Thursday, July 31, 2014

Come on, get going on making better use of your lives

Statements like that--get going!--make me want to take a nap. Linda P. Fried, a prof at Columbia University's Mailman School of Public Health, says we have added 30 years to our lives in the past 100 years--and retirement is wasting them.

This was reported in the WSJ, July 8, 2014. Well, Linda, you look certain-agey but not "old." Perhaps your systems have not started to wobble.

You say forget "retirement communities," weave old people into all aspects of the community. We can walk everyplace to get groceries and other needs. Parks, back fence chats. Public transit will be accessible to those with a hitch in their giddyup.

To have a reason to get up, older people will just keep working. Institutions will ask older people to solve their most complex problems. The ones that require mature minds.

People will see they are leaving this world a better place. Of course, their "proper investments" will insure they stay out of the catfood aisle.

All this sounds good, doesn't it? Well, what about taking care of parents or even sick adult children? What about children who move back in? What about children who can't move back in because the housing is age-restricted? What if those nifty investments are creeping along, while Steve Forbes is cleaning up?

What if you can't afford "care" like your parents could?

And let me tell you, getting older does mean getting tireder, less nimble, more shaky, more likely to fall. Mature minds, aside.

About that walking to the store--what if you can't do that anymore?

I am such a Debbie Downer today.

But designing the last 30 years of life as a win-win, as Fried says? You may get a win or two or a laugh or two, but the trajectory is pretty clear.

Wednesday, July 30, 2014

Baby Boomers: Maybe a Hepatitis C test?

My regular readers know I am not enthused with exhaustive testing--who would have time for anything else?

Baby Boomers are more likely than other age groups to have the viral infection called Hepatitis C.

This attacks the liver, can be fatal, and is easily acquired--even by sharing a razor at the gym.

Kristin Gourlay, writing on the USC Annenberg website, http://reportingonhealth.org, says people born before 1945 and 1965 are more likely to have this for various reasons.  More drugs were  injected in the 1970s and 1980s. The blood supply was not screened for this until 1992. Unsafe tattooing and piercing could also spread it.

Go to the Centers for Disease Control and Prevention to see if you are at risk. http://cdc.gov.

Why get tested now? Because the disease can hide out in the body and do damage before you get symptoms.

There is a cure--but it's scary expensive--$84,000 for 12 weeks.

Will this lead to rationing? Probably. Won't everything? Better to get in line early.

Tuesday, July 29, 2014

New go-to site on cancer

The American Association for Cancer Research (aacr.org) has started a new website called CANCER RESEARCH Catalyst.

Go to http://blog.aacr.org.

Samples from an early issue:

The challenge of pancreatic cancer

New info on Tamoxifen

Click through to new issue of Cancer Today

Be sun sensible

You get the idea. If you have this disease or know someone who does, this might be a valuable touchpoint.

You never know what you will pick up.

You know my favorite saying: "So much has been written about everything, it's hard to find anything out about it."

This true of cancer--but the AACR is a good place to check.

Monday, July 28, 2014

Crowdfunding for cures

I always get incensed when I hear about people who hold bake sales to get money for a transplant. There has to be a better system!

Now, according to Ed Silverman, WSJ, July 15, 2014, the new approach of crowdfunding is being applied to early stage research on drugs or tests.

Early stage because you need to know yes or no on the promise of something without spending a ton--crowdfunding doesn't raise tons.

They did a study of 97 campaigns for cancer and other disease research and concluded that the approach could lead to more visibility, preliminary findings, and maybe more money from other sources.

These campaigns raised in the range of $45K on average (Drug Discovery Today).

It's a start, is how researchers, parents, and patients look at it.

Friday, July 25, 2014

How does seven hrs of sleep sound?

Get your eight hours! Or maybe nine! Now, sleep researchers say people are sleeping less and this may be OK.

Seven hours is becoming a popular amount.

In fact, too much sleep is associated with the usual roster of horrors--diabetes, obesity, heart disease, you know the list.

All this is included in Sumath Reddy's story in the WSJ, July 22, 2014. You can find the studies in there.

How much do you--personally--need? While on vacation, turn off the alarm clock, don't drink alcohol or caffeine close to bedtime, and see how long you stay asleep.

That can't be right--it isn't even technical!

I can tell you when you get older and maybe take diuretics, sleep is naps--two hrs at a time.

Thursday, July 24, 2014

Let nurses nurse us


Anyone who's been in the hospital knows that it's not the monosyllabic inhouse doctors or the regular doctors (if you can get them to come over) that really help you, it's the nurses.

