Topics

QUESTION: Why does my leg hurt and feel numb sometimes? Is this related to my lower back?

•••

ANSWER: Numbness or tingling sensations in the legs could definitely be related to your back. What you are describing sounds like lumbar spinal stenosis, but it’s important that you have your spine evaluated to determine the exact cause and course of treatment.

Another problem that can cause numbness is neuropathy, which is a complication from diabetes, or peripheral vascular disease. Seeing a spine specialist can help pinpoint the problem.

Stenosis is a medical term simply meaning narrowing, so essentially this is “spine narrowing.” The nerves of the spine are getting pinched as they exit from the spinal canal through the center hole between the bones, which is called the foramen.

This nerve compression can result in sciatic pain that radiates down through your leg. You may also feel a loss of strength and fatigue in the legs as the sciatic nerve is pressed and becomes inflamed and irritated.

Many find that leaning forward may relieve the pressure and stop the pain — this is referred to as the “shopping cart sign.” It’s also common for this type of pain to happen during specific activities, or it can come and go rather than being a constant sensation.

A combination of conditions can lead to spinal stenosis, including facet arthritis and disc degeneration, which occurs in everyone to some extent, through aging. As we get older, the height between the vertebral bodies is decreased, thus reducing the space available for the nerves to exit from the spine. Pinched nerves are a very common occurrence.

WHAT CAN YOU DO?

First, have your spine evaluated by an orthopedic surgeon to determine the severity of your condition. Although it is best to start with a surgeon, most cases will be treated non-surgically.

Some of us like shopping for a new car. The other 99 percent of us, not so much. Bring along some confidence on your next trip to the car lot. A little bit of knowledge can save a lot of money.

TO GET STARTED

Know your budget, your credit score and what is important to you in a car before you walk into a dealership. This will help you keep from getting sidetracked; you don’t want to come home with a vehicle that’s outside your budget, pay an inflated interest rate or get a car that is not what you wanted.

Always buy or lease based on the sale price of the vehicle. You may spend more money if you make a decision because the monthly payment seems low. Run the numbers and compare car prices. If the payments end up being too high for your budget, it’s the wrong car for you.

AND REMEMBER …

Take a friend along so that you don’t get caught up in the excitement of a deal that is outside of your comfort zone. Don’t make financial decisions under the influence of emotion.

Don’t put a lot of money down on a lease. First payment and plates is all you should write a check for. Keep your money liquid for important expenses. If you have a trade-in, put it toward the purchase of the car. Leasing? Take the check and bank it.

Always have a used car inspected by your mechanic. It can save you time and money, even if the dealership has certified that the car is mechanically sound.

Take the car home overnight. A 20-minute test drive won’t tell you how comfortable you are with the size, feel and maneuverability of the car.

When you go into the finance office to sign papers, remember: You are buying or leasing a vehicle.

For many, this is the season of gift-giving. Most older adults have all the things they need. It’s a challenge finding just the right present.

If you have a loved one in this category and they have a dog or cat living with them, there are plenty of items or services you can provide to help make the holiday a bit brighter for pets and their owners.

Want to keep up appearances?

Offer to pay for pet grooming services.

Feeling generous?

Make a donation to their favorite pet-related charity in their honor.

More time than cash?

Give a coupon book filled with chores you can do to help them care for their pet over the year.

No time?

Pay for pet cleaning services so they don’t have to pick up pet waste from the yard. Or ask their favorite veterinarian if you can pay for their veterinary care services.

Feeling strong?

Buy heavy supplies such as pet food or cat litter and deliver it to older friends or family members to save them a trip to the store.

Like the outdoors?

Schedule a walk with them and their dog once a month or once a week.

As much as some of us (me included) would like to control every aspect of our lives, we can’t. What we can control is our attitude toward what happens to us.

We all experience and continue to experience trying times in our lives. The what in these situations is less important than the how.

CUT THE NEGATIVE ATTITUDE

How we react and move through these particular situations will determine their effect on our physical, mental and emotional well-being. Up to 40 percent of our happiness comes from how we choose to approach our lives. We tend to focus on our problems, especially during trying times. We then get in the habit of focusing our attention on all the negative things happening in our lives.

What would happen instead if we switched that focus to the many good things that happen to us each day?

What if we took time daily or weekly to reflect on things we are grateful for in our lives?

EXAMPLE GRATITUDE JOURNAL ENTRIES

• I am grateful for my knowledge of how to live a healthy lifestyle and that I can help others do the same.

• I am grateful that I devoted time to my strength-training routine today.

• I am grateful for my family and friends.

INCREASING HAPPINESS

Gratitude is the forgotten factor in happiness research. Studies show grateful people:

• Report higher levels of positive emotions

• Have greater life satisfaction

• Experience greater vitality

• Are more optimistic

• Are healthier

• Build strong relationships

• Handle adversity better

• Experience lower levels of depression and stress

People who have a strong disposition toward gratitude have the capacity to be empathetic and to take the perspec – tive of others. They are also rated as more generous and more helpful.

Grateful individuals place less importance on material goods, are less likely to judge their own and others’ success in terms of possessions accumulated, and are less envious of others.

Money is a tool, and usually we look at how it can be used to our benefit. But that tool can be used to benefit others through gifting and charitable giving. If you have a desire to share your financial success, incorporate those thoughts into your financial plans.

After you determine who gets your money, you need to decide when the giving will occur. If the gifts are to individuals, as of 2016 donors can give $14,000 to each person and the gifts do not need to be reported on tax forms or subjected to gift taxes.

