Surgical Weight Loss Program offers options for patients

by Alyssa Harvey, The Daily News, originally published on 11/5/2011

Keri Clark hadn’t always been overweight.

“I gained a little bit after getting married and having kids,” she said.

In 2001, she had twins and nearly died.

“I had high blood pressure issues. They were premature,” she said. “I was going into kidney failure. I stayed in the hospital for almost a month.”

Her metabolism changed and Clark said she “really blew up,” going from 180 pounds to 269 pounds from 2002 to 2003.

“I didn’t exercise,” she said. “I never did when I was younger.”

After having the twins, Clark became a labor and delivery nurse, often working 12-hour shifts.

“My knees and back were hurting. It was a very demanding job,” she said. “It’s what made me want to do it.”

“It” was weight loss surgery. Clark had a duodenal switch, which involves making the stomach smaller and rerouting the small intestine. She had the surgery in March 2010 in Nashville.

“I don’t think it’s for everybody, but I think everybody should have the option,” she said of weight loss surgery. “You have to do your own research. Be honest with yourself. Is this surgery right for me?”

Clark is now helping others have the option as a bariatric nurse liaison for The Medical Center’s new Surgical Weight Loss Program. Located on the first floor of Riverside Professional Center, the program offers support for patients before and after their operations, which will be done at The Medical Center. The service offers everything a patient may need, including a seminar to help potential patients learn more, insurance specialists, a nurse practitioner, a psychologist and a dietitian. There is also a support group that works in conjunction with the program.

“We do laparoscopic surgery. It’s minimally invasive,” said Dr. John Oldham, who, along with his partner, Dr. Derek Weiss, will do the operations. “It’s much better for patient outcomes. We’ve done 6,000 procedures and haven’t had to convert anyone to an open procedure.”

Oldham and Weiss are bariatric surgeons with Bluegrass Bariatric Surgical Associates in Louisville. They will perform different types of surgery, including the adjustable gastric band, which is placed around the top part of the stomach to reduce food intake; sleeve gastrectomy, in which the outer 85 percent of the stomach is removed, making it the size of a banana; gastric bypass, in which a pouch for food is made at the upper end of the stomach and the pouch is connected to the upper small intestine; and the greater curvature plication, which is new.

“No insurance covers it yet. It’s an investigative procedure,” he said. “You fold the outer portion of the stomach in and make it smaller.”

Patients usually have to have a body mass index of 35 or greater and some related condition such as sleep apnea, diabetes or heart disease, in order for insurance to cover surgery, Oldham said. Those with a BMI of 40 and up don’t have to have a health condition for insurance to cover it. Gastric band surgery is available for those with a BMI of 30 to 34.9, but insurance does not cover it.

Each surgery is a tool designed to help the patient get to a healthy weight, and each one is different, Oldham said. Gastric bypass and sleeve gastrectomy patients lose the majority of their weight in the first year – 60 percent to 70 percent of excess body weight. The gastric band procedure is the safest because there is no cutting the stomach or rerouting the intestines.

“There is no magic procedure. They have to commit to do this,” he said. “There is a lot of education involved. A lot require a six-month diet before they have surgery.”

There is also more education after the surgery, including time with an exercise physiologist and support group meetings, Oldham said.

“They commit to being patients for the rest of their lives. Once a year, we check their vitamin levels and make sure their bodies are doing what they should be doing,” he said. “Exercise has to become an important part of their lives as well. You have to be committed to make changes in your lifestyle to do it.”

Clark said she started thinking about weight loss surgery in 2007. She had family members who were obese and wanted her life to be different.

“I worked with people who had it done,” she said. “It’s scary because you’re choosing to have surgery. What kind of life am I going to have if I don’t?”

After her surgery, Clark was in the hospital for five days. Her surgery was not laparoscopic. She understands that people worry about the possibility of complications, but today’s surgeries are more advanced, she said.

“We have to overcome ’70s and ’80s surgery,” she said. “People died during those surgeries.”

Clark has made some lifestyle changes since her surgery and is about 8 pounds from her goal weight.

“When you start to feel full, you stop,” she said. “If you try to stuff yourself, for me it really hurts. It’s not just an uncomfortable feeling.”

Clark said her feelings about food have changed. Some people feel as if they should have an entire cake after they have had one piece.

