At first glance the sentence above seems preposterous.  However, with a bit of explaining, it will make more sense.  Personally, I feel this is a huge breakthrough for explaining many things, including the rising rates of obesity, depression, diabetes, and breast cancer in the Western world.

When we were evolving, we experienced about 12-14 hours of darkness every 24 hours. We did not have lights or TV’s or computers to occupy our time at night.  In the modern world, this is exactly what is going on.   Most of us spend our night time hours surrounded by light.  Our homes are lit up with TV’s, computers, cell phones and other gadgets.   City lights from outside our homes also reach our eyes.   What is the effect of all this “unnatural” light at night on our bodies?

According to doctors and researchers, all this light interferes with our body’s natural rhythms (called circadian rhythms).    Enter melatonin.    Melatonin is an important hormone that has been proven to be protective against cancer.   Our pineal gland produces melatonin, but only when it is dark.   Completely dark. Light will stop the production of melatonin – even a little bit of light.  The reason this is so important is because melatonin is what makes us sleepy.  It enables us to sleep soundly and deeply.  The way it should theoretically work is when the sun sets, the body begins to produce the melatonin.   After an hour or so we begin to become sleepy and eventually fall asleep at a decent hour – say 9pm.   We would sleep soundly and only be awakened by the sun coming up.

But what is happening in present day society is far different.   Many of us actually ratchet up the light around us as night falls.  At this point I need to explain I am speaking about a particular light called blue light.  Blue light is picked up readily by a photoreceptor in our eye that has nothing to do with vision.  Blue light penetrates this photoreceptor more than green or red lights.  Thus, blue light is very powerful at regulating melatonin and our circadian rhythms.

This blue light is emitted from our computers, TV’s, light bulbs, iPads and other gadgets.  Researchers are warning us that as we stare into these things at night, our melatonin is suppressed and our bodily rhythms are disrupted.  Our bodies are confused as to whether it is day or night.  Which hormones to secrete or shut down?   This creates havoc in the body and been directly related to insomnia, depression, obesity, cardiovascular disease and of course cancer.  Because blue light at night can disrupt our hormones, studies are showing that breast cancer in particular, to be related. In primitive countries where they do not have all this blue light at night, the incidence of breast cancer is much less.  And as countries “westernize” their rates of breast cancer increase.

When researchers want to study the effect of disrupted body rhythms and melatonin, they look at shift workers.  Shift workers, such as nurses, have been shown to have higher incidences of many health problems including depression, diabetes, cardiovascular disease and breast cancer.   A study by Dr. Eva Schernhammer, an epidemiologist at Harvard, found nurses who have worked the night shift for 15-30 years had higher risks of breast and colon cancer.  “People who work at night will always have lower levels of melatonin than the normal population (who are not exposed to light all night)”.

In fact, the World Health Organization in 2007 classified shift work as a risk factor for breast cancer.  And in 2009, the Danish government began compensating female shift workers who have breast cancer.

So now that we are aware of the implications of blue light at night, what are some of the things we can do to protect ourselves?

• Use full spectrum bulbs in your house and office during the day.  Because remember this VERY important point: blue light is not dangerous! It just signals your body to be awake.  You want to have that during the day but not at night where it disrupts your body’s rhythms.  (In fact, studies show we are not having enough bright light around us during the day when we need it and too much at night when we don’t.)
• Turn off computers and electronic gadgets once the sun sets, and avoid watching TV late at night.   You especially do NOT want to fall asleep in front of the TV all night long!  Some remotes have timers on them so you can program the TV to turn off by a certain time.
• Use “low blue lights” in areas where you spend most of your time in late evening, such as your living room, bedroom and bathroom.
• If you have to get up to go to the bathroom in the night, make sure your path is clear and resist turning on the light for even a few moments.  That short of time is enough to stop all melatonin production and disrupt things.
• Sleep in TOTAL darkness.  This means no night lights, no clock radio or cell phone glowing on the bedside table and use blackout shades and drapes if ANY light from outside is coming through your window.   Many experts say you should not be able to see your hand in front of your face.
• Sleep when it is dark outside and get up when the sun comes up.  At the very least try and be asleep by 10pm and be up by 6 am.
• Avoid working the night shift.  This one cannot be stressed enough.  Experts strongly suggest you trying to switch your hours if you are currently working at night.  At the very least try not to keep the shift longer than a month or two to give your body time to readjust in between.  Perhaps give your supervisor this article to read!
• If you have to do shift work, when you come home to sleep, make your bedroom as dark as possible by using black out shades.  Use all the tips above to simulate night so you will produce melatonin.  Also try wearing eye pads to shut out the last bit of light.

