Mel Walsh

Saying Goodbye With Grace

     

            Sometimes I write about things that are hard to talk about. I do it so that when you encounter the same hard things, you will have an easier time. And today’s topic is: visiting a friend or relative who is dying.

            It’s not easy on anyone---these visits---but here’s a refreshing perspective: one dying man---his blog name is just Bill---keeps an online journal of the process. He thinks it’s harder on the people around him than on him. Bill says ”I have really come to appreciate just how much harder it is on my family and friends than on me. They worry about saying the wrong thing or just generally upsetting me. They carry this extra burden. I don’t. Sometimes it almost seems backwards. I am the one dying, but they are the ones full of fear and worry. I want to tell them: OK. Everybody just take a deep breath and relax.”

            So let’s do as he suggests and relax. Then let us use our collective common sense. First, remember it is normal to be fearful about visiting dying relatives and friends. It’s something our culture doesn’t have much experience with, shielded as we are from dying. (Our great grandparents died at home with the family. All hours were visiting hours—children welcome.) Now dying relatives are usually whisked off to institutions, isolating us from full participation in the last meaningful life experience. So we don’t have many examples of how to behave, but here’s a one-word clue: Normally.

            Just go with the flow of the visit and follow your relative’s lead. Maybe he or she wants to revisit old times. And it’s always appropriate to tell people how much they mean to you and to thank them for who they are. In fact, it’s a good everyday habit to get into.

(I’ll start: Me, I really appreciate the readers who cut this column out and put it on their refrigerator doors. Fridge fame. Thank you.)

            Now, this same man, Bill, also says he doesn’t want the process of dying to take away from the enjoyment of the time he has left. Dying people can get tired of all the medical talk and want to talk about anything but.

Before you do visit, it’s wise to check and see if the visitee is up seeing people and to ask if there are physical limitations. For instance, maybe people vulnerable to infections should not be hugged.

            What makes the support process easier today is that family and friends are banding together in a care-giving posse, usually organized by email. One non-profit website, Caring Bridge, organizes group support in a beautiful way. Thirty million people visited the site last year, so it seems to work. Go to www.caringbridge.org/seehowitworks. There you can organize your own village to give someone you love a great goodbye. 

When Taste Buds Grow Old

     

            Sometimes I feel as if I’m an anthropologist explaining the Tribes of Geezerland to those with no silver hair. It helps that I am of the tribe—an insider by means of the number of candles on my birthday cake. But still, even with a degree in gerontology---the study of older people---I remain surprised by what can happen as we grow older.

When Taste Wears Out

Here’s one of the changes: People can lose some of their ability to taste and smell food. This may seem like a small thing compared to say---cancer or heart disease---but if someone loses interest in food because she can’t taste it, she may lose weight, become malnourished and shrivel up into a human dust bunny. Wouldn’t you become depressed if you couldn’t enjoy one of the enduring pleasures of life, a good meal? Life without pepperoni pizza ain’t no life at all.

And I’m not alone in valuing the pleasures of the table. When I was an ombudsman for the elderly in long-term care---trained to hear the complaints of people in assisted living and nursing homes---the number one complaint was the bland food. These assisted living folks lived in the land of oatmeal and tapioca. I ended up, not rescuing people from evil caretakers, but talking to the administrators about starting ethnic food nights---Asian, Mexican, Italian—dinners with zing instead of food for zombies.

How It Happens

What causes this loss of taste and smell? Here’s a list from Dr. Paul Takahashi of the Mayo Clinic: Nose and sinus problems---maybe allergies or sinusitis; medications such as antibiotics and blood pressure meds; mouth sores, tooth decay or poor dental hygiene; head injuries; smoking and diseases such as Parkinson’s and Alzheimer’s.

So What To Do?

If the problem is severe, work with a doc to investigate the possibilities above, but here are a few easy tips to up the taste of food. You should know them whether you are an older person or someone caring for an older person.

* Stock the pantry with spices and flavorings that can be added to dinner. And throw out the old spices that have lost their power. If you’ve been told to limit salt, there are other choices. My current favorite is Chinese Five Spice Powder which goes into pasta sauces and soups. Also good is Garam Masala, a blend of coriander, black pepper, cumin, cardamom and cinnamon. I put it into chicken, rice and fish dishes.

* Use already prepared sauces. Think curry sauce over chicken or make fish baked in foil with chutney. Ketchup and the various mustards are useful. So are soy sauce marinades, Annie’s salad dressings and even orange juice---all of which make good pre-soakers for chicken and fish.

Last, here’s my prescription: Bon appétit. 

Happy Geezers---The Truth

Who’s Happy? The Surprising Answer

Do you think that the older you get, the more unhappy you’ll be? Well, that’s a common stereotype, but it’s not true. Researchers at a recent meeting of the American Psychological Association reported that mental health generally improves with age. So we older people aren’t just sitting around in our Depends and our decliners, wailing and waiting for The End.

In fact, more and more national studies such as the General Social Survey are coming up with this truth: older people are happier than middle-aged people. Yes, it’s hard to believe, but here it is again:

It seems that the longer you live, the happier you will be.

How Can That Be So?

            Well, older people do have their challenges such as arthritis and not being able to hear Frank Sinatra songs as well as they used to, but there are compensations---things that make up for health glitches---that produce an increasing level of happiness. So what are these keys to contentment?

            Steering Around Stress

Researcher Susan Charles reported that older people tend to avoid or limit stressful situations. We’ve learned over time what things are likely to hit the fan and we’ve learned to stay away from rooms with fans. Example: When I was younger and less experienced, it took me six months to figure out that a man was a bad actor. Now I can spot one instantly at 50 yards. (It’s kind of like bird-watching, but with no printed guide.)

Another example: we older people learned there are some things we cannot change---like the behavior of family members---so we tend to stop beating our heads against that particular wall. (After all, with the more limited energy that comes with age, we may have to put it towards the survival of ourselves and our spouses. We don’t have the reserves of spirit go through a nervous bustdown because grandchild Jason got nabbed for drugs again. He’ll either learn or he won’t.

 Valuing The Sunset

Another key to elder happiness seems to be this: We know we don’t have a whole life ahead of us, so we want to make the most of the time we have left. We want to enjoy the sunsets of the sunset years. That again means staying away from bad actors and negative situations. Why spoil the remaining time with avoidable agony?

As researcher Charles noted, older people “have had more time to learn and understand the intentions of others which helps them avoid stressful situations”.  So life experience really helps on the happiness front. We know where the traps are.

Hey, it’s taken a lifetime to learn the map of the traps, but it’s paying off. The bluebird of happiness supposedly now knows where we geezers live. (OK, he’s late, but better late than never.)

One Weird Challenge: Staying Well in the Hospital

    Here’s a pop quiz: What kills more Americans every year than AIDS, breast cancer and auto accidents combined? The answer is---infections acquired in the place that is supposed to be hospital-clean---a hospital.

You’ve probably read about superbugs like MRSA (methicillin-resistant Staphylococcus aureus), a common threat in today’s American hospitals, but did you know there are things you can do for yourself and your family to cut the chances of infection from MRSA or other bad bugs when in any hospital?

Keeping Safe: Personal Actions

Sure, hospitals all over the country should be doing what they can to cut their infection rate, but there are things ordinary people can do to keep from becoming one of the almost 100,000 people who die from hospital-acquired infections every year.  A group called RID, The Committee to Reduce Infection Deaths, offers many tips on its website, www.hospitalnfection.org.

First, they recommend that hospital personnel clean their hands before treating you so that they don’t spread infections from one patient to another. That may seem obvious to the point of duh!, but a 2004 study found that when doctors in a hospital were secretly observed by infection control experts, only 57% bothered to clean their hands between patients. (Medical students were among those who did the best, surgeons among the worst.)

Now, sometimes a patient is so out of it after treatment that a family member has to be the watchdog on the clean hands issue. And family members would do well to clean their own hands before they come in contact with the patient. Many hospital rooms now have an alcohol hand-cleaning dispenser on the wall, so if you are visiting someone, it’s easy to clean up.

Another tip from RID: wash with chlorhexidine anti-bacterial soap before surgery to cut down the population of bad bugs on the skin. (Cranky Pants’ knee surgeon provided him with special soap and instructions for scrubbing down before surgery.)

Another idea: Bacteria can enter the body through a catheter---a little tube inserted into the urinary tract that will empty the bladder into a plastic bag---not the sexiest part of a hospital stay. RID advises avoiding a urinary tract catheter if at all possible or having the catheter removed as soon as it makes sense. That last advice is easier said than done after surgery, because it’s more convenient to lie back and use a catheter than to get up and walk to the bathroom. But and however, the staff will rightly see that a patient is up, about and off a catheter ASAP.

There are many more tips at www.hospitalinfections.org. But maybe the best advice is to stay healthy so you can stay home, though I would hate to see what bugs lurk on the keyboard of my home computer.

Microsoftia scuzillia?  Ick. Where’s the alcohol wipe?

Big Health Care Liars: Don't Read Their Lips

The truth shall set you free.

Of what? Of worry about the medical myths now making the rounds in Media Mythland. The greatest of these may be the myth that Congress intends to force people to meet with government counselors who will advise them how to die---this to get them off the Medicare rolls. These myths have escalated into major paranoia. Example: the government wants to euthanize old people---Death for Geezers.

So What’s The Truth?

The truth is that most Americans have not yet told their physicians and loved ones what kind of medical care they would like if they become unable to express their own wishes. (Remember Terri Schiavo?)

So say an emergency arises. Someone---maybe you---is too out of it medically to say what treatment you want or don’t want. Spouses and children are left to guess and sometimes fight over treatment options just because the ill person has never signed a living will, known in California as the---long breath here---Advance Health Care Directive Including Power of Attorney for Health Care Decisions.

The House of Representative Attempts to Help

So in the proposed health care reform bill, H.R. 3200---America’s Affordable Health Choices Act of 2009---there’s Section 1233, Advance Care Planning Consultation. It allows people, if they so desire, to consult with a health care practitioner to learn about advance directives including living wills.

This proposed benefit would be completely voluntary. People would not be forced to have a consultation every five years as the mythmakers say. They would not have to have any consultation at all, but my questions are: why wouldn’t you want to know your options? Why wouldn’t you want to control your medical care if you are incapacitated? Most of us don’t want to live on like a two-legged vegetable hooked up to a machine.

Taking Care of Yourself

Here’s an idea: Take action on your own, ignoring both the fear mongers and the partisan fighting in the House of Representatives. Just quietly get done what you want done. The California Medical Association offers a kit, including the Advance Directive, which you can fill out and sign. They offer this help for just 6 bucks.

 Put In a Simple Order

Go to www.cmanet.org and click on Advance Health Care Directive Kit. You can order a single copy or multiples if you want to distribute them to friends, family, club or group. Phone orders will be handled at 415/541-0900, credit card or check accepted. Ask for Karen.

If you want to see the proposed bill, just put HR 3200 into the Google search box. It’s an easy scroll down to Section 1233, the one about the consultation. But hey, why not go over to the park for a picnic instead? Have a consultation with Mother Nature.

It's Not You

One thing older people never forget is that they are afraid of forgetting.

When we forget someone’s name, we remember the A word---Alzheimer’s. One senior moment seems like a certain sentence of dementia. Not true, but what is true is that various medications can cause memory problems---a disturbing side effect that is not well known.

What People Need To Know

While only 12% of the US population, older people account for 30% of all prescriptions. The average older adult takes five prescription drugs along with three over-the-counter drugs. Without getting into an argument about American people being over-prescribed and under-prevented, the fact is that the Rx lines at pharmacies are heavily populated by cotton tops.

 Actually, people of any age who take prescription drugs should know about a Johns Hopkins health alert titled: First Step to Clearing up Memory Loss---Check Your Medications. Here are just some of the drugs that can cause memory loss: the anti-inflammatory prednisone (Deltasone, for example); heartburn drugs such as cimetidine (Tagamet), famotidine (Pepcid), and ranitidine (Zantac). Also causing possible memory loss are anti-anxiety/sedative drugs such a triazolam (Halcion), alprazolam (Xanax) and diazepam (Valium). The health alert goes on to say that even too high a dose of insulin can cause low blood sugar and abnormal mental function. Still other drug classes to watch: meds used for cancer, heart disease, high blood pressure, pain, nausea, Parkinson’s disease, allergies and colds.

The good news in the report is that memory loss can often be reversed or minimized by changing meds or lowering the dose under a doctor’s supervision. They also suggest other strategies to keep out of trouble: avoid the use of multiple drugs, see that each drug is carefully monitored by a single primary care doctor and use drug-free periods to see if the effects on memory are really a side effect of the medication.

Given the fragmentation of health care and the many docs one person can go to, it’s smart to always have an updated list of meds in one’s wallet and on the refrigerator. Another tip: Put all your meds in a bag and bring them to your family doctor for review.

Still another smart action: write down when you start a med and what the results are. If your memory acts up after starting a new med, you’ll have the documentation on paper so you don’t have to rely on uncertain recall. Also, after taking a new drug, record any other changes---physical or mental---so you can discuss them with your doctor.

Last, here’s a quote to remember from the JH report: “In geriatric clinics, the most common cause of reversible dementia including memory loss is an adverse reaction to medications”.

So it may not be you after all, but a pill.

Please remember that.

Losing Yourself

Whoa! I lost something and I have no idea where it went.  Specifically, I lost 10% of myself.

When you lose weight, people want to know how you did it. Were you blessed by The Calorie Fairy? Did you live on grapefruit rinds? Then people ask for advice.

I’m no weight loss guru, but I have a few hints for those who want to lose parts of themselves, something they weren’t using anyhow, something like fat.

Here’s what’s working for me: there’s one big thing and then little actions taken a bit at a time. Here’s the big thing:

Turn on your food radar. Use it 24/7. It will seek out and identify good choices as well as alert you to incoming enemy attacks such as restaurant servers who push drinks and desserts.

Then there are the little things:

·      Fill half the dinner plate with veggies.

·      Shop farmers’ markets and produce sections.

·      Use smaller plates and dish out smaller portions.

·      At dinnertime, keep the pots of food in the kitchen and not at the table. That way you have to get up for seconds.

·      Write down what you eat so you can’t cheat. If you bite it, write it.

·      Don’t give up dessert. Just have small helpings once in a while so you don’t feel deprived.

·      Don’t let yourself get hungry. Think ahead and travel with food. Keep an insulated lunch box in the car with goodies---an apple, a stick of low-fat cheese.

·      Cut out sweet drinks including those specialty coffees full of sugar and whipped cream and the caloric shakes. (McDonald’s X Large Triple Thick Shake has 1160 calories.)

·      Consider the math. One pound is 3500 calories. If you want to lose a pound a week, you have to cut 500 calories a day. How to do that? Cut down on alcohol, desserts, second helpings, mindless snacking and supposedly “healthy” stuff. (A large Jamba Juice Orange Dream Machine has 690 calories.)

·      Weigh every morning. (Some experts are against weighing in every day, but I like constant feedback.)

·      Know what you are doing when you eat out. This will be easier if and when all restaurants begin to post the calorie, fat, sugar and salt content of their meals on their menus. For now, you can look up online what might be acceptable at your favorite fast food place. Weight Watchers has a restaurant reference book to put in the car. 

·      Walk briskly for 20 minutes.

Now, to get back to where we started---where does fat go once you lose it? I have consulted the best medical sources and have concluded that fat cells go to the thighs of the cheerleader you hated in high school.

Actually, fat cells don’t go anywhere. They just shrink. 

What to Eat (Really)

            Nutritionists have had to eat their words---a high fiber diet of books and newsprint.

For instance, do you remember when they wrote that we should abandon butter (bad fat) in favor of margarine (then considered a good fat)?  But nutritionists changed their minds and margarine became a bad fat. Enter olive oil, which is now a good fat---unless you consider the calories---120 a tablespoon---which could make it an iffy fat if you are trying to cut back on the size of your fanny print.

Or consider the fact we were told to carbo load---we grazed in pastures of pasta for a while---until we were told the opposite---avoid the pasta if you don’t want to look like an over- stuffed manicotti. Which is what our grandmas told us 50 years ago.

The Food Advice Workers

            For the first time in history, professionals are telling us what to eat. But they have been wrong and they often don’t agree with each other now. (I was researching a piece about weight loss, talking to the major diet professionals of the US. I was told by one that I would never get a consensus on the subject. He was right. I abandoned the piece.)  

            But there’s help in this confusion---one author who says we should listen to ourselves and to what our grandmothers told us before we let the nutrition people sit at the head of our tables---before food merchandisers in the markets and the malls took over our eating choices.

That would be Michael Pollan. His book, In Defense of Food: An Eater’s Manifesto, is what to read if you are fed up with the conflicting advice about food. Yes, Michael is our man, a good researcher who was smart enough to ask the nutrition professionals this telling question: What is the one thing you know for sure about a good diet for humans?