“I had a piece of cake, and it was really good, but I don’t have to eat the rest of it,” she said. “I’ll get cravings, but it’s not like I have to go eat all of it.”

She eats a high protein, low carbohydrate diet and no longer craves empanadas, which was her favorite food.

“It changes your taste buds,” she said. “You’ve got to change a little bit.”

Clark said weight loss surgery is a tool, not a cure.

“You can gain it back,” she said. “It’s a tool, like you would use health equipment at BAC.”

Copyright 2011 News Publishing LLC (Bowling Green, KY)

'Winter blues' hitting again: Steps urged to fight seasonal disorder

by Alyssa Harvey, The Daily News, originally published on 11/5/2011

Some people find no joy in the end of daylight saving time.

It brings shorter days with less sunlight. For some people it’s the beginning of the “winter blues,” or Seasonal Affective Disorder, a type of depression that occurs at the same time every year.

“People with SAD have symptoms that start in the fall and may continue through the winter months. Reduced sunlight can drop serotonin levels in people with SAD,” said Dr. Mrinal Mullick, a psychiatrist at The Medical Center. “The biological internal clock of the Circadian rhythm tells when we’re asleep and when we’re awake. It’s the destruction of the Circadian rhythm. It’s a combination of genetics and brain chemistry.”

SAD is different from general depression, Mullick said.

“It’s mostly associated with oversleeping and a craving for high-carb foods,” he said. “They have a feeling of hopelessness, a loss of energy and a loss of pleasure in activities.”

Greenview Regional Hospital respiratory coordinator Tuyen Trinh said some of the symptoms of SAD include depression, sleep problems, a tendency to overeat, loss of concentration, anxiety, mood problems and lowered sex drive.

“Four to 6 percent of the population suffer from SAD. Adults, teens and children can have it,” she said. “A lot of people have it but don’t know they have it. It happens in females four times more than in males.”

When men have SAD, though, their symptoms are more severe, Mullick said. Other risk factors for SAD include having certain other mental illnesses and how close one lives to the equator.

“The further you live away from the equator, the prevalence increases,” he said. “If you already have depression or bipolar disorder, it can make it worse.”

Although SAD can’t be prevented, there are ways to ease the symptoms, including using light therapy, Trinh said. People should be cautious with it and consult their doctors because UV lights can be damaging to the eyes.

“You can use a light box. It emits enough light for the body to soak up or you can sit near a window,” she said. “Take walks in the afternoon. Do things outdoors.”

People can use light therapy for an hour or two daily, Mullick said.

“It starts working quickly, in two to four days with very little side effects,” he said.

Some people may need antidepressants such as Paxil, Zoloft or Prozac, Mullick said.

“If people have typical SAD, they start taking it before the symptoms start,” he said. “They generally continue for a couple of months after the symptoms resolve.”

Psychotherapy can also help, Trinh said.

“It can help identify negative thoughts and changes,” she said. “Once you understand it, you won’t feel as bad.”

Mullick and Trinh encourage lifestyle changes to help ease symptoms.

“Trim branches at your home so you can have more sunlight. Sit next to the windows at work. Take a walk outside,” Mullick said. “If you are eating lunch in the office, sit in the park and eat it if it’s not very cold. Physical exercise helps relieve stress and anxiety.”

Developing healthy sleeping and eating habits and having a strong support team of family and friends can help, Trinh said.

“Socialize,” she said. “One of the symptoms of SAD is being withdrawn. Take trips where there is more light and come back when winter is over.”

Students should ask for help if they have SAD and lose concentration in class, Trinh said.

“During that time you may not have focus like you would another time,” she said.

Be patient, Trinh said.

“Don’t expect symptoms to go away immediately,” she said. “Don’t be too rough on yourself.”

People should not view SAD as a weakness, Mullick said.

“You should not just ignore it if the symptoms are persistent,” he said. “Get help, especially if you have suicidal tendencies.”

Trinh agreed.

“People often disregard. They just go on through the winter like that,” she said. “There’s less light. We can’t stop that. We can only prepare ourselves. Talk to your doctor on recommendations on how to treat it.”

Copyright 2011 News Publishing LLC (Bowling Green, KY)

Morgantown toddler progresses in battle with spina bifida

by Alyssa Harvey, The Daily News, originally published on 10/22/2011

Zoe Lovell happily banged two plastic cups together as Julie Thornton, an occupational therapist at The Medical Center, clapped her own hands and said, “Bang, bang, bang, bang, bang.”