Remember that constipation itself is not a disease, but a symptom that something within the system is not quite right.  Here are some guidelines to help you decide if you truly are constipated:

1. You seem to have difficulty passing stools, or it seems to take forever
2. The stools are hard or lumpy
3. You feel blocked up, like you can not empty your bowel completely
4. You have fewer than 3 bowel movements a week

Why do we get constipated?  There are many different reasons — poor diet, lack of exercise, and overuse of laxatives are the most common offenders.  Other factors include medical conditions, certain medications, and consciously holding back bowel movements.

A poor diet is one of the leading causes of constipation.  Lack of fresh fruits, vegetables, and whole grains in the diet is a prime cause.  Research increasingly shows that regularly eating these foods can help prevent constipation.  Too much fat, sweets, dairy products and eggs also can be a problem, and is not a healthy way to eat.  So is the consumption of prepared foods on a regular basis.

A lot of seniors live alone, and just don’t enjoy cooking for one or eating alone.  It’s easy to adopt a constant diet of instant meals, already prepared. The problem is that too often these meals are lacking in fiber, as well as other vital nutrients, and contain way too much salt and fat.  Folks who have problems with their teeth will often choose foods that are soft and overly processed, containing small amounts of fiber, if any.

Not drinking enough liquids is also a leading cause of constipation.  We cannot stress enough the importance of adequate fluid intake.   Water is always the cheapest and the best, but any liquid counts — juice, milk, coffee, tea, soup.  In fact, so many people enjoy a good bowl of soup at mealtime, why not add plenty of vegetables and broth, and get some of your daily liquids this delicious way?  Just watch out for the salt.  If you buy canned or packaged soup,  ALWAYS CHECK THE LABEL FOR SODIUM CONTENT!   Please do try the many varieties of low-sodium soups available now.   Why not spend some time cooking up a batch of your own?  If that seems a bit overwhelming, perhaps you could enlist the help of a friend, neighbor, or family member to give you a hand.  Many seniors have treasured, time-tested soup recipes that have been passed down through the years. Soup freezes well, and can be put into smaller containers ready to take out and heat when needed.   Nothing beats the taste of home-made soup in my book, and eating a bowl often brings back happy memories of a pleasant day spent in the kitchen, chopping, blending, and stirring, as well as thoughts of that special person who first made it for you.

Overuse and dependence on laxatives and enemas can only spell trouble for your bowels. Rather than being a cure for constipation, their frequent use will cause your bowels to “forget” they can work on their own.   Eventually this will lead to your body no longer having any natural bowel movements.   Frequent diarrhea is usually the end result, with resultant loss of even more liquid from the body, not to mention the discomfort, unsanitary conditions, and difficult clean-up that diarrhea brings.

We’ve all been lectured to the nth degree about the importance of exercise, but it is so very true, especially in regulating bowel movements.  Too much sitting around by couch potato types makes for too little bowel activity!   If you’ve been ill or otherwise confined to bed, you will probably suffer from constipation until you’re back on your feet and moving around.  Keeping active, even if it’s just walking around the house or yard is always the best bet.

Try not to hold in your bowels on a regular basis — if you wait too long to go, or practice this on a regular basis, it may result in constipation.  Most of us prefer to use our own bathroom at home.  Make a visit to the bathroom before going out.  Perhaps you can schedule your excursions well before or after a visit to the bathroom is expected.

There are certain serious medical conditions that can lead to constipation.  Among them are stroke, diabetes, intestinal blockage, and irritable bowel syndrome.  These conditions can cause a malfunction in the nerves and muscles that your body uses for moving the bowels.   Speaking with your doctor about this is a good first step in determining if this is a problem for you.

Quite a number of commonly used medications may cause constipation. Antidepressants, antihistamines, antacids containing aluminium or calcium, and medicines to treat high blood pressure and Parkinson’s disease are often offenders.  Speak with your doctor if this seems to be the case.

Let’s put a positive spin on all this and discuss what we can do to help keep constipation at bay as much as possible.  As we mentioned, first rule out that a medical condition or medicine is the root cause by speaking to your doctor.  If that is not the case, here are some time-tested ways to help get things moving again.

The number one remedy is to simply add some fiber to your diet!  Try fresh fruit or vegetables, whatever kind you like.  Bear in mind that corn and potatoes should not be your first choice — they’re not particularly helpful.  Dried fruits such as prunes, figs, apricots and dates are tasty and full of fiber.  They make a wonderful sweet dessert or snack.   Small doses will work fine — dried fruits are concentrated sources of fiber.  Be aware that you can get too much of a good thing!

