Caring for someone with dementia can be exhausting, so be sure to practice self-care. Doing so can help you take better care of yourself as well as others.

Caring for a loved one with dementia? Don’t neglect self-care.

Written by Robin Hamon, senior social worker with the UK Sanders-Brown Center on Aging.

Caring for someone with dementia can be exhausting, but many caregivers ignore their own needs in order to care for others – at the expense of their own health and welfare. You might think you have too much on your plate or feel guilty about doing anything for yourself when someone else desperately needs you. But you can be a more effective caregiver when you carve out some time to renew and re-energize.

Here are some tips to add caring for yourself while you are providing care for someone else.

  • Stay positive. Seek out what makes you feel happy. It can be as simple as spending time with a pet, listening to music or taking a walk in your neighborhood. Take one day at a time. Avoid trying to anticipate every bad thing that might happen. Replace negative thoughts and habits with positive ones (make lists of beautiful sights you have seen, spend 10 minutes stretching or focus on your breathing for a few minutes).
  • Empower yourself. People assume there is no way to get help without draining their bank account. There are some free or reduced-cost assistance programs that provide support, information and respite. Educate yourself to avoid these false assumptions. By doing so, you’ll feel better equipped to deal with even some of the hardest situations.
  • Accept that you can’t do it all and prioritize accordingly. Don’t let chores and obligations compete with “you” time. Forgive yourself for being less than perfect, find help with household chores, drop outside responsibilities that you don’t enjoy. Be true to your diet, medicine and exercise routines. Do something fun every day.
  • Stay connected. Find opportunities where you can safely “let off steam” and get positive reinforcement. If family and friends aren’t available, there are support groups, church families and other activity groups that can provide fresh ideas to help you redirect or de-stress – and maybe even have fun while you are doing it.

Taking care of yourself is one of the best things you can do for the person you’re caring for. By focusing on your well-being, you can improve quality of life for all involved.

You can call the Alzheimer’s Association at 800-272-3900 for additional resources, or you can visit the Family Caregiver Alliance’s website.


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A new video-conferencing technology at UK allowed a record number of Kentucky high schools to participate in the broadcast of a live surgery last November.

UK program gives high-schoolers chance to watch live surgery

Because of a new video-conferencing technology at UK, a record number of Kentucky high schools participated in the annual broadcast of a live surgery last November.

That broadcast went to 20 high schools from all eight AHEC regions across Kentucky, with around 400 juniors and seniors, said Michael Witt, health careers program coordinator for the UK Area Health Education Cooperative (AHEC).

For this broadcast, Dr. Joseph Iocono, chief of the division of pediatric surgery at UK, arranged for students to view a laparoscopic appendectomy. Dr. John Draus, associate professor of pediatric surgery, performed the operation while Dr. Iocono narrated.

By setting up a system where one surgeon performs the operation and another provides commentary, the patient’s safety is maximized while students receive an immersive experience. Video technology gives the students a surgeon’s perspective, and audio transmission allows them to hear the surgical team interact. It’s as if they are in the operating room themselves, Witt said.

Great care is also taken to protect and secure patient privacy. Patients and their families are fully informed and must give permission.

UK hitches to a cloud to improve outreach

UK’s live surgery broadcasts began in 2009. They are part of a collaboration with UK AHEC, Kentucky Tele-Health and the UK College of Medicine. It is a key component in AHEC’s efforts to build and maintain a health careers pipeline in Kentucky. Support from the Department of Surgery and its chair, Dr. Jay Zwischenberger, has allowed the live broadcast flourish.

“In the past seven years, the technology has advanced at an incredible rate,” said Rob Sprang, director of Kentucky Tele-Health at UK.

And the number of interested students has grown with the technology. In 2009, only a few dozen students participated. Seven years later, the broadcast reached several hundred students.

Cost reduction is another change from almost two decades ago. Neither UK nor any public school system is now required to purchase hardware for video conference services, but it wasn’t long ago that both UK and participating schools needed equipment that was extremely expensive.

In 2016, UK invested in ZOOM, a company specializing in cloud-based video conference technology. The surgery broadcast was a perfect opportunity to use this technology. UK simply has to give participating schools access to a live stream of the surgery in ZOOM’s “cloud,” which can be shared through any smart classroom or device. The broadcast is high definition, the sound is clear and the cost is a fraction of the price UK and Kentucky schools used to pay.

