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Dr. Alexander Watson

Dr. Alexander Watson is a distinguished physician specializing in physical medicine & rehabilitation (PM&R) with a clinical focus on obesity medicine and pre-surgical optimization (prehabilitation). He is the lead physician and founder of Admire Medical in Middletown, Delaware. 

Dr. Watson earned his medical degree and a master’s degree in business administration from Rutgers, The State University of New Jersey. He completed his residency training at the University of Pittsburgh Medical Center, where he provided prehabilitation counseling for patients prior to solid organ transplant, spine surgery, bariatric surgery, and cancer treatments. Dr. Watson has published multiple book chapters and articles on back pain, obesity medicine, and the continuum of care during cancer rehabilitation. He is also the author of Healing in Advance: Your Prehabilitation Handbook, a book for patients, and co-editor of A Prehabilitation Guide for All Providers, both of which are on track to be released by the end of 2024.

During his residency, Dr. Watson explored the interaction between obesity and common PM&R conditions, e.g. back pain, arthritis, and neurologic disease, which he now applies to his patients at Admire Medical. By targeting weight loss and physical activity, Dr. Watson provides long lasting improvements in pain, sleep, and risk for developing life changing illnesses like heart attack and stroke. He also uses comprehensive assessments, tailored treatment plans, and rehabilitative interventions to address musculoskeletal, neurological, and pain-related conditions. Because so many of these conditions are related to weight and hormonal imbalances, Dr. Watson prescribes weight loss medications and hormone/testosterone replacement therapy when needed. 

www.AdmireMedical.com     302-592-4953      114 Sandhill Drive      Suite 201     Middletown     Delaware

@admiremedical on instagram         @AdmireMedicalDE facebook

Catherine Wilkins

Catherine Wilkins is the co-owner of Heart & Home, a beloved boutique and gift shop with two locations in Pike Creek and Peoples Plaza, Delaware. Originally from Tennessee, Catherine moved to Delaware to start a family with her husband, Mike. She spent many years at MBNA before deciding to become a stay-at-home mom. After dedicating time to her family, she reentered the workforce, embracing the exciting challenge of business ownership.

Three years ago, Catherine was presented with the opportunity to purchase Heart & Home alongside her dear friend, Lynn Bouscaren. Though she had plenty of shopping experience, running a business was an entirely new venture. Catherine quickly adapted, describing the process as learning 15 jobs at once. Despite the challenges, she has loved every moment of this incredible journey.

Catherine is passionate about customer service and believes that shopping should be fun. For her, gift-giving is a love language, a heartfelt way of showing care and appreciation for others. She takes pride in helping customers find the perfect gift for every occasion and strives to make each shopping experience memorable.

Heart & Home has proudly served the Delaware area for over 30 years and has earned the Best of Delaware award year after year, reflecting its legacy as a community favorite. Catherine and Lynn are proud to carry on that tradition, ensuring every customer leaves happy. Known for its free gift-bagging service, Heart & Home offers a true one-stop shopping experience, with gifts ready to give, no extra work required.

One of Catherine’s favorite aspects of owning Heart & Home is the camaraderie she shares with her staff; many of whom are experienced women she affectionately describes as “girlfriends.” Working alongside these women and her business partner, Lynn, makes each day enjoyable, as they collectively share experiences and help customers discover special gifts.

Catherine’s dedication to the legacy of Heart & Home continues to drive her, as she works to uphold the store’s reputation as a one-stop shopping destination where gift-giving is celebrated and shopping is a blissful experience.

www.HeartAndHomeDe.com

Heart & Home Pike Creek     4770 Limestone Road    Wilmington    Delaware     302-999-8980

Heart & Home People’s Plaza    230 Peoples Plaza    Newark    Delaware    302-392-8980

@heartandhomede on instagram       @heartandhomede on facebook

Janice Viamontie

Janice Viamontie is a Licensed Clinical Social Worker who provides mental health counseling in Delaware. Throughout her career, she has held the titles of crisis therapist and behavioral health consultant. These positions allowed her to gain expertise in assessing mental health crisis and working with families providing mental health counseling. She provided workshops for school staff surrounding mental health concerns in students and how to support them, and factors related to suicide prevention awareness. 

Janice opened Viamontie Counseling & Consulting Services LLC, a thriving mental health private practice that employs therapist with a variety of specialties. Her approach to therapy is a combination of person-centered, cognitive behavioral, and solution-focused therapies, geared at meeting the client where they are in their therapeutic journey. She believes that it is necessary to see the client as a whole, and not just as their concerning issues. Janice views therapy as a collaborative process, and prides herself on providing a safe and comfortable environment. She uses this as the foundation for her private practice.  

Janice has written a pre-marital and marriage workbook and provides structured pre-marital sessions for couples on various topics. She offers clinical supervision services to social workers looking to become licensed in the field. This allows her the opportunity to teach and help grow upcoming professionals. She recognizes the importance of perinatal and postpartum mental health support and encouraging mothers to care for themselves. She wrote a journal that allows mothers to process their feelings after childbirth called “Embracing the Journey – 30 Day Journaling Prompts and Exercises” and affirmation cards to encourage new moms during the beginning stages of motherhood titled “Kind Words for New Moms: Because Selfcare Matters, Especially Now.”