The answer: Eat more vegetables. (Ghosts of grandma.)

Here are some of Pollan’s recommendations.

* Don’t eat anything your great grandmother wouldn’t recognize as food.

* Avoid products containing ingredients that are unfamiliar, unpronounceable, more than five in number or that include high fructose corn syrup.

* Avoid products making health claims. (If they are healthy, they probably don’t have to advertise. Pollan calls this “the silence of the yams”

*Shop the sides of the market---the fresh stuff---and avoid the processed products in the middle.

* Shop farmers’ markets.

* Eat mostly plants, especially leaves. Meat should be a side condiment.

* Eat like an omnivore. Get diversity into your diet.

            So you want a guide that will demystify all the baloney about food, read Michael Pollan. I am reasonably sure I won’t have to eat those words. 

You---As Fred Astaire

 

            Hoo boy. I never thought I’d get a big thrill out of a cane---unless Fred Astaire was attached to the end of it. But canes have become works of art. So have hiking sticks and other aids to ambulation.

            Whether you or a loved one wants a cane for medical reasons or a staff for hiking, the choices are now dazzling. There is life beyond boring aluminum canes and rickety sticks for navigating trails.  

Cane Hate

It ‘s a fact. People who need canes will often resist buying one. I know. I was once there myself. I finally bought a wooden number and decorated it to cheer the limping hours. Though I no longer need a cane, I developed an eye for cane design. Or thought I did.

But while I wasn’t looking, cane design has taken off so brilliantly that there is no longer any reason to settle for a frumpy cane. Now you can buy one of hundreds of designs. The choices are overwhelming---floral, paisley, stars, animals, plus hunting and fishing images for guys. There is---I kid you not---even a cane made out of a bull’s reproductive organ, a kind of taxidermist’s trick, but it’s not suitable for lunch with the girls. (Or maybe in 2009 it is. I can’t keep up.)

And even the ugliest canes---quad canes---have gotten a style lift. (Quad canes are super stable with four points hitting the surface rather than just one). They are useful in maintaining balance, but have all the aesthetic appeal of a bed pan. Happily, quads now come in great colors and patterns.

Even More

If you want a folding cane to take on the plane, it’s available.  How about a cane with a flashlight or an alarm? There are also canes with seats, canes that conceal an umbrella and of course, canes that hold a flask—Scotch not provided. I didn’t see one that dispenses pills or holds an iPhone, but maybe that’s coming.

Hiking

If you want a shepherd’s crook to hike like Marie Antoinette or an old thorny stick from Ireland to walk hill and dale, you can get it online. More modern walkers might prefer lightweight trekking sticks that look like ski poles and are good for keeping balance on uncertain terrain. They also take weight off knees and hips, helpful to Boomers with faltering joints.

If searching for a cane, you can look first in the local drug and sport stores for their cane and hiking selections. But if you want to see the whoie wide world of canes, go to www.fashionablecanes.com. If they don’t have a cane for you, it probably doesn’t exist.

They also have gift certificates if you know someone who could use a little stabilizing. But don’t blame me if they buy the bull one.

Get in the Blue Zone

 

            Cavemen were not health planning wonks.

And when it comes to foresight about our own wellbeing, today’s humans are still pretty blind. Our brains were made to think “now”, not two years from now, which is why the idea of chocolate fudge today is so much more forceful than the image of a weigh scale reading a year from now.

So when we humans come up with an idea about health that is future-oriented---living longer, for instance---and we actually motivate a town to think ahead and set itself in motion to get its citizens an extra two years of life---it’s a downright marvel.

It’s also the biggest community project ever undertaken by the AARP.

The town is Albert Lea, MN and, sponsored by the AARP, they are running an experiment, the Vitality Project, where the interested townsfolk practice four keys to a long life. (The keys come from a book written by the Vitality Project’s  leader, Dan Buettner. The book is The Blue Zones: Lessons for Living Longer from the People Who Are Living The Longest.)

Dan studied the world’s longevity hot spots and for the Vitality Project, he translated the information into four areas. So this is what the town is doing…

The Four Keys

Community Environment: Creating more bike and walking paths, garden plots and a farmer’s market, making it easier to get out and move, making it easier to get fresh plant-based food.

Social Groups: Forming walking and biking clubs. On the walking front, parents and seniors started what they call Walking Buses, where the adults and children form a small pedestrian group to walk the students back and forth to school.

Home and Work Habits: Revamping school and business cafeterias, grocery stores and restaurants. There are also cooking classes that teach people how to prepare healthy meals and how to serve meals from the stovetop and not the table, where it is too easy to reach out for second helpings.

Building the Inner Self: Having a sense of purpose and a strong connection to community is one of the keys to longevity. The Vitality Project offers workshops on how to find activities that offer maximum psychological reward.

Some of the results of the experiment reveal old attitudes. One high school teacher who now walks to school upset her students by leaving her car at home. The kids thought only people who were convicted of drunk driving walked anywhere.

What’s the Future?

We’ll find out in October when results will be announced, but interested townspeople plan to keep on keeping on when the Vitality Project is officially over. Furthermore, the AARP hopes to replicate the positive results they expect throughout the country. If you want to stay up on this fascinating experiment, google AARP Vitality Project where you can sign up for the newsletter.

 

The End of Overeating

Gather round and you shall hear…not that I walked five miles through snow drifts to school—but worse.  Much worse.

When I was young, there was no fast food. No pizza joints, no burger palaces. We ate---are you ready?---real from-scratch foods at home. And there were almost no obese people in America then. Americans, if they looked down, could see their toes, not their belly buttons.

But, after World War II, the GI’s stationed in Italy brought back a taste for a tomato pie called “apizza”, and so the fast and fattening food rush was on. It was joined by McDonald’s and also extended into the supermarkets by a food industry that learned how to put together fat, salt and sugar to make snacks that jumped off the shelf and onto your weight scale.

And so the fattening food tide spread over the land. Now there is almost nowhere that unhealthy food is not available. Public rest rooms are the only places I can think of where you have no chance of running into a Triple Bypass Burger.

The End of Overeating

            That’s the title of a new book by David Kessler, MD, who not only does a convincing job of detailing the spread of fast food throughout the US, but also explains how we as eaters get hooked. He explains why, biochemically speaking, so many of us crave what’s not good for us, a conditioned response often engineered by an industry that states out loud that its purpose is to invent “craveable” foods. And so we become hypereaters.

Dr. Kessler also covers what he calls “food rehab”. Food rehab involves unhhooking from the obsession with unhealthy combinations of fat, salt and sugar.

Basic Rehab

Here is the Cliff Notes version of a few rehab principles according to Kessler:

·                   Know that conditioned hypereating is a biological challenge, not a character flaw.

·                   Conditioned hypereating is a problem that needs to be managed, not cured.

·                   Every time we give in to the urge for sugar, fat and salt, it gets harder for us to act differently the next time.

·                   Lapses are to be expected.

The Restaurant Environment

            Now it’s hard to eat out sensibly if you have no idea about the contents of the food you may order. So Kessler wants restaurant menus to list what is in the dish. (Visualize the labels already required on processed foods---something Kessler made happen as head of the FDA. New York City already mandates this menu info, so it is not only possible, it’s already being done.)

Me, I want to know that a medium Oreo® Sundae Shake at Burger King comes in at 1110 calories and 35 grams of fat.

The book is The End of Overeating: Taking Control of the Insatiable America Appetite.  

The Invisible Antidepressant

Feeling down?

Well, if I said you could self-administer an upper that didn’t require a prescription or any skuzzy dealings with the drug underworld or pharmacies in faraway lands, would you want it? If I told you even more---that this remedy was invisible but real, would you believe me?

Well, maybe you wouldn’t listen to me, but how about the white-coated docs at Duke University Medical Center who ran several studies comparing the benefits of a prescription antidepressant to the benefits of getting your body up and moving? Intrigued by the many indications that the motion of the body and the state of the mood were connected, the Duke doctors set up a formal study that compared the moods of three groups---those who took an antidepressant, those who did aerobic exercise and those who did both.

After 16 weeks, here’s what they found: People on antidepressants had the most immediate relief of their symptoms, but by the end of the 16 weeks, those who were “just” exercising, had the same relief of symptoms and improvement in mood.

Hi ho----sneakers, just as good as pills. What a concept!

The Mayo Clinic Weighs In

Yep, the folks at Mayo agree and add more: They see four benefits to exercise:

·      Confidence: You meet a goal, you look better, you feel better. In other words, heads up, knockers out and proud of yourself.

·      Distraction. You stop dwelling on how bad you feel and shift your thought patterns to more positive channels like walking out to see the sunset.

·      Interactions. Depression and anxiety can lead to isolation. Going out for a walk with a buddy or going to the gym or an exercise class can get you out of the shell of depression and into some companionship. Even walking Fifi is a companionable experience.

·      Healthy coping. You’re doing something positive about your downer mood. You aren’t drinking excessively to make yourself feel better and not just sitting around hoping the problem will go away.

I’d add my own benefit: By using exercise as a natural upper, you’re not putting yourself in harm’s way from drug side effects. Some of the side effects from antidepressants include insomnia, nausea, diarrhea, loss of libido, weight gain and ironically, suicidal thoughts. On the other hand, to be fair, some people do report great relief from these drugs. I just wonder if they tried walking in the sunshine as a way of upping their moods. (Lack of light is an acknowledged cause of depression.)

The Last Word

Dr. Gary Sachs of Harvard Medical School says: “Here’s your exercise program. Go to the door. Look at your watch. Walk 7.5 minutes in any direction. Then turn around and walk home. Do that at least five days a week.”

We can do that.

All Burned Up

My father-in-law, Cranky Pants, Sr., was sleeping. His house caught fire. Awakened by the noise, he started to get dressed. He put on his pants and his shirt. He was putting on a tie, when neighbor John Madden burst in. (Yes, that Madden.)

Madden said:  For xxxxx sake, get the hell out of here.

And so, before he could put on his coat and tie, Cranky Pants, Sr. was swept to safety along with his wife who thought it sensible to stop first and put on her fur coat.

This is not the fire behavior recommended by www.firesaftey.gov.

The Hot Truth About Fires and Older Adults

            We geezer people are more likely to expire in a fire than younger folks. And the super geezers, 85 and older, are five times more likely to go to heaven through flames. Why?

            Response times slow as one ages. Meds can cause drowsiness and impaired mental function. Old wiring or space heaters put near flammable materials can start fires. People fall asleep with lit cigarettes. Older people who live alone don’t have the extra eyes and ears that detect a fire early enough to get out. Also, some older people cannot smell smoke---their noses took early retirement.

What To Do?

            No matter what age you are, here are some basic precautions:           

·      Install smoke alarms. Two-thirds of fire deaths happen in homes that have no smoke alarms or dead-battery alarms.

·      Check the smoke alarm batteries at least once a year. That’s a nice birthday present to yourself.

·      Make sure there is an alarm near the bedrooms and on every level of the house.

·      Don’t put the alarms too close to a fireplace or kitchen. How do you tell what’s too close? When the darn thing goes off every time you do a stir fry.

·      Give a brief thought to how you would get out of the house if there were a fire.

·      Give yourself this lecture: Once I am out of the house, I will stay out of the house. I will not go back in for family photos or my wallet. (Leave your wallet or purse on a bedside table. You can just grab and run.)            

One More Idea.

      How I love candles---romantic, can’t see the dust. Right now, I always do a bedtime sweep to make sure the candles are out. When I’m 95, I may forget. And that’s where faux candles come in. Battery run, some of them look and act like actual candles. I once tried to light a battery candle, it was so real.

      OK. I am an idiot, but at least I wasn’t putting on a tie in the middle of a bonfire.     

      So stay safe. BBQ is something you eat, not something you are.

Sixteen Tons and What Have You Got?

            Me---and many like me. Refer to us as tubby, pudgy, large or fat, but don’t call us pleasantly plump. There is nothing pleasant about being overweight. Fat looks good on those Ruben’s models, but in real life, fat paves the way to illness, joint problems and a life sentence to Macy’s Women. And, as my friend Cindy says, there is nothing pretty about a stomach that seems to need a sling.

            So what to do?  If you read, you already know the mantras: Eat less, move more, scarf up veggies and fruits, watch portions and so on until we can say it all by heart. But and however, it’s easier to say than do. Why isn’t there a kind of lifestyle 911 that we can call for help? In fact, there is such a group: Weight Watchers.

Anchors Aweigh with Weight Watchers

With flexible weekly meetings and lots of good advice about living in the real food world, Weight Watchers can help. Cranky Pants and I started Weight Watchers and are inspired by the people there who have lost 25 to 45 pounds and kept it off.  

Weight Watchers groups now cover the country. To find the one closest to you, go to www.weightwatchers.com  and click on: Find a Meeting. Or use the phone book.

WW makes it easy to keep going by offering a monthly pass that can be put on a credit card. Go to as many meetings as you like for $39.95 a month.

How Wrong Could I Be?

            Weight Watchers gives out little booklets where you are supposed to record everything you eat and drink. How stupid, thought I. How kindergarten can you get? Well, it works. I can’t lie to myself about what I eat because I can see the evidence of my Inner Pig in print.

            Also cool: WW’s advice is to “keep ahead of hunger”, meaning never let yourself get hungry. They spotlight the extra-filling foods in their literature and I can truthfully say, I don’t get hungry because I am eating all the time. OK, it’s an apple instead of a Twinkie, but it works.

Getting Yourself to Go

 You probably won’t call and won’t go until you have the Last Straw Moment, that time when you’ve just had it with yourself. It could be a glance in the mirror or a photo that shows you two-ax handles wide. Maybe it’s having nothing to wear or maybe it’s a health issue.

 Or perhaps you just want to get back into the dating and mating game, but worry that if you ever got on top of anybody, they would be squashed flat. Death by sex and it would be all your fault.

Whatever your motivation, go with it and go.

 

Vitamin D: Action Hero Painkiller?

            Sounds silly----ordinary old vitamin D as a possible reliever of pain?  Why D is something you get just by baring skin in the sun or buying a cheap supplement at the grocery store.

            But if you have generalized muscle and bone pain, you may want to read what researchers at the Mayo Clinic have found: People with low vitamin D levels take nearly twice as much narcotic medication for pain as people whose vitamin D levels are normal. So far it’s just a correlation between the level of meds people require and their D levels, not a proven cause and effect.

But if a group of people who are low on D require almost twice as much morphine, fentanyl or oxycodone as those with a good D level, well, maybe they are in twice as much pain because they have half as much of what might turn out to be a natural pain preventer or reliever. That’s the theory that has grabbed the attention of medical investigators.

One of them, Dr. Michael Turner, the lead physician of the Mayo study, says: “Vitamin D is known to promote both bone and muscle strength. Conversely, deficiency is an under-recognized source of diffuse pain and impaired neuromuscular functioning. By recognizing it, physicians can significantly improve their patient’s life.“

Personally, I’d add that by bringing the vitamin D/pain theory to the attention of our docs, those plagued by mystery pain with no obvious cause may be on their way to overdue relief.

            On a YouTube video, Dr. Turner adds that people who are overweight seem prone to have pain that may be caused by low vitamin D. He says it’s because vitamin D likes to reside in fat. So when any of us have inviting layers of fat, the vitamin takes up residence in Fat City rather than circulating throughout the body the way it’s supposed to, bathing muscles and bones in a nice D bath.

Dr. Turner also adds that checking D levels requires just a simple inexpensive blood test that can be ordered by your doctor.

 (To see Dr. Turner online, just google: Mayo Pain Turner.)

Can This Happen to You?

            Yes, especially if you are older. Scientists say that about 50 to 60 percent of older people in North America do not have satisfactory vitamin D levels. We older people are not outdoors as much as we were when young. Then we only went inside when the sun set. Outside now, we cover up and use sunscreen, so the sun can’t get through to do it’s D magic on us.

Well, no doc has yet advocated skipping about nude in the sunshine---that would give dermatologists heartburn---but you may want to talk to your doc about vitamin D levels and supplements. 

The View from Inside Cataract Surgery

            If there is any part of the body we humans don’t want anyone to fool with, it’s our eyes. The women I know would rather get a pelvic exam than have anyone poke around in their peepers.

For them and others who fear cataract surgery, I have three words: Get over it! And then get on with attending to any loss of vision that results from a cataract.

What is a cataract?

            As older people age, the lens in their eyes can grow cloudy. The condition is known as having a cataract . As the lens grows more opaque, the process is called ripening. 

Early symptoms? Seeing halos around lights, sensitivity to glare and difficulty seeing at night. Later, an advanced cataract can seriously interfere with vision. In Third World countries, the cataracts can become so advanced, people are blinded and one can actually see the cream-colored lens in their eye---a complete clouding.

