Fred Cicetti is a freelance writer who specializes in health. He has been writing professionally since 1963. Ask him a question at: fred@healthygeezer.com

With Fred Cietti

​​​​Healthy Geezer 

September 08, 2016

From The Geezer's Mailbag
Q. Is it dangerous to take a beta-blocker for high blood pressure?
A. There was one study that found that beta-blockers may increase the risk of having a heart attack or stroke if you are using them to treat high blood pressure alone. If you are taking a beta blocker, discuss it with your doctor. Warning: Don’t stop taking the drug on your own. 

      Beta blockers, also known as beta-adrenergic blocking agents, are medications that reduce your blood pressure by blocking the effects of the hormone epinephrine, also known as adrenaline. When you take beta blockers, the heart beats more slowly and with less force; this reduces blood pressure. Beta blockers also help blood vessels open up to improve blood flow.
      Doctors prescribe beta blockers to prevent, treat or improve symptoms in a variety of other conditions, such as irregular heart rhythm (arrhythmia), heart failure, chest pain (angina), heart attacks, glaucoma, migraines, generalized anxiety disorder, hyperthyroidism and tremors.
      The following are the brand names for common beta-blockers: Sectral, Tenormin, Kerlone, Zebeta,  Cartrol,  Tandate, Lopressor, Toprol XL, Corgard, Levatol, Visken, Inderal, Betapace, and Blocadren.
Q. How should I go about choosing a surgeon?
A. The American College of Surgeons (ACS) recommends that you look for a surgeon who is board certified and a fellow of the college.
Specialty boards certify physicians who meet published standards. For physicians to become board certified in a surgical specialty, they must complete the required years of residency training in that specialty, and then pass a comprehensive examination. 

     The specialty boards issue certificates that are valid for six to ten years. To retain certification, physicians must become recertified and must show continuing education in their specialty. 
Fellows of the ACS are board-certified surgeons whose education, training, professional qualifications, surgical competence, and ethical conduct have been found to be consistent with the college’s standards. The letters “FACS” after a surgeon's name stands for Fellow of the American College of Surgeons.
     If you want to know about a surgeon, you can phone your state or county medical association for help. Or you can just ask a prospective surgeon to provide credentials. Often, you can find the information you need hanging in frames on a surgeon’s office walls.
Q. What questions should I ask before undergoing an operation?
A. Here is a list of  significant questions you can ask you doctor before the surgery:

• Why do I need the operation?
• Do I need it now, or can it wait?
• What happens if I don’t have the operation?
• What are the benefits of having the operation?
• How long will the benefits last?
• What are the risks of having the operation?
• Are there alternatives to surgery?
• How will the surgery affect my quality of life?
• Where can I get a second opinion?
• What experience do you have performing this surgery?
• Where will the operation be done?
• Will I have to stay overnight in the hospital?
• Is it possible to have same-day surgery as an out-patient?
• What kind of anesthesia will I need?
• What are the side effects and risks of having anesthesia?
• How long will it take me to recover?
• Will I be in pain? How long will the pain last?
• When will I be able to go home after the surgery?
• What will the recovery be like?
• Can you draw a diagram and explain how you do the surgery?
• Can you please mark the part of my body you will operate on?
• Is there anything else I should know about this surgery?


July 28, 2016

Age-Related Macular Degeneration
Q. I’m 70 and I’m starting to see a blurred area in the middle of my vision. Any ideas?
A. Have this checked immediately by an eye care practitioner. What you describe is a symptom of age-related macular degeneration (AMD), a leading cause of vision loss in Americans 60 years of age and older.

     The macula is at the center of the retina in the back of your eye. The retina transmits light from the eye to the brain. The macula allows us to perform tasks that require central vision such as reading and driving.
In some cases, AMD advances so slowly that people notice little change in their vision. In others, the disease progresses faster and may lead to a loss of vision in both eyes. It comes in two forms—wet and dry.
Wet AMD occurs when blood vessels behind the retina start to leak and raise the macula. An early symptom of wet AMD is straight lines that appear wavy. Wet AMD is considered to be advanced AMD and is more severe than the dry form. However, dry AMD can turn into wet AMD at any time.
     Dry AMD occurs when macular cells break down, gradually blurring central vision in the affected eye. Central vision in the affected eye can be lost. Dry AMD generally affects both eyes, but vision can be lost in one eye.
     The risk of getting AMD increases with age. Other risk factors include smoking, obesity, race (whites are at higher risk), a family history of AMD, and gender (women are at higher risk).
AMD is detected through a comprehensive eye exam that includes a visual acuity test, a dilated eye exam, and tonometry. Visual acuity is measured with an eye chart test. In the dilated eye exam, drops are placed in your eyes to enlarge the pupils. Then, a magnifying lens is used to examine your retina. Tonometry measures the pressure inside the eye.
     You may also be asked to look at an Amsler grid. With one eye, you will stare at a black dot in the center of the grid. You may notice that the straight lines in the pattern appear wavy or are missing. These may be signs of AMD.
Other tests that may be done include:
•  Using special dye and camera to look at blood flow in the retina (fluorescein angiogram)   
•  Taking a photo of the inner lining of the eye (funds photography)
•  Using light waves to view the retina (optical coherence tomography)
     Once dry AMD is in the advanced stage, no treatment can prevent vision loss. However, treatment can delay and possibly prevent AMD from progressing to the advanced stage. Some vitamins and minerals may reduce the risk of developing advanced AMD.
     Wet AMD can be treated with surgery, therapy, and injections into the eye. None of these treatments is a cure for wet AMD. Each treatment may slow the rate of vision decline, but the disease may progress anyway.
     The U.S. Food and Drug Administration has approved the Implantable Miniature Telescope (IMT) to improve vision in some patients with end-stage age-related macular degeneration.
     Surgically implanted in one eye, the IMT is a small telescope that replaces the natural lens and provides an image that has been magnified.
     If you have lost some sight from AMD, don't be afraid to use your eyes for reading, watching TV, and other routine activities. Normal use of your eyes will not damage your vision further.

July 21, 2016
From The Geezer's Mailbag
Q. I'm 68 and thinking of taking testosterone. Will it help me to feel younger?
A. There is some controversy about whether testosterone therapy should be used in men who have naturally lower testosterone levels because of aging. It remains unclear whether restoring earlier testosterone levels benefits older men.
 
      For example, studies found that healthy men who took testosterone medications got bigger muscles, but in most studies the men weren’t stronger. And, if you suffer from erectile dysfunction, taking testosterone may not relieve your condition. 
     The potential benefits of this therapy are: more muscle and strength, increased bone mineral density, thicker body hair and skin, elevated sexual desire, more energy, less irritability and depression, and improved mental capacity.
     The potential risks are: growth of existing prostate cancer, benign growth of prostate that can worse urinary problems, sleep apnea that makes you start and stop breathing as you sleep, reduced sperm production, fluid retention, baldness, skin reactions, enlarged breasts, testicle shrinkage, acne, and excess blood production that can increase your risk of heart disease.
Q. I have a problem with twitching eyes. Is that a symptom of anything?
A. Eye-twitching—also called eye spasms or blinking disorder—is known technically as blepharospasm. It usually is not a serious condition. 

     In most cases, the eyelid spasms stop on their own. The most common causes are fatigue, stress, prolonged staring, eye strain, and caffeine. The best remedies are more sleep, relaxation techniques, reduced caffeine, warm soaks, eye drops, and correcting vision deficiencies.
     In most people, eye-twitching develops spontaneously. However, the symptoms of dry eye frequently precede it.
     You should see an eye doctor if twitching continues for more than a week, completely closes your eyelid or affects other parts of your face. Other symptoms that require medical attention are a drooping upper eyelid, redness, swelling, or a discharge from your eye.
Q. How do you get Legionnaires’ disease? 
A. Most people become infected with Legionnaires’ disease when they inhale microscopic water droplets containing legionella bacteria. If you choke or cough while drinking, you can get water in your lungs. If the water contains legionella, you may develop Legionnaires’ disease, which is a form of pneumonia. 

     Legionnaires' disease primarily affects the lungs. However, it can cause infections in wounds and in other parts of the body, including the heart.
     Those who are especially vulnerable to Legionnaires’ disease are older adults, smokers, heavy drinkers and people with weakened immune systems. 
     If not treated, Legionnaires' disease can be fatal. Immediate treatment with antibiotics can usually cure Legionnaires' disease. 
     The legionella bacteria usually are found in water; they grow best when the water is warm. So, legionella is often found in hot tubs, plumbing, water tanks, whirlpool spas on cruise ships and large air-conditioning systems. 
     Legionnaires' disease is common in the United States. About 25,000 cases of the illness occur each year and cause more than 4,000 deaths. The fatality rate is similar to that of other forms of pneumonia, which is about  15 percent. 

July 07, 2016

What's Up, or Not?
Q. Anyone watching male-oriented TV programs would get the impression that erectile dysfunction is rampant. How common is it?
A. Erectile dysfunction (ED) is very common. Depending upon how you define ED, there are 15 million to 30 million men who have it. ED ranges from complete impotence to unsatisfactory performance.

     But it doesn't have to be a part of getting older.  As you age, you may need more stimulation and more time, but older men should still be able to get an erection and enjoy sex.
The incidence of ED increases with age. Between 15 and 25 percent of 65-year-old men experience this problem. In older men, ED usually has a physical cause, such as a drug side effect, disease or injury. Anything that damages the nerves or impairs blood flow in the penis can cause ED. 
     The following are some leading causes of erectile dysfunction: diabetes, high blood pressure, atherosclerosis (hardening of the arteries), prostate surgery, hormone imbalance, alcohol and drug abuse. 
And, of course, there are your emotions. It should be no surprise that, if you’re having a relationship problem with your sex partner, you can suffer from ED. Here are some other psychological influences: anxiety over a previous failure, everyday stress, depression, and feeling unattractive to your partner. If you’re suffering from ED, you should see your doctor for a discussion and physical exam.
      Monitoring erections that occur during sleep can help the diagnosis. Healthy men have involuntary erections during sleep. If nocturnal erections do not occur, then ED is likely to have a physical rather than psychological cause. Tests of nocturnal erections are not completely reliable, however. 
      The cause of the ED will determine the treatment. Some ED medicines are injected into the penis. Other medicines are taken orally. In addition to medicines, there are vacuum- pump devices and surgery. 
Millions of men have benefited from three drugs that treat ED. These three, which are advertised endlessly, are Viagra, Levitra and Cialis. All of them increase blood flow to the penis, which produces an erection. Viagra, Levitra and Cialis improve the response to sexual stimulation, but they do not trigger an automatic erection as injections do. 
      Oral testosterone can reduce ED in some men with low levels of natural testosterone, but it is often ineffective and may cause liver damage. Nitroglycerin, a muscle relaxant, can sometimes enhance erection when rubbed on the penis.
      Research on drugs for treating ED is expanding rapidly. If you have ED, you should ask your doctor about the latest advances.

June 09, 2016

Xerostomia, AKA Dry Mouth
Q. My mouth seems to be a bit dry most of the time. Does this mean anything?
A. Everyone experiences dry mouth occasionally. We get it when we are under stress. But if you have dry mouth all or most of the time, you need medical help. The medical term for this condition is xerostomia.
     Symptoms of this problem are: saliva that seems thick, sores or split skin at the corners of your mouth, difficulty speaking and swallowing, bad breath, a change in your sense of taste, increased plaque, tooth decay and gum disease.
      Most xerostomia is related to the medications taken by older adults rather than to the effects of aging. More than 400 medicines can affect the salivary glands. These include drugs for urinary incontinence, allergies, high blood pressure, depression, diarrhea and Parkinson's disease. Also, some over-the-counter medications often cause dry mouth.
      Dry mouth can also be caused by cancer treatments such as chemotherapy and radiation, nerve damage in the head or neck, the autoimmune disease Sjogren's syndrome, endocrine disorders, Alzheimer's disease, stroke, anxiety disorders and depression.
      Sjögren's syndrome can occur either by itself or with another autoimmune disease such as rheumatoid arthritis or lupus. Salivary and tear glands are the major targets of the syndrome. The result of the syndrome is a decrease in production of saliva and tears. 
     The syndrome can occur at any age, but the average person with the disorder at the Sjögren's Syndrome Clinic of the National Institute of Dental and Craniofacial Research (NIDCR) is in his or her late 50s. Women with the disorder outnumber men 9 to 1.
      In addition, tobacco, alcohol (in beverages and mouthwash), drinks with caffeine, snoring and breathing with your mouth open can aggravate dry mouth. 
     If you think you have dry mouth, go to your doctor or dentist. Your doctor may adjust your  medication that is suspected of causing the problem. Or, your doctor may prescribe  a medication to stimulate saliva production.
     There are other ways to improve saliva flow. Try sugar-free hard candy or chewing gum. Avoid lemon-flavored hard candy, because it makes saliva acidic, increasing the possibility of tooth decay. You can also sip water regularly, try over-the-counter saliva substitutes, avoid breathing through your mouth, and use a humidifier in your bedroom.
      If you have dry mouth, you have to pay greater attention to your teeth. Brush your teeth with an extra-soft toothbrush after every meal and at bedtime. If brushing hurts, soften the bristles in warm water. Floss your teeth gently every day. Always use toothpaste with fluoride in it. If you have a sweet snack, brush right away.
If you would like to ask a question, write to fred@healthygeezer.com.

June 02, 2016

Low-Impact Exercise
Q. I’ve got problems with several joints and I heard low-impact exercise is something I should try. What is low-impact and can you suggest some exercises?
Warning: If you want to begin a new exercise program, you should consult your physician and request a list of exercises that are best for your age and physical condition.
A. As you age, your body becomes less flexible and more vulnerable to injury. Low-impact exercise does not place excessive pressure on your body. There are many low-impact activities that can give you a good, relatively safe workout.

