ELDR blogs

The Overmedicating of America

Sun, 05 Oct 2008 18:46:40 -0400

Americans take so many drugs that 100,000 of us die every year because of those drugs. It is not illness that causes those 100,000 deaths, but the damaging effects of drugs taken for illness. Beyond these deaths there are millions of adverse drug reactions every year, resulting in hospitalizations, lost days from work, lost income, and sometimes chronic disability. What kinds of drugs are these? What kinds of illness? Why does this happen?

It is important to remember that any drug can cause side effects, or an allergic reaction, and that the reaction may be severe. Higher doses of drugs and combinations of drugs increase the risks. People who are sicker are more often prescribed multiple medications, yet these are the people most likely to be more sensitive to adverse effects. It is common for patients who enter my office to be taking 5 or 6 medications at once. I have seen patients taking 15 medications at the same time! It is virtually certain that their complaints will be related to these drugs.

These are the most commonly over-prescribed classes of drugs: antidepressants, antipsychotics, sedatives, stimulants. These are the pills that affect the brain. They often cause oversedation, memory loss, loss of concentration, and confusion.

Antidepressants and antipsychotics. These may worsen depression and raise the risk of suicide or even homicide. Children only ten years old have committed suicide after taking antidepressants prescribed for them by family physicians or psychiatrists. Parents have asserted they were never informed of an increased risk of suicidal thinking. Now there is a black box warning accompanying these drugs, warning of an increased suicide risk in children and adolescents.

Antidepressants and sedatives increase the risk of auto accidents, of accidental falls and hip fractures. Physicians are advised not to prescribe antipsychotic medications to older people with dementia, because of more frequent cardiac events including sudden death. These drugs continue to be heavily prescribed.

Sedatives and stimulants. These are addicting and will lead to withdrawal symptoms when stopped. They also lead to a desire for more drugs and the high risk of long-term dependency.

Some of the main adverse effects of these drugs are that they cause mental dullness, reduce emotions, and prevent the confrontation of problems in life that need to be handled.

Pain and anti-inflammatory medications include narcotics, muscle relaxants, non-steroidal anti-inflammatory drugs, and over-the-counter drugs like aspirin and acetaminophen.

Narcotics. These are highly addicting and lead to a vicious cycle of drug dependency even after the medical reason for their prescription has resolved. Other methods of managing pain should be employed whenever possible before narcotics are prescribed, such as physical therapy, laser therapy, acupuncture, prolotherapy, nutrients for pain both oral and injected. Narcotics should be used in the lowest dosage and for the shortest required duration.

Non-steroidal drugs, such as ibuprofen. These agents cause high blood pressure, gastrointestinal bleeding, kidney and liver damage, fluid retention and edema, and congestive heart failure. It has been estimated they cause 15,000 deaths per year. Patients should be informed of these complications, and be told to use them, again, in the lowest dose and for the shortest duration necessary.

Antibiotics. Many infections are mild and do not require antibiotics. Many infections are viral in origin and will not respond to antibiotics. These include most upper respiratory infections, including sinusitis, and most cases of bronchitis. Antibiotics may cause serious adverse reactions, including rashes, kidney or liver damage, and emergence of resistant bacteria such as MRSA, the current scourge of hospital-acquired infections.

The fluoroquinolones, a class of potent antibiotics, may cause confusion, agitation, disorientation, neuropathy, and inflammation of tendons leading to rupture. I have seen several patients who experienced rupture of the Achilles tendon after taking these antibiotics, requiring surgery or use of a cast and crutches for months. Antibiotics also lead to yeast infections and imbalance of bacteria in the large intestine. Diarrhea, abdominal pain and nausea may result, and may not resolve until probiotics, or good bacteria, are taken as supplements.

Patients should request—and doctors should prescribe—antibiotics only when indicated, and probiotics should be taken at the same time to reduce side effects.

Blood pressure medications. One fourth of the adult population of the United States has high blood pressure, and in only one third of them is it controlled. Many patients are taking three or four medications at the same time because one is not sufficient. The best way to control blood pressure, however, is through weight reduction and the avoidance of salt. Potassium and magnesium are minerals that effectively reduce blood pressure. Fruits and vegetables are uniformly low in salt and high in potassium and magnesium. These are the foods people should try to eat as much as possible.

There is a mind-set in the United States that favors the use of drugs to the exclusion of safer and more effective measures of disease prevention and treatment. Physicians, partly through their training and partly through the powerful influence of pharmaceutical companies, routinely pursue a drug approach to medical problems. There is a lack of education and understanding, and an undue assertion of vested interests, leading to an unwarranted and dangerous dependency on medications. Reversing this trend will improve our health, save us money, and extend our useful lives.

- Dr. Sosin is the Founder and Medical Director of the Institute for Progressive Medicine in Irvine, California. He has authored two books, Alpha Lipoic Acid: Nature's Ultimate Antioxidant, and The Doctor's Guide to Diabetes and Your Child.

^{The information contained on this blog is provided for educational purposes only and is not intended to diagnose, treat or cure any illness or condition. The recommendations contained on this site have not been reviewed by the U.S. Food and Drug Administration (FDA). No content contained on this site is a substitute for professional medical advice, diagnosis or treatment. Never increase, reduce or discontinue any medication or treatment without first consulting your doctor.}

The Financial Hurricane

Sun, 05 Oct 2008 18:36:39 -0400

Knocked down by the financial hurricane? Get up and reboot!

The financial crisis that toppled major Wall Street banks and snarled credit markets around the world has also taken a toll on nest eggs, forcing people to rethink when and if their savings will allow them to retire.

More than half of people surveyed in an Associated Press-GfK poll released Wednesday said they worry that they will have to work longer because the value of their retirement savings has declined (Associated Press, Oct. 1, 2008).

Talk about an inconvenient truth. I know the feeling. I watched the monster eat a giant hole in my IRA in September.