The year-old Morgantown toddler later cried in frustration when Thornton held toy keys slightly out of her grasp in hopes that Zoe would reach further to grab them.

“Yay for Zoe!” Thornton cheered whenever Zoe got the keys. “Good girl!”

Zoe was receiving occupational therapy Wednesday for visual motor and fine motor skill delays she has because of spina bifida.

According to the Centers for Disease Control and Prevention website at www.cdc.gov, spina bifida is a type of neural tube defect that affects the spine and is usually apparent at birth. The condition can happen anywhere along the spine if the neural tube doesn’t close all the way. It can cause physical and mental disabilities that range from mild to severe, depending on the size and location of the opening in the spine and whether part of the spinal cord and nerves are affected.

Thornton, who has been working with Zoe for about 10 months, said she was helping Zoe with a variety of things, such as grasping objects with her thumb and index finger and crossing her midsection from one hand to the other instead of reaching out for things with both hands.

“She’s progressing well,” Thornton said. “I was seeing her once a week. Now I’m seeing her every other week.”

John and Hillary Lovell, Zoe’s parents, tried for a long time to get pregnant with their first child, Faith, now 2.

“It was a very uneventful pregnancy,” she said.

The couple didn’t expect a second pregnancy to happen quickly. They were surprised when one month after they started trying for a second child, Hillary Lovell was pregnant. This pregnancy wasn’t uneventful, though. When she was 17 weeks pregnant, the couple went in for a routine ultrasound.

“I thought we would find out if we were having a little boy or a little girl,” John Lovell said.

Instead, the couple were referred to a specialist, who told them their baby had spina bifida. “We were heartbroken, but we’re thankful we got to be prepared for that,” John Lovell said. “We got more comfortable with it over time.”

The couple started going to see a specialist in Nashville every month to check on Zoe’s progress. Toward the end of the pregnancy, Hillary Lovell was being seen three times each week. She went to the hospital for a scheduled cesarean section. Zoe had surgery the day after her birth, Hillary Lovell said.

“We were in the (neonatal intensive care unit) after her birth,” she said. “There was an opening in her back. They had to go in and close that.”

Zoe has a shunt because of hydrocephalus, a buildup of fluid in the skull that could lead to brain swelling. The hydrocephalus may have caused Zoe to be farsighted, Hillary Lovell said. On Wednesday, she peered at the world through pink glasses.

“We have baby glasses all over the house,” Hillary Lovell said, laughing.

The couple wanted Zoe to have the best life possible. Her name even expresses that desire.

“We chose to name her ‘Zoe’ because it’s the Greek word for ‘life’ – abundant life,” John Lovell said. “We want her not to just have a life, but an abundant life, that this world would not hinder her.”

Zoe has physical therapy each week and occupational therapy every two weeks at The Medical Center. First Steps, a statewide early intervention system that helps children from birth to age 3 who have developmental delays, helps Zoe at the family’s home. Zoe also visits the Spina Bifida Clinic at Monroe Carell Jr. Children’s Hospital at Vanderbilt, where she sees a neurosurgeon, orthopedist, urologist, physical therapist, occupational therapist and dietitian.

“All the doctors you need come to you,” John Lovell said. “I counted six doctors on one visit. We go once every three months.”

Zoe’s opening was low on her back. She can move everything down to her toes, Hillary Lovell said.

“She’s just weaker,” she said. “She has gross motor delays. They’re on their own timetable.”

She may also have bowel and bladder issues to some degree, John Lovell said.

“How that plays out is such a wide range,” he said.

Zoe has been a joy for the couple. They laughed as Zoe smiled and babbled.

“She has a personality,” Hillary Lovell said.

The Lovells want people to know about spina bifida and encourage women of childbearing age to take a daily multivitamin with folic acid, because it may reduce the risk of spina bifida. They also want people to know that having a child with spina bifida is “not the end of the world.”

“The doctor will try to tell you you won’t have a good life, but you definitely do,” said Hillary Lovell, gazing at her smiling daughter sitting in her lap. “You manage it and move on. It’s not nearly as scary as I anticipated. You educate yourself.”

“And be patient,” John Lovell added.

