Over the last 25 years, we’ve witnessed amazing advances in science and medicine. What was once thought impossible is now being accomplished. Genetic testing is one example. With a small sample of saliva, your risk for certain diseases can be predicted. Unfortunately, just as technology has evolved with these tests, so have the opportunities for scammers.
This month, the U.S. Department of Health and Human Services Office of Inspector General sent out an alert about fraud schemes involving genetic or DNA testing. These scams have been targeting Medicare beneficiaries through phone calls, booths at public events, health fairs and door-to-door visits.
A typical scheme might go something like this: A scammer offers free ice cream or gift cards at a retirement community, senior nutrition center or Medicare expo for anyone who listens to a pitch about free DNA testing. It’s important to know: Medicare will pay for genetic testing for patients with advanced cancer or a family history of certain types of cancer if the test is medically necessary and is ordered by a treating physician. The fraudster will usually downplay or even ignore the medical necessity criteria and the need for a doctor’s order.
The scammer may swab a person’s cheek right there to collect saliva and gather identifying information, such as a person’s name, date of birth and Medicare number. Medicare beneficiaries have also been sent genetic testing kits and asked to return the completed kit with their insurance information. This is so the scammer can bill Medicare thousands of dollars of expensive and medically unnecessary genetic testing.
How do you tell the difference between a genuine, medically-necessary genetic test and these fraud schemes? Talk to YOUR doctor about it. This is the person with whom you’ve placed your trust regarding your healthcare.
Here are some things you can do to protect yourself from this scheme:
*If a genetic testing kit is mailed to you, don’t accept it unless it was ordered by your doctor. Refuse the delivery or return it to the sender. Keep a record of the sender’s name and the date you returned the items.
*Be suspicious of anyone who offers free genetic testing and requests your Medicare number. If your personal information is compromised, it may be used in other fraud schemes.
*Look for charges on your Medicare Summary Notice statements for unnecessary tests or screenings that you did not want or were not ordered by your doctor.
If you suspect that you’ve been a victim of this scam or any Medicare fraud, report it. Call the Oklahoma Insurance Department’s Medicare Assistance Program at 800-763-2828.

Do you have cramping in your legs while walking or at rest? Is it difficult for you to walk long distances? Do you have restless, cold or pale legs or feet? Do you have hair loss in the lower legs, infections or wounds that take a long time to heal or fungal infections of the toenails? You may have peripheral artery disease (PAD).
Peripheral artery disease is the narrowing or hardening of the arteries that carry blood to your limbs. Arteries are the blood vessels that carry oxygen rich blood to all the tissues in the body. Arteries can develop plaque buildup on their walls as we all get older. The plaques are generally a combination of cholesterol, fat, scar tissue and blood clots. Calcium deposits may also develop. This plaque progressively blocks blood flow to the limbs. In the legs, this reduced blood flow can cause cramping and pain.
Men and women over the age of 50 are most prone to peripheral arterial disease. Incidence becomes increasingly common with each year of life – men are affected earlier, but women catch up quickly. People with diabetes, high blood pressure, smokers, people with high cholesterol, obesity, sedentary lifestyle and genetic predisposition are at increased risk for developing this disease.
Diagnosis is determined with careful history and physical exam of an individual. Simple screening methods can include blood pressure measurement of the wrist and ankle or an ultrasound exam. In some instances a CT, MRI or arteriogram exam may be required.
Symptoms or consequences of the disease include pain, cramping in the legs with exercise or movement. Burning pain, numbness, tingling in the feet, and wounds or infections that are slow to heal or do not heal may also be present. Pale, blue, or cold feet may also be a sign of PAD.. If peripheral artery disease is left untreated or treated too late, it can lead to amputation of the toes, feet or legs.
PAD is preventable!
* Smoking – never start, or if you still smoke – QUIT!
* Diabetes – it’s very important to work with your primary healthcare professional to control your diabetes with a combination of medication, healthy diet, lifestyle modification and weight loss.
* Cholesterol – manage with medication, healthy diet, and exercise
* Overweight – manage with diet modification, weight loss, regular exercise
This disease can be treated surgically or with a minimally invasive procedure through an IV placed into the artery of the wrist, arm, foot, or groin. Treatment can include angioplasty or atherectomy. Angioplasty is the use of special balloons of various sizes that are used to expand an artery to its normal size. The balloon is removed after treatment is complete. Atherectomy removes plaque from the artery wall similar to a “roto-rooter” removing buildup from pipes. This can be achieved with different devices which incorporate cutting blades or lasers. Another method of treatment includes placement of stents which are used in select situations to expand an artery to its normal size and hold it open with a “scaffold”. Stents are permanent implants.
This can be treated by select cardiologists, vascular surgeons and interventional radiologists. If you feel that you may be at risk for PAD, or have some of the symptoms, you should consult your primary healthcare professional to screen for it, and to discuss treatment options.
You are also welcome to call our Vascular Center to schedule a prompt and free consultation. You can contact us at 405-608-8884. We are a specialized center staffed with highly experienced professionals, including a Vascular/Interventional physician, dedicated to treating PAD on an outpatient basis using the latest proven technology to combat this epidemic.
Dr. C.V Ramana is a vascular and interventional radiologist with more than 20 years of practice experience. He has expertise in all areas of vascular and interventional radiology. Dr. Ramana has a Ph.D from Yale University and MD from CWRU in Cleveland, Ohio where he subsequently completed his fellowship in Vascular and Interventional Radiology at the Cleveland Clinic.