She believes taking care of yourself is the best way to make your mark on the world. Allow Janice to help you discover your best self, because you matter and so does your mental health. 

Interested in services with one of our amazing therapists, book online or email at info@viamontiecounseling. For workshops and professional consultations contact Janice Viamontie at [email protected]. 

www.ViamontieCounseling.com    302-307-6558      @viamontiecounseling on instagram

Kristin Stetler Donovan

Throughout my life I have been passionate about caring for others. As a young girl, I volunteered; as a young woman, I had the honor of caring for my mother and my father; and currently, I am honored to hold the title of Mother to three wonderful boys! I am married to an incredible husband, who supports and encourages me in my personal and business endeavors. I was born and raised in Delaware and will more than likely always reside in Delaware. After graduating from University of Delaware with a BAAS in Interpersonal and Organizational Communication, I joined MBNA, now known as Bank of America, where I worked and managed for many years before leaving to raise my children and care for my parents. 

Once my children were older and my parents had passed on, it only seemed logical to take my 25 years of management and caregiving skills to begin a new chapter of my life, this was just over 11 years ago. After losing my parents and a sibling within a three-year timespan, it inspired me to open my agency and serve those that were tired and in need of additional support. No one knows better what is entailed in being a caregiver for a loved one better than someone who has been one.

My agency is bonded, licensed and insured and has been serving seniors for over 10 years. We were previously part of a franchise, and now Aging in Place Senior Care Services is independently owned and operated, planning on being here to help provide support for seniors for many years to come. 

My ultimate desire in life is to find a way to help as many people as possible and now, together with my staff, we are doing just that. Ensuring safety, preserving dignity, and serving respectfully is our utmost priority! Quality care starts with a careful and meticulous hiring process, hiring only those who meet our high standards and who are truly committed to the families they serve. Our staff has a unique ability to match people with just the right caregiver; one who is compatible with our client’s care requirements, lifestyle, and personality. There is a perfect caregiver for everyone, and we won’t stop until we find the perfect match!  

www.AgingInPlaceSCS.com     302-722-8240     @aginginplacescs facebook

5586 Kirkwood Highway     Orchard Commons Business Park     Wilmington    Delaware

Thank You To Our Location

The University and Whist Club for allowing us to have our profile and cover photoshoot for our 4th Quarter 2024 Issue at their beautiful location. The historic Tilton Mansion, home to The University and Whist Club, is one of Delaware’s premier fine dining clubs with a rich history dating back to 1802. The Club offers a unique environment for members, their families and guests to dine, socialize, and entertain. Throughout the year, members enjoy a wide array of benefits and special events ranging from in-home catering services to half price room rentals and special dining menus. The legacy of The Club is built upon family, and your membership extends to spouse and children. They invite you to call for a tour. 

www.UniversityAndWhistClub.com    302-658-5125  

@uwc805 on instagram     @universityandwhistclub on facebook

805 North Broom Street     Wilmington     Delaware

To Our Stylist

I would also like to thank Lori Zaiss, Owner of Fusion Salon, and her wonderful team of stylist and makeup artists for providing hair and makeup for our shoot. As always it was a pleasure working with Fusion.

Fusion Salon   302-479-9444      www.FusionSalonDE.com     3444 Naamans Road     Wilmington Delaware    @fusionsalonde on instagram      @fusionsalonde on facebook

Thank You To Our Photographer

I would like to thank Debra Zeccola of Debra Zeccola Photography of Newark, DE for being our photographer for our profiles and covers photoshoot. Debra has over 28 years of experience as a licensed professional photographer. Debra provides her clients with outstanding photography services for weddings and events, family and individual portraits, baby photos ,and so much more. Debra is a joy to work with, and I couldn’t ask for a more professional photographer than Debra.

Debra Zeccola Photography     302-540-5800     @ZeccolaPhoto on facebook

[email protected]      www.debrazeccolaphotography.com 

By Amber Sharp, MSN, APRN, FNP-BC, Owner of 

Phases Medical Spa

Morpheus8 is a subdermal adipose remodeling device that combines fractional radiofrequency energy and microneedling to rejuvenate the skin and destroy fat cells. This award-winning medical device, uses tiny gold needles to penetrate the skin, delivering radiofrequency energy to the deeper layers. Microinjuries created by the device initiate the wound healing cascade, stimulating collagen and elastin remodeling. Once these tiny microinjuries finish the regeneration process, skin is left revitalized and healthier. With this device, we can target common concerns such as wrinkles, skin laxity, scars, and cellulite. Therefore, Morpheus8 can morph the face and body into a more youthful and contoured appearance. 

Who is a good candidate for Morpheus8?

• Suitable for all skin types and tones, including darker skin, due to its customizable settings that minimize the risk of hyperpigmentation.
• Adults experiencing mild to moderate skin laxity, wrinkles, acne, uneven skin tone, texture irregularities, or scars.
• Those looking to prevent or address signs of aging without invasive surgery.

