Medications And Dementia

The CDC and estimated 177,000 older adults visit the emergency room due to medication problems.  As we move through this journey of dementia with my father, I can see just how easy it is for seniors to become overwhelmed, confused, or over-medicated. 

Each day is a struggle to allow my father to maintain some independence and for me to ensure he is safe and compliant with his medication. This Demon of Dementia has led my father to have poor judgement and poor reasoning. 

For us the following steps have seemed to make the situation more manageable.

1. Dad and I fill his medication container together.  This doesn't always work because he still thinks he can manage his medications independently - so I check them box daily for additions and subtractions.  

2.  Every morning when we set up breakfast we have him bring his medications to the table.
This is a gentle reminder and gives us an opportunity to watch him take his medications (making sure he is swallowing without difficulty and that he is still able to handle the pills without them falling on the floor).

3. Prompting him at bedtime, he always says goodnight, to take his medications.  This is the area we often struggle with - he often gets side-tracked between the den and his room. So this area we will continue to work on. 

Tomorrow we are going to see a geriatric specialist - he was so upset when I tried to discuss his memory issues and seeking a diagnosis, that I have sort of told a little white lie.  He thinks we are going to see a geriatric specialist about some skin lesions and his neck issues.   I hate not being honest but, I need to know, where are we on this journey with dementia? Is there anything that we can do to slow this journey with the dementia demon? 

Some of you may be thinking, aren't you a nurse practitioner?? Why do you need to go to a specialist??? This is my father, I need to know that he is receiving the best care possible. When providing care for a family member you are not always objective...I need the objectivity. 

Stay tuned for more updates
~ Connie~ 

Dementia Sucks

Living with a family member that has dementia is difficult, there I said it!  

Dementia sucks!

In August of last year my then 86 year-old father came to live with us.  He was beginning to have some memory issues.  The issues were starting to impact his life - he was a risk when driving, he was starting to have anger issues, he did not always remember to eat or to take his medication.  He had started having difficulty managing his finances.

 Ready or not we drove to Texas and brought him to our home in Northeast AR. This was a big move for a man who was born and raised in Texas and never had any plans of moving out of Texas.

The first few months we adjusted.  The Big Man and our youngest son pitched in and we established a routine for providing care for Pops.

Routines are important for people with dementia.  Structure helps keep things constant which minimizes the confusing that occurs with dementia.

But, we were not prepared for the feelings that come with watching a vibrant independent person loose their ability to be able to recall dates, memories of their life, or complete simple daily task.

Life will never be the same - it is like loosing someone you love, yet they are still standing right in front of you.

Next week we are headed to the geriatric specialist - I know there is nothing we can do to stop this demon called dementia, but maybe we can slow the process down?? maybe we can find a way to accept what the next months or years may hold??? maybe we can find ways to make Pop's life less forgetful???

Over the next few weeks I will be sharing what we learn - check back weekly to find out how we can live with the demon called Dementia. 

~ Connie ~

Spring and Seasonal Allergies

The trees are blooming, you can hear the grass growing, and the flowers are poking their heads out of the ground in Northeast Arkansas – this means some people are sneezing, they have runny noses, and itchy eyes.

Each spring, summer, and fall, tiny particles are released from trees, weeds, and grasses. These particles, known as pollen, hitch rides on currents of air. Although their mission is to fertilize parts of other plants, many never reach their targets. Instead, they enter human noses and throats, triggering a type of seasonal allergic rhinitis called pollen allergy, which many people know as hay fever.

Short of staying indoors when the pollen count is high--and even that may not help--there is no easy way to evade windborne pollen.

The types of pollen that most commonly cause allergic reactions are produced by the plain-looking plants (trees, grasses, and weeds) that do not have showy flowers. These plants manufacture small, light, dry pollen granules that are custom-made for wind transport. Samples of ragweed pollen have been collected 400 miles out at sea and two miles high in the air. Because airborne pollen is carried for long distances, it does little good to rid an area of an offending plant--the pollen can drift in from many miles away. In addition, most allergenic pollen comes from plants that produce it in huge quantities. A single ragweed plant can generate a million grains of pollen a day.

 

A pollen count, which is familiar to many people from local weather reports, is a measure of how much pollen is in the air. This count represents the concentration of all the pollen (or of one particular type, like ragweed) in the air in a certain area at a specific time. It is expressed in grains of pollen per square meter of air collected over 24 hours. Pollen counts tend to be highest early in the morning on warm, dry, breezy days and lowest during chilly, wet periods. Although a pollen count is an approximate and fluctuating measure, it is useful as a general guide for when it is advisable to stay indoors and avoid contact with the pollen.

You can track pollen counts via your smart phone.

The Weather Channel App will allow you to setup notifications on pollen counts.