There is unanimous agreement that we have a crisis on our hands. And even though linguists and scholars have debunked the popular notion that the Chinese word for crisis (weiji) incorporates the words for both "danger" and "opportunity," thinking Americans have to be hoping they can find the opportunity in this danger.

So where's the opportunity in our current crisis? I believe it is in rethinking the old notion of "retirement" as a period of rest and relaxation, and instead deciding that this is the time to reboot oneself into a period of extended productive contribution.

It might be continuing in the same line of work, starting a new business, consulting, or taking up an "encore career" in a socially meaningful (and paid) role in such fields as education, health care or community work.

RebootYou.com has been promoting the idea of working beyond the so-called "normal retirement years" for reasons other than financial emergency. But a financial emergency definitely gets your attention. To paraphrase Samuel Johnson, "Nothing focuses the mind like losing your life savings."

Fifty-five percent of people surveyed for the AP-GfK poll said they were worried that the financial crisis would reduce their savings and force them to postpone retirement. The poll, conducted Sept. 27-30, 2008, was based on phone interviews with a nationally representative sample of 1,160 adults. It had a margin of error of 2.9 percent.

In a previous blog, I wrote about the new book, Working Longer: The Solution to the Retirement Income Challenge. The premise of that book is that even without a financial crisis, many people will have to work longer than they thought they would just to maintain their standard of living. With a crisis, the number is undoubtedly larger.

RebootYou.com can help. I invite you to click over to the site and check out the possibilities. There are dozens and dozens of ways to reinvent yourself. And if you've already done it, tell us your story so we can share it with others. Look for the heading, "Submit your story" for the easy steps to follow.

At Last, A Victory for Decency

Sun, 05 Oct 2008 18:30:23 -0400

Heralding a rare and glorious victory of decency over dogma, Governor Schwarzenegger signed the California Right to Know End-of-Life Options Act (R2K) into law recently. When the law goes into effect in California January 2009, the impact will reverberate across the nation.

For all the fuss among right-to-lifers, you'd think R2K opens some radical new practice, or forces doctors to violate their patients' interests. Here's what it does:

When a dying patient asks, "What are my options?" the Act instructs the doctor to answer the question. Period.

Answering the question completely and honestly, the doctor must disclose all legal and feasible options, or refer the patient to someone who will.

Is an honest answer too much to expect from your doctor?

Apparently, for some, it is.

Outraged activists entreated the governor not to sign. They included the Alliance of Catholic Health Care, Eagle Forum, the Christian Medical and Dental Association, California ProLife Council, Crusade for Life and (inexplicably) disability rights organizations like California Disability Alliance and the Foundation for Independent Living Centers.

The offending end-of-life option—the one these folks don't want patients to know about—is a merciful procedure called "palliative sedation." When pain, breathlessness, diarrhea or other torment becomes unbearable for dying patients, doctors can use powerful drugs to sedate the patient to unconsciousness until death comes.

Palliative sedation is a well-accepted practice in hospice and palliative care environments. Knowing about this option comforts many as they anticipate the last few months or weeks of life. If pain, suffocation or other agony gets too bad, escape into a coma-like state can ease their suffering and spare their family the torture of watching such suffering. People find courage and hope in this knowledge.

Why would a doctor want to withhold knowledge that may bring hope and courage to life's most difficult struggle? Is it because the Church orders Catholic institutions to strictly observe its "Ethical and Religious Directives for Catholic Health Care Services?" Is it because Directive #61 instructs that a person, "...should not be deprived of consciousness without a compelling reason" and "patients experiencing suffering that cannot be alleviated should be helped to appreciate the Christian understanding of redemptive suffering"?

Fair enough. Never would I intrude in another person's expression of religious faith and belief. Government should not interfere with those who choose to emulate the Passion of Christ on their death bed. But these activists want government to impose their choices on everyone.

The California Catholic Daily called palliative sedation "a morally questionable end-of-life option" as the excuse to keep it secret. There's no excuse for holding a patient hostage to your own religious and moral code.

One religion simply cannot be allowed to bind everyone in a state, or a nation. Would we tolerate such parochial protection of the moral precepts of other religions?

Would we guard the right of a Christian Scientist to withhold information on antibiotics from a patient asking what can be done for her infection? Would we excuse a doctor who shares the Jehovah's Witness belief that blood products are immoral and withholds knowledge of transfusions from his patient with a bleeding disorder?

Of course not. We'd call that entrapment, and would not tolerate healthcare professionals who put vulnerable patients at risk of suffering and harm in service to the professional's own religious and moral beliefs.

But the R2K opponents feel outraged at losing a similar right: The right to entice patients into their healthcare systems with the promise of comprehensive care and then withhold treatment—even withhold information about treatment—that could relieve suffering but is deemed immoral by a religion the patient may not share.

Really, sirs, have you no decency?

Thank you, Governor, for signing a bill that promotes both good end-of-life care and religious freedom, all at once.

– Barbara Coombs Lee is President of Compassion & Choices (www.compassionandchoices.org), a nonprofit organization dedicated to improving care and expanding choice at the end of life.

Minding Your Mind

Sun, 05 Oct 2008 17:47:46 -0400

Have you ever noticed how easy it is for your mind to slip into negativity? I have. For example, I have been thinking of joining an online dating service. However, each time I scan the sites, my mind convinces me that it is a waste of time. I tell myself that I don't have the patience to engage in the same conversation repeatedly with strangers with whom I feel no chemistry. My mind cautions me that the ads may lie. People promote themselves as tall when they are short and post pictures of themselves taken fifteen years ago. "Statistics are not in my favor," I conclude. With that, negativity wins out and I spend most Saturday nights watching DVDs with my cat George.

Although I am generally a positive person, these moments of negativity often take hold without my awareness. Like a pre-programmed record, it is the nature of the mind to get stuck in a groove, repeating limiting thought patterns that seem so old and ancestral, they just might predate us. Because they are so familiar, we tend to believe such thoughts are the gospel truth.

