Thursday, December 28, 2006

Communication tips for doctors

"As baby boomers increase in age, the face of the American population will change dramatically. By the year 2030, a projected 71 million Americans will be age 65 or older, an increase of more than 200 percent from the year 2000, according to the U.S. Census Bureau. It's estimated that some 6,000 people turn age 65 every day and, by 2012, 10,000 people will turn age 65 every day."

This is the opening paragraph of an article in the Family Practice Management journal, Sept. 2006. As you and/or your parents age, you might be getting less face time with your doctor. The article suggests tips for the doctors, but it also alerts us patients to the problems.

Here's the summary, but stop and read the whole article.

1. Allow extra time for older patients.

2. Minimize visual and auditory distractions.

3. Sit face to face with the patient.

4. Don't underestimate the power of eye contact.

5. Listen without interrupting the patient.

6. Speak slowly, clearly and loudly.

7. Use short, simple words and sentences.

8. Stick to one topic at a time.

9. Simplify and write down your instructions.

10. Use charts, models and pictures to illustrate your message.

11. Frequently summarize the most important points.

12. Give the patient a chance to ask questions.

13. Schedule older patients earlier in the day.

14. Greet them as they arrive at the practice.

15. Seat them in a quiet, comfortable area.

16. Make signs, forms and brochures easy to read.

17. Be prepared to escort elderly patients from room to room.

18. Check on them if they've been waiting in the exam room.

19. Use touch to keep the patient relaxed and focused.

20. Say goodbye, to end the visit on a positive note.

Saturday, December 16, 2006

Keep your eye on your eyes

"About 41% to 46% of adults aged 50 years and older have not had a dilated eye examination and 30% to 35% have not visited an eye-care professional during the past year, according to data from 5 states that participated in the new CDC Behavioral Risk Factor Surveillance System (BRFSS) vision module during 2005.

The study also found that whereas annual dilated eye examinations are recommended for patients with diabetes and individuals aged 65 years and older, 44% of those aged 60 to 69 years and 32% of those aged 70 to 79 years had not been tested in the preceding 12 months.

Moreover, approximately 50% of those who had not visited an eye-care professional during the preceding year said that they had no reason to go. Twenty percent cited cost/insurance as the cause. The apparent lack of concern regarding the need for preventive eye care remains a major public health concern, according to the CDC."

Reported at Medscape.com from this CDC report.

Sunday, December 10, 2006

Do you take low dose aspirin?

Many people take low dose aspirin daily. I was born with an extra circuit in my heart which over the years caused atrial fibrillation. It was ablated (zapped) a few years ago, I was on medication for awhile, and now I just take a 81 mg aspirin once a day (a blood thinner). A-fib puts you at risk for a stroke.

I noticed an article in the Berkeley Wellness Letter on, "Should Your Aspirin Wear a Coat." I guess I thought a coated aspirin would be better, but according to this article, that's not necessarily true. It depends on why you're taking it. The coating can prevent quick pain relief. In my case, it doesn't matter if it takes an hour or so longer to work, so you need to always check with your doctor before starting any regular use of aspirin.

The article points out some things about aspirin I didn't know. Go to the archive of UC Berkeley Wellness Letter, and click on December 2006.

Saturday, December 09, 2006

Age and Beauty

In a very interesting Washington Post article that claims we are hard wired in our perception of beauty, David Von Drehle concludes with an epilogue about age.

"Our era is sexually candid but chronologically dishonest. A recent ad for anti-wrinkle cream in a major fashion magazine employed a model who appeared to be in her teens. Countless ads for men's underwear feature slim bodies, taut as a Renaissance Saint Sebastian. The skivvies, bulging like a one-pound bag toting a two-pound puppy, shout all man. But the inevitably hairless bodies whisper still boy. The most widely circulated magazine in the country is published by the AARP; its standard cover image is a movie star or other celebrity who has managed, with the help of a stylist and modern technology, to look 20 years younger than the truth.

If today's Americans are uniquely obsessed, it's not with beauty, but with youth. The aging baby boomers who have shaped so much popular culture for such a dreadfully long time are now pondering age spots, varicose veins, worry lines and droopy breasts. Vogue's August effort was titled "The Age Issue," but it could have been called "The Fear of Age Issue." Along with the article on cosmetic surgery for feet, ("I will always feel young as long as I can wear heels"), the magazine promoted human growth hormone for "an ageless body," detailed the merits of vascular surgery for younger-looking legs ("the bruises have faded almost completely within two weeks") and explained why a 48-year-old woman decided to get braces on her teeth -- for the second time.