Copyright 2011 News Publishing LLC (Bowling Green, KY)

Strong finish takes victory in 10K

by Zach Greenwell, The Daily News, originally published on 10/16/2011

Former Western Kentucky runner Patrick Cheptoek set the pace for most of The Medical Center 10K Classic on Saturday.

But it was that other fraction of a second that made the difference.

Cheptoek was edged at the finish line by winner Reuben Mwei in the 32nd annual running of the event, creating the closest finish in the race’s history.

“The race was great, and the weather was just perfect conditions for running,” Cheptoek said. “I ran well and led the whole race from the start until the very end, but the only bit of disappointment was that I was kicked at the finish line. But overall, I’m happy.”

Mwei, a Kenya native, officially finished with a time of 29:13, while Cheptoek finished with a 29:14. But the more precise results showed that Mwei’s burst past Cheptoek at the finish line gave him the win by 19 tenths of a second.

“I caught up with a pack and decided to not push it and stay with them and see how it goes,” Mwei said. “But then on the last mile, I decided to just go for it. (Cheptoek) was pushing it really hard, and I thought, ‘I need to make a move now.’ ”

Cheptoek, from Kapchorusa, Uganda, graduated from WKU in August and decided to turn professional. He ran two races in Illinois and Ohio prior to Saturday, setting personal bests in the 5K and 10K.

“I’ve put my effort into it, and I’ve been really happy with my running so far,” Cheptoek said.

Ngatuny Emmanuel finished third in the men’s division with a time of 29:35.

Bonita Paul, also a WKU graduate, won the women’s division with a time of 35:34.

The victory had been a long time coming for Paul, who finished between second and fifth in her first four entrances in the race.

Paul was a member of the WKU track and cross-country teams until her graduation in 2005, but she still lives in Bowling Green and continues to train.

“It was great, with all of the local people,” Paul said. “They’ve seen me running around town every day, and they were cheering me on, yelling my name and number.”

Paul finished ahead of Sonja Friend-Uhl and Maria Busienei, who recorded times of 36:09 and 37:51, respectively.

Other division winners were Darlene Hoagland, senior grand masters female; Gary Romesser, senior grand masters male; Lilly Wheet, grand masters female; Barry Ross, grand masters male; Yvonne Petkus, masters female; and Chad Newton, masters male.

Copyright 2011 News Publishing LLC (Bowling Green, KY)

Amputee overcomes major obstacles to reach race

by Alyssa Harvey, The Daily News, originally published on 10/13/2011

An accident on Sept. 15, 2001, set Cameron Clapp’s life on a different course than he had planned.

The San Luis Obispo, Calif., man, then 15, was struck by a freight train after a night of underage drinking with his identical twin brother, Jesse.

“I grew up next to railroad tracks. I never thought it would happen,” he said by phone Wednesday during an interview with the Daily News. “I did not hear it coming.”

Clapp lost both legs and his right arm in the accident.

“They cut off my legs to above the knees and my right arm to above the elbow. I have a little bit of my shoulder. I call it my nub,” he said. “I can move my legs and arm around.”

Doctors told Clapp he wouldn’t walk again, but five months after the accident he was walking independently with prosthetic legs.

“Today I move around very well. I’m a high-functioning amputee. I use two prosthetic legs to walk. They’re C-Legs – that stands for ‘computer legs,’ with microprocessors in them,” he said. “I can trust them to be there for me for every step. I use them to drive my car, too.”

He also travels to do athletic events.

“I’m really independent. I do everything I want to do,” he said. “I also have running legs and swimming legs. I compete in athletic events and triathlons.”

Clapp plans to run The Medical Center 10K Classic on Saturday. He will also be at the 10K Classic starting line at the W.R. McNeill Elementary School parking lot at 6:30 a.m. and post-race at Houchens-Smith Stadium from 9:30 a.m. to 10:30 a.m.

The 10K Classic has several events. The 5K will start at 7:30 a.m., followed by the 1.5-mile Fun Walk at 7:50 a.m., the 10K Wheelchair Race at 8:25 a.m., the 10K Classic at 8:30 a.m. and the Children’s Classic at 10:15 a.m. For a list of entry fees or the route, visit www.themedicalcenter10kclassic.com.

Online registration closes at midnight tonight, but people can register at the Southern Foods Pasta Party and The Medical Center Health and Fitness Expo, which will be from 4 p.m. to 8 p.m. Friday at the Sloan Convention Center, or from 6 a.m. to 8 a.m. Saturday before the race.

