Danger of Falls in Seniors Reminds Me of My Mother

A senior that fell down a flight of stairs. (iStockphoto/Thinkstock)
A senior that fell down a flight of stairs. (iStockphoto/Thinkstock)

Talking about seniors falling reminds me of my mother. She wanted to be independent and mobile. Her children helped her achieve that goal by finding people to assist her at home. My brother and sister were in the same city so they made sure she was safe and comfortable.

My mother had multiple medical problems. She was in her 80s. Her peripheral vision was diminished. This blinded her to furniture as she was walking. She had right foot drop from neurological problems. This made it difficult to lift her foot often causing her to trip. She used a walker to aid her unsteady gait. She had osteoarthritis and osteoporosis. She was lucky to never break a bone from falling.

The shower area was equipped with handles. This made it easy for her to maintain balance while getting in and out of the tub. Sometimes she would get dizzy spells. She also had mild congestive heart failure. Once a month her wonderful family physician would make an old-fashioned house-call to check her blood pressure and give a vitamin B injection.

To maintain her safety and independence we hired in-home help twice daily. In addition to this, a physiotherapist would come once-a-month to assess and advise her on mobility and balance. A massage therapist would come once-a-week to take care of her aches and pains. She also subscribed to an emergency call system that utilized a neck pendant with an emergency call button. Help was always only a button-push away. It was also nice to have wonderful, helpful, and caring neighbours.

The worst part of the year is winter. Icy roads, parking lots and sidewalks are dangerous for young and old alike. We must be vigilant at all times. If it takes a village to raise a child then it takes a community to care for a senior. This involves family, friends, neighbours, volunteers and health care professionals. A team effort.

When we fall the consequences can be serious. Particularly in seniors. Many of them are on blood thinners. Statistics show that 50 per cent of seniors who fall do so repeatedly. Almost half of seniors that fall experience minor injury and five to 25 per cent experience serious injury. About 40 per cent of nursing home admissions are the result of falls. Falls cause more than 95 per cent of hip fractures among seniors, 20 per cent will die within the first year and 50 per cent will never regain their pre-hip fracture functioning. These are serious statistics.

There is a lot we can do to prevent our seniors from falling. Some steps were covered earlier in this article. Also, we should remember to keep our seniors active. Activity improves muscle strength which improves balance. Exercise at least 30 minutes a day. It does not have to be all at once. For example, 10 minutes three times a day. You can walk, dance or take an exercise class. Tell your doctor if you feel lightheaded while exercising. You may have a blood pressure problem or something more serious. Do not ignore these warning signs.

I can go on and on but you get the point. Slow down, be careful, watch your surroundings and ask for help if you cannot do something. Children, keep an eye on our precious experienced “young” folks. One day we will be wearing their shoes, my friend. Remember, November is Seniors’ Falls Prevention Month.

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Indoor Tanning Beds are Not Safer than Natural Sunlight

A woman lying in a tanning bed. (Stockbyte/Thinkstock)
A woman lying in a tanning bed. (Stockbyte/Thinkstock)

Many snowbirds are getting ready to move down south for winter. Some are also booking holidays to get away for a couple weeks to warmer places. The idea is to get away from cooler temperatures, spend time on a beach and soak in the natural sunlight. Before they go away, some travellers visit indoor tanning salons to get a mild tan thinking that this would protect them from sunburn and skin cancer.

There are people who like to look tanned year round and visit indoor tanning salons on a regular basis ignoring the fact that indoor tanning is as bad as basking in the natural sunlight. Some parents encourage their children to visit indoor tanning salons. Studies have shown indoor tanning bed use and childhood sunburns increase skin cancer in young adults.

There is no doubt, exposure to ultraviolet (UV) radiation damages your skin, whether the exposure comes from tanning beds or natural sunlight. The damage eventually leads to premature aging of the skin and skin cancer.

A recent Mayo Clinic study, published in the April 2012 issue of Mayo Clinic Proceedings, found dramatic rise in skin cancer in young adults, especially among people under 40. Researchers speculate indoor tanning bed use and childhood sunburns are key culprits. The study found the incidence of melanoma has escalated, and young women are the hardest hit.

“We anticipated we’d find rising rates, as other studies are suggesting, but we found an even higher incidence than the National Cancer Institute had reported using the Surveillance, Epidemiology and End Result database, and in particular, a dramatic rise in women in their 20s and 30s,” says lead investigator Jerry Brewer, M.D., a Mayo Clinic dermatologist, who was quoted in one of the reports.

The study found the incidence of melanoma increased eightfold among young women and fourfold among young men. The lifetime risk of melanoma is higher in males than females, but the opposite is true in young adults and adolescents. The good news is mortality rates from the disease have improved over the years, likely due to early detection of skin cancer and prompt medical care.

If you are a frequent user of indoor tanning beds then you are 74 per cent more likely to develop melanoma. Young women frequent indoor tanning salons more often than young men even though many of them know indoor tanning has carcinogenic effects that increase the risk of melanoma.

A study from New Brunswick showed that by Grade 12, one-third of girls were using tanning salons, and one-third of them were going with their mothers, says a report in the Medical Post. It is unacceptable that mothers should encourage their daughters to expose themselves to well recognized carcinogens. There are seven other studies involving nearly 7,400 cases showing that first exposure to sunbeds before age 35 increase melanoma risk by 75 per cent.

The message is clear, exposure to ultraviolet rays ultimately lead to premature aging of the skin and skin cancer. So, understand the risk and take care of yourself. There are many ways to enjoy winter months. Be safe and have fun.