"How sad it is!" lamented the handsome young Dorian Gray. "I shall grow old, and horrible, and dreadful. But this picture will remain always young. It will never be older than this particular day in June." As Oscar Wilde knew, an aging person's obsession with looking young has less to do with beauty than with the realization that beauty dies.

Time waits for no one, no matter how many sets of braces one wears. The struggle to preserve the physical bloom, whether through single-minded obsession or through artifice, is a fight that can never be won, for human beings are made of flesh, not stone."

Friday, December 08, 2006

Mediterranean Diet and the Risk for Alzheimer's Disease

You've probably seen reports or summaries of this article by Nikolaos Scarmeas, MD and others, which appeared in the June 2006 Annals of Neurology (2006;59:9212-921). I can't think of another health problem that is more distressing to contemplate as we age than Alzheimer's Disease. The Mediterrean Diet is characterized by high intake of vegetables, legumes, fruits and cereals, unsaturated fatty acids (mostly in olive oil), and moderate high intake of fish, with low to moderate intake of dairy products (cheese or yogurt), and low intake of meat and poultry, plus wine during meals.

When you think about it, our own mothers didn't think there was any single miracle food--at least not back in the 40s and 50s. The fad diets started later. I'm not sure my mother ever said, "Eat all the colors," but that was the implication. We always had meat, potatoes, vegetables and fruit, with a light dessert, and the snacking was kept very simple. We had fresh fruits and vegetables when they were in season in northern Illinois, and home canned when they weren't. Potatoes, lettuce, peas, corn, beets, etc. came from the garden beside our house. Eggs and milk were purchased locally.

From reading this article it would seem we get too caught up in focusing on a single nutrient or eating plan and forget the big picture. They decided to study dietary patterns of a region or people rather than a self-selected group that volunteered to change their eating patterns. For instance, if I decide to try the "Mediterranean Diet" living in Columbus, OH, the results will be biased toward someone who's had other health benefits, or detriments. We don't really know how it would have affected me differently if I were 20 years younger, or if I'd never had HRT.

The researchers' conclusions after doing a community based study of 2,258 nondemented individuals in NY (details how they found them in the article): "Higher adherence to the MeDi was associated with significantly lower risk for development of AD." It's a very interesting study that deserves more attention and further research.

There is a follow up study reported in the October issue of the same journal

Thursday, November 30, 2006

It's the journey!

At 81 suffering from a few minor health aggrevations, he took up a biking challenge. He found it's the journey that matters.

"In 2002 my son Ed talked me into getting into the annual American Lung Association Mt. Diablo Challenge race. Over 1,000 riders enter each year, all ages, so I said I’d try it on the mountain bike. Years ago when we lived in Walnut Creek Ed and I had gone up that mountain many times, but I hadn’t tried it for over 25 years. Boy was I embarrassed! It took me 2 hours, 35 minutes to get to the top. I kept seeing riders coming back down. I couldn’t understand why the bike (and me) were so sluggish. When I reached the top, the timekeeper was packing up and wouldn’t take my time. He said: “Next time ride faster!”.

I took that to heart and bought a nice Romulus by Rivendell in Walnut Creek and trained all the next year. I learned more about heart monitors and the different heart zones and what they do. My doctor, who is also a bike rider, got me to John Muir Hospital for a treadmill test and echocardiogram. The cardiologist said: “Go do it! You don’t have any clogged veins or arteries.” And so I entered the Mt. Diablo challenge for 2003 at age 81.

To cut a long story short, I made it in one hour and thirty-five minutes by the clock when I got to the top. (Not official time, that’s published later this year on the Internet.) I got a nice medal for being the oldest rider to get to the top and three expensive bike shorts. One pair fits me fine, one pair fits Betty for our tandem riding, and one pair was HUGE, which I gave away. Thank you somebody for donating those real neat bike shorts.

All the early symptoms of getting older have gone away. I never have a sinus headache, no stomach problems, (unless I eat Mexican), bone density of 50-year-old, no more touches of arthritis, sleep perfectly every night, and seem to have a mental alertness of a much younger person. Betty experiences the same benefits. I ride between 70 and 100 miles a week; Betty does between 40 and 50. You will see us from time to time on our tandem riding with you, and you’ll see me riding up that mountain sometimes on Wednesday’s training for the 2004 challenge.