The following are some low-impact exercises that you can review and discuss with your doctor. I put these in alphabetical order:
• Cycling -- Riding a bike gives you a substantial workout. I enjoy riding bike trails because I get to enjoy nature while getting low-impact exercise. I gave up riding on streets because there are too many dangers posed by cars and trucks. If you don't want to ride outdoors, you can pedal a stationary bike indoors. 
• Golf -- Golf is great for increasing flexibility and strength. Swinging a club is more exercise than it appears to be. If you can walk 18 holes with a hand cart, you are in great shape already. But riding the course with a golf cart will still have you walking more than you would think. 
• Swimming--Swimming poses very little injury risk. The water relieves the stress on your body. Swimming also is a whole-body exercise.  There's lots strengthening and stretching while afloat. It's great for your arms, legs, back and shoulders.
• Tai Chi -- In Asia, tai chi (tie-chee) is considered to be the most beneficial exercise for older people, because it is gentle and can be modified easily if a person has health limitations. A person doing tai chi progresses slowly and gracefully through a series of movements while breathing deeply and meditating. Tai chi relaxes and stimulates the body and mind. Tai chi has been called moving meditation. 
• Walking -- Walking is one of the simplest and best low-impact exercises. All you need is a good pair of shoes or sneakers and a place to walk. On cold and rainy days, I see a lot of seniors walking around indoor malls. When you can, a beneficial exercise is leaving the car keys at home when you have to run an errand.
• Water aerobics -- Water aerobics is another exercise that can work the whole body. The concept behind this exercise is that everything you do is resisted by the water. This exercise is so popular among seniors that an iconic photo you see often is of a bunch of older people in a pool smiling.
• Weight-lifting -- You should begin doing your moves without weights. Then go to light weights. You can increase the weight amounts gradually. Getting a personal trainer for weight-lifting is a smart idea. 
• Yoga -- Yoga practice includes physical postures that participants flow into and then hold before proceeding to the next posture. Yoga has been shown to help alleviate many of the health problems faced by older adults. In fact,  the many benefits of Yoga are supposed to combat the aging process. Yoga can help your balance, a serious concern for seniors. 


May 26, 2016

Macular Pucker vs. Degeneration
Q. My brother told me he has a macular pucker. Is this the same thing as macular degeneration? 
A. First, a bit of biology...

     The lens in the front of your eye focuses light on the retina in the back of your eye. The lens is like the one in a camera, and the retina is like film. The space between the lens and retina is filled with the vitreous, a clear gel that helps to maintain the shape of the eye.
     The macula is at the center of the retina in the back of your eye. The retina transmits light from the eye to the brain. The macula allows us to perform tasks that require central vision such as reading and driving.
A blurred area in the middle of your vision is a symptom of age-related macular degeneration (AMD), a leading cause of vision loss in Americans 60 years of age and older.
AMD comes in two forms—wet and dry. Wet AMD occurs when blood vessels behind the retina start to leak and raise the macula. Dry AMD occurs when macular cells break down. 
A macular pucker is scar tissue that has formed on the eye's macula.  Like AMD, a macular pucker can blur central vision. Another symptom of macular pucker is seeing straight lines as wavy or broken.
People with a macular pucker might have difficulty seeing fine details and reading small print. They might also have a gray area in the center of vision, or even a blind spot.
Vision does not get progressively worse for most people with a macular pucker. Severe vision loss is uncommon. It is not unusual for someone to have puckers and still have normal vision. Usually, macular pucker affects one eye. 
     As we age, the vitreous slowly shrinks and pulls away from the retinal surface. In most cases, there are no serious adverse effects. However, sometimes there is damage to the retina's surface. As the damage heals, scar tissue is formed. When the scar tissue contracts, it causes the retina to pucker. 
Sometimes macular pucker is caused by an injury or a medical condition, such as diabetes, that affects the eye. Macular puckers can sometimes form after eye surgery. 
Macular pucker is also known as epiretinal membrane, preretinal membrane, cellophane maculopathy, retina wrinkle, surface wrinkling retinopathy, premacular fibrosis, and internal limiting membrane disease.
In many cases, the symptoms from macular pucker are mild, and don't require treatment. People usually adjust to mild visual distortion. In rare cases, surgery is required. 


May 19, 2016​
From The Geezer's Mailbag
Q. Any suggestions for dealing with tinnitus?
A. Most tinnitus—a symptom, not a disease—comes from damage to the microscopic endings of the hearing nerve in the inner ear. People who suffer from tinnitus hear phantom noises that include not just ringing but whistling, hissing, buzzing, roaring and clicking. Tinnitus is most common in people over 65.

Besides treatments such as hearing aids, drugs and therapy, there are techniques for dealing with tinnitus. Here are some:
Music. Many people find focusing on music helps them ignore their tinnitus.
Noise.  Avoid noise, which can make your tinnitus worse. If you can’t escape a noisy environment, wear ear plugs.
Salt. Cut your salt intake which impedes blood circulation. Good circulation can help relieve tinnitus.
Blood pressure. High blood pressure can affect tinnitus. Get your pressure checked.
Stimulants. Stay away from coffee, tea, colas and nicotine.
Exercise. This improves circulation.
Fatigue.  Get enough rest.
Stress. Stress can intensify tinnitus. Try relaxation techniques.

Q. Is it possible to find out what the chances are of having a heart attack?
A. There is a calculator that tells you what the odds are of having a heart attack in the next 10 years. The calculator is for adults 20 or over who do not have heart disease or diabetes. You can find this calculator on-line at: 
http://cvdrisk.nhlbi.nih.gov/calculator.asp
The risk-assessment tool is based upon the Framingham Heart Study, a joint project of the National Heart, Lung and Blood Institute and Boston University. The objective of the Framingham Heart Study, begun in 1948, was to identify the common characteristics that contribute to cardiovascular disease (CVD), which affects the heart and blood vessels.
The calculator asks seven questions: your age, gender, total cholesterol, HDL level, whether you smoke, systolic blood pressure (the first number), and whether you are taking medication for blood pressure. You plug in your numbers and the calculator generates your odds as a percentage. 
Q. Do you think an annual physical is really necessary?
A. Regular health checkups are important. How often you get one depends on your condition.
Let me put it to you this way: How often do you have a mechanic check your new car? How many times do you visit the garage with a car that’s cranked over 100,000 miles? If you’re over 65, get regular physical exams even when you feel great. 
You can read about the federal guidelines for physical exams at the two following web pages. These are for people over the age of 65.
The guidelines for women are at:
http://www.nlm.nih.gov/medlineplus/ency/article/007463.htm
The guidelines for men are at: 
http://www.nlm.nih.gov/medlineplus/ency/article/007466.htm
May 12, 2016

Don't Miss a Beat!
Q. How serious is angina?
A. Angina pectoris--or simply angina--is the medical term for chest pain or discomfort usually caused by coronary artery disease. Angina is a sign that someone is at increased risk of heart attack, cardiac arrest and sudden cardiac death. If you get angina, you should get medical attention immediately. 

Angina (pronounced “an-JI-nuh” or “AN-juh-nuh”) hits when the heart doesn't get enough blood. This usually happens when there is a narrowing or blockage in one or more of the vessels that supply blood to the heart.
Angina can come from exertion. It may make you sweat or lose your breath. The pain can strike your arm or neck, too. 
“Stable angina” comes on with exertion and then goes away easily. You can have this kind of angina for a long time. 
When the pattern of angina changes a lot, it's called “unstable angina.” This is a danger sign. Unstable angina may be the first sign of a heart attack. 
Then there is “variant angina pectoris” or “Prinzmetal's angina.” It usually occurs spontaneously and almost always occurs when a person is at rest.  It doesn't follow physical exertion or emotional stress, either. Variant angina is caused by transient coronary artery spasm. 
Physicians have a variety of diagnostic tools.
An electrocardiogram (EKG or ECG) can tell a doctor if your heart has been damaged by a heart attack. If the EKG is done while you are having chest pain, it can also show if your angina is caused by a problem with your heart.
A stress test is often done while you walk on a treadmill. Your doctor will look at your EKG to see if it's abnormal when you exercise. Your doctor may also have x-rays of the heart taken before and after you exercise. These pictures can show if an area of the heart is not getting enough blood during exercise. 
A cardiac catheterization involves inserting a long, thin tube into an artery in the arm or leg and then guiding it into the heart. Dye is injected into the arteries around the heart. X-rays are taken. The x-rays will show it if any of the arteries that supply the heart are blocked.
Most people diagnosed with heart disease have to take medicine. Medicines called beta blockers, calcium channel blockers and nitrates can help relieve angina. 
There are surgical options. 
Angioplasty uses a tiny balloon to push open blocked arteries around the heart. The balloon is inserted in an artery in the arm or leg. A stent (a small tube) might be put into the artery where the blockage was to hold the artery open.
In bypass surgery, the surgeon uses a healthy blood vessel taken from your leg, arm, chest or abdomen and connects it to the other arteries in your heart so that blood is bypassed around the diseased or blocked area  This increases the blood flow to the heart. 

May 05, 2016

Drug-Related Interactions
Q. Is it true that licorice can interfere with some medications?
A. Some forms of licorice may increase the risk for digoxin toxicity. Digoxin is used to treat heart failure and arrhythmias. Licorice may also reduce the effects of blood pressure medications or diuretic drugs (water pills).

These are just a few of many drug-related interactions that can occur in your body. Drug interactions fall into three categories. There are drug reactions with foods and drink, dietary supplements and with other drugs.
When you start any medicine, don’t be afraid to throw a lot of questions about it at your doctor, nurse or pharmacist. The first question should be: Can this medicine interact with anything else I put in my body? 
The following are some interactions we should all know about:
ALCOHOL
You should avoid alcohol when taking medication. Mixing alcohol with certain medications can cause nausea and vomiting, headaches, drowsiness, fainting, or loss of coordination. It also can put you at risk for internal bleeding, heart problems and difficulty breathing. 
In addition to these dangers, alcohol can make a medication less effective or even useless, or it may make the medication harmful or toxic to your body. Alcohol can also affect many over-the-counter medications and herbal remedies.
 
GRAPEFRUIT JUICE
You shouldn't consume grapefruit if you are on some statins, which are used to lower cholesterol. Grapefruit juice contains a chemical that can interfere with the enzymes that break down statins in your digestive system. This can be dangerous because it's uncertain what the effect would be on your total cholesterol. 
Grapefruit juice can raise the level of some medications in the blood. For example, grapefruit can cause higher blood levels of the anti-anxiety medicine buspirone, the anti-malaria drug quinine, and a medication used to treat insomnia—triazolam.
ANTIHISTAMINES
Some over-the-counter (OTC) antihistamines taken for colds and allergies can increase the depressant effects of a sedative or tranquilizer. Antihistamines taken with blood pressure medication may elevate the blood pressure and may also increase the heart rate.
CHOCOLATE
Eating chocolate and taking monoamine oxidase (MAO) inhibitors could be dangerous. MAO inhibitors treat depression. Someone who eats an excessive amount of chocolate after taking an MAO inhibitor may experience a sharp rise in blood pressure. The caffeine in chocolate can also interact with stimulant drugs such as Ritalin (methylphenidate), increasing their effect, or by decreasing the effect of sedative-hypnotics such as Ambien (zolpidem).
ST. JOHN'S WORT 
St. John’s wort is an herb most commonly used for depression. This herb can reduce the concentration of medications in the blood. St. John's Wort can reduce the blood level of medications such as digoxin, certain statins and the erectile-dysfunction drug Viagra.
VITAMIN E 
Taking vitamin E with a blood-thinning medication such as Coumadin can increase anti-clotting activity and may cause an increased risk of bleeding.
GINSENG
This herb can interfere with the action of anticoagulants such as Coumadin and heparin. Combining ginseng with MAO inhibitors may cause headache, trouble sleeping, nervousness, and hyperactivity.
GINKGO BILOBA 
High doses of the herb Ginkgo biloba could decrease the effectiveness of medications to control seizures.


April 28, 2016

How Common is Amnesia?
Q. In soap operas, the writers love to include characters with amnesia who don't remember their identities. Is it common for someone to actually forget who they are?
A. It's extremely rare. People with amnesia usually are aware of their identities. A person's identity is among the most durable long-term memories.

Amnesia, which means loss of memory, comes in several forms.
The most common type is anterograde amnesia. People with this form have trouble learning and making new memories.
Those who suffer from retrograde amnesia have an impaired ability to recall past events and information that were once familiar.
Transient global amnesia is a temporary loss of all memory, but you  remember who you are, and you recognize people you know well. It is a rare form of the disorder.
Psychogenic amnesia is caused by trauma such as surviving an explosion. A victim of this form of amnesia can lose personal memories and autobiographical information briefly. This form of amnesia is probably the inspiration for all those soap scribes.
There are different types of memory affected by amnesia. Memory can be divided into:
Immediate: Recalling information a few seconds after learning it
Short-term: Recalling recently learned information minutes or more after presentation
Long-term: Memory of remote events occurring months or years ago
There are other memory definitions, too:
Procedural memory about how to perform a task such as knitting
Declarative memory about past information or experiences
Semantic memory that is independent of time, such as vocabulary
Episodic memory linked to a time such as birthday
Prospective memory about a future occurrence such as a planned meeting
There are other symptoms of amnesia. These may include confusion, disorientation, seizures, tremors, lack of coordination and false memories.
Any trauma or disease that impacts the brain can affect memory. The following are some causes:
Brain tumors, heart attack, head injury, encephalitis (brain inflammation), stroke, carbon monoxide poisoning, dementia, seizures, electroconvulsive therapy, drugs such as benzodiazepines that treat anxiety.
There are no drugs to treat most types of amnesia. Scientists are looking into brain neurotransmitters hoping to find ways to treat memory disorders. 
For now, there are techniques being used to help people with amnesia. These include occupational therapy to develop memory, and the use of electronic organizers, notebooks and photographs as reminders.
March 31, 2016
Be Aware of Elder Abuse
Q. How common is elder abuse? 
A. The U.S. Administration on Aging found that more than a half-million people over the age of 60 are abused or neglected each year.  

