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Wise as Salamon’s Health News

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. 2790.   These excerpts have been edited. Read the full post in this month’s newsletter along with past columns at https://www.brooklinema.gov/Archive.aspx?AMID=37




JUST OUT!  Dr. Salamon’s columns are in a new book:  “Ask a Geriatrician,” filled with good words on good health.  Copies are available at the Senior Center. For more information, please call 617. 730. 2777





MAY: What is the difference between Pandemic, Epidemic and Endemic?

It’s hard to believe that a full 2 years after COVID made its grand entrance to the US, we are still dealing with its ongoing presence. There are several questions about COVID, and it seems that the answers are constantly changing. But for now, in early 2022, here are some of the topics:

  • EPIDEMIC is the spread of a disease throughout an area where it usually is not present.
  • PANDEMIC is when the disease spreads over a larger area, often the entire world.
  • ENDEMIC means that a disease recurs regularly, never really going away, such as the flu. We will have to see if COVID becomes endemic, requiring regular vaccinations.

APRIL: What exactly is anemia and is it part of normal aging?
Anemia is a word that means “without heme.” Heme , or hemoglobin, is contained in red blood cells which supply our body with food and oxygen. At first we may not feel when the red blood cells and hemoglobin become too low. However, if it progresses, we may feel tired, weak, get short of breath, dizzy and even develop chest pain. While some people may have lower levels as they get older, a sharp drop warrants a workup.

MARCH: I hear so much about the Opioid Epidemic. Is that something older adults need to worry about? YES! There is an opioid crisis among older adults, but we don’t hear much about it in the press. For adults aged 65 and older, opioid-related hospitalizations increased by 34% and emergency department visits increased by 74% between 2010 and 2015.

DECEMBER: Where do things stand now, and in what ways has it impacted the lives of health professionals treating patients with COVID? Events related to COVID still are happening so rapidly that it’s good to slow down and take a “trip through memory lane” to think back over the events that have changed the world in such a short time and the miraculous response that continues to evolve. Let’s go through a timeline of events.

OCTOBER:  What is sciatica?  It is a pain that can travel down each leg though it usually only affects one side.  It occurs when something compresses part of the sciatic nerve like spinal stenosis or a herniated disc. People who sit for a long time are more prone. Treatment: ice for a couple of days.  Can be followed by heat.

SEPTEMBER:  Do I need a flu shot? Last year’s flu season was one of the lightest.  It is possible to catch the flu after you are vaccinated however it reduces the severity. You cannot get the flu from the flu shot. Flu vaccine is recommended for everyone older than 6 months. The best time to get the shot is the end of October and early November.  The CDC says it is okay to get the Covid vaccine and the flu vaccine at the same time. (!)

AUGUST: I got both shots. I’m 88, is it safe to leave the house? Yes, and always have your mask. If you’re outside, you are most likely safe. Mass has a high rate of vaccination. Wear the mask inside. We don’t know yet about booster shots.

JULY:  Still hot!  You may be more susceptible to the heat with heart and kidney issues, blood pressure, alcohol, over or under weight, and medications. Heat exhaustion and heat stroke are uncommon but worrisome. Get to a cool place, drink, put your feet up. Heat stroke needs immediate medical attention.

JUNE: It’s hot! Symptoms of dehydration can be: dry mouth, muscle cramps and nausea. Severe dehydration is called heat stroke and often requires hospitalization. Imbibe: water, popsicles, fruit especially melon, tea, coffee, Gatorade, lemonade.

MAY:  What is aortic stenosis?  As we age, the valve becomes narrow and doesn’t open fully to let blood pass through. This causes blood to back up. Stenosis means narrowing. Causes: calcium build up, birth defects, rheumatic fever, and radiation therapy. Treatment: drugs and/or surgery.

APRIL:  How can I prevent diabetes?  Diabetes is caused when sugar and fat cannot be absorbed. They stay in the blood causing blood sugar to rise. Common risk factors: family history, being overweight, some medications, and age.  Symptoms: thirst, urinating often, yeast infections, skin problems, weight loss, and dry mouth among others. To treat diabetes, it is important to maintain a normal weight and get daily exercise.  Without treatment, there is the possibility of damage to the eyes, kidneys and the development of neuropathy.

MARCH: It’s your annual physical. Ask about:  Blood pressure, cholesterol, bone density, colonoscopy, vaccines (flu, DTAP, shingles), hearing, BMI, depression, vision. Checkups work. 

FEBRUARY:  How common is lung cancer? Lung cancer is the most common cause of deaths from cancer in the world. The most common cause is smoking. It can lie dormant for years and suddenly start to grow. Symptoms: cough that doesn’t get better, difficulty breathing, coughing up blood, chest pain, hoarseness, weight loss, bone pain, headache. Diagnosed by chest x-ray and CT scan. Biopsy may be followed by surgery, radiation, chemotherapy, targeted drug therapy and immunotherapy. Treatments are so much more effective now. It is important to diagnose and treat early.

JANUARY: Should I see a cardiologist before or after a heart attack? If before, what symptoms should I look for? Chest pain, or angina, is a common reason. It can be caused by a blockage, which narrows the arteries so much that blood and oxygen can’t get through, especially during physical activity. The doctor may order an EKG, stress test, ultrasound or cardiac catheterization. Other symptoms: pressure, squeezing, heaviness in the chest; pain or pressure in your neck, jaw, back or arm; paleness, cold sweat, or rapid and uneven heartbeats; difficulty catching your breath.

DECEMBER:  What do we need to know about the vaccines? So far, the vaccines require two doses, 3-4 weeks apart.  We don’t know if the vaccines reduce the risk of getting the virus, or they keep us from getting sick and we can still be carriers. We also don’t know how long protection lasts. There is no evidence the vaccines are unsafe. Health care workers will be offered the vaccine first. If you have had the virus, still get the vaccine. Keep wearing masks, distancing and washing hands.

NOVEMBER:  I am tired when I go to bed but then I cannot sleep. As the sun rises, I fall asleep and cannot get up until noon. Do you have suggestions?  As we get older, our sleep may change.  Insomnia may result from stress, depression, anxiety, medications or health problems. Alcohol, the computer, pain, lack of exercise, snoring, and sleep apnea may cause sleep problems. 

Turn off the TV and computer an hour before. Read a book or an electronic device that doesn’t have a light source. Wear ear plugs to block snoring. Get aerobic exercise like walking, dance and golf during the day. Talk to your doctor about melatonin. Short day naps are okay. Avoid alcohol and caffeine late in the day. It is common to have short periods when we have trouble sleeping but it usually passes.

OCTOBER: Asked and answered by Suzanne Salamon – What is it like to have my 98 year-old mother move in with us?

My mom, Lilly, is as tough as they come. Two months ago, she fell. Incredibly, she is pretty much back to herself. We rented an apartment for her, four minutes from our home. She spends hours online; Google is her best friend. When I ask her how she feels about her new stage of life, she said: “I am the luckiest person alive.”  (Read the whole story here in the November 2020 issue: https://www.brooklinema.gov/Archive.aspx?AMID=37   Page 4)

SEPTEMBER: What is Telehealth? Meetings between patients and doctors by phone, computer or smartphone. Have your questions ready along with a list of medications and be ready to write instructions and suggestions. A blood pressure machine at home is handy particularly if your medications are being adjusted.

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 New York Times, Huffington Post, New Yorker

  • 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
  • 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
  • Eat Your Heart Out, by Gretchen Reynolds, Times, March 7
    Your Heart
  • 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
  • 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
  • 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