Tuesday, August 6, 2013

Barnacles of Old Age

The Woodman and I went to the  Dermatologist today. I wanted to see if she had a magic elixir to make me less old looking and Woody had lumps and bumps that needed to be evaluated. When you get old, you turn into a fish with scaly things! The medical term is barnacles of old age! Seriously! Usually they get really dry and you can sort of scratch them off, but at times you need a little help to get them under control. And of course, skin cancer checks annually or whenever a mole changes size or color are mandatory as you age. The Woodman got a few facial spots frozen so he will look great for his reunion, but we are both skin cancer free.

Using sunscreen will decrease your risk of skin cancer. Examining your body for changes in moles or  other skin changes will find more serious issues such as malignant melanoma early and offer a better chance of cure. Malignant melanoma is a dangerous form of cancer that often is diagnosed late as we ignore our skin! Often lesions are in areas of too much sun exposure like your back and legs...places that may be hard to view so engage your spouse, significant other or a good friend to help you look! Brad Paisley has a line in one of his songs "I want to check you for ticks"! I want you to check yourself for skin changes!

Now as to making me look younger...well that's for another entry but it's not looking too good.

Thursday, September 20, 2012

Don't forget the dentist!

Sometimes we neglect preventive care and only focus on illness. Dental care is one issue that we often forget when facing a chronic or debilitating illness. The Surgeon General and the American Dental Association (ADA) both say good oral hygiene is important to good health.

MouthHealthy.org, the ADA’s consumer website, provides information about how to better care for your mouth and gums. Poor mouth care can lead to an increase of bacteria in the mouth, infection and serious medical complications. The ADA site states that infections may be associated with heart disease, stroke,diabetes and other health problems. Correct brushing and flossing, regular dentist visits and a healthy diet can reduce medical complications due to poor oral hygiene.

For example, individuals with diabetes may face an increased risk of oral complications when high glucose levels lead to an increase in bacteria in the mouth and potential gum disease. With over 20 million people struggling with managing diabetes on a daily basis, preventing gum disease and other oral complications may seem the least of their worries. In fact, taking care of your teeth and gums is an important part of good health. Seeing your dentist and dental hygienist regularly is recommended.

The American Heart Association recently reported that there appears to be no causative relationship between gum disease and heart attacks or strokes, but additional studies are needed. What they did say is that people who don't take care of their cardiovascular health by stopping smoking, controlling their diabetes or high blood pressure, may not pay close attention to their oral health.

Poor oral health can lead to a variety of problems, not the least of which is tooth loss. Controlling gum disease and taking care of your teeth throughout your life has other benefits too. I have an acquaintance who has poor fitting dentures and is losing weight, can't eat what he enjoys, and is probably not receiving adequate nutrition. Many older people are able to maintain their teeth well into "old age" with proper oral hygiene and regular dental care. I happen to love to eat...with dentures, the taste of food is minimized! I want to enjoy my calories, thank you very much!

To read more about good oral hygiene, Colgate Oral and Dental Health Center is a great website with lots of good information as is Crest's website. Talk to your doctor and dentist about how good oral health will benefit you!

Tuesday, September 11, 2012

Caregivers Need Help Too!

Patients often receive state of the art and state of the science treatment when they are in the hospital. With discharges from the hospital occurring sooner rather than later, some amount of care at home is expected after leaving the hospital. When professional caregivers, such as homecare nurses or physical therapists, are not part of the home care,  the burden of post discharge care falls to family and close friends. The National Cancer Institute has a wonderful book, Caring for the Caregiver, that is available online at the following link: http://www.cancer.gov/cancertopics/coping/caring-for-the-caregiver. While this book addresses those who care for cancer patients, it includes great tips for anyone caring for someone suffering from illness.

Caregivers may feel stressed and overwhelmed at times, and may even feel angry, sad, or worried. Sharing how you feel and talking with others often helps. A good friend is the best thing a caregiver can have! A counselor or social worker is also an option if you don't think you can handle your situation without professional help. The stress you're feeling is normal, but if your sadness or anger lasts more than a few weeks or interferes with your activities of daily life, you may be depressed. You should not be afraid to talk to your doctor or your loved one's doctor about your feelings.

Loneliness is a significant problem for caregivers. If you are needed at home all the time, you may begin to feel no one cares when you are cooped up inside. Don't be afraid to ask for help. Sometimes just getting out to the grocery or for a quick visit with friends is all it takes to revitalize you for a while. People often offer to run errands or bring food, but sometimes it's better if you can just leave home for a while. If someone calls and offers to help, ask them to come visit so you can get out for a bit. Just remember though that not everyone may be comfortable around those who are ill. If you take care of yourself, you may have more energy and will feel better.

Your loved one may also have guilt feelings that you are putting your life on hold. Having someone else come in occasionally gives both of you a break! Recently my husband went to visit an older uncle for the afternoon. His aunt raved about how great it was that his uncle could have "men talk"! Sometimes people offer help you don't need...don't be afraid to turn them down or suggest that you might prefer that they do something else. For example, if someone offers to mow your grass when you've already arranged a yard service, ask if they could perhaps bring supper one night instead or take your child on a play date.

Often chronic illness places strain on a family, even if the patient is not home bound. While you both may be able to get out and enjoy things on occasion, physical limitations or emotional problems associated with the illness need to be addressed. A friend's husband is struggling with a variety of health issues including diabetes. He is choosing to ignore his diet restrictions as if he doesn't have a problem, and refuses to take care of himself. My friend is at her wit's end! Others may refuse to use assistive devices like wheelchairs or motorized carts because they don't want to "look disabled". In situations like these, professional counseling is highly recommended as this behavior is detrimental to the individual's health or the couple or family relationship.