Kathy Shaw of Oklahoma City was less than six months out from treatment for breast cancer when she learned that she had nodule on a lobe of her lungs that was cancerous.
It was more than she could bear to think about. She had just undergone a double mastectomy, chemotherapy and radiation, and the idea of undergoing another major surgery was disheartening. She was told that lung cancer surgery would involve a large incision, the spreading of her ribs to access the lungs and a lengthy hospital stay and recovery.
“I went ahead and made the appointment for the surgery, but in my heart, I didn’t feel like I would go through with it,” she said.
Instead, she began looking for another option. That search led her to J. Matthew Reinersman, M.D., a thoracic surgeon at Stephenson Cancer Center at OU Medicine. Reinersman and his colleague Subrato J. Deb, M.D., are the only two surgeons in Oklahoma who specialize in a minimally invasive surgery for lung cancer called VATS – Video-Assisted Thoracoscopic Surgery. The surgery, which requires only three small incisions, removes the cancer while giving patients a much shorter hospital stay, less risk for complications and faster recovery.
“I had the VATS surgery, and I went home after two days,” Shaw said. “I think I took one or two pain pills, but I didn’t experience what I would call real pain. Because of the procedure and Dr. Reinersman, my recovery has been pretty remarkable.”
Reinersman has been performing VATS for patients with lung cancer since he arrived at Stephenson Cancer Center four years ago. Studies have shown VATS to result in outcomes that are just as good as those in a traditional, open surgery, but with all the benefits of a minimally invasive procedure.
In the traditional procedure for removing cancers of the lung, surgeons make a large incision on the patient’s side and push apart the ribs to reach the lungs. This results in significant pain for the patient and a hospital stay of at least five to seven days, which then leads to greater risk of pneumonia, blood clots and infections.
During VATS, Reinersman makes three small incisions to insert a tiny camera and his surgical instruments. The camera transmits images of the lungs onto a video screen to guide the surgery. Depending on the location of the cancer, he may remove a small part of the lobe, the entire lobe or more of the lung. Nearby lymph nodes also are dissected to ensure the cancer has not spread.
“The advantage is that we can get patients out of the hospital as soon as one to three days after the procedure,” Reinersman said. “They have less pain, fewer side effects and can return to their normal activities faster.”
The reduction of pain is a significant advantage of VATS. Patients having open surgery for lung cancer usually receive an epidural catheter in their backs for pain control. Pain must be managed because patients need to be able to take deep breaths and cough to lower their risk of getting pneumonia – something they won’t do as well if they are hurting. Because VATS is minimally invasive, no epidural catheter is needed and pain is greatly minimized. Surgeons also use nerve blocks to provide long-acting pain control in the nerves that run along the ribs.
“When I see my patients back in the clinic a couple of weeks after surgery, they’re usually taking little to no pain medicine and they’ve resumed doing most of the things they want to do. It’s really gratifying,” Reinersman said.
Reinersman considers VATS for any patient with lung cancer, but the best candidates are those with Stage 1 or 2 cancer, he said. VATS is also preferable for patients who have borderline lung function because the procedure is easier for them to tolerate than an open surgery.
In Shaw’s case, she has never been a smoker. About 20 percent of people diagnosed with lung cancer are non-smokers, Reinersman said.
“That shows the importance of lung cancer screening and early diagnosis and treatment,” he said. “It’s not a death sentence. If we can catch it early, we can get them through it. We’ve done hundreds of VATS surgeries here.”
Many surgeons will use VATS for simple surgical procedures in the chest, but Reinersman and Deb are experts in its use for removing lung cancer, a more technically complicated surgery. The surgeons also are unique because they focus solely on surgeries of the chest and esophagus, whereas many cardiothoracic surgeons focus mostly on the heart.
OU Medicine is also the only institution in Oklahoma that submits its lung cancer surgery data to the Society of Thoracic Surgeons General Thoracic Surgery Database, where it can be viewed by the public. OU Medicine’s two-star rating is equivalent to that of larger institutions like Mayo Clinic and M.D. Anderson.