About 90 percent of abusers are related to the victims. People older than 80 years suffer abuse and neglect two to three times their proportion of the senior population.
Almost four times as many new incidents of abuse, neglect, and/or self-neglect were not reported as those that were reported and substantiated by public authorities.
All 50 states have elder-abuse prevention laws and have set up reporting systems. Adult Protective Services (APS) agencies investigate reports of suspected elder abuse. To report elder abuse, contact your APS office. You can find the telephone numbers at the website operated by The National Adult Protective Services Association. Go to: http://www.napsa-now.org/
The APS agency keeps calls confidential. If the agency decides there may be a law violation, it assigns a caseworker to investigate. If the victim needs crisis intervention, services are available. If elder abuse is not substantiated, most APS agencies will work with other community agencies to get necessary social and health services.
The senior has the right to refuse services offered by APS. The APS agency provides services only if the senior agrees or has been declared incapacitated by the court and a guardian has been appointed. 
What is elder abuse? It can take a variety of forms: physical, sexual, emotional and financial. Neglect of an older person also is within the umbrella of elder abuse.
One of the most common types of elder abuse is self-neglect. Self-neglect often occurs in older adults who have declining health, are isolated or depressed, or who abuse drugs or alcohol.
If you're concerned an older adult might need help, these are symptoms to look for:
 • Physical injury such as a bruise, cut, burn, rope mark, sprain or broken bone;
• Refusal of the caregiver to allow you to visit the older person alone.
• Indications of dehydration, malnourishment, weight loss and poor hygiene.
• Negative behavior such as agitation, withdrawal, expressions of fear or apathy.
• Unexplained changes in finances.

February 25, 2016

Transient Ischemic Attack
Q. Is a TIA dangerous?
A. TIA stands for “transient ischemic attack.” A TIA is an interruption in the flow of blood to a part of your brain. Its symptoms are the same as for a stroke. A TIA lasts anywhere from minutes to many hours. It goes away and leaves no apparent permanent effects.

     If you have a TIA, your chances of having a stroke are increased nine times. Treat a TIA like an early warning and get to your doctor immediately for a check-up.
A stroke, which is also called a “brain attack,” is caused by a blood problem in the brain. An “ischemic stroke” is caused by too little blood in the brain. An “hemorrhagic stroke” is caused by too much blood. 
About 80 percent of strokes are ischemic strokes; they occur when blood clots or other particles block arteries to your brain. Hemorrhagic stroke occurs when a blood vessel in your brain leaks or ruptures.
     During a stroke, brain cells are deprived of oxygen and nutrients and begin to die. The earlier a stroke is treated, the better the results. 
     In the USA, stroke is the third-leading cause of death behind heart disease and cancer. It is the leading cause of adult disability. 
     The most common stroke symptoms include: sudden numbness, weakness, or paralysis of the face, arm or leg — usually on one side of the body; trouble talking or understanding; sudden blurred, double or decreased vision; dizziness, loss of balance or coordination; a sudden headache with a stiff neck, facial pain, pain between the eyes, vomiting or altered consciousness; confusion, or problems with memory, spatial orientation or perception.
     The following can increase your risk of a stroke: a family history of stroke or TIA, aging, race (blacks are at greater risk),  high blood pressure, elevated cholesterol, cigarette smoking, diabetes, obesity, cardiovascular disease, previous stroke or TIA, heavy alcohol drinking and uncontrolled stress.
Your doctor has many diagnostic tools for stroke. Among these are: physical exam, blood tests, carotid ultrasonography to check the carotid arteries in your neck, arteriography to view arteries in your brain, a computerized tomography (CT) scan of the neck and brain, a magnetic resonance imaging (MRI) of the brain, among others.
Treatments are varied and include drugs to fight clots, and medical procedures to keep blood vessels open.

February 18, 2016

Possible Cause For Parkinson's Disease
Q. Is it true that pesticides are responsible for people getting Parkinson's disease?
A. Although genetics is very important in Parkinson's disease (PD), environmental exposures also increase a person's risk of developing the disease. Scientists have known for some time that farm workers who used pesticides, or people who lived or worked near fields where they could inhale drifting pesticides, have an increased risk of PD. 

     PD was first described in 1817 by Dr. James Parkinson, a British physician. It affects 1 in 100 people over the age of 60. It can also affect younger people. The average age of onset is 60. Research suggests that PD affects at least 500,000 people in the United States. 
     PD is a complex disorder of the central nervous system. It is the second most common neurodegenerative disease in the United States, after Alzheimer's. 
     The defining symptoms of PD include tremor, slowness of movement, rigidity, and impaired balance and coordination. As these symptoms become more pronounced, patients may have difficulty walking, talking, or completing simple tasks. They also may experience depression, difficulty sleeping and other problems.
     The progression of symptoms in PD may take 20 years or more. In some people, however, the disease progresses much more quickly. 
In the early 1960s, scientists determined that the loss of brain cells was causing PD. The cells that were depleted produced dopamine, a chemical that helps control muscle activity. Today, PD is treated with drugs and surgery.
     Medications for PD fall into three categories.The first includes drugs that increase the level of dopamine in the brain. The second category affects neurotransmitters in the body to ease some of the symptoms of the disease. The third category includes medications that help control the non-motor symptoms of the disease such as depression. 
There are two commonly used surgical treatments for PD: pallidotomy and deep brain stimulation. Because these procedures are invasive, they are usually reserved for severely afflicted Parkinson's patients who do not get adequate relief from medications.
     Surgeons discovered that, by removing or destroying parts of the brain that were “misfiring,” some of the symptoms of PD could be alleviated. One of these operations is pallidotomy. 
Scientists have found that they can mimic the effects of pallidotomy by deep brain stimulation (DBS). With DBS, an electrode is implanted in the brain in a way that calms the abnormal neuronal firing. DBS is now the primary surgical intervention for PD. 
     A wide variety of complementary and supportive therapies may be used for PD. Among these therapies are standard rehabilitation techniques, which can help with problems such as gait and voice disorders, tremors and rigidity, and cognitive decline. Exercise may help people improve their mobility. 
While Parkinson's is a complex disease, research has progressed a great deal in recent years. Halting the progression of PD, restoring lost function, and even preventing the disease are now considered realistic goals.

February 11, 2016

From The Geezer's Mailbag
Q. What can I do to avoid lead exposure?
A. Lead exposure can cause anemia, make you irritable, affect your memory and ability to concentrate, and it can increase blood pressure, particularly in older people. Lead can also lead to digestive problems and cataracts. Exposure to high lead levels can be fatal. 

     The following are some significant sources of lead exposure: tap water, lead-based paint that was used before it was banned from housing in 1978, soil,  household dust, lead crystal or lead-glazed pottery.
Here are some steps you can take to prevent exposure to lead:
• Clean up paint chips immediately.
• Clean floors, window frames, window sills, and other surfaces weekly. 
• Wash hands often.
• Clean or remove shoes before entering your home to avoid tracking in lead from soil.
• Repair damaged painted surfaces
• Plant grass to cover soil with high lead levels. 
• To remove lead hazards permanently, you must hire a certified lead-abatement contractor. Contact the National Lead Information Center (NLIC) to locate certified contractors in your area. You can email NLIC on this website: http://www2.epa.gov/lead
Q. What’s the best way to treat a nosebleed?
A. Resist every instinct in your body to tilt your head back or to lie down.  You have to keep your head higher than your heart to cut down on bleeding. And, if you lean back, you can swallow blood, which can produce vomiting and diarrhea.

     The best technique is to sit down and lean slightly forward so the blood will drain out of your nose. Then, using your thumb and index finger, squeeze the soft portion of your nose together.
Hold your nose until the bleeding stops. Don’t let go for at least 5 minutes. Repeat as necessary. You can also place an ice pack across the bridge of your nose. 
Self-treatment can stop almost all nosebleeds. If bleeding persists, get immediate medical attention.
Q. I’m thinking of getting a tattoo. How could it affect my health?
A. Complications from tattoos are relatively uncommon. However, there are risks that include: blood-borne diseases such as hepatitis, tetanus, tuberculosis and HIV/AIDS; granulomas, which are bumps that can form around tattoo; keloids, which are scars that grow beyond normal boundaries; local bacterial infections, and allergic reactions.

     Also, tattoos can create a misdiagnosis with Magnetic Resonance Imaging (MRI) because there is metal in many tattoo pigments. Magnets attract metals. So, tattoo pigments may interfere with the quality of the image from an MRI. In some rare cases, people experience swelling or burning in the tattoo when they have an MRI. 
If you decide to get a tattoo, make sure the establishment is licensed and reputable.

January 28, 2016

It's a Matter of Taste
Q. Do we lose our sense of taste as we get older?
A. In general, sensitivity to taste gradually decreases with age. But there are some whose taste isn’t affected by getting older. 

    The ability to taste food and beverages means a lot to seniors. Let’s face it; we lose a lot of the pleasures of our youth, but eating well isn’t usually one of them. 
Taste also has a major impact upon our physical and mental health. Our sense of taste is especially important if we have to stay on a diet. If food loses its appeal, we may eat improperly and put ourselves at risk for heart disease, stroke and diabetes. Loss of taste can lead us to overeat, undereat, or add too much salt or sugar to our food. 
     While taste is important, we recognize flavors largely through our sense of smell. Try holding your nose while eating. Smell and taste are closely linked in the brain. It is common for people who lose their sense of smell to say that food has lost its taste. This is incorrect; the food has lost its aroma, but taste remains. Loss of taste occurs less frequently than loss of smell in older people.
When an older person has a problem with taste, it is often temporary and minor. True taste disorders are uncommon. When a problem with taste exists, it is usually caused by medications, disease, or injury.
In some cases, loss of taste can accompany or signal a more serious condition, such as diabetes or some degenerative diseases of the central nervous system such as multiple sclerosis.
There are several types of taste disorders You can have a persistent bad taste in the mouth. This is called a dysgeusia. Some people have hypogeusia, or the reduced ability to taste. Others can't detect taste at all, which is called ageusia. People with taste disorders experience a specific ageusia of one or more of the five taste categories: sweet, sour, bitter, salty and savory. 
The most common complaint is “phantom taste perception,” which is tasting something that isn’t there.
If you think you have a taste disorder, see your doctor. Diagnosis of a taste disorder is important because once the cause is found, your doctor may be able to treat your taste disorder. Many types of taste disorders are reversible, but, if not, counseling and self-help techniques may help you cope.
If you cannot regain your sense of taste, there are things you can do to ensure your safety. Take extra care to avoid food that may have spoiled. If you live with other people, ask them to smell and taste food to see if it is fresh. People who live alone should discard food if there is a chance it is spoiled.

December 10, 2015

From The Geezer's Mailbag
Q. What is St. John’s Wort?
A. St. John's Wort—also known as hypericum herb, klamath weed or goat weed—is a plant with yellow flowers that are used to make teas and tablets. For centuries, the plant has been considered a remedy for mental problems, including depression and anxiety.

     Does it work? St. John's Wort is not a proven therapy for depression. There is some scientific evidence that St. John's Wort helps in the treatment of  mild-to-moderate depression. However, there have been two major studies that showed St. John’s Wort is no better than a placebo for treating moderate depression.
Before you go to a store to buy some of this herb, consult with your personal physician. There are negative side effects from taking St. John’s Wort. These include: sensitivity to sunlight, anxiety, dry mouth, dizziness, gastrointestinal symptoms, fatigue, headache, or sexual dysfunction. This plant can also interact with drugs you’re taking.
If you believe you are depressed and want treatment, there are approved antidepressant medications that work. Most people with depression get better with treatment that includes these medicines. 
Q. What is a stem cell?
A. In your body, you have specialized cells that make up your brain, blood, bones and other anatomical parts. Stem cells are not specialized; they are master cells. Stem cells divide to form specialized cells or new stem cells. 

     There are two basic forms of stem cells—embryonic and adult.
Embryonic stem cells come from embryos that are a few days old. These cells  
can divide into more stem cells or any type of body cell. Embryonic stem cells have the greatest capacity to regenerate or repair diseased tissue in people. 
Adult stem cells is a term used to describe stem cells found in adult tissues, children, placentas and umbilical cords. Adult stem cells are often present in only small quantities. The primary functions of adult stem cells are to maintain and repair  tissue.
     The conventional wisdom has been that adult stem cells create only one kind of specialized cell, but a new theory suggests that these cells may have the potential to do more. For example, bone-marrow stem cells responsible for producing blood might be able to make nerve tissue.
Q. Can stem cells be used to treat Parkinson's disease?
A. Stem cells offer the possibility of a renewable source of replacement cells and tissues to treat many medical problems including Parkinson and Alzheimer's diseases, spinal cord injury, stroke, burns, heart disease, diabetes and arthritis.

     Parkinson disease (PD) may be the first disease amenable to treatment with stem cells. In the early 1960s, scientists determined that the loss of brain cells was causing PD. The cells that were depleted produced dopamine, a chemical that helps control muscle activity. Today, PD is treated with drugs and surgery.
      PD is a complex disorder of the central nervous system. It is the second most common neurodegenerative disease in the United States, after Alzheimer's. The defining symptoms of PD include tremor, slowness of movement, rigidity, and impaired balance and coordination. 
If you would like to ask a question, write to fred@healthygeezer.com.