And that’s really my message. Keep a challenge in front of you no matter how old you get. Keep reaching out for the best that’s in you. Remember that the journey is often more rewarding than the destination, and don’t become totally satisfied with the destination…because there are always further and better destinations to try for. I’m going to get up Diablo in 2004 under 1 ½ hours!"

Full story here.

Tuesday, November 28, 2006

Seven deadly sins of retirement

was the topic of today's "Retire Smart" by Humberto and Georgina Cruz (Columbus Dispatch). It's possibly a repeat, but I don't see it on the web. If it comes up, I'll add a link. Here are the points they make:

1. Thinking or saying "I am too old to___________." Obviously, you're always too old for some things (playing dolls, mud pies, dating 16 year olds), but you know they are talking about defeatism here. I did wait too long to join the choir--about 40 years, and my voice was gone, but not my desire.

2. Constantly talking about ailments. Oh yes, and Amen to that. No surgery or ache but my own are interesting! I wrote a fictional story about the Whistle Stop Pot Luck which involves this one. In the story, each dinner guest gets a whistle to blow TWEET when the topic of Age, Health or Weight comes up. These are the three most boring topics that people over 50 discuss.

3. Finding excuses to postpone something. Procrastination. Some of us had this problem from a very young age. Jobs may have kept it in check.

4. Holding grudges. That will not only shorten your days, but make everyone else's seem longer if you talk about who did you wrong when.

5. Becoming intransigent. Clinging to values and beliefs and refusing to consider another viewpoint. Yes! I became a Republican when I was 60. But I have friends who have never considered the possibility that there is another way.

6. Feeling a false sense of entitlement. Don't be rude. Turn off your cell phone and don't talk loudly in restaurants, would be my advice. Also, you aren't the only car on the road.

7. Engaging in home owner association wars. We don't have those here, but we've got excellent management and only 30 units. However, I know people who have had to move. When shopping for a retirement or empty nester home, you'd sure want to check around on that. The by-laws and the escrow account can't tell you that.


If I could add seven pet peeves of my own about retired or nearly retired folks. . .

a) Appearing in public dressed like a slob--leave the sweats, shorts and ratty shoes in the garage or tool shed.

b) Not dressing your age. A 20 year old can wear a mini-skirt, but a 50 year old just looks like she's stepped from a 70s movie.

c) Trying to be the ladies' man or gushy flirt you once thought you were. You're not fooling us.

d) Not keeping up appearances. Even if you never did it before, hire someone to help with the housework or yard work if you don't know what to do. Everyone who visits will appreciate it. After my mother died, Dad hired a person to clean once a month. He had no idea how to do it, and at 86 he wasn't about to learn.

e) Becoming focused totally on the grandchildren. Are you the only person allowed to babysit? They are taking over your best years. We don't get do-overs.

f) Not wearing your hearing aid and/or false teeth if you have them. You'll be able to hear me and I'll be able to understand you. My mother-in-law got dentures when she was in her 40s; I knew her for over 40 years and never saw her without her teeth! My grandmother, who was blind, didn't need a hearing aid until her mid-80s. She thought hearing loss a much worse problem than blindness because it interferred with communication.

g) Talking inappropriately--this is related to the hearing aid--in church, at the theater, movies, concert, etc. If it's not on, you won't realize you are disturbing others. Because of rock music, head phones and ear buds, early deafness is now appearing much earlier than among our parents' and grandparents' generations.




Monday, November 27, 2006

Randy's epiphany

Randy Kirk has a blog called The Truth about Everything. Recently he wrote about turning 50 eight years ago.

"It has been 8+ years since my friends gathered to give gifts tied with black ribbon, but I do remember that passage more than most. You see, I had an Epiphany. Up until that birthday I simply counted the total number of years God has given me on this earth. Starting at 50 I looked at it the other way. How many years are left.

The good news was that because of good genes, I could easily live into my eighties and be in decent physical and mental health. So I decided to assume 35 years to go. It was an exciting revelation, because it really meant enough time for an entire career...assuming I wanted a new career.