If you are married, both you and your spouse each can give up to $14,000 without triggering tax on the gift. For example, together, couples can give $28,000 to an individual. Gifts above that amount are not subject to gift taxes until the couple’s accumulated lifetime gifts to all exceeds $10.68 million. However, they must be reported on the giver’s tax returns by filling out Form 709. Those gifts can be specified to be used now or for a long-term benefit such as funding a 529 College Savings Plan, a Roth IRA or a saving and investment account.

CHARITY GIVING

If the gift is to a charity, it may be tax-deductible. To deduct a charitable contribution, taxpayers must file Good Gifts Charitable Giving and Your Financial Plans By James S. Lineweaver Form 1040 and itemize deductions on Schedule A. Charitable gifts can be made now, or planned for the future. Future gifts can be specified in your will or by naming a charity as a beneficiary on a retirement account or life insurance policy.

Planned gifts are both smart and generous. If you need money for your lifetime expenses, they are available, and the remaining assets benefit your desired charity. If you don’t itemize deductions on your 1040, once you reach age 70 1/2 you can transfer up to $100,000 a year from your IRA directly to charity as a Qualified Charitable Distribution (QCD), without that distribution counting as part of your adjusted gross income.

On Aug. 1, 2016, the Ohio Department of Medicaid drastically changed eligibility rules for Medicaid benefits for people who are disabled and others who need long-term care.

My column in the September/ October 2016 issue of this magazine highlighted three significant changes in these new rules: How Medicaid deals with the applicant’s home, how Medicaid treats retirement funds that belong to an applicant’s spouse, and the applicability of a rule (new in Ohio) that bars Medicaid coverage for people who have too much income.

SO, WHAT DOES “TOO MUCH INCOME” MEAN?

As I wrote in the last issue, “too much income” sounds weird. But because Medicaid provides money for medical coverage for the poor, having “too much income” can make someone ineligible for help.

Those whose gross income is higher than $2,199 per month are ineligible for Medicaid coverage for long-term care. (That amount is adjusted from time to time to compensate for inflation.) That $2,199 is not enough to pay for long-term care for most people; it would cover a few hours of home care each week.

Because the amount of income that blocks eligibility is not enough to keep up with the costs of long-term care, a method has been created to make it so that only part of a Medicaid recipient’s income actually counts as income. As an aside, don’t look for logic here. This stuff is crazy. It’s what satisfies the rules, though. The only explanation I can offer for this “too much income” thing is that these are the rules.

To make some income not count as income for Medicaid purposes, recipients can run some of their income each month through a Qualified Income Trust, commonly referred to as a Miller Trust.

“Qualified Income” is not counted as income for Medicaid eligibility purposes, and the monthly money that goes through the Qualified Income Trust is “Qualified Income.”

Each week, veterans — many with minds upended by both seen and unseen battle scars — enter Dr. Walter Knake’s Beachwood office.

A welcoming flame glows from an electric fireplace. An Oriental rug blankets the floor. Propped everywhere are stuffed animals. The vibe is cozy and soothing. Except for the American and military flags in a corner and a large bulletin board packed with medals, patriotic badges and pins, the clinical psychologist’s office could be the den in a suburban home.

FAMILIAR ISSUES

Each Nov. 11, Americans honor military veterans. Knake treats the ones who rarely feel honored or respected; much of their energy is consumed by the psychological effects of their military service.

Post-traumatic stress disorder (PTSD) is one issue. Others may be dealing with traumatic brain injuries or relationship issues, alcoholism, drug addiction or a combination of problems. About 70 percent of Knake’s patients are combat veterans who hear about his practice through word of mouth.

An average of 22 veterans commit suicide each day, according to statistics from the U.S. Department of Veterans Affairs. Aging veterans are the most vulnerable; 65 percent who died from suicide were 50 or older. Veterans made up 18 percent of all suicide deaths, according to most recently available statistics, but comprised just 8.5 percent of the county’s population.

Battlefield trauma and its long-term emotional consequences aren’t new. From the time people have fought wars, many carried the effects into middle and old age. Today’s PTSD was yesterday’s battle fatigue, shell shock or war neuroses.

As America continues losing its World War II and Korean War veterans, those who served in Vietnam are filling Knake’s appointment book. When people approach their 60s and 70s, most become increasingly reflective and have more time to think. For veterans, their thoughts often turn to their war experiences, he says.

Volunteerism has a long tradition in the United States: from neighbors helping neighbors, to parents coaching their children’s sports teams, to retirees volunteering their time to help a local nonprofit organization fulfill their mission.

The need for volunteers to help in our community continues to grow, and there is a volunteer opportunity for everyone.

The Corporation for National and Community Service reported that one in four Americans volunteered through an organization, and three in five helped their neighbors in 2014.

Most people who want to volunteer find it a difficult search, mostly because they are not sure of what they want to do, what needs currently exist and if they can offer enough time.

Greater Cleveland Volunteers, a nonprofit in Cuyahoga County, enriches the community and individuals through volunteer service. They work one-on-one with anyone who wants to find out more about volunteering in Cuyahoga County.

THE TIME ISSUE

Many people feel they don’t have enough time to devote to volunteering, says Joy Banish, GCV’s executive director.

“Our agency partners with more than 100 nonprofit agencies in Cuyahoga County. We are finding there are many one-day and short-term volunteer opportunities. This fits nicely in someone’s schedule that is not able to make an ongoing commitment.”

She adds that there also are volunteer jobs that people can do at home.

Generally people aren’t sure that their time can make a difference — it does.

“Assisting at local food pantries is so uplifting. I know the agency needs help, and I’m there for them,” says volunteer Walter Reddick, who was placed through Greater Cleveland Volunteers.

When someone is not sure of what they want to do, many end up surfing the web.

Randy Helbert knew he wanted to help others, so he started looking online.

“When I was in grade school, it was discovered that I had a hearing impairment,” Helbert says.