December 03, 2015

Several Types of Hepatitis Viruses
Q. How many kinds of hepatitis are there?
A. Your liver helps your body digest food, store energy and remove poisons. Hepatitis is an inflammation of the liver that makes it stop working efficiently.
 
     Hepatitis is usually caused by a virus. There are five main hepatitis viruses--types A, B, C, D and E.  There are several other causes of hepatitis.
Some people who have hepatitis have no symptoms. Others may have loss of appetite, fatigue, nausea, vomiting, fever, muscle and joint pain, diarrhea, dark-colored urine, pale bowel movements, stomach pain, and jaundice.
Hepatitis A
     Hepatitis A virus (HAV) is in the feces of infected persons. It is most often spread through contaminated water or food. Hand-washing can prevent the spread of this virus. Many cases of HAV infections are mild; most people with HAV make a full recovery and remain immune to it. However, HAV can be life threatening. Safe and effective vaccines are available to prevent HAV.
Hepatitis B
     Hepatitis B virus (HBV) infections range in severity from a mild illness lasting a few weeks, to a serious long-term illness that can lead to liver scarring (cirrhosis) and cancer. HBV usually gets better on its own after a few months. 
     It is transmitted  through contact with infectious blood, semen, and other body fluids from having sex with an infected person, sharing contaminated needles for injecting drugs, or from an infected mother to her newborn.
     Hepatitis B vaccination is recommended for all infants, older children and adolescents who were not vaccinated previously, and adults at risk for HBV.
Hepatitis C
     Hepatitis C virus (HCV) usually causes a chronic condition that can lead to cirrhosis of the liver and liver cancer. Hepatitis C virus is mostly transmitted through exposure to infected blood.  Sexual transmission is also possible, but is much less common. It can also spread from mother to baby during childbirth. There is no vaccine for HCV. 
Usually, hepatitis C does not get better by itself. The infection can last a lifetime.  Medicines sometimes help. Serious cases may need a liver transplant.
Hepatitis D
     Hepatitis D virus (HDV) infections occur only in those who are infected with HBV. The dual infection of HDV and HBV can cause a more serious disease. Hepatitis B vaccines provide protection from HDV.  HDV is transmitted through contact with infected blood. Hepatitis D is uncommon in the United States.
Hepatitis E
     Hepatitis E virus (HEV) usually does not lead to a chronic infection. It is caused by ingesting fecal matter in contaminated water or food. HEV is a common cause of hepatitis outbreaks in developing parts of the world. It is rare in the United States. Safe and effective vaccines to prevent HEV infection have been developed but are not widely available. 
 Alcoholic hepatitis
     Alcoholic hepatitis is likely to affect people who drink heavily for a long time, but all heavy drinkers don't develop it. Moderate drinkers can get alcoholic hepatitis. If you have this form of hepatitis, you must stop drinking; it can be fatal.
     Women have a higher risk of developing alcoholic hepatitis than men do. Other factors which may increase your risk include: type of beverage (wine is less risky than beer or liquor), binge drinking, obesity and being African-American or Hispanic.
Toxic hepatitis
     Toxic hepatitis is from exposure to over-the-counter pain relievers, prescription medications such as cholesterol-lowering statins, herbs and supplements, and industrial chemicals. Alcoholic hepatitis can be included in this category.
Autoimmune hepatitis
     Autoimmune hepatitis is inflammation that occurs when your body's immune system attacks your liver. 
Untreated autoimmune hepatitis can lead to cirrhosis and liver failure. When treated early, autoimmune hepatitis often can be controlled with drugs that suppress the immune system.
If you would like to ask a question, write to fred@healthygeezer.com

November 26, 2015

Nutty For Nuts
Q. Are nuts really good for your heart?

A. The Harvard Men's Health Watch reports that studies show healthy men, and those who have already suffered a heart attack, can reduce cardiovascular risk by eating nuts regularly. Here are some facts about nuts:

Fiber. All nuts contain fiber, which helps lower your cholesterol. Fiber also makes you feel full, so you eat less.
      Some nuts contain plant sterols, a substance that can help lower your cholesterol. 
 Nuts contain mono- and poly-unsaturated fats known to benefit the heart.
       Many nuts are rich in omega-3 fatty acids. Omega-3s are a healthy form of fatty acids that seem to help your heart by, among other things, preventing dangerous heart rhythms that can lead to heart attacks.  
Nuts are a source of l-arginine, which is a substance that may help improve the health of your artery walls by making them more flexible and less prone to blood clots that can block blood flow.
 Vitamin E in nuts may help stop the development of plaques in your arteries, which can narrow them, leading to chest pain, coronary artery disease or a heart attack.
      In addition, nuts may help lower cholesterol by simply replacing less healthy foods in your diet.
“Nuts may not be the key to cardiovascular health, but adding nuts to a balanced, healthful diet can take you one step away from heart disease,” says Dr. Harvey B. Simon of Harvard Medical School.
However, there isn't hard evidence for the benefits of nuts to your heart. The U.S. Food and Drug Administration (FDA) only allows food companies to say evidence suggests but does not prove that eating nuts reduces heart disease risk.
      Most nuts contain at least some substances that are good for your heart. However, while nuts are loaded with nutrition, they are also high in calories; as much as 80 percent of a nut is fat. Two ounces of nuts a week appears to help lower heart disease risk, so don't eat nuts like an elephant or you will become one.
Nuts don't vary a lot in caloric content. Almonds are on the low end with 160 calories per ounce. Macadamias are on the high end with 204 calories per ounce.
     Most nuts appear to be good for you. Walnuts, almonds, macadamia nuts, hazelnuts and pecans are considered very good for your heart. 
WALNUTS. While all nuts contain heart-healthy omega-3 fats, walnuts have high amounts of alpha linoleic acid (ALA). Research has suggested that ALA may help heart arrhythmias, and a 2006 Spanish study suggested that walnuts were as effective as olive oil at reducing inflammation and oxidation in the arteries after eating a fatty meal. 
ALMONDS. These nuts contain more calcium than any other nut, making them a great food for overall health. They are rich in fiber and vitamin E, an antioxidant that helps fight dangerous inflammation and possibly health conditions such as lung cancer and age-related cognitive decline.
MACADAMIAS. Although high in fat, macadamias supply good levels of the healthy mono-unsaturated variety. They're a rich source of fiber and contain minerals including magnesium, calcium and potassium. 
HAZELNUTS. These are a good  source of folate, which plays a key role in keeping homocysteine within normal levels. Homocysteine is an amino acid which has been associated with heart problems as well as conditions like Parkinson's disease. 
PECANS. These are packed with plant sterols. Pecans are also antioxidant-rich which helps prevent the plaque formation that causes hardening of the arteries. They're rich in oleic acid, the healthy fat found in olives and avocado. As a good source of vitamin B3, pecans help fight fatigue.
 
If you would like to ask a question, write to fred@healthygeezer.com

​​November 19, 2015

Glaucoma: A Leading Cause of Blindness in the U.S.
Q. What exactly does glaucoma do to your eyes? 
A. Glaucoma is defined as a group of diseases that can damage the eye's optic nerve, which carries images from the eye to the brain.  Here’s how glaucoma works:
      A clear fluid flows through a small space at the front of the eye called the “anterior chamber.” If you have glaucoma, the fluid drains too slowly out of the eye and pressure builds up. This pressure may damage the optic nerve.
      However, increased eye pressure doesn’t necessarily mean you have glaucoma. It means you are at risk for glaucoma. A person has glaucoma only if the optic nerve is damaged. 
Glaucoma can develop in one or both eyes. The most common type of glaucoma starts out with no symptoms. Without treatment, people with glaucoma will slowly lose their peripheral vision. Eventually, the middle of your vision field may decrease until you are blind.
      Unfortunately, there is no cure for glaucoma, a leading cause of blindness in the United States. 
     Any vision that glaucoma destroys cannot be restored. Early diagnosis of glaucoma is extremely important, because there are treatments that may save remaining vision.
     Almost three million people in the U.S. have glaucoma. Those at highest risk are African-Americans, everyone over age 60, and people with a family history of glaucoma.
Glaucoma is just one reason seniors should make regular visits to an eye doctor. Glaucoma is detected through a comprehensive eye exam that includes a visual acuity test, visual field test, dilated eye exam, tonometry, and pachymetry.
     A visual acuity test measures vision at various distances. A visual field test measures peripheral vision. In a dilated eye exam, a special magnifying lens is used to examine the inside of the eye. In tonometry, an instrument measures the pressure inside the eye. With pachymetry, an instrument is used to measure the thickness of your cornea, the transparent part of the front of the eye.
The most common treatments for glaucoma are medication and surgery. Medications for glaucoma may come in eye drops or pills. For most people with glaucoma, regular use of medications will control the increased fluid pressure. 
     Laser surgery is another treatment for glaucoma. The laser is focused on the part of the anterior chamber where the fluid leaves the eye. This makes it easier for fluid to exit the eye. Over time, the effect of this surgery may wear off. Patients who have laser surgery may need to keep taking glaucoma drugs.
Studies have shown that the early detection and treatment of glaucoma is the best way to control the disease. So, have your eyes examined thoroughly and regularly if you are in a high-risk category. And that includes all of us geezers.
If you would like to ask a question, write to fred@healthygeezer.com.

November 12, 2015

From The Geezer's Mailbag
Q. How successful are heart transplants?
A. The survival rates for heart transplants have improved steadily since the first successful human heart transplants were done in the late 1960s. 
Almost nine out of 10 patients survive the first year following a heart transplant. After five years, the survival rate drops to about seven in 10. After 10 years, the rate drops again to about 5 in 10. After 20 years, about 1.5 in 10 are still ticking.

     Approximately 2,300 heart transplants are now performed each year in more than 150 heart-transplant centers in the United States
     There is no widely accepted age cut-off. However, most transplant surgery isn't performed on people older than 70 because the procedure doesn’t have a high success rate for patients in that age group. The majority (52 percent) of candidates are between the ages of 50 and 64.
Q. What is leukemia? It sounds complicated.
A. Leukemia means “white blood” in Greek. If you get leukemia, your bone marrow—the soft material inside bones—makes abnormal white blood cells that block production of normal white blood cells, which you need to battle infections. Leukemia cells also interfere with the red blood cells that distribute oxygen throughout your body, and platelets, which help your blood to clot.

     Leukemia symptoms include: fevers or chills, night sweats, frequent infections, weakness or fatigue, shortness of breath, headache, bleeding, bruising easily, bone pain, swelling or discomfort in the abdomen (from an enlarged spleen), swollen lymph nodes, especially in the neck or armpit, weight loss, and tiny red marks on the skin, 
      The two basic types of leukemia are acute and chronic. Acute leukemia develops quickly. Chronic leukemia develops slowly and usually occurs during or after middle age. Leukemia is also categorized by the type of white blood cell that is affected. 
     There are four common types of leukemia:
Chronic lymphocytic leukemia (CLL).  Most people diagnosed with this form of the disease are over age 55. CLL almost never attacks children.
Chronic myeloid leukemia (CML), which primarily affects adults.
     Acute lymphocytic leukemia (ALL), which is the most common type of leukemia in young children. It can also affects adults.
     Acute myeloid leukemia (AML), which occurs in both adults and children.
Q. What is the difference between a “D.O.” and an “M.D.”?
A. D.O. stands for doctor of osteopathic medicine. M.D. is the abbreviation for doctor of medicine. M.D.'s are also called doctors of allopathic medicine. 

      Here are a couple of brief dictionary definitions:
os·te·op·a·thy  n. A system of medicine based on the theory that disturbances in the musculoskeletal system affect other bodily parts, causing many disorders.
al·lop·a·thy  n. A method of treating disease with remedies that produce effects different from those caused by the disease itself.
      Osteopathic medicine is a safe, established practice. Like MDs, DOs must pass a state medical board examination to obtain a license to practice. There are about 15 MDs for every DO in the United States.
Both DOs and MDs are fully qualified to prescribe medication and perform surgery. Like a medical doctor, an osteopathic physician completes four years of medical school and can choose to practice in any medical specialty. However, osteopaths receive an additional 300 to 500 hours in the study of  manual medicine and the body’s musculoskeletal system. 


November 05, 2015

Arthritis: Inflammation of the Joints
Q. It seems to me that arthritis is a catch-all term for all kinds of aches and pains. What exactly is arthritis?  
A. Arthritis, which comes in more than 100 different forms, is inflammation of the joints. Osteoarthritis, rheumatoid arthritis and gout are the three most common forms of arthritis among seniors. Osteoarthritis is the most prevalent. None are contagious.

Osteoarthritis
      You get osteoarthritis when cartilage—the  cushioning tissue within the joints—wears down. This produces stiffness and pain. The disease affects both men  and women. By age 65, more than 50 percent of us have osteoarthritis in at least one joint.
     You can get osteoarthritis in any joint, but it usually strikes those that support weight. Common signs of osteoarthritis include joint pain, swelling, and tenderness. However, only a third of people whose x-rays show osteoarthritis report any symptoms.
     Treatments for osteoarthritis include exercise, joint care, dieting, medicines and surgery. For pain relief, doctors usually start with acetaminophen, the medicine in Tylenol, because the side effects are minimal. If acetaminophen does not relieve pain, then non-steroidal anti-inflammatory drugs such as ibuprofen and naproxen may be used.
     The dietary supplements glucosamine and chondroitin sulfate are used by many who say the supplements can relieve the symptoms of osteoarthritis.
Rheumatoid Arthritis
     Rheumatoid arthritis, which is characterized by inflammation of the joint lining, is very different from osteoarthritis. It occurs when the immune system turns against the body.  It not only affects the joints, but may also attack other parts of the body such as the lungs and eyes. People with rheumatoid arthritis may feel sick. 
     There’s a symmetry to rheumatoid arthritis. For example, if the right knee is affected, it’s likely the left knee will suffer, too. Women are much more likely than men to get rheumatoid arthritis. 
     Treatments for rheumatoid arthritis include exercise, medication and surgery. Reducing stress is important. 
     Some drugs for rheumatoid arthritis relieve pain. Some reduce inflammation. And then there are the DMARDs (disease-modifying anti-rheumatic drugs), which can often slow the disease. 
Gout 
     Gout usually attacks at night. Stress, alcohol, drugs or an illness can trigger gout. It’s caused by a build-up of crystals of uric acid in a joint. Uric acid is in all human tissue and is found in foods. 
     Often, gout affects joints in the lower part of the body such as the ankles, heels, knees, and especially the big toes. The disease is more common in men. Early attacks usually subside within three to 10 days, even without treatment, and the next attack may not occur for months or even years.
      Most people with gout are able to control their symptoms with treatment. The most common treatments are high doses of oral non-steroidal anti-inflammatory drugs, or corticosteroids, which are taken by mouth or injected into the affected joint. Patients often begin to improve within a few hours of treatment. 