*Not Ideal For* – Individuals with severe acne, skin infections, or those who are pregnant or breastfeeding.

Morpheus8 can be used on the face and body, including:

Face and neck: Helps with tightening sagging skin, reducing wrinkles, improving overall texture, and even improving tiny spider veins.

Arms: Addresses crepey skin texture and sagging.

Abdomen: Contours, and improves skin laxity, texture and stretch marks, particularly post-pregnancy or weight loss. 

Thighs and buttocks: Reduces cellulite and tightens the skin. Contours and lifts.

Knees: Smooths cellulite and improves skin laxity and crepiness.

Pre-procedure care

• Avoid tanning and wear SPF for at least 7 days before treatment.
• Avoid active ingredients like retinoids, exfoliants, and strong acids for at least 3 days before treatment. 

Morpheus8 procedure 

A numbing ointment is applied to the treatment area for 45 minutes. The skin is then thoroughly cleansed and sterilized. It is normal to feel pressure and a heat sensation during the procedure. Treatment duration ranges from 30 minutes to 45 minutes. Immediately after the procedure the skin will look and feel like mild sunburn. Recovery typically takes 1 to 3 days, longer for more aggressive treatments.

Post-procedure care

• Avoid direct sun exposure and use a high-SPF mineral sunscreen, as the skin will be more sensitive post-treatment.
• Use gentle cleansers and moisturizers. Keep the treated area moisturized and hydrated to support healing. 
• Avoid active ingredients like retinoids, exfoliants, and strong acids for at least 7 days. 
• Avoid makeup for at least 24-48 hours post-treatment to allow the skin to breathe and heal properly.
• Refrain from activities that cause excessive heat or sweating (e.g., saunas, hot tubs, intense exercise) for 48 hours to prevent irritation.

How quickly will i see results?

Initial results: Visible improvements can typically be seen within a few days after the treatment, as the skin begins to heal, and the production of new collagen starts.

Optimal results: The most noticeable results usually occur after 3 to 4 weeks and improve over the next 3 months as collagen production continues.

Treatment sessions: Multiple sessions (usually 3) spaced 4-6 weeks apart are recommended for best results. Depending on individual needs and goals more than 3 treatments may be necessary.

Future treatments: One treatment annually for maintenance is recommended. Morpheus8 can turn back the clock but does not stop it. So, we recommend a healthy lifestyle and consistent UV protection for lasting results.

Phases Medical Spa offers a variety of aesthetic and wellness services for everyone. We invite you to visit our website at www.phasesmedicalspa.com to view our service menu or call 302-500-4220 for more information.

Bio

Amber Sharp is a board-certified Family Nurse Practitioner and has worked in the healthcare industry for more than 15 years. Skincare is her passion, and she is dedicated to providing safe, science driven, evidenced based treatments. 

Testimonial

“This is an excellent medspa, best in the area. Amber and Mark are the perfect team of professionals who are passionate for people and skin care, focused on creating a pain free and safe environment. My Morpheus8 treatment today was fantastic! It did not hurt! Come here for all of your skin needs!” ~ S. M.

By Alexander Watson, MD & Angela Barone, DNP

Do you have an upcoming life event—a knee replacement, wedding, or vacation—that demands you looking and feeling your best? Unsure whether your diet, sleep, exercise or “other” needs the most attention? Consider a holistic medical weight loss program for the fastest and most lasting results.

Pre-surgical “boot camp” programs (aka “prehabilitation”) use many strategies that are equally appropriate when preparing for a big event or wedding. Prehabilitation programs are broken into several pillars; at Admire Medical, these are: exercise/physical activity, lifestyle, and “neuro/psych” (anything dealing with the brain or nerves).

Why is this strategy helpful? First, you hit weight loss goals faster, plus other benefits like a better complexion and more confidence. Second, weddings are stressful! By optimizing exercise, nutrition, mental health, sleep, and a bit of pampering, anybody in the wedding can feel their best and dance the night away. Third, these programs typically focus on sustainability. The upcoming event is not “the end,” but a means of achieving an active lifestyle less burdened by pain, weakness, obesity, or other chronic diseases. Let’s dive into specifics.

What better time to prioritize exercise than before a honeymoon or reception filled with dancing?! With these goals in mind, it is important to include both aerobic and strength training. You are less likely to sweat through formalwear and require frequent breaks if aerobic conditioning is up to par. Honeymoons often involve sightseeing, which is more exciting when you are capable of hiking Hawaiian volcanoes or skiing in Aspen. Strength training ensures your first dance includes a graceful lift without an embarrassing mishap. Extra muscle comes in handy for filling out a tux or when wiping out on the slopes.

The indirect benefits are even more exciting and provide lasting advantages. With strength training, research shows you’ll achieve better quality sleep, and the combined training styles help keep your metabolism burning after significant weight loss while more effectively controlling diabetes. For parents of the happy couple, strength training helps to maintain muscle mass and bone density, which is useful when lifting grandkids or stowing overhead luggage when traveling.

