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Understanding Macular Degeneration: The Importance of Early Detection and Specialized Care

By
Guest Columnist
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Age-related macular degeneration (AMD) is one of the leading causes of vision loss among adults over 65. This condition affects the back of the eye where light is processed by macula. The macula is the part of the retina providing sharp, detailed vision needed for reading, driving, and recognizing faces. Two categories of macular degeneration are “dry” and “wet”. This article will focus on dry macular degeneration and therapy options to help slow vision loss from it.

Macular degeneration begins silently. Early symptoms may include mild blurring, difficulty seeing in low light, or the appearance of wavy or distorted lines. Later on, a dark or empty spot near the center of the vision can develop. In advanced stages, central vision may be lost entirely. Regular eye exams are crucial because early AMD can be detected during a dilated retinal examination or with specialized imaging.

A few major risk factors include age, family history, current smoking, and genetics. Individuals with a family history of AMD should be especially vigilant about screening.

Routine eye exams with an optometrist or general ophthalmologist are the first line of defense in identifying AMD. However, once AMD is suspected or diagnosed, referral to a retina specialist is essential. Retina specialists undergo additional years of fellowship training specifically in identifying and treating diseases of the retina and macula. This specialized expertise allows for detailed diagnostic imaging, tailored treatment plans, and access to the latest clinical advances in emerging therapies for AMD.

For patients with intermediate dry AMD, one of the most promising new therapies involves photobiomodulation (PBM) using the Valeda Light Delivery System, an FDA-authorized device. PBM works by exposing the retina to specific wavelengths of light that stimulate the mitochondria—the “powerhouses” of our cells. By energizing these tiny structures, PBM helps improve cellular metabolism and reduce oxidative stress thought to have a role in slowing AMD. Clinical trials, including the LIGHTSITE III and LIGHTSITE IIIB, have shown that PBM can lead to improved visual function and contrast sensitivity in patients with intermediate AMD. These studies support PBM as a safe, non-invasive treatment option for eligible patients. In addition, there are FDA-approved injections for geographic atrophy, a more advanced stage of dry AMD. These treatments aim to slow progression and preserve remaining vision, marking a major milestone for patients who previously had limited options.

For AMD that has advanced beyond the ability to benefit from the therapies mentioned there are still options. Many vision aids and tools are available today that can help optimize remaining vision. Getting a referral to a Low Vision specialist is another step available to help individuals affected by advanced AMD. Early identification and intervention is key. Just like controlling blood pressure or diabetes early to prevent complications later on, addressing macular degeneration before it becomes advanced can make a significant difference in the long run. Current therapy slows down AMD to keep vision better for longer, but does not completely stop or reverse dry AMD. Regular follow-ups and referral to a retina specialist can ensure timely diagnosis, access to cutting-edge treatments, and personalized care to preserve sight for as long as possible.

Dr. Jed Assam is a board-certified, fellowship-trained retina specialist dedicated to the diagnosis and treatment of AMD along with other macular and retinal disorders. He is the founder of VRA Vision in Sioux Falls, a Center for Excellence in Macular Degeneration, and is passionate about patient education and early intervention to prevent vision loss. Follow The Prairie Doc® at www.prairiedoc.org Facebook, Instagram, YouTube and TikTok includes On Call with the Prairie Doc®, a medical Q&A show (most Thursdays at 7pm YouTube and streaming on Facebook), 2 podcasts, and a Radio program (on SDPB, Sundays at 6am and 1pm).