Upon examination, some of my coaching clients have revealed that negativity serves to protect them. After all, they reason, if you don't expect much, you can't get hurt. Negativity keeps us from stretching to become the kind of person who attracts what we want. Having assumed our self-imposed boundaries, we then righteously cling to the comfort of our limited self-definitions and worldview. For many people, the tendency towards negativity increases as we age, thus shrinking our world exponentially.

Recently, I had the opportunity to experiment with changing my limited thinking when the Board of my Mother's homeowners' association met to discuss "the feral cat problem." Neighbors were concerned that the five feral cats my Mom feeds and has had spayed posed a threat to the community. One neighbor was convinced that a stray cat had ripped her screen while another complained that one had defecated on her lawn. The Board notified my Mother that she could state her case at the meeting. Being unable to attend, she sent me instead.

People told me that fighting a homeowners' board is as effective as spitting in the wind. Therefore, I chose not to fight. Instead, I collected information from Alley Cat Allies, a non-profit organization, brainstormed the board's objectives and identified my talking points. Most importantly, I reframed the situation. Instead of negatively assuming I would meet with resistance, I imagined on a sensory level that I was met with kindness and understanding. On a daily basis for weeks before the meeting, I sent good thoughts and love to board members. As these cats were very important to my Mom, I envisioned victory. Failure was not an option I wanted to consider.

You could have knocked me over when the board gracefully and gratefully accepted my information and suggestions. They allowed my Mom to keep her cats and I received a valuable lesson in minding my mind.

Since then, I have become more aware of the way my mind cons me. To better mind my mind I have come up with three fast ways to eliminate negativity.

1. I say, "Cancel" every time a negative thought or image appears in my mind. This practice is like pressing the delete key on my computer.

2. Instead of saying "I have to" do something (like wash my floor or write a report) I now say, "I get to do" these things. As soon as "I get to," I start noticing the positive opportunities in the tasks that lie ahead.

3. I've noticed that negative thoughts constrict and rob me of my vitality. Thus, after I say ‘Cancel' I kinesthetically take space. I do this by taking a couple of deep breaths to release my tensions. I then imagine that like the sun, I am radiating 360 degrees around me. In so doing, I shine my way through the darkness.

How do you shift away from negative thought patterns? Please take a moment and write a comment. Thanks.

- Aimee Bernstein is a writer and the President of Open Mind Adventures, a company that provides consulting, coaching and training in the areas of leadership, organization and personal development.

Inspired to Dance

Tue, 23 Sep 2008 13:41:27 -0400

Just because she's pushing 82, doesn't mean that Pearl has to give up dancing. On the contrary, learning Salsa has been a plenty of fun. So every Thursday evening, Pearl struts over to the dance studio to listen to the music and move to the groove. The group starts with practice steps and then learns to build them like puzzle pieces set to music. Body movement and partner interaction is part of the creative process that distinguishes individual style. A wink, a swing, a twist. Dance is the imaginative work of the mind and body in unison; a purposeful interpretation to music.

What happens when dancers meet life hurdles? How do they find creative solutions to continue their life passion?

Jodi Stolove was a dancer and teacher who had broken her ankle. Not willing to be immobile and abandon her students, she taught classes from her chair. And that became a successful business called Chair Dancing ® which is non impact aerobics from a seated position. Jodi says, "These medically sound programs are a new fitness option for active people or those whose physical condition, restricted mobility or age limit their participation in conventional forms of exercise." She sells home videos for instruction, and you can always improvise.

Dancer Kitty Lunn had a very big hurdle to overcome. Her love of dance started at the age of eight. But while preparing for her first Broadway show in 1987, Kitty Lunn slipped on ice, fell down a flight of stairs and broke her back. Paraplegic and depressed, she could not imagine dancing again when she could not even walk. But she also could not give up her love of dancing because "the dancer inside me didn't know or care that I was using a wheelchair; she just wanted to keep dancing." In the fall of 1995, Kitty founded Infinity Dance Theater, a non-traditional dance company featuring dancers with and without disabilities and performs all over the world.

In addition to dance concerts, the Company is dedicated to educational programs by "teaching other dance educators to bring the joy and drama of motion and movement to a new level of inclusion by expanding the boundaries of dance and changing the world's perception of what a dancer is." Kitty continues to take a "mainstream, professional ballet class every day and has developed wheelchair dance techniques strongly rooted in and growing out of classical ballet and modern dance."

There are many challenges in life but few as great as finding creative solutions to build our lives with passion and dignity.

- Judith Zausner is the Founder and President of Caring Crafts, Inc. which offers craft kits and supplies to adults with fine motor skill problems and/or attention difficulties. Awarded a grant from the Society for the Arts in Health Care, Judith is dedicated to empowering creativity to encourage independence and enhance wellbeing.

Peabody Hotels are Just Ducky

Tue, 23 Sep 2008 13:09:29 -0400

On a recent trip to Orlando with our five-year-old-grandson, Hunter, my husband and I chose to stay at the Peabody Hotel. It's all it's quacked up to be. That's because the grand, luxurious 891-room hotel, which is in the middle of a major expansion to include a 32-story Peabody Tower, is home to the famous Peabody Ducks.

There is also a Peabody in Memphis and in Little Rock. All three hotels feature a huge lobby fountain where the adorable ducks swim and enchant visitors who crowd the lobby at 11 a.m. and 5 p.m. daily to witness a ritual that's just ducky. The Legend of the Ducks explains it all.

In the 1930s, the Peabody Memphis' general manager and his friend—both of them avid hunters—prankishly placed three live duck decoys in the lobby fountain. Rather than thinking it a fowl deed, the hotel's guests loved watching the ducks swim in the fountain. A tradition evolved and it continues today—to the amusement and applause of onlookers.