Laura Landro wrote in the WSJ (July 22, 2014) about efforts to free up nurses for more bedside time. Instead, they are often chasing test results, calling people, arranging tests, getting meds--sometimes walking as  much as 5 miles a shift around the hospital to round up things for their patients.

Talking with patients and family, evaluating pain, taking complaints, comforting, remaking soiled beds, and maybe just chatting a second--all these take short shrift. One study showed that in a 12-hour shift, nurses spent 2.5 hrs at the bedside.

The more time at the bedside, the fewer the falls, bathroom accidents, infections, medication errors, and the higher the satisfaction. I remember very clearly one time I have been "stuck" so much they got the nursing supervisor--a great sticker--to come in and do it. Years later, I was in the same hospital and remembered her because of her skill and kindness.

My daughter remembered a nurse's kindness in the ER and sent a letter about it--and the nurse got an award at a ceremony.

This time with patients and family is needed as stays grow shorter and more must be done at home--this needs explaining.

Steps some hospitals are taking include bringing the meds to the floor and storing supplies in the patients' rooms. Computers are also in the patients' rooms. One program is called Care at the Bedside. One nurse uses the in-room computer to show patients their images and x-rays.

Another change is to hand over the patients at shift's end in the rooms, not the hall. They ask patients specific questions about how things went in the last shift.

Hospitals are also letting licensed practical nurses and certified nurse assistants render more care at the bedside.

All this is good--not that I want to test it out soon.

Wednesday, July 23, 2014

Ta ta to your ta-tas?


I watch that E! "reality" show called BOTCHED about bad plastic surgery. Often, women need their breast implants removed or the procedure revised.

Plastic surgeon Robert Kraft, MD, in Fresh Meadows, NY, (not a part of the show), says 20,000 removals are done each year in the US.

Usually the implant has ruptured or collagen fibers have grown around it, giving it that stuck-on tennis ball look.

Breast implants, sadly, are not designed to be forever. Sometimes women change their minds, too. The implant may wrinkle under the skin. Or an allergy may develop. Or the breasts may become uneven or more uneven. Or the implants may be painful.

The surgery is same-day--you go home afterward. If new implants are not being inserted, the physician must lift the tissue to look more natural.

You may also need drains and a compression bandage or bra for a time.

This is surgery, as they point out on BOTCHED, not a spa treatment.

Tuesday, July 22, 2014

Your Ma wears army shoes

Or maybe she SHOULD wear army shoes.  A third of men and half of women wear shoes that don't fit--according to a UK study (reported in the WSJ, July 16, 2014).

Just the other day, my sister was holding out her feet and lamenting her bunions. "My feel look like Mom's," she groaned.

Yet, she is always saying her feet hurt, she can't walk too far in a certain pair of shoes, and so on.

Me, I am mostly barefoot. Yet, my big old boats have gone from an 8 to a 9 in past years.

They still have those silver foot measuring things, I guess, but you can also outline a shoe and then step on the outline barefoot--if your foot lops over the line--the shoe is too small.

Average sizes are creeping up--be warned.

Stilettos are a bad injury causer. But all shoes have bad potential--even flats. Flats provide no support and stretch the tendon in the back of your leg.

Shop of shoes late in the day, when your foot is larger. Some online buyers try several sizes.

Remember those funny stools salespeople sat on to put a shoe on your foot--well, they still do and the foot going in the shoe should make a certain "shwoosh"--good fit.

I remember those huge x-ray machines that showed your green toes in the shoe. They didn't last long--too much radiation. Yet, I know no one with toe cancer.

Monday, July 21, 2014

Bugs and more bugs--YOW

Stinging and biting insects...my daughter is constantly leaping from her chair on the patio and whirling around with the spray can...eek, eeek.

She hates yellow jackets, their weird legs dangling down as they slowly buzz you looking for a fun place to sink their red-hot stinger.

We paid some dudes $200 to remove a bee clump the size of a TV out of our tree. That was just a couple of weeks ago.

Which bugs hurt the worst? Sumath Reddy, WSJ, July 15, 2014, says 4% of people are allergic to insect venom--even a bee sting can cause hives or even fatal shock.

You may be fine the first few times you get stung, then, BAM, you get a reaction.

Yellow jackets come around in the late summer and fall, cruising trash cans like irritable juvenile delinquents. Bees can only sting once--jackets are mean and lay into you over and over.

Wasps...hornets...fire ants. Some other charmers.

We have fire ants out here--get some dry stuff called Amdro and scatter it around--they carry it back to the nest...and well, it's sad.