The lifestyle pillar includes other aspects of weight loss, including medications and nutritional strategies. When paired with exercise, revamping one’s health is easier, those changes last longer, and may involve less overall sacrifice. Cutting out alcohol and tobacco removes anchors that stifle your progress. Plus, fine-tuning this pillar turbocharges neuro/psych optimization.

Pain is activity limiting, joy smothering, and sleep disrupting. As part of the neuro/psych pillar, we target pain through medications and therapies to keep other objectives on track. Restful and restorative sleep is a keystone of health, so we aggressively target nighttime pain, daytime stress, and late-night snacking, so your sleep is as refreshing as possible. With good sleep, your mood improves, appetite becomes controllable, and personal exercise “bests” become attainable. Plus, you’ll glow in those wedding photos.

Weddings are a great example, because they are life events where self-care becomes a priority. They require a clear timeline with a “finish line date” to keep you on track while pursuing health goals. However, anyone can use this approach, any time. After our patients complete a prehabilitation program and recover from a knee replacement, we restart the timeline with a different target date. Goal-setting is critically important; otherwise, busy lives put self-care in the backseat. We’ve only got one life to enjoy the company of family, see the world, and feel our best.

When tackled with a clear strategy, these programs require less time and attention. When guided by your wellness team, you spend more time enjoying better health, not preoccupied with inefficient DIY attempts. For more information please call 302-592-4953, email [email protected] or visit us online at www.admiremedical.com.

Bios

Dr. Watson is a distinguished physician specializing in physical medicine and rehabilitation (PM&R) with a clinical focus on obesity-related conditions. During his residency, he explored the interaction between obesity and common “PM&R conditions” like back pain, arthritis, and neurologic disease. Angela Barone is a dedicated family nurse practitioner specializing in women’s health and HRT. Her glowing reviews speak to her compassion and attentiveness with her patients, as she crafts personalized treatment plans to address individual needs.

Testimonial

“I’ve been to plenty of doctors and I have never been treated with this level of care in my life…Angela was amazing. She answered every single question I had. She made me feel like I was a part of my own care team/plan instead of a visitor.” ~ A.A.

www.admiremedical.com

click www.admiremedical.com/page/memberships for a membership appointment

114 Sandhill Dr. Suite 201 Middletown, DE 19709

302-592-4953

[email protected]

 follow them on instagram @admiremedical

and  facebook @admiremedicalDE

By Lynn Bouscaren & Catherine Wilkins, Owners

Let us make your holiday shopping a breeze this year! Heart and Home is well-known as Delaware’s go-to gift shop for a reason. We make it easy, fun, and gift bagged to go! Literally, stop by on your way to the party, and we’ll have you covered with a thoughtful, beautifully wrapped gift in hand.

Hostess gift ideas (also great for teachers, co-workers, hair stylists)

For the perfect hostess gift, we recommend consumable items—things that can be enjoyed without the need for long-term commitment. A Michele Design Works hand soap and lotion set is a beautiful and practical choice. Pair a Stonewall Kitchen gourmet food item with a stylish kitchen towel, and you’ve got a gift that’s both elegant and functional. A seasonal candle, with its warm fragrance, also makes a lovely gift that anyone can appreciate.

Gifts for mom, special friends, sister, or daughter

Jewelry, pajamas, robes, bath and body products, or candles are always wonderful choices for the special women in your life. How about a cute sweater or scarf? You know her style, and we can help you find the perfect gift that feels like it was handpicked just for her. Send your husbands or significant others our way—we’ll turn them into heroes! When in doubt, a Heart and Home gift card is always a thoughtful option.

Engagement and wedding gift ideas

While we might not be on the wedding registry, you can still find a unique, unforgettable gift for the happy couple at Heart and Home. Consider a stunning pewter frame from Beatriz Ball to showcase their favorite moments or a beautiful Lynn and Liana cutting board that will become a cherished heirloom in their new home. These thoughtful gifts are perfect for celebrating a new chapter in their lives.

What’s the best gift?

The one you buy yourself, of course! Come browse our boutique that features beautiful clothing alongside our expanded handbags, jewelry, and accessories. Treat yourself—you deserve it.

Let us guide you through this busy holiday season. With our personalized shopping experience, unique gift selection, and complimentary gift bagging, we’ve got something for everyone on your list. Open seven days a week with extended holiday hours, Heart and Home is your one-stop-shop for thoughtful, trend-forward gifts. 

Testimonial

“I went shopping at Heart and Home for my daughter’s birthday, and they had so many choices. My daughter loved everything I had picked out, and they even bagged my purchases in a beautiful gift bag with colorful tissue paper and ribbon. Love this place.” ~ P.R.

Thank you for continuing to shop locally with Heart and Home. We can’t wait to see you!