            Lucky for us we don’t live on a mountaintop in Nepal, but within calling distance of cataract surgeons, those miracle workers who painlessly extract the cloudy lens and just as painlessly insert a clear new one, cleaning up one’s vision and---I say from experience---upping the mood of older people who realize they don’t have to be the victims of age and nature when it comes to enduring cataracts and the resulting loss of vision.

 Lucky also that Medicare covers cataract operations for older people. People who are against “socialized” medicine such as Medicare may change their minds once they begin seeing again. (Also cheery: people can be more productive and stay independent longer if their vision is restored, to say nothing of what the surgery will do for the easier reading of this newspaper.)

Really, Should I Be Scared?

No. The operation itself takes about 20 or 30 minutes, about as long as all the insurance paperwork. The client is typically given a sedative. Ten milligrams of Valium certainly made me not have a care in the world.  A little device–again painless—holds your eye open so you don’t even have to worry about not blinking. Then you see a lot of bright light and some colors. That’s it.

After the Surgery

`I went out to breakfast with Cranky Pants after my surgery, but did nap and lie around like a pooped puppy the rest of the day. Clients are given two kinds of eye drops to use after surgery. As for vision after surgery, it may take a while for a blur to disappear. I, on the other hand, could see well right off the bat.

Docs don’t like to work on both eyes at once, so a second surgery is scheduled if there are cataracts in both eyes. But by then, you’ll be an old hand.

Or is it an old eye?

When Mom Gives Up On the Kitchen

 

            Tea and toast---that’s what my mom lived on for a while in her 80’s until the rest of us found out. Asked why she teetered on the edge of malnutrition when she had access to groceries, she said: Because it was easy.

            OK, being cooking-fatigued in my 70’s, I get that. Older women have cooked for 50 years and may want to retire after decades of looking deeply into a frying pan.

What I also get is that mom was not alone. Older people as a group are at risk of malnutrition. In Sweden, a study of 436 seniors between 75 and 80 found about 15% were at risk of malnutrition and that’s in a First World country with good services for seniors. Surprisingly, women were at higher risk than men---which may again indicate women get really sick of slinging the family hash. Everybody gets to retire but the family cook.

Women who lived alone were at the highest risk and I understand that too.  Many of us will keep on cooking for the other person in the house, but when we live alone, it doesn’t seem worth the trouble to shop, cook and clean-up for one. Heck, it’s just me for dinner.

And so we have tea and toast. Or maybe cornflakes for dinner.

In the Swedish study (May issue of the Journal of Clinical Nursing), people who were in poor health tended to take the worst culinary care of themselves. Why? It’s hard for anyone with arthritis to even open a can or jar. It’s difficult for the vision-impaired to measure ingredients.

So What Are the Solutions?

There are community answers that are big---group lunch programs and home-delivered meals. And there are community answers that are small---sharing the meal you just cooked with the older person next door. 

As for formal meal programs, most areas in the US have a group lunch program and some kind of Meals on Wheels home delivery service. To find the meal programs in your area, call Eldercare Locator at 800-677-1116.  In Grass Valley, one phone number will yield information about the group lunches at the High Noon Café and home-delivered meals: 530-273-4961.

On the personal side, offer to bring non-driving neighbors to the grocery store. Or ask if you can pick up a few things for them. Share the too many strawberries you just bought. Leave meals in the freezer when you visit the oldsters in the family. Introduce them to meal programs and write down the phone numbers for group lunches and home-delivery.

And tell them a truth about contemporary life. These programs are not a depression-era breadline thing. Forget the stereotype of a soup kitchen. Today’s nutrition programs are edible thanks for what older people have given the rest of us over a lifetime.

 

Sometimes I talk to myself in public. Some would call this insanity, but I call it writing a column.

 Columns are the way I lecture myself and of course, you too. Together we learn to up our Vitamin D, check out our blood pressure and note the salt content of prepared foods such as pizza before we scarf down a day’s salt limit in one encounter with pepperoni.

So here’s another of those self-lectures---this one about how to stay independent, bright-eyed and bushy-tailed into the years ahead.

 First, the bad news from a study at the University of Pittsburgh.  Women are living longer than men, but some of them aren’t living better. Women who gained weight over the years and women with arthritis are more likely than other women to be disabled in their later years.

Translation: Being disabled can mean needing help from our children, the ones we say we don’t want to bother in our old age. Being disabled can also mean we miss a lot of family fun. Example: If we are obese to the waddle point, we are not going to take nature walks our grandkids. And forget travel. On most trips, we have to be able to get up and keep up. And I don’t know about you, but I don’t want to stay home sitting in my decliner, watching Golden Girl re-runs while I miss out on seeing the rest of the world.

Trying for Better As Well As Longer

The experts at the University of Pittsburgh expect things to get worse unless we get smarter. Obesity rates are still rising which will translate into rising disability rates. This trend will have an enormous impact on the quality of life of older women.  So can you say expensive in-home care? Can you say nursing home?

To be fair, skilled nursing facilities can be a godsend and despite the stereotype, some of them are well-run. (Aside: check out the turnover rate of the facility’s staff. If they are in and out fast, you should be too. However, if they remain on the job, it may mean they and their patients are well-treated.)  Still, a nursing home is not the upbeat mental picture most of us want to have about our old age.

So let me ask: What’s the five-star movie in your head about being 60, 70. 80, 90 and 100?

Mine involves a much thinner woman, one whose joints are not aggravated by the weight she puts on them. She is folk dancing on the terrace of Nepenthe in Big Sur.  She is waltzing at the weddings of great grand kids. She is still writing columns hoping to preach herself into good behavior.

And I hope you dance along with me.

Up The Medical Creek---But With a Paddle

  When it comes to navigating the health care system, do you feel up the creek without a paddle? Or In middle of the Pacific without a paddle and there are fins following the canoe?

Well, if you’re in a hospital on your own without a human angel watching over you, you may feel as though you are at sea alone. So assemble a care posse to help out if you are going to a hospital. Don’t go in without family or friends to watch over your care and speak up if you are in la-la-land or just too sick to speak up yourself.

Take a simple, common problem: Suppose the controller device that rings for help is beyond the reach of the hospitalized person.  A buddy can make sure the controller is always within reach.  A buddy can also go out to the nurse’s station to ask for help that has not been forthcoming when the controller buttons have been pressed. And pressed.

A buddy can also make sure the tray table hasn’t been shoved out of the way and inaccessible. I have seen many people unable to reach their bedside water supply.

Can you say post-op dehydration?

 

Medical Patientry 101

                    Whether it’s you that's entangled in a complex health care system or a loved one, it’s important that you learn how to navigate the bumps. But few are taught medical system literacy. So here are a few of the issues where we need expert coaching: Asking for a second opinion without offending the doctor; asking the right questions about diagnosis and treatment; requesting infection-control procedures before anyone works on you or inserts an IV; double-checking the dosage and name of meds, understanding consent forms and much more.

There’s Help: Books

            Patient advocacy is just coming into its own as a life skill. If you want to read up---here are some options:

            The Empowered Patient: Hundreds of Life-Saving Facts, Action Steps and Strategies You Need to Know, by Dr. Julia Hallisy.

            YOU: The Smart Patient…Insider’s Handbook for Getting the Best Treatment, by Michael Roizen and Mehmet Oz.

More Help: The Web

            Mouse on over to www.everypatientsadvocate.com. That’s the site for Trisha Torrey, who is also About.com’s expert on patient empowerment. She offers down-to-earth advice and usable facts---the only kind of fact my mind will glom onto. (No, I don’t even know when the Battle of 1066 was.) Look at Trish’s site and check out her article about how to evaluate medical “news”.

In-Person Help: A Conference

            Big doings in San Francisco on the patient empowerment front: a May 16^th conference called Empowered Health Care, keynoted by Dean Ornish, MD.  More info at www.empoweredhealthcon.com.           

            In sum---all us medically involved mice quivering before the system should cheer up. It is possible to be assertive while sporting a bare-bottomed hospital gown.

Staying Alive: Low-Salt Living Is Part of the Plan

Somebody out there cares about you.

The American Medical Association is going to bat for your heart and circulatory system, meaning the docs want to keep you from congestive heart failure or a stroke induced by high blood pressure.

The AMA says one very effective way to avoid these health disasters is to cut back on salt. Salt keeps water in the body and makes blood pressure go up. Why? The system has more fluid in it, but it’s the same old circulatory pipes that have to handle the extra pressure. (You don’t have to be a plumber to get the concept.)

The Coming Salt Wars

 Right now, most of us eat twice as much salt as is good for us. So the AMA, which has never before requested the regulation of a food ingredient, has asked the FDA to classify salt as a food additive. That would mean the packaged food companies would have to limit how much salt they can add to your frozen dinners, chip snacks, popcorn, canned goods and ready-to-cook pizzas.

Of course, industry interests will fight the AMA and so it will go. But we don’t have to sit on the sidelines watching the coming salt wars. We can control our salt intake here and now.

Easier Said Than Done

Since supermarkets are hidden salt traps, you have to be alert when shopping. Start reading those labels with this in mind: The Center for Disease Control says 1500 mgs a day is the upper limit of what most of us should have. Some frozen dinners have more than that for just one meal. But there are low-salt foods out there. Also, look for places where you can order groceries online such as www.healthyheartmarket.com.

In the dairy department, pick low salt cheeses. Swiss, ricotta and fresh mozzarella tend to be less salty. The deli case may have low-salt turkey for sandwiches. The freezer may offer little cubes of frozen herbs---garlic, basil, parsley---to punch up meals

Mitigating the Salt Disaster

There are ways to cut the salt of prepared products. I use canned chicken broth, cut it with water and add a splash of sesame oil to jump up the flavor. I cut mayo with yogurt or no-fat sour cream. (FAGE no-fat yogurt is a winner.) Or use less of a salty product---just a small swipe of mustard rather than a slather.

Instead of high salt crackers, try no-salt matzos. They are excellent carriers of dips and peanut butter.

The good news is that this salt reduction program is likely to work to lower blood pressure. The other news it that it may push you into more from-scratch cooking with fresh ingredients. If so, here’s some help: The No-Salt, Lowest Sodium Cookbook by Donald Gazzaniga. And don’t miss this fabulous blog full of tips and recipes: http://dontsalt.blogspot.com.  

Mel Walsh is a gerontologist, author and columnist. Her latest book, Hot Granny, is available at www.Amazon.com.

 

Halt The Salt

 

We’re a nation of salt junkies, but to sober us up, the experts at the Center for Disease Control are finally getting the message out about salt’s connection to high blood pressure. In a recent report, the CDC says we eat far too much salt, especially in processed and prepared food. A single frozen meal may have as much as a teaspoon of salt--about 2500 mgs. Same for those cans of soup in your pantry. Sea ‘o salt.

And going out to eat will not save us. Fast food meals are also loaded with salt. So are chips, nuts, hot dogs and many of the foods that are not fresh and not prepared by your own darling hands.

So Who Cares?

            Probably you should. As the Center For Disease Control says: Too much salt is bad for your health: “It can increase your blood pressure and your risk for a heart attack or stroke”. Since these conditions are among the leading causes of death in the US, salt is not just a matter of taste, it can be a matter of life or death. Personally, since I have cut my salt consumption, my blood pressure has fallen from one-hundred-and-awful over mumble-eight to something that doesn’t make the nurse turn pale.

Currently, the recommended limit is 2,300 mgs of salt a day---about a teaspoon---but the CDC says most people would be better off at 1,500 mgs a day, hard to do if your food groups are the three currently popular choices: canned, frozen and fast.

But, once you make the salt breakaway, you can taste the food underneath the disguise of sodium. And you certainly do build up a shelf of herbs and spices. Pepper is a help here as is Chinese Five Spice Powder for sauces and soups plus Garam Masala which I add to almost anything just to wake up the people at the table.

Grow your Own Taste

Now is great to start a mini herb garden. I grabbed some clay pots and just put in chives, oregano, peppermint, spearmint, chocolate mint, dill, basil, lemon verbena, lemon balm and bay. I also keep a water glass filled with a bunch of parsley next to the stovetop. You could do the same with any green herbs you love. Snip them over what’s in the frying pan.

Additionally, a lemon in the fridge is always good to add zing and I pour orange juice, the taste of sunshine, over everything but Cranky Pants. It’s especially good on fruit compotes and baking chicken parts.

Next week there’ll be more about a low-salt lifestyle that won’t bore your taste buds, but meanwhile, one excellent paperback is Cooking Without a Grain of Salt, by Elma Bagg, Susan Bagg Todd and Robert Ely Bagg.

They show how to get high taste without getting high blood pressure.

Good on them.

Hunting for Docs

 

            Tell me I’m not hallucinating. I remember when people could call a doctor’s office and get in that day. The wait was hours, not weeks or months.

It would take a book, not a column, to say how and why the medical delivery system has changed over time, so I’ll stick to a smaller point: I have a friend who was peeing blood and the urologist in her medical system couldn’t see her for a month. Anyone with a bladder infection knows how uncomfortable it is. An appointment the next hour seems too far away. (She found care elsewhere.)

            My conclusion from that and the many other reports I’ve heard is that there are not enough doctors in CA. Sure, you can get into the debate about whether we have a shortage or not. Some think it’s just that we practice medicine inefficiently. (See the various reports at the Kaiser Family Foundation, www.kff.org. )

Well, maybe that’s it, but I cannot discount the stories I hear from people all over CA. Here are some of their experiences and they certainly seem related to short staffing:

* Appointments for an office visit not available for months even though the condition seems urgent, painful or medically pressing.

* Urgent care centers so crowded one can wait for 3 or 4 hours.

* Emergency rooms so overwhelmed that unless you are bleeding profusely or have fallen on the floor in a spectacular fit, you will grow roots in your fanny sitting in the waiting room.

Urgent care centers and ER’s are often overwhelmed because people are using them for un-urgent care like colds. And they are doing this partly because they don’t have a primary care/family doctor.

Trying to Find A Family Doc

To their credit, the urgent care center I visited last week on the California coast was trying to solve the problem of people cluttering urgent care with their sniffles. At the end of the visit, the staff gave out a helpful list to clients without a family doctor. It was titled: Primary Care Physicians Accepting New Patients.

Study the list. Find a doc. That was the good idea. But I noticed that several of the docs listed said their practices were closed to new patients, but maybe they would accept patients on a case-by-case basis. Other docs refused to treat people who were covered by Medicare, Blue Cross, Aetna or Tricare. Another put a geographical cutoff on his practice He only accepted patients who lived in certain nearby towns. Some wanted yearly retainers of up to $3000.

It sure seemed like looking for a doc in a haystack.

Don’t Blame the Docs

They are the victims too. When’s the last time you saw a happy relaxed doc who had an active practice? They are overworked and caught in the same inefficient system you are. And even those who give up a private practice to work in something like an urgent care clinic are still overworked--- sometimes 12 hours a day.

And then they have insurance matters strangling their practices and student loans weighing on their earnings. Further, some in rural areas are poorly reimbursed for their services by Medicare and other organizations. What’s more, the doctors who are doing basic family practice and primary care, earn way less than the specialists.

We’ll see if the stimulus money is intelligently applied to improve some of these issues. People like Senator Charles Grassley are on the case to improve access to primary care. And we’ll see what President Obama does, but I say that there is something you and I can do without being elected to Congress or the White House. Here’s the plan:

Do everything possible to stay healthy and out of the broken system. And you know the drill: Eat fresh veggies and fruits, fish, whole grains. Exercise a half-hour most days. Stop smoking. Stop over-drinking. Stop OD-ing on a toxic mix of legal drugs. Some people I know take 12 drugs.

And how did they get them from doctors they can’t get in to see?

Canada? Mexico? Borrowing from a friend? Stealing from Mom’s medicine cabinet? I don’t know,

What I know for sure is we have some control here and we are foolish not to use our power to surf this mess.

So---and I really mean it—take care of yourself.

Clean 'N Green: The Way of the Geezer Healthnik

I love your lungs. In fact, I love everything that keeps you healthy, breathing and reading this column. But and however, it has come to my attention that you sometimes use cleaning products that are not good for you, that are bad for the environment and hard on your poor old tattered wallet, the one that used to have money in it.

            And Karen Logan feels the same way about these issues. She’s the author of Clean House, Clean Planet: Clean Your House for Pennies a Day The Safe, Nontoxic Way.  She begins with a list of the bad guy chemicals, the ones we spray and scrub with, such as ammonia, bleach, formaldehyde, lye, sulfuric acid and other chemicals. They are especially not good for young people or for us oldsters who may already have compromised health and so-so lungs that aren’t what they used to be.

But I didn’t need Ms. Logan to tell me about the effect of some cleaning products. I know after I use them it is sometimes hard to breath for the rest of the day, especially after using sprays to shine glass and mirrors.

            What I did need were some clues about safer nontoxic ways to keep the nest from looking like a pigpen, a thing I have never seen, but I imagine pigs don’t clean their bathroom mirrors. So here are a few of her ideas, tested in my own house, the home of mediocre but well-meant housekeeping. Actually, Ms. Logan’s products might make me a better housekeeper since I can breath easy after I use them.

