MEL WALSH--LIFE & HEALTH AFTER 60

Kneeophilia: In Love with Titanium

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.

 

 

SABOTAGED BY SWEETENERS? THE DOC WHO THINKS SO

    This morning I got a new best friend. He doesn’t know it, but it’s Dr. Richard Daines, the State Health Commissioner of New York. I read that he is sticking his neck out, an unusual position for a public official, trying to get through a tax on sugary sodas. The proposed tax would presumably discourage the consumption of unhealthy drinks and also---I figured this one out myself---help the strained state treasury.

To understand why Doc Daines has a passion for this issue, you have to answer this question: how well do know your soda? Well, according to the Mayo Clinic, my go-to folks for medical info, if you take 8 teaspoons of sugar and add it to something liquid, you would approximate the sweeteners in a 12-ounce can of soda.  Think deeply on this image. Consider adding 8 teaspoons of sugar to your cup of coffee or tea. You wouldn’t do it, but with a can of soda, the soft drink industry does it for you---130 calories, 8 teaspoons.

Specifically, why does Doc Daines worry?

He and many others think that sugary soft drinks contribute to obesity, one of the imperative national health issues and certainly, for many of us, a private health issue too. The American Heart Association says that women should consume no more than 100 calories a day of added sugar----men, no more than 150 calories a day.

 But guess what we really do? Most Americans get more than 22 teaspoons a day of added sugar. That’s 355 calories and, as the Mayo Clinic report says, this “far exceeds USDA guidelines and the American Heart Association recommendations.” I would add that it takes 3500 excess calories to make a pound of weight gain, so drink a soda a day for ten days and voila, you have your weight gain right there.

Is diet soda an answer?

Well, it’s not a health drink and some studies suggest that drinking more than one soda a day---diet or regular---increases your risk of obesity and related health problems such as diabetes. Me, I’m trying to get off the soda bandwagon altogether. I have switched to---are you ready?---water, the original Garden of Eden beverage. I also drink teas and my own version of orangeade: ½ inch of orange juice in a glass and fill the rest with water. These actions can save on your calorie budget. Ditto for your household budget.

The culture that catches you and yours

We are surrounded with the siren calls and marketing snares of the soft drink industry. Entire aisles of supermarkets are devoted to soft drinks. Fast food places bundle soft drink specials with your burger and fries. Even gas stations are sugar sinkholes---whole walls of them devoted to sugary drinks. And that says nothing about the advertising or the fact that soft drink manufacturers have bought influence into the nutritional centers of universities, the source of many studies that underlie public health recommendations. Just last month the Yale School of Medicine accepted money from PepsiCo to do “nutritional science research”.

Now, if you think this sweet soda stuff isn’t your issue—you don’t drink them----remember, as Doc Daines does, that this is a public health issue, which means, among other things, that the public may end up paying one way or the other for the treatment of fellow citizens who are downing sodas as their mealtime drink, constant drinkholder choice, gas station watering selection and regular “treat”.

If you don’t believe any of this, when you go to the supermarket, notice the relationship between what people have in their carts and what those people look like. Lurk in the soda aisles. I won’t say more. Just try it. To me, that connection is both a warning and an inspiration.

 And if you see Cranky Pants with his cart, tell him this: Put those things back!

 

Sugar and Geezer Spice

    First, let’s do sugar….and take a quick look at the subject of pre-diabetes. Don’t run away now, because you may be pre-diabetic and don’t know it. An estimated 30 percent of Americans are pre-diabetic, which means their blood sugar levels are above normal, but have not yet reached the level of diabetes. Other names for this condition are metabolic syndrome, impaired fasting glucose and impaired glucose tolerance.

Risk factors include being overweight, inactive, over 45 and having high blood pressure. (Man, that describes a lot of us.) Excess fat and inactivity seem especially important as causes. Even inadequate sleep has been linked with the development of pre-diabetes: current recommendations are to make sure you get more than 5.5 hours a night.

Test indications

Your doc may have told you that you’re pre-diabetic if a fasting blood sugar test measured out at 100-125 mg/dL. If you test lower than 100, you’re considered normal, and if 126 or more, you are in blood sugar trouble.

The good news is that you can get those levels down and become post-pre-diabetic and yes, I made that name up, but it describes how you can reverse those bad blood sugar readings.

Getting back to normal

            It’s so simple to say and so hard to do: First, aim for 30 to 60 minutes of moderate activity a day. (The only way I get close to this ideal, other than walking, is to watch TV and dance around at the same time. A hilarious spectacle to be sure, but it works.) Second, if you are overweight, losing just 10 to 20 pounds will make a significant difference in your risk---so say the experts. Third, eat more healthy foods. You know what they are….the green leafies and other members of the plant kingdom, whole grains and lean proteins such as fish, unbreaded and unfried. (Can you say poaching, broiling or grilling?)

            As for treating pre-diabetes, you don’t have to over-worry about access to health care because you always have access to yourself and your own behavior---at least that’s what I tell myself. And here’s my other self-lecture as I look in the mirror:

            Health is the best health insurance.

So that’s pre-diabetes in a nutshell.

And now for something completely different…

The grand opening of The Geezer Dairies

            My job in this column is to write about health, but there’s so much more to say about adult life that I’ve started writing The Geezer Diaries on my blog. There’ll be at least a new column every week. This week there’s one entry about the stages of age and another about birthdays, yours and mine. And those curious about Cranky Pants can at last see him.  So visit when you can. Now would be good. I live at www.melwalsh.com or just google Mel Walsh to get there. The door is always open at The Geezer Diaries.

The Universal Occupation

    

            OK, pop quiz: What occupation might you or someone in your family take up one day? Hint: If you get into this line of work yourself, you are going to be one tired puppy. Plus there’s no pay, lousy hours, usually no training, little support and the benefits are invisible.

            Why do it? It’s probably a case of love given and love returned, for this occupation is caregiver---taking take of someone, usually a family member, who is ill, disabled, frail or otherwise in need of help when it comes to daily life. Your job description may include grocery shopping, cooking, driving, giving meds, handling finances and helping someone eat, shower and dress.