Brands we carry & love . . . 🩷 Kendra Scott   🩷 ENewton   🩷 Brighton  🩷 HOBO  🩷 Pom Pom of London   🩷 SCOUT  🩷 Liverpool of Los Angeles   🩷 THML   🩷 Swig  🩷 UGG  🩷 Barefoot Dreams   🩷 Spartina

Follow @heartandhomede on instagram and @heartandhomede facebook

www.HeartAndHomeDe.com

Heart & Home Pike Creek, 4770 Limestone Road, Wilmington, Delaware 302-999-8980

Heart & Home People’s Plaza, 230 Peoples Plaza, Newark, Delaware 302-392-8980

By Lena Thayer

It’s hard to care about an issue that you may not believe affects you; but there is an issue impacting us all every day, we just don’t notice it. Medicare fraud is costing taxpayers billions every year, threatening the healthcare of our seniors, their financial security, and jeopardizing the future of the program for aging Americans. $60 billion, that’s a really big number, and that is the estimate for how much is stolen from Medicare across the U.S. on an annual basis. It’s estimated that Delaware accounts for about 5% of that number; so roughly $3 billion. Imagine what could be accomplished in Delaware with $3 billion not being wasted on Medicare errors, abuse, and fraud? It’s thought that Medicare fraud is a victimless crime, but that belief is wrong. Medicare fraud impacts everyone. This article will discuss how Medicare impacts Americans in varying ways and how you can help prevent Medicare fraud from happening.

Direct impact

Delaware is one of the top ten states in the US in terms of percentage of elderly residents: with more than 22% of the state’s population, higher than the national percentage of 19%. This high percentage of elderly residents makes Delaware particularly vulnerable to the effects of Medicare fraud. When fraudsters siphon off Medicare funds, the immediate consequence is a depletion of resources available for genuine beneficiaries. This means that our seniors might face delays in receiving essential medical services, experience a decline in the quality of care, and endure increased out-of-pocket costs.

Economic impact

Medicare fraud doesn’t just hurt seniors; it affects everyone who pays taxes. The $3 billion lost to fraud in Delaware could have been used to improve healthcare infrastructure, fund public health initiatives, or even reduce the tax burden. Instead, this money is lining the pockets of criminals. This massive loss of funds leads to higher healthcare costs and insurance premiums for everyone. It’s a drain on the economy that stifles growth and diverts resources from essential services.

Community impact

Beyond the financial implications, Medicare fraud undermines the trust in our healthcare system. Seniors who fall victim to fraud often face significant emotional and psychological stress. They may become wary of seeking medical help or mistrustful of legitimate healthcare providers. This erosion of trust can have severe consequences, as it may lead to underreporting of medical issues or hesitance in participating in necessary medical procedures. Additionally, the burden of dealing with fraud-related issues often falls on family members, further straining family dynamics and resources.

Legal and ethical concerns

Medicare fraud is not just a financial crime; it is a moral and ethical violation. Those who commit Medicare fraud are taking advantage of a system designed to protect our most vulnerable populations. They are not just stealing money; they are stealing health and security. The legal system must continuously adapt to address new and sophisticated forms of fraud, but it also needs the public’s help to identify and report suspicious activities.

How you can help

Preventing Medicare fraud requires vigilance and proactive engagement from everyone. Here are some steps you can take to help combat this issue:

1. Stay informed: Educate yourself about the different types of Medicare fraud, such as billing for services not provided, performing unnecessary tests, or falsifying a diagnosis.
2. Monitor statements: Regularly check Medicare Summary Notices (MSNs) and Explanation of Benefits (EOBs) for any suspicious charges or services you do not recognize.
3. Report suspicious activity: If you notice any discrepancies or suspect fraud, report it immediately to the Medicare hotline at 1-800-MEDICARE or the Delaware Senior Medicare Patrol.
4. Protect personal information: Never share your Medicare number or personal information with anyone who contacts you unsolicited. Scammers often pose as representatives from Medicare or healthcare providers.
5. Educate others: Spread awareness about Medicare fraud among friends, family, and community members. The more people are aware, the harder it becomes for fraudsters to succeed.

Conclusion

Medicare fraud is a pervasive issue that affects us all, directly, and indirectly. By understanding its impact and taking steps to prevent it, we can help protect our seniors, safeguard our financial resources, and ensure the longevity and integrity of the Medicare program. Every effort counts in the fight against Medicare fraud, and together, we can make a significant difference. Let’s stand up for our seniors, our community, and our future by staying vigilant and proactive in the battle against Medicare fraud.

https://smp.dhss.delaware.gov/

302-255-9774

Follow on facebook @DelawareDHSS and instagram @deldhss

By Robert M. Carroll, M.D.

This familiar phrase is one we have all heard as part of the seemingly endless pharmaceutical advertisements that bombard our daily lives. Whether it is a sign on the side of a public bus, a commercial during daytime television, or a video on our smart phone, we are inundated with information about the newest medications. This is for good reason: over four billion prescriptions are filled in the United States every year, and many of these advances have changed public health for the better. Increased systemic medication use is not without risk, though, and understanding how some of these drugs may affect our vision is critically important.