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What would make the liver quit working?

A cirrhotic liver. (iStockphoto/Thinkstock)
A cirrhotic liver. (iStockphoto/Thinkstock)

Dear Dr. B: What would make the liver quit working? This person did not use alcohol. Could West Nile virus, hepatitis or E. coli possibly affect your liver?

Two most common causes of liver failure in North America are alcohol and acetaminophen use. Acetaminophen is present in over-the-counter pain and cold medications like Tylenol. We will come to this later. Let me first answer your question.

As far as I know, West Nile virus does not cause liver failure. Usually. West Nile fever resolves spontaneously and completely. In a worst case scenario, fatigue, headache, weakness, movement disorders can persist for weeks or months. Severe disease involving the nervous system can result in death or permanent disability. Death is from swelling of the brain and respiratory failure.

Hepatitis does cause liver failure. Hepatitis is a generic term used for inflammation and damage to the liver cells. The liver cells can be damaged by drugs, any kind of toxins, alcohol, inherited diseases, certain metabolic diseases and viruses. Generally speaking, when we say hepatitis, it refers to viral hepatitis A, B, and C. Hepatitis C is the commonest reason for liver transplant in the U.S.

E. coli infection is very common. But it is not a common cause of liver failure. E. coli can cause infection of the urinary tract, gallbladder, bile ducts and the infection, in rare cases, travel to the the liver, brain (meningitis) or lungs (pneumonia). The majority of infected individuals make a full recovery within a week. About six per cent of patients end up having kidney failure (hemolytic uremic syndrome). Of these, between three to five per cent of patients will die.

Alcohol is a poison. Any amount of alcohol can produce damage to the the liver. The liver is very sensitive to alcohol. If you have had previous problems with the liver then the best thing is to avoid alcohol and acetaminophen.

The most common agent causing liver damage is acetaminophen. However, It is considered the safest medication for fevers, aches and pains, but only if taken in small recommended amounts. In large amounts, greater than those recommended, can result in the liver damage or failure. Acetaminophen overdose is a common reason for considering a transplant.

We have five vital organs – the liver, the brain, the heart, the lungs and the kidneys. The liver plays a vital role in the metabolism of fat and carbohydrates, synthesis of proteins, detoxification of poisons and storage of good nutrients. When the the liver fails, either acutely or chronically, these important functions do not occur. Thus, the person faces severe ill health. There are numerous other reasons why the liver can fail. It is impossible to discuss them all here. However, you get the idea. It is easy to damage your liver if you are not careful.

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There are Many Options to Alleviate Jet Lag

A tired traveler. (iStockphoto/Thinkstock)
A tired traveler. (iStockphoto/Thinkstock)

People travel for business or pleasure. But there is always a price to pay in terms inconvenience before, during and after the trip. Disruption of your body’s circadian rhythm is one of those inconveniences if you are travelling across time-zones (east-west or west-east).

What is circadian rhythm? It is your body’s 24-hour biological clock. Circadian rhythms are physical, mental and behavioural changes that follow a roughly 24-hour cycle, responding primarily to light and darkness in your environment. The rhythm is disrupted because your internal clock is unable to adapt to a rapid change in the light-dark cycle. This causes disruption in sleeping and eating patterns, also known as jet lag.

The inconvenience of jet lag may last several days and some experts have suggested the recovery rate of one day per time zone crossed. During the days of propeller flights, jet lag was not a problem as the flights were slower and of more limited distance. Crossing one or two time zones does not typically cause jet lag nor does north-south travel. So it all depends on the number of time zones you cross.

There are no serious health consequences to jet lag. It does make you tired, moody, and may cause diarrhea or constipation. Airline pilots and in-flight cabin crew members are monitored for jet lag for safety reasons. You don’t want your plane crash or have hot coffee spilled on your lap.

There is no easy solution to prevention or management of jet lag. But the options are many. Before travel, try to go to bed a little earlier each night. That does not happen as we are busy trying to finish all we need to do before the trip. Some people try homeopathic tablets. Recently, I read about a new innovation Valkee Brain Stimulation Headset, which helps to alleviate jet lag by channeling bright light into the brain through the ear canal. Do your homework before you use pills or the headset.

An article in the New York Times (August 15, 2012) discusses “the latest (and perhaps most effective) jet-lag solutions” being developed by the fatigue management team at NASA Johnson Space Centre in Houston to help astronauts overcome jet lag two to three times faster than other travellers.

First, understand that the direction you are travelling makes a difference. Most people have an internal body clock that makes it harder for them to travel east. If you’re travelling east and want to adapt to the new time, you will have to wake up earlier and go to bed earlier than you normally would. This is known as advancing your body clock.

If you’re travelling west, you’ll have to adapt to the new time by waking up later than usual and going to bed later than usual, delaying your body clock. You can do that by wearing sunglasses even if you are in the plane. The idea is to ease yourself into the new time zone by consciously manipulating your exposure to light. So keep those sunglasses on.

Some people use synthetic melatonin to induce sleep. It is not a regulated medication so discuss with your doctor first. Light-therapy lamp is another option. It can speed up the process up to one hour per time zone if used correctly. You can try fasting to change the circadian rhythm to adapt to new eating time. Viagra has been tried in hamsters and the recovery from jet lag is faster by 50 per cent. It has not been tested in humans.

Controlling jet lag is fundamentally about controlling light and darkness. It is not always easy to do that. So, forget about jet lag, pack your suitcase and fly away – with or without Viagra.

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