October 08, 2015

Available Vaccines For The Elder
Q. Are there vaccinations for older people? Which ones should I get?
A. To get the appropriate vaccinations for you, discuss the subject with your physician. 

The Centers for Disease Control and Prevention (CDC) offers these general recommendations for seniors:
• Influenza vaccine to protect against seasonal flu.
• Tdap vaccine for tetanus, diphtheria, and pertussis. Tetanus, sometimes called lockjaw, affects the nervous system. Diphtheria is a respiratory disease. Pertussis is commonly known as whooping cough. 
• Pneumococcal vaccine for pneumococcal diseases that cause infections in the lungs, blood, brain and ear. Pneumococcal diseases can take various forms, including pneumonia and meningitis.
• Zoster vaccine, which protects against shingles, a painful skin disease caused by the chickenpox virus awakening from a dormant state to attack your body again.
     There may be other vaccines to consider because your health, job, or lifestyle may put you at higher risk for certain diseases. For example, people with diabetes should get the Hepatitis B vaccine. 
If you are planning to travel out of the country, find out which vaccines are recommended or required. Visit the CDC Travel Health site to learn more. Go to: http://wwwnc.cdc.gov/travel/
In childhood, we are given vaccinations that provide immunity against a broad range of diseases. Recent evidence indicates that the immunity conferred by childhood vaccinations may diminish as we age. So, it is now possible to receive a supplementary booster injection for these childhood diseases. 
      Aging weakens our immune systems making us vulnerable to infections, which are more dangerous to older people. Vaccines can help boost the immune systems of older people. 
Immunizations teach your body how to defend itself when viruses or bacteria invade it. They expose you to small amounts of viruses or bacteria that have been weakened or killed. Your immune system then learns to recognize and attack the infection if you are exposed to it later in life. As a result, you will either not become ill or have a milder infection. 
     Our immune system is a complicated network of cells, tissues, and organs. It is composed of two major parts: the innate immune system and the adaptive immune system. Both change as people get older. 
      The innate system is the first line of defense. It includes the skin, the cough reflex, mucous membranes, and stomach acid. A second line of defense includes specialized cells that alert the body of the impending danger. Inflammation is an important part of our innate immune system. 
     The adaptive immune system is more complex than the innate immune system and includes the thymus, spleen, tonsils, bone marrow, circulatory system, and lymphatic system. These different parts of the body work together to produce, store, and transport specific types of cells and substances to combat health threats. 
If you would like to ask a question, write to fred@healthygeezer.com.

October 01, 2015

Palliative Care
Q. If a very sick patient in a hospital is put on palliative care, does that mean they aren't going to make it?
A. No. Recent evidence indicates that palliative care alongside standard care extends lives.

     Palliative care is not the same as hospice care. Palliative care is designed to improve the quality of life of patients and their families. Hospice is for the end of life. In fact, hospice requires that a patient be certified as being six months from death, and it requires stopping most curative treatments. 
      Palliative medicine is a relatively new, fast-growing interdisciplinary specialty. A team of physicians, nurses, social workers, psychologists, chaplains, dietitians, pharmacists and rehabilitation specialists work together with a patient’s other doctors to provide an extra layer of support. 
      It is for people with serious illnesses such as cancer, cardiac disease, HIV/AIDS, cystic fibrosis, chronic obstructive pulmonary disease (COPD), kidney failure, Alzheimer’s, Parkinson’s and Amyotrophic Lateral Sclerosis (ALS).
      Palliative care is a good option for someone with a serious illness who needs help managing pain or other symptoms, understanding and coping with a medical condition, and navigating the health care system.
The first principle of palliative medicine is to help people feel better. It focuses on symptoms such as pain, shortness of breath, fatigue, constipation, nausea, loss of appetite, difficulty sleeping, stress and depression. 
     It not only brings physical, emotional and spiritual relief, but improves a patient's ability to tolerate medical treatments. Palliative care can begin at diagnosis, and can be given at the same time as curative treatment.
     Palliative care also strives to improve communication between patients, their health care providers and family members. It is also designed to coordinate care, especially as patients move from the hospital to home or to another care facility.
     About 80 percent of major hospitals offer a palliative-care service.  Palliative care is almost always covered by health insurance, including Medicare or Medicaid.
Because of improvement in health care, most Americans who live beyond age 65 can expect to make it to almost 85. However, those survivors may suffer from pain, medical complications, depression, and disability.      This phenomenon has generated a greater need for palliative care.
      “We need to think about palliative care not as care at the end of life, but as improving a patient's quality of life,” says R. Sean Morrison, M.D., professor of geriatrics and palliative medicine at the Mount Sinai School of Medicine. “For the vast majority of patients with chronic illness, both life-prolonging and palliative treatments are necessary and appropriate.”
If you would like to ask a question, write to fred@healthygeezer.com.

September 24, 2015

From The Geezer's Mailbag
Q. I understand that getting a hernia fixed today is a lot easier than it used to be. Is that true?
A. You get a hernia when a section of an internal organ bulges through weak abdominal muscle tissue. The protruding organ is usually the intestines. About 80 percent of hernias are located in the groin. The overwhelming majority of groin-hernia victims are men.

     About 5 million Americans develop hernias annually, but only 700,000 get them fixed surgically. The common theory for this phenomenon among doctors is that most people fear having an operation. But hernia surgery today is not the ordeal it once was with a large incision and long recovery.
     Today, patients requiring hernia surgery are in an out of the hospital the same day. The surgery takes about an hour. Most patients resume their normal lives within a few days after the surgery.
The operation can be done with a small incision or by minimally invasive laparoscopic surgery that employs a slender, tubular, optical instrument with a surgical tool. 
Q. Do men have different brains than women?
A. Here are some fascinating facts:

• Dr. Gabrielle M. de Courten-Myers, a University of Cincinnati scientist, has determined men have about 2 billion more brain cells than women but the extra cells don't make them smarter than women
• Louann Brizendine, a San Francisco neuropsychiatrist and author of The Female Brain, asserts that the difference between male and female brains explains why women like to discuss their feelings, while men love to dwell upon sex.
“Women have an eight-lane superhighway for processing emotion, while men have a small country road," Brizendine says. “Men, however, have O'Hare Airport as a hub for processing thoughts about sex, where women have the airfield nearby that lands small and private planes.”
• A brain-scanning study suggests that when males watch a mild electric shock given to a cheater, they don't feel his pain. Instead they enjoy it. Women's brains empathize with the cheater’s pain and they get no pleasure from it. 
• Men tend to perform better than women at certain spatial tasks, target-directed motor skills, mathematical reasoning, and navigating. (Is that why they don’t ask for directions?). Women tend to excel at word tests, identifying matching items and  precision manual tasks.
• Men and women with equal IQ’s achieve the same scores with different areas of the brain, Richard J. Haier, PhD reported in NeuroImage.  He also found that women have more white matter and fewer gray matter areas related to IQ than men do.
Q. What is hip resurfacing?
A. It is a surgical alternative to total hip replacement. 

      The hip is a ball-and-socket joint. The ball is at the top of the femur (thigh bone), and the socket is in the pelvis. In hip replacement surgery, the ball is replaced with a metal or ceramic substitute. The socket is fitted with a metal cup to hold the new ball. 
      The primary difference in hip resurfacing is that the surgeon doesn’t remove the femural ball. Instead, the damaged ball is reshaped, and then a metal cap is anchored over it. 
     A crucial issue in joint replacement is longevity. A substitute hip is good for about 20 years, and it is difficult to remove and replace one that’s shot. Hip resurfacing, unlike hip replacement, preserves enough bone to permit a total replacement if it is necessary later. 
     Surgeons estimate that 10 to 15 percent of people with bad hips can consider hip resurfacing instead of replacement. For example, resurfacing is not recommended for patients with osteoporosis, a disease that makes bones porous and vulnerable to fractures.
September 17, 2015

Skin Tags and Liver Spots, Oh My!
Q. My skin has all kinds of small thingies on it like my father used to have. My doctor checks them out and says they are all harmless. But, what exactly are they?
A. As we age, most of us start sprouting an array of unwanted growths. Let's go over the common ones:

LIVER SPOTS: The official name for liver or age spots is “lentigines” from the Latin for “lentil.”  These are flat, brown with rounded edges and are larger than freckles.  They are not dangerous. 
KERATOSES—Seborrheic keratoses are brown or black raised spots, or wart-like growths that appear to be stuck to the skin. They are harmless. Actinic keratoses are thick, warty, rough, reddish growths. They may be a precursor to skin cancer.
CHERRY ANGIOMAS—These are small, bright-red raised bumps created by dilated blood vessels. They occur in more than 85 percent of seniors, usually on the trunk. These are also not dangerous.
TELANGIECTASIA—These are dilated facial blood vessels.     
SKIN TAGS—These are bits of skin that project outward. They may be smooth or irregular, flesh colored or more deeply pigmented. They can either be raised above the surrounding skin or have a stalk so that the tag hangs from the skin. They are benign.
Now we get into the cancers of the skin.
SQUAMOUS CELL CARCINOMAS—These are in the outer layers of the skin. They are closely associated with aging. These are capable of spreading to other organs. They are small, firm, reddened nodules or flat growths. They may also be cone-shaped. Their surfaces may be scaly or crusted.
BASAL CELL CARCINOMAS—These are the most common of the skin cancers. They develop in the basal layer below the surface of the skin. Basal cell carcinomas seldom spread to other parts of the body. They usually appear as small, shiny bumps or pinpoint, red bleeding areas on the head, face, nose, neck or chest. 
MELANOMAS—The melanoma is the deadliest form of skin cancer. Melanomas can spread to other organs and can be fatal. They usually appear as dark brown or black mole-like growths with irregular borders and variable colors. They usually arise in a pre-existing mole or other pigmented lesion. 
Skin cancer is the most common type of cancer in the United States. About half of all Americans who live to 65 will have skin cancer. Although anyone can get skin cancer, the risk is greatest for people who have fair skin.
Ultraviolet radiation from the sun is the main cause of skin cancer. All skin cancers can be cured if they are treated before they spread. The most common warning sign of skin cancer is a change on the skin, especially a new growth or a sore that doesn’t heal. 
Check your skin often. Look for changes in the size, shape, color, or feel of birthmarks, moles, and spots. And don’t be reluctant to go to a doctor whenever you see anything on your skin that you suspect might be a problem. 
Dermatologists recommend that, if you are a fair-skinned senior, you should get a full-body skin exam once a year. This kind of check-up isn’t a bad idea for any senior. 


September 10, 2015
Do You Smell What I Smell
Q. My six-year-old grandson insists that I smell like an old person. Do you have any idea what he's talking about?
A.There was a study that suggests people can tell if you are old by how you smell. The study was done at the Monell Chemical Senses Center in Philadelphia.

     Researchers asked volunteers between the ages of 20 and 95 to sleep in T-shirts with nursing pads sewn into the armpits. 
After the five nights, the researchers put the pads in jars. Each jar contained cut-up quarters of pads from several people in the same age group. A separate group of  volunteers was asked to sniff the jars and rate the odors.
     The odor of people 75-95 was judged to be less intense and far more pleasant than the scent of either young or middle-aged adults. In general, men smelled worse than women, but that distinction disappeared in old age, the researchers found.
     Johan Lundstrom, co-author of the study and an assistant professor at Monell, said the study "shows that there's yet another signal hidden in the body odor that we are somehow able to extract and make use of."
Previous research had suggested that body odor provides clues to sickness, gender and kinship. In recent years, scientists have shown that humans use their noses when selecting romantic partners.
     There is a negative connotation to “old-people smell.” Where does it originate? 
Here are some possible causes offered by experts on aging:
• Stale air. Old people tend to keep the thermostat on high, their windows closed and shades down. Their homes are stuffy breeding grounds for mold and bacteria.
• Dirty digs. It's more burdensome for older people to do house-cleaning. 
• Unlaundered clothes. Doing laundry is difficult for many older people, so they tend to have soiled clothes around.
• Incontinence. Sometimes the aged don't get to the bathroom in time and don't clean up properly.
• Faulty senses. An older adult's senses of sight and smell have dulled. Older people often don't see dirt or smell bad odors.
• Bad breath. As we age, the tissues of the mouth produce less saliva, which is the best defense against bad breath. Older people don't brush their teeth as well as they used to. And dentures retain odors if they aren't replaced when they should be.  Digestive problems, such as acid reflux, are increasingly common as we age; these send stomach odors up into the mouth.
• Dehydration. It's common for older people to drink very little without realizing it. When a person is dehydrated, odors from foods such as garlic or onion become more concentrated. Urine is more concentrated, too, so just a drop of leakage can produce a strong smell.
• The unwashed. Older people take fewer baths because they are viewed as a lot of work when you are just staying at home.  And, there is a fear of falling in the tub.
• Medicinal smell. Older people take a lot of medications, which can cause a subtle chemical odor to come through the pores of the skin. They also use a lot of mentholated products such as Ben-Gay and Vicks Vapo-Rub.
• Cleaning solutions. We associate ammonia and Lysol with aging because it is used in nursing homes.