At each Peabody, a uniformed Duckmaster (think Robert Preston in The Music Man) brandishing a baton, leads four female ducks and one male duck from their onsite deckside Duck Palace (it looks like a large glass-enclosed shower stall) down the elevator and into the lobby while a John Phillip Souza march plays. It gives "search the Web" new meaning. Just look for the webbed feet.

The ducks scurry (they look like little feathery Keystone Cops!) along a red carpet across the lobby, up a few removable steps and into the fountain. At 5 p.m. daily, the ritual reverses so the ducks can retire to their Duck Palace.

Photo by Martin Sandler

On Sunday morning, Hunter served as an Honorary Duckmaster; when we checked into the hotel, we had placed his name on a list to request that he be chosen as such. His simple job was to make sure the ducks didn't wander off. My husband and I quacked up as we watched it all.

Afterward, as the three of us sipped ice cream sodas in the Peabody Orlando's kitschy 50s-style B-Line Diner, Hunter was still excited about having been touched on each shoulder by the Duckmaster's baton and being knighted "Sir Hunter, Honorary Duckmaster." He has the frame-worthy certificate—and we have the photos—to prove it.

Photo by Martin Sandler

Peabody Orlando is five minutes from Universal Orlando Resort theme park, so we also have photos of happy Hunter posing with Shrek, the Simpsons, Spiderman and other icons. From Seuss Landing and Toon Lagoon to E. T. Adventure, Animal Actors on Location, and the Universal Horror Make-Up Show, Hunter was enthralled. So were we.

Too bad we couldn't send the bill to the Peabody Ducks!

- Roberta Sandler is an award-winning writer/author. Her newest book is A Brief Guide to Florida's Monuments and Memorials, published by University Press of Florida. She and her husband live in Wellington, FL.

Staying Healthy and Vigorous All Your Life

Tue, 23 Sep 2008 12:51:38 -0400

The headline on the story in the August 26 New York Times says it all: "Living Longer, in Good Health to the End."

Isn't that the way we all want it to be?

I think so. This article, by Jane E. Brody in the Times' Personal Health column, is one of many I've seen lately offering encouragement that the final years of life don't have to be a prolonged period of discomfort, distress and suffering.

"There is increasing evidence that the societal burden of increased longevity need not be so drastic," says the article. "Long-term studies have shown that how people live accounts for more than half the difference in how hale and hearty they will remain until very near the end."

Dr. James E. Fries of Stanford University in 1980 put forth the idea that good health and vigor can be extended well into a person's 80s, and illness and disability can be compressed into a short period at the end of life.

Many studies have come to a consensus that genetic factors—such as the amount and proportion of HDL and LDL cholesterol in the blood—account for only about 35 percent of the length of a person's life. The rest—roughly 65 percent—is determined by environmental factors.

It's never too late to adopt habits that predict a healthy old age, according to Dr. Richard S. Rivlin, an internist and director of the nutrition and cancer prevention career development program at Weill Cornell College.

"While measures started early in life are most likely to have the greatest health benefit, older people should never feel that turning over a new leaf at their age is anything but highly effective," he is quoted in Brody's article.

He said people in their 70s can do a number of things to help prevent hypertension, heart disease, osteoporosis and even cancer. These include restricting calorie intake, limiting saturated fats, replacing simple sugars with fiber-rich whole grains, and eating plenty of high quality protein.

Another very important measure that people in their 70s can take to stay healthy is to make exercise a regular part of their daily lifestyle, including aerobic activities that elevate the heart rate, weight-bearing activities that strengthen muscles and bones, and stretching exercises that reduce stiffness and improve flexibility and balance.

Many long-term studies have pinpointed exercise as the single most potent predictor of healthy longevity, in women as well as men, Brody wrote. She concluded: "It's not that very old people... can exercise because they are healthy, these findings indicate. Rather, they achieve a healthy old age because the exercise."

- Lee Callaway of Redwood City, CA, has reinvented himself several times, including a transition from corporate executive to consultant, two trips back to graduate school and, most recently, as the founder of RebootYou.com. His driving force is staying active, discovering and trying new things, and continually searching for new challenges.

Working Longer

Tue, 23 Sep 2008 12:29:27 -0400

A major premise of RebootYou.com is that it makes sense to stay active after "retirement." There are many reasons—physical and mental health, economics, and preventing the waste of experience and knowledge, among others.

In fact, we believe that "retirement" in the conventional sense—withdrawing to a passive, unengaged existence—is a bad thing.

One of the reasons for continuing to work described on www.rebootyou.com is the need or desire to continue to make money—other than Social Security or a pension.

Now along comes a book whose main message is that many people will have to work longer than they thought they would, just to maintain their standard of living.

The book is Working Longer: The Solution to the Retirement Income Challenge, by Alicia H. Munnell and Steven A Sass (Brookings Institution Press.)

Munnell and Sass "note that the nation's retirement system, as embodied by Social Security and Medicare in the public sector and I.R.A.'s and 401(k) plans in the private sector, is contracting in its ability to replace workers' lost income—even as life expectancy is increasing."

"About 19 percent of men and 33 percent of women who survive to age 65 will live to age 90 or older and have to support themselves for almost 30 years," Munnell and Sass write. "The arithmetic does not work."

The authors cite numerous studies that turn up these very inconvenient truths:

For people who retire at 65 today, it is estimated that Social Security will only provide the equivalent of 39 percent of their incomes after deductions for basic Medicare contributions.
Those who plan to retire in 2030 can expect net benefits of only 30 percent of their incomes.
In 1989, 66 percent of American employers provided post-retirement health care benefit programs. By 2006 that number had fallen to 35 percent.
Americans do not save enough. In a 2004 Federal Reserve study, the theoretically possible or simulated amount of money owned by people aged 55 to 64 was $314,000. However, the actual average savings was only $60,000.