Meeting increased demand through AHEC summer camps

“It’s important that the program be interactive. We pushed its limits with 400 students. If we increase the audience, we lose that valuable communication between students and Dr. Iocono,” Witt said. “But the demand is out there, and we are considering possible solutions to meet that demand.”

Knowing technology can help meet the growing demand is a “good problem” for AHEC to have, but the surgery broadcast is just one part AHEC’s strategy to connect teens with UK’s clinical and research staff. Another avenue is for high school juniors and seniors to attend AHEC’s Summer Enrichment Program or the Health Researchers Youth Academy.

These camps give students a look at clinical care and laboratory settings during the summer. There is no cost to attend, but admission is very competitive. The 2017 deadline for both camps in is March 6.

Those interested can apply at https://medicine.mc.uky.edu/ukaheccamp/.


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Some patients who receive brain tumor radiation develop radiation necrosis, causing debilitating effects. But a new clinical trial could change that.

UK and Norton partner in first-ever clinical trial for radiation necrosis

Radiation saves countless lives, but in rare cases, it causes a debilitating complication. Around 3 to 5 percent of patients who receive radiation for brain tumors, or arteriovenous malformations (AVM), develop radiation necrosis.

Radiation necrosis causes headaches, nausea and vomiting, cognitive problems, and neural dysfunction. Although a variety of medications has been used to manage symptoms, there is no approved cure. But a joint clinical trial at Norton Brownsboro Hospital in Louisville and UK HealthCare could change that.

The first trial of its kind that treats the brain directly

Led by Dr. Shervin Dashti and Dr. Tom Yao from the Norton Neuroscience Institute and Dr. Justin Fraser at UK HealthCare, the trial is the first in the world to deliver a dose of a cancer drug directly to the brain. This allows a larger amount of the drug to reach the brain, making treatment more effective.

Dashti has seen the effects of radiation necrosis on patients who have already experienced the trauma of brain cancer or AVM. In addition to the symptoms caused by the condition itself, patients suffer from side effects of steroids used to manage it: insomnia, mood changes and weight gain.

“There was nothing that worked for treating it, and people were devastated,” he said. “What we’re doing now is something completely different, and I think it has a chance to really change the way we treat this.”

More than three years ago, Dashti developed this treatment when two young patients were in desperate need. Only 12 and 13, both girls had developed radiation necrosis and were experiencing severe side effects from steroids. They had disabling headaches, gained 50 to 60 pounds each, missed significant amounts of school or withdrew entirely. One patient experienced focal seizures in her arm and leg; the other patient was hospitalized for fluid overload.

With no other treatment available, Dashti and Yao spoke to the first patient and her family about trying a low dose of Avastin directly to the brain. They agreed, and within 12 hours of the procedure, her headaches were gone. Brain scans over several months showed continuous improvement, her arm and leg had strengthened so she could walk without help, and she returned to school.

Jade Cain, now 16, was the second patient. She was 11 when the AVM was diagnosed and 13 when she met Dashti. According to her mother, Desiree Fischer, 75 percent of her brain was swollen by that time, and she was so depressed she didn’t want to leave the house.

“We’d been doing three or four months of steroids, and she ended up on all other kinds of other medications, too, because she developed thrush. So that’s what led us to this procedure. She spent a week in the children’s hospital because she was in fluid overload. She couldn’t do any more steroids because that was going to kill her.”

Fortunately, the treatment worked just as well for Cain. Her headaches went away, she was off steroids within four weeks, and she returned to school.

She had a final angiogram of her brain in March 2016, and everything was normal.

“It the most amazing, complete response after one treatment, and the imaging response was unbelievable. It was a miraculous recovery for both of them,” Dashti said.

Partnering with UK HealthCare

The success of these two patients motivated Dashti to start a clinical trial. He asked Fraser, director of cerebrovascular surgery and surgical director of the comprehensive stroke center at UK’s Kentucky Neuroscience Institute, to join them.

“We’re in this position of facing an uncommon complication of a treatment that is becoming more commonly used, and we don’t have a great way to fix it,” Fraser said. “What’s special about our procedure is that patients get the drug once, directly to the brain, as opposed to a complete course of the drug that can cause serious side effects.”

The trial is supported by both institutions and has received expert project management support from the UK Center for Clinical and Translational Science.

Showing gratitude and support

Cain’s family has raised more than $20,000 for the Children’s Hospital Foundation. At the decision of Cain and her mother, these funds are directed specifically to support research on radiation necrosis.