Story and photos by Taprina Milburn, Communications Coordinator for RSVP of Central Oklahoma

When Linus Affolder, 89, lost his wife, Carolyn, of 47 years in 2013, he said the grief was like going through a dark tunnel.
“I could be sitting on the patio and break down. Things would just trigger the tears,” the Oklahoma City resident explained. “I wanted her back. She was my foundation and strength; my right-hand person.”
Carolyn had been sick with leukemia for many years and as the disease progressed, the couple traveled to Houston’s MD Anderson Cancer Center almost every weekend for treatments. During those years, the Affolders had to step away from all of the volunteer activities they did individually and as a couple to concentrate on Carolyn’s health.
The loss was overwhelming when Carolyn died, Linus said, and he tried to manage the grief and loneliness on his own for as long as he could.
“A lady from church who had lost a son told me about a grief program at Christ the King Catholic Church that helped her, and so I started going. It was a four-month program and we met on Thursdays and learned about the phases of grief and shared our stories with one another. One of the things that stood out for me was the suggestion that getting back to volunteering could help in my grieving.”
So, Linus picked up where he left off years ago as a volunteer with Britvil Food Pantry in north Oklahoma City, an opportunity he found through the Retired and Senior Volunteer Program (RSVP) of Central Oklahoma, a program that matches seniors 55 and older with volunteer opportunities in the community.
“That was the starting point for me to get back out and be around people,” he said. “It revitalized me because I have people that I look forward to seeing and a weekly obligation to help others.”
There are no components of our life that grief doesn’t affect, said RSVP of Central Oklahoma board member and Licensed Professional Counselor Marla Mercer-Cole, who has a private counseling practice and leads grief groups through Mercer Adams Funeral Service.
“Grief affects us emotionally, physically, and spiritually,” she said. “There is a huge paradigm shift when we lose a loved one, especially a spouse. It leaves you shaken. You don’t feel of much value any longer and don’t know what your purpose is moving forward. I encourage the people in the groups that I lead that although we will always miss that person, we do begin to adapt physically and emotionally.”
She said that volunteering often helps with that process and has on many occasions referred her senior clients or members of her grief groups to contact RSVP of Central Oklahoma or other organizations to find out about volunteer opportunities.
“We have the capacity to be enlarged as humans to have compassion and empathy because of what we’ve been through,” she said. “Doing something altruistically for someone helps others but also gives you a break from the heaviness of grief. It helps with connections and making friends and reminds us that if we are still here, we have a purpose.”
She also encourages grievers to surround themselves with positivity and look for things for which to be grateful. Research shows that gratitude changes brain chemistry and complaining and negativity does, too, she said.
And last, read as much as you can about grief because knowledge is power, and if you are ready, join a grief group.
“Some people who are grieving worry that something is wrong with them until they are in a grief group and hear others who share some of the same things you are going through,” she said.
Today, Linus is involved with several volunteer opportunities each week and joins friends at three church-sponsored senior luncheons each month.
“Pushing myself is what I have to do,” he explains, “but I feel a difference when I get out with people and my friend base is enlarging.”
To learn more about ways to volunteer in your community, call the Retired and Senior Volunteer Program (RSVP) of Central Oklahoma, at 405.605.3110 or visit rsvpokc.org.