Try incorporating some whole grains into your diet.  Eating oatmeal (rolled oats, not the instant kind in a little envelope) is a great way to start your day, especially with some fruit on top!  Make your toast and sandwiches with whole grain breads or English muffins. Brown rice is better than white rice.   Eat your potato baked, with the skin on — try a sweet potato rather than your usual russet, and you’ll get a leg up on healthy beta-carotene, so necessary for healthy vision and immune system.  Have you tried barley in your soup instead of noodles, rice or potatoes?

Take some beans, please! They’re inexpensive, loaded with fiber, easy to keep and store. You should always have a can or two in your pantry.  Try them in a salad instead of croutons (you are eating fresh salad greens, aren’t you?) or in chili (make it with ground turkey instead of beef to reduce artery-clogging fat).  Need a quick, healthy, fiber-rich snack?  Scoop up a small handful of nuts (unsalted if you please) or pop some corn — both have plenty of fiber.  Once you get on the bandwagon of fiber-rich foods, you’ll find there are many more you like than you realized — they’re everywhere you look!

Yes, you can use fiber-rich additives — the kind you mix with a glass of water.  But nothing beats eating healthful, fiber-rich foods at every meal.  It’s easy to get in the habit once you educate yourself and become aware of the nutrition value in what you eat every day.

Don’t forget to drink enough liquids to keep yourself hydrated.  As we age, our tastebuds and thirst indicator don’t function as effectively.  Don’t rely on feeling thirsty — you may not be.  Drink something at regular intervals during the day to keep yourself properly hydrated, and this will also help regulate your bowels.  And do keep as active as you can. Couch potatoes do not have healthy elimination, especially as they age.  Walk around the house or the block, go out and get your mail, do some yardwork if you’re up to it physically.

If you follow these tips and still have problems, talk to your doctor.  Perhaps there is an underlying condition that you’re unaware of.   But take heart, this is not rocket science! Some simple changes in diet and exercise may be just what you need to feel better, and they’re all simple steps you can take on your own.  Give it a try — what have you got to lose but that awful constipation?

By: Amy Weisser, Case Manager

Seniors know that keeping safe at home is paramount.  Falls are the leading cause of injury death among the senior population.  A fall can often make the difference between staying at home and having to move to an assisted living facility.  Since most people vastly prefer staying in their own home if at all possible, preventing falls is of primary importance.  We have put together some common-sense tips to help you stay safe at home and maintain your personal independence.

The bathroom is a prime location for falls.  Some recommendations:

1. Put up grab bars on the bathtub/shower surround.
2. Install a senior-friendly elevated toilet seat that screws on securely to stay in place, and install grab bars alongside the toilet.
3. If practical, replace your toilet with a taller senior-friendly model, and install those grab bars, too!
4. Don’t stand while showering. Buy a sturdy, plastic bathing chair or bench to put in the shower or tub.  Install a hand-held flexible shower head that you can use while seated.
5. If possible, replace a bathtub with a walk-in shower stall. Stepping over the side of the tub to get in and out is an accident just waiting to happen, and often prevents many seniors from bathing.
6. A shower curtain is preferable to glass shower doors.
7. Put a non-slip rubber mat in the tub or shower stall.

Your living room can be made safer by following these recommendations:

1. Get rid of old, sagging furniture.  Replace it with newer pieces that offer firm back and seat support.  That way, you can sit down and get up again more easily.
2. Make sure your carpeting is firmly secured.  If you must use area rugs, secure them underneath with a non-slip pad.  Don’t use small throw rugs anywhere  in your home—they’re a shortcut to falling.
3. Keep your living areas as uncluttered as possible.  Trailing electrical or telephone cords will easily trip you up.  Get rid of old newspapers and magazines before they clutter the room. They’re so easy to recycle today.
4. Make sure your rooms are well-lit, with lamps and light switches easily within reach. Replace burnt-out bulbs immediately. Keep a flashlight within easy reach in the rooms you spend the most time in for insurance if you lose electrical power. Don’t forget to periodically check the batteries.

Here are some common-sense safety rules for the bedroom:

1. Keep a light on at night in a room adjacent to your bedroom. Always have a nightlight on in your bedroom, bathroom, and hallway.
2. Make like a log when you get out of bed. Roll over to the side of the bed. Swing your legs carefully over the side until your feet touch the floor. Sit there for a minute or two to get your balance. Stand up SLOWLY!  This  helps avoid a low blood pressure fluctuation that could make you dizzy.
3. When you put on slacks, socks, hosiery or shoes, sit in a chair or on the edge of your bed.  It’s best to always wear shoes or slippers inside, rather than going about in stocking feet.  Low-heeled, supportive shoes with non-skid soles are best. If you wear slippers, make sure they fit snugly, have a closed heel, and a non-skid sole.