“From the steroid use, my child who weighed 105 pounds went up to 160 pounds in one month. Had this treatment already been approved, we could have omitted all that. She battled to get the weight off and to overcome poor body self-image,” Fischer said. “I wish it had been approved way before. And I hate that my child is the one who had to go through it, but I tell her, ‘You have no idea what you’ve done – you’ve paved the way so other people hopefully won’t have go through what you went through.’”

If you are interested in learning about participating in this study, please contact Elodie Elayi at elodie.elayi@uky.edu, or review the study information at ClinicalTrials.gov.


Next steps:

  • UK’s Center for Drug and Alcohol Research has recently made progress on a treatment for those with opioid use disorder. Learn more.
  • Clinical research helps develop the treatments and medications of the future. Learn how you can help.

Promising results in UK clinical trial get opioid therapy closer to market

A clinical trial at the UK Center on Drug and Alcohol Research (CDAR) revealed a promising therapy for moderate-to-severe opioid use disorders.

The randomized, double-blind clinical trial compared weekly and monthly dosage of CAM2038, a buprenorphine therapy developed by Braeburn Pharmaceuticals and Camurus, with the current standard of care: a daily dose of buprenorphine/naloxone.

Reaching a milestone for FDA approval

Led by Dr. Michelle Lofwall in UK’s CDAR, the trial established the drug’s non-inferiority to the current treatment, a critical milestone in the application for FDA approval. While results indicated CAM2038 met non-inferiority, a key secondary outcome also demonstrated that CAM2038 was superior to current standard treatment, based on a pre-defined distribution of illicit opioid use.

Opioid overdoses cause more than 30,000 deaths every year, and 2.6 million Americans suffer from an opioid use disorder. More than 12 million people misused a prescription opioid pain reliever and 800,000 used heroin in 2015. The National Institutes on Drug Abuse has called for safe, proven solutions to initiate treatment and stabilize patients through an extended opioid recovery program. The Surgeon General’s Report called for more access to evidence-based effective treatments, like buprenorphine, for opioid use disorders.

The study’s positive results provided the necessary evidence for entering the FDA-approval submission process. Evidence suggests people with a moderate-to-severe opioid use disorder might benefit from receiving an injectable therapy administered on a weekly or monthly basis. The weekly injection is appropriate for induction and initial stabilization, and the monthly injection is better for stabilized patients. Together, both weekly and monthly medications allow for individualized dosing, which is critical for optimal patient outcomes and recovery from a deadly disease.

Eliminating stigmas

Lofwall, a psychiatrist and associate professor in the UK College of Medicine, served as principal investigator on the study, along with Sharon Walsh, director of the CDAR. Lofwall, who sees patients’ personal struggles with opioid use disorder in clinical practice, stresses the need for progressive and practical therapies to treat opioid addiction. An injectable therapy administered in a clinician’s office eliminates the risk of diverting traditional forms of buprenorphine and decreases the risk of relapse and overdose. The discreet nature of the therapy also eliminates any stigma and shame felt by patients taking oral opioid maintenance medications in daily life.

“If approved, the CAM2038 weekly and monthly injectable buprenorphine medications can improve how we treat opioid addiction and decrease the stigma associated with the medication that is in large part due to concerns about non-adherence and diversion,” Lofwall said. “Together with the six-month buprenorphine implant, these new long-acting medication delivery systems would allow us to administer a proven medication to the patients directly, leading to improved medication efficacy as demonstrated in this trial as well as avoiding the potential for missed or stolen doses, diversion or accidental pediatric exposure, which are significant public health concerns.”

Braeburn Pharmaceuticals, an Apple Tree Partners company, is a commercial-stage pharmaceutical company delivering individualized medicine in neuroscience. Long-acting therapeutic treatment options can be essential to improving patient outcomes and facilitating recovery in neurological and psychiatric disorders, which are often complicated by stigma and present significant public health challenges.


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‘Gill Goes Red’ on Feb. 3 in support of heart health in Kentucky

In February, institutions around Lexington will celebrate Heart Month with activities that promote healthy habits such as exercise, smoking cessation, stress reduction and improved diet.

This year’s ‘Gill Goes Red’ will involve treats and prizes

UK’s Gill Heart Institute will focus on ways to make your diet more heart-healthy with a celebration and information about simple ingredient substitutes that can make your transition to a healthy diet easier.