If you know you are allergic, get an epinephrine pen.  Sometimes shots can be given in a series--say if you are an allergic beekeeper.

You might also want to ditch the deodorant and perfume--they love sweet smells.

Many people, the article said, get stung on the lips or mouth--the yellow jacket may have crawled into a soda bottle.

Shudder.

If you do get nailed, put ice on it. My mother also recommended baking soda mixed with water to form a paste.

Friday, July 18, 2014

Theatrical older folks hit the boards

"Law and Disorder" is the name of the ongoing drama put on the in-house network of the retirement home of the Motion Picture Actors in LA.

Instead of bingo, they act--because, as one put it, we are not old enough to collapse or pass out. A crude way to put it, but I see where he was going.

There are also other age-nuanced shows, such as "The Roaring 90s" and  "Alive and Kicking."

The average age of newcomers to the residence is 87. You have to have worked 20 yrs in the biz to get in the place.

It sure beats bingo, chortled one.

Like a real-life "Coccoon." Love it.




Thursday, July 17, 2014

Solutions looking for problems

According to Laura Johannes, WSJ, July 8, 2014, there are devices out there to stop big bites from itching by applying a zap of heat or electricity.

Not much of this has been tested in any meaningful way--the idea is that the zap gives the body something else to worry about or intercepts the itch sensation.

Terapik costs $13 or so and you aim infrared at your bite for 30 secs. It heats the bite to 140 degrees.

Biteaway from Germany runs about $35 to $60 and uses hot metal to stop the itch.

Hot metal, huh? In some states, that would be illegal.

Therapik claims to neutralize venom. But docs say it wouldn't unless it was hot enough to burn the skin.

Good grief, people! A swab of rubbing alcohol, calamine or maybe even a salve with a pain-relieving agent. Drugstores everyplace!

Wise up.

Wednesday, July 16, 2014

Medicine side efx--all in your head?

This one hit home with me. I feel like I am not good with medicine, which I have come to think of as wads of chemicals.

I listen to those commercials--and mock them...with their "resulting in stroke which could result in death" stuff.

According to Sumath Reddy, WSJ, July 18, 2104, and a doctor at Duke, people hear those side effects and get them. Or they look up the medicine on Google and get the side effects listed.

I look up stuff AFTER I feel crappy--how to they 'splain that? I once had to take Flagyl--was sick as a pup and looked it up--ooops, Flagyl effect. It had a name!

One-third to a half of those with chronic conditions (in my case atrial fib, arthritis, and weird kidney function), are noncompliant with meds.

I am noncompliant with about everything else, but if I agree to take a med, I take it. But, I swear downing five pills in the morning leads to hours of queasiness and malaise and intestinal difficulties.

But, naturally, they did a study and people on the placebo had side efx. So--don't believe yourself.

I do find docs don't take all this seriously. I am allergic to calcium channel blockers--I get a rash. One cardiologist gave me this anyway and showed his assistant my "verapamil rash." How fun for them.

In another study, some patients were leery of pancreatitis from a drug--and some of them stopped it when they got sick. The doctors said they just has an upset stomach, silly puppies.

So you have to decide--believe the TV (they are required to list those things, some of them vanishingly rare) or give the drug a try.

As one doc told me--all drugs have side effects and sometimes the effect is to help the condition.  Your call.

Tuesday, July 15, 2014

Forget energy drinks--try being healthy

I am sitting here, trying to not barf because of taking my BP pills all at once in the AM.

But I read the advice of a London holistic nutritional therapist named Elizabeth Montgomery. She advocates getting energy from healthy practices.

Guess it's worth a try.

First, she says, don't skip breakfast. Forget sugary cereal--include some protein. I had an English (empty cals, I hear, but they taste great) and a schmear of deviled ham (prob too salty).

Be sure your snacks contain protein (nuts, seeds, pulses (wha?), or goats cheese. You have to be a Rockefeller to nibble goats cheese, but I do grab some cheddar sometimes.

Eat plenty of greens. Be careful with potatoes--I admit, I am not--although I am careful to put catsup on the Fries of the French.

Include a lot or raw foods-they are bursting with lifeforce energy, she says. Also whirl up a spirulina shake. Algae. I once tried it and got so speedy I had to quit. An algae overdose.

Just typing this made my nausea go away. So I recommend typing.

I know--cynic, heal thyself. Let me go check my supply of pulses.

Monday, July 14, 2014

Anything new colon-wise?

Since my whole medical history has made it into this 9-year-old blog, or however old it is, why not my disgusting guts history?