Miracle Glass and Mirror Cleaner

            You have to try this to believe it, but club soda, applied with a spray bottle, is a very effective glass cleaner. It takes a little longer to dry than the commercial blue spray many of us use, but it cleans as well if not better. The trick is to use a lint-free cloth to rub the club soda around after spraying and another lint-free cloth to dry the surface to a sparkle. (I just use two ends of one long cloth---one end to rub the stuff around, the other to dry with.)

            Something funny happened to me when I first used club soda. The spray bottle began spraying on its own. Ah, a haunted sprayer.

            No, it was just the bubbles in the fresh club soda trying to get out of the spray bottle. So I took the top off, let the bubbles out and it’s now behaving.

Another Cleaner, This for Floors and Other Surfaces

            I’ve tried the vinegar spray routine as a floor and surface cleaner and abandoned it because I hated the house smelling like a salad, but there’s a way to get the cleaning and disinfecting power of vinegar and have a spray that smells good. Here’s Ms. Logan’s recipe.

            Fill a spray bottle half way up with water. (She uses a two-cup sprayer. I go for a three-cup number.) Fill the other half of the bottle with white distilled vinegar. (Don’t use wine or apple vinegar, just the clear stuff.)

Here’s the smart part: Add 15 to 20 drops of essential oil to make it smell nice. She uses peppermint oil, I use clove. You may use lemon or lavender or whatever you can pick up in the essential oil section of your health food store. Heck, go for it and use jasmine and pretend you are cleaning floors in Maui.

This simple concoction can be sprayed on floors and other surfaces. I’ve begun using it on everything in the bathroom and if Cranky Pants gets dirty, he may get spritzed.

 

So white vinegar, water and a scent. Simple.

Clean House, Clean Planet has many other recipes and then, of course, you can pick up more ideas with an online search. Dr. Andrew Weil has some cleaning recipes at http://www.drweil.com/drw/u/id/ART00580.

Now, I think I’ll refill my club soda bottle and watch it spray all by itself.

 Hey, it’s hot times here at the Mediocre Housekeeping Institute.

Plants as Heroes

Well, you better stop breathing now. That’s if you have typical indoor air contaminated by formaldehyde, xylene, benzene and other badzenes and nastyhydes. Where does this toxic mix come from?

            Carpets, particle board, paints, photocopiers, wall coverings, adhesives, gas stoves, grocery bags and cleaning products for starters. And today, indoor spaces are more efficiently sealed to save energy and protect us from drafts---that is, fresh air. An old log cabin let in plenty of fresh air. A super-insulated home keeps old air in and fresh air out.

So What?

According to the indoor air experts, there are at least eight answers: allergies, asthma, eye/nose/throat irritation, fatigue, headache, nervous system disorders, respiratory congestion and sinus congestion. I’d add that old indoor air just smells bad. Call it second-hand breath or stale air, it’s not what we were meant to put in our lungs and yet most of us spend most of our time inside. 

One Simple Solution

Open the doors and windows. Yes, that’s not the best idea when it comes to saving energy in the winter, but some of us clean out our insulated living boxes with a quick airing of the house every day. As Emily Dickinson said: “Inebriate of air am I….” meaning the lady got high on oxygen. Me, too. and I’m not alone.

In the last century, some houses were even constructed with sleeping porches. They had roofs and were screened and sometimes even had pull-down wall beds, so people had at least eight hours of fresh air.

Other Options: Plants As Air Fresheners

            Yes, plants look pretty, but a Boston fern is more than just a pretty face. It and other houseplants act as air filters for polluted air. They can take the badzenes out of the air and deliver them to the good bacteria at their roots. These helpful bacteria in the plant pot then break down the pollutants. OK, that’s simplified, but essentially what happens.

            The expert on this process is NASA scientist, Dr. B. C. Wolverton, he who has turned his experience with space capsules and fresh air into a good book, How To Grow Fresh Air: 50 Houseplants that Purify Your Home or Office.

            This book has excellent photographs of each plant, rates them for effectiveness in cleaning the air and ease of growing. Care directions are given and happily, most plants here do not need a lot of light.

Here are some of his stars, commonly available houseplants, some of which you may already have:

His top recommended plants include Boston fern and a look-alike, a fern called Kimberly Queen. Then there’s the well-known Peace Lily, which will bloom readily indoors and once tried to take over my master bedroom. Wolverton also says English ivy is an excellent filter.

Larger air heroes include indoor palms such areca, lady, dwarf date and bamboo palms. The rubber plant—hard to kill—also turns out to be a good filter as well as the ever-present ficus, or weeping fig.

 

Your Own Little Air Space

Wolverton recommends clustering the plants around what he calls “a personal breathing zone”. You probably have at least 3 personal breathing zones, places where you spend a lot of time. Think bed, desk chair and designated TV watching spot.

I am about to set up a little fern forest around my PB Zones. If Wolverton and NASA ever turn out to be wrong, I will still have a pleasant Garden of Ease and Comfort and a good level of plant-induced humidity. That moisture should keep me from drying out and crumbling into geezer dust.

Killer Light Bulbs?

Sometimes the developing news in modern medicine is hard to digest. I had trouble believing that any responsible fertility doc would help a woman into a pregnancy that ended in octuplets when the woman already had six in vitro offspring, no visible means of support and no helping hand from a life partner.

            So I had just struggled with that news when this report popped up on my computer screen:

There is a credible link between cancer and artificial night lighting. While nothing is proved---your desk light is not going to kill you tonight---various studies indicate that people who live or work under nighttime illumination---think graveyard shift workers or night nurses---have a higher rate of cancer than those who don’t. This link seems especially true of prostate and breast cancers.

How Could This Be So?

The best guess so far is that artificial light suppresses the production of the hormone melatonin, the hormone that regulates our natural rhythms. When people live under artificial light at night, it causes melatonin production to drop off.

So what? Well, studies done on rats and conducted in lab Petri dishes indicate that melatonin does slow the development of cancers. So the theory goes that in humans, if the melatonin supplies go down, the risk of cancers goes up.

High in the Sky

Well, this theory was so intriguing to some researchers, they thought up a new way to cross-check the evidence of a night lighting/cancer connection. They used satellite info to detect the most illuminated countries on the planet---they looked at 164 countries---and compared that to the rate of prostate cancer in each country. The rate of prostate cancer was higher in the brightly lit parts of the globe, adding another piece of the puzzle to the theory. 

Now, one way we readers of medical info go wrong is to confuse a relationship with cause and effect. Just because there is a relationship between night illumination and higher cancer rates does not prove one caused the other. However, if several human and lab studies indicate the same connection, and if observations from a satellite also indicate the same connection, then these researchers may be on to something. As David Blask, a professor at Tulane, states: “Put all this together and it argues pretty strongly that light-induced melatonin suppression may be at the heart of this.”

So what’s a 1000-watt night owl to do? Probably nothing until the evidence is clearer and even then, the solution may be simply to take melatonin tablets.

As for the issue of staying up into the wee hours under bright lights, I’m not worried for myself or my age peers. The only lights we see after 9 PM are our bedroom nightlights, probably not visible by satellite.

 

What's In Your Ears?

I have frogs in my ears. They sound like spring peepers on speed. Other people report they have bees, frying pans or dental drills in their ears---at least that’s what it sounds like with a condition called tinnitus.

            Tinnitus is a buzzing or a high-pitched sound in the ear. There are no frogs, bees, frying pans or drills present. There is just phantom noise, usually worse when it is quiet and there are no other sounds around to mask the concert in the head.

Tinnitius is associated with hearing loss and with age---around 13% of people 65 and older have a din in their ears. Exposure to very loud noises can cause tinnitus, not only in older people with ears damaged by high-decibel rock concerts or noisy workplaces, but even in the young who are exposed to loud noises whatever the source. According to audiologist Theresa Schultz, hearing loss with tinnitus is the primary cause of disability for veterans coming home from Iraq and Afghanistan. Think gunfire and grenades.

For some, the sound of tinnitus is so loud and persistent, it damages the quality of their lives. They form support groups. They go to audiologists seeking relief. For other like me, it’s a low buzz at night, but playing a radio or a CD masks the sound. Replacing the frogs with music can work.

Mystery Noises, Mystery Workings

Nobody knows the actual physical pathways of tinnitus, but some think it originates in the central nervous system and has multiple causes. Besides noise-induced damage to the ears, tinnitus is sometimes associated with ear infections, earwax build-up and the use of aspirin or other drugs.

Is there a cure? Well, some strategies can mitigate the problem. Sometimes a hearing aid will reduce symptoms. Soft background music can help. So can sound machines. There are sound machines where the user can choose to listen to waves, running water, rain and other natural noises. (If they ever make one featuring spring peepers, count me out. I get peeped up on my own.)

Sound machines can be investigated at www.soundmachinesdirect.com, but a cheaper solution is to use whatever you already have to generate soft and relaxing music---a radio, CD player or an iPod on low volume. (Note that I say “relaxing”, for some physicians feel that anxiety over tinnitus makes the situation worse.)

Hearing Conservation

Knowing how loud noises can damage the ear and possibly set off tinnitus, I have gotten defensive about preserving hearing. I have walked out of concerts where the decibel level was high to the point of pain. I now carry ear plugs to be used at the movies, especially during Coming Attractions, where the decibel level seems set by teens whose own hearing has already been impaired by their MP3 players.

So yes, I am the Hearing Patrol of the family. My mantra: Turn it down! When a grandchild is in the back seat listening to an iPod through her earbuds and you in the front can hear her music, it’s time for the Hearing Patrol to spring into action.

Yes, I am probably perceived as the hearing nag, but better that than having the next generation grow frogs in their ears. 

Simple Answers to the Health Care Mess

I have a down-to-earth solution to the health care crisis in the US.

 In two words, it’s broccoli and sneakers.

Maybe I’d better explain or better yet, let Deepak Chopra, Dean Ornish, Rustum Roy and Andrew Weil explain it for me. These four champions of holistic lifestyles recently nailed their views to the cathedral door in a Wall Street Journal article claiming that so-called alternative, holistic medicine was now mainstream and it was the drug-reliant, surgery-happy establishment medicine that is questionable today.

OK, they were more dilplomatic—and they really are for integrating mainstream medicine that works with alternative modes that work---such as meditation and herbs. But they and other experts today are making a strong case for preventing illness in the first place through lifestyle changes such as a good diet---that’s the broccoli---and exercise---those are the sneakers.

 Still, people have trouble believing that such simple affordable things can keep them out of the hospital and out of medical trouble, but it’s true. As the four experts say: “The evidence is mounting that diet and lifestyle are the best cures for our worst affllictions.” And one of their goals is to move the US medical system from disease care to real health care and disease prevention. It’s cheaper, safer and it works. What else could we ask for?

The High Cost of Staying Stuck Where We Are

So why are Americans coughing up almost $100,000 for each coronary bypass procedure to the combined tune of 44 billion dollars a year? And why do we pay close to $50,000 for each angioplasty to the combined cost of 60 billion a year?

Because we don’t believe simple prevention works? Because lifestyle change takes a little thought? It is, after all, easier to open a package of chips than to steam veggies---easier to push buttons on the remote than to push oneself to walk.

Me, I don’t know all the blocks to health behaviors that work, but thanks to recent studies, I do know what mostly doesn’t work, at least when it comes to heart health.

(Prepare to be surprised.)

What doesn’t work are expensive, invasive operations on the cardio system. Here are the facts as published in the New England Journal of Medicine and summarized by the four health professionals in their Journal article: Angioplasties and stents “do not prolong life or even prevent heart attacks in stable patients (i.e., the 95% of people who receive them). Coronary bypass surgery prolongs life in less than 3% of patients who receive it.”’

Wow. We don’t get what we are paying for.

So I think it’s time to stop the stupid behavior, especially mine own. For me now, it’s a half hour a day of exercise of any kind and 5 to 9 servings of fruit and veggies, no matter how many faces Cranky Pants makes about plants on his plate. (Tip: if you have juice for breakfast and heap your cereal with a cup of fruit—think berries and bananas---you have 3 servings in the bag before lunch.)

What To Expect From Barack

You already know. Barack exercises most mornings and reportedly eats salmon, broccoli and brown rice for dinner. The prez is tuned in.

Me, I expect future programs where health is rewarded and incentives put in place to behave ourselves health-wise. And, looking at the future high costs of Medicare and the fact the Feds are broke, I ask myself what will happen if taxpayers begin to wonder why they should subsidize older people with bad dog lifestyles who incur high medical expense through Medicare. Our kids may grab the cookies out of our very hands so they don’t have to subsidize our heart surgeries.

So, bottom line, isn’t it time to bypass the bypass?

As I said, broccoli and sneakers.

When the Sky Is Falling: A Simple Plan

It’s epidemic. I’ve got it. Maybe you have it too. You might be picking it up from your television set.

            What I’ve caught is a disease called crisis-itis. I made up the word, but not the symptoms. Don’t know about you---though I can guess---but I am a nervous wreck, unable to sleep, cranky as a winter bear, fatigued from a mean election process that has gone on so long, it can be measured in light years.

            And I’m also getting seasick from watching the market roll on rough seas. (There goes the 401(k), down for the third time. Is that the wreckage of my pension floating out to sea? And where does a federal government that’s in record-breaking debt get the money to rescue failing corporations? Isn’t the pot imagining the kettle is made out of gold?)

            So there you have it: my worry map and it’s probably a lot like yours, except if you are older like me, you realize that it’s impossible to work another 30 years to get back any money you may lose in the market.

            On the other hand, there is a little dark humor to the scene, including the fact that we have socialized some big finance, mortgage and insurance companies, but some are trying to keep the government from sinning its way into “socialized medicine”, aka universal health care. I can manage a weak smile over that irony, but the rest of the scene makes me wish I could go to sleep and wake only when Cranky Pants comes to the castle, kisses me and tells me it’s OK to come out. The dragons are gone.

Controlling the Stress

            Everything I’ve read about stress in the last two decades says that people who have little control over their lives suffer the most stress while those who are able to exert some force and direction are better off. Now, we can’t control the markets or the election process beyond one vote, but we can control ourselves or at least make a good try at relieving anxiety. And we should be motivated to proceed down the road towards greater calm.

            The Mayo Clinic lays out of some of the effects of stress on the body, feelings and behavior...

            Body: Headache, chest pain, pounding heart, high blood pressure, shortness of breath and problems with the gut and with sleep.

            Thoughts and feelings:  Anxiety, restlessness, worrying, irritability, depression and many more downer states.

            Behavior: Overeating, angry outbursts, drug abuse, excessive drinking, increased smoking, social withdrawal and blaming others….which I will not do, but tell me, why did you buy that bad boy mortgage?

Solutions

            There are ways out of any stress mess:

            Exercise: Walk on the sunny side of the street. Get on the treadmill like Cranky Pants. He’s on it every morning right now and his motivating trainer is named Dow Jones.

            Nature: She is always there. Got the sun in the morning and the moon at night. Stars are a bonus. So are Hubble images. Yes, those pics let you know what a tiny piece of stardust you are, but then, so is everything else that is bothering you.

            Meditation: I don’t do lotus positions, but I do lie around and think of beautiful things. Resident in my mind is one room I decorate over and over again, sometimes in mid-century modern, sometimes in French Provincial. I don’t know if your guru would approve, but it works for me.

            Massage/Water relaxation: Maybe you can’t afford a regular massage, but at least one massage will reset the body’s anxiety thermometer. A hot tub or a hot shower also relieves tension. So, instead of watching the nightly news, go sit in a hot tub. The rest of the world is in hot water. You might as well join them.

            Music: Relaxer’s choice. I like a CD of Chinese lullabies or anything by Stan Getz. Taiko drumming might do it for you.

            Friends: Spouting off to friends helps. Always has. Always will. But a little venting goes a long way. If you spend the whole time together complaining, you’ll feel worse than when you started.

            Community events: We live in a place rich in community events. The company of people having good time is an upper. At the Draft Horse Classic I found my Rx: take two Belgians and go back for more in the morning.

            The KVMR Celtic Festival is this weekend….fiddles, bagpipes, singing plus a new something called the Faerie Wood. I don’t know what that is, but I bet you can’t be in it and think about the Securities and Exchange Commission at the same time.

            

Staying Upright

If I ever do one thing for you, let it be this: may I keep you from cracking your head or any other precious body part in a fall that could send you to bed, the ER or heaven.

            In movies and cartoons, falls are funny. Prat falls were the bread and butter of the old vaudeville comedians. But in real life, falls can stop life as you know it. The more “ordinary” changes include everything from having to rely on pain pills to get through the day to not getting anywhere at all because the hip is broken or the car-shifting arm in a sling. Big changes include being bed-ridden, unable to work or take care of yourself and, worse case, leaving the planet for Higher Places. As I write this, today’s local obits tell the sad story of an older woman who died from a fall.