Senate Bill 142
Authored by Sen. Stephanie Bice, the bill prohibits the use of antipsychotic drugs unless a patient was previously diagnosed with a psychotic disorder, with some exceptions.
Bice said according to research from the Centers of Medicaid and Medicare Services, Oklahoma is the worst state in the nation when it comes to the use of antipsychotic drugs for nursing home patients who have received no psychiatric diagnosis to warrant the use of such medications. Bice said it happens to one in five nursing home residents in Oklahoma.
“It’s pretty shocking, really. Nursing homes are basically prescribing these drugs as a pharmaceutical restraint to make it easier to handle the patients, but it’s extremely dangerous. It can result in illness, injuries, cognitive decline and even death,” Bice said. “Until this legislation, there’s been nothing that requires the patient, their family or other caregivers to be informed about the use of these powerful drugs. Senate Bill 142 is about requiring informed consent and a proper diagnosis.”
Under the provisions of SB 142, a nursing home patient would have to be examined by the prescribing clinician and diagnosed with a psychiatric condition before an antipsychotic drug could be given. Further, the clinician would have to confirm with the nursing facility that they had received informed consent from the resident or their representative.
In May, Gov. Kevin Stitt signed the bill into law effective Nov. 1.
“AARP Oklahoma applauds Gov. Stitt and the legislature for taking action to reduce the inappropriate use of antipsychotics and chemical restraints on nursing home residents,” said Sean Voskuhl, AARP Oklahoma state director. “With the passage of Senate Bill 142, Oklahoma’s most frail and vulnerable will now be treated with the dignity and respect they deserve.”

Senate Bill 888
Oklahoma is second in the nation for nursing home residents with low care needs who could be better served in home and community-based settings. Authored by Sen. Kim David, this bill provides seniors and their families options that best suit the individual’s long-term healthcare needs while saving the state money.
“Oklahoma spends 70 percent of its long-term care dollars on nursing homes, and only 30 percent on less costly alternatives. Oklahoma’s senior citizen population is expected to increase by nearly 100,000 in the next 30 years – a trend we won’t be able to afford unless we start using more affordable options,” said David, R-Porter. “By using a variety of home and community-based services, other states like Texas, Alaska and Colorado have obtained a 50/50 mix or better in long-term care spending, achieving significant cost savings while allowing senior to choose care in their preferred setting. This bill will provide Oklahoma’s elderly with more options while providing significant savings to the state that can be used on other important services.”
SB 888 allows seniors to take advantage of options counseling to ensure they are fully informed of their options prior to admission to a long-term care program, including less costly choices like home health and adult day services.
The bill was also authored by Rep. Carol Bush, R-Tulsa.
One option provided under SB 888 is the PACE program, which is a Medicare and Medicaid program that helps meet people’s health care needs in their homes, community or local PACE center rather than going to nursing homes or other care facilities. PACE provides all the services and care covered by Medicare and Medicaid if authorized by the individual’s health care team. Services include, among others, adult day primary care (including doctor and recreation therapy nursing services), dentistry, emergency services, home and hospital care, meals, physical therapy, social services and transportation.
In May, Gov. Stitt signed the bill into law effective Nov. 1.

Free program offers help for those recovering from loss of loved ones

If you have experienced the death of a loved one, grief is the normal and natural response to loss. INTEGRIS Hospice provides on-going grief support.
Conducted by certified grief specialist, Marla Mercer Cole, MS, LPC, the six-week free evening program provides a step-by-step approach for those who wish to resolve their loss issues and move beyond their grief toward a richer quality of life.
Program Dates: June 17 – July 22 (Monday evenings) from 6:30 to 7:45 p.m. at INTEGRIS Cancer Institute, 5911 W. Memorial Road in Oklahoma City in Conference rooms D and E, southwest entrance.
To enroll for the session: Call 405-603-1708. Programs are free of charge; space is limited.
Marla Cole is a licensed professional counselor specializing in the field of grief and loss. As current vice president of Mercer Adams Funeral Service in Bethany, she also directs the aftercare program for families they serve and oversees community relations.
Normal grief responses include appetite loss, difficulty sleeping, feelings of guilt or regret, lack of concentration, mood changes, numbness or crying.