“We have close to 1,500 signed up so far for all three events combined,” said Andrea Norris, community wellness manager at The Medical Center’s Health and Wellness Center and a coordinator of the event. “We usually have close to 1,800 to 1,900 participants total. We will have 100 sign up at the expo.”

The 10K Classic has been a tradition in the community, Norris said.

“It not only supports The Medical Center, but also Western (Kentucky University) and all the sponsors who want to be a part of it. It’s not just the runners taking part,” she said. “It’s a good atmosphere for the community. It encourages a healthy lifestyle and support.”

Clapp said he and his brother, who died of a drug overdose in January 2008, were extremely active before the accident.

“We always excelled in sports. We were the fastest kids in school,” he remembered. “We grew up next to the beach surfing.”

He does many athletic events annually. His next event after the 10K Classic will be the 18th annual Aspen Medical Products San Diego Triathlon Challenge on Oct. 23.

“I train really hard and get excited about them,” he said. “I really love these events I’m involved in every year.”

This is his first time running the 10K Classic. In fact, Clapp has never run a 10K.

“I’m more of a sprinter. I did a 5K in Indiana about four years ago. I’m gonna try to do the entire 10K. I haven’t had a lot of time to train for it. I’m excited. I know I can do it if I’m really prepared to do it,” he said. “I think if I complete the 10K, I will be the first triple amputee in the whole world to complete a 10K. There are other people doing athletic events, but there is nobody with my level of amputation.”

The 10K won’t be Clapp’s only activity in Warren County. A motivational and youth speaker, he’s also scheduled to speak at South Warren High School this weekend.

“It’s my passion in life right now. I almost died. It had negative consequences,” he said. “I love speaking to young people. I admire them. They’re our future generation.”

Clapp also visits other patients, amputees and people in the medical field to show them that recovery is possible.

“I didn’t know if I could do it. Over time, I worked hard at it,” he said. “It was a struggle. I never thought I’d be able to run a 10K.”

Clapp said he couldn’t have recovered without a good support system, which includes Hanger Prosthetics & Orthotics, which has more than 670 locations nationwide, including Bowling Green, and provides his prosthetic care. He will be at the Hanger Prosthetics booth during the Health Expo.

“Hanger Prosthetics have helped me live my life to the fullest. I’m very grateful for what they’ve done for me,” he said. “You can show the world you can do anything. ‘Impossible’ is an opinion, not a fact.”

— For more information about The Medical Center 10K Classic, visit www.themedicalcenter10kclassic.com. For more information about Cameron Clapp, visit www.cameronclapp.com.

Copyright 2011 News Publishing LLC (Bowling Green, KY)

Asthma program to assist sufferers

by Alyssa Harvey, The Daily News, originally published on 9/12/2011

Learning to control asthma can be overwhelming, whether one is newly diagnosed or has been dealing with it for a while.

“People who have asthma are the least educated about their disease,” said Denise Houchins, a certified asthma educator at the Barren River District Health Department.

The health department is working to change that with the new Asthma Management Program, which will help people learn how to manage the disease. The first class will be at 5:30 p.m. Wednesday at the Warren County Health Department. The 11⁄2- to 2-hour class will meet the fourth Wednesday of each month and will help participants understand the effects of asthma on their lungs, know how medications work and when they should be taken, correctly use devices including peak-flow meters, nebulizers and holding chambers, and understand triggers and how the environment plays a part in asthma.

“It’s not a support group,” Houchins said. “It’s an opportunity for you to get educated on your disease or your child’s disease and how to manage it at home.”

The Kentucky Respiratory Disease Program got a grant from the Centers for Disease Control and Prevention to address asthma at eight sites across the state. One of those sites is the Barren River district. The program will also provide home assessments with a written referral from a school nurse or physician to help identify triggers and allergens in the home as well as training workshops for various facilities.

“Our goals are to have asthma education for school and day care staff and businesses and industries,” Houchins said.

Asthma is a chronic inflammatory disease of the airways, said Justin Srygler, respiratory director at The Medical Center. There are various types, including exercise-induced asthma, which is often seen in athletes, and occupational asthma, which is seen in industries.

“It’s most commonly going to have symptoms of airway obstruction – wheezing, coughing, chest tightness and shortness of breath,” he said. “Some people have mild to moderate asthma and never have been diagnosed with it.”

