SINAI HOSPITAL
Sinai Hospital Ambulatory Services Division
is pleased to welcome
Yefim Levy, M.D.
ate professor of medicine in the di-
vision of gerontology at the Uni-
versity of Maryland Medical
Center. He is co-director with Dr.
Dariush Elahi of the clinical phys-
iology section at the Pepper Cen-
ter.
One group will be given a su-
pervised aerobic exercise program,
weekly nutrition counseling and,
if needed, help to stop smoking.
The second group will not partic-
ipate in these programs but it will
see a center doctor for routine
care.
Dr. Poehlman said the exercise
program would start at 15 min-
utes three times per week,
progress to 45 minutes to one hour
three times per week over six
months, then stay at that level.
The nutrition program would fol-
low the American Heart Associa-
tion's recommended diet of 30
percent fat in the daily intake of
food.
'We'll follow the groups for five
years and see what happens," Dr.
Poehlman said.
Already, though, the previous
projects have shown the benefits
of exercise, even for people with
such serious illnesses as CHF and
PAD.
Dr. Peter Vaitkevicius, assis-
tant professor of medicine in the
division of gerontology at the Uni-
versity of Maryland Medical Cen-
ter, conducted the CHF pilot
project with Drs. Michael Fisher
and Stephen Gottlieb. Eleven
CHF patients were put on a three-
month, three-days-a-week indi-
vidualized exercise regimen. (The
participants were all men because
the population was recruited from
the VA Hospital clinic.)
They included one 74-year-old
man who had gone to his bedroom
closet to retrieve his shoes, be-
came exhausted and laid there for
four hours, unable to get up until
his wife returned home to help
him.
Contrary to standard medical
advice to CHF patients to avoid
strenuous exercise, Dr. Goldberg
said all the participants showed
improvement, some as much as a
25 percent increase in exercise
capacity. They were able to walk
farther and faster without short-
ness of breath, and some were
able to perform chores around the
house they'd been unable to do
before.
For example, the man who was
too exhausted to leave the closet
had barely managed two minutes
at 1 mph on the treadmill. Three
months later, he was walking 30
to 40 minutes at 2 mph. Nine
months after the study started,
he was driving a car and
going shopping, Dr. Vaitkevicius
said.
But there are limits. Elderly
people with cardiovascular dis-
ease who start exercising will be
at a lower level of exercise capac-
ity than a healthy senior adult.
They can never achieve the degree
of improvement someone without
a disease could.
Lillian Gampel, a 68-year-old
Pikesville grandmother, partici-
pated in the second pilot project
for people with PAD. For six
months, Mrs. Gampel, who has
undergone surgery for poor leg cir-
culation, and 13 other participants
(12 men, one other woman) exer-
cised under supervision three
times a week. The PAD project
was directed by Dr. Goldberg in
collaboration with Drs. William
Flinn, Andrew Gardner and Lois
Killewich.
Now on a maintenance routine,
Mrs. Gampel exercises twice
weekly at the Pepper Center, 30
minutes on a treadmill and 10
minutes on a rowing machine.
"I've seen an improvement,"
Mrs. Gampel said. "I can walk far-
ther distances and for longer pe-
riods of time without pain." One
recent weekend, she and her hus-
band, Irvin, visited. Atlantic City.
"We walked and walked. Before
this program, I'd never have been
able to do that."
in the practice of Medicine
with a specialty in Internal Medicine.
Dr. Levy joins the office of
Vladimir Klemptner, M.D., P.C.,
who also specializes in Internal Medicine.
Dr. Levy is fluent in the Russian language.
To make an appointment, please call
(810) 559-1950
during normal business hours.
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P
24777 Greenfield Road
Southfield, Michigan 48075
(810) 559-1950
ushing the en-
velope on aging
research.
Dr. Goldberg and the Pepper
Center researchers are aware of
the risks for the sick elderly who
undertake an exercise program,
even a closely monitored research
study.
Still, the preliminary results
are encouraging and significant.
Nursing homes and assisted-liv-
ing facilities aren't necessarily the
outcome if the sick elderly can be
kept functional. Dr. Goldberg en-
visions the research ultimately
leading to a clinical program to
maintain the lessons learned, ei-
ther at the Pepper Center or satel-
lite sites.
"Older people don't go to Gold's
Gym and Bally's [Fitness Center]
because young people push them
away from the machines and all
that equipment is confusing. They
get overwhelmed," said Dr. Gold-
berg. He is convinced that in the
right environment, with proper
instructions, seniors would
exercise.
"The question is, is the med-
ication older people go to doctors
for really a quick fix which doesn't
really give them permanent im-
provement? We'd like to get them
back to their functional level ei-
ther before they got sick or at a
maximal functional level relative
to their disease."
Exercise, said Dr. Goldberg,
"can give people the ability to cope
with disease and to sustain inde-
pendence. If you're in better
shape, you'll have a better qual-
ity of life." L
III III
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for information about our private,
apartment homes offering personalized
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Contact
Arlene Lubin, M.S.W., C.S.W.
Activities of Daily Living Center
(810) 353-2810
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28301 Franklin Road • Southfield, Michigan 48034 • (810) 353-2810
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