Story and photos by Darl DeVault

Oklahoma Senior Games cycling competitors gathered Sunday, September 16 last year at the Lake Stanley Draper Marina to stage for their either one lap or two lap races starting north around the lake. Many of the 55 cyclists who started racing at 8 a.m. in a mass start travelled from out of state to qualify for the 2019 National Senior Games in Albuquerque, New Mexico.
“Oklahoma offers many of these Texas riders racing today another chance to qualify for nationals,” said Kathleen Fitzgerald, OSG state director. “It is surprising at first, how far they will travel to qualify for nationals, until you talk to them and realize these are really competitive older folks who want to stay fit year-round as cyclists.”
The 22K and 44K road races drew the most contestants last year at Draper, while the 5K and 10K time trial events that started at noon and 1 p.m. saw many of the same road racers participate.
The 22K course, one clockwise lap around Draper, saw the group stay together. They finished almost together on the long downhill that sweeps from the south to the finish near the road that leads into the marina. Many of the racers continued for another lap around Draper to contest the 44K category.
The 40 and over bicycle racers were hoping to place first through fourth place at last year’s games so they could qualify for the 2019 National Senior Games in New Mexico. Those games just took place June 14-25.
Many of the same racers, trying to qualify for Nationals, lined up again at noon or 1 p.m. to start an individual 5K or 10K time trail on an out and back loop north on the lake road. The cyclists, many riding specialty time trial bikes, began their race against the clock in one-minute intervals. Starting order was from youngest to oldest starting with males and ending with females.
The events observed U.S.A Cycling rules and went off without any wrecks or mishaps throughout the day.
In the time trial events, riders were not allowed to draft (take pace behind another rider) closer than 25 meters ahead, or two meters to the side. If anyone had broken this rule, they would have received a time penalty.
Both road race distances and the two time trail distances offered dual opportunity for qualifying for nationals. Qualifying in any event at the 2018 event earned the athletes the right to compete in either or both their respective events at Nationals.
2019’s events for 40+ cyclists will take place Saturday, September 21 at the lake with a similar schedule as last year. Entry Deadline is September 7 this year and staging will again be at the marina at 8301 SE 104th. Street.
Divisions will be contested in recumbent, Paralympic Upright, Paralympic Handbike, Paralympic Tandem and Paralympic Tricycle if enough racers enter those categories,
Racers 40+ can go online to okseniorgames.com for more information or call (405) 821-1500.
In a recent article published by the Harvard Medical School’s Harvard Health online, bicycling is described as providing important physical benefits. First, it is an aerobic workout, which for seniors is the heart of any health plan, pun intended. Cycling, therefore, is good for their heart, brain and blood vessels.
Cycling is easy on joints, Dr. Safran Norton says in the article. He says that unlike walking, cycling is good for anyone with joint paint or age-related stiffness.
Bicyclists use their largest muscle group, the legs, which helps them build muscle while toning other muscles needed to keep them balanced and steer the bicycle.
These benefits carry over into everyday activities while helping cyclists build bone density, says Dr. Norton.
Greater Fort Lauderdale, Florida will host the 2021 National Senior Games, the largest multi-sport championship event in the world for adults 50 and over. More than 10,000 qualified athletes, accompanied by an estimated 15,000 visitors, are expected to compete in 20 medal sports in 2021.
The National Senior Games, begun in 1987, has 54 affiliated qualifying member games in North America promoting wellness and active, healthy lifestyles for older adults.

