Five Healthly Resolutions for Women

Five Healthy Resolutions for Women appeared at WebMD. I've added my own comments, and not lifted large sections to post, so pop on over and read the whole article. We've heard it all before, but January 2008 is a good time to renew your resolves of 2007.

Eat, but don’t pig out. All or nothing approach will kill your resolution. When I lost 20 lbs. a year ago, I had a list of things I would avoid, like French fries and cheese, but I allowed myself my favorite restaurant meal on Friday nights--Philly Cheese steak with Fries--which had just about everything on the list!

Jump outside the box. Most workout intentions fall by the wayside by February. Like the diet, don’t be unrealistic. If you hate exercise or you aren’t athletic (like me), you won’t get there by resolving to be different. It’s just you. Park further away. Take the stairs. Take dance lessons. Volunteer to walk a neighbor’s dog. Wear a pedometer.

Guard against the bone thief. Women and osteoporosis. For postmenopausal women 1,000-1,500 milligrams daily if on menopausal hormone therapy. Exercise helps the bones too, as does good nutrition. Smoking and alcohol have to be watched too. To paraphrase Ben Stein, nothing you overindulge in when you're young is worth being disabled or an invalid when you're older.

Get an A+ in taking health exams. Mammogram. Bone density. Pap smear. The colonoscopy is the only exam we have that actually can prevent cancer--find a polyp and have it removed before it causes trouble all during the exam. Colon cancer is so nasty--and so preventable.

Take care of the caregiver. Stress can really lower your immune system. Moms and daughters seem to always be looking out for someone else. Take the time to assess your situation. Who'll take care of everyone else if you're laid up?

Besdine's Boomers

Dr. Richard Besdine uses the mnemonic "Besdine's Boomers" to remember these mid-life strategies for healthy aging.

Blood pressure -- get screened at least once a year and treat appropriately if high
Exercise -- keep the mind and body as vigorously active as possible
Smoking -- stop as soon as you can; the benefits accrue immediately
Driving -- have a physician evaluate you for driving risk
Immunizations -- get a flu shot every year and a pneumococcal vaccine once
Nutrition -- proper nutrition is critical, especially for cardiovascular health
Environment -- keep your home environment safe with smoke and carbon monoxide detectors; get rid of toxic substances under the sink
Screen for cancer regularly -- Colon cancer screening as recommended by your physician; skin should be evaluated by a physician once a year; for women a mammogram annually and a pap smear as recommended by your physician

Booze -- avoid excessive alcohol; alcohol and smoking accelerate bone loss
Osteoporosis -- women and men should get a minimum of 1500 mg. calcium a day; one-quarter of all hip fractures in the elderly occur in men
Oral health -- healthy teeth and good dentures are important for proper eating; see your dentist annually
Mobility -- stay as active as possible
Emotional health -- too little attention is paid to stress reduction in old age, when events such as the loss of work and the death of friends and spouses can cause stress and emotional upheaval
Rx drug safety -- beware of taking outdated and conflicting medicines
Social Networks -- important for stress reduction and overall emotional health

Richard W. Besdine, M.D.
Professor of Medicine and Director,
University of Connecticut Center on Aging,
University of Connecticut Health Center

Seen at Alliance for Aging Research

Unbelievably good deals

This is a terrific little reference book. "Unbelievably good deals and great adventures that you absolutely can't get unless you're over 50" by Joan Rattner Heilman, 2007-2008 edition, McGraw Hill, 2007, will set you to dreaming about what you're going to do with all that free time when you are retired. There are 19 chapters on travel, education, sports, shopping, etc. Chapters 2-12 actually deal in some way with travel--lodging or airfares, tours, cutting costs, etc. This author doesn't want you to pay sticker price for anything. Always ask about a senior discount.

If you are a single man over age 45 and a great dancer, consider being a "host". You can cruise for (almost) free, working 3-4 hours a day. All you have to do is not get romantically involved with any of the passengers.

This summer at Lakeside I met a kite-flying teacher who was wildly enthusiastic about the Evergreen bed and breakfast club, which is featured in this book. It's for people over 50, has 3,500 members and 2,000 host locations. A couple pays $15 for each overnight stay. The club dues are $60 (single) and $75 (couple). Check www.evergreenclub.com.

Recommended automobiles

Jonathan Welsh of the WSJ recommends the following cars if you've had a knee replacement: 4 door Ford 500 (Taurus), Chevrolet Impala, Buick Lucerne and Dodge Charger or Chrysler 300. Can't imagine trying to get into a Charger with bad or stiff knees.

More stuff, more stress

A few years ago, a well-heeled girlfriend told me that her 80-something mother was living in a tiny trailer in Arizona with a minimum amount of furnishings. She'd told her family, "When I die, just push it over the cliff." She wasn't poor; but she'd learned what most of us do after awhile--your possessions own you, not the other way around. In an article, about "Stressed out Moms" Ingrid Schlueter writes,

One factor seems to be expectations going into marriage. Newlyweds of my parents’ generation had very modest expectations financially. My parents started out in a basement apartment in Des Moines, Iowa that didn’t have much in the way of amenities. They graduated to a studio apartment later and then to a three bedroom flat where my brother, sister and I spent our early childhood years. From there it was a very simple, three-bedroom Milwaukee bungalow. No family room, one bathroom, old, basic kitchen and bath. The carpet when we moved in was the original and that goes for the linoleum as well. Mom made it all comfortable and homey, and we kids didn’t know that we lacked a thing. That’s where my parents lived until I was married.

