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Wise as Salamon/News Links

ssalamon_non_cg_2566Suzanne Salamon, MD is chief associate of clinical geriatrics at Beth Israel Deaconess Medical Center.   Email general questions to mdeery@brooklinema.gov or call Maureen: 617. 730. 2743.   These are excerpts. Read the full post in this month’s newsletter (link on front page)

SEPTEMBER:  What is the best way to take care of my feet?  The American Podiatric Medical Association estimates that the average American has walked 75,000 miles by the time they’re 50.  Foot problems may include decreased cushioning, dryness of skin and nails, heart disease and diabetes that can lead to poor circulation.  Wear shoes that don’t rub, cut nails straight across, keep feet clean and dry.  Read the column in its entirety in the newsletter.  See link on front page.

AUGUST:  Should I get the new shingles vaccine Shingrix?  There are 5 vaccinations you need: flu vaccine every year, Prevnar 13 once, pneumonia vaccine once, Tdap once then every 10 years, shingles once. If you had Zostavax you should also get Shingrix.  It requires two shots given 2-6 months apart.  It is recommended for people over 50, even if you had shingles, got the older shingles vaccine or are not sure if you had chickenpox. Medicare Part D covers Shingrix but check with insurance about copays.

JULY:  Do I need to treat sleep apnea? It is a disorder that causes you to stop breathing while you are asleep. This can happen when the back of your throat closes. When the airway is blocked, less air can reach your lungs and your brain. Lack of oxygen can also cause high blood pressure, heart disease, stroke and memory loss.  The biggest risk for apnea is being overweight.  A CPAP (continuous positive airway pressure) machine is one treatment. Also mouth guards that are fitted by a dentist.

JUNE:  Every spring, my nose and eyes start to water.  What can I do?  Pollen from grass, trees and flowers cause allergies.  Often people think they have a cold. However, allergies are not associated with fever or aches and pain. There is more evidence we see more allergies now because we are becoming “too clean.” When we are exposed to “dirt” or pollen or peanuts, we develop antibodies which protect us from allergic reactions later. Try air purifiers and filters. Wash hands and clothes and take off shoes at the door.

MAY:  What vaccines do I need?  Flu every year, pneumonia 23, prevnar 13, tetanus, diphtheria and pertussis (DTap), and the new shingrix for shingles; are all recommended if you’re over 65. If you have a cold or are on steroids, wait until you’re better.  Keep a record of your immunizations.

APRIL:  Is there such a thing as too much sleep?  There is.  Narcolepsy can cause sleepiness but it’s rare.  Other causes: drugs, alcohol, cigarettes, no activity, obesity, depression, anxiety, boredom and some medications.  Try to limit in bed time.  Use an alarm, go to sleep before midnight, no alcohol before bed, wear an eye mask, eat breakfast soon after awakening with tea or coffee, exercise, keep to a schedule, and avoid sleeping pills.

MARCH: I can’t sleep. We think 7-8 hours help us think more clearly and improve memory.  Non-medical ideas: take a short nap before 5 pm, no spicy foods, less caffeine, no alcohol 3 hours before bed, exercise, warm showers, read a book. If insomnia persists, speak with your doctor about a sleep therapist.

FEBRUARY: Highs and lows of blood pressure.  High pressure is called hypertension. Older recommendations: 150/90 needs treatment. Newer studies suggest the top number be lower than 140 although side effects of extra medications may cause more problems than they solve.  Some drugs like steroids, cold pills, ibuprofen and naproxen may contribute. High pressure predisposes to heart attacks, strokes, kidney disease, eye problems and ED.

JANUARY:  COPD  Chronic obstructive pulmonary disease includes chronic bronchitis, emphysema, asthma and bronchiectasis.  Symptoms: shortness of breath, chronic coughing and wheezing.  Causes: smoking, second hand smoke, chemicals, fumes, dust and air pollution.  You may get help from exercise pulmonary rehabilitation which teaches techniques that may help breathlessness.

DECEMBER:  Sleep. “I’m tired when I go to bed and then I cannot sleep.” As we get older, our usual sleep habits may change.  We think the ideal amount is 7-9 hours.  Possible sleep disorder: trouble falling asleep, trouble getting back to sleep, not refreshed, irritable, rely on sleeping pills or alcohol.  Try: turn off TV and computer one hour before, read a book, block out snoring, aerobic exercise, melatonin, short naps, no alcohol or caffeine late in the day, chamomile tea.