If you can arrange it, consider joining a Caregiver Support Group. Local hospitals or other healthcare agencies often provide these groups free of charge. Sometimes it helps just to be with others who understand exactly what you are going through.

In the book, Caring for the Caregiver, is some excellent advice:

"As a caregiver, try to remember to:
  • Strike a balance each day.
  • Focus on your needs, too.
  • Care for yourself while caring for your loved one.
  • Make time for resting and relaxing."
The Institute of Medicine states that "the burden of illnesses and disabilities in the U.S. and the world is closely related to social, psychological and behavioral aspects of the way of life of the population" (IOM, 1982:49-50, www.iom.edu). Protecting both patients and caregivers is an important part of making health care work. As hospital stays get shorter, the need for caregivers in the home increases. Don't be afraid to ask for help!

Monday, September 10, 2012

Wash Your Hands!

Something as simple as washing your hands can prevent up to 80% of infectious disease including colds and flu! So why don't we wash our hands more? According to the Centers for Disease Control and Prevention (CDC), routinely washing hands with soap and water or using 60% strength alcohol gel hand sanitizers could reduce deaths associated with diarrhea by as much as 50%. A million deaths a year could be prevented if we just practiced good hand hygiene. How many times have you seen someone use the toilet and then leave a restroom without washing their hands? Anything they touch could be contaminated including the door handle! Of course, I know you always wash your hands after using the toilet.

Foodborne disease outbreaks are spread by contaminated or dirty hands and many hospital acquired infections are a result of poor or no hand washing by healthcare professionals, patients and family members. Food poisoning is often caused by handling raw meat or poultry with bacteria on their surface and failing to wash hands or preparation areas before handling dishes or placing items on the counter. This cross contamination, or the transfer of germs from the meat to your hands to the next item you touch, could easily be prevented by a little soap and water! This same type of cross contamination is true in hospitals and healthcare settings if doctors and nurses don't wash their hands between patients or tasks.

So if hand washing is so important to prevent disease, why don't more people wash their hands? Excuses range from "I just don't think about it" to not enough time and everything in between! The CDC and the World Health Organization are encouraging people to take an active role in reminding everyone to wash their hands! If you are in the hospital or doctor's office, it is OK to ask anyone who enters your room if they have washed their hands. If you are in a public place, I'll leave it up to you to decide if you want to remind people you see who don't wash! But certainly, be more aware of hand washing or using hand sanitizers when you are out in public...you never know who hasn't been so diligent!

Be sure to teach your children how to wash their hands.  Using soap and water and singing a song like Happy Birthday or Twinkle Twinkle Little Star makes hand washing fun and keeps the kiddos scrubbing for at least 15-20 seconds. If no soap and water are available, use a 60% solution of alcohol gel hand sanitizers and rub until dry. If we all wash our hands more often, I wonder how many infections we could prevent in our families!

For more information, see the CDC website on hand washing at http://www.cdc.gov/handwashing/

Happy Hand Washing!!

Sunday, September 9, 2012

Why we need a new vision for health care!

This is the first entry in my new effort to make health care work for all of us. For years, I've posted on others' sites under the pseudonym Healthcare for All. I've received positive comments on my posts, but I think it's time to branch out and address topics I feel are important rather than reacting to others.

After a career of over 40 years in health care, first as a nurse and later as a healthcare administrator and now a healthcare consultant, I think I have much to contribute to the discussion of why health care isn't working. From concerns about access to care and the ability to gain insurance coverage  to questionable quality in the care received and poor clinical outcomes, the state of the healthcare industry in the U.S. is not where any of us would like it to be. We listen to career politicians who describe how they are going to "fix" health care, and yet none of them have any direct knowledge of the effort it takes to run a hospital or physician practice while dealing with limited resources, conflicting care guidelines, an aging workforce and thousands of patients unable to pay for the care they need.

Recently, the Institute of Medicine released a scathing report on the state of the healthcare industry entitled Best Care at Lower Cost-The Path to Continuously Learning Health Care in America. Three major areas that need to be addressed were identified by the committee that developed the report: the rising complexity of health care, unsustainable cost increases, and outcomes below systems' capabilities. They reported that $750 billion, or approximately 30 percent of health spending in 2009, was wasted. More than 75,000 deaths across the U.S. could have been prevented with proper care according to one estimate. The committee also stated that engaging patients and their families in decisions regarding their care leads to better outcomes and reduced costs, but such participation remains limited. The entire report can be accessed here:

"Making Health Care Work" is an overwhelming topic..I hope I haven't taken on too much! But then, we have to start somewhere. We spend a lot of money on the pursuit of health, but countries with national health care services have better outcomes than we do! From maternal fetal statistics to longevity, we are not the leaders in the world.

I would love to address the Accountable Care Act (ACA), or as it has been renamed, "Obamacare", but I think that might be too challenging. Healthcare costs as a percentage of GDP have increased for many years. It has threatened the US economy and placed our businesses at a global disadvantage. The auto industry routinely tacks on thousands of dollars in healthcare costs to their products...just one example of cost shifting healthcare costs to all of us. Hospitals and physicians set rates higher to cover the uninsured patient who can't afford to pay...more cost shifting. While not perfect, the ACA is a start. I don't want to completely politicize this blog, but I will incorporate some points from the ACA going forward as appropriate...for now, I just recommend that we don't "throw the baby out with the bathwater"! Let's agree that allowing parents to keep their children on their insurance longer is a good thing...especially since it took my children longer than 4 years to get through college! I'm sure as we look carefully at the component parts of the ACA, there will be other good things we need to keep. Take the time to carefully consider what we really need to address in health care going forward and remember that using health care as a bargaining chip in a political race is not always in the best interest of all of us!

Pat Stanfill Edens, MS, MBA, PhD, RN, LFACHE