September 03, 2015

De-"Bunking" Sleepwalking Myths
Q. Is it true that sleepwalkers can't be hurt when they walk in their sleep?
A. This is a common misconception. Sleepwalkers (aka somnambulists) are often injured when they trip and fall in their sleep.

     Another myth is that you should not wake up a sleepwalker. It is not dangerous to awaken a sleepwalker. In fact, it can be quite dangerous not to wake a sleepwalker. The only problem with rousing a sleepwalker is that the person will be disoriented for a while.
     The term sleepwalking is defined as a disorder that occurs when people are active while sleeping. The activities are not limited to walking. Some sleepwalkers can perform complex functions. Some can get dressed, walk out the door and drive all while asleep. 
     Sleepwalking is classified as a parasomnia.  Parasomnias are abnormal things that can happen to people while they sleep such as nightmares, sleep paralysis, sleep aggression and sexomnia. Yes, people are capable of performing sex acts while sleeping.
     Most sleepwalking episodes last for less than ten minutes. However, they can go on for a half hour or even more. Sleepwalking usually occurs during deep sleep, early in the night. Sleepwalking episodes can occur multiple times a night for a few consecutive nights.
     Sleepwalking can occur at any age. It is much more common in children than adults. It seems to be an inherited trait. 
     Fatigue, lack of sleep, and anxiety are all associated with sleepwalking. So are alcohol, medications, mental disorders, sleep-disordered breathing, restless legs syndrome, migraines, head injuries, and sleeping in unfamiliar surroundings.
     Occasional episodes of sleepwalking aren't usually a cause for concern. However, consult your doctor if the sleepwalking episodes become more frequent or lead to dangerous behavior or injury.
     Most people don't need any specific treatment for sleepwalking. In some cases, short-acting tranquilizers have been helpful in reducing sleepwalking. Treatment for adults who sleepwalk may include hypnosis.
     The primary problem with sleepwalking is potential injury. If you are sleepwalking, you should move any objects that are tripping hazards such as wires and small furniture. Expandable gates on stairways are advisable.
     The prevalence of sleepwalking in the general population is estimated to be between 1 percent and 15 percent.

August 27, 2015


August 20, 2015

The Dreaded Colonoscopy
Q. When seniors gather, it doesn't seem to take long before we get to our aches and pains. You must get more than your share of that.
A. My friend, Pete, has instituted a colonoscopy rule. He insists that, if a bunch of us geezers are talking about aches, maladies and visits to the doctors, everyone has to change the subject as soon as someone uses the word colonoscopy. Usually we switch to grandchildren, which is a lot more fun.

     But, while we are on the subject of colons...
     Colorectal cancer—cancer of the colon or rectum—is the second leading cause of death from cancer in the United States. Early detection of colon cancer is especially important because, if it is found in its early stages, it can be cured nine out of ten times.
      Who’s at risk? The chances of getting it increase with age. But other risk factors include  polyps, your history, diet and whether you’ve had ulcerative colitis.
      Polyps are benign growths on the inner wall of the colon and rectum. Not all polyps become cancerous, but nearly all colon cancers start as polyps.
      Colorectal cancer seems to run in families. And, someone who has already had colorectal cancer may develop this disease a second time. So greater vigilance is a good idea if you or your relatives have had it. 
     This form of cancer is more likely among people on a diet high in fat, protein, calories, alcohol, and both red and white meat. Low-fat, high-fiber diets seem better for the colon.
      Ulcerative colitis is a condition in which there is a chronic break in the lining of the colon. Having this condition increases a person's chance of developing colorectal cancer.
     The following are some symptoms of colorectal cancer: blood in the stool, diarrhea, constipation, stools that are narrower than usual, frequent gas pains or cramps, unexplained weight loss, unrelieved fatigue, vomiting. 
     Go to your doctor if you have symptoms. The medical profession has many detection tools. These include: a test to check for hidden blood in the stool; a sigmoidoscope, a lighted instrument for examining the rectum and lower colon; a colonoscope, a lighted instrument to examine the rectum and entire colon; a barium enema with a series of x-rays of the colon and rectum; a digital rectal exam to feel for abnormal areas.
      Two recent studies showed that colonoscopy can find many pre-cancerous polyps that sigmoidoscopy misses. Another major advantage of the colonoscopy is that it enables the doctor to remove any polyps found during the procedure. 
     There is a virtual colonoscopy, a minimally invasive procedure. Doctors are able to see the entire colon using 3-D computer graphics from a computerized tomography scan, or CT scan. 
      Known as CT colonography, this exam is an alternative for patients who are at risk of complications from colonoscopy such as patients who are frail. If a virtual colonoscopy finds significant polyps, they have to be removed by conventional colonoscopy.


August 13, 2015
As The World Turns
Q. I have had some nasty allergies all of my 72 years. Usually, my head gets clogged up. Recently, my ears became involved and I experienced vertigo for the first time. Is this common?
A.We have to define terms first. Vertigo is the feeling that either you or your surroundings are spinning. It is more than being just lightheaded or dizzy, because you are subjected to the illusion of movement. 

      If you feel your body is moving, you have subjective vertigo. When you sense that your surroundings are moving, you have objective vertigo.
If you are experiencing vertigo, you should see a doctor for a check-up. Vertigo can be a symptom of a serious health problem.
About one in ten people over 65 experience difficulty with balance. More than 40 percent of Americans will go to a doctor complaining of dizziness. Getting older is only part of the problem. Inner-ear disturbances are the primary cause.
       The inner ear consists of a system of fluid-filled tubes and sacs called the labyrinth. The labyrinth serves two functions: hearing and balance.
Labyrinthitis is an ear disorder that involves swelling of the inner ear. If you get labyrinthitis, the parts of the inner ear become irritated and inflamed. This inflammation disrupts the transmission of sensory information from the ear to the brain. This disruption causes vertigo, dizziness, and difficulties with balance, vision and hearing.
The following raise your risk for labyrinthitis: allergies, viral illness, drinking large amounts of alcohol, fatigue, smoking, stress, and some drugs.
     Labyrinthitis usually goes away within a few weeks. Medications that may reduce symptoms include antihistamines to reduce inflammation, compazine to control nausea, meclizine to counter dizziness, and sedatives.
There are other causes of balance problems. Here are few major ones:
• Benign paroxysmal positional vertigo (BPPV). With BPPV, one of the most common causes of balance problems, you get vertigo when you change the position of your head. You may also experience BPPV when you roll over, get out of bed, or when you look on a high shelf. BPPV is more likely in people over 60.
•  Ménière's disease, which also can give you intermittent hearing loss, a ringing or roaring in the ears, and a feeling of fullness in the ear.
• Blood-pressure medications and some antibiotics. If you are taking any drugs in these categories and feel off-balance, it’s worth discussing with your doctor.

August 06, 2015

Can I Get Rid of My Wrinkles?
Q. Is there anything I can do about all these wrinkles?
A. The common causes of wrinkles include genetic influences, normal aging, sun exposure and smoking.

     People who smoke tend to have more wrinkles than nonsmokers of the same age, complexion, and history of sun exposure. Cigarette smoking causes biochemical changes in our bodies that accelerate aging. 
Here's some advice from the American Academy of Dermatology about reducing the signs of aging:
• Wear sunscreen every day because the sun’s rays can accelerate signs of aging. Use a sunscreen or facial moisturizer that offers broad-spectrum protection and has an SPF of at least 30. Be sure to apply sunscreen to all skin that is not covered by clothing.
• Do not tan. Getting a tan from the sun or a tanning bed exposes you to harmful UV rays that can accelerate aging, causing wrinkles, age spots, a blotchy complexion and even skin cancer.
•Moisturize. Moisturizing traps water in the skin, which can help reduce the appearance of some fine lines and make your complexion look brighter and younger.
• Test products, even those labeled hypoallergenic. To test, dab a small amount of the product on your inner forearm twice a day for four to five days. If you do not have a reaction, it is probably safe to apply to your face.
• Use products as directed. Active ingredients can do more harm than good when too much is used. Applying more than directed can cause clogged pores, a blotchy complexion, or other unwanted effects.
• Stop using products that sting or burn unless prescribed by a dermatologist. Irritating the skin makes signs of aging more noticeable. 
• Limit the number of skin products that you use. Using too many products on your skin, especially more than one anti-aging product, tends to irritate the skin. This often makes signs of aging more noticeable.
• Shop smart. People often think that the more expensive a product is, the more effective it will be. This is not always the case. There are some very effective, affordable products in the skin care aisles of your local stores.
• Give products time to work. While a moisturizer can immediately plump up fine lines, most products take at least six weeks to work. Sometimes it can take three months.
How about wrinkle creams?
     Research suggests that some wrinkle creams contain ingredients that may improve the appearance of wrinkles. But many of these ingredients haven't undergone scientific research to prove this benefit. The American Academy of Dermatology says that over-the-counter wrinkle creams do little or nothing to reverse wrinkles. 
     However, the U.S. Food and Drug Administration has approved prescription tretinoin cream to treat aging skin. In addition, the FDA has also approved lasers for skin treatment.
Tretinoin cream, which is a vitamin A derivative, is sold under the brand names such as Atralin, Avita, Renova,  Retin-A and Tretin-X.
     Tretinoin cream is approved for reducing the appearance of fine wrinkles, roughness and  dark spots. It will not eliminate wrinkles. It will not restore skin.
Lasers remove layers of skin. Laser therapy is an outpatient treatment requiring anesthesia.


July 30, 2015

From The Geezer's Mailbag
Q. Does aging affect the functioning of your thyroid?
A. The thyroid is a small, butterfly-shaped gland located in the middle of the lower neck. It produces hormones that control  metabolism, which are the chemical processes cells in the body perform to keep us alive.
It should come as no surprise that the thyroid gland often peters out as we get older. The thyroid stimulating hormone (TSH) test checks to see if your thyroid is producing the right amount of hormone for your system. If the gland is making too much hormone, you get hyperthyroidism; if it makes too little, you get hypothyroidism.

      Hypothyroidism is very common in people over 60 years of age; the incidence of it steadily increases with age. When thyroid disease is caught early, treatment can control the disorder even before the onset of symptoms
     The symptoms of hypothyroidism include: fatigue, intolerance to cold, constipation, forgetfulness, muscle cramps, hair loss, depression, weight gain, dry skin, hoarseness and mood swings.
 Q. How common is it for men to get enlarged breasts?
A. Breast enlargement in males is common. About 30 percent of older men have this condition, which can be caused by hormonal changes or simple weight gain. 
When the usual balance of the female hormone estrogen and the male hormone testosterone in a man shifts, he can get “gynecomastia,” which is derived from two Greek words that mean “woman” and “breast.” 
Estrogen controls female traits including the growth of breasts. Testosterone dictates male traits such as muscle mass and body hair. Males normally produce small quantities of estrogen to regulate bone density, sperm production and mood.

     Gynecomastia can be caused by a health problem such as liver, kidney or thyroid diseases. And, this condition can also result from drinking alcohol or taking drugs such as steroids, marijuana, amphetamines and heroin. There are medications that can cause gynecomastia, too.
If you have enlarged breasts, see your doctor for a check-up. Enlarged breasts can be a symptom of breast cancer or a testicular tumor.
Q. Do copper bracelets relieve arthritis pain? 
A. There is no scientific evidence that copper bracelets do anything more than make a fashion statement. However, there is no proof  that the bracelets don’t provide relief to arthritis sufferers.

     Copper bracelets for arthritis have been around for a century or more. Many people swear that they work. Some doctors suspect that the positive reports are based upon symptoms going away by themselves.
Folk remedies like copper bracelets seem to be harmless. However, they often delay effective medical treatment, so these so-called “cures” are not completely benign.



July 16, 2015

​​Better Off Letting It Go Up In Smoke
Q. I've never been a smoker and I just don't get why people do it. What's the attraction?
A. Only a non-smoker could ask that question. Every smoker, chewer and sniffer knows how wonderful tobacco can be. I know it's probably not politically correct to say anything nice about tobacco, but it's the truth.
All tobacco products contain nicotine, which is an addictive drug. According to the American Heart Association, the “nicotine addiction has historically been one of the hardest addictions to break.” Nicotine is up there with heroin and cocaine.

What does nicotine do for you? Nicotine:

  • Decreases the appetite and helps you keep weight off.
  • Boosts mood and may even relieve minor depression. 
  • Stimulates memory, alertness and concentration.

So why don't we all gobble up nicotine. Because it:

  •  Increases heart rate by around 10 to 20 beats per minute.
  •  Increases blood pressure by five to 10 mmHg (because it tightens the blood vessels).
  •  Raises the blood level of blood sugar (glucose) and increases insulin production.
  •  Increases bowel activity, saliva, and phlegm.
  •  May cause sweating, nausea, and diarrhea.
  •  Creates anxiety, irritability, headache, hunger, and a craving during withdrawal.