There is an app called Pollen.Com

How to Treat Seasonal Allergies (aka Hay Fever)

Anti-Inflammatory Nasal Spray - works directly at the source to relieve your symptoms and won't cause drowsiness.
Antihistamines - Block only one of the many inflammatory substances (histamine) that produce symptoms.

Eye drops - Helps treat itchy, watery eyes associated with allergies, but not the stuffy nose or sneezing

Nasal Decongestants - Clears nasal passages but can, after 3 days of use, cause a “rebound effect,” which makes a stuffy nose worse. 

Home Remedies - Some, like saline rinses, may provide decongestant relief for some people. 

Allergen Avoidance -This means to simply avoid—if possible—your allergy triggers.

If you seasonal allergies are impacting your life - make an appointment to see your local physician. 
~ Connie Ash, MSN, FNP, APRN ~
Family Medicine Associates
Blytheville AR.
870-762-5360

Mc Donalds is Planning to Make Us Healthier

Lately I have been thinking a lot about what I eat. As I was reading a few blogs today I ran across a great post by Ashley at Manic Mom -  Ashley takes the time on her blog to explain McDonalds recent announcement.

" McDonald’s announced that they would stop purchasing poultry that had been exposed to any type of human antibiotics by March 2017." This is a great step towards improving the health of those who eat at McDonalds!!!!!  I am super excited!!!!

Here is Why We Don't Need the Antibiotics
Did you know that food animals (animals raised solely for human consumption) get 80% of the antibiotics used in the U.S. -- mostly in ways that can lead to the growth of drug-resistant superbugs.

Emerging drug resistance in bacteria is one of the world's greatest health threats, according to the CDC, the FDA, the World Health Organization, and a wide range of medical professional societies.
The FDA has no problem with the antibiotics used to treat disease in animals. And it has no problem with antibiotics used under the direct supervision of a veterinarian who is treating specific animals. Beside the shortage of antibiotics that occasionally occurs, when animals are feed low dose steroids over long periods of time, it is a recipe for growing drug resistant bacteria in food animals.

So Why Are We Being Fed Antibiotics?
Over 80% of antibiotics used in food animals is put into their feed or water by livestock producers, almost always on a herd-wide basis. This makes animals put on weight faster even if they don't eat more food.

What is Changing?
Take a look at Ashley's blog - at Manic Mom  she does a great job of explaining what McDonalds plans to do to cut the use of  poultry fed antibiotics.

Remember that we are what we eat - II can only say one thing - I wish more restaurants would take the same step McDonalds is taking - Thank you McDonalds!!!!!!
Thank you Ashly at Manic Mom for allowing me to share this awesome good news.
~ Connie ~

 

Flu Season

The Flu Season is here - according to the Centers for Disease Control and Prevention (CDC) this flu season could be worse than usual, due to an aggressive strain of influenza virus. 

Why is this Flu Season Worse? 

A strain of influenza called H3N2 appears to be circulating. This strain has appeared during the 2012-13, 2007-08, and 2003-04 flu season, the three seasons with the highest death rates in the past decade, according to the CDC. 

"We know that in seasons when H3 viruses predominate, we tend to have seasons that are worse flu years, with more hospitalizations from flu and more deaths from influenza," CDC Director Dr. Tom Frieden said during a news briefing.

To make matters more difficult, about half of the H3N2 viruses detected by CDC researchers so far appear to have mutated, and have genetically "drifted" away from the virus strain included in this year's flu vaccine.

"They're different enough that we're concerned that protection from vaccination against these 'drifted' H3N2 viruses may be lower than we usually see," Frieden said.

Five children already have died from the flu this season, said Dr. Joseph Bresee, chief of the Epidemiology and Prevention Branch in the CDC's National Center for Immunization and Respiratory Diseases.

Three of the five children had the H3 flu virus, although doctors don't know if they had the mutated form of the virus, Bresee said.

What Should My Healthcare Provider Do? 

Because vaccine protection is likely to be shakier than usual this season, CDC officials are urging doctors to use antiviral drugs as soon as possible for any suspected flu cases.

Drugs like Tamiflu and Relenza can't prevent flu, but will reduce the amount of time people are sick, Frieden said.

"Antivirals aren't a substitute for vaccination," Frieden said. "Vaccination prevents flu. But antivirals are an important second line of defense to treat the flu. And this year treatment with antiviral drugs is especially important, particularly for people who are at high risk for serious flu complications or for people who are very sick with flu."

The CDC is recommending that doctors not wait for the results of a flu test before starting patients on antiviral drugs, he said. Antivirals are most effective when given within two days of the onset of symptoms.

A CDC health advisory issued Wednesday urges doctors to aggressively use antiviral drugs in suspected flu patients who are:

• younger than 2 years old,
• 65 or older,
• suffering from chronic disease -- such as asthma, diabetes, heart or lung disease -- or have a suppressed immune system,
• pregnant,
• morbidly obese,
• residents of nursing homes or chronic-care facilities.