If the person has dementia or a brain injury, the job is harder and full of surprises. I was once taking care of a friend with an injured brain and had to move fast when she started eating the salt shaker on her dinner tray. So the job keeps you on your toes and it can also keep you on your feet. A recent survey in CA indicated caretakers of brain-impaired people put in an 89-hour week.

Help is at hand: Classes for caretakers

Now I know how corny it is to call a group of people angels---but the professional eldercare people who help family caretakers are heavenly critters in my book. This spring Sierra Nevada Home Care and Del Oro Caregiver’s Resource Center are offering seven free Monday classes from April 5 through May 17. It’s an information-dense series---thank goodness---for who of us has taken classes in caregiving?

Some of the subjects: Learning effective communication techniques when dealing with challenging behaviors; understanding brains altered by strokes and dementia; learning about nutrition for the elderly and about dealing with incontinence; becoming familiar with valuable resources for caregivers; getting the skinny on legal and financial planning and health care directives; learning safe transfer techniques, meaning helping frail people get up and down without throwing out your back; and---this one is vital---taking care of yourself. (The idea here: If you don’t have your own oxygen mask on, you can’t help others.)

Details

The seven Monday classes will run from April 5 through May 17, 10 AM to 1 PM, snacks provided. The place: Sierra Nevada Home Care, Brighton Greens Center at 1020 McCourtney Road, Suite A, Grass Valley. Easy to find, lots of parking. Register early as there are only spaces for 15 people. To register, call the Del Oro Caregiver Resource Center at 1-800-635-0220. If respite care is needed for your loved one, let them know when you call. (Note: this series is not for professional caregivers, but for unpaid volunteers doing it on their own.)

What if you can’t go?

            Surf on over to www.caregiver.org, the online home of Family Caregiver Alliance. They are a great resource, offering tips, fact sheets, information about clinical trials, inspiration, personal stories and support groups. Also, call Helpline at 530/273-2273 and ask about local support groups and services.

            As for books, the most read and positively-reviewed caregiving book on Amazon is Elder Rage by Jacqueline Marcell and Rodman Shankle. I haven’t read it, but will read Gail Sheehy’s forthcoming book, Passages in Caregiving: Turning Chaos into Confidence, in the stores May 4^th.

Last words

            I end with a story about my baby-sitting mother-in-law’s experience as a family caregiver when I was in the hospital having my fourth child. After days of caring for my three very young sons---she phoned me in my hospital room with a three-word question:

Where’s the gin? 

Toot, toot, tootsie, hello!

            Today, class, we will consider body parts that nobody talks about, the ones you may be a bit ashamed of, the parts you keep covered most of the time. I’m talking about feet.

            As tires are to a car, so feet are to a body. Without good tires, even the best car isn’t going anywhere. Without good feet, even the best body will have trouble getting around. If you need to walk---who doesn’t?---you need tootsies that work and don’t hurt.

Feet through the ages

            Babies’ feet are so cute, we kiss them. Our moms used to plant loving little kisses on ours. But, over time, feet may not only become unkissable, but worn out, misaligned and just plain painful to use. We end up with feet only a fetishist could love.

Well, blame it on shoes that aren’t the right size. (Feet can change over time and should be measured once a year.)  Or blame it on high heels, pointy-toed shoes, bad genes or aging (which wears out the protective pads at the bottom of the feet). You can even blame the problems on over-zealous shoe salesmen who assure you with the look of an angel that the shoes pinching in the store will stretch out when you get home. That is some stretch—the classic shoe store lie that women may believe if the shoes are “cute”.

And you can’t just blame us women for being a little silly about shoe choices. Men who go gaga over high heels encourage women to end up with shortened leg ligaments and misshapen feet. (It’s our version of Chinese foot-binding and why Cranky Pants should give it up about the allure of stilettos. I wouldn’t wear them for Robert Redford.)

So what to do?

            Get your feet re-measured. (Duh.) Buy shoes that are in the actual shape of your footprint, that feel good in the store. Buy nothing that’s a maybe. Wear new shoes around the house for a while and if they don’t fit, bring them back and try again.

            There are brands favored for comfort: Easy Spirit, Hush Puppies, Teva, Mephisto (especially the All-Rounders), Merrell, SAS, Birkenstock and on the sport shoe front, New Balance and Brooks.  The current style craze is for shoes that rock---literally. Their backs don’t quite hit the floor. Me, I hate the rocker shoes---like walking through an earthquake. On the other hand, CP loves them. Different strokes for different feet but if you want the rockers, bring money.

Now, most comfort shoes can be made even more comfortable with socks that are padded. Thorlo socks started the padded trend and was so successful that other manufacturers came on board. You can always find the basic padded sport sock, but now padded socks come in black dressier versions. (Thorlo socks are worth every penny and last a long time—if your mate doesn’t make off with them.)

Drug store relief

            A visit to the foot care section of the drug store may help with your walking comfort level. Today, there are all kinds of foot gizmos designed to provide relief---from extra padding for the soles to protection for corns and bunions, those lovely bumps that arrive when your feet decide to grow sideways.

Professional help

            As always, if home remedies and well-selected shoes don’t help, get thee to a professional. No, not a pedestrian. The word is podiatrist. A good podiatrist can fit you with special orthotics and help with the problems of misbehaving feet. They may have products that drugstores don’t carry and though they will not go all kissy-kissy over your tootsies the way your mom did, they may keep you on the road.

            And that’s the point---keep on keeping on---passing through the valley of corns and hammertoes and forward into life on the open road. 

When friends are graduating from the planet....

    Sometimes I write about things that are hard to talk about. I do it so 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. 

 

    

How to cut down on your sick days

    Health news has gotten so complicated that when a simple health tip turns up on my computer, I almost can’t believe it. Wow, the fact I see before me is easy to carry out. It works. It doesn’t involve a Senate committee. Readers can use the info the minute they put down the paper. Halleluiah!