Hydroxychloroquine (brand name Plaquenil) is a medication initially created to prevent malaria but is now most commonly used to treat autoimmune conditions such as rheumatoid arthritis or lupus. While it works well for many patients, it also carries a low, but serious, risk of central vision loss. Chronic use of hydroxychloroquine can lead to toxicity of the retina, the thin layer of tissue that lines the inside of the eye and carries the signals to make the images that we see. There is about a 1-2% chance of developing toxicity from this medication over the first 10 years of use, but that risk can increase significantly with longer duration. Patients have no symptoms with early toxicity, and the American Academy of Ophthalmology has recommended screening exams for all patients taking hydroxychloroquine. If you are on this drug, a retina specialist should examine you and use special testing to determine if there are signs of retinal toxicity.   

Pentosan polysulfate (brand name Elmiron) is a medication used to treat interstitial cystitis, a painful condition that primarily affects women with symptoms of chronic urinary urgency, frequency, and pelvic discomfort. In 2018, retina specialists at Emory School of Medicine discovered a pattern of abnormal retina findings in patients taking pentosan. These patients complained of blurry vision, difficulty reading, and trouble adapting to dark environments. Many had findings easily confused for age related macular degeneration, but special retinal imaging tests revealed unique manifestations associated with this medication. There is now a clearly identifiable risk of retinal toxicity with pentosan, primarily linked to long-term use and high doses. All patients who have taken pentosan should have a dilated eye exam and retinal imaging performed by a retina specialist.

Semaglutide (brand names Ozempic and Wegovy) is a popular medication with great outcomes in the treatment of diabetes and obesity. While it was being approved, one of the many clinical trials found an association with worsening of diabetic retinal disease in patients who had diabetic retinopathy. Due to this, semaglutide carries a warning that patients with diabetic retinopathy may experience vision issues and should have their eyes examined while on the medication. One possible explanation for this finding is a phenomenon already known for decades where diabetic retinopathy temporarily worsens with rapid blood sugar control. Fortunately, these changes typically reverse themselves and in general, good blood sugar regulation is the best thing a diabetic patient can do to protect their vision. More recently, researchers from Harvard Medical School reported a potential association with semaglutide and ischemic optic neuropathy, a specific type of eye stroke that can cause significant vision loss. Their work does not imply any direct causation from the medication, but more investigation is warranted. There is yet to be definitive proof that semaglutide can make diabetic eye disease worse or cause vision loss. However, the consensus of many retina specialists is that patients who are taking semaglutide should have a dilated eye exam and it may be necessary to follow you more closely. 

We are fortunate to live in an age where rapid scientific advancements allow many of us to live longer, healthier lives. It is important to remain informed about potential risks of medications, though, especially as it pertains to your vision. You should always speak with your prescribing medical provider if you have questions about any medication you are taking, and they can refer you to an eye care specialist for an evaluation. If you are taking any of the medications reviewed in this article and would like to schedule an appointment with a retina specialist at Eye Physicians and Surgeons, please call 302-652-3353 or visit www.eyephysicians.com.

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Bio

We are very excited to announce our newest retina specialist at Eye Physicians and Surgeons, Dr. Robert Carroll. Dr. Carroll is a board-certified, fellowship-trained vitreoretinal surgeon who specializes in the care of diabetic retinopathy, age related macular degeneration, retinal vascular disease, and posterior uveitis as well as small-gauge sutureless surgical repair of retinal detachment, macular hole, complex diabetic pathology, and secondary intraocular lenses. 

Dr. Carroll completed his undergraduate degree in biochemistry with honors at the University of Notre Dame and earned his medical degree at Rutgers-Robert Wood Johnson Medical School. He completed his internship at Albert Einstein Medical Center in Philadelphia, residency in ophthalmology at Mount Sinai Hospital in New York, and fellowship in vitreoretinal surgery at the Scheie Eye Institute of the University of Pennsylvania, where he was awarded the Fellow Excellence in Teaching Award.

Please join Eye Physicians and Surgeons in welcoming Dr. Carroll to our practice!

By Frank DeMarinis, Certified Senior Advisor

Last issue we submitted the “WHY” we do what we do. This issue we’d like to focus on the “WHAT” via a few case studies to illustrate the importance and role of a power of attorney and healthcare proxy service. 

Jim’s story

“Jim” a long-term security officer at a local hospital fell in love with a nurse at work and agreed to retire to her hometown in the Islands to maximize their retirement income. When he began to lose his faculties, she purchased him a one-way plane ticket back to Philadelphia with the clothes on his back and $1000 dollars. He ended up in a homeless shelter at 86 years old in Wilmington. She continued to collect his Social Security offshore. It took several hundred focus hours to recreate his identity and secure back his income to eventually qualify for Medicaid and an appropriate senior living residence. Thankfully our agency was listed as his secondary proxy/POA, and we were able to assist after a pro bono legal petition to file for elder abuse and abandonment. The only reason we were contacted was he still had a dog-eared emergency card in his wallet indicating our contact information. 

Jane’s story

“Jane” was a hoarder and a recluse at 89 years of age. She was estranged from family and friends. For several years we simply held her hand, made wellness visits and assisted in basic management of her daily needs doing the best to keep her safe and cared for. After seriously being hurt in the home due to clutter and disrepair of her staircase she was hospitalized. With no safe discharge plan or known family contacts, a petition was initiated for guardianship to make her a ward of the State. Thankfully she was on our emergency proxy service, and we received a notification from the Hospital via the Emergency Notification Service (ENS). We acted quickly to liquidate the home and assist in placement in a group home that she was agreeable with and now she continues to thrive in her 90s.