            I know, I know…I’m a nag, but my own fall last winter and the fact my friends are going down like clear-cut timber is turning me into a fallevangelist.

            In my own fall I was lucky: A concussion just ruined a vacation and not a life. A CAT scan revealed that my brains had not scrambled and when I asked the doc if he saw another book inside my skull, he said yes. So, for an author, that was the one good part.

Basic Advice About Staying Safe

·      Homes: Our homes are snakepits when it comes to falls. If you have a residential choice, go for a single story or one with the master on the main floor. Get good lighting, especially on stairs. Remove little rugs that will trip you up. Put in a movement-sensitive night light for the 1 AM trips to the john. Stay off ladders. Put a non-skid mat in the tub and a safety bar over the tub. Safety bars for the bath have gotten more chic, less sterile.

·      Little Critters: Grandkids and pets can trip you. Grandkids leave their toys around on the floor. Your dog can pull you over when the leash is wrapped around your wrist and he goes dashing after a squirrel.

·      Meds: Many are the medications and med interactions that can decrease alertness, cause dizziness or just screw up your balance. Maybe your doc can switch the med or order a lower dose, but be aware of what meds can do to you. Consider asking if they are really necessary and proven effective in actual practice. (Lest you think I am too negative here, remember all the recalls of prescribed drugs that once passed FDA muster.)

·      Travel. This is my downfall. A gawker, I look up at the sights when I should be looking down at the cobblestones. Or I fail to notice that the marble floors of the museum are wet. Enough said. Get your travel radar going when you go to unfamiliar places.

·      Physical Shape: If you dance, exercise, hike and otherwise move yourself in space, you will have better control of your balance, more agility and greater muscle strength to keep it all together.     

·      Know your own vulnerabilities. It may be in the garden, on the front steps or riding your bike on rocky dirt paths. Cranky Pants’ downfall is driveway ice. Friend X’s is getting up and out of bed too fast before her blood has a chance to catch up to her brain. Mine is unfamiliar places. Know yours.

Big Doings in the World of Falls

            The local Falls Prevention Coalition has declared September 21 to 28 the week they will do everything they can to keep the people of Nevada County upright. They start with a kickoff event on Sunday, September 21 at Peace Lutheran Church, 828 West Main in Grass Valley---2:30 to 6:30 PM---offering info, entertainment and a free meal. They then proceed through the week with workshops and seminars. To register for the Sunday event or to find out more about the week, call Helpline at 530-273-2273.

            Now, remember, I don’t want to meet you in the ER, but if we do get there at the same time, I’ll be the one eating her words.

 

            

 

This Gas Is Free

I’m full of hot air. So are you. Specifically, we’re full of nitrogen, hydrogen, carbon dioxide, oxygen and the bracing air of cow pastures everywhere, methane. Experts say it’s normal to emit gases up to 20 times a day from a body outlet of your choice, so what you are doing in secret (or in public if you are outgassing freely) is probably normal.

            Still, you may want to know what to do to reduce gas---there are surprising causes of gas----and what to do if you find yourself so full of it, you fear taking off into the air like a helium balloon.

            Also in today’s lesson, we’ll learn when to see a doc about our gassy selves. But if you just want to know a little more about the mysteries of your digestive system, the government offers a handy online piece called: What I Need To Know About Gas.

            This is true---just Google it. The pamphlet will give you the basics about gas, which is not always a joke, but really a problem for some people, the ones whose gas imitates the pain of appendicitis or whose gas lodges in their chest imitating a heart attack---all of which the poor souls find out only after a trip to the ER.

 

Gas Lessons

            Here’s the info that the feds and other sources like the Mayo Clinic think you should know about burping and what they all delicately call rear end emissions, flatus. (Many articles are written about passing gas, but the other F word is not mentioned. So, never one to break new ground when it comes to irritating delicate readers, I will continue to write nicey-nicey and call these emissions flatus. You translate.)   

 

What Causes Gas?

            Yes, beans, but different people have different triggers. Some triggers are broccoli, cabbage, brussels sprouts, onions, artichokes and asparagus. Other people react to pears, applies and peaches. Still others react to whole wheat and bran. And then some who are lactose intolerant may become gassy after ingesting dairy products or packaged goods that contain milk such as bread, cereal and salad dressings.

            Carbonated drinks---think of them as pre-gassed liquids---are another culprit. So beer and sodas may be the engines of your gas factory.

            Antibiotics can also turn on the gut gas machine. (Many docs recommend yogurt with live cultures as a fix to the problem.)

 

The Surprise Trigger

            As I was skipping through the jazzy information in the National Digestive Diseases Information Clearing House and the American College of Gastroenterology, I found that some experts believe these common sweeteners are triggers: sorbitol--- often used in products for diabetics---and fructose---a corn sweetener used in too many commercial products today---soft drinks, baked goods, even cottage cheese, yogurts and salad dressings. So look to these     stealth triggers if your mate is complaining about your constant burping.

 

Other Triggers

            Swallowing air gets air into your system, which is a duh kind of fact---air in, air out. Eating slowly helps cut down air intake. Chewing gum is supposed to be avoided, as is smoking and false teeth that don’t fit, though I don’t get the logic of that last one. Drinking through a straw also puts air into the gut. So drinking beer through a straw while chewing gum and wearing bad dentures is probably a no-no. You heard it here first.

            Seriously, the bottom line to all this: cut down on the foods and drinks that you are sensitive to and reduce the amount of air you swallow.

            The National Institutes of Health also suggest relaxing while you eat and walking for 10 or 15 minutes after a meal. People from Europe get this—walking in the town square after a slow food meal.

 

Uncomfortable Bloating

            Gas lodged in the gut can be uncomfortable or even painful. Some products may help. The Mayo Clinic advises products with simethicone such as Gas-X or Mylanta. They also recommend trying Beano, or peppermint tea or activated charcoal like CharcoCaps. Sometimes these products are effective… sometimes not.

 

When to See A Doctor

            Gas releases from the human body are normal, but if they are accompanied by any of these symptoms, see a health professional:

            Vomiting, persistent abdominal pains, diarrhea, weight loss, bleeding and sometimes, heartburn.

            So there you have it---The Little Story of Gas and if you’ve been worried about releases a dozen times a day, don’t. It’s just your gut bacteria having a party. And the next time your friends chide you for F & B---Flatus and Burps--- tell them that if we weren’t meant to do it, we wouldn’t have been born with two handy dandy release valves.

                        Mel Walsh is a gerontologist and certifiable geezer. Her book of advice for older women, Hot Granny, is available at The Book Seller in Gras Valley and online at Amazon and Barnes & Noble.

Housework: Breathing Easy

You have a matched pair, all pink and pretty and I want you to keep them that way. I refer to your lungs, your portable oxygen tanks. You don’t see them and if you are lucky, you don’t hear them, though people with asthma hear them far too often.

            Wheeze, wheeze.

            You already know that smoking isn’t good for your lungs, but did you know that cleaning sprays were connected to a 30 to 50 percent increased risk of asthma? One study of the subject involved 3,500 people from 10 countries and was published in the American Journal of Respiratory and Critical Care Medicine. Researchers found that the regular use of sprayed fresheners, furniture cleaners and glass cleaners was linked in a significant way to breathing difficulties.

            I’ve noticed this phenom in spades---spray an air freshener or a cleaner---have trouble breathing---that’s my experience and my unscientific experiment of one. So if you’ve had your own experiment of one or are paying attention to the experiment with 3,500 other people, you may want to know what to do besides leaving the house a mess and smelling like yesterday’s boiled cabbage.

Green Cleaning

            Luckily, there are simple products that work and are deemed to be green, safe and friendly. They are the things your great grammy used, vinegar and baking soda being the stars of the eco-lineup.

            But and however, I don’t know if we older people have exactly been the first adopters of safe cleaning methods. I sense that our kids and their kids got out of the starting gate faster than we did. We are the Chlorine Generation, disinfecting everything that moves under a microscope with products sporting the phone number of a poison control center, products that little grandkids could take out from under the sink and investigate at their peril.

            But better late than never, and here are two safe cleaning recipes from the public health section of the King County website in Washington State, www.metrokc.gov/health/asthma/facts/greencleaning.html:

            Tub and sink cleaner. Sprinkle baking soda on the porcelain fixtures and rub with wet rag. Add a little liquid castile soap to the rag for more cleaning power. Rinse well to avoid leaving a hazy film.

            Drain cleaner. This recipe will free minor clogs and help prevent future clogs. Pour ½ cup of baking soda down the drain first, then ½ cup vinegar. Let it fizz for a few minutes. Then pour down a teakettle full of boiling water. Repeat if needed. If the clog is stubborn use a plunger. If very stubborn, use a mechanical snake.

            There are several other simple cleaning recipes on this web site, including the use of vinegar and water in a spray bottle to clean glass. Actually, I just dump some vinegar on my glass dining room table and rub it around. I use white or apple cider vinegar and the smell evaporates quickly.

Stale Rooms, Safe Fresheners

            Some of us now live in fairly modern well-insulated houses, no fresh air coming in through chinks in the log cabin walls. This is good for our utility bills, but sealed rooms keep in all the gunky dead air. So open those windows and doors and let the fresh air in and out. Air is a great air freshener.

            If you want a flower scent, grow or buy some lavender for potpourri and, when the scent gets weak, refresh with essential oil of lavender.  I’ve also boiled cinnamon sticks in water on the stovetop for a few minutes. Last, I’ve tried to tell Cranky Pants that home-made oatmeal cookies are not the best way to make the indoor air fragrant, but he says cookies don’t cause asthma.

Words for the Wise           

            Green living is a BIG subject and covers far more than cleaning products and air fresheners. A book that gets raves in the Amazon online reviews is “Easy Green Living: the Ultimate Guide to Simple, Eco-Friendly Choices for You and Your Home”. Author Renee Loux is the host of TV’s “Easy Being Green”. Her book shows how to switch to a green lifestyle and how to make safer choices in all kinds of household products. As the review says, she is making the world safer, one cleaning spritz at a time.

Medicaring: A Few Newer Things

Did you hear the story about the geezer who was asked his opinion about government funding for health care? He said: “Medicare is working fine for me, so I don’t want the government getting involved and messing it up.”

            Well, you and I know Medicare is THE government health care funding program for older folks. It is involved in almost every aspect of seniors’ health care. When older people need a new hip, a cataract operation or want to see a doc about a hitch in their getalong, their medical adventures are heavily financed by Uncle Sam.

             Sam got into the medical business back in 1965 when President Lyndon Johnson signed Medicare into law as part of his Great Society program. Ex-prez Truman was the first one to sign up. That was fair as it was Truman who first proposed that the federal government become involved in health care. But Truman had to wait 20 years for it to happen and then, the program was not the universal care he wanted, but benefits just for us older folks.

            So who knows how long it will be before all our citizens have such good access to health care? (Myself, I feel a bit guilty that my age group is the only one singled out as worthy of help in the health arena, though Medicaid did eventually come on board for those without much money.)

New Medicare Happenings

            If you could see your TV set through the smoke in the last few weeks, you learned that Congress passed a new Medicare bill over President Bush’s veto. Without this new bill, doctors’ fees would have been cut over 10%. But Congress was nagged---I mean lobbied---by the likes of us. Plus it is an election year and we oldsters are famous as voting types, so the cut got cancelled.

            And, though not much talked about, this bill had other provisions that will affect Medicare recipients. These are the things the new bill will do for you:

·               Reduce out-of-pocket expenses for mental health visits. Mental health clients will eventually have the same co-pay as other visits---20%, not the present 50%. (If you are bi-polar or have other common brain disorders, this change will save you a lot of money.)

·               Give a slight boost to preventive care. You will now have 12 months to get a physical after entering the Medicare program. Present limit is 6 months. So there will be more time to make that appointment to get checked out.

·               Boost payments to doctors who use electronic prescriptions, rather than the written ones that are easily misunderstood. So this new development should be a step towards your greater safety. Only about 40,000 doctors use e-scripts now. And, if they don’t get with the 21^st century, they will begin to get their fees docked by the government.

·               Last, Medicare will pay for anti-anxiety drugs like Valium and Xanax, but not until 2013, so if you worry before then, you’re on your own.

More on the Washington Horizon

            Candidate McCain has been bringing up an idea that President Bush could not get through and that is the idea of privatizing Social Security---having people invest privately for their own retirement. I would bet McCain will have an especially rough time selling this idea now when the financial markets are rocky, banks are failing, and the economic forecasts not cheery.

            Expect a lot of debate on this issue between the parties. Me, I’d bet the idea of privatization will fail again, but I won’t bet very much.

            I need the dough for my retirement and really, given the present return on bank CD’s, I am not sure I can wait five years for the government Valium. 

The Moment

Have you had The Moment yet? That’s the time when you realize you are---take a deep breath---old. And not just old, but a member of the merry band of people known as the “elderly” or worse, as the “frail elderly”.

Now I would have bet my AARP membership that I was 20 years away from old. Old was an every-receding horizon. I could march on in life and yet never reach that horizon. Inside, I was forty-three. Sometimes, in my more rebellious modes, I was even a snotty fifteen. OK, when surrounded by twelve youngsters who called me grandma, I shot up into my late 50’s. But really, I didn’t feel old.

My Moment: What Did It?
Heat did it. Yeah, I know that in Northern California there was also smoke and ozone pollution, but it was the heat. I had to leave a 50th class reunion early because of the heat. Had to cancel radio shows because of the heat and eventually, hightailed it for the fog of the coast because the numbers on the thermometer went into the three-digit range.

But who was this new wimp? Could it be someone who, on the online weather sites, is called a “sensitive group.” Could it be “elderly”?

Seems so. Me, the sick and the infants. Me who used to be able to hike hours in the Arizona summer sunshine.

Part of the problem is that I don’t perspire much or at all. The natural cooling system is on the blink. My doc tells me to carry a spray bottle of water. I have been known to pour an entire bottle of water over my head at times one might call inappropriate. But part of the problem has to be connected to my age.

So What To Do After Your “Moment”?
When such a moment comes---and it will---pay attention and take care of whatever vulnerability makes you feel old. Whether it’s heat sensitivity, lung issues connected to pollution, heart issues connected to exertion, joint problems connected to---well---to joints, take care and fix it.Read up, look online for solutions and consult a good health care practitioner. Heck, write medical columnist, Dr. Gott, he who gives advice in this paper. If he doesn’t have a suggestion for just about every ill, nobody does.

If the Problem is Heat
Mr. Carrier invented air conditioning for summers like this. And there are simply lovely fans, both electric and paper. (You can buy a box of little paper fans online at eBay for almost nothing.) At a sports store, buy one of those cooling neckerchiefs that you soak in water and then tie around the neck. They work by slow evaporation and the fridge is a smart place to store these wet bandannas at night.

Drink lots of water—duh!---and don’t sit out on the car while your mate waits in the prescription line at the pharmacy. Cars in summer are death traps, literally. Amazing how fast they heat up.

Also remember Tom Lehrer’s song: only mad dogs and Englishmen go out in the mid-day sun. Pretend you are Spanish and take a siesta in the hot afternoon and come to life at night when it’s cooler. However, party, not hearty, but smart. Alcohol will only make you feel warmer, no matter how charming that G&T looks visually.

Words to the Wise
You may have a vulnerable body part or a glitch in some system, but it doesn’t mean some bad fairy suddenly turned you into a down and out geezer. Sure, you may have a parts problem, but don’t allow The Moment to eat away at your entire self image. I figure I have an antiquated cooling system, but the rest of me is fine. Brain better than ever. Sassiness levels up to the mark. Engine running smoothly, but darn it sure runs hot. So I just have to pull over to the side of the road and lift the hood up now and then.

And you, your bad part may be sixty-five or ninety, but the rest of you is whatever you say it is. Try fifty as a nice round number.

Toot, Toot, Tootsies

What’s your favorite body part? No, not that one.

            OK, let me put it another way. What    parts of the body are essential to keep you mobile, able to travel, ready to dance and stable enough to stand forever in the pharmacy line?

Yes, the feet.

Poor feet---they are so far away from our eyes, down south of the body, that they get short shrift. Out of sight, out of mind, especially if the tummy gets in the line of sight.

But feet begin to enter our conscious minds when, as older people, we decide not go on trips because of the walking, when we realize that corns, bunions, hammer toes, fallen arches, and calluses are keeping us from doing what we want. We had other plans for ourselves in retirement, ones that didn’t involve Dr. Scholl.

Now, that’s a downer moment---the time when we realize that some things are beyond us. We can’t hike the Pacific Crest trail or the Hill Towns of Italy. We may have trouble walking to the mailbox.