So What’s The Deal?

Just two simple things can cut your chances of sick days. First, keep your hands off your face. Second, wash your hands.

Hands-on-your-face is one way bad bugs sneak into the body. I bet you knew this about your nose and your mouth, but did you know it about your eyes? According to Mark Nicas, an environmental health expert at Berkeley, the eyes can be a port of entry for viral infections. Who knew? And those hand-to-face touches account for about one-third of your risk of infection. (Here we are worrying about others infecting us when we are doing a pretty good job of infecting ourselves.)

And can you guess how many times a day you might touch your face? Well, videos of college students at work on their computers tell the story. Researchers counted the touches. The students touched their eyes, noses or lips once every four minutes. (I rubbed my eyes and scratched my nose while just writing those few paragraphs.)

But, wait there’s more news from Bad Bug Land….

Wash Your Hands

OK. You heard it before, but people forget. Studies show clearly that hand washing or cleaning with an alcohol-based sanitizer cuts down sickness. Example: students who lived in a dorm where hand washing was emphasized missed 43 percent fewer days of school than students in a dorm with no hand-washing program. That’s an immense difference.

Another study involved children and the risk of their bringing home bad bugs from school and transmitting them to their families. Half the families were given hand sanitizers plus educational materials and half were left alone as a control group. In families with hand sanitizers, the risk of getting a gastrointestinal illness from a sick child dropped 60% compared with the control families.

Remember This

I hate to bring this up, but it may motivate you: In one city in Britain, researchers found 57 percent of the men sampled had fecal material on their hands. Ugh.

So those signs in public bathrooms are right. Don’t leave the loo without washing your hands. Me, I also wash my hands every time I come in the house from an outing, before handling food and any time the chocolate melts before I can get it in my mouth.

Knock on the heads of some Senators, I am seldom ill with common oddments of bug-based symptoms. So it pays not to washout on washing-up.

But I’m still working on the hands-to-face part. Do they make nose scratchers?

Financial Fumbles: Normal or a Symptom?

            Some of us are not too bright when it comes to money. We have Inflammatory MasterCarditis---the brain disconnected from the credit card balance.

In the US, this can be considered normal financial behavior, but there’s a connection between the brain and the wallet that can detect an abnormal medical condition. Example: A recent study funded by the National Institute on Aging indicates that inability to manage money may an early sign of Alzheimer’s disease (AD).

Looking at financial skill levels, researchers compared a group of people with MCI, the mild cognitive impairment thought to be a precursor of AD, with people who were normal. The skills assessed? Understanding a bank statement, paying bills, balancing a checkbook and counting coins and currency.

Without going into the details of the study---how many subjects, how long it went on and other details that will numb your eyes----the researchers summarized their work this way: “Declining financial skills are detectable in patients with mild cognitive impairment in the year before their conversion to Alzheimer’s disease.” That‘s a statement from Daniel Marson, a professor of neurology, who adds “This indicates that physicians and health care providers need to watch patients with MCI closely for declining financial skills and advise families and caregivers to take steps to avoid negative financial events.”

Easier Said Than Done

Have you ever tried to separate a declining elder from his or her checkbook? It’s like taking away the car keys---our two symbols of independence and we cling to them like bees to honeysuckle. But, when things go awry---when people begin to pay the same bills two or three times or neglect to open the bills, something has to change.

So what can be done? Some people recognize their financial impairment and willingly assign trusted others to take on the money duties such as bill paying and checkbook balancing. Some adult children become co-signers on the checking account. Online banking using an automatic bill-paying setup is another solution. When things get really bad and someone with AD is getting into major financial trouble, an official financial conservatorship can be established.  

How Useful Are Financial Fumbles as an Early Diagnosis?

Some claim they are useful as an alert to watch for boulders in the road ahead. Some claim it’s not useful since there is no cure for AD. Why know the early symptoms if there is no cure, but only a medication such as Aricept which supposedly slows the progression of the disease?

Well, there’s no cure, but early detection and early medication can act as a parachute. It slows the descent.

As usual, it’s our choice how to handle these issues.

Meanwhile, I don’t let anyone see my checkbook. They’d say I’ve had AD since I was 21. 

Your computer is an anti-depressant

            I heard a rumor that you don’t always do what I tell you.

            Well, that’s ok, because I don’t always do what I tell me. But I try and evidently, so do you because something I’ve been harping on for a long time has come to pass: Older adults are going online in record numbers. And what’s more, they are mentally better for it. Less depressed. Feeling more connected to family and friends.

So How Do “They” Know Older Adults Are Online?

            No, it’s not through tracking porny sites. A better way to track Internet use is to monitor the installation of broadband. Pew Research Center, premier tracker of trends, found that in 2008, 50% of Baby Boomer households in the 50-64 age group had broadband. By spring of 2009, that use had jumped to 61%. We are on our way to full coverage.

            An older age group---my team---took an even bigger jump. Only 19% of people over 65 had broadband in May of 2008. Today Pew estimates Internet use by Americans age 65 and over at 42 percent. Way to go.

            Now to convince the other 58%.

Why Bother?

            Because a recent policy paper has proved what we Internet nuts know intuitively: that Internet use can have positive psychological effects.  The paper, released just this month by the Phoenix Center, is titled Internet Use and Depression Among the Elderly. Not a barn burner title, but their findings are important. In the 7000 people studied, the use of broadband reduced depression about 20%. And the authors claim their methods showed clear cause, not just a correlation. (See for yourself at www.phoenix-center.org.)

            Given the billions spent on depression-related health care costs, the financial implications are important. Anti-depressants are the most frequently prescribed meds in the US. Some people pop anti-depressants like candy and it’s expensive candy. Consumer Reports figures the cost ranges from $90 to $200 a month. (Interesting cost comparison: In communities where there is a choice of broadband providers, the average monthly cost of the connection is $38.30.)