You’ll want to keep your kitchen safe, too, by following these tips:

1. Arrange your kitchen with a sensible, easy-to-navigate flow. Place appliances, especially your microwave, where they’re convenient and easy to use.
2. Place your most often-used items within easy reach. Pots and pans, dishes and grocery items should be put where you can get them without having to bend over, squat or get on a stepladder. Don’t stand or chairs or stepladders! Rearrange frequently used items.  Use a hand-held grabber when you need something that’s stored out of reach, or has fallen on the floor.
3. Never try to move heavy, awkward items on your own. Ask for help.
4. Forget the high-wax shiny floor!  Safety is much more important.
5. When you cook on the stove, always position the handles of your pots to the side, away from the front.

Stairways present a special hazard. Here are a few safety tips to follow:

1. Make sure you have a handrail on each side of all stairways. Also, you should have a light switch at both the top and the bottom of the stairs. Put in a nightlight at both the top and the bottom of the stairs, too.
2. If your stairs are carpeted, make sure it’s secured firmly, with no folds.
3. For basement stairs, affix brightly colored tape on the top and bottom tread. Limit, or eliminate entirely, trips down to the basement if possible.

Remember, falls in the home are a senior’s most frequent occurring accident.  Preventing falls and the serious injuries that often accompany them can go a long way towards maintaining your independence!

I have exercised regularly for years and logged many hours outside as well as in the gym.  Since I am an avid “people watcher”, I have watched how other people spend their time at the gym.  And much of the time I find myself irked at what I see.  I am irked because I see the mistakes that are being made as “missed opportunities”.  And because I know what the consequences will be 20-40 years down the road.  So I thought I might climb up on my soapbox and gripe about a few things I have noticed over the years in hope of eliciting some positive changes…

First and foremost on my list is women and strength training.  Hello?  Could it be that the word still has not reached women how important this is?  To be fair, I do see some of the younger woman lifting.  But I rarely see middle aged women and I never see elderly women lifting weights.  Why not?  Is that pesky rumor that you will “get so buff you’ll look like your on steroids” still going around? The only way a woman is going to get that muscular IS to be on steroids!  Why is lifting weights so important? Oh, my, where to begin?

Ok, first, you will look great! Your triceps will not continue to wave after your hand has stopped.  Your rear end will halt its journey south.  And it will increase your metabolism because muscles burn calories more than fat.  You will also start noticing that everyday things you do have become easier, like lifting groceries or getting in and out of that SUV.  Weight lifting will strengthen your bones and prevent osteoporosis.  And the grand daddy of them all:  Picture a frail, elderly person hesitantly taking baby steps and holding on to furniture to get across the room.  This picture is not normal and not inevitable.  Losing your sense of balance is not a normal part of aging!  It is due to muscles loss (from aging) and muscle weakness (from non use), period!  If you strength train, you will build muscle mass that you would normally lose as you age.  The result?  You will stride strong and confident across a room at 85 because your balance is fine and your legs are strong. That’s called payback!
Another problem I see with many elderly people (I am not picking on you all, really!) is that there will be 3 or 4 of them walking very slowly around the track talking up a storm.  Now, there’s nothing wrong with taking a leisurely walk with your friends as long as you’re not counting it as your exercise for the day.  It seems we have become reticent to tell seniors they need to pick up the pace!  They need to break a sweat!  They need to be breathing harder! (good rule of thumb is that you could talk if you had to but you would rather not) Remember, just because you are in a gym, on a track, wearing warm ups and sweat bands, doesn’t make it exercise.

Time to pick on the middle aged set now.  Year after year I see the same ones come in faithfully yet they never lose a pound and never gain a muscle.  I think I might see some of the reasons.  One is called a cell phone.  If you are on the treadmill, Stairmaster, walking the track, etc. and are yakking on your cell phone the entire time, you are not exercising! (Remember the rule about being enough out of breath that talking is unpleasant?) What about bringing books to read?  Since when did we start bringing books to read while we exercised? When I see someone kicked back on the bike leisurely thumbing through their latest edition of People, I notice something:  they never work up a sweat.  How could they?  When you are truly “present” when exercising you are concentrating on your breathing, your muscles, how you are feeling, can I push a little harder and of course, how much longer do I have?  But if you are intently reading your novel?  Exercise has taken a back seat.

In closing, I want to stress that what I am not saying is that everyone needs to become an uber-athlete or gym rat.  I think many of the situations I have described are just examples of ways people try to avoid the same thing.  And that “thing” is the discomfort of feeling fatigued.  Because yes, exercise makes you sweat, breathe harder and it makes you…tired.  There are many people who just intensely dislike feeling that way whether they are lifting weights or running and will go to great lengths to avoid it (read above).  Others learn to endure and push through.  My article talked about the long term benefits of exercise.  But there’s also a delicious short term benefit.  The people that learn to push through the discomfort and fatigue know what it is.  It is how fabulous you feel afterward.  What goes up must come down.  The level of discomfort is directly proportional to the level of euphoria you feel afterward.  The harder you work the more of those endorphins that flood your brain.  It’s nature’s way of getting you to come back!