Ways to Fight Back

            Well, life and feet aren’t perfect, but here are a few ways to keep those tootsies in the best possible shape:

* Shoes

The right shoe can make all the difference in your ability to get around. I have been lurking on the hiking and travel websites and here are some of the brands walking folks love: Ecco, Rockport, Mephisto, Merrell, Teva, Clarks, New Balance and Easy Spirit. And then there are the sport shoe brands that became famous for making sneakers on steroids, among them Nike, Adidas, Reebok and Brooks. But remember each of these brands makes a great variety of styles. Some will fit you and others will not.

Whatever brand you choose, get a good fit. If shoes are not comfy in the store, taking them home won’t change things. Look for a sole that will flex with you, but is still thick enough to protect your feet from concrete and pebbles.

When it comes to shoes, I think lightweight is good. The more like a cloud, the better I like them. And today’s shoes can be engineered so that they can provide support and protection and still not weigh much. It was yesterday that walking shoes had to be made of heavy leather.

Make sure there is room in the toe box so you can wiggle your toes. (I still look for my mom to pinch the toe and declare it adequate for another school year. Some rituals never die.). And make sure there’s room for the socks you usually wear. Plus the heel shouldn’t be slipping and most of all, you shouldn’t be in a hurry when you are in the store. Take your time. Shoes are mega-expensive and blisters hurt.

Double check your decision: Take the shoes home and wear them around the house. If they don’t feel good, back they go pronto.

* Socks

            Socks have come a long way since you wore bobby socks. Some wool socks like SmartWool can be washed without worry. Brands like Thorlo make socks with different levels of padding. To me, a padded Thorlo on the foot can make almost any shoe far more comfortable. Though these and other padded socks are not cheap, they are worth it as an escape from foot torture.

* Pads, liners, inserts, etc.

            These accessories from the foot section of the drugstore take experimentation. Some are helpful and some just make things worse.

* Be kind to yourself after walking.

            Some people soak their tootsies in a cold tub. Others roll their feet back and forth over a tennis ball on the floor. Still others massage with products like the Body Shop’s peppermint lotion for feet. And if there are cracks in the heels, there are heavy-duty creams to take care of that problem. At night, just rub the cream in well, put on clean socks and go to bed. (If you do this in the morning, you may slide around in soggy socks all day.)

* Foot docs

            If you are having persistent pain in your tootsies, get thee to a foot doctor who can often help with just some simple suggestions. Get a second opinion if anyone suggests surgery. 

Well, time’s up, so it’s toot, toot tootsie…goodbye. Take care of those feet and be glad you’re not a centipede.

Hearing Around Corners

            Can you hear me?

I said: CAN YOU HEAR ME?

            Older people do experience hearing loss though many don’t call it that. Instead, they say other people mumble or don’t speak loud enough. The trouble, they say, is with other people’s voices.

Well, in reality, up to half of the people now over 75 have age-related hearing loss and my guess is that when rock and rollers and the ear-budded MP3-ers get older, those numbers will go up.

Are you losing some hearing?         

            Here are some clues:

People complain you turn the TV volume up too loud.

It’s hard to hear in crowded rooms (which is why older people prefer quiet restaurants).      

You have to ask people to repeat themselves.

It’s harder to hear on a phone or a cell phone. (I blame that one on bad reception.)

You feel a bit out of it and socially isolated because you can’t hear at social events or meetings.

You have begun to fake it by smiling and nodding, hoping what you are agreeing to is not an assignation in the park.

When people talk to you from another room, you find you can’t hear around corners.

So Why Not More Hearing Aids?

            Because many people have trouble with them. Let me count the reasons I’ve heard: They make what you hear too loud---over-amplification---and with feedback issues, the devices can emit noise themselves. The batteries die. They have to be removed to shower or sleep. They are also said to be too ugly and obvious, too cumbersome---the wearer notices their presence. Other complaints: they are not at all sexy, an indicator that you are old and falling apart, too expensive and not paid for by Medicare. So, in general, the cost-benefit ratio of a hearing aid just doesn’t add up for many people.

On the other hand, some get great benefits from their hearing aids. The aids allow them to live near normal lives, to remain in the world socially and professionally and to hear the nags of their beloved with greater clarity. (Of course that only means the spouse is heard, no guarantee that they are listened to. That is a whole ‘nother subject.)

New Hearing Aid Making Debut 

            If you or your nagged one has a hearing problem, keep an ear out for a new kind of hearing aid, known as The Lyric, made by InSound Medical of Newark, California and advertised as “the world’s first extended wear hearing device.” The Lyric is placed so far in the ear, it is invisible to the observer. You can wear it 24/7, can shower with it and, since it is not an implant, the tiny device can be removed with a small magnet. It lasts from one to four months and when the battery gets low, a ten-minute appointment with a qualified ear care provider will replace the entire little Lyric. For some, that appointment will be a drawback. For others, it will be a worthwhile inconvenience in order to enjoy a giant step forward in hearing aid design.

            Now, not every ear configuration is suitable for the Lyric and it does cost $2,900 to $3,600 for an annual subscription that includes its periodic replacement. Right now, according the company website, there is no provider yet in Nevada County, but a list of Northern California providers can be pulled up on the company website at www.insoundmedical.com. Here you will find more information plus illustrations of the actual device. Their address is: 39660 Eureka Drive, Newark, CA 94560. Phone: 1.800.941.6072.

The New Old Vitamin

            The swami says you are about to get excited about vitamin D.

Hey, I used to think vitamin D was dull, too. In fact, since I didn’t have rickets, I didn’t think about vitamin D at all. Well, if that’s true of you too, it’s time for both of us to wake up and smell the new data that are coming out about vitamin D, information that can change our lives and health.

There is a large and growing body of evidence that many people are deficient in vitamin D---their tanks are low. Several studies show that from 40 to 100% of US and European older people have insufficient levels of vitamin D. So think: common, very common deficiency. And that low level can be harmful, increasing muscle weakness and even increasing the risk of cancer and other diseases.

On the other hand, adequate levels of vitamin D may protect against colon, prostate and breast cancer and one study of 50,000 men at the Harvard School of Public Health suggests that higher vitamin D levels lower the risk of all cancers by at least 30%.

So Who Knew About Falls and Vitamin D?

The role of vitamin D in preventing falls is astonishing. In a randomized controlled trial---which is the kind good scientists do---nursing home residents who were given 800 IU of vitamin D per day plus calcium had a 72% reduction in the risk of falls compared with the placebo group in a study that lasted five months. Well, it makes sense. If the lack of vitamin D can lead to weak muscles, adequate levels could mean a stronger, steadier person.

Lack of vitamin D has also been linked to type 1 diabetes, multiple sclerosis, hypertension and cardiovascular disease. If you want to know more, a very thorough article about vitamin D deficiency appears in The New England Journal of Medicine, July 19, 2007, by Michael Holick, M.D., Ph.D. and them’s no creds to sneeze at.

How to Get Vitamin D

First, think sun. Yes, we’ve been told to fear the sun because of skin cancer, but now, other doctors who are not dermatologists are arguing we need to arrive at a more balanced view of sun exposure. What the medical community is trying decipher: how to get vitamin D levels up to where they should be at the same time protecting our skin. Dr. Holick has this recommendation: “Exposure of arms and legs for 5 to 30 minutes (depending on time of day, season, latitude, and skin pigmentation) between 10 a.m. and 3 p.m, twice a week”---which any of us could do by putting on shorts and a tee shirt to take the dog for a walk.

Dermatologists, long enemies of the sun, but now aware of the benefits of vitamin D, are still recommending only vitamin supplementation and food sources such as salmon and cod liver oil. When it comes to taking vitamins, the current official recommendation is not over 600 IU’s a day, but that may be changing to 800 IU a day. Stay tuned to the debate, for the issue will be taken up by the USDA as more and more science comes in about the benefits of vitamin D and the bad things that happen when we don’t have enough.

And we thought we were home-free if we didn’t have rickets.

Words for the Wise

A quick footnote: low vitamin D and calcium levels lead to soft bones and that in turn can lead to bone pain. To quote Dr. Holick: “One study showed that 93% of persons 10 to 65 years of age who were admitted to a hospital emergency department with muscle aches and bone pain and who had a wide variety of diagnoses, including fibromyalgia, chronic fatigue syndrome, and depression, were deficient in vitamin D”.

Watching the Watchers: Checking on the FDA

You spend the first 50 years of your life learning what’s true and the next 50 unlearning what you learned in the first 50. Before I hit the half-century mark, I used to think that was a cynical take on life---but now, teetering on the brink of geezerhood---I think it may be true.

            Let me count the ways I’ve gone into reverse: I was taught that virtue was always rewarded, that nothing bad happened to good people, and that you could trust expert opinion—after all, they were the experts and you were the intellectual peon.

            And the last idea---the one about experts always being right---is what I am unlearning so rapidly that my old brain cells are shedding on the rugs. There’s a discarded opinion hanging from the back of the sofa and another on the counter in the bathroon---old opinions in the garbage and some in front of the house in a box marked “Free.”

The Medical Opinion See-Saw

            Frankly, it’s the researchers in the medical field who get on my nerves. They reverse the “truth” far too often. What we used to count on, we can’t count on any more. For how many years were we women told to take estrogen? We were all full-figured wenches in those days. Now, it’s: Don’t take estrogen. Nasty stuff.

            Oh. OK.

And so we said goodbye to our C cups.

            And there are the other pills that went from the medicine chest to the garbage can when they were withdrawn from the market. Our landfills are littered with discarded medicine bottles and 20 years from now there’ll probably be Vioxx in the ground water.

The Latest Reversal

This month one of the main “truths” about medical approaches to diabetes took a dive. The headline? “Diabetes Study Partially Halted After Deaths.” Why? An intensive effort to lower blood sugar---once thought to be a ticket to better health---actually resulted in more deaths.

“It’s confusing and disturbing that this happened. For 50 years we’ve talked about getting blood sugar very low” said Dr. James Dove, the president of the American College of Cardiology.

You said it, doc.

Not Just Me

            Lest you think it’s just this columnist who is cranky about the pharmaceutical research trends in the USA, a 2007 Consumer’s Report on the FDA and the pharmaceutical industry said that 9 out of 10 Americans want reform in this area. They want warning labels, follow-up safety studies for already released drugs and public disclosure of all clinical trials, not just the ones that make a drug look good.

I think the people---not the experts---are on to something here. With these reforms in place, with full, honest and complete information, maybe the number of medical reversals would go down. The data would be more solid from the start.

            If you want to know more, read The Truth About Drug Companies: How They Deceive Us and What To Do About It by Marcia Angell, M.D., former editor-in-chief of The New England Journal of Medicine. 

Words for the Wise

To keep yourself healthy, find good information at www.worstpills.org and at www.citizen.org. Click on Health Research Group.

If you are diabetic, talk to your own doc about the recent news from the diabetic study and what it may mean to your treatment.

Now I don’t mean to condemn all drugs, researchers or drug companies. Who has not been helped by this industry? Think immunizations, the advent of polio shots, the antibiotics that got your fever down. But there is current skullduggery in this corporate sector and it should be addressed.

One thing to focus on: As Dr. Angell notes, drug companies now pay the FDA to review each submitted drug, about a half-million dollars for each drug and in total, a “substantial part of the FDA budget.”

Well, here’s one truth hasn’t changed in over 50 years: He who pays the piper calls the tune and if we don’t like these tunes, we taxpayers better step up to hire the piper ourselves.

                        

Mel Walsh is a gerontologist and certifiable geezer. Her book of advice for older women, Hot Granny, is available at The Bookseller in Grass Valley and online at Amazon and Barnes & Noble.

   

It Doesn't Take Much to Keep Rocking and Rolling

Keep It Simple Stupid---that’s the mantra abbreviated as KISS and the older I grow and the less time I have in front of me---the more that acronym makes sense. I may have it tattooed on the back of my hands so I can see it every day. Maybe then I would make better choices---good choices that save time, money, stress and sanity.

Well, while cruising the Internet to find interesting bits for you this week, I found a research study just out from Japan that can help simplify your life and mine. This study in the International Journal of Sports Medicine turned up results suggesting that older people can benefit in stamina, vitality and general health, not by becoming Jack LaLanne or Jane Fonda, but by doing just a bit of exercise every week.  And I mean just a bit.

The researchers at Nara Medical School tested whether a simple short at-home program could boost the fitness of older adults. The 200 adults were assigned randomly to an exercise group and a control group. The exercisers were told to walk aerobically for at least 20 minutes twice a week and to increase the number of steps they walked daily. They were also asked to attend an exercise class just once a month. The study went on for 32 weeks and the benefits to the exercisers were “comparable to those seen with a standard supervised exercise program.” The exercisers reported improvements in mental and physical health and in vitality. They also tested as being more fit than the controls.

I take this study to mean we can get good fitness results if we just fast-walk the dog, trot our lard bottoms outside to see the weather up close and personal and also roam round the house and yard for oxygen breaks. All simple stuff. Check out the study by googling: at-home walking regimen boosts fitness.

Moving and Grooving Despite Arthritis

Now, on a related subject, it has come to my attention that some of us may have arthritis. Actually, 46 million Americans have arthritis. If you listen hard, you can hear us scraping our geezer bones together. We don’t so much rock and roll now as rock and creak.

But there is a simple thing we can do to improve the pain, increase mobility and strength. (Am I the only one who can no longer open the pretzel bag on an airplane? Or who has trouble hoisting a carryon into the overhead compartment?) And that simple thing is---you guessed it---exercise.

Now there is a fitness program available across the nation called PACE, People With Arthritis Can Exercise. It was recently evaluated to see what really happened to people enrolled in the program. Did they improve or was it all just another health hoax?

They improved. They reported less pain and fatigue and also increased confidence in their ability to handle their arthritis. (That improved mental attitude is surely better than giving up and just passively letting the disease have its way with you.)

In sum, the lead researcher, Dr. Leigh Callahan, says that exercisers can “expect improvements in symptoms, self-efficacy for arthritis management and improvements in upper and lower extremity function.” In other words, exercise can keep us rocking and rolling and feeling in charge.

And it’s so simple---so KISS.

For more info, google: more evidence exercise helps arthritis sufferers.

Good Food for Geezers-Our Very Own Food Pyramid

Do you remember the nutritional food pyramid? It’s the drawing you saw in health class, the one that showed what people should eat and how much of it---the one that had no hot fudge sundaes on it.

Well, this month people over seventy get their own official food pyramid and though it doesn’t include hot fudge, I think it is the first food pyramid that doesn’t seem too steep to maneuver or too hard for us humans to try. In fact, this new plan, MyPyramid for Older Adults, makes a lot of sense.

As you can see from the graphic, it is about a healthy life, not just about healthy eating. At the bottom of the pyramid are pictures of older people doing what we should do to keep active: walking, swimming, yard work, etc. Next level up on the pyramid are the eight glasses of fluid we should be putting away every day. Then we get to the fruits and veggies, whole grains, various proteins and a smattering of the good oils. But here’s the difference:

The illustration shows food stored in reclosable freezer bags and small cans for the pantry. In other words, the nutrition scientists have gotten realistic. They finally realize that all older people will not go shopping every day for fresh produce. We use pantry and freezer to make our meals because we may be snow bound, wanting to save on gas or just staying home to watch Oprah or a bass fishing show. It’s then that pantry and freezer come in handy—especially when food products are packaged in reclosable containers, whether those cartons or bags are on the shelf (cereal), in the fridge (cheese) or in the freezer (fruit and veggies.) We then can take out just what’s needed for one or two eaters and save the rest well wrapped for another meal.

Furthermore, reclosable containers reduce waste and save money. So it is greatly to the credit of the scientists from Tufts University---the ones that created this pyramid---that they have their feet on the ground when it comes to meal-making.

Another innovation on the pyramid is a little flag on top to alert older people to the fact that they may need supplements to meet all their nutritional needs. Older people have lower calorie requirements and it can be hard to meet all nutritional requirements when eating less. So the flag reminds us to consider taking calcium plus vitamins D and B12. This is a shift from the usual advice that we don’t need supplements and that healthy eating will take care of all our vitamins and minerals.

More details can be found online by googling: Modified MyPyramid for Older Adults. The article about the pyramid can be found in the January 2008 issue of the Journal of Nutrition.

Me, I’m cutting out this pyramid and putting it on my refrigerator door. And I wish grocery stores would put the pyramid on their shopping carts just to remind us to go for the potatoes, not the potato chips.

A Very Fishy Tale

How long has it been since you kissed a fish?

Never? Well, me neither, but both of us better get started. You kiss the mackerel  and I’ll do the salmon.

But why this demo of affection? Because more and more it looks as if the oils from fish are protective against the disease we all dread---Alzheimer’s Disease, known in the aging biz as AD. (AD, a brain disease, causes memory loss, personality change and in the bitter end, death.) So the good news is that research keeps piling up data indicating oils in fish are protective against AD. And there is no bad news about the fish oil-AD connection---which is why I am kissing the first fish I meet today.

So Why Are Such Important Facts Obscure?