But Don’t Stop Taking Your Pills

            If you and your doc have agreed an anti-depressant is for you, of course you shouldn’t stop treatment and take a daily dose of Internet instead. But, if you have been feeling isolated, not in touch in family and friends, think Internet. And if you want to fire off letters to politicians, monitor finances and see what pilots have overshot what city today, think Internet.

            I’ll meet you there. Try www.melwalsh.com.

 

Giving parts of yourself

So I’m cleaning out my swamp of a purse, including a wallet with an outdated driver’s license, organ donor card attached. I threw away the donor card. No one would be interested in someone older than dirt. After all, there must be an expiration date on what I’d have to offer another human in the way of needed parts. I guessed I was probably too rusty and dusty to be useful.

How wrong can a woman be?

Very: A friend told me that her deceased husband, aged 80, made a recent and valuable donation of his tissues to help someone else. It seems, no matter what the age, all kinds of parts can be still useful. Think bones and skin, eyes and organs. It’s the ultimate in recycling and really needed. Over 100,000 people are currently waiting for organs.

So What Keeps People From Giving?

Rumors. Myths. Here’s are some of the unfounded fears: Medical staff will let me die just to harvest my precious parts. I won’t really be dead. They’ll charge my family for it. All these are not true. And even if you have planned a grand open coffin send-off for yourself, you can still have it. The experts know how to make you look pretty.

And of course, when it comes to barriers to donation, there’s the denial factor---I will live forever, the first immortal---and also the ick factor of imagining people doing unpleasant stuff to your precious body.

How to get over these normal responses and get on with a donation? Imagine the people you will help. Think how nice it would be to have part of yourself still living and helping someone else live too.

More Info

Get inspired and informed by visiting these sites: www.organdonor.gov and www.mayoclinic.com. Put “organ donation” into the Mayo search box and you can ease your mind by learning more about the myths and misconceptions.

If you want an easy sign-up as a donor, go to www.donatelifecalifornia.org/register. In minutes you’ll get properly registered with the state, a printable donor card and an easy way to email members of your family to tell them your wishes. If you don’t live in CA, there’s a list of state registries at www.organdonor.gov

Your once and future geezer

           Wonder how you’ll do as an older person? Well, researchers at the University of Chicago can polish your crystal ball. They are doing a study of people aged 57-85---the National Social Life, Heath and Aging Project. They go into people’s homes and ask about health, relationships and sex lives, though how they get honest answers about sexual behavior in face-to-face interviews with a spouse in the next room is a mystery. Their walls must be thicker than mine.

Health Findings: Parfum De Tiger Balm

            In the health department, arthritis is one thing these older adults had in common. In the 75+ group, 62.8 % had arthritis, which explains the sweet smell of Tiger Balm in the morning in the homes of older folks---that and our snappy copper bracelets. Among that same older group, though, only 16.8 % reported a heart attack. Is this good news or have those with heart problems already passed into the Great Beyond, beyond the questions of researchers?

 Is a mystery.

            Statistically, hypertension may also be in your future in that 60% of the same older group—75 to 85—have high blood pressure, which may be related to the fact that 55.2 % of them are also obese. And the younger group is even more rotund---61.2 % of the 57-64 year olds are obese. (I am beginning to feel very self-conscious about the buttercream cupcakes I made last night.) 

About Relationships

            I hope this won’t ruin your day, but not all older people said they like to spend time with their partners. Only about 50% of men said they like to spend time with their partners and by the time partnered women got to be over 75 only 47.7 % said they liked to spend time with their honey-buns.

If these results aren’t misprints, we have a problem. Retirement means two people alone in a house all day. Lordy, if you don’t enjoy that, your days are toast.

But here’s the mystery: the vast majority of people in the study said they were happy in their relationships. Maybe the contradiction just translates into what has become a retirement mantra:  I married you for life, dear, but not for lunch. Get the heck out of the house.

Now… The Sex Thing

            The younger ones in the study had more lifetime sex partners than the people 75+. Forty-seven percent of women 57-64 had more than two lifetime sex partners, while only 20% of the oldest women had more than two sex partners in their lifetimes. Well, no surprise here. The fast-lane Boomers among the group had reliable contraceptives and Woodstock. The older ones—well, they were pre-pill and pre-rock and probably lived more in the Tony Bennett lane.

Last, when it comes to sex, men stay true to form. While, most women 75 and older said sex is NOT an important part of life, 75% of men over 75 said sex is still important.

So go ahead. Put that picture in your crystal ball---it’s going to be marriage counseling in our walkers.

 

Dog Bliss You

 

            Everyday is an excellent time for counting blessings, especially the blessing of being owned by a pet.

Scientists tell us pets are good for our heart rates, blood pressure and exercise habits. Think daily dog walks. Pets are also excellent as furry tranquilizers. I get more out of petting a dog than the dog does. Though I’m presently dogless, I remember the highlight of the family day: everybody down on the carpet after dinner to pet and praise Rowdy, the love sponge.

Pets and trippy kitchens

Over the holidays, you may be spending more time in the kitchen, so consider that when owners do trip over pets and injure themselves, it’s often in the kitchen. Sometimes pets just lie in the way to watch the culinary action. (You are their Food Channel.) Sometimes they do figure 8’s around your ankles, a free ankle rub.

What to do? Well, you can just keep an eye out for your pets the way you would for a toddler---think low moving object---or you can teach dogs to stay out of the kitchen. (Forget cats.) Or you can put a baby gate across the door and not worry about tripping over the dog when carrying hot pasta water.

Pets and night tripping

The pet who sleeps next to the bed is in the way when people get up in the dark, but that situation works both ways. People can step on the pet. So a motion sensitive nightlight is a good idea. One web site, www.keepdoggiesafe.com, sells glow-in-the-dark collars.

Another bedroom safety issue from the dog’s point of view:  people who own a burrowing dog, say a dachshund, know that if they throw themselves on the bed or even just sit on the edge, they may squash the dog who has nosed into bliss under the covers. And some of those little dogs are so smart they could sue you.