For instance, it could mean retiring and getting involved in some type of charitable activity full-time. It could mean writing for a living instead of making water bottles. The idea opened up a vast panoply of possibilities. Instead of dreading the future, I was filled with hope and expectations.

Eight + years later, I still have 28 years of potential, according to my personal actuarial table. Such an idea continues to be very motivating."

Used with permission.

Thursday, November 23, 2006

Happy Birthday LJMcInnis

She turns 50 tomorrow, just in time for this blog! So I've linked to her. Visit her blog, R Cubed and tell her Norma sent you.

Wednesday, November 22, 2006

I wouldn't have thought of Boise

Today I picked up a copy of Where to Retire, Sept-Oct, 2006, at the library. It may be the first time I've ever looked at it. My reasons for living/retiring in this particular city aren't usually listed--"my children are here, my friends are here, and I know the city."

Anyway, on p. 136 was an interesting article about a couple who lived in northern Virginia, in the hubbub of Washington DC, and they flew to Boise for the inaugeration of Gov. Dirk Kempthorne, whom they met when he was a senator (he's now Sec. of the Interior). It was instant love from the airport on. They've since moved from their first Boise home of 3200 s.f. to a patio townhouse of 1970 s.f. After a few details of their personal lives and activities, touring the west in their motor home, riding their Harleys, and dabbling in business, the writer moves on to tell us about Boise. She says it's traffic woes are on the rise, which must make people from DC laugh and slap their knees.

Where to Retire.

My biggest turkey

Thanksgiving reading for investors. Here.

Saturday, November 18, 2006

If you buy a condo


Many older boomers and retirees have decided they want to spend more time traveling or with the grandchildren and less time cleaning gutters and raking leaves. They have moved to condominiums or free standing homes in an association. We love it; haven’t missed our home of 34 years even a minute. However, if you go this route, be considerate.

Please have the decency to attend the business meetings. You don’t need to socialize, you can even vote by proxy. I get so frustrated when we have something important to change in our by-laws, and the board members always have to go out and scare up the missing home owners. Because our units are all different sizes, it isn’t just 75% of the owners, but 75% of the ownership. This probably won’t surprise you, but the richest folks with the largest units, are the ones who don’t show up or send a proxy.

Pew report on working after retirement

More than three quarters of today's workers (77%) expect to work for pay even after they retire, according to a new Pew Research Center survey. Of those who feel this way, most say it's because they'll want to, not because they'll have to. News release on the report here. The information for this report was gathered in June-July 2006.

Working after retirement; the gap between expectations and reality.

Health benefits of modest weight loss

When your BMI (body mass index) increases, the risk of dying from any cause increases. If you're a boomer or older, you've probably packed on a few resistant pounds in the past few years. I added 20 lbs when we got broadband for the computer! At 150 I was "borderline overweight" and now at 139 I'm back in the upper range of "normal." And I'm back in my favorite slacks. I'm working on a modest weight loss now because we're having a great retirement and I want it to stay that way. With even a modest weight loss, you can experience the following:

Decreased risk of heart disease

Decreased risk of diabetes

Decreased risk of some cancers

Decreased levels of blood glucose (blood sugar) and insulin

Decreased blood pressure

Decreased levels of LDL (bad cholesterol) and triglycerides

Increased HDL (good cholesterol)

Decrease in severity of sleep apnea

Reduced symptoms of degenerative joint disease

Improvement in gynecologic conditions

Decrease in problems with pregnancy and labor

Reduced incidence and symptoms of depression

Decrease in discrimination

Easier to exercise and be physically fit

Many of these points come from The Step Diet Book, Workman Publishing, 2004, which might work, but my pedometer doesn’t. Any article you read on health will probably include some or all of these.

Friday, November 17, 2006

A note from cousin Dianne

Working for God on earth does not pay much,
but His Retirement plan is out of this world.

Wednesday, November 15, 2006

Who is blogging?

Three percent of online U.S. seniors have created a blog and 17 percent have read someone else's blog, according to the Pew Internet & American Life Project. But those stats were from a year ago. Let me go dig up some new ones.

I looked at the project (dated June 2006) and noticed it says 2% of bloggers are 65 or over, 14% are in the 50-64, so unless they've got a very high threshold for "senior," that above figure looks a bit low. However, according to Pew, only 7% of people over 65 are using the internet, so if 2% of the bloggers (12 millinion Americans) are over 65, I'd say the ones that are using it must have a lot to say.