Dear Savvy Senior,

I need to locate a good in-home caregiver for my 83-year-old mother. What’s the best way to find and hire one? Looking for Care

Dear Looking,
Finding a good in-home caregiver for an elderly parent can be challenging. How can you find one that’s reliable and trustworthy, as well as someone your parent likes and is comfortable with? Here are some tips that can help.
Know Your Needs
Before you start the task of looking for an in-home caregiver, your first step is to determine the level of care your mom needs. This can pinpoint the type of help she’ll need. For example, if she only needs help with daily living tasks like shopping, cooking, doing laundry, bathing or dressing, a “homemaker” or “personal care aide” will do.
But, if she needs health care services, there are “home health aides” that may do all the things a homemaker does, plus they also have training in administering medications, changing wound dressings and other medically related duties. Home health aides often work under a nurse’s supervision.
Once you settle on a level of care, you then need to decide how many hours of assistance she’ll need. For example, does your mom need someone to come in just a few mornings a week to help her cook, clean, run errands or perhaps bathe? Or does she need more continuous care that requires daily visits or a full-time aide?
After you determine her needs, there are two ways in which you can go about hiring someone. Either through an agency, or you can hire someone directly on your own.
Hiring Through an Agency
Hiring a personal care or home health aide through an agency is the safest and easiest option, but it’s more expensive. Costs typically run anywhere between $14 and $25 an hour depending on where you live and the qualification of the aide.
How it works is you pay the agency, and they handle everything including an assessment of your mom’s needs, assigning appropriately trained and pre-screened staff to care for her, and finding a fill-in on days her aide cannot come.
Some of the drawbacks, however, are that you may not have much input into the selection of the caregiver, and the caregivers may change or alternate, which can cause a disruption.
To find a home-care agency in your mom’s area ask for referrals through friends, family or doctor’s offices, or use the Area Agency on Aging’s home-care locator service at PayingForSeniorCare.com – click on “Find Quality, Affordable Care.” In addition, Medicare offers a home health compare tool at Medicare.gov/HomeHealthCompare to help you find and compare home health care agencies.
You also need to be aware that original Medicare does not cover in-home caregiving services unless your mom is receiving doctor’s ordered skilled nursing or therapy services at home too. But, if your mom is in a certain Medicare Advantage plan, or is low-income and qualifies for Medicaid, she may be eligible for some coverage.
Hiring Directly
Hiring an independent caregiver on your own is the other option, and it’s less expensive. Costs typically range between $12 and $20 per hour. Hiring directly also gives you more control over who you hire so you can choose someone who you feel is right for your mom.
But, be aware that if you do hire someone on your own, you become the employer so there’s no agency support to fall back on if a problem occurs or if the aide doesn’t show up. You’re also responsible for paying payroll taxes and any worker-related injuries that may happen. If you choose this option make sure you check the aide’s references thoroughly, and do a criminal background check, which you can do sites like eNannySource.com.
To find someone, ask for referrals or try eldercare-matching services like Care.com or CareLinx.com. Or, for a fee, an aging life care expert (see AgingLifeCare.org) can help you find someone.
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.

It is the distinct pleasure of the Troy and Dollie Smith Wellness Center at the INTEGRIS Cancer Institute to invite you to our 25th annual art exhibit dedicated to the curative powers of creativity and to all whose lives have been affected by cancer.
The exhibit showcases all forms of art including fiber, graphics, oil, watercolor, mixed media, photography, pottery, sculpture, writing and poetry. Register art by Monday, July 8, 2019. Deliver art by Friday, July 19. Pieces will be displayed from July 25 through Sept. 6, 2019.
Artists of all ages wishing to express how their lives have been affected by cancer will have their work on display. The pieces may be by individuals or collaborative, done by professionals as well as first-time artists.
In lieu of a 10 percent sales commission, there will be a nominal $10 registration fee for each piece submitted (limited to two entries only) per artist. Registration proceeds will benefit the INTEGRIS Foundation’s Art Therapy fund to help continue the exhibit dedicated to all affected by cancer.
The registration fee will be due from the artist on the art drop-off day, Friday, July 19, 2019 between 10 a.m. and 6 p.m. Registration fees will be accepted in cash or a check made payable to INTEGRIS. Registration of art is available at integrisok.com/celebration-of-life or by calling 405-773-6600.
OPENING RECEPTION
Artists, cancer survivors, families and friends will be recognized at the 25th annual Celebration of Life Art Show and Opening Reception on Thursday, July 25, 2019, from 5:30 to 7:30 p.m. at the INTEGRIS Cancer Institute, 5911 W. Memorial Road, Oklahoma City, OK 73142. To RSVP for the event, please call 405-951-2277.