Staying upright outside

I’ve read 150 blog posts on the subject of people sustaining injuries from their pets. A common theme is outdoor injuries and it’s not just dog owners who get injured, but runners who don’t see the leashes strung across the path or passersby who are knocked down by dogs chasing squirrels. There were pleas to keep the leashes short and the dogs trained. But the website above has another solution---leashes with LED lights.

What a concept: The dog as a Christmas tree.

If you don’t know what gift to get your pet, take a stroll around a local pet store to survey the offerings. If it’s a dog toy, be sure to tell Rover to put his toys away each day because the blogs clearly indicate pet toys are a common cause of falls.

Last, if you do trip, please forgive the pet. After all, it’s only human.

 

Is Your World Whirling?

            Are you a dizzy blond? Whatever your hair color, if you have brief episodes of unsteadiness or vertigo, you may have a form of short-lived dizziness that is common and benign. In fact it’s called benign paroxysmal positional vertigo or BPPV and it’s commonly caused by a change in head position. So if you get briefly dizzy from lying down from an upright position, sitting up in bed, turning over in bed, or moving your head to look up or down, you may have BPPV. Usually it’s nothing to worry about unless these episodes occur at a time and place where they increase your chance of falling.

            Migrating crystals

            BPPV is caused by the movement of tiny crystals within your ear. When you move your head, the force of gravity can cause these crystals to migrate into parts of the ear where they aren’t supposed to be. Specifically, they move from something called the otolith organ (which monitors the position of your head) to the semi-circular canals, not their normal place of residence. So people may react to the migration of the crystals by becoming dizzy, light-headed and sometimes, nauseated. Also, blurred vision can be part of the symptom picture.

            So what to do?

            Just put the tiny crystals back where they belong. Really. If a doctor determines you have BPPV, it’s likely that he or she will turn your head this way and that to get those crystals back where they belong in a procedure called canalith repositioning. (Audiologists and physical therapists can also do this series of movements.) You may also be taught how to do these exercises at home, thereby saving the time and expense of an office visits.

            When to see a doctor

            Here are the recommendations of the Mayo Clinic: Call the doc if you have any unexplained dizziness or vertigo that recurs periodically for more than two weeks. The clinic’s website---www.mayoclinic.com---notes that it is uncommon for dizziness to signal a serious illness. But and however, call the doc immediately if you have dizziness combined with any of the following:

A new, different or severe headache, fever of 101 or higher, double vision or loss of vision, hearing loss, trouble speaking, leg or arm weakness, loss of consciousness, falling or difficulty walking, numbness or tingling, chest pain or rapid or slow heart beat.

Today’s take-home points

If you get dizzy when you move your head one way or the other, especially when lying down, and the vertigo goes away in less than one minute, chances are the doc will diagnose you with BPPV and your head will be moved around by trained personnel and/or yourself to get those tiny crystals back where they belong. But, if you have dizziness along with any of the other above symptoms, pick up the phone pronto.

 

Alzheimer’s: Helping the Helpers

            If awards for distinguished service were given to caregivers, the family members caring for those with Alzheimer’s would be on top of the honors list. They and those they care for have a rough road to travel. However, as with any tough journey, there are ways to make it easier.

Here are some tips:

Get informed

Almost none of us grew up knowing anything about Alzheimer’s Disease or AD, so there’s a void when it comes to accurate information and common sense tips about handling this brain disorder. To the rescue come many good books, among them Learning to Speak Alzheimer’s: A Groundbreaking Approach for Everyone Dealing with the Disease, by Joanne Koenig Coste. This book gets five-star reviews from readers. Then there’s A Caregiver’s Guide to Alzheimer’s Disease: 300 Tips for Making Life Easier by Patricia Callone. The older classic in the field is The 36-hour Day: A Family Guide to Caring for People with Alzheimer’s Disease, Other Dementias and Memory Loss in Later Life, by Nancy Mace and Peter Rabins.

Online, there’s good information about everything from symptoms to caregiving at www.alz.org, the Alzheimer’s Association website. This national group runs a 24/7 telephone hotline at 1.800.272.3900.  

Which brings us to the subject of support…

Get support

This is not the time to go solo like the Lone Ranger. (Actually, even he had help and moral support from Tonto.) No, this is the time to seek out the village it takes to care for people with dementia. Round-the-clock phone support is at the number above and here’s the kind of help they offer:

Understanding AD, medications and other treatment options, general info about aging and brain health, caregiving skills, legal, financial and living arrangement decisions, crisis assistance, education on the issues families face every day, plus referrals to local community programs. They also have message boards where people can trade concerns and questions.

Sierra Nevada Memorial Hospital runs an Alzheimer’s Outreach Project which includes supportive group meetings for caregivers. Get more info 530.274.6350  X 250.

Local adult day care services for the brain-impaired have been greatly curtailed by government budget cuts. Decimated is not too strong a word. However, a feisty group of families---give them an award!---has managed to start an adult day program, Helping Hands, in Penn Valley. Their phone is 530.432.2540.

Online, the biggie website for caregivers is www.caregiving.org, the home of the non-profit National Alliance for Caregiving. Check out their Resources tab.

Get out of town

Easier said than done, but if anybody needs a vacation, it’s someone who is a 24/7 caregiver. Adult day care services offer a mini-vacation of a few hours, but these have been almost totally closed down in this community with the people in Penn Valley doing their best just 3 days a week.

Bottom line: Services for older people shrink as the older population grows. We can do better than that, can’t we? 

 

Go Fishing for Health Food

            Americans have this thing about fish.  Though experts regard it as one of the best foods on the planet when it comes to health, a lot of people think fish stinks---in more ways than one. Even those of us raised as Friday Fish Catholics usually preferred our fish disguised as a bread stick or packed into a tin can. Anything more exotic---even the pope couldn’t get us to eat it.

            Why? Well, unless we lived by water, not much really fresh fish was available in our youths and then most of us didn’t know how to cook it beyond frying. But three things have changed.