The overwhelming data shows that chronic periodontal (gum) disease contributes to the development of heart disease and stroke.  About 75% of Americans have mild to advanced gum disease.  And heart disease is the leading cause of death for men and women.   And yet most people are not aware of this deadly connection.   As a former dental hygienist, I can tell you that flossing can literally save your life…

How could gum disease affect the heart?  Inflammation and bacteria seem to be the underlying link between the two.  Diseased gums dump high levels of bacteria into the bloodstream. These harmful bacteria components can travel to other organs in the body, like the heart, and cause damage.   The bacteria from the gums enter the bloodstream and connect to the plaques in the coronary arteries.  This leads to formation of blood clots, which, if break off, lead to stroke and heart attacks.

We are becoming increasingly aware that inflammation in the body is a common factor in many diseases – including periodontal disease and heart disease.  There is a connection between the inflamed gums and the swelling of arteries that still needs to be understood.  Somehow, researchers theorize, the inflammation in periodontal disease increases inflammation throughout the body.  We know inflammation is an underlying factor in heart disease.

We also know that it is the amount of bacteria in the mouth that makes a difference rather than which strain of bacteria we are finding.  When the gums are swollen and bleeding and you have a mouth full of bacteria, the bacteria easily finds its way into the bloodstream in huge numbers.

Gingivitis is the fist stage of periodontal disease.  It is the only stage that is reversible.  The symptoms are red, swollen, bleeding gums.  But the infection has not yet started to erode away the bone that supports your teeth.   By brushing and flossing regularly, you can clear up gingivitis to healthy gums again.  Why? Because you are removing the cause: the bacteria under the gums!  Once you have periodontal disease you have lost supporting bone for the tooth.  You should see a gum specialist called a Periodontist.

The biggest advice I can give is to FLOSS!  I also recommend using an ultrasonic toothbrush.  It removes plaque much better than manual toothbrushes.  The name of the game is to completely remove all plaque every 24 hours every day!

Technorati Tags: blood clots, diseased gums, elderly care, gingivitis, gum disease, heart damage, heart disease, home care, inflammation, periodontal disease, periodontist, plantar fasciitis, Senior Home Care, stroke

By: Amy Weisser, Case Manager

As Mohammed Ali  famously said, “Float like a butterfly, sting like a bee.”  That comment could also be used to describe atrial fibrillation (commonly called a-fib) as well as the fancy footwork of the great one.   How so?

Many people have described a-fib as a fluttering in the chest, not unlike that of a butterfly. And unfortunately, if not taken care of, the end result makes a bee sting pale in comparison.

In a-fib, the upper part of your heart (the atria) beats much faster, or quivers—and is out of sync with the lower part of your heart (the ventricles).  This fluttering, or flip-flopping feeling happens because your heart is generating electrical signals that are causing the atria to contract rapidly and erratically.  That is atrial fibrillation —a-fib for short.  Your entire heart isn’t quivering though—-just the upper part, and it’s usually the left atria, rather than the right.

The biggest danger with a-fib is that it leads to a much higher probability of suffering a stroke or heart attack down the road.   Since your atria isn’t properly doing its job of evenly pumping blood down to the ventricles (the lower half of the heart) some blood may pool there.   Pooling blood is bad news, because it can give rise to the formation of blood clots.  If a blood clot travels to the brain and lodges in an artery, the blood supply is blocked and that causes a stroke.

The American Heart Association tells us that having untreated a-fib increases your risk of having a stroke by 5-6 times, especially if you’re older.  The rest of this bad news story is that a stroke resulting from a-fib is much more serious than other kinds of strokes.   50% of a-fib strokes are major and disabling; 44% of patients suffer major neurological damage; 23% die. Contrast that with an average death rate of 8% from strokes resulting from other factors.

We’ve already mentioned that with a-fib, the upper part of your heart, the atria, isn’t pumping enough blood down into the lower half of your heart (the ventricles).  This reduced blood supply affects the rest of the body.  Your brain and other organs may suffer, and if the a-fib goes untreated, you are more likely to develop dementia.  Other physical symptoms are weakness, dizziness, fatigue, shortness of breath, and swelling of the legs.  You may have an increased tendency to faint.  Untreated a-fib can lead to other heart problems later, such as congestive heart failure or heart failure.  It may lead to a heart attack as your heart becomes strained and weakened over time.