Today, few newlyweds start out this way. Home ownership is seen as essential for many, even if it requires both husband and wife to work outside the home. It’s a dangerous way to begin because once the couple starts relying on two incomes to live, it is very hard to stop when a baby comes. Then the couple begins the stressed out years of trying to find and pay for exorbitant childcare, while strangers get the privilege of caring for their baby. Add a couple more children to the picture, and you have a lot of outgo for that same two-income couple and the race to meet all the demands begins."

That's exactly the same thing our Irish bus driver John (50 and the father of 5) said about the younger Irish generation setting up homes and getting mortgages. It's not a local problem. [See my Ireland trip log]

Cross posted from Collecting My Thoughts

Adorable baby gifts

If I had to buy a baby gift, here's where I'd go on the internet.

Thirty years ago

Thirty years ago I would have never dreamed that topics like retirement, 401-k plans, osteoporosis, nutrition or exercise could become so interesting. My reading tastes have changed completely--in fact, on Thursday I think I'll tell you 13 things about JAMA.

Cross posted from Collecting My Thoughts.

Saved by a case of poison ivy

We've known each other about 40 years--were neighbors when we were both apartment dwellers in 1967. At an art show this morning she told me she'd had a cervical something-ectomy, didn't get the exact term. She's an avid tennis player, but had called her doctor for some poison ivy treatment, and in passing mentioned that she had a tingling in her neck--sort of felt like little bugs crawling around. He told her he would schedule an MRI, which sort of surprised her. Well, she had bone spurs on her spine, but had felt no pain except the tingling. One wrong move on the tennis court or a fall, and she might have been paralyzed. She immediately had the surgery and was recuperating most of last summer. Now she has two small rods supporting her neck, but everything is fine, and she's back to making her art work and playing tennis.

I looked up "bone spurs + tingling + neck" and learned that, "In persons 60 and older, bone spurs are common. Only a little more than 40% of the population will develop symptoms that require medical treatment as a result of bone spurs." She really had no significant pain. Pay attention to those tingles, and Thank God for poison ivy!

Sex and the sixty year old

The February 14 issue of JAMA has an article on the sexual difficulties of a 60 year old woman, just in time for Valentine's Day, but I didn't see it until April 1. It seems that Ms. B has diabetes, hypertension, hyperlipidemia, and asthma now, and when she was younger she had endometriosis, bladder suspension surgery for incontinence and a hysterectomy for uterine fibroids. As might be expected, she takes a lot of medication, has back pain, and is allergic to some of her meds. She doesn't smoke or drink, and works as a psychologist. Oh yes, she didn't go through menopause until 58, so she dates her complaints to decreased desire and less stimulating sex to that. The author isn't specific, but says Ms. B. has some "body image" issues. One of the comments about obesity and sexual issue made me suspect that might be the problem.

I would be out of the mood just listing her health problems, so I can imagine trying to live with them. The article lists all sorts of reasons for sexual dysfunction and what life style or medical changes can be made. However, I found the very last paragraph quite instructive--almost humorous.

PHYSICIAN: How should I bill for a sexual health consultation in order to be reimbursed?
DR. POTTER: . . . Examples of reimbursable ICD-10 diagnoses include: lack or loss of sexual desire (F52.0), failure of genital response (F52.2), menopausal and female climacteric states (N95.1), postmenopausal atrophic vaginitis (N95.2), dyspareunia (N94.1), and orgasmic dysfunction (F52.3).

There are 122 references in the bibliography.

The old to extremely old ratio

There's a proposal to reexamine the health care of the elderly, and not so elderly. It used to be that there were a lot of people in their 50s and 60s to help care for those in their 80s and 90s. For instance, my parents were in their 50s when my mother's parents died, and 70s when my father's died. They were there for errands to the doctor, taking in food, helping with home chores, taking them to church, supervising medications, and visiting them for companionship. And they had brothers and sisters, cousins, nieces, nephews and grandchildren also available. People today are living longer (although in my family we always had people living into at least their 80s it seems in every generation), having children later or none at all, and when they do have families, they are smaller. This will have an impact as the boomers age.

"They estimate that in Switzerland, the oldest old support ratio has fallen from 139.7 in 1890 to 13.4 in 2003. They predict that these oldest old support ratios will decrease to 3.5 in Switzerland and 4.1 in the US by 2050." Seen at Medscape.com

Late in life divorce

"One woman in her eighties, married for fifty-three years, woke up after transplant surgery and announced to her husband: 'I don't know how many years I have left, but I do know I don't want to spend them with you.' "

That's probably a bit drastic but Calling it Quits author Deirdre Bair says it's happening. And often it's the ladies making the move.

New treatment for wrinkles

Possibly you were too busy over the holidays developing wrinkles while buying gifts and anticipating bills to notice that the FDA has approved a new treatment for those deep lines--something that lasts longer than Botox and Restylane. It's called Radiesse and is produced by BioForm Medical Inc.

And if you don't care about lines and wrinkles, you might use it to plump your retirement portfolio. Sales are expected to rise 15% annually through 2010--just 3 years away-- to $935 million.

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.

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.

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.

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."

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

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.

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.

retirement advice
good manners
senior housing
Humberto Cruz

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.