Asthma is a dangerous disease that shouldn’t be taken lightly, Srygler said.

“There are 250,000 deaths from asthma globally,” he said. “It’s devastating. People need to really understand the dangers.”

There isn’t a really precise method for diagnosing asthma, Srygler said. Medical professionals measure pulmonary function and check a patient’s response to a short acting bronchodilator or inhaled corticosteroids.

“We make it based on a monitored pattern of symptoms and a response to therapies, something that will dilate the airway so they can breathe better,” he said. “The big thing is using (inhalers) correctly.”

Patients should also try to avoid allergens and irritants that can trigger an acute asthma attack, Srygler said.

“They’re going to be more at risk for asthma after they have a lot of positive allergy attacks,” he said. “You want to try to find out what (the allergens and irritants) are and try to avoid that.”

For more information about the class, call Denise Houchins at 781-8039, ext. 154, or visit www.barrenriverhealth.org/asthma.

Copyright 2011 News Publishing LLC (Bowling Green, KY)

Honoring the fallen: City firefighters, officers, emergency personnel pay tribute to first responders who died in attacks

by Justin Story, The Daily News, originally published on 9/12/2011

In a solemn ceremony on a rainy morning, city firefighters gathered Sunday with police officers and emergency personnel at the Bowling Green Fire Department’s central station to remember the victims of the Sept. 11, 2001, terrorist attacks in a 10th anniversary memorial ceremony.

A steady rain that fell through much of the event moved the ceremony into the Moltenberry Headquarters Fire Station on East Seventh Avenue, though the stage from which the speakers addressed the crowd remained outdoors.

Nearly 3,000 people were killed in New York, Washington, D.C., and Pennsylvania after terrorists hijacked commercial airlines, two of which crashed into the World Trade Center towers and another that slammed into the Pentagon. A fourth crashed in Pennsylvania after passengers took control of the aircraft.

Sunday’s ceremony paid tribute to the first responders who died in the attacks.

“Never in American history has our nation’s public infrastructure suffered such a tragic loss,” BGFD Chief Greg Johnson said.

In all, 343 firefighters, 60 law enforcement officers and eight emergency medical providers lost their lives responding to the attacks.

Several BGFD firefighters, Bowling Green Police Department officers and Emergency Medical Services personnel from The Medical Center took turns reading the names of the first responders killed that day.

The remembrance was punctuated by a bell-ringing ceremony saluting the firefighters who died 10 years ago.

Traditionally, three rings of a bell would signify the end of a shift. BGFD firefighter Keith Potts gave the bell three sets of three rings in honor of the firefighters who died, denoting that their duties have been completed.

Following the bell-ringing ceremony, Sgt. Jeff Manning of the Glasgow Fire Department played a mournful rendition of “Amazing Grace” on the bagpipes.

Randy Fathbruckner, EMS director for The Medical Center, put into stark terms the toll that first responders took fighting the fires and tending to the dead and injured in the aftermath of the attacks.

Fires continued to smolder in New York for nearly 100 days and an estimated 14,000 to 19,000 people at the scene began suffering from chronic respiratory ailments afterward.

“One in five Americans knew someone that was either killed or hurt in the attacks,” Fathbruckner said.

Retired BGPD Assistant Chief Marieca Brown sang “The Star-Spangled Banner” near the beginning of the ceremony and Marty O’Callaghan, wife of BGFD Assistant Chief Brian O’Callaghan, sang “America the Beautiful” shortly before the closing.

The ceremony was one of several held throughout the area. Members of the local Rolling Thunder chapter planned to clean headstones belonging to veterans at Fairview Cemetery on Sunday afternoon.

Stephen Racz of Bowling Green Rolling Thunder Chapter 3 said the group’s vice president, Daren Bowen, noticed the condition of veterans’ headstones at another cemetery, which led to Bowen suggesting cleaning headstones at Fairview as a service project.

“We thought it was appropriate that our service project entail something with the veterans, and our chapter decided we would take this upon ourselves as a service project,” Racz said.

In Barren County, Glasgow joined several other communities by sounding outdoor warning sirens for one minute at noon on Sunday as part of a National Moment of Remembrance. Several churches also rang their bells during that time.

Copyright 2011 News Publishing LLC (Bowling Green, KY)