I was on blood thinners, bled, and had to have a colonoscopy, which of course requires you not be on blood thinners or that they be neutralized.

I spent a night in Hell, I mean the hospital, trying to "cleanse" and neutralize the thinners. The colonoscopy could not be completed--took a wrong turn or something. I have given up.

Joseph Walker, WSJ, June 9, 2014, says 28% of people from 50 to 74 have never been tested, even though 76% are insured (this test is scary expensive).

The cleanse, the yuk factor, the embarrassment, fear of anesthesia, who knows...It is invasive.

So they tried to make it less so with a computerized one--no tube all the way "up." But if "something" is found--then you get the whole ride.

Also--those stool tests the doc hands out.

Now they are trying a giant pill with a camera for people with complete tests--750,000 a year of those.

Find anything--still get the tube.

They are also talking about a home DNA test to look for some marker. Then what? The tube?

As a responsible health care reporter--I am supposed to tell you to get this. So your course is clear.

Friday, July 11, 2014

Do we need more "old people" doctors?

Geriatricians--these are medical doctors with advanced training in taking care of people over 65--with their multiple ailments, multiple meds, rambling descriptions, many specialists.

By 2030, according to a story by Barbara Sadick (WSJ, June 9, 2014), one in five Americans will be over 65. That's 70 million!

Yet, last year, there were 797 fellowships in cardiovascular and 125 in geriatrics. The latter is not growing in popularity among docs.

Office visits for older people run longer as a rule, they docs only get paid fee for service (Medicare). Often there are no cures--just ways to make people more comfortable.

Still, four heavyweight med schools joined forces in 2004 to provided more geriatric training. They like a holistic approach--physical, psychological, economic, social, nutritional.

When my mother was alive, she had a Medicare HMO that had no--ZERO--geriatricians on the roster. A plan for old people with no doctors trained in old people.

But do we need them to be? Maybe a little more patience, a constant monitoring of the nutty overprescribing of meds, and minimization of the running around and getting tests routine.

Now, I am old, too--and am often irked by doctors rushing me, cutting me off, patronizing me, and calling me "youngster." That is the worst.

I have pretty good luck asking them what would they advise if I were their mother. Try it.

Thursday, July 10, 2014

Zzzzzz

Crummy economy, crazy govt, global hot or is it cold, tots crying to get into the country, terrorists--having any trouble sleeping?

For 60 million Americans sleepless nights are a regular problem. This can lead to irritability, bad performance, or health problems. Insomnia is not just trouble falling asleep, but also trouble staying asleep, or falling back to sleep. It's chronic if it happens three nites a week for three mos.

Dr Larisa Wainer, Morris Psychological Group in Parsnippany NJ, has some dos and don'ts.

DO

Keep a schedule--go to bed at the about the same time, same for waking. This includes weekends.

Wind down for 30 mins. Keep the room cool and dark. No electronics.

If you start worrying, jot down what you are thinking. This sort of "takes care" of it.

DON'T

Drink caffeine or alcohol in the latter part of the day. Same for a heavy meal.

Don't clockwatch. If you are lying there awake for 20 mins, get up and do something else.

Also--I have a Teddy bear. Maybe it's just me. But he's a pretty effective anti-terrorist device.

Wednesday, July 09, 2014

Want to mini-size that?

Anne Gasparro and Julie Jargon, WSJ, June 25, 2014, talk about portions. But what about people for whom a portion is all the food on the plate? Or people who don't stop until the food is gone?

There used to be talk of obese people having a wacky satiety point--they never feel full. You don't hear that much anymore.

Restaurants go up in portions--supersize--and down--100 calorie packages.

Potato chips are now in 100 calorie packs. That seems wrong somehow. Even the Cheesecake Factory has Skinnylicious portions. Stop--my head is exploding!

Does having to open another 100-cal pack make the person think the food is "gone"? Not always.

A value menu burger (almost a slider) is alongside a triple burger tower.

I actually think a prepackaged smaller portion can cut intake--mainly because we are too lazy to get up and grab another one.

Will this make the weight fall off? Does it ever?

Tuesday, July 08, 2014

It's a jungle out there

I happened on a show about retired soccer great (and hunk) David Beckham taking a trip to the Amazon basin to ride motorcycles in the mud and see what he could see on land and on the river.

He came across as a pretty adaptive guy getting into the grunge and not too metrosexual. Some natives tried to rub off his tatts (he has two sleeves), which was amusing. He also tried to describe to one man what he "did"--and had to explain soccer. The guy was not too enthralled. Was this a game?