Will this year's flu vaccine protect me? 
It takes about four months to make flu vaccine and ramp up production, Frieden said. This lag means that every year, immunologists have to take an educated guess as to which flu strains should be included in the vaccine.

Even though this year's vaccine does not directly protect against this particular H3N2 strain, Frieden still recommends that people get their annual flu shot.

The vaccine will protect against several active strains of flu, and could even provide some protection against mutated flu viruses, he said.

"If we have a severe season, getting a vaccine that provides even partial protection may be more important than ever," he added.

Reference:
Consumer Health (2014) Flu Shot May Offer Less Protection This Winter. http://consumer.healthday.com/infectious-disease-information-21/flu-news-314/flu-694358.html

Good Morning Let The Stress Begin

Do you feel stressed? Do you know when you get up in the morning you are going to spend the majority of your day multitasking or feeling out of control?

Many things have an impact on our health - diet, exercise, sleep, social patterns, environmental exposure, work, and stress play a crucial role in our health.  Over the last two weeks I have seen several patients in my clinic who are physically ill from stress.  Stress can cause, headaches, stomachaches, memory loss, and obesity, just to name a few common symptoms associated with stress. Today I want to try explain how stress impacts your health.

What is stress?
Stress is something we cannot put our finger on, we cannot measure it, and often we dismiss stress as not being real. But, in reality our bodies are driven by the nervous system which tries to maintain a perfect balance.  The body is a miraculous creation, we have many built-in options to try to keep us healthy and safe.  But, just like an automobile if we do not take care of our bodies, the options wear out, switches get broken, and safety features fail.

For instance: Your central nervous system has two branches, the parasympathetic (think: peace) nervous system and the sympathetic (think: stress) nervous system. The two work like a switch — when one is turned on, the other is off.

The sympathetic nervous system is associated with the rapid release of stress hormones, slowed digestion, and faster breathing and heart rate. This is the state you are in when you are speeding through your day stressed out and multitasking like crazy to get everything on your to-do list done. I know this feeling, for many years this is how I l have functioned every day.

What happens when we are stressed?

1. Stress changes gene expression.

The chemicals your body produces when you are under stress turn on or off of genes that change everything from how much fat you store, to how well your immune system works, to how fast you age, to whether or not you will develop cancer.

2. Stress causes brain damage.

High levels of stress hormones damage critical parts of the brain, such as the hippocampus, the area responsible for memory. One reason people experience “adrenal burnout” after long term chronic stress, is because the brain, in order to save itself, turns off the adrenals.

3. Stress shuts down the immune system and increases inflammation.

From slowing wound healing, to diminishing the protective effects of vaccines, to increasing your susceptibility to infections, stress is the ultimate immune-modulator. Stress can also reactivate latent infections — people who get cold sores know this from experience.

4. Chronic stress damages the energy powerhouses of your body, your mitochondria.

These energy factories produce ATP, the currency through which all cells and organs in your body do their work. The good news is this damage is reversible over time, as stress goes away.

5. Stress reduces your ability to metabolize and detoxify.

Studies have shown that the activity of hundreds of genes responsible for enzymes that break down fats and detoxify prescription drugs, are negatively impacted by stress. Stress can also increase your toxin burden by increasing your desire for high fat, high sugar foods.

6. Your cardiovascular system responds to stress, increasing cardiac output if you have to run away from a tiger.

But chronic stress has been shown to increase the thickness of the artery walls, leading to high blood pressure and heart disease.

                                                

     

7. Stress messes with your sex hormones.

Stress increases the amount of something called sex hormone binding globulin, the school bus that ferries testosterone and estrogen around your body, meaning fewer of these hormones are available to your cells. Chronic stress also increases the production of cortisol, leading to something called “cortisol steal,” where fewer sex hormones are produced.

8. Stress is bad for your bones and muscles.

There is evidence that higher stress levels are associated with lower bone mineral density, and many studies show that people under chronic stress experience more physical pain.

9. The gut and stress are intimately intertwined.

You may have heard that 95% of your serotonin is in your gut, and you may remember a time when you were nervous or sad, and your belly was in knots.

But more research is showing how stress impacts the function of your gut every day. It slows transit, leading to constipation and the re-circulation of hormones like estrogen through your liver. It increases the overgrowth of bad bacteria. And it loosens the barriers between the cells that line the intestines, creating something called leaky gut, which then leads to inflammation, food sensitivities and even autoimmune disease.

Next week I will start a series on how to help minimize the effects of stress on your health.

~ Connie ~

Dehydration

Dehydration can occur quickly - Jamie at Jamie's Thots does an excellent job of explaining how quickly dehydration can occur.  

                                                   

 She also gives you a great outline of signs and symptoms of dehydration.   Please take a moment to visit her site so that you can be more productive and prevent health problems.

~ Connie ~