Munnell and Sass recommend that people postpone their retirements from the current average age of 63 to age 66. Four more years of work changes the ratio of retirement to working years from 1 to 2, meaning 20 years of retirement and 40 years of work, to almost 1 to 3, or 16 years of retirement and 44 years of work.

Working longer, the authors say, would delay the need for people to tap into their I.R.A.'s and 401(k)'s, increasing their total assets and the future income they can produce. It would also maximize the benefits of Social Security, which are about one-third higher for recipients who are 66 than for those who are 62.

The authors raise other important issues, which we will discuss in subsequent blogs: whether older workers will be healthy enough to continue to work, whether they will want to, and whether employers will be willing to employ them.

If you're interested in ordering the book, please click here. The link will take you to the resources section of RebootYou.com, and Working Longer is the first book listed.

No More Antibiotics for Dental Procedures

Tue, 23 Sep 2008 12:14:09 -0400

Those of you who have been taking antibiotics for dental procedures may inform your dentists that antibiotics are now only rarely indicated to prevent heart infections. The American Heart Association has published new guidelines for the use of antibiotics for dental procedures. Patients with mitral valve prolapse and insufficiency, the largest group of patients previously targeted for antibiotic therapy before tooth cleaning or extraction, are now spared that therapy.

It appears that the risk of cardiac valve infection is much greater from brushing your teeth at home than from going to the dentist for professional cleaning. Three brushings at home release bacteria into the blood stream as frequently as one professional dental cleaning or tooth extraction. Since we brush our teeth every day, and only visit the dentist a couple times a year, the cumulative risk of brushing at home predominates.

Accordingly, it is recommended that only the following individuals receive antibiotics before dental procedures:

1. Those with a prior history of heart infection
2. Those with prosthetic cardiac valves
3. Those with congenital heart disease
4. Cardiac transplant recipients with valvular disease

Over the years I have written antibiotic prescriptions hundreds of times for patients going for dental procedures. Many of them developed diarrhea or yeast infections from those antibiotics.

It is likely that many dentists will not be aware of this new recommendation, and will continue to require patients with heart murmurs or mitral prolapse to take antibiotics.

If you have been subject to this requirement in the past, you may want to carry a copy of the article from Circulation, published online Apr 19, 2007: Prevention of Infective Endocarditis, Guidelines.

Cosmetics and Chemicals

Mon, 01 Sep 2008 11:37:39 -0400

We all want to look beautiful on the outside, but our actions may come with a significant cost to our well-being. There are many substances used in common cosmetic products that have been shown to be harmful to our health. Beauty products are absorbed through the skin into the bloodstream where they can reach various tissues. A recent study reported by the environmental working group found that the average adult used nine cosmetic products daily and more than 25% of women used 15 or more. This gives us ample opportunity for exposure to chemicals contained in these products. We will discuss two of the most troubling chemicals.

The first are parabens. Parabens are widely used as a preserving agent in cosmetic products as well as in some drugs and foods. They prevent the growth of bacteria and other organisms. A recent study conducted in Europe and reported by Harvey and Darbre found that 77% of beauty products tested contain parabens, so chances are you have them in your beauty products. Another study conducted in the United Kingdom by Darbre found parabens present in breast cancer tumors.

A proposed link between underarm products and these cancers may explain the fact that a disproportionate number of breast cancers are found in the upper outer quadrant of the left breast were these products would be applied more heavily by a primarily right-handed population. The study did not conclude that the cancer was a direct result of the parabens. Exactly how and why parabens were associated with these tumors has yet to be established. Parabens have been shown to be estrogenic in a number of studies performed on rats and mice. It has been well established that estrogenic substances negatively influence many breast cancers. Additional studies in this area are ongoing.

Another group of toxic substances are phthalates. Phthalates provide softness and flexibility to plastic products and carry other chemicals, making them "fragrant." Therefore, they are heavily used in colognes, perfumes, after shaves, lotions, hair products, lipsticks, blush, eyeliners and deodorants. They also are used commonly in nail polish. Phthalates are of particular concern in pregnancy in that they have been linked to birth defects in animals. They are being found at alarming levels in women of childbearing age.

Pthathlates also affect the fertility of men. A recent study at the Massachusetts General Hospital and Andrology laboratory followed 406 men, also being studied for semen quality, to determine if they use of personal-care products increased phthalate concentration in their bodies. Men who use cologne or aftershave within 48 hours before urine collection had 200% higher levels of phthalates than the nonusers. Each additional type of product use increased phthalates exposure and excretion by 33%. Toxicology studies have shown significant decreased sperm production and infertility in men associated with phthalate exposure.

While there are still questions regarding parabens and phthalates, it would be prudent to avoid exposure to these chemicals for the time being. It is possible to find natural skin care products that are made without parabens and phthalates—just read the labels. Our practice uses and recommends Hylunia Skin Care Products, as they do not contain harmful chemicals and additives. Please also visit www.ewg.org/reports/skindeep2 and www.thinkbeforeyoupink.org for more information.

_{The information contained on this blog is provided for educational purposes only and is not intended to diagnose, treat or cure any illness or condition. The recommendations contained on this site have not been reviewed by the U.S. Food and Drug Administration (FDA). No content contained on this site is a substitute for professional medical advice, diagnosis or treatment. Never increase, reduce or discontinue any medication or treatment without first consulting your doctor.}

Share Your Life Story

Thu, 21 Aug 2008 10:11:40 -0400

So many times I have been fascinated by other people's life stories. I'm totally engaged by the oral drama that makes that individual unique and can't refrain from asking questions before the rest of the story unfolds. Sure, I have an unusual personal history, too, that makes people marvel at my challenges and perseverance. But we are all walking chronicles of a colorful life legacy that is not like that of anyone else—totally different, totally driven by our experiences, decisions, reactions. And so the telling of our stories is filled with a poignant string of memories and reflections that are inherently inspirational and creative.

