent trike. See SunSeeker.bike and TerraTrike.com for a nice variety, but be aware that recumbent bikes are more expensive, typically ranging between $1,000 and $2,500.
Send your senior questions to: Savvy Senior, P.O. Box 5443, Norman, OK 73070, or visit SavvySenior.org. Jim Miller is a contributor to the NBC Today show and author of “The Savvy Senior” book.

Amy Chlouber, Sunbeam Family Services Early Childhood Mental Health Coordinator, LPC-S, was recently honored with the 2017 C.V. Ramana Award. The award recognizes Chlouber for her outstanding contributions to children’s mental health in Oklahoma.
The C.V. Ramana Award was established to honor individuals who have played exceptional roles in enhancing awareness of children’s needs and the development of education and services to meet those needs.
Amy leads Sunbeam’s Infant Mental Health efforts with enhanced and expanded Infant Mental Health services across the organization’s four core programs: early childhood, foster care, counseling and senior services. She and her team also provide training for child welfare professionals and the District Courts of Oklahoma County as well as community presentations that create awareness about the mental health needs of infants and very young children who experience stress and trauma.
“Amy leads this initiative with her vision and passion for the youngest and most vulnerable in our community. She is the Russell Westbrook of Infant Mental Health. Talented. Passionate. Resourceful. Focused,” said Sunbeam Family Services CEO Jim Priest. “I don’t know how well she shoots free throws, but I know she consistently scores a triple double in the arena of Infant Mental Health.”
Amy is an Endorsed Infant Mental Health Mentor-Clinical/IMH-E ® (IV-C) who has worked in the mental health field for more than 20 years, specializing in infant and early childhood mental health in public, private and non-profit organizations. She has provided home and office-based therapy services and support to biological, kinship, foster and adoptive families. Amy developed and served as Clinical Director of a private mental health agency satellite office where she provided consultation and training to child welfare professionals and foster families as well as content expertise in juvenile court. She served on the Board of Directors of Canadian County CASA and provided training to CASA volunteers for many years. Amy was one of the original therapists chosen to participate in Oklahoma’s Early Childhood Mental Health Consultation pilot in licensed child care facilities. She served as the Mental Health and Disabilities Coordinator for Early Head Start through Sunbeam Family Services where she provided consultation and training for direct care and administrative staff and was instrumental in the design of the mental health program of OKC Educare. Amy left Sunbeam to work at the state level for seven years providing leadership and oversight of the Oklahoma Infant and Early Childhood Mental Health Strategic Plan. She has served on numerous local, state and national early childhood work groups. Amy is on the Board of Directors of the Oklahoma Association for Infant Mental Health (OK-AIMH) and is currently President-elect. She returned to Sunbeam in 2015 as the Early Childhood Services Manager.

The Brightmusic Chamber Ensemble presents “Bach and Brahms II” in its sixth annual spring chamber music festival at St. Paul’s Cathedral in downtown Oklahoma City.
The four-concert festival will present some of the best-loved works by two of the world’s greatest composers, including two of Bach’s Brandenburg Concertos and works for organ, a cello suite, a cantata, and the powerfully moving Chaconne from Bach’s Partita No. 2 in D minor, described by violinist Joshua Bell as “not just one of the greatest pieces of music ever written, but one of the greatest achievements of any man in history. “ Also on the program will be works by Brahms: sonatas, organ and chamber works and lieder featuring Philadelphia baritone Randall Scarlata.
Fourteen Brightmusic musicians will be appearing during the Festival. See the attached sheet for a complete list.
All concerts will begin at 7:30 pm, except for the 4:00 pm Sunday concert, at St. Paul’s Cathedral, 127 NW 7th Street (at Robinson). A pass for all four concerts is available at the door or on our website at www.brightmusic.org/concerts for $50 each (a savings of $30 over individual concert tickets of $20). Students and active-duty military personnel are admitted free with ID. Also, any who would like to attend but feel they cannot due to financial hardship as a result of recent layoffs in the energy sector are invited to join us as guests of the musicians by simply advising the person at the front desk that they are guests of the musicians and no questions will be asked. More information about the festival is available on Brightmusic’s website at http://www.brightmusic.org.