200,000 leaves – Building the Compost Pile

By
Guest Columnist
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A mature shade tree like an oak can have around 200,000 leaves in a year. Those leaves fall off this time of year making for a lot of organic matter to deal with. Leaves are a great material for making compost to use in your garden! Making compost from organic materials as they become available is a very slow process. The process can be accelerated by making hot compost. Start with a 6- to 8-inch layer of “brown” materials such as straw, old mulch, or tree leaves. Add a 2- to 3-inch layer of “green” materials such as grass clippings, coffee grounds, weeds, kitchen waste, or freshly harvested plant material. Alternate brown and green layers until the pile is 3 to 5 feet high. If green materials are in short supply, add a small amount of commercial garden fertilizer (about 1 to 2 cups per square yard) or an inch or two of manure. The fertilizer or manure provides nutrients that allow microorganisms to build up in the compost pile to ensure decomposition. Water after each layer. Brown materials can be difficult to find at certain times of the year. Stockpile leaves bagged in the fall and add them to the compost pile as needed.

 

The top of the compost pile should be dish shaped, so it is slightly lower in the center than on the sides. This allows rainfall to soak into the pile instead of running off. In dry conditions, the pile should be soaked weekly so it stays moist. The compost pile eventually will reach 150 to 160°F before it begins to cool down. When this happens, it is time to turn the pile. Slice through the layers and turn the materials upside down. Move materials from the outside of the pile to the inside. After mixing, form the dish at the top and water. Let the pile heat up and cool down as before. Compost should be ready four to six months after the pile is started. Most gardeners keep two piles or divide the pile into two sections, using one side to accumulate new material and storing last year’s compost in the other.

 

As the compost pile progresses, check for signs the process is going well. The pile should shrink or sink in two to three weeks. If not, loosen it with a shovel or fork to aerate, adding moisture if compost is dry. A strong ammonia smell or other offensive odors may indicate overwatering or an imbalance in materials. Ammonia odors can occur when composting a lot of fresh, green plant material, especially grass clippings. After four to five weeks the inside of the pile should be hot. Push a wire or stick deep into the pile, pulling it out and touching it to check temperature. In three to four months, the pile should be about half its original height. Compost will be dark, moist, and crumbly and should smell like moldy leaves with a rich, earthy odor.

Chicken Stuffing Casserole

By
Debbie Dance Uhrig
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0

I must be ready for Thanksgiving because I created a quick meal tonight for the two of us. It tasted like Thanksgiving in a one dish meal. A bit like the ‘Thanksgiving In a Cup’ which ran 2-3 columns back. It features two over the counter ‘pre’ purchases, stove top stuffing and a can of mushroom soup. Not my norm, that’s for sure, but it was a yummy one dish meal.

I have a recipe a ‘bit’ like this one that is made with shredded zucchini, chicken and the stove top stuffing. There are going to be many flip outs for this little casserole dish. Sometimes what we have on hand truly rules the outcome of many dishes.

I’m also going to shock you when I share how I used a Southeastern Mills Chicken gravy packet for the top of the casserole. A little salad on the side, poof, a nice family dinner. This recipe was for an 8 x 8 dish, it will easily double for a 9 x 13 baking pan. Another fun thing is how it only took one large, pre cooked chicken breast, for the 8 x 8 pan.

If the cheese is too much and you need to cut back, it can certainly be omitted. I really don’t think you are going to miss it all that much.

One thing I’ve been cooking with a great deal the last couple of weeks is fresh parsley. I almost put some in this dish, but didn’t. I would definitely think of adding it to the recipe.

Need another direction for this quick fix casserole? Go with the herb stuffing and use pre cooked sausage and chopped apple with the onion and celery, Like things spicy, use a little pepper jack cheese instead of cheddar.

This simple dish could come in real handy as you prepare for the holiday season. The meal comes together quite quickly while you prepare holiday goodies or wrap a few gifts. This is my favorite week of the fall season. Here in the Ozark Hills the first week of November is always a pretty one, and the temperatures are grand.

Oh yes, pumpkin fans, be sure and stop by Culvers for my favorite shake, the pumpkins salted caramel. Simply yours The Covered Dish.