     Nicotine is a substance found in the nightshade family of plants. It kills bugs, therefore it has been used an insecticide.  A drop of pure nicotine would kill a person.
Nicotine is named after the tobacco plant Nicotiana tabacum, which was named after Jean Nicot de Villemain, French ambassador in Portugal. Nicot de Villemain sent tobacco and seeds from Brazil to Paris in 1560 and promoted their medicinal use.  Nicotine was first isolated from the tobacco plant in 1828 by German chemists Posselt & Reimann, who considered it a poison. 
     There are several strategies for treating nicotine withdrawal. Nicotine supplements can help. These include gum, inhalers, nasal spray and skin patches. There are also non-habit-forming prescription medications to get off nicotine.
     The symptoms of nicotine withdrawal usually go away in less than a week. Withdrawal is the most uncomfortable part of quitting, but the real challenge is beating long-term cravings.
Each cigarette contains about 10 milligrams of nicotine. A smoker gets about one-two milligrams of the drug from each cigarette.
     With each puff of a cigarette, a smoker absorbs nicotine into the bloodstream. In eight seconds, nicotine changes how the brain works. Nicotine stimulates the release of large amounts of dopamine. Dopamine stimulates the brain's pleasure and reward circuit.
     The nicotine in cigarettes isn't what kills you. Cigarette smoke is a complex mixture of chemicals produced by the burning of tobacco and additives. The smoke contains tar, which is made up of more than 4,000 chemicals, including more than 60 known to cause cancer. Some of these substances cause heart and lung diseases, and all of them can be deadly. 

July 09, 2015

Don't Fall For It
Q. I am 83 years old and I am very afraid of falling down stairs. My mother broke her hip that way,  and I think of her every time I am on stairs.
A. If you think about falling while you are on a staircase, you increase the risk of falling. You have to learn how to redirect your attention away from your troubling thoughts and let your body take you up and down the stairs.

     The techniques used to block out your worries and act naturally are taught my Zen masters and sports psychologists. The basic concept is this: distract yourself with anything benign so that your worries cannot creep into your consciousness.
Here's an example:
     Many years ago, I read a book, The Inner Game of Golf  by W. Timothy Gallwey. The author employed Zen techniques to allow golfers to use their skills to hit the ball instead of thinking their way through shots. I tried his techniques and immediately improved my game. I was amazed but not convinced. Then I had an experience that proved to me that these Zen techniques worked. 
Gallwey recommends replacing your controlling thoughts with mantras--words or sounds you can repeat in your head to keep your worries out of your way. My two mantras were “club back” and then “hit.” That's all    I thought about as I went through my swing.
     One afternoon, I found myself in a fairway bunker about 120 yards from the green. The ball was partially submerged in the sand. I had only a vague idea of how to hit this shot to the green. I stepped into the sand with a 7-iron. I focused on my mantras and swung thoughtlessly at the ball. It landed 10 feet from the hole.
     You can use the same technique when you are on the stairs. Choose a mantra and repeat it until you are back on a flat floor. Just counting the stairs as you traverse them might work. But a recent study suggested a novel method--clenching your left hand before you go to the stairs. This seems to work for right-handers only. About 90 percent of us are right-handed.
     For the study, German researchers tested the skills of athletes. Right-handed athletes who squeezed a ball in their left hand before competition were less likely to choke under pressure than right-handed players who squeezed a ball in their right hand.
     Reasoning is associated with the left hemisphere, while the right hemisphere is linked with automatic body movements.
Juergen Beckmann, chairman of sports psychology at the Technical University of Munich, and the lead researcher, theorized that squeezing a ball or clenching the left hand would activate the brain's right hemisphere and reduce the risk of an athlete choking under pressure. 
     "Many movements of the body can be impaired by attempts at consciously controlling them," Beckmann said. "This technique can be helpful for many situations and tasks."
Sian Beilock, a University of Chicago psychologist and author of Choke: What the Secrets of the Brain Reveal About Success and Failure at Work and at Play, also recommends distracting the mind with meaningless details or speeding up movements so the brain doesn’t have time to over think. She also recommends writing down your worries.
     There is work in clinical psychology showing that writing helps limit negative thoughts that are very hard to shake and that seem to grow the more you dwell on them. The idea is that you cognitively outsource your worries to the page. 

July 02, 2015

From The Geezer's Mailbag

Q. My doctor ordered a TSH test. What is that?

A. The thyroid is a small, butterfly-shaped gland located in the middle of the lower neck. It produces hormones that control  metabolism, which are the chemical processes cells in the body perform to keep us alive.
It should come as no surprise that the thyroid gland often peters out as we get older. The thyroid stimulating hormone (TSH) test checks to see if your thyroid is producing the right amount of hormone for your system. If the gland is making too much hormone, you get hyperthyroidism; if it makes too little, you get hypothyroidism.


     Hypothyroidism is very common in people over 60 years of age; the incidence of it steadily increases with age. About 25 percent of people in nursing homes may have undiagnosed hypothyroidism because the symptoms of this condition can be misinterpreted as signs of aging.
The American Thyroid Association recommends that all adults begin their screening at age 35 and every 5 years thereafter. Experts in this organization argue that such early screening is inexpensive and would prevent progression to hypothyroidism.
The symptoms of hypothyroidism include: fatigue, intolerance to cold, constipation, forgetfulness, muscle cramps, hair loss, depression, weight gain, dry skin, hoarseness and mood swings.
      The symptoms of hyperthyroidism include: weight loss (not always in seniors), heat intolerance, hyperactivity, muscle weakness, palpitations, tremors, nervousness, irritability, insomnia, enlarged thyroid gland, frequent bowel movements, vision problems or eye irritation.

Q. I recall an episode of Seinfeld  that got a lot of laughs about man breasts. I have them and it's not funny. Is there a cure?
A. Breast enlargement in males is common. About 30 percent of older men have this condition, which can be caused by hormonal changes or simple weight gain. 
When the usual balance of the female hormone estrogen and the male hormone testosterone in a man shifts, he can get “gynecomastia,” which is derived from two Greek words that mean “woman” and “breast.” 
Males normally produce small quantities of estrogen to regulate bone density, sperm production and mood. Natural hormonal changes that lead to gynecomastia occur not only in old age but also during infancy and adolescence.

     Gynecomastia can be caused by a health problem such as liver, kidney or thyroid diseases. And, this condition can also result from drinking alcohol or taking drugs such as steroids, marijuana, amphetamines and heroin. There are medications that can cause gynecomastia, too.
     If you have enlarged breasts, see your doctor for a check-up. Enlarged breasts can be a symptom of breast cancer or a testicular tumor.
Gynecomastia usually will go away without treatment. This condition is often treated with drugs. Sometimes, enlarged breasts are reduced surgically.

Q. Can copper bracelets treat arthritis?
A. There is no scientific evidence that copper bracelets do anything more than make a fashion statement. However, there is no proof  that the bracelets don’t provide relief to arthritis sufferers.
Copper bracelets for arthritis have been around for a century or more. Many people swear that they work. Some doctors suspect that the positive reports are based upon symptoms going away by themselves.
Folk remedies like copper bracelets seem to be harmless. However, they often delay effective medical treatment, so these so-called “cures” are not completely benign.


June 25, 2015

Pardon? Excuse Me? What?

Q. It seems like a lot of my friends are watching TV with the volume way up, and accusing everyone of mumbling. How common are hearing problems among seniors? 


A. About  one in three Americans over 60 suffers from loss of hearing, which can range from the inability to hear certain voices to deafness.


     There are two basic categories of hearing loss. One is caused by damage to the inner ear or the auditory nerve. This type of hearing loss is permanent. The second kind occurs when sound can’t reach the inner ear. This can be repaired medically or surgically. Presbycusis, one form of hearing loss, occurs with age. Pres-bycusis can be caused by changes in the inner ear, auditory nerve, middle ear, or outer ear. Some of its causes are aging, loud noise, heredity, head injury, infection, illness, certain pre-scription drugs, and circulation problems such as high blood pressure. It seems to be inherited.Tinnitus, also common in older people, is the ringing, hiss-ing, or roaring sound in the ears frequently caused by expo-sure to loud noise or certain medicines. Tinnitus is a symptom that can come with any type of hearing loss.Hearing loss can by caused by “ototoxic” medicines that damage the inner ear. Some antibiotics are ototoxic. Aspirin can cause temporary problems. If you’re having a hearing problem, ask your doctor about any medications you’re taking.Loud noise contributes to presbycusis and tinnitus.

     Noise has damaged the hearing of about 10 million Americans, many of them Baby Boomers who listened to hard rock with the volume turned up as far as possible.Hearing problems that are ignored or untreated can get worse. If you have a hearing problem, see your doctor. Hearing aids, special training, medicines and surgery are options.Your doctor may refer you to an otolaryngologist, a physi-cian who specializes in problems of the ear. Or you may be referred to an audiologist, a professional who can identify and measure hearing loss. An audiologist can help you determine if you need a hearing aid.There other “hearing aids” you should consider. There are listening systems to help you enjoy television or radio without being bothered by other sounds around you. Some hearing aids can be plugged directly into TVs, music players, microphones, and personal FM systems to help you hear better.

Some telephones work with certain hearing aids to make sounds louder and remove background noise. And some audito-riums, movie theaters, and other public places are equipped with special sound systems that send sounds directly to your ears.Alerts such as doorbells, smoke detectors, and alarm clocks can give you a signal that you can see or a vibration that you can feel. For example, a flashing light can let you know some-one is at the door or on the phone.


June 18, 2015

Weight Control

Q. If you want to control your weight, is it better to eat three meals a day, or should you eat more, smaller meals? 

A. There is no scientifically proven answer to this question. Until there is, I’d suggest simply reducing your total food intake for each day until your weight goes down.

     Personal Note: I’ve struggled to keep pounds off all my life. I’ve learned that calories count. You take in more than you burn; you gain weight. You burn more than you eat; you lose weight. Exercise helps, but the calorie burn off usually doesn’t amount to much. The best exercise is pushing yourself away from the table. Eating a bunch of small meals a day instead of breakfast-lunch-dinner is part of the popular media, which 
means you should be hearing “fad alert” in your head. Here are some of the claims:

• The body burns calories to digest. Eating six to eight meals a day enables your body to use more calories to aid digestion.

• Eating lots of meals rather than three will boost metabolism and control blood sugar.

• More meals means less stored fat in the body. 

• When people consume the same number of calories in a single daily meal rather than three, they show significant increases in blood pressure, total cholesterol levels and levels of bad LDL cholesterol.

• Eating every three-to-four hours can ward off hunger and prevent binges that lead to weight gain.

• Eating more often helps regulate proper digestion to prevent gastrointestinal problems.

• Eight meals a day will increase energy levels and accelerate muscle growth.

     To repeat, there is no proof that eating more frequently does any of the above. My own conclusion about weight control was confirmed in an editorial that appeared in the American Journal of Clinical Nutrition. A team of nutrition researchers concluded that weight loss comes down to “how much energy (or calories) is consumed as opposed to how often or how regularly one eats.” However, there was a recent study that indicated we may be better off eating only three meals a day. The study was done on mice, so the findings have to be confirmed by tests on humans. Satchidananda Panda, a regulatory biologist at the Salk Institute in La Jolla, led the study published by the journal Cell Metabolism. Panda and his team put groups of mice on different eating regimens for 100 days. Mice in two of the groups ate high-fat, high-calorie food. Half of them were allowed to snack throughout the night and day. The other mice had access to food only for eight hours at night, when they were most active. The mice that ate only for eight hours were almost as lean as mice in a control group that ate regular food. But the mice that ate around the clock became obese, even though they consumed the same amount of fat and calories as their counterparts on the time-restricted diet.


June 11, 2015

Considering a Scooter…

Q. I don't walk so well anymore and I'm considering getting one of those scooters that I see seniors driving. What do you know about them?

A. They have become increasingly popular since they were invented in 1968. As more baby boomers hit the market for mobility assistive equipment, we will see more scooters.
There are about 1.7 million in the United States using wheelchairs or scooters. About 90 percent of these people have manual wheelchairs. There are155,000 using electrically powered wheelchairs, and 142,000 riding scooters. Motorized scooters serve the same function as motorized wheelchairs, but the scooters are easier to maneuver and are more versatile. And because they now have sleek designs and are marketed primarily as a product to facilitate movement, rather than to assist the disabled, they appeal to a broader spectrum of the public. I shopped online for scooters. They seem to range from about $500 to about $4,500.
If your doctor submits a written order stating that you have a medical need for a scooter, Medicare will help cover the costs under the  following conditions:

• You have a health problem that causes difficulty moving around in your home.
• You’re unable to do activities of daily living even with the help of a cane, crutch, or walker.
• You can't operate a manual wheelchair. 
• You’re able to safely operate, and get on and off the scooter, or have someone with you who is always available to help you use the device safely. 
• You must be able to use it in your home. Medicare won’t cover a scooter if it will be used mainly for leisure activities, or if it’s only needed to move around outside your home.
     A mobility scooter usually has a swivel seat over three or four wheels, a flat area for your feet and handlebars to steer it. Mobility scooters are usually battery powered. The scooters come in models with front-wheel drive or rear-wheel drive. The front-wheel-drive scooters are usually smaller and are used indoors. They usually hold up to 250 pounds.  The rear-wheel-drive scooters are used both indoors and outdoors with a typical maximum capacity of 350 pounds. There are heavy duty rear-drive scooters that can carry up to 500 pounds. Scooters have a few advantages over wheelchairs. * Swiveling the seat of an electric scooter is generally easier than moving the foot supports on most conventional wheelchairs. 
• A major selling point of mobility scooters is that they do not look like wheelchairs, which evoke negative feels in some people.
• Mobility scooters are usually more affordable than powered wheelchairs.
However, there are disadvantages when compared to powered wheelchairs.
• You need to be upright and have upper-body strength to operate a scooter.
•  Scooters also have fewer options for body support, such as head or leg rests. They are rarely designed for ease of patient transfer from seat to bed.
• Scooters are longer, which limits their turning radius and ability to use some lifts or wheelchair-designed access technologies such as kneeling bus lifts. 
• Some mobility scooters have low ground clearance which can make it difficult to navigate certain obstacles, such as traveling in cities without proper curb cuts. 