Are you at risk for developing a-fib? After the age of forty, one in four Americans are.  Statistics tell us that this year in the US alone, there will be 340,000 new cases.   If you already have other heart problems, you are at greater risk for developing a-fib.

Up to 40% of open heart surgery patients develop a-fib after surgery.  People who suffer pericarditis (inflammation of the sack-like membrane around the heart) are also at higher risk. Obesity, congestive heart failure, mitral valve disease, and hypertension can all be factors.   So can heavy drinking—so much so, that hospitals sometimes call a-fib “holiday heart”. Fatigue, emotional duress, significant infection or pain, and illegal drug use can all lead to a-fib.  Smokers (even ex-smokers), people with hyperthyroidism (overactive thyroid), and people who have lung disease are also more likely to develop a-fib. Men are more susceptible than women, and athletes also are more susceptible, because of their larger hearts. Basketball players, more than other athletes, seem especially vulnerable—so perhaps height plays a role.

No matter the cause or underlying factors, if you suspect you may have a-fib, the best step you can take is to see your doctor. Most likely he’ll order various tests.

Serious a-fib can be treated with meds or other therapies, like shocking the heart into a regular rhythm.  A mild case of a-fib may not require any treatment at all.  But do get a checkup. And rest assured, there are many therapies in development to treat a-fib.     Just watch out for bee stings!

Technorati Tags: a-fib, American Heart association, atria, atrial fibrillation, congestive heart failure, elderly care, fluttering in chest, heart, heart attack, home care, hypertension, mitral valve disease, obesity, Senior Home Care, stroke, ventricles

It’s a sobering statistic:  up to 65% of patients suffer from depression after experiencing a heart attack.  Besides the mental anguish the patient feels, those who have depression following their heart attack are 2 to 3 times more likely to have a second heart attack and three times more likely to die from a heart attack or other heart condition in the future.  Thankfully doctors are realizing this is a critical issue that goes far beyond just feeling a “bit blue”.  It is a life threatening, serious illness and needs to be addressed early and aggressively…

We are not completely sure why depression is so prevalent after heart attacks (and heart surgery).    Certainly it would be understandable to feel down after having such a traumatic event.  There is also an abundance of fear and anxiety.  Patients may fear having another one.  They may ruminate on how this changes their life going forward.  But researchers say there is also biological and chemical changes occurring in the body that trigger or cause depression after a cardiac event.   Persistent, depressive symptoms after a heart attack are associated with vascular brain changes.

While talk therapy can be helpful, medication, specifically SSRI’s, is normally what is needed to treat the depression.  The SSRI’s are preferred over the older, tricyclic antidepressants, because of their cardiac side effects.   Unfortunately, although antidepressants have been shown to be effective in treating post heart attack depression, they have not been shown to decrease the odds of having another heart attack or dieing from one.  But by treating the depression, you increase the odds the patient will quit smoking, exercise and follow prescribed changes in lifestyles.  And that certainly couldn’t hurt things.

Many times the depression starts several days following the heart attack, after the patient is at home.  That is why it is so important to monitor yourself or a loved one for depressive symptoms.  Trouble sleeping,  no appetite, no motivation, aches and pains can all be symptoms of depression and must be brought to the doctors attention at once.  .

Also, as a note, one study found that patients being treated with the drug Digitalis were significantly more likely to be depressed at the 3 and 4 month mark than patients not taking that drug.  Digitalis may have brain and CNS effects that contribute to the development of depression in post heart attack patients.

The AAFP Guidelines for the Detection and Management of Post-Myocardial Infarction (heart attack) Depression has 4 recommendations:

1. Patients who had had or are having an MI (heart attack) should be screened for depression and at regular intervals-especially in the hospital.
2. Patients diagnosed with depression should be treated to improve their depression symptoms and they should be followed up and monitored closely.
3. Psychotherapy may be beneficial for treatment of depression after a heart attack
4. Selective serotonin reuptake inhibitors (SSRI’s), are preferable to tricyclic antidepressants for treatment of depression in these patients.

Technorati Tags: anxiety, depression, fear, heart attack, heart surgery, home care, Senior Care, Senior Home Care, vascular brain changes

By: Amy Weisser, Case Manager

How do you mend a broken heart?  Well, that all depends on what has broken your heart.   In this article, we are not speaking of a true heart attack, or any kind of actual cardiac damage. On this Valentines Day, we are going to discuss what happens when you truly experience heartbreak.   Or more accurately, perhaps we should say heartache.    Heartache is nothing new, of course — Psalm 69:20 mentions that King David laments that his heart is broken from insults, not physical pain.   In more recent times, doctors are increasingly recognizing this condition, and more research is being done, notably at Johns Hopkins Hospitals and Heart Institute.   People who fall into this category are suffering from “stress cardiomyopathy”,  and not a true heart attack, or “myocardio infarction”.   In fact, these people have few classic markers of heart disease, if any.   But the symptoms are often the same: shortness of breath; intense, squeezing chest pain; fluid build up in the legs, and heart failure.   While quite serious of course, the good news is that a broken heart leaves no permanent damage and the heart usually recovers in a few weeks’ time.