“Gill Goes Red” will take place at noon on Friday, Feb. 3 in the hospital’s Pavilion A atrium. There will be giveaways and free treats with a “secret ingredient” that makes them a healthier option. People who correctly guess the secret ingredient will be eligible to win a prize.

Starting a healthy diet? Taking baby steps can help.

According to Gretchen Wells, MD, PhD, director of Women’s Heart Health at the Gill, excess dietary fat, sugar and salt all contribute to poor heart health and can cause diabetes, heart attack or stroke, among other diseases. However, she acknowledges that drastic changes in diet can be difficult to maintain long-term.

“For some people, making gradual changes in their diet reduces the likelihood of failure,” said Wells. “We encourage people to make significant changes to reduce the amount of fat, sugar and salt in their diet, but if taking baby steps over time increases their chances of success, I’m all for it.”

Finding ways to increase nutrients in food

Vanessa Oliver with LiveWell, UK’s Health and Wellness program, will be a featured speaker at Gill Goes Red. Oliver will share her tips on easy substitutions and add-ins to increase nutrient value in foods.

“I’m often looking for ways to add healthy ingredients into meals,” Oliver said. “As long as people pay attention to portion size, there are easy ways to make foods healthy and tasty at the same time.”


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The rate of Americans with a life-threatening peanut allergy has greatly risen. But avoiding peanuts might not be the best idea when it comes to prevention.

Careful exposure to peanuts may prevent allergies, experts say

George J. Fuchs III, MD

The rate of Americans suffering from food allergies, including a life-threatening peanut allergy, has dramatically increased in the past few decades. But avoiding peanuts entirely might not be the best idea when it comes to prevention.

New evidence shows peanut exposure can be OK

Peanut allergies are the leading cause of death caused by food-induced asphyxia, although death from a peanut allergy is rare. Peanut allergies typically begin during early childhood and persist into adulthood. For years, pediatricians recommended parents proceed with caution when introducing potentially allergenic foods. They advised a strict elimination of peanut products from the at-risk child’s diet until 3 years of age. But now experts point to evidence that early and frequent exposure to peanuts can prevent a lifelong peanut allergy.

Kentucky Children’s Hospital pediatric gastroenterologist Dr. George Fuchs served on an expert panel convened by the National Institutes of Health to address the prevention and management of peanut allergies in children. In a reversal of former medical recommendations, the National Institutes of Allergy and Infectious Disease approved the guidelines advising the deliberate inclusion, instead of exclusion, of age-appropriate peanut products in the infant diet.

A panel of experts re-examines an old way of thinking

The panel, which released its guidelines in January, cited high-quality research indicating that children at risk for peanut allergy who consume peanut-containing products early in life are actually less, not more, likely to develop an allergy. In the landmark Learning Early About Peanut (LEAP) allergy trial, fewer than 2 percent of children given peanut protein as part of their diet developed a peanut allergy at 60 months of age.

In contrast, 13 percent of children in a peanut-avoidance group developed a peanut allergy. The panel recommended children prone to peanut sensitivity, such as those already diagnosed with an egg allergy or eczema, begin to receive age-appropriate peanut-containing foods as early as four to six months of age. The recommendations advise those children without a predisposition to food allergies receive peanut products at the same time they transition to solid foods.

UK doctor presents key points on preventing peanut allergies

Fuchs, who serves as the chief of pediatric gastroenterology, hepatology and nutrition at KCH, presented key points from the new guidelines to colleagues at the American Society of Nutrition Symposium in December. Fuchs said early introduction of peanut products enhances tolerance and reduces the risk of a peanut allergy. Avoidance of peanuts only increases the likelihood of a permanent peanut allergy.

“For the past few decades, pediatricians have been telling parents to eliminate peanut products from their baby’s diet, when avoidance may actually be the root of the allergy problem,” Fuchs said. “Our panel found introducing peanuts early on was the single-most effective step in preventing an allergy. There is a window of opportunity to teach the body’s immune system to accept that food.”

The authors anticipate the new guidelines will reduce the prevalence of peanut allergies in the U.S. Read the National Institutes of Allergy and Infectious Disease’s new recommendations for parents and caregivers here.


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Pediatric surgeon tells little Connor’s story of hope

Written by Dr. Ana Ruzic, a pediatric surgeon at Kentucky Children’s Hospital.

Let me tell you a true story of hope. It may be difficult to read, but I promise you nowhere as difficult as being its main character. This is Connor’s story.