NOVEMBER:  Men’s Health Prostate health.  Heart disease, the number one cause of death in the US.  Men are affected earlier without the effects of estrogen. Risks for men and women are cholesterol, blood pressure, smoking, physical inactivity and weight.  Depression and suicide: white men over 85 are more likely to commit suicide than Americans in any other age group. Possible signs: withdrawal from activities, negative thoughts, talking about death, impoverishment or physical decline, getting wills and finances in order.

OCTOBER:  Osteoporosis describes bones that are weaker either because one loses too much bone or is not making enough bone.  It is common.  It’s diagnosed with a bone mineral density scan that’s painless.  Prevention and treatment:  calcium, vitamin D3, walking, stairs, dancing, tennis, yoga.  Medication may be needed: pills, intravenous and injections.

SEPTEMBER:  Hepatitis C is a contagious liver disease that spreads mostly through infected blood.  This can come from sharing drugs, needles, sex with an infected partner and tattoos.  Most people have no symptoms; other have jaundice, abdominal pain, nausea and fatigue.  It can lead to liver cancer and cirrhosis.  Have a blood test if you had a transfusion/transplant before 1992, got a clotting drug before 1987, were born between 1945-1965, are on long-term dialysis, have HIV or abnormal liver tests.

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 New York Times, Huffington Post, New Yorker

  • For Diabetics, Health Risks Fall Sharply, by Sabrina Tavernise and Denise Grady, Times, April 16
    Progress Report
  • Younger Skin Through Exercise, by Gretchen Reynolds, Times, April 16
    Time Passes
  • A Number That May Not Add Up, by Jane E. Brody, Times, April 14
    Weight Matters
  • The Sixth Stage of Grief, by Joel Yanofsky, Times, April 11
    Buying a Puppy
  • Why a Brisk Walk Is Better, by Gretchen Reynolds, Times, December 4
    Pick up the pace
  • The Power of a Daily Bout of Exercise, by Gretchen Reynolds, Times, November 27
    Eat and run
  • In the End, It’s Not About the Food, by Corey Mintz, Times, November 26
    Just a little
  • Think Like a Doctor, by Lisa Sanders, MD, Times, October 3
    A Green Heart
  • A Youthful Glow, Radiating From Within, by Jane E. Brody, Times, September 30
    You look mahvelous
  • Manson Whitlock, Typewriter Repairman, Dies at 96, by Margalit Fox, Times, September 8
    Work works
  • Online Lessons in Dementia Management, by Judith Graham, Times, Sept 5
    Caring and Coping
  • On Becoming an ‘Orphan,’ by Paula Spahn, Times, July 1
    Profound Shift
  • When Aggression Follows Dementia, by Paula Spahn, Times, July 12
    Heart Breaker
  • When Exercise Stresses You Out, by Gretchen Reynolds, Times, March 13
    Hate it?
  • Eat Your Heart Out, by Gretchen Reynolds, Times, March 7
    Your Heart
  • The 20 Million, by Mark Bittman, Times, June 12
    Hardly eat
  • Gross Ingredients In Processed Foods , by Sarah Klein, Huff Post, May 14
    Eat no meat
  • We Could Be Heroes, by Mark Bittman, Times, May 15
    Eat less meat
  • The Disconnect: Why are so many Americans living by themselves?, by Nathan Heller, New Yorker, April 16
    Love story
  • Nutrition: Options Play a Role in Healthier Choices, by Nicholas Bakalar, The Times, February 13
    Food story
  • The Fat Trap, by Tara Parker-Pope, The Times, December 28
    Sad story
  • In the Body’s Shield Against Cancer, a Culprit in Aging May Lurk, by Nicholas Wade, The Times, Nov 21
    Old story
  • For Beginning Runners, Advice Can Be a Hurdle, by Gina Kolata, The Times, November 14
    Running story
  • What Boomers Do Best (and how you can prosper after 50), by Julia Moulden, Huffington Post, June 12
    Loud story
  • When the Roommate Has Four Legs, by Antoinette Martin, The Times, October 20
    Dog’s life
  • Redefining the Hot Dog, a Cart at a Time, by Jeff Gordinier, Times, August 9 “There are children in New York who have never eaten a hot dog.” Very sad story
  • When Are You Too Old to Exercise?, by Judith J. Wurtman, Huff Post, April 13
    Old story
  • The D Word, by Nora Ephron, Huff Post, 11/8/2010 “There are good divorces, where every­thing is civil, even friendly. . . In my next life I must get one of those divorces.” The D word