The American Nurses Association (ANA) today announced its continued opposition to the pending American Health Care Act (AHCA) and urges Congress to reject this flawed legislation. ANA, which represents the interests of more than 3.6 million registered nurses, has expressed serious concerns throughout negotiations about the critical impact the AHCA would have on the 24 million people who stand to lose insurance coverage if AHCA becomes law.
“This bill is an extreme departure from ANA’s priorities,” said ANA President Pamela F. Cipriano, PhD, RN, NEA-BC, FAAN. “AHCA would cut Medicaid funding by $880 billion over 10 years, dramatically increase premiums on seniors, restrict millions of women from access to health care, weaken the sustainability of Medicare, and repeal income-based subsidies that have made it possible for millions of families to buy health insurance.”
Under AHCA, states would have the option to waive essential health benefit protections which prevent insurance companies from charging Americans with pre-existing conditions significantly more for coverage. Even worse, insurers could decline coverage for substance abuse treatment, maternity care, and preventive services. “As the nation’s most trusted profession and largest group of health care professionals, nurses understand the importance of health coverage,” Cipriano continued. “ANA urges Congress to not deny peoples’ right to health care and quality of life by standing with the American people in opposing AHCA in its current form. ANA will continue to work with Congress to help improve health care delivery, coverage, and affordability for all Americans.”

Q. I never really thought about “conversational intimacy” and the role it plays in a relationship. It is much harder than people think and sad to think I lost my marriage because of it. I wanted to make others aware of the knowledge I gained and to encourage you to do it before it is too late.

A. My name is Jim and I was married for 16 years. My wife and I both worked full time and we were raising two children. We were busy like all married couples with children’s activities and managing a home.
My wife would occasionally tell me that we needed “to talk” and I would get very busy hoping she would forget. She didn’t. These “talks” always made me anxious. She wanted to discuss a problem or issue related to our marriage or “my behavior.” I would attempt to talk, she would get frustrated and I would completely forget the English language. She could “out talk” me.
We went to counseling and my wife would vent her frustrations to the counselor, often crying saying how alone she felt. I would sit there and pat her on the back, which interesting enough made her dislike me even more. That’s when I learned about “conversational intimacy.” (which I was lacking).
The counselor had us sit facing each other and make eye . (Also hard to do). It was really grueling and strangely informative. I realized that my wife and I had no trouble with physical intimacy (that is until she began to really dislike me) but I’m not sure we ever really had conversational intimacy to begin with. Of course we “talked” during dating and engagement and I’m sure after we married but intimate conversations were rare.
We practiced in the counselor’s office but at home we struggled. My wife had developed some resentments towards me for my lack of concern for her desire to talk, apparently building for several years. I learned that resentments can’t easily be discarded.
She was upset that it took so long for me to “get it.” When she told me that she wanted a divorce I was devastated. I had no idea I had caused so much damage by not making myself available, listening, validating her feelings and trying to find solutions. Having physical intimacy was way more enjoyable and didn’t really require much talking. I made myself very available.
As I sit here in my apartment, alone, after taking my children back to my ex-wife’s house (previously my house too), I have become wiser. I learned how important it is to occasionally have deep conversations, to really get to know the person that I have grown to love.
new drug and you find it does help your symptoms. But when you are told it will cost $475 after your samples are gone, what is the point.
I was personally given a prescription for a skin cream, with a coupon because the doctor told me it might be expensive. When I went to pick up the prescription the pharmacy tech had a strange look on his face when he told me the small tube of cream was $1042 after the coupon!!
Be cautious. Pay attention to the side affects listed for these drugs. If you can make behavioral or life changes, try that first. Your health and your money are at risk.

Vicki L Mayfield, M.Ed., R.N., LMFT Marriage and Family Therapy Oklahoma City

If you would like to send a question to Vicki, email us at news@okcnursingtimes.com