Nearly one year ago, Connor Stacy went home from the Kentucky Children’s Hospital Neonatal Intensive Care Unit, or NICU, snuggled in his mom’s arms, too small to fit in his elf hat but nearly three times as big as the day he was born. Just recently, his mom sent me a photo of Connor wearing that famous hat. He is getting close to walking and speaking. To anyone who took care of him in his six-month NICU stay, he is the definition of hope.

Connor Stacy and his elf hat.

A premature birth, then more complications

I met Connor and his family in August 2015. They had already lived through a hailstorm of trauma, experiencing a premature birth and the subsequent marathon of the neonatal ICU.

For a NICU family, meeting a surgeon is never an easy feat. While some of these consults involve more benign needs, such as reliable IV access or an expected hernia that can wait for a repair, all too often they indicate a need for an emergent operation. Along with our neonatologists, my three surgery colleagues and I carry the privilege and the burden of meeting NICU families on a sudden, unexpected and very bad day. And on the day I met him, Connor went from well to critically ill in a matter of hours.

In the morning, he was eating and growing, and by the early afternoon, he was in advanced stages of necrotizing enterocolitis (NEC), a severe intestinal infection often seen in premature neonates. By the early evening, he was in multi-system organ failure. More than half of babies with NEC do not make it, despite aggressive management and all the advancements of modern medicine.

Treatment for Connor

Our first step was to remove the damaged portions of Connor’s small intestine. Connor weighed only 1,200 grams and was so fragile we could not move him to the operating room. Instead, we did the operation in the NICU. In the course of the following five days, he underwent three major operations. And somewhere in the midst of it all, his kidneys stopped making urine.

When the kidneys fail, the body fills up with toxins and fluid and their function is replaced by dialysis. The dialysis continues until the renal function recovers or further treatment becomes futile. Futility is the antithesis of hope, but we have the responsibility to our families, our patients and each other to recognize that point of no return.

I didn’t know if we would reach that with Connor, other than to tell his parents we would “keep going until we were no longer doing treatments for him, but to him.” That is not my quote, by the way.  It was taught to me by Dr. Joseph Iocono, some years ago when I was his resident. He is now my boss, my colleague and my mentor.

Thinking outside the box

Connor needed dialysis, but unfortunately, we don’t have a great way to dialyze 1,200-gram babies. With Connor, our care team had to improvise, think outside of the box and believe in something far greater than each of us individually: science, divinity, neither or both. Above all, we had to rely on faith in each other.

As joined as we are by this story, we are all different in the ways we approach medicine and patient care. We are guided by our own stories, each as different as the next. We do not always agree and that is exactly what Connor needed – for us to challenge one another, our biases and our previous outcomes. This is also the story of true multidisciplinary medicine, which takes the impossible and makes it the standard of care.

With the help of Dr. Aftab Chisti and Dr. John Raus, we devised an inventive technique to sustain Connor’s life by providing manual dialysis for Connor for two weeks until his renal function spontaneously recovered.

Connor’s team

In those two weeks Crystal, Mary, Becca, Kim, Lindsey, and a number of other nurses performed manual dialysis every 15-30 minutes for 12-hour shifts at the time.

And while the physicians came and went, Genine and Heather, Connor’s neonatal nurse practitioners, kept the care consistent and in order for the rest of us. For months to follow, Genine and Heather encouraged Connor’s family, nursed his wounds, protected his development, loved him and bonded with him the way only mothers do, before having to let him go. This is their story, as much as it is Connor’s.

By the time he was discharged home, Connor crossed paths with 11 neonatologists, four pediatric surgeons, 15 neonatal nurse practitioners and PAs, two nephrologists, nine surgery residents, and an array of respiratory, music, speech, occupational and physical therapists, each an essential piece of his puzzle.

I cannot begin to touch on the village it took to get him home. Nor can I begin to describe the dignity, compassion and kindness with which his parents, Chrissy and Dustin, graced each of us, despite living through a battle none of us will ever completely appreciate – that of a NICU parent. This, above all, is their story.

Those of us who take care of neonates carry within us a healthy dose of realism, which we drown with cautious optimism every time we walk into the hospital. Hope is that intangible quality of pediatric physicians, in whose shadow we walk each and every day, careful not to share it too much or risk losing credibility. We hold it close nonetheless. It is our guiding light, held brighter by the courage of our little patients and their families, breathing life in the very walls that surround our children’s hospital.