How does it happen?  When some people experience a severe, sudden emotional setback, their body may react be releasing a large quantity of stress hormones.  The two main culprits, among others, are adrenalin and noradrenalin.  Both are very powerful agents.  When suddenly released into the bloodstream by the endocrine system, the effect on the heart can be overwhelming.  The heart, suddenly awash in stress hormones, may react with the classic symptoms of a heart attack.

Cardiologist and study co-investigator Hunter Champion, M.D., Ph.D explains:  “The chemicals may cause spasm in the coronary arteries, or have a direct toxic effect on the heart muscle, or cause calcium overload that results in temporary dysfunction.”  More studies at Johns Hopkins are planned.  The researchers would especially like to know if certain people have a genetic vulnerability for stress cardiomyopathy, and why the predominant patient profile is a middle-aged or elderly woman, although there have been cases in women as young as 27.  All displayed symptoms of a heart attack after receiving sudden shocking news:  a death, a car accident, an armed robbery were some of the instances cited.

One of the beneficial results of the study will be to make doctors more aware of stress cardiomyopathy, and how to distinguish it from true heart attack.  While not as common as heart attack, “broken heart syndrome” happens more frequently than most doctors realize.  As the condition becomes better known, more cases are expected to be diagnosed.

So how do you mend a broken heart? Since there is no permanent damage in these cases, the heart is soon pumping normally again.  Unlike a broken teenage heart, these well-seasoned hearts can quickly be healed, often in two weeks’ time with appropriate care.

Technorati Tags: broken heart, cardiac, cardiologist, elderly, heart attack, heart disease, home care, Senior Care, Senior Home Care, stress hormones

Have you ever had a loved one, who had no previous mental problems, or only slight dementia, go into the hospital or ICU?  Once there, did their entire personality and behavior take a 180 degree turn for the worse?  Did their grasp on reality go out the window?  Normally polite and mild mannered, did the person begin yelling at you and the staff?  Did they try to rip out their IV line, climb out of bed or think bugs were crawling all over them?  If you are nodding your head to any of this, more than likely your loved one had an episode of “Hospital Psychosis”….

First of all, what is hospital psychosis and how can the hospital or ICU cause it?  We all know the hospital is a stressful place to be.  It feels foreign.  It’s noisy.  Different and unfamiliar people are coming and going at all times of the day and night.  It is impossible to get a good nights sleep in the hospital.  So you have extreme stress exacerbated by sleep deprivation very early on.  Adding sedatives or anesthesia into the mix can also make the person more vulnerable.

Other possible causes:

• Constant light from machines and staff entering in and out can disrupt normal biorhythms
• Stress from being ill, away from home, loss of control of normal life
• Unfamiliar people coming and going at all times
• Away from loved ones or usual caregiver
• Pain, metabolic disturbances and dehydration can be huge factors
• Disorientated to time, day and what is going on in the world

Hospital psychosis is related to the length of stay in the hospital.  Family members may comment that the person seemed “not quite himself” the first day or two.   But by day three there was hallucinating, his speech was slurred with profound memory loss.  Some people develop the psychosis more abruptly.  Within hours of being admitted they may begin talking gibberish or try to climb over the rails out of bed. They may continuously brush at the bed thinking there are bugs everywhere.

Hospital psychosis is real and it can be very dangerous when it’s severe.  Especially ICU psychosis where there are no windows, very limited contact with family and noisy machines.  These agitated patients have been known to begin ripping out vital tubes and IV catheters with disastrous results. So it’s important to remember that hospital psychosis can be life threatening.

Hospitals, doctors and nurses should first and foremost be aware of what hospital psychosis is and just as importantly what it isn’t.  In the past there seems to have been some reluctance on the part of the medical establishment to acknowledge that hospital psychosis exists.  Many times it remains untreated.  This is unacceptable! Frustrated and scared family members are told that its  just medication reactions, or the person has dementia, etc.
Hospital staff should understand that in most cases, the person has no history of dementia or mental problems.  The patient and family can be helped tremendously by a staff that:

• Watches for and is alert to symptoms of possible hospital psychosis
• Knows importance of taking immediate action,
• Is capable of explaining it fully to everyone involved, including patient
• All staff informed and committed to managing and treating early on
• Can empower family members by informing them what they can and should do, as well as behaviors to avoid
• Offer reassurance that the condition is temporary, will subside once the person goes home, and should fully resolve.