June 04, 2015

From The Geezer's Mailbag

Q. Are hallucinations reason enough to see a doctor?
A. Hallucinations can be a symptom of a variety of problems—both physical and mental. They can be caused by schizophrenia, dementia, depression, Parkinson’s disease, stroke, fever, drugs, and alcohol. You should see a doctor immediately about this symptom.

     Visual loss is a common cause of hallucinations, too. About one in ten people with vision problems has hallucinations. It is suspected that this phenomenon is under-reported because victims fear they are losing their minds and don’t want their doctors to know.
Complex hallucinations among people with vision loss is called Charles Bonnet Syndrome (CBS). Charles Bonnet was a Swiss philosopher. In 1760, he described this condition in his blind grandfather. 
These hallucinations can strike at any age, but usually affect seniors. The most likely reason that the syndrome affects the elderly is the prevalence of visual problems in this age group. The common conditions leading to CBS are age-related macular degeneration, glaucoma and cataract. 
Q. Does it have to be very cold outside to get hypothermia?
A. You don't need a frosty winter day to suffer from hypothermia. Hypothermia occurs when your body doesn’t maintain a normal temperature, which is about 98.6 degrees Fahrenheit. When your core temperature drops to 95 degrees, you are suffering from hypothermia, which can be lethal. 

     You can get hypothermia in an air-conditioned environment. It can strike you if you are soaked in the rain on a cool, windy day, or if you fall into chilly water. Water colder than 70 F can  begin to cause hypothermia quickly.
     People older than 65 years are especially vulnerable to hypothermia because they tend to suffer from illnesses or take medications that interfere with regulating body temperature. Also, older adults often produce less body heat because of a slower metabolism and less physical activity. 
Seniors make up about half of the annual fatalities from hypothermia in the United States.
Low body temperature impairs the brain, so hypothermia is especially dangerous because its victims may not know they’re in trouble. Severe hypothermia eventually leads to cardiac and respiratory failure, then death.
     Hypothermia comes on gradually. Shivering is a common and obvious sign. Shivering is a natural response that increases muscle cell activity and generates heat. 
But, shivering alone does not mean you have hypothermia. Healthcare professionals recommend looking for “umbles,” too.  These are stumbles, mumbles, fumbles and grumbles. 
Watch for these specific symptoms: confusion or sleepiness; slowed, slurred speech; shallow breathing; weak pulse or low blood pressure; changes in behavior such as apathy; change in appearance such as pale skin; poor body control or slow reaction times.
Q. Do you have any suggestions for what to do in a fire?
A. Seniors face the highest risk of perishing in a fire because their senses don’t detect danger as easily as they used to, and they don’t move quickly to escape during an emergency. 

     Here are some general fire-emergency recommendations: 
• If you must exit through smoke, crawl under it (smoke rises). 
• Cover your mouth and nose with a moist towel or an article of clothing to protect yourself from dangerous fumes. 
• Always touch closed doors; if they are warm, don’t open them. Don’t touch doorknobs. 
• If your clothing is on fire, drop to the floor and roll to extinguish flames.
• Avoid elevators; use stairs or fire escapes.


May 28, 2015

Seniors and Low Vision

Q. What kind of glasses should you get for low vision?
A. Low vision is a significant reduction in visual function that can’t be corrected by regular glasses, contact lenses, medicine or surgery. Low vision can range from moderate impairment—such as tunnel vision or blind spots—to almost total blindness. 

     One out of every 20 people has low vision. About 135 million people around the world suffer from this impairment.
Irreversible vision loss is most common among people over age 65.  However, losing vision is not just part of getting older. Some normal changes occur as we get older. These changes usually don't lead to low vision.
Low vision can be caused by diseases, disorders, and injuries that affect the eye. Many people with low vision have age-related macular degeneration, cataracts or glaucoma. Almost 45 percent of all cases of low vision are caused by age-related macular degeneration, which progressively destroys the central retina (macula) at the back of your eye. The retina is to your eye what film is to a camera.
If you think you may have low vision, consult an eyecare professional who can tell the difference between normal changes in the aging eye and those caused by disease.
There are many signs that indicate possible vision loss. Under normal circumstances, do you have trouble recognizing faces of people you know? Is it difficult for you to read, sew, match the color of your clothes? Do lights seem dimmer than they used to? 
     Vision changes like these could be early warning signs of eye disease. Usually, the earlier your problem is diagnosed, the better your chances  are for successful treatment and maintaining your vision.
Regular eye exams should be part of your routine health care. However, if you think your vision has changed, you should see your eyecare professional as soon as possible.
     A specialist in low vision is an optometrist or ophthalmologist who is trained to evaluate vision. This professional can prescribe visual devices and teach people how to use them.
Devices and rehabilitation programs can help you adapt to vision loss. They may help you maintain your lifestyle.
     These devices include: adjustable lighting; large-print publications; magnifying devices; closed-circuit televisions; electronic reading machines; computer systems with voice-recognition; telescopes, and telephones, clocks, and watches with large numbers.
     Rehabilitation programs offer a wide range of services such as low-vision evaluations and special training to use adaptive devices. They also offer guidance for making changes in your home as well as group support from others with low vision.



May 21, 2015

Use Caution While Taking Any Medication


Q. My daughter heard that grapefruit juice can be toxic for some people. Is that true?
A. The juice, itself, is not toxic, but you should be careful taking medicine with any grapefruit.

     Grapefruit juice can raise the level of some medications in the blood. The effect of grapefruit was discovered after using juice to mask the taste of a medicine. So, be sure to ask your doctor or pharmacist if it is safe to have grapefruit with your medications.
     Taking medicine can be hazardous to your health. You have to know what you’re doing.
For example, calcium-rich dairy products or certain antacids can prevent antibiotics from being properly absorbed into the bloodstream. Ginkgo biloba can reduce the effectiveness of blood-thinning medications and raise the risk for serious complications such as stroke.
     You should educate yourself so you know what active ingredients are in the prescription and over-the-counter medicines you are taking. 
Some people treat over-the-counter pain relievers as if they are harmless. They can hurt you if you take them improperly. They contain drugs such as acetaminophen, ibuprofen, naproxen sodium and aspirin. Acetaminophen is in Tylenol. Ibuprofen is in Advil. Naproxen sodium is in Aleve.  
     Many prescription or over-the-counter medicines that treat multiple symptoms, such as cold and flu medications, also include acetaminophen and the other pain-relieving  ingredients. So you have to be careful not to take too much of any one ingredient by ingesting more than one medication that contains that ingredient.
     Seniors take more medicines than any other age group because they have more health problems. Taking several drugs a day presents dangers. Here are some more tips to avoid these hazards:
Always inform your doctor or pharmacist about all medicines you are already taking, including herbal products and over-the-counter medications.
     Tell your doctor, nurse, or pharmacist about past problems you have had with medicines, such as rashes, indigestion or dizziness.
Don't mix alcohol and medicine unless your doctor or pharmacist says it's okay. Some medicines may not work well or may make you sick if you take them with alcohol.
     The best advice is this: Don’t be afraid to throw a lot of questions about your medicines at your doctor, nurse or pharmacist. Here are some good ones: 

  • When should I take it? As needed, or on a schedule? Before, with or between meals? At bedtime?
  • How often should I take it?
  • How long will I have to take it?
  • How will I feel once I start taking this medicine?
  • How will I know if this medicine is working?
  • If I forget to take it, what should I do?
  • What side effects might I expect? Should I report them?
  • Can this medicine interact with other prescription and over-the-counter medicines—including  herbal and dietary supplements—that I am taking now?
  • And, ask your pharmacist to put your medicine in large, easy-to open containers with large-print labels. 


May 7, 2015

Fiber and Whole Grains

Q. My wife insists on buying nothing but crunchy brown bread because she says it is good for us. I’m a bit skeptical about this and suspect we are victims of hype to sell this kind of bread. What do you think?
A. I’m presuming that your wife wants to get whole grain bread to put more fiber into your diet. Whole grains are cereal grains that include the bran, the germ, and the core of the kernel known as the endosperm. Bran is a tough, fibrous outer layer, which is a source of fiber. 

     Before the Industrial Revolution, we did not process grains. These grains gave us fiber (aka roughage), healthy fats, vitamins, minerals, plant enzymes, hormones, and hundreds of other beneficial plant compounds.
     The invention of industrialized roller mills in the late 19th century changed what we got from grains. Milling strips away the bran and germ of the grain, making it easier to chew and digest.
Consumers have to be cautious about what they buy to get fiber. The U.S. Department of Agriculture (USDA) warns that foods labeled with the words multi-grain, stone-ground, 100% wheat, cracked wheat, seven-grain, or bran are usually not whole-grain products. Look for whole grain on the package.
     Also, color is not an indication of a whole grain. Bread can be brown because of molasses or other added ingredients. You have to read the ingredient list to see if a product is from whole grains.
The USDA recommends reading the Nutrition Facts label on packages and choosing whole grain products with a higher percentage of fiber. 
How much fiber is enough?  The American Dietetic Association recommends a healthy diet include 25 to 35 grams of fiber a day. If you want a precise, personal estimate for fiber intake, you can use a fiber calculator provided by the University of Maryland Medical System. Visithttp://www.healthcalculators.org/calculators/fiber.asp
There are many health benefits to eating whole grains:
• Bowel health. By keeping the stool soft and bulky, the fiber in whole grains helps prevent constipation and diverticular disease, which is characterized by tiny pouches inside the colon that are easily irritated and inflamed. Softer stool also reduces pain from hemorrhoids.
• Longevity. A report from the Iowa Women’s Health Study linked whole-grain consumption with fewer deaths from non-cardiac, non-cancer causes. 
• Cardiovascular disease. Eating whole grains substantially lowers cholesterol,  triglycerides, and insulin levels. Any of these changes would be expected to reduce the risk for cardiovascular disease. 
• Diabetes. In people with diabetes, fiber can slow the absorption of sugar and help improve blood sugar levels. A healthy diet that includes fiber may also reduce the risk of developing type 2 diabetes.
• Cancer. The data on cancer are mixed, with some studies showing a protective effect and others showing none. 
• Weight control. High-fiber foods generally require more chewing, which gives your body time to register when you’re no longer hungry, so you’re less likely to overeat. Also, a high-fiber diet tends to make a meal feel larger and linger longer, so you stay full for a greater amount of time. 
     To get more fiber in your diet, you should include whole grain products, fruits, vegetables, beans, peas, nuts and seeds.
Fiber supplements such as Metamucil, Citrucel and FiberCon help, but getting your fiber from foods is better because supplements don’t provide the variety of fibers, vitamins, minerals and other beneficial nutrients that foods do.
     Warning. Fiber supplements can influence the processing of some drugs, such as aspirin, warfarin (Coumadin) and certain anti-seizure and antidepressant medications. Fiber supplements can also reduce blood sugar levels, which may require an adjustment in your medications or insulin if you have diabetes. Don’t take fiber supplements before consulting your health care provider.


April 30, 2015

From The Geezer's Mailbag


Q. What is a normal body temperature?
A. Body temperature fluctuates during the day between 97 F and 99 F. When you wake up, your temperature is at the low end of the range; it increases as the day progresses. 

     The common standard for a “normal” temperature is 98.6 F. However, the range of normal is about a degree above or below 98.6.  
An oral temperature above 100 degrees Fahrenheit or a rectal or ear temperature above 101 F is considered a fever in the majority of adults.
     If your temperature reaches 103 F, you should contact a physician. Another alarm bell is a fever that lasts more than three days.
A fever usually means your body is fighting an infection from bacteria or a virus. In older adults, the immune system doesn’t function as efficiently as it does in younger people. The body's fever response to infection is not always automatic in elderly people. More than 20 percent of adults over age 65 who have serious bacterial infections do not have fevers. 
Q.  Do older people faint more than younger people?
A. Yes. When you pass 70 years, you double the chances of fainting. And the odds triple after 80. Fainting is common. About one in three people faint at least once in a lifetime. 

     Syncope (SINK-o-pea) is the medical word for fainting or a temporary—a few seconds— loss of consciousness. Fainting happens when your brain isn’t getting enough oxygen from your blood supply. 
Syncope is often foreshadowed by “premonitory symptoms” that include nausea, feeling lightheaded and irregular heartbeats. 
     Syncope is a symptom, not a medical condition. Syncope can be an indicator of a serious problem, so it should not be taken lightly. If you have a fainting spell, get checked out by a doctor. It’s sometimes difficult to diagnose syncope in seniors because there can be multiple causes.
Q.  What is “nocturia”?
A. Nocturia is the need to urinate at night. Both men and women get nocturia. 

     Some people with severe nocturia get up as many as six times a night to go to the bathroom. The International Continence Society defines nocturia as two or more voids at night.
Nocturia is more common among seniors than younger people. In a survey taken by the National Sleep Foundation, about two thirds of the adults (55 to 84 years old) polled reported an urge to go to the bathroom at least several nights a week.
     There is a variety of reasons for nocturia in older people. 
First, we produce less of a hormone that helps us retain fluid. Because of this decreased capacity, seniors produce more urine at night. Second, the bladder—a muscular sac—loses its capacity to hold urine. Third, we have more health problems that can affect the bladder.
     Many men suffer from nocturia because of benign prostatic hyperplasia (BPH), also known as enlarged prostate. The prostate is a walnut-size organ that surrounds the tube (urethra) that carries urine from the bladder and out of your body. 
     Pelvic organ displacement, menopause and childbirth can cause nocturia in many women. The pelvic floor is a network of muscles, ligaments and other tissues that hold up the pelvic organs: the vagina, rectum, uterus and bladder. When this hammock-like network weakens, the organs can slip out of place and create disorders.
If you would like to ask a question, write to fred@healthygeezer.com.