There was also a story in the WSJ by Jen Murphy (June 24, 2014) about a hotel exec who likes to run in the jungle--more challenging. He says running in the jungle makes him think better at the office.

To duke it out with the temps and humidity, he wears North Face shorts, Arc'teryx shirts and jackets and Salomon sneaks (Speedcross 3).

Even if you don't nip down to the Amazon, you may need to deal with humidity. I remember this from St Louis and DC. When you breathe in, nothing happens.

When the outside temp is above 90, Jen Murphy writes, you will gain heat from the air. Your sweat does not evaporate.

In fact, a vapor barrier forms around you sending the heat up.

You need more than just constant water--you need some electrolytes.

But above all--start slow and build. You need to acclimate.

This means get your body used to a hostile environment, basically. Don't be a dope.

Monday, July 07, 2014

Do you need stitches?

Heidi Mitchell, WSJ, July 1, 2014, reports that there are different kinds of cuts. An abrasion is superficial and will close over with simple bandaging.

Lacerations are what we think of as "cuts." A dog bite can be a laceration, but is not usually stitched because it would stitch in bad germs and bacteria.

If you see tendons, muscles or yellow fat--it may need stitching. A lot of bleeding also calls for attention.

If you do go to the ER, you may be glued back together--no stitch removal and no numbing beforehand. Glue is for nonmoving parts.

Scalp wounds bleed a lot--so stitches may be indicated.

If the wound seems to be healing well, it's probably OK--acute pain or heat, maybe get it checked out.

Stitches can only be placed in the first 12 hours anyhow.

Mom used to say, "I needs air to heal." I am still here. And we still have air.

Thursday, July 03, 2014

Don't dismiss the boat

Uh-oh--no people inside
Ah, Fourth of July--boats, water, beer, laughs. The latter two can be a bad idea, though, if you want to see a July 5th.

First, people should wear lifejackets. True, they are hot and not a snappy fashion statement (think Michelin Man).

Telling people this--the Red Cross has turned blue--is not enough. A law would help--in Victoria, Australia, wearing of jackets increased 41% when a law was passed.

No law here--22% wear them voluntarily. They are required in small boats--under 16 feet.

Fifty-nine people died in drowning deaths before the legislation. After this dropped to 16. Of those 16, more than half had no jacket on.

Other hazards--alcohol. Most boating mishaps involve the Demon Rum. Yes, beer is alcohol!

Also it does not hurt to have a professional boat captain--someone who knows how to operate a boat.

There are also courses for this--try one.Also--learn to swim. You still need a jacket, but this is a plus.

You may think you are just partying or fishing--but you might be danger from your ride.

Wednesday, July 02, 2014

TMI!

Sue Shellenbarger, WSJ, June 25, 2014, says people who blab WAY too much at the office are oversharers.

Their coworkers may try to hide or else move to the center of the room hoping others listening in will curb this.

Three workers out of five have an oversharer around. That is a lot of discussions of sex or disease. Or divorce. Or spendy purchases.

The types are:

The Blunderer--this one does not notice that the listener is cringing or making excuses to escape.

The Narcissist--surely everyone wants every detail of his or her life. (Facebook)

The Patient--all the gory or gross details.

The Storyteller--can tackle almost any topic.

The Worrier--tries to blot anxiety with chatter.

The True Confessor--not afraid to talk about ANYTHING.

Of course, we want to shape how others see us--but feel free to conceal deep personal details.

Tuesday, July 01, 2014

I am sitting, I am doomed

Here we go again--now sitting will kill ya. Not  just inactivity--but sitting.

Sitting, in one roundup study of other studies, was associated with cancer, diabetes, and cardiovascular disease.

Even if you exercise--that does not cancel out the sitting.

Sitting--naturally--makes you fat...you only burn one calorie a minute (seems low to me, but I am sitting right now, which is probably making me stupid).

The cancer comes from the obesity--doesn't everything?

Sitting also leads to a Vitamin D deficiency--which can up the risks of colon cancer. Would sitting in the sun help?

But--don't panic, much less hop to your feet--short breaks to move can help break this sitting curse.

Also walk to meetings, climb stairs, use a treadmill desk, bike, walk, park away from the door--all the standbys.

One guy eliminated sitting entirely--which leaves what, lying down? Isn't that the death thing in action?

OK, I am sarcastic. I also read today that if you can't walk 400 meters (who knows how far that is) in 15 mins without holding onto a wall pr person, you are severely impaired.

That would be me.
OK, I am sarcastic.