Turning the Page…By Terry Polanin, APRN

The Telomere Effect—Aging, Longevity, “Canaries in the Coal Mine”

As I write this last newsletter article for the Couri Center, I am very proud to have been a part of a practice whose very foundation is about promoting healthy lifestyles for women.  It has been a privilege guiding our patients through our integrative lifestyle focus to embrace a future full of beauty in themselves and their surroundings and finding moments to appreciate joy and peace.

That said, I would like to share with you some recent scientific research about our telomeres. Being able to see a future bright and healthy, does require some effort on our part, preserving our telomeres. For the past 40 years in nursing, I have seen many changes in healthcare and the health of our American people.  I am grounded in the belief that staying healthy, emotionally and physically, can help to “turn back time” and most of my passion in this profession has been promoting healthy habits and lifestyles.

As you know, it is not an easy path for many of us as we navigate our way through the multitude of “diets” and exercise recommendations available today.  I was enlightened recently by a speaker at a national conference discussing The Telomere Effect, a theory on cellular aging impacted by lifestyle factors and stress.  Telomeres are the end caps of our DNA.  When telomeres critically shorten, the end of the DNA is exposed to damage, and the cell dies.  Telomerase is a cellular enzyme that rebuilds telomeres and has additional non-telomeric roles in cell survival.  Who doesn’t want their cells to survive or thrive for that matter?  Telomeres typically shorten as we age.  Many studies have shown that life stress, or perceived life stress (if you feel like the things happening to you are stressful) can shorten telomeres.  Shorter telomeres will increase cortisol (stress hormone) and over time increase inflammation in our bodies.  Adverse childhood events will shorten telomeres, even stress exposure intrauterine (babies in the uterus) can reduce the telomeres as we age.  Dr. Couri was one of the first physicians in the Peoria area to integrate the philosophy of adrenal health and stress management, into western medicine at the Couri Center practice in early 2010.

The good news is cell aging by telomere loss can be reversed with telomerase!  Several studies have shown that accelerated telomere loss can be reversed within 4 weeks by reactivating telomerase.  This raises the question—can molecular aging be reversed? That answer seems yet to be determined, but many studies are showing promising results.  In the book, The Telomere Effect (Eppel and Black, 2017), the research they have performed suggests favorable measures to improve the telomeric effect on our bodies.  Such as:

1) Regular exercise

2) Dietary “Restraint.” Eat a more plant-based diet, with less processed and sugar-laden foods.

(See research from Dr. Ornish Lifestyle Study published in Lancet, 2008)

3) Vitamin C, D3, E, folic acid in foods or vitamin supplements (See our Couri Center store for quality brands such as Xymogen or Metagenics, or Nordic Naturals)

4) Omega 3 fatty acids-Fish oil (We suggest Nordic Naturals for quality fish oil)

5) Social Support

6) Mindfulness, Meditation, Yoga

7) Stress Management (Such as time for yourself, a walk/hike in the woods, weekend get-a-ways)

8) Statins (Yes, this was on the list and suggested for lowering cholesterol and its anti-inflammatory properties)

9) Estrogen (Yes!! Especially if started in early menopause.  Talk with your provider for further information)

10) Sleep

11) Anti-depressants (Yes, it was on the list, and of course, many of the measures mentioned above will also naturally boost your mood if actively done regularly in our lives)

Unfavorable measures on our telomeres were: obesity, insulin resistance (Pre-Diabetes), elevated homocysteine levels (a measure of inflammation), and cigarette smoking. Have your labs checked!

If you need assistance in improving your lifestyle habits and reducing the telomeric effect, please see your Couri Center health care provider and/or Leslie Bayer, our Registered Dietician, who will help navigate you.  It has been my pleasure to work with Leslie, over the years, as she has been a vital component of the integrative health care we provide at the Couri Center.

And now, please bear with me as I reflect back on the 44 years I have spent fulfilling my childhood dream of becoming a nurse, and the 39 years as a Nurse Practitioner/Advance Practice Registered Nurse.  I am feeling melancholic, as my retirement in March 2019 draws near.  I honestly cannot put into words the joy I have received through the patients that I have met along the way who trusted and allowed me into their personal lives as a health care provider.  You have really taught me much more than I did you, I am sure.