If you are in the medical field, can you imagine the peace of mind you can give by having this conversation with a patient or family member?  If you work in an ALF or Nursing Home your client has to go to the hospital, take it upon yourself to educate the patient and family.  This prepares them and reassures them.  If you are a patient’s primary doctor and have to admit him-take the time to educate your patient and family about hospital psychosis and the possibility it could occur.

What things can be done to  prevent hospital psychosis?

• Encourage family and friends to conduct very frequent low key visits!  The patient needs to be surrounded by familiar faces.
• If the person had a caregiver assisting them at home, make sure their caregiver continues to come and be with the patient as MUCH as possible-talking, reading, just sitting together.  Clients who utilize their caregiver when the family can’t be there have smoother sailing!
• Protect the patient from unnecessary excitement, noise, chaos or arguments
• Insist staff do all they can to coordinate lighting with day and night
• Insist your loved one have blocks of dark, quiet uninterrupted sleep each night.
• Disorientation worsens symptoms so make sure patient has his glasses to see, his hearing aid to hear
• Having their caregiver there to answer simple questions, without waking the patient, when staff comes in to ask endless questions .
• Doctor may use anti-psychotic or antidepressants to treat symptoms but w/ extreme caution-it’s possible their side effects could worsen the situation.

Please call our office if you have any other questions or would like to discuss this further with Heavenly Helpers Senior Home Care!

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Technorati Tags: dementia, home care, hospital, Hospital psychosis, memory loss, senior health, Senior Home Care, sleep deprivation

Article written by Amy Weisser, Case Manager

Let me guess! One of your New Years Resolutions was the same as one of mine: shed some pounds. Of course this year we are serious and we know exercise has got to be part of the plan. Of all the activities one could do, walking is by far the most popular. It’s the simplest and most cost effective way to exercise. But almost any method you choose to increase your fitness level is going to depend on healthy feet. If they’re not in good shape, exercise can quickly become an uncomfortable, if not downright painful activity. And yes, we all know what happens next: The new shoes rest in the box they came in, and the iPod, loaded with music, just sits….As a final insult, your new treadmill becomes the family coat rack. In other words, exercise just doesn’t happen.

One of the most common and painful conditions that’s visited upon the dedicated exercise enthusiast, is plantar fasciitis.   (Can you say: plan-ter-fash-ee-eye-tus?)   Some of you may unfortunately already be on speaking terms with these uncomfortable, pins-and-needles or “burning the soles of the foot” pains.   For those of you lucky souls (no pun intended) who aren’t, here’s a quick guide to the most common causes.

8 FACTORS THAT CONTRIBUTE TO DEVELOPING PLANTAR FASCIITIS:

• Being middle-aged or older
• Having tight Achilles tendons—they connect the calf muscles to your heel
• Starting intensive walking or running without any prior conditioning
• Not wearing properly cushioned exercise shoes, or shoes with poor arch support
• Being overweight or suddenly gaining a lot of weight
• Having a pronated foot—–that’s an inward roll or twist of the foot
• Having very high arches, or very flat feet
• Working in an environment that involves long hours of standing or walking on a hard, non-cushioned surface

How to make it better?  Start with the number one remedy:  Give those aching feet a rest!  At the very least, cut back for awhile.  Other things worth trying:

• Don’t walk or run on hard, unyielding surfaces such as concrete.
• Take an over-the-counter pain med such as aspirin, naproxen, or ibuprofen.
• Ice your heels—a bag of frozen veggies often does the trick.  Try an ace bandage or towel under the ice to protect your heel from direct contact.
• Always stretch your muscles, especially those calf muscles when you first get up.
• In fact, spending a few minutes in all-over stretching is a great idea for everyone—-don’t just bound out of bed in the morning.
• Treat yourself to a new pair of shoes.  Look for better arch support and a nicely cushioned heel.
• You might try shoe inserts or heel cups for better support.  Important: If you do, use them in both shoes, even if only one foot hurts—it’s imperative to keep your feet properly balanced.

Give our suggestions a try, and see how you do.  You should feel relief within several days.  A complete recovery could take anywhere from a few weeks to a few months.   If the pain persists, see a Podiatrist (a foot doctor).  You may need a shot of steroids in your heel, or splints to wear at night.  Forearmed is forewarned!  The benefits of regular exercise so far outweigh the negatives, you’ll be glad you’re keeping that body moving.  And besides, that coat covered treadmill really is an eye sore…

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Technorati Tags: aging, Exercise, feet care, fitness level, health, home care, leg care, losing weight, pain relief, plantar fasciitis, Senior Care, senior health care, Senior Home Care