The inspirational part is a result of the hurdles we have mounted and the courageous road taken to respond with solutions.

So what makes your story telling creative? Talking about what we know—and no one knows more about our life story than ourselves—is actually a complex process. We reach for those mental pictures of our past, decide on what we are going to share and then package our thoughts into language that will convey information laced with imagery. Spontaneously we choose words that will convey the meaning of that experience(s)and this sharing of details and events becomes a verbal novel. We select adjectives to describe situations, our voice pitches to accent important parts and our body language adds an extra thrust to the story. We relay our autobiographies like actors playing ourselves. It is truly a creative process and can be made permanent in written form using journaling, novel/play/poetry writing or translated into an art form using a variety of materials such as paints, photography, textured surfaces for collage or in theatre, music and dance projects.

Elders Share the Arts (ESTA) was founded on the premise that we, as elders, benefit from expressing ourselves and because of today's fragmented society where families live far apart, communities can benefit from being guided to embrace these legacies.

To provide an outlet for self expression and enable the healthy aging process, ESTA, focused on New York City, established "Living History Arts, a synthesis of oral history and the creative arts that engage older adults in a process of drawing on their memories and re-creating them into literary, visual, or dramatic presentations." These may include live performances such as Pearls of Wisdom, a touring ensemble of storytellers and urban folk artists, traveling exhibitions and workshops to facilitate creative expression.

In addition to the creative juice that flows, there are many benefits for telling stories. It is a social vehicle and a learning tool. We use our thoughts to reminisce and reflect, expressively share, and also to connect. Sharing our life journey gives us the opportunity to remember and nostalgically look at our past. It also provides a passage of intimacy between you and the listener because you are sharing a personal experience, and that can provide a positive link, a connection. The power of connection is integral to our well-being and happens naturally by communicating in a personal way. Oftentimes it can create change in attitude from both the story teller and the listener.

Director Steven Spielberg said, "People have forgotten how to tell a story. Stories don't have a middle or an end any more. They usually have a beginning that never stops beginning."

Poet Maya Angelou said, "There is no greater agony than bearing an untold story inside you."

So go ahead; share, connect and get creative with telling your life story!

Say Goodbye to the Ocean

Tue, 12 Aug 2008 09:59:30 -0400

Say goodbye to the ocean. Sorry to break the news, but the global ocean covering 70 percent of the earth's surface is rapidly reverting to its gooey-gray primeval state. Deprived of oxygen, by the end of this century, the ocean will be unable to support the vast diversity of life we have come to associate with it. Instead of shellfish, whales, and tuna, it will be teeming with algae and jellyfish.

Humankind's gluttonous appetite for plastic, fertilizers, and carbon fuels is the cause.

Plastic? You might wonder what planet I'm writing this from, but the average consumer in an industrialized country uses 250 pounds of this foul stuff every year. Plastic from around the world, including billions of plastic pellets representing its initial form, gets into the ocean from multiple entry points—rivers, sewage, ship spills, litter, runoff, etc.

Virtually nonbiodegradable, plastic absorbs concentrated amounts of toxic chemicals such as DDT and PCBs. Eating pellets or other pieces of plastic kills more than a million birds each year along with hundreds of thousands of other fish and wildlife.

The United Nations Environment Programme estimates that 46,000 pieces of plastic are floating on every square mile of the ocean. It has gotten so bad that a plastic garbage patch the size of Texas has formed in the Pacific in an area of slack wind and sluggish currents between California and Hawaii. And there is another such patch off the coast of Japan.

And now for fertilizer: You may think we are fertilizing lawns and crops, but ultimately we are fertilizing the ocean and feeding algae, jellyfish, and bacteria. As a result, huge dead zones of marine biotoxins are spreading from the mouths of the world's major rivers, and massive algae blooms are occurring off many coastlines.

Off the coast of Sweden, for example, gigantic blooms of cyanobacteria turn the Baltic Sea into a cesspool of stinking, yellow-brown slush each summer. Off Florida's gulf coast, toxins from red tides are killing thousands of sea mammals and causing respiratory illnesses among coastal residents. Jellyfish swarm so thick near the Spanish coast that nets have to be strung to protect swimmers, and white mucus blobs of congealed algae and bacteria, some bigger than a person, foul the beaches north of Venice, Italy. And there are many more examples—it's getting worse every year.

Last but not least is the burning of carbon fuels. Since the Industrial Revolution began, the ocean has absorbed 500 billion tons of carbon dioxide, steadily increasing to today's rate of 100 million tons per hour. Normally the ocean acts as a passive sponge for CO2, but we've long since passed the tipping point where acidification kicks in.

As the acidity of the ocean rises, it produces less of the calcium carbonate that coral and other sea animals need to build shells and skeletons. Since 1980, the world's coral has been reduced by 20 percent, even though 25 percent of all species of ocean life live at least part of their life cycles on coral reefs. By the end of the century, the acidity of the ocean will have increased by 150 percent. There will be no more coral, no more shellfish, and no more of the plankton that most other fish depend upon.

The ocean, as we know it, will no longer exist.

This makes me mad as hell.

Floating Away on a Mini-Vacation

Mon, 11 Aug 2008 16:13:26 -0400

My husband Marty and I live in Florida, which gives us easy driving access to five major cruise ports. For the value, there is no vacation that beats a cruise. We've been pampered on about fifty cruises—to the Greek Islands, the Mediterranean, Alaska, Mexico, the Bahamas and the Caribbean—lasting from three to sixteen days.

Our favorite type of vacation is the mini-cruise, a 3-4 night getaway to the Bahamas aboard Royal Caribbean's Majesty of the Seas, a 1,200-room, almost-74,000-ton beauty that was elegantly refurbished last year. Its dedicated home port is Miami. Majesty sails from Friday to Monday morning and Monday afternoon to Friday morning. What happens during this time is bliss and relaxation. Escape? It's all about the cruise!