Chicken Stuffing Casserole

1 box low sodium chicken or turkey Stove Top Stuffing

½ of a large sweet onion, chopped fine

3 stalks of celery, chopped fine

½ cup dried craisins

1 can cream of mushroom soup

1 can of milk

1 cup shredded cheddar cheese

1 large pre-cooked chicken breast, cut into chunks

2 whole eggs, lightly whisked

Additional cheese for the top, adding towards the end.

Mix all ingredients except the additional shredded cheese into a bowl. When well blended spread into a greased 8 x 8 baking dish. Bake at 350 to 375 for approximately an hour. Towards the end of baking sprinkle on additional cheese. While the casserole is baking start preparing the gravy to serve over the top of the dish. Great leftovers to take for lunch. Enjoy-

Per pound price for whole turkeys up 70% compared to last year

By
jennifer
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0
Photo courtesy: plainville farms

Prices for centerpiece turkeys are up, but overall consumers are likely to see a mixed bag of price increases and decreases as they shop for traditional Thanksgiving holiday meals.

While recent price trends for whole turkeys were much higher than last year, the cost of other traditional fare like hams and potatoes, as well as baking items like eggs and butter were lower, said David Anderson, Ph.D., Texas A&M AgriLife Extension Service economist and professor in the Texas A&M Department of Agricultural Economics, Bryan-College Station.

Anderson said overall prices and seasonal specials indicate opportunities for shoppers to find value as the holiday approaches.

“You may see higher prices on some items but remember that grocery stores always have a strategy for Thanksgiving,” he said. “Typically, it’s built around a special feature on the turkey to get people into the store, and I suspect this year will be no different.”

Turkey production down, prices up

Anderson said wholesale prices for whole turkeys were $1.68 per pound compared to 99 cents per pound this time last year – a 70% increase. Two factors – the resurgence of highly pathogenic avian influenza, HPAI, and lower overall turkey production – have reduced supplies that have triggered higher prices.

Turkey and egg production were hit hardest during previous outbreaks of the disease, and turkey supplies are still recovering from losses that continued into late spring. Commercially raised turkey hens take 15-18 weeks to reach maturity while larger toms take 20 weeks or more to reach harvest weights.

“Turkey production takes time, and so even the recovery from avian flu in the spring is impacting supplies,” he said. “The buildup on whole turkeys for Thanksgiving happens throughout the year as birds are held back to meet that holiday demand.”

Anderson said turkey production is down more than 8% year over year as the industry continues to grapple with low prices, increased input and labor costs, and shifting consumer demand. Aside from whole birds for the holiday season, most turkey ends up as deli meats in grocery stores and sandwich shops.

While Americans are eating double the amount of turkey they did in 1970, the 14.8 pounds per person consumed in 2023 is 18% lower than the 18.1 pounds per capita consumed in 1996.

Frozen turkeys at a grocery story (Photo: USDA Food Safety and Inspection Service)
Frozen turkeys at a grocery story (Photo: USDA Food Safety and Inspection Service)

Finding fewer specials so far

Many grocers set contracts with turkey wholesalers long before the holiday to lock in prices and the number of birds to meet expected demand, Anderson said. This can present opportunities for grocers to offer special prices or buying incentives to shoppers.

The retail outlet survey data shows grocers have been offering fewer specials compared to last year, he said. Prices may be lower in some cases, but there are fewer items being featured with special prices.

Anderson said it would be difficult to speculate on what triggered this retail trend, but he’s curious to see if special offers trend upward in the next few weeks.

He suggests shopping early for turkeys if size and brand are a consideration but that shoppers could find deals on centerpiece birds by shopping late as well.

“Even at the higher price, turkeys always seem like a good value relative to other meats when you consider leftovers and secondary meals that we get out of them,” he said. “As an economist we tend to focus on price, but in this case, I have to consider value.”

Mixed bag of prices on other items

Meanwhile, shoppers are also likely to find lower prices on some items like baking pumpkins, potatoes, milk and eggs, and higher prices on other meats like hams and steaks.

Eggs were $1.60 per large dozen compared to $3.30 for the same dozen last year, a 51.5% decline, Anderson said.