Marsha’s story

“John” one of our longest standing clients was only in his 70s when he reached out to our agency for emergency contact service. He was concerned about his wife whom he cared for with dementia. There were no friends or family equipped or able to step in should something happen to him. We kept in touch 2-4 times a year with no active service needs. When he passed suddenly of a stroke the Department of Aging was involved and his wife was committed to mental health institution due to the anxiety and behaviors exhibited after her husband’s passing. We had several years of rapport with “Marsha” and were able to stop her unfortunate long-term placement and were able to bring her back home with home care services. Her mental health improved being back home. She lived several years prior to requiring hospice and passing according to their wishes. We scattered her ashes at the beach where she and her husband loved per his requests. 

Sad and unfortunate stories, yes – but these are the challenges which have blessed us with positive outcomes due to one connecting factor – they planned ahead. Yes, of course we fund our business through traditional estate planning, Medicaid, Senior Advisement, Downsizing and Senior Placement, but the efforts and outcomes we make through our Non-Profit Program are what continues to personally drive us forward in our vocation.

Our advice and consultation are always free of cost. We appreciate offering what resources and guidance we can. Call us for a free consultation, Frank Demarinis at 800-564-0173.

Remember . . .

 “Plans are nothing; planning is everything.” ~ DDE

Jerry – If you’re reading this, your cat lived his remaining best life with us in front of a warm fireplace. This issue is dedicated to you . . .

Frank DeMarinis, Certified Senior Advisor 

1-800-564-0173

www.AdvancedDirective.info

[email protected] 

By Maureen E. Krienen, 

How it all began

Krienen-Griffith Funeral Home goes back 107 years, when my great-grandfather, Carl Krienen, and his brother, Bill, incorporated Krienen Brothers Funeral Home. Since its beginning, a Krienen has been at the helm serving families in Delaware. I am the 4th generation Krienen serving as President of our family-owned and operated funeral home.  

A lot has happened to get us to today. Krienen Brothers began in the City of Wilmington in 1917 and in 1928 opened a second location in Old New Castle. Carl and Bill operated the funeral home until 1963, when Carl passed away. His sons, Bill, II and Carl, Jr., left their jobs at Boeing and Bell Telephone, respectively, to take the reins at the family funeral home.

During this time, Krienen Brothers expanded. Russell Griffith owned and operated Griffith Mortuary in Elsmere. He was ready to retire. Krienen Brothers purchased Griffith Mortuary and became Krienen-Griffith Funeral Home in 1970.

History repeated itself when Bill, II passed away in 1993, and my father, Bill Krienen, III, purchased the business from Carl, Jr.  

I was named President of Krienen-Griffith Funeral Home in January 2020.  My father is active in the business, but I have the privilege of running our family funeral home. 

I am a graduate of Padua Academy, University of Delaware, and the American Academy of McAllister Institute. I received my Funeral Director License in November 2017. My knowledge goes well beyond what I learned in the classroom. From the time I was born, I have been in and around the funeral home. I have learned from the best with regard to how funeral service works and how to meet each family’s needs . . . with compassion, dignity, and integrity. 

Planning a funeral

At-Need funeral planning takes place when someone has died. There are many options available, and many decisions must be made when it comes to planning a memorialization of someone’s life. Families must answer these questions: Burial, cremation, or maybe direct burial? Casket and vault, or what urn? Family cemetery plot or mausoleum? Mass, Memorial Service, maybe a Graveside Service? Minister, priest, or no clergy? Obituary? There are many more questions to be asked and decisions to be made.

It is very uncommon that any one individual is THE person responsible for making all the decisions when a funeral needs to be planned. So, most people are unprepared, and also grieving, when decisions need to be made.

Preplanning a funeral

Preplanning begins when someone sits down and discusses their final wishes with a spouse, children, sibling, friend. After having that conversation, make an appointment with a funeral director. At no charge and with no obligation, I will sit down with the individual either at our funeral home or at their home. We discuss what services they want. A Cost of Funeral Goods and Services document will be completed. All of this information is kept on file until the time of death. It is not required to pay for a preneed funeral.

Prepaying is an option

Once the conversation has been had, the type of funeral has been decided, and the funeral director has been contacted, a discussion will take place to determine if it is wise to pay in advance. 

When you prefund a funeral, Krienen-Griffith is not permitted to hold those monies and cannot access those monies until the death has occurred. 

A funeral insurance policy is opened in the exact amount of the funeral at today’s prices. A policy is issued. The policy has a growth rate, and the expectation is that the policy will grow and keep up with the cost of the funeral. At the time of death, whether it be two years, ten years, or more, the funeral cost is covered. Krienen-Griffith guarantees that if the policy does not keep up with our increases, we will discount the funeral to meet the amount of the policy. If the policy grows at a faster rate than our increases, a refund is issued to the family.