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This week’s featured physician is Dr. Brian Rinker, plastic surgeon and director of the Plastic Surgery Residency Program at UK HealthCare.

Plastic surgeon Dr. Brian Rinker talks about the art of ‘restoring lives’

Making the RoundsThis week’s featured physician in our Making the Rounds blog series is Dr. Brian Rinker, plastic surgeon and director of the Plastic Surgery Residency Program at UK HealthCare. His specialties include aesthetic surgery, breast reconstruction, microsurgery and correction of congenital hand anomalies.

How did you become interested in plastic surgery?

Like most people, I didn’t have any idea what plastic surgery was when I started medical school. I thought of it as, you know, “Doc Hollywood,” cosmetic surgery – that sort of thing. I had no idea what plastic surgeons actually did. And then when I found out as a medical student, it just fit so well with my personality and the things I enjoy doing.

It’s just such a creative specialty, and so varied. We get to treat so many kinds of patients with so many different kinds of problems, and it’s always exciting and always interesting, so I fell in love with it immediately.

How is plastic surgery different from other types of surgery?

I think the average person doesn’t know what plastic surgery truly is. They see the cosmetic side of plastic surgery – which is important – but it only makes up about 10 percent of the actual specialty. You know, most of what we spend our time doing is restoring and reconstructing defects from trauma, from cancer surgery or from congenital defects.

My job is a little different than some other surgeons because, in general, I’m not saving lives. In general, what I’m doing is restoring lives. I’m restoring people back to the way they were, restoring their function, their appearance, their body image after an injury or after a loss due to cancer surgery. And it’s very inspiring to see the type of impact you can have in people’s lives – they can get back to their work or the things they love to do and get back to feeling whole again.

How would your family describe you?

I got a card from my daughter, who’s 8, the other day, that says, “I like my daddy because he’s big and huggable.” So I guess that’s how my daughter would describe me.

Describe your ideal weekend.

Well, I like to go out into the countryside where it’s peaceful. I like to bring my kids and just do something simple and fun like go for a hike or fish or camp out.

What fictional character would you like to hang out with?

I’d like to hang out with Sherlock Holmes. I think that he would be a great guy to hang out with, have a conversation with. Very knowledgeable. And he is also based on a physician, so I think we’d have a lot to talk about.


Watch our video interview with Dr. Rinker below, where he discusses how plastic surgery treats more than just physical issues.


Next steps:

Read some tips for buying healthier foods to reduce fat, sugar and salt, which are associated with a higher risk for obesity, heart attack and diabetes.

Want to eat better? Grocery shop like a cardiologist.

Susan Smyth, MD, PhD

Susan Smyth, MD, PhD

Written by Susan Smyth, MD, PhD, the medical director of the UK Gill Heart & Vascular Institute.

Many of us vowed to eat healthier foods in the new year but don’t know how to begin. Here are some tips for healthy grocery shopping that’ll help you reduce the amount of dietary fat, sugar and salt in your diet, which can help prevent obesity, heart attack, diabetes and other diseases.

Start in the produce section

Make your meal healthier by substituting foods with lots of color from natural sources (not artificial colors) for foods that are white or brown. Start in the produce section with fresh fruits and veggies, which are high in vitamins and fiber and low in fat. Be sure to check labels on processed foods like guacamole or prepared salads with dressing; they may contain high amounts of fat, sodium and/or sugar.

Tips for dairy and deli

In the dairy section, stick with low-fat options where possible. Beware of flavored yogurts, which can contain as much as half of the recommended daily allowance of sugar. Recent research indicates that eggs are fine in moderation, but check with your doctor first.

At the butcher shop, lean meats like chicken and fish are the healthiest options. Processed meats, like lunch meat or hot dogs, contain high amounts of sodium.

Choose wisely in the bakery

The bakery department can be tricky. While breads and other baked goods can have a place at your dinner table, the hidden sugars and sodium in bread might surprise you. Just two slices of packaged white sandwich bread may account for as much as a quarter of your recommended daily sodium intake. Instead, select breads made from whole grains, which can lower your LDL (bad cholesterol) and decrease the risk of diabetes by almost a third.