Dairy products like milk, butter and cheddar cheese have also experienced a sharp price decline because of higher production, he said. The U.S. dairy herd hit its highest number since the 1990s, and the nation’s 9.5 million milk cows are producing 28 pounds more milk per cow per year than they did last year.

On the other hand, potatoes like russets for baking and yellow gold for mashed potatoes have gone up slightly. Anderson said. Russets were 98 cents per pound compared to 84 cents per pound last year while yellow gold potatoes were 87 cents per pound compared to 74 cents last year.

Prices on another popular holiday item – cranberries – were also up – $2.45 per 12-ounce bag versus $2.37 last year, Anderson said.

At the retail level, prices for sliced boneless hams were relatively static $5.54 per pound compared to $5.53 per pound last year. The cost of spiral sliced hams was up – $3.17 per pound compared to $2.88 per pound last year.

“I think consumers are feeling the pressure at grocery stores with higher prices overall,” Anderson said. “But I also think there will be opportunities to find deals on those go-to items we buy to create traditional Thanksgiving Day meals.”

PHOTO: Man Taking Roast Turkey Out Of The Oven. (Photo: iStock – monkeybusinessimages)

“Listen to your gut”

By
Guest Columnist
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0

People often talk about having a “gut feeling” or are told to “listen to their gut” when making a decision. Do you know what your gut is trying to tell you? There are multiple things that your digestive system can do to get your attention. Do you know what your body is trying to tell you? Here are some of the things your gut could be trying to say.

Pain just below the breastbone that occurs soon after eating could be a sign of a stomach ulcer. Pain that improves with eating, but then comes back 2-3 hours after eating could be a sign of an ulcer in the small intestine right past the stomach. The pain from ulcers is often described as a burning pain. This pain improves with acid blocking medication like a PPI (Proton Pump Inhibitor) or antacids.

The gallbladder can also cause significant pain in the right upper part of the abdomen, especially after eating fatty foods. Often this pain will radiate to the right shoulder or between the shoulder blades. It can lead to significant nausea and diarrhea. This pain usually will come and go. It can become very severe if a small gallstone gets stuck in the bile duct between the gallbladder and the small intestine. Infections of the gallbladder can cause fevers and chills as well.

Issues with the small intestine can also cause serious pain. The condition of Irritable Bowel Syndrome (IBS) causes abdominal pain, bloating and changes in bowel movements. IBS can cause severe diarrhea, severe constipation or both. IBS is considered a diagnosis of exclusion since these symptoms can be caused by many other conditions like Microscopic Colitis, Celiac Disease, Crohn’s Disease, Ulcerative Colitis, Small Intestine Bacterial Overgrowth, and even Colon Cancer.

However, it is important to note that not all pain in the stomach area is from the digestive system. Heart attacks can also give symptoms of indigestion, nausea, vomiting, and stomach pain. These subtle signs happen more frequently in women and can lead to delay in diagnosis. Aortic dissections or ruptured aortic aneurisms can also cause severe, tearing pain in the abdomen that can radiate to the back or shoulders.

If you notice your gut trying to tell you something, listen and get it checked out by a doctor. Many of these issues have similar or overlapping symptoms. Finding a physician who can order and interpret the right tests to find the answer is key. Your gut knows when something is wrong, and you should trust it. Listen to your gut and stay healthy out there.

Dr. Jill Kruse is a hospitalist at the Brookings Health System in Brookings, SD. She serves as one of the Prairie Doc Volunteer Hosts during its 24th Season providing Health Education Based on Science, Built on Trust. Follow The Prairie Doc® at www.prairiedoc.org, FaceBook, Instagram, YouTube, and Tik Tok. Prairie Doc Programming includes On Call with the Prairie Doc®, a medical Q&A show (most Thursdays at 7pm on YouTube and streaming on Facebook), 2 podcasts, and a Radio program (on SDPB, Sundays at 6am and 1pm).

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