My journey began in the late 70s when I was teaching Nursing at OSF at the time, and we were asked to continue our education.  The request was honored by obtaining a Master’s Degree in Nursing. This was a time when very few nurses had Bachelor’s Degrees, and the University of Illinois had just opened their graduate school at the Peoria School of Medicine.  I was accepted and asked to consider starting a new, expanded role for the nurse. Mind you, at this time in Peoria there were very few female physicians and certainly no nurses who would provide health care, other than at the hospital bedside, under the Doctor’s orders.   It was a “man’s world” in medicine, but a concept that intrigued me (the women’s movement was also gaining momentum) and the University of Illinois was preparing to lead the way in this new concept for medicine and nursing.  We decided to call ourselves Nurse Practitioners, but we were still practicing under our RN license and signing the physicians’ name to prescriptions.

The landscape was changing. With more complex technology, HMOs and evidence-based medicine, and more complicated patients were coming on the horizon, there were a few “broad-minded “physicians that welcomed the concept of “collaborative practice” with an RN willing to expand their role and basically see the healthier, wellness-type patients for routine physical exams and acute care in offices or clinics.

Preventive, patient education was my passion, so I delved into developing diabetic, weight control, hypertension, and chronic disease programs for our patients to complement the physicians’ medical care. (And offered to perform the women’s health exams which were welcomed). There were about six Nurse Practitioners in Peoria at that time striving to advance this new role, which was met with skepticism and some resistance from much of the medical community at the time.  However, by the mid-90s, it seemed that hospitals were starting to expand into primary care and buying physician practices which led to the need for more primary care providers since the growing population of seniors and chronic diseases were over-whelming physician practices.  A perfect opportunity for Nurse Practitioners and Physician Assistants (PAs) (a few PAs had been in the area also at that time) to integrate into the primary care practices, especially pediatrics and family practice.

At that time, I was given the opportunity to become the Coordinator of the Mid Level Provider group (a term I felt confusing to the public and somewhat demeaning to the professions) at Methodist Medical Center, which by this time had about 20 NPs and one PA. This was an opportunity to develop standards of care, position descriptions, and develop collaborative practice incentives.  It was also a time to change our group name, which I fondly called the Advance Practice Providers, now shortened to APPs.

It was an exciting time.  I was given the opportunity to develop a collaborative practice at the Friendship House for Christian Services in an underserved area of Peoria.  Additionally, I was asked to help begin a family practice in a school-based clinic housed in the Valeska Hinton School (with a progressive Principal, Ken Hinton, who believed children and families needed to have health care to be fully able to learn/succeed).    As time progressed, our nurse practice act was amended, and by 2002 we officially became APNs (Advance Practice Nurses) with the ability to sign our own names to prescriptions, based on our credentials, while working collaboratively with a physician(s).

Now, as I look back, I am so amazed and thankful at the progress we have made from the “ghost” provider in the 80s to a respected colleague and an integral part of health care teams in the 21st century.  We’ve come a long way!

This is probably way more than you wanted or did read, but thank you for listening as I “stroll down memory lane” to I look back on the joys and challenges of this “calling” I’ve been privileged to be part of.  And thank you to my patients, over the past 39 years as an APRN (that title recently amended), who have shared your lives with me and taught me about life.  I will never forget you.

Lastly, thank you to Dr. Michele Couri and her husband Tim Couri, who had the vision to bring contemporary women’s health care into the 21st century in central Illinois, with a focus on women, and designed by women.  It has been an honor to work with you and with the marvelous providers and staff that I have spent the past eight years with as colleagues and friends.  As my strong, loving 93-year-old mother always says…God never closes one door that He doesn’t open another.”

As I transition into retirement, I plan to focus on our three amazing children and their spouses. There is so much to look forward to!  We are expecting our first grandchild in May, our daughter’s wedding in October, as well as, a full schedule of international travel with my wonderful husband of 40 years. We also have a new 8-year old rescue bulldog Mack, my elderly 32-year-old horse Copper and my dear 93-year-old mother keeps ME young with lots of shopping!  I hope this keeps my mind off retiring from the Couri Center and the bittersweet close of this door.  So, I will remember the saying as I walk out the door in March, “Don’t cry because it’s over, but smile because it happened.”  I will probably do both.

 

God bless and to your health,

Terry Polanin, APRN