Majesty's refurbishment added the pool deck's Windjammer Marketplace, with an "island" buffet concept near the Johnny Rockets Diner, Compass Deli, and pizzeria. The promenade deck now boasts a Seattle's Best Coffee and an ice cream parlor. The spa has been expanded. For "working" vacationers, there is an onboard business center.

Aside from new carpeting and new décor ship-wide, guestroom bedding has been upgraded to lush. A new night club, Boleros, has a festive Latin flair. The fitness center is still there as is the top deck's signature Viking Crown Lounge. The food in the dining room and elsewhere remains top-notch. The service is still attentive, activity choices are wide, and the entertainment is smile-inducing. This is what a mini-vacation should be.

Cruise Line International Association reports that more than 12 million people cruised last year, and for many, it was a first experience, typically on a short cruise. Think of it as a getaway to a floating resort. Here is a sampling of such cruises:

Carnival Cruise Lines offers 2-5 day year round cruises to the Bahamas and Caribbean from four Florida ports plus Mobile, New Orleans and Galveston; and voyages to Mexico from San Diego. On October 15, Holland America's Eurodam offers a 3-day cruise round trip from Fort Lauderdale to the Bahamas.

Norwegian Cruise Line's Norwegian Sky has 3-4 day Bahamas cruises from Miami. Princess Cruises' series of West Coast Sampler cruises includes 3-night getaways between Los Angeles and Vancouver, and on May 5, 2009, a 4-day Alaskan Sampler cruise between Vancouver and Seattle aboard Golden Princess.

How about Royal Caribbean's 5-night Bermuda itinerary from Baltimore and Norfolk, or a 5-night sailing to Canada/New England from Boston? This fall, Celebrity Cruises' Celebrity Mercury sails 3-4 night Pacific Northwest itineraries round trip from Seattle. In 2009, Cunard's Queen Mary 2 does a 5-day "4th of July Getaway" to Halifax and Boston, round trip from New York. That's reason to celebrate. Have a bon voyage!

Our Last Kiss

Wed, 06 Aug 2008 23:55:23 -0400

On August 2, 2001, I kissed Robert for the first time in the moonlight after our line dance class.

On August 2, 2008, I kissed him for the last time.

***

Those of you who read Better Than I Ever Expected: Straight Talk about Sex after Sixty know our love story, and know that Robert was living with leukemia and lymphoma. After the book was published, Robert had six months of chemotherapy , leaving his cancer in remission. We had two glorious years of health, vigor, and intense, joyful love after that. We felt we were the happiest, luckiest couple in the world.

Last April, Robert was diagnosed with a new blood cancer: multiple myeloma. It's a debilitating, painful, and incurable cancer of the bone marrow, causing extreme bone pain and fragility. Within a month he was living with five spinal fractures and excruciating pain, despite the best efforts of his medical team and an array of powerful narcotics.

I didn't write anything about our life during this time because Robert asked for privacy. If you're a regular reader, surely you noticed that I became curiously silent for most of the past couple of months, and when I did post, it lacked the personal candor that you expect from me.

Ten days before his death, Robert entered into home hospice care, and the marvelous hospice team was able to bring him relief from the pain. He then wavered between sleeping and waking, sometimes marvelously lucid and rational, often only partially conscious, and occasionally uttering beautiful messages from the world he was visiting. Here are some of the things he told me as he floated in and out of lucidity, and I'll treasure them always:

* "Do you remember the time we laughed so hard that we shook the feathers off our caps?"

* "We did have fun together, didn't we? We did have fun."

* "Wasn't it wonderful when we walked in the water in every state, or almost every state?"

* "It was just yesterday that we walked and walked, and I knew the name of every flower."

* "I came by here hoping to see you."

Yes, I'm still committed to this work I do as an activist for elder sexuality, and don't worry, I'll have my voice back soon. My work was almost as important to Robert as it is to me, and he made me promise I'd keep my torch burning. He was a private person, and sometimes I embarrassed him with my candor, but he believed I was doing the right thing talking out loud about this hush-hush topic, and he supported me all the way.

I welcome your comments here and your private emails to me. I know I have many readers who have visited without commenting. If my work here has made a difference to you, if you learned something useful or were moved by my book, I hope you'll honor me with your words. I could use them now.

Warmly,

Joan

– Joan Price is the author of Better Than I Ever Expected: Straight Talk about Sex after Sixty. Visit her website at joanprice.com and her sex and aging blog at betterthanieverexpected.blogspot.com. You can email her at joan [at] joanprice [dot] com.

Driving the Dying to the Back Alley

Wed, 06 Aug 2008 23:38:30 -0400

Ask any woman. The back alley is an inherently unsafe and degrading place to go for medical treatment.

At one time the epicenter of the back alley for end-of-life choice was a Volkswagen bus in Michigan. Today's epicenter is a veterinary pharmacy in Tijuana, Mexico.

A recent New York Times article, ("In Tijuana, A Market for Death in a Bottle," July 21, 2008) explains it all and has quickly become one of the most visited and emailed pieces on the Times website. The zebra-striped burro featured in the accompanying photo gives the whole scene a surreal, Fellini-like tone.

Yet desperate, determined people from around the globe regularly visit this scene to obtain the short-acting barbiturates they know could deliver to them or their loved one the same rapid mercy they have seen delivered to their beloved pets. They come with no Spanish language skills. They carry pictures of the bottle they seek as they labor to decipher confusing instructions on dosage.

If it weren't so sad it would be comical, in addition to surreal, to watch the couple on a linked video lamely explain to a quizzical shopkeeper how the reason they need a really big dose is they have a "really big" dog (150 pounds). The shopkeeper doesn't seem to be buying that story.