Spend less time in the interior aisles

The interior aisles of the grocery store are treacherous. Almost everything in a plastic wrapper is highly processed and loaded with fat, salt, sugar or all three. If you spend a lot of time in the middle aisles, do a lot of label-reading and look for healthier substitutes. Plain canned beans in water are a good choice, as are some nuts and dried fruit. Also, be aware of serving sizes per package: for example, canned soups are sometimes advertised as low sodium – but if the serving size is half a can, and you’re accustomed to eating a full can of soup, you’ll be getting double the dose of sodium.

Consider frozen options

In the frozen food aisle, frozen veggies without added sauces and fruits without added sugar can substitute for fresh varieties. Choose low-fat ice cream over regular versions. And be very careful of frozen pizzas, dinners and snacks, which can be loaded with sodium.

Perhaps the easiest way to eat better is to make a grocery list that emphasizes naturally colorful foods – the more vegetables, the better — and stick to it.


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Chizimuzo Okoli tried his first and last cigarette when he was 6. He wound up in the ER, but the experience led him to study mental illness and tobacco use.

One puff leads UK researcher to study tobacco and mental illness

UK College of Nursing Assistant Professor Chizimuzo Okoli picked up his first and last cigarette when he was 6 years old. The mistake landed him in the emergency room, but the experience inspired his life’s work studying mental illness and substance use among marginalized and underrepresented populations.

Many people living with schizophrenia, bipolar disorder and other severe mental illnesses do not have access to tobacco treatments derived from evidence-based research.

“There are many reasons for that, but I believe it is primarily because of the stigma that comes with their illnesses, which has caused them to be neglected,” Okoli said.

Okoli found that the smoking rate among people with mental illness in the U.S. had stayed the same since the 1950s, compared to a decrease in population smoking rates overall – an alarming fact that lit a fire in him to dig deeper and get to the root of the problem.

“These patients don’t die from schizophrenia or bipolar disorder – they die because of COPD (chronic obstructive pulmonary disease), cardiovascular disease or cancers primarily related to tobacco use or secondhand smoke exposure,” Okoli said. “I wanted to bring tobacco treatment to this population because they’ve been severely underserved.”

Creating a tailored treatment plan

To combat this issue and better serve this population, he currently works with patients living with schizophrenia at Eastern State Hospital (ESH) to create a tailored tobacco treatment program for people mental disorders. In his study, he elicits the experiences of smoking cessation among current and former smokers living with schizophrenia.

“Patients living with schizophrenia often smoke to reduce side effects of their psychotropic medications,” he said. “But it also allows them to sensory-gate for a short period of time, meaning they are able to concentrate more easily.”

As the director of Tobacco Treatment Services and Evidence-Based Practice at ESH, Okoli got involved in the hospital’s PALS (Providing Acceptance, Love & Support) program that aims to boost patient morale and mood through community engagement. The program was initiated in July 2015 by ESH nursing staff when they realized only 10 percent of the approximately 2,900 patients ESH treats every year receive visitors.

“Volunteers for PALS provide friendship and support to patients. They spend one-on-one time playing games, reading or simply talking and listening,” Okoli said. “Afterward, we look at patient, volunteer and staff satisfaction to understand their experiences and identify if the volunteers’ perspective toward patients, particularly stigma, has altered.”

‘An exceptional colleague and scientist’

Okoli also serves as the director of the Tobacco Treatment and Prevention Division of the Tobacco Policy Research Program. In this role, he has addressed secondhand tobacco smoke exposure policy in indoor and outdoor public spaces as well as using biomarkers of tobacco exposure. Okoli was an integral part of the research team assisting his mentor Ellen Hahn, the Marcia Dake Endowed Professor of Nursing, in the implementation of Lexington’s smoke free law in 2004.

“Dr. Okoli is an exceptional colleague and scientist,” Hahn said. “His caring and compassion for helping individuals with mental illness quit using tobacco is the driving force for his timely and important research program.”

Okoli was born in Nigeria, but earned his bachelor’s, master’s and doctorate degrees at UK.

He completed two postdoctoral research fellowships in Canada after studying at UK. His research career flourished in Vancouver, where he was involved in opening a clinic for tobacco treatment for people with substance use disorders and mental illness. Now, in 2016, there are 13 of these clinics open in Vancouver.

“Dr. Okoli’s dedication to serving those who need it the most is uplifting and resonates so well with the nursing profession,” said Janie Heath, PhD, the dean of the UK College of Nursing. “He has truly found his calling and we are honored to stand alongside him in his endeavors to change the stigma around those with mental illness and substance use disorders.”


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