First, supermarkets now carry a much wider range of fish, some of it frozen as soon as it is caught. Plus there is a resurgence of specialized fish markets, one right here locally. More about that later, but the thing is that we can now get decent supplies of fresh or fresh frozen fish rather than relying on cans or on dried, salted codfish, a special form of torture inflicted on us New Englanders.

The second change: there is now is a deeper nutritional understanding of what fish can do for a body. Omega-3 fatty acids, iodine, iron, and choline—these are so important to health that both the American Heart Association and the USDA recommend two fish servings a week. And our grandmothers were right when they told us that fish is brain food. In the good book, The 150 Healthiest Foods on Earth, author Jonny Bowden tells how fish seem to lessen the effects of dyslexia and attention deficit disorder and have been linked with increased intelligence in infants and young children.

Incidentally, Dr. Bowden says that though mercury is found in some fish, the health benefits of eating fish far outweigh any possible negative effects of mercury. He says to stay away from fish known to be contaminated---canned albacore tuna, for instance---but he gives a green light to canned light tuna. To keep up on this issue, try www.oceansalive.com.

The third change is culinary. People now know there’s more than one way to cook a fish. Many people today know how to use a microwave to cook fish or how to bake it wrapped in foil so the juices don’t escape. And there are wonderful fish cookbooks available. The absolute bible is Fish & Shellfish, The Cook’s Indispensable Companion by James Peterson. If this book and its photos don’t inform and inspire you, I will eat codfish on this newspaper's front steps.

 

Boob Tubing: Can Cable Kill You?

    I hate to bring this up since this is Noah Week, the week of the great rains, and, stuck inside, you may be logging a lot of time in front of the TV set.

Is this bad? It all depends on how much boob tubing you do.

Researchers in Australia decided they wanted to know if TV watching was connected to longevity. In other words, can cable kill you? Or do the lousy shows just make it seem as if you are living a long time?

Now we have long known that exercise is good for health, but these researchers specifically wanted to know how much sitting is bad. They studied the habits of 8,800 adults over a period of 7 years, excluding people who already had cardiovascular disease. Here’s what they found: Compared to people who watched fewer than two hours of television daily, those who watched more than four hours a day had a 46 percent higher risk of death from all causes and an 80 percent increased risk of death from cardio illness. Well, since older people in the US supposedly spend about 6 or 7 hours a day watching TV----this study is not good news.

So we can begin to wonder if Dancing With The Stars is worth it. And these findings also suggest that any prolonged sedentary behavior, whether in front of a TV set or a computer, may pose a risk to one’s health.

Solutions

First, move while you watch. Health clubs have been onto this for a long time and so have many people with a home set-up of an exercise machine and a TV set. My own solution is to select a half-hour show that I would otherwise feel guilty about watching---usually a food show---and watch it while moving about in a silly way that I call Dopey Dancing. (You will have your own way of exercising while nobody’s looking.) For people who have trouble standing, there are TV shows and CD’s that show how to exercise from a sitting position. Sit and Be Fit on PBS is one good choice. See www.sitandbefit.org.

Second, time your bad habits and act accordingly.  I am beginning to mentally log in how much browsing time I put in on the internet. (If those hours were stretched from San Francisco to NY, they’d miss NY and hit Karachi.) I am trying to fill those hours with something that will get the body moving—gardening is the first choice and housework the last, but both are better than an early e-death.

Third: Make up for the sitting with activity away from the Boob Box. Some go to health club classes. Some find that a simple device like a pedometer helps them get more active. A pedometer can attach to the belt or waistband and tell if you are getting the recommended 10,000 steps a day.

Pick up a pedometer at local sports stores or order on Amazon. Omron seems to own the pedometer market and a basic counter from them is about 14 dollars. 

Bad drug trips

Be smart about how you take meds. Don’t suffer from a homemade pharmaceutical cocktail gone bad. When it comes to taking drugs, such goofs are common. Experts at the Institute of Medicine say consumer mistakes with meds cause harm each year to over 1.5 million people in the US.

            To get a real-life snapshot of how people get in trouble with their meds, WebMD asked a panel of two docs, a nurse and a pharmacist to outline the most common mistakes made by the pill-taking public. Here’s what they said:

Make sure your drugs don’t interact in an adverse way. Yes, your doc should check one med against another, and, if a pharmacy has all your records, maybe they can pick up on the clash. Also, the interaction info could be in the pharmacy paperwork that comes in the little bag of Rx goodies. Still, it’s smart to cross-check your meds yourself---worth the extra effort because bad things can happen to innocent drug-takers.  Example: Coumadin, a blood thinner, should not be mixed with aspirin, another blood thinner.  (This is a case where something can actually be too thin! )

The website eHow lists the best online drug interaction sites, among them drugs.com and drugsdigest.com. Learn more by searching “drug interactions”.

No computer? No problem. All of us should make a habit of asking the doc if any new drug will clash with any of our old prescriptions, any over-the counter meds or any foods. (Don’t laugh: you can’t eat grapefruit products if you are taking Zoloft, Zocor, Mevacor or Lipitor---those among many other drugs that don’t mix with grapefruit. Even eating marmalade made with the bitter Seville orange is a no-no with some drugs.)

Ask if the drug in question can be mixed with alcohol.  Taking sedatives or tranquilizers along with a nice little chardonnay can send you into the Land of Inattention, so drinking, tranquilizers and driving do not mix. (The same can be said of the sedative antihistamines.)

The panel also noted another common but little known interaction: Mixing Tylenol and alcohol can cause liver damage.

Ask questions in the doctor’s office. Write down the name of the med, what’s it’s for and when you should take it. The panel noted that patients only remember about a third of what is said in a doctor’s office, so writing down the info is an excellent idea.

Other suggestions:

Make sure you get the right prescription at the pharmacy.

If you use several pharmacies, see that each has a list of your meds.

Take the meds, as directed, not just when you happen to think of it. (A pill box organizer can help here.)

If you are hospitalized, either you or a family member should make sure you are getting the right drug and getting it on time. Sometimes that means chasing nurses down the hall. If you go out there in a flapping hospital gown, you will get their attention. 