You may not have heard much about fish oils preventing or delaying AD because fish oil is not a patentable drug. Nobody on earth invented fish and so no drug company can claim a patent which would corner the market. With no great financial rewards in sight, no drug company is going to advertise it on TV or spend the money to urge you to ask your doctor if fish is right for you.

What’s more, the fishing industry---the basic purveyor of finny critters and their oils---can’t promote health benefits in the US unless they conduct wildly expensive drug trials to satisfy the FDA. And then, after all the trouble and expense of trials to prove the efficacy of fish oil, they couldn’t patent the product either. So the fish industry is silent too.

But there’s good news: research is still being conducted, often funded by your tax dollars, at the National Institutes of Health and the National Institute for Complementary and Alternative Medicine. Here are some of the facts they have turned up thanks to the money we send them.

The Up-To-The Minute Research

            From the current issue of the Journal of Neuroscience comes the info that the omega-3 fatty acid docosahexaenoic acid (DHA) found in fish oil increases the production of LR11, a protein found at reduced levels in people with AD and “which is known to destroy the plaques associated with the disease”. So low levels of LR11 may be a factor in causing the disease. To me, this means I might go kiss a fish or rather eat it and maybe get some LR11 into my brain.   

Salmon and mackerel seem to be the oily fish most recommended by nutritionists which may give new meaning to the expression “Holy Mackerel’”. Anything that can delay or prevent AD is indeed holy.

Now the results in the journal above were achieved on rats and mice and I was curious to check out the results in the human world. What country eats the most fish? Japan by far---three times as much as North Americans. And what is the incidence of AD in Japan? Half of what it is here.

So while all the answers about AD are not yet known, the above is enough for me to grill up salmon more often---and, as the people at the Monterey Aquarium tell us, to make it wild salmon.

Words for the Wise

            There are many extra added attractions to fish which is why the American Heart Association tells us to eat fish at least twice a week. Some of the latest research focuses on mood. It indicates fish may help elevate mood and fight depression. One study at the University of Pittsburgh School of Medicine found that people with higher levels of omega-3 in their blood were “more agreeable.” 

            I don’t know what you are going to do with this information, but me, I’m going to make a salmon salad sandwich for Cranky Pants.

In Love with Titanium---& Other Inanimate Objects

Let us now praise titanium. And we shall not forget cobalt and chrome alloy. Then, of course, we shall also give thanks to ultra-high molecular weight polyethylene.

For these are the materials that new knees are made of and new knees can mean a new life. Knee replacements typically release people from pain (think bone-on-bone crunching) and from restricted mobility (think limping and cane.) It’s as if patients have had a successful trip to Lourdes without ever getting on a plane. About 95% of patients with a first knee operation have no pain anymore or very little of it.

Now it’s one thing to know the stats, but even more dramatic to see older people saved from a life of limping and too many pain pills. Most cheering of all is watching older people swing dance as they did at a recent local concert featuring the bright beat of Glenn Miller. Yes, some mid-life people took to the dance floor, but they were outnumbered by us swinging geezers. My mate, Cranky Pants, took to the dance floor just 18 days post-op with his new knee. (He has not yet named it, but I am lobbying for the name Fred---as in Astaire.)

OK, so my man didn’t swing me over his head, but he was dancing to celebrate his titanium and polyethylene and maybe even the substance that held the knee together and that would be methacrylate, a bone glue that is well worth dancing about. And I, his partner, a woman who had to go through airports in a wheelchair 10 years ago, was out there dancing with him. My dancing days are not over, but starting again. That’s due to my titanium hips, which get me searched, wanded and patted down at airports now, but a wanding is better than a wheelchair.

The Downside

            You already know there are risks to any surgery---risks associated with anesthesia and blood loss, plus the possibility of blood clots, infection and other bugaboos. But one way to ensure the best possible outcome is to find the most accomplished and experienced joint replacement surgeons. Our surgeon did 11 replacements in that one day.

Another is to do everything you are told to do---everything. Take the anti-clotting meds. Wear the anti-clotting stockings after surgery. This is no time to resist authority. “They” know more than you do.

            Still another way to ensure success is to go to a hospital or ward that specializes in joint replacement. Cranky Pants was at a center that did nothing but joint replacements. The post-op care was highly specialized and knowledgeable. Also, post-op classes and group rehab were done each day so the client and the designated family coach---think designated nagger---could not only meet and greet other patients, they were in a class that educated all there about fast recoveries and post-operative success.

Age seemed no barrier to surgery. In class, we met a 96-year-old woman with a new knee. She was tired of limping around her house and wanted to get out more. Volunteers even provided a buffet meal to encourage everybody to walk the corridors to the lunch room with their brand new replacements. All nice treatment, of course, but it was great to be out of there by the third day having just spent two nights in a hospital setting.

            Pain. Alas, some pain is part of post-op life, especially with knee replacements. As for the op itself, it’s always some form of la-la land, but the trick is to be smart enough to switch over to the post-op pain meds as the anesthesia wears off. So pay attention. Nobody knows your pain level better than you do. Speak up about it. Macho does not work as a pain reliever.

Worry about getting “addicted” to pain meds seems to have subsided in the medical community we encountered and the new thrust is---take what you need to get by without pain. Just be sure you are pain-medicated before those first tentative walks and before beginning those physical therapy exercise sessions.

Rehab

            Every joint replacement procedure has five stages: 1. Worry and pain. 2. More worry and pain. 3. The op itself. 4. The hospital/center stay. 5. Rehab, which means doing all the exercises recommended, overseen by a home-visiting therapist and later, by an out-patient therapist. If you don’t do these, you may not get sufficient range of motion in the new joint. So move it.

Words to the Wise

            Read more about knee and hip replacements at www.johntdearbornmd.com. Click on Patient Education and Research to get your questions answered and to find out more about less invasive surgery and the Washington Center for Joint Replacement. They also offer a good set of links to other sources of information. For specialty centers in your area, google: joint replacement clinic or orthopedic clinic. Also, local hospitals often offer education classes to the public about joint replacement options.

           

Mel Walsh is the author of Hot Granny, now in its second printing and a great girlfriend stocking stuffer for the holidays. Visit Mel at www.melwalsh.com

Confessions of a Geezer Columnist

        When you write a column about aging well or a book about how to be a Hot Granny, people assume you have it all together yourself. They expect…what? Maybe a highly perfected geezer. Well, ha! And double ha.

        The truth is that like everybody else, I struggle with all the areas that us older adults have to pay attention to if we want to live to be old, happy, healthy and useful. To get older life right, both research and common sense tell us we have to stay connected to the world (friends, family, mates), have a mission or purpose (usefulness), have a little fun (morale), have something to look forward to (hope) and ignore the old ideas about age being the end of the road. And, as a base for it all to work, we’ve got to make time in our lives for the habits that will make us healthy and fit oldsters. Because if we can’t move, we can’t dance the dance of life.

My Less Than Perfect Parts

       Well, I do fine with the friends/family/mate part. I have a fairly new husband who signed up for better or worse in 2003. I have 6 kids, 12 grandkids and a few good friends, some of them from 50 years ago. Plus I have a purpose---talking here to you every week. And I have been known to enjoy myself, always setting up something to look forward to. And I surely don’t accept the old negative notions about growing older. So at least I have aimed my imperfect self in the right direction.

        No, it’s the fit part that gives me fits. You, too?  Is physical fitness a lifelong issue? Me, I was someone who always managed to get an excuse from gym. (Just how many times a month can a girl have cramps? I set the Guinness Book of Records there.)              

       So that’s one place that’s always been a challenge---getting off my bottom five times a week to move briskly for at least a half an hour. Well, going to a gym helps a lot. Having a friend who will kick you if you don’t go is even better. So those are my current solutions to the fit part, but there is one more personal obstacle to healthy aging and that is measured in pounds---many pounds---most of them on me.

.

The Universal Struggle

          So weight is my challenge now. I see my future and it looks like Obesity City for me by 80, if I live that long with my fat parts dragging me down and out. Yeah, yeah, I was normal weight too until I hit 60. But the metabolism slows down so much as you grow older, it takes a month to digest a candy bar.

However, I have found help by reading dear Dr. Gott, he who appears regularly in this paper to tell you how to cure your night cramps and your nail fungus. Well, Dr. Gott also has ideas about how to take weight off and keep it off. Very simple: No sugar, no flour. Just two things to remember and it works. Lost one dress size so far.

          Ok, it’s a little tricky this no sugar thing because food manufacturers are always adding some form of sugar---fructose, for instance---to almost every food, even cottage cheese. Markets are full of products that have added sugar, so read the labels.

          And the no flour part can be tricky too, because the doc says to look for whole grains, not just whole wheat flour. Which means, if you are serious about being Gott-ified, there will be loaves of Ezekiel bread in your freezer. (It’s a specialty bread, but is now carried in mainstream stores.)

Words for the Wise

            To learn more about Dr. Gott’s weight loss program, read for Dr. Gott’s No Flour, No Sugar Diet. Another book that gets good reviews on Amazon is Get the Sugar Out: 501 Simple Ways to Cut Sugar Out of Any Diet, by Ann Gittleman.

            And maybe by spring we’ll both be shadows of our former selves.

            

Gravity: Take It or Take It

            Gravity is one of those things you don’t notice until you fall on your face. Or on your whatever. A fall---gravity gone bad---can be especially dangerous for older adults. Think ER dangerous---with head injuries and fractured hips. And know that about one-third of older adults will fall this year. Bottom line, seniors capsize at an alarming rate.

Now my readers write and testify what gravity has done to them---backward falls over pets, painful glissades on ice, airlifts home from vacations where they were looking up at the sights instead of down at the curb. And they want me to tell you what to watch out for. First on their list? It’s….

Vacations. Love those castle steps and cobblestone streets---all the quaint elements that satisfy our hunger for interesting visuals. On vacation, we are lookie-loos---tourist gawkers all---and no wonder because our vision is stale from seeing too many mall parking lots. So we look up at the parapets and don’t see the step. Or we look down at the steps and don’t see the low stone arch leading to the dungeon. Also, when on vacation, we take the sightseeing boat in bad weather and the waves buck us onto the deck because we weren’t holding on. Or, at the hotel, with no room lights on at night, we stumble over a suitcase on the way to the little room at 2 A.M. Bottom line: Get your travel radar going and visually take in your surroundings. Pack some caution along with your melatonin. Throw in a nightlight, too.

            

            Gardens, Patios and Porches. Maybe it’s the change in levels or the steppingstone not securely set on the garden walk, but gardens are connected to the fall of man in a way that isn’t biblical. Statistically, men tend to fall in gardens more than women and maybe it’s because they usually are the high hedge pruners and the gutter cleaners, but something else may be at work. My observation is that some older men refuse to admit these chores are risky and they keep on keeping on even after bad falls. But macho men with silver hair might consider this: Is taming the wisteria worth a trip to the ER?

Dark Places. Older people can’t see as well in the dark and it takes our eyes longer to adjust to unlit spaces. A dark theater aisle will trip us up when an umbrella sticks out in the aisle. That’s why a tiny flashlight on a key chain helps avoid falls. You can carry your own light all the time and then, voila---you can also read the menus in dark restaurants.

Pets. Cats weave in and out between ankles. Dogs jump up on people and knock them over. So pets are one way to meet gravity head-on or maybe, bottom up. Moral: watch out for your pets. Also, when it comes to animals, I know too many older people who have fallen from horses. They broke ribs, punctured lungs and fractured collar bones. Even strong and experienced older folks are sent to heaven by their horses. William the Conquerer was one of them. So retirement may be a time to abandon the Black Beauty dreams and take up something on the ground instead. Mud wrestling might be safer than horses.

Words to the Wise

Of course, we should have pets, travel, garden and go to theaters---that’s what retirement is for. We don’t want to go through life as Nervous Nellies. So consider the advice of my friend Gail, The Astronomy Major, she who took a huge header off her porch. She was looking at the stars and ending up seeing them--unconscious. She hasn’t given up on the heavens, but says the answer is mindfulness. When in motion, be mindful. Think about what you are going to do and think about what you are doing.

The best fall prevention gadget sits between our ears.

Seeing Things When You Can't See

            Hallucinations and intriguing visions. No magic mushrooms required.

That’s what aging Boomers have to look forward to---but only if their eyesight falters in their later years. And therein lies a strange but true tale where normal undrugged people may get to see monkeys on the sidewalk or lions in the yard or people in a treetop---each vision a “sight” that isn’t really there.

These visual illusions are “seen” by sane people---usually older adults---who have lost some or most of their sight. Called the Charles Bonnet Syndrome after the 18^th century naturalist who first described it, such phantom sights are fairly common in people with low vision. Estimates range from 10 to 40 percent of that group and---this is just a guess---the incidence may be higher because people would hesitate to ‘fess up about phantom visions for fear of being thought “crazy”.

What is crazy is that something relatively common is relatively unknown. And the obscurity of this syndrome may mean that many with Charles Bonnet Syndrome (CBS) suffer in silence and ignorance. In one study of people with CBS, 78% admitted that they didn’t tell their doctors about the phantom visions. No wonder. Some doctors mistake it for mental illness or they tell their patients not to talk about such silly things.

No one yet knows why these phantom visions happen to people with deteriorated eyesight, but some feel that when the brain is deprived of stimuli from the eyes, it’s starved for visual information and so makes up images. Others speculate it’s akin to the phantom feelings that amputees have---sensations that the leg or arm is still there.

Phantom Vision 101

Here’s more info to pass on to older people with eyesight troubles. (Imagine their relief if they are having hallucinations and don’t know the cause of their visual acrobatics.)

What happens: In one study reported in The Lancet, the respected UK medical journal, older people with low vision reported “seeing” a wide variety of phantom images. Unlike people who are delusional, most of these people knew immediately that the visions were not real.

The visions would occur daily, weekly or monthly and would be of people, animals or objects, mostly of things never seen before by the person reporting. Some of the visions looked very real, others less clear. Most were in color, but some in black and white. Most occurred with the eyes open and under poor lighting conditions. Looking away, putting on a bright light or moving the eyes swiftly could sometimes stop the phantom image.

About a third of the people with CBS in this study did not like the experience at all.  Some were anxious---no wonder---and irritated. And others were amused. Most reported that their general feelings of well-being were not disturbed by the visions, a fact I would find hard to believe if it weren’t for my friend who tells me about his phantom visions as they happen. He seems to enjoy them, but then, he knew about the phantom vision phenomenon, learning about it at a community low vision center.

Boomers and Bonnet

            When aging Boomers come up on eyesight problems, maybe they will take Bonnet Syndrome in stride if and when it comes down to phantom visions. A generation used to LSD and psychedelics might enjoy a series of visions, though those who have had them do not report oceanic insights or finally knowing what the universe is all about. So maybe it’s best not to plan to finally get “it”---whatever it is. I figure if you didn’t get the meaning of the universe in the 60’s with Timothy Leary, you are not going to get it in your 70’s with Charles Bonnet.

Words to the Wise

            Please share information about phantom visions with any person who has suffered loss of sight. It would be a gift to someone already burdened with macular degeneration or glaucoma to know these visions are sometimes par for the course. Get more info online by searching Charles Bonnet Syndrome.

Take This Column Lying Down

Someday your prince will come.

Right. In Cinderella’s dreams. Well, I often saw evidence that his horse was here, but no sign of the prince.

However, a prince actually did come riding into in my life just last week and his name is Dimitrios Trichopoulos. He lives, not in a palace but at the Harvard School of Public Health. He is the expert who says that something I’ve felt guilty about for 45 years is good for me.

Yes, not only good, but I should keep doing it and maybe invite others to join me.

So consider this an invitation to---are you ready?---to take a nap. According to Dr.Trichopoulos, napping seems to prevent death from heart disease. He and his public health colleagues in Greece looked at almost 24,000 Greek citizens and found a strong link between health and regular napping. In fact, for some people, napping was a matter of life and death.

The results of the six-year study indicated that people who were regular nappers---at least three times a week for 30 minutes a time---were 37% less likely to die of a heart attack than non-nappers. The association was particularly striking in working men.

On the other hand, the researchers could conclude nothing meaningful about women because not enough of them died during the study to make their fates statistically significant. (That’s women for you. We’re really Mack trucks in drag.) Still, I intend to keep on napping, as I feel it is not only good for me, but necessary. I must be part cat-----they who are such accomplished nappers and I figure there must be others like me, hidden away after lunch, on couches or in desk chairs or even toes up in bed, getting 40 winks or more, before they start the afternoon.

A Napper’s Reward

You who nap know the glories of after-lunch shut-eye. Napping is like re-booting the computer after the software gets all tangled up. Turn off the computer and such problems often solve themselves. And so it is with people. Turn them off with a nap and they straighten out and come back to the world with their operating systems restored. Shakespeare knew this 400 years ago. He called sleep “Nature’s sweet restorer”. And so it is.