Krienen-Griffith has never gone back to a family and billed them for any amount for the services they purchased in a prefunded funeral. I guarantee that practice will not change.

What is left to do when you have preplanned your funeral, the information has been shared with loved ones, and the funeral has been paid for? Go live your life . . . to the fullest.

It is unknown the day or the hour a death will occur. My advice is this: become educated on funeral planning, let someone know your wishes, know a loved one’s wishes, be proactive, and be prepared.

There are countless advantages to planning a funeral in advance. Krienen-Griffith has served families since 1917 and will continue to do so with compassion, experience, and integrity. Call 302-994-9614 or visit www.delawarefuneral.com.

Choosing the right funeral home matters – Choose Krienen-Griffith

– Serving the community for 106 years

– Owned and operated by the 4th generation of the Krienen family

– All details professionally handled

– Personable, compassionate, and caring staff

– Experienced in customizing services to fulfill family needs and desires

1400 Kirkwood Hwy., Wilmington, DE  19805

101 W Sixth St., New Castle, DE 19720             

302-994-9614

[email protected]

www.delawarefuneral.com

By Brian H. Sarter, M.D., F.A.C.C., F.H.R.S.

Patients who have heart rhythm abnormalities can be difficult to diagnose. Very often these patients have symptoms that are sporadic and unpredictable. Abnormality of the heart rhythm can lead to symptoms of palpitations, racing heart rates, light-headedness, chest pain, shortness of breath and fainting spells. Furthermore, some heart rhythm disturbances such as atrial fibrillation may not cause any symptoms but can lead to stroke. Since management and treatment of these heart rhythm abnormalities varies depending on the mechanism, an electrical recording of the abnormality at the time they occur is critical. Various wearable monitors provide an opportunity to capture these heart rhythm abnormalities but generally these monitors can be worn only up to three weeks. Very often symptoms may not occur during the monitored period or the monitored period may be too short to definitively rule out a significant heart rhythm abnormality.  

Recognizing that more prolonged periods of monitoring are necessary, the implantable loop recorder was developed. These devices can monitor a patient’s heart rhythm for up to three years. They continuously record the patient’s heart rhythm and if an abnormality is detected, it is stored within the device. The device can then wirelessly communicate with a web-based monitoring system to be reviewed by the cardiologist. Many studies over the past 10 years have confirmed the utility of these devices to improve heart rhythm abnormality detection leading to improved management of these patients.  

The implantable loop recorder is a small device (about the size of clip on a pen) that is inserted under the skin in the chest. The procedure is usually performed in the doctor’s office under local anesthetic and takes about 5-10 minutes to perform. There is minimal risk of the procedure, the device has no wires or patches, and there is no concern about getting the device wet during bathing or swimming. These devices are generally safe for use for patients who require MRI imaging.  

Patients who should be considered for an implantable loop recorder are generally those referred to a cardiologist in whom a heart rhythm abnormality is suspected but remains undiagnosed despite standard testing. The two most common indications are for patients with recurrent episodes of fainting of unclear cause and those with strokes that are felt to be related to atrial fibrillation. The use of implantable loop recorders has undoubtedly benefited many patients over the past 10 years.  

For more information please visit our website at www.cardiocppa.com or call us at (302)-478-5055 follow @cardiocppa on facebook

Bio

Dr. Brian H. Sarter has been a member of Cardiology Physicians since April 1998.  Dr. Sarter attended Duke University where he graduated Summa Cum Laude with his Bachelor’s Degree in Science.  He attended the New York University School of Medicine where he was elected to Alpha Omega Alpha (Medical Honor Society).  He completed his Internal Medicine training at the Hospital of the University of Pennsylvania.  He continued at the Hospital of the University of Pennsylvania to complete two years of his Cardiology fellowship and did additional training in the subspecialty of Electrophysiology at Hahnemann University Hospital and Medical College of Pennsylvania.  Dr. Sarter has authored or co-authored over 30 papers in the field of Electrophysiology which have been published in major Cardiology Journals.  He is a Fellow of the Heart Rhythm Society and American College of Cardiology and a member of the Delaware Medical Society.

Dr. Sarter has a strong commitment to clinical and consultative Cardiology and his added expertise in Electrophysiology allows our Practice to service the needs of patients with cardiac rhythm disturbances.  Dr. Sarter has extensive experience in both medical and interventional treatment of cardiac arrhythmias.  He is highly proficient in defibrillator implantation, pacemaker therapy, and radiofrequency ablation of both ventricular and atrial dysrhythmias.  He is the first physician in the community to have implanted biventricular pacing devices for the treatment of chronic refractory congestive heart failure and the first physician in the community to offer curative catheter ablation for atrial fibrillation.  Dr. Sarter is the Medical Director of the Heart and Vascular Interventional Services and the Associate Chief of Cardiology at ChristianaCare Hospital in Newark, Delaware.

Dr. Sarter and his wife Eileen were married in 1991 and have two children, Jake and Darian.  Dr. Sarter enjoys spending time with his family as well as jogging, golfing, skiing and exercise.