What to Eat (Again)

 

            Sheesh! I am so sick of changing nutritional advice. When I was young, bread and potatoes made you fat. My grandmother said so. But, by some miracle, 30 years later, these same foods didn’t make you fat. No, it was just the buttery toppings you put on them. So said the nutritionists back then and we got permission to carbo-load. And now, deep into The Age of the Glycemic Index, bread and potatoes make you fat again.

            There are a gaggle of other confusions. Eat meat---you need it to be big and strong. Or, don’t eat meat---draft horses don’t eat meat and they are big and strong. Or, got milk? Good. But, on the other hand, milk is food for baby cows, not for humans: lactose intolerance tells us so.

And on and on until you want to throw in the towel and eat anything that fits in your mouth. So will someone out there please boil it down and tell us what is true? Are there any enduring truths, some universal rules to guide us as we trundle our carts around the supermarket?

            To the rescue

            Enter best-selling author, Michael Pollan, he who has made it his business to seek out the basics of nutrition. His most recent book is a short and sweet little thing called Food Rules: An Eater’s Manual. The book answers the questions: What should I eat? How should I eat? Pollan distills world-wide nutritional research into short guideposts. You can read his book in one evening.

            But first, why should you care?

            Because people who eat the typical Western diet---processed foods, a lot of meat, much sugar, much fat---suffer from a high rate of Western diseases: obesity, type 2 diabetes, cardiovascular disease and cancer. It’s that simple: our diet makes us sick.

             Food rules, the basics

Pollan’s mantra is this: Eat food, mostly plants, not too much. And by food, Pollan means the plants and animals people have been eating for generations, not the highly processed foods that are coming to dominate the American diet.

In all, there are 64 tips in Food Rules, including such gems as: Don’t eat breakfast cereals that change the color of the milk. Also: If it comes from a plant, eat it. If it was made in a plant, don’t.

            

Visual hallucinations: What you see isn’t there

           It was 1972 when I first saw lightening in the middle of my office. I thought someone had slipped a hallucinogen into my coffee. (Secretly dosing someone’s food and drink with street drugs was a form of humor back then.)

I held on to my chair until the images passed, but the zigzag edges appeared again months later, cutting up the center of my field of vision so I couldn’t read or even watch TV.  So what was happening?

It was an ocular migraine

That’s a misleading name---ocular migraine—as there is no associated headache. (These visual happenings are also known as eye migraines or ophthalmic migraines.) The symptoms? Some people experience a small blind spot in the center of vision, either alone or perhaps with bright lights or the shimmering zigzag lines that I “saw”.  Whatever the particular visual experience, it interrupts normal activities and if you don’t know why you are having eyesight interruptus, it is frightening.

Are eye migraines harmful?

            Evidently not. Even if you’re driving I-80 at 75 miles an hour, you can see well enough to pull over until vision becomes normal again. Medical texts say eye migraines can last up to 20 to 30 minutes, with no known aftereffect. Nobody knows the cause, but my experience is that excessive stress brings them on. Others may have different triggers.

Treatment

            There are no specific treatments. Some docs prescribe the same meds used for regular migraine headaches. (You need to talk to your health care professional about the options.) And some people just ride it out, not wanting to get on meds for a condition that is so fleeting.

I find getting into a hot shower and letting the water pour on all sides of my head is a simple solution that works. But I may not be typical and not everyone is at home with a shower handy when their vision goes catawampus.

Seeing things: One more possibility

When an older visually-impaired person begins to see lions, tigers and bears or almost any other apparition, it doesn’t necessarily mean they are demented. It may mean they have Charles Bonnet syndrome. That’s where the brain seems to make up for the lack of visual input by inventing its own movies.

You can imagine that seeing things is pretty startling to anyone who can’t see much at all. Luckily, people who have this syndrome are usually aware that what they are seeing is not real.

The British Medical Journal calls this syndrome “not uncommon”.  So why haven’t most people heard of it? My guess is that nobody wants to tell others about their visual hallucinations for fear of being thought crazy.

A favor to ask

Older people with deteriorating vision will not be able to read this, so you might do your visually-challenged elders a favor by telling them about Charles Bonnet syndrome. That way they’ll be prepared if a fish shows up in the living room. 

Things That Go Bump in Your Gut

Today we are going to consider one of your hidden assets, your lovely gut, the place where all that chocolate went on Valentine’s Day only to be transformed into something far less glamorous. Without your inner food processer, you could not live. No guts, no life.

Your digestive system mostly just tootles along. You don’t have to babysit it the way you may have to coddle your skin or your feet. So yes, it’s a low-maintenance body system---the kind I like. Make that mostly low-maintenance for there are times when the gut acts up.

The antibiotic upheaval

Taking antibiotics may cause diarrhea. The antibiotics not only kill the bad bacteria, they kill some of the good ones that keep your digestive system healthy. And when the good ones die, an organism called c. diificile may take over and cause diarrhea.

Enter probiotics

Probiotics are dietary supplements that contain beneficial bacteria like the good guys that are already in your gut. Many contain acidophilus, a general term for live lactobacillus bacteria. It’s thought t these probiotics can ease or prevent diarrhea from antibiotics.

Probiotics are commonly found in the refrigerated section of a health food store, though there are some tiny acidophilus pills, brand name Pearls, which need no refrigeration. Pearls are helpful for those who can’t swallow big pills or who are traveling.

Newer probiotic

Andrew Weil M.D. is a fan of general acidophilus products, but he also recommends a probiotic called Culturelle which contains lactobacillus GG. To get his full view on the issue, Google Dr. Weil acidophilus. He reminds us to check the expiration dates---bacteria die---and emphasizes the fact that  supplements contain much higher doses of good bacteria than foods such as yogurt. Dr. Weil also says you can’t overdose on acidophilus, but that you may waste your money buying too many products.