Napping and Older Adults

            In the retirement years, confirmed nappers no longer have to sneak naps in the workplace. No, in retirement, undercover nappers can come out of the closet and enjoy a rich array of snoozing opportunities. Things haven’t been so good in one’s personal napping world since nursery school. So, yes, older adults can finally nap without criticism from a boss. That’s unless they have a non-napping mate, in which case, save this article and show it to your honey-bun---the one who thinks napping is a bad habit.

But it’s not. Medically-encouraged daytime snoring is reality at last. And if your mate does not want you to “waste the day” napping, tell him or her to go to---well---to go to Greece and see the people there, napping under olive trees, lowering their stress levels, saving their hearts and lives.

Having The Last Laugh

            Our work-obsessed culture has made fun of siesta-seeking Mediterranean snoozers---slacking off in the middle of the day and so forth---but who has the last giggle? An almost 40% reduction in “coronary mortality”---fatal heart attacks----is not only significant in a positive way, it is a result achieved without a visit to a doctor, without an expensive prescription or a bad side effect. Napping is a procedure that does not have to be insured, approved by an HMO or paid for by shorting the grocery budget.

Snooze, you win---it’s the new mantra.

Now I think I’ll take that nap. But not before I thank Prince Dimitrios who is probably catching a few zzzz’s in his office chair—knocking off for a while from the Herculean task of trying to get the rest of the world into bed.

The Swami Knows Your Future

             Pass me the turban. Today I am a swami. I can read your health future, m’dear. In my crystal ball I see---well, I’m not sure I should tell you what I see---it’s not good---but since I am a seer, I know you can prevent this fate.

What fate? A fall. A bad fall. One that can send you with sirens and flashing lights to the ER. Now don’t yes-but me. The stats are on the swami’s side: If you are an older adult, one out of three of you will fall this year. It will hurt, be expensive and possible dangerous. Actually, you could die.

            Dying ruins your whole day. Even “just” a bad fall can lead to major disability---to a state that all of us older people fear: The Dependent Life. That’s the one where your children and an evil caregiver call all the shots and give you some too.

Also---I hate to tell you this---falls can lead to life of pain. Think fractured hip or pelvis or spine. Think major brain trauma.

And now I will lay off. You get the picture.

The Skinny About Falls

My info source is really the Center for Disease Control and they count our falls and know what happens after. Here’s what the CDC says:

·                    About 1.8 million people 65 and older were treated in an ER for nonfatal injuries from falls. Almost 14,000 of them are no longer with us.

·                    Among older adults, falls are the leading cause of injury deaths.

·                    In 2000, the direct medical cost of non-fatal falls was $19 billion.

There are probably more enjoyable ways to spend our Medicare dollars---maybe colonoscopies for all. (OK, maybe not.)

Keeping Out of Trouble

            Bad falling fates can be avoided by paying attention to four simple things:

·                    Your house. If you are choosing a retirement home, go for one floor. If you already have steps, use a handrail and have lights at the top and bottom of the stairs. Put a non-skid mat in the tub or shower. Get tub handrails which now come in upscale bronze. Put in nightlights and motion sensitive lights. Keep your home pathways clear of clothes, shoes, cords and loose rugs. Watch for small pets. Wear shoes that won’t slide off. Even check your pants. We get shorter with age which means pant legs get longer. I’ve seen feet get tangled up in pants.

·                    Your eyes. If you have lousy vision or won’t go your eyes checked because Medicare doesn’t cover it, save up and see right. You’ll trip over what you can’t see. Cataract surgery is a breeze if that’s what you need. And watch the bi-focals when looking down at steps. It can be tricky to see depth accurately through the lower part of a bi-focal as you are using a reading lens to judge something way beyond reading distance---your toes.

·                    Your medications. Meds can make you dizzy, sleepy, unsteady---an end-of-the-rock concert mode. So first ask your doc to review all meds and see which ones might be eliminated. Than make sure you are taking the right dose. Last, don’t drive your John Deere lawn tractor when on heavy meds.

·                    Your physical state. If you are used to exercise, you will have better balance. Look to tai chi, dancing, even walking. They all contribute to better balance so that if you begin to fall, you can right yourself before the tipping point.

Words for the Wise        

            There are good people out there whose mission is to keep older folks upright. You can meet them on the Internet. Go to www.stopfalls.org and get a few more lessons in staying out of the ER. And to see what else the Center for Disease Control has to say, go to www.cdc.gov and type adult falls into the search box.

            OK, for me, it’s turban off and crystal ball back on the shelf. Your fortune is now in your hands.

And feet.

            

Stroke of Luck

There is a time to be a geezer rebel—I love those naughty days---but also a time to do what we’re told. Dealing with a loved one who is having a stroke or having one yourself—these are times to follow doctor’s orders.

The prescription is simple: Get to the ER. 

Knowing stroke symptoms and then dialing 911 for the men in the little white truck may save us from disaster. That’s what medical authorities unanimously tell us to do because fast treatment of stroke---within three hours-- makes all the difference in medical outcome---no if’s, and’s or but’s.

If you value your life or care about the welfare of a loved one---you need to learn the symptoms of stroke. Here they are: sudden numbness, weakness or tingling on one side; difficulty speaking or writing; slurred speech; impaired vision; and difficulty walking. To make things simple, cardiologists have devised three questions to be asked of someone who may be having a stroke:

1.      Can you raise your arms and keep them up?

2.      Can you speak a simple sentence?

3.      Can you smile?

I remember these questions with the dubious acronym of ASS---Arms, Speaking, Smiling---but that’s just me. I figure it’s better to remember any way I can than to be a donkey and not know. 

            The range of symptoms connected to a stroke---the disruption of motion, speech, sensation and vision---are due to a malfunction of the body’s Mission Control, the brain. In fact, it makes sense to think of a stroke as a brain attack----like a heart attack, but between your ears.

There are two kinds of brain attacks, a block or a break. With a block, a clot clogs a vessel, cutting off the oxygen that brains need to function right. About 80% of all strokes involve a block. But with a break, a vessel tears and bleeds. If you collect medical terms, the block attack is called an ischemic stroke and the break attack is called a hemorrhagic stroke. Between them, they are the third leading cause of memorial services, right after heart disease and cancer.

As for treatment, tPA (tissue plasminogen activator) is the only FDA-approved treatment for ischemic stroke. With tPA, there is a magic window of three hours in which the docs can deliver the medication to the patient with good results. After that time window, damage has been done and it’s too late to get the best outcome.

Since stroke is the leading cause of serious, long-term disability in the US, we need to deal with it well if it happens, which means getting medical help fast. But first, here’s how to deal with it like a dumb cluck:

Call your daughter and wait an hour for her to come over to see what she thinks. Or call a neighbor and sit it out together. Drive yourself to the hospital and wait quietly in the waiting room.

But smart people call 911. Pronto. Just don’t be like the guy who wasted time on the phone asking the information operator for the number of 911.

Words for the Wise… Much good information about stroke, recovery, caregiving and clinical trials is available at the Internet Stroke Center, www.strokecenter.org. They also post the latest stroke news from around the world and link readers to important reports from professional meetings. 

Another source is the American Stroke Association, www.strokeassociation.com. They offer online discussion groups as well as a chance to do consumer advocacy and fundraising for the cause. Then there’s the National Stroke Association, www.stroke.org, offering access to support groups as well as a free subscription to their magazine, Stroke Smart.

You may not want to know all about stroke—it’s easier always to evade information like this----but if you need information, these organizations are a stroke of luck.

And last, here’s a pop quiz. What was that acronym and what did it stand for?

                        

Truth Under The Stethoscope

            Cross your heart---do you tell little lies to your doctor? Or do you keep quiet when you should speak up? Did you ever have a pain in your right side, but figured if you told the doc, you would need surgery, so you kept quiet and hoped for the world’s first self-healing appendicitis?

Or, like me, do you look up the side effects of a newly prescribed pill---the Internet is the first stop-off point for us hypochondriacs---and then decide that the cure may be worse than the disease?  So then no pill is taken, which brings up the next problem: Do we confess our non-compliance at the next visit? 

Fibber Nation

In WebMD’s survey of 1500 people, 38% of the people admitted to lying about following their doctor’s orders, 32% lied about diet and exercise, 22% lied about smoking, 17% lied about sex, and 16% lied about alcohol use.

So why is it so hard to tell the truth in the examining room? Several reasons: What if people told the doc they sought a second opinion? What if the doc knew they weren’t medically monogamous? People don’t want to hurt their doctor’s feelings. And what if something embarrassing appeared on their medical records and the insurance company found out about it? Or what if  “authorities” learned they’ve smoked pot for the last 20 years?

Still Another Reason: Fear of Firing

Patients also lie because they afraid the doc will fire them. They imagine scenes where the doctor says: “You won’t do anything I suggest. You are suspicious of pills, shots, surgeries, blood drawings and the magazines in my waiting room and I’m not going to take it anymore.”

In a time of doctor shortages, getting fired by a medical practitioner looms as something serious. That’s especially true if you don’t live near an urgent care place---a doc-in-the-box who will see you pronto. So people fib to stay on their doctor’s good side. In their view, truth is a medical elective.

A Root Cause of Non-Communication

Basically, there isn’t time in today’s harried medical practice to build the trust necessary to tell hard truths. Almost gone are the old family practitioners---the people who delivered the babies and presided over the last breath. They saw you in and saw you out. Now they see you for 15 minutes.

Today, an older person has brief encounters with a series of doctors: the cataract doc, the arthritis specialist, the heart person, the colonscopist, the sawbones sticking in the new hip and the mysterious person behind the screen taking the mammary pics. Sure, we benefit from the specialized knowledge of these experts, but we’ve lost continuity---the basis for friendship and trust.

It is hard to build a relationship with a fleet of short-timers, the doctors you hear outside the door of the examining room, riffling through your chart, trying to remember you and your prostate. This doesn’t feel like a one on one situation. More like one on no one, the no one being you shivering in your little shortie exam gown. And you are now going to tell that doc the most embarrassing parts of your medical self? Hard to do, but maybe medically self-defeating to hold back, which is something to consider as you think about the quality and results of your medical care.

Words for the Wise…

            Here are three solutions for finding a trusted doctor who might actually get to know you, warts and all: 1. Look for an internist or a family practitioner, a go-to-person for basic medical needs and the source of referrals to experts. 2. Try to find a geriatrician who specializes in the care of older adults. 3. Investigate concierge care. That’s when a doctor with a large patient load pares down that number and for extra fees---above and beyond insurance payments---offers more immediate appointments and closer personal attention.

Concierge care---what would Dr. Kildare think?

                         

Rx: A Glass of Wine

Like you, I want a long life, so pass me a glass of wine. Or two. But no more.

Researchers recently summarized the major work done on the subject of wine drinking, health and longevity. In all, they analyzed thirty-four studies involving over a million people, so these were impressive conclusions, not some will-of-the-wisp study involving the wine-drinking lives of eighteen tipplers from Nothingbury.         

The pooled data published in the Archives of Internal Medicine show that drinking a moderate amount of alcohol “reduces the risk of death from any cause by roughly 18%.” For women, the benefits occur when they drink up to two glasses a day. For men the benefits happen when they drink up to four glasses a day.

But and however, amounts of alcohol over those limits will radically increase the risk of death. The liver can take only so much zinfandel. And certain types of cancer are related to large amounts of alcohol. So moderation is key here. Major partying does not go with silver hair. Sorry. You should have done that back in school when the human nitwit index was at its highest. Now it’s too late.

When All Bets Are Off

            Of course, if your body can’t handle alcohol or you’ve had trouble in the past with behaviors leading to AA, then don’t begin with the chardonnay in the hope of living longer.  And dinner out on the town with four glasses of wine is not the time to start your health regime of a daily dose of vino. DUI’s will lead to jail, not to health nirvana. But you knew that.

            What people sometimes don’t know is that the older you get, the harder it is to metabolize alcohol. Over the years, I have become an easily addled person indeed, for a half-glass of wine on an empty stomach can go to my brain in under three minutes. There she blows---Mel with her shot-glass of chardonnay.

            Don’t laugh. If you are over 50, check out your own current responses to alcohol. I can’t prove it, but I think many in their older years could pass a breath test and yet still be too impaired to drive at their best. Add in impaired night vision---can you see the man dressed in black on the black bike?--- and driving may not be the best idea after dosing oneself with even legal levels of the healthful fermented grape.

The Right Way To Do It

            Turns out the same researchers also say there is a right way to drink your wine. They are from Italy and they should know. Chugalugging is not their preferred method. No, small amounts, preferably at meals, is what they suggest. Giovanni de Gaetano, one of the authors of the study, tells us that “wine is the ideal partner for a dinner or lunch, but that’s all: the rest of the day must be absolutely alcohol-free.”

           So much for the Happy Hour.

            Dr. Gaetano also tells us: “The message carried by scientific studies like ours is simple. Alcohol can be a respectful guest on our table, but it is good just when it goes with a healthy lifestyle, where moderation leads us to a consumption inspired by quality, not by quantity.”

            And if that isn’t an excuse to go out and buy a good bottle of wine, I don’t know what is. So pick me up a 2002 d’Yquem while you’re out.

Words for the Wise…

            Some readers can remember back just fifty years ago when nobody but priests and people from the Old Country drank wine. But we live now in the days of wine plenty---many selections from all kinds of outlets. Of course, the easiest thing to do is find a good local merchant. But, if you have an adventurous palate and want to go beyond the beyond, look up K & L Wine Merchants, www.klwines.com. They deliver to your front door. What you do after that is up to you.

###

Copyright © Maryellen Walsh 2007

The Coziness Concierge

            Winter—it’s the time of year when sunset comes right after lunch, when a sharp rise in global yukkiness means storms, dark days and long faces. Which gets us to the subject of fixing the blues inside the house when the weather outside is white.

It can be hard keep up the spirits in winter. We older adults often live alone which can pre-dispose us to the blues virus---you know, those pre-spring, cabin-fever, I-want-to-live-at-the-equator blues.

So what to do to keep the mood light in winter? Ask your personal coziness concierge---me. Or ask anybody who has, for decades, tried to modify the family’s moods when the weather outside is frightful.

Doing the Heavy Mood Lifting

 Here are proven ways to keep things cozy and bright.

 Light: That’s what you don’t have now. So make it yourself. Keep some energy-saving bulbs lit during the darkest days. See if the light therapy lamps and bulbs advertised as mood enhancers work for you. Try candlelight---even at breakfast. If it makes you happy, why not? Last---this always works---get outside. That’s where the sun is.

Bottom line here is that light is about as effective as anti-depressants in improving mood, so say Dr. Robert Golden and colleagues. Curious? Look it up in the American Journal of Psychiatry, April 2005.

Music: It’s the sound of silence in the house that can get you down in winter. So cheer the air. Put on your favorite CD’s. Listen to good music at night. Research shows you’ll sleep better with a bedtime dose of tunes that relax.

Company:  Have a video night at home with movie buff friends or a TV hockey night with people who love pucks. Consider a pet. They are almost always in a catchable good mood. Golden retrievers are on their own perpetual Zoloft trip.

Revive Your Interests: Knit, design a garden, read old novels, learn to make puff pastry, take up the guitar, do art---whatever lights your fire. Our ancestors whiled away their farmhouse winters with indoor pastimes. We can too.

Comfort Food: Hot chocolate will not cure everything, but a dose with a marshmallow on top goes a long way as a mood modifier at dark o’clock. Also explore the kitchen anti-depressant known as soup. There are now wonderful veggie soups that come in boxes needing no refrigeration, ready on the shelf to fix a downer day.

Warmth: You can’t be happy if you’re cold. It’s why igloos are not known as party pads. Well, by our time of life we should know enough to put on a sweater to keep warm. Right? But sometimes we need to be reminded to…

Wear long underwear, top and bottom. (This is a New England girl talking to you. We Yankees know two things---maple syrup and how to stay warm.) Ski undies are widely available and even come in dainty pointelle patterns for us ladies. Also, wear layers--- turtleneck, sweater, jacket. And consider a hat. Bare heads lose body heat.

Be nice to your feet. If your feet are frigid, the rest of you will know it. Besides, feet go everywhere you go and it’s only fair to take care of them. Wear heavy socks. Get lined waterproof boots if you are going out into weather.

So, light the lights and put on the tunes and please keep your bumbershay warm. Cozy up and imagine yourself wrapped up in warm angel wings—or maybe just wrapped up in a warm angel—your choice.

But Seriously…if you suspect you have seasonal affective disorder, the persistent wintertime blues known as SAD, or you are continuously depressed no matter what the season, talk with a physician. Learn more from the National Institute of Mental Health: http://www.nimh.nih.gov/healthinformation/depressionmenu.cfm. There’s information about symptoms, treatment, publications, research, clinical trials, crisis management and helping organizations. Or call NIMH toll-free at 1-866-615-6464.