An additional option

The Mayo Cllinic website mentions a probiotic, Saccharomyces boulardii, a cousin of baker’s yeast. It’s used in Europe to help prevent antibiotic-associated diarrhea and comes in capsules. Also noted: this product may not be for you if you have a yeast allergy or HIV/AIDs.

There are many other probiotic options, many of which can be found on an Amazon search. It’s valuable to read the customer reviews of these products, which then can be found locally in our health food stores or online.

Food sources

You already know that probiotics are found in foods such as yogurt---note the “live cultures” on the label---and also in kefir, a cultured milk drink that’s a cousin of yogurt and a base for smoothies. But again, these food sources have fewer of the good bacteria than the supplements. Some people cover both bases by using a supplement and also eating yogurt with live cultures

Helping with other health issues

According to Mayo Clinic gastroenterologist, Michael Picco M.D., there is not only “encouraging evidence” that probiotics may help with antibiotic-associated diarrhea, but they may prevent and treat vaginal yeast infections, urinary tract infections, help with irritable bowel syndrome and also shorten the duration of intestinal infections. They may even help prevent eczema in children.

Who knew?            

Smile.... And Your Heart Smiles With You

    

I guess we ordinary people always suspected it---moods can effect our heart health. But we heard this is a downer way---people dying of broken hearts and other bummers.

However, what’s getting attention on the medical landscape these days is the opposite idea----people can live longer because of a happy heart.  The Rx suggested here is joy, pleasure, contentment and yes, happiness.

Is there evidence that happiness promotes heart health?

Well, researchers from Columbia University Medical Center in New York followed 1,739 healthy adults over 10 years, taking periodic measurements of their negative emotions---depression, hostility, anxiety---and their positive emotions---joy, enthusiasm and pleasure. They also monitored the state of individual heart health or heart disease. Without boring you with details about how they controlled for this or that, what they found was a correlation between the state of the emotions and the health of the heart. Happier people had healthier hearts.

Happiness seemed to ward off heart disease.

This finding, if further strengthened by clinical trials, could have major implications for the treatment of heart disease. If heart troubles can be prevented by boosting positive emotions, will doctors prescribe HBO comedy specials, lovable Labrador retrievers or whatever else floats your happiness boat?

The team’s leader, Karina Davidson, Ph.D., said the study was the first to examine the relationship between clinically-assessed positive emotions and heart disease. She called for more research, but said people should try and put fun into their daily routines, rather than enjoying life in short bursts.

“Some people wait for their two weeks of vacation to have fun and that would be analogous to binge drinking, ” she said. “If you enjoy reading novels, but never get around to it, commit to getting 15 minutes or so of reading. If walking or listening to music improves your mood, get those activities in your schedule. Essentially, spending a few minutes each day truly relaxing and enjoying yourself is good for your mental health and may improve your physical health as well.”

Is this just happy hoo-hah?

            No. This study is regarded by the cardiac community as the one that most clearly suggests happier people have lower rates of heart disease. But a correlation does not prove cause and effect and certainly more research is needed to prove that happiness is an evidence-based Rx for heart disease. Also note: this study does not mean any of us can ignore established risk factors---smoking, inactivity and wallowing in saturated fat---my once favorite form of edible entertainment.

So what to do?

            You already know what makes you happy. Unless you have a heroin habit, do those things more often.

If I follow my own advice---I always try to---I’ll hang out in plant nurseries for some botanical therapy, plan a summer garden, listen to jazz, sit on my deck and do nothing, and laugh with Cranky Pants, who is not really cranky.

But I bet you knew that too. 

Rx Through The Ears

            Today’s offer from this column: a cheap and effective prescription with no side effects. You don’t have to ask your doc if it is right for you. It needs no drug store, so there’s no waiting in The Line Eternal to pick up the prescription that, it turns out, can’t be found. Or wasn’t filled yet. Or was never called in.

You know this drill, you who stand and wait for the little brown bottle and the big horse pills you end up not taking because the ads on TV have scared the motivation out of you. No, this Rx is already in your house and car. It’s music.

Music is music to your body

            Mother and dentists have known for years that music relaxes people. Moms sing lullabies and dentists, ahead of docs in this area, learned decades ago that music relaxes patients who may be uptight because someone else’s hand is their mouth. With a drill.

            Research supports their common sense. One study at the University of Maryland Medical Center showed that music opened up the arteries a relaxing 25%---if people liked what they listened to. But, if the music was annoying, that same study showed it narrowed the arteries by 6%. (Me, I think rap narrows mine so my blood just stops in its tracks.)

The music of nature

Other studies show that distracting patients with nature sounds reduces pain during anxiety–provoking medical procedures. But we don’t’ need studies to believe there has to be a reason CD’s of birdsong and babbling brooks are popular soothers of the body and spirit. Heck, we evolved listening to the sounds of nature. Birds were early man’s music. (Radio Avian: The Cave Person’s Choice.) Nor do we need studies to explain the existence of one radio station in the UK that plays nothing but birdsong.

That station’s website, www.birdsongradio.com, suggests you listen on the computer  “whilst working”. (Hope your boss likes larks.) You can also get this relaxing station on your iPhone through the wonderful app, WunderRadio, which connects you to radio stations all over the world. (If someone told me ten years ago that I could listen to a jazz station in Switzerland with just a few finger taps on a palm-sized machine, I would have suggested anti-psychotic medication.)  

Listening to my own advice

            Me, I’m just finishing up three days of first-rate health therapy listening to jazz, swing and big band music at the Jazz Bash by the Bay, a festival in Monterey CA put on by Dixieland Monterey (www.dixieland-monterey.com). Looking around at hundreds of happy faces over these last days, the word I think of is “joy”.

The music seems to elevate the spirits of all those who come to hear. The therapy must be potent as this festival has been going on for 30 years. (And no, it’s not the more famous Monterey Jazz Festival. Jazz Bash is a whole ‘nother music fest.)

            Now I try to be cool and behave myself in public, but seeing some pretty ancient folks get up and dance, inspired by the beat of great American jazz, well, that does bring me to tears. Good tears.

Hey, that’s just more therapy.

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.

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.