Tragically, after bickering about which one of them is right on the dose, this couple returns to Australia empty-handed. The woman, with advancing Alzheimer's Disease, resigns herself to her fall-back plan, obtaining a pistol and shooting herself when she no longer recognizes her husband.

Now this is where I get angry. What kind of barbaric, merciless society would consign a loving, conscientious, thoughtful and considerate woman to such a cruel ending to her fruitful and meaningful life? Shame on this callous, cruel world.

Only a few places in the world have made it legal for dying patients to receive life-ending medication from their physician and self-administer it: Belgium, Luxembourg, Netherlands, Switzerland and Oregon.

In Oregon the practice has been closely watched and voluminously reported for 10 years. Most Oregonians are comforted to have a death with dignity option; few use it (about one in 1000 deaths) and hospice and pain care have grown and flourished with the law in place. Just last month an esteemed panel of pain care experts awarded Oregon an "A" grade for pain care, joining only four other states so honored.

Here's the irony. Solid medical research, over long periods of time and across many geographic regions, shows underground, back alley assistance happens FOUR TIMES as often (one in 250 deaths) as legal death with dignity in Oregon. Meticulous studies show the underground practice in Oregon has completely ceased, having been replaced with an open, transparent, regulated, safe medical practice one-fourth the size of covert, illegal assisted deaths in the other 49 states.

So you'd think, rationally, death with dignity opponents would promote legalization, to keep the incidence down at least. You'd be wrong! Apparently right-to-lifers prefer to drive the dying to a rampant, dangerous back alley of degradation than to a rare, safe medical practice of dignity. Go figure.

Yes, underground practice goes on unfettered in 49 states. But just because you're venturing in the underground, is no reason to stay in the dark.

Promise me this. If you or someone you love needs to talk with a non-judgmental, knowledgeable and compassionate expert in peaceful dying, please, please, call Compassion & Choices. Our consultation program applies over 20 years' experience walking people through the labyrinth of end-of-life choices. Our network of medical professionals and trained volunteers covers over the nation.

We understand each person, situation and family is different and regardless of the situation, we can always identify a peaceful, humane escape from unbearable suffering. Different situations call for different options. There's no need to break the law. Often the answer is right there, waiting to be discovered through a careful, frank conversation. Effective medication is almost always available without traveling to Mexico or any other country.

Compassion & Choices never abandons a client to their suffering and never charges a fee for consultation. Our counselors and volunteers will stay with you through the tough times— ongoing consultation lasts an average of five months until the time of death.

Assurance of a peaceful death brings great comfort to people facing terminal illness. We often say that assurance "enhances the celebration of life." It's just that the assurance and the celebration are usually available without the risks of foreign travel.

- Barbara Coombs Lee is President of Compassion & Choices, a nonprofit organization dedicated to improving care and expanding choice at the end of life.

When Wishes are Fishes

Wed, 06 Aug 2008 23:30:02 -0400

How do we get doctors to honor our wishes at the end of life? Everyone recommends preparing an Advance Directive, and I'm no exception. These documents are not infallible, but they are the best thing we've got going for us when we can't speak for ourselves.

But I must warn you about one popular Advance Directive form that purports to implement your wishes, but could actually subvert them with its stealth anti-choice language. It's called "Five Wishes."

There are two general kinds of Advance Directive. One is called a "health care proxy" or "power of attorney for health care" and it delegates a person to make decisions on your behalf. The other, the "living will" specifies your wishes. Because anti-choice activists keep tightening the rules of evidence that govern end-of-life decisions, you need both documents. One names the decision-maker. The other guides the decisions.

Most people use their state-approved Advance Directive form, and these are the most trouble-free and reliable. But the widespread form called "Five Wishes" should come with a warning label. Why? Because the religious dogma imbedded in it could actually subvert your wishes when the time comes.

In 1997 James Towey started a Florida organization called "Aging with Dignity" and wrote "Five Wishes." With the help of the Robert Wood Johnson Foundation and others, Five Wishes spread across the country. Aging with Dignity claims more than 15,000 organizations distribute Five Wishes, and most of them probably do not know about the religious slant. Many people now have these on file, instead of their own state forms. Five Wishes is a wonderful form in many ways, but fair warning is in order.

One good thing about Five Wishes is its simplicity. It really does avoid the legalese that makes forms written by legislatures so tedious and opaque. Five Wishes includes things you might never think to include in your "wishes," like the wish to be rubbed with warm oils as you die, or be soothed with a cool cloth. Also, Five Wishes wisely includes brain damage (that would include dementia) along with terminal illness and coma, as a condition that triggers your instructions about life-support treatment.

But Towey makes no secret of his desire to spread the tenets of his Catholic faith and encourage others to live by them. When he left Florida to lead faith-based initiatives at the White House he described his goal unabashedly as to "get into heaven."

Five Wishes incorporates the Catholic creed that while it is permissible to take action you know will cause death, it is never permissible to intend death. It's a subtle concept, but central to Catholic theology related to the end of life. It carries the name "doctrine of double effect."

Those of us trained in the law usually assume responsibility covers what we know will result from our action, in addition to what we intend. "I didn't intend to break the window" is no defense if I knew the window was closed and chose to throw a baseball to my friend outside anyway.

The double effect dogma can trip you up if you don't see it coming. Wish Number 2, "My Wish For the Kind of Medical Treatment I Want Or Don't Want," includes the general instruction "I do not want anything done or omitted by my doctors or nurses with the intention of taking my life."

Then the form goes on to list medical interventions that keep a person alive and allows you to check the box, "I do not want life-support treatment." Thus it creates internal conflict within the document.

Even if you check the "do not want life-support" box, a hospital or doctor could object that stopping life support would "intend" death and the form you signed expressly prohibits that. What a confusing mess that could create!

My advice—use your own state form. You can download them free, along with instructions and useful additions to the form, at the Compassion & Choices website.

If you have already filled out Five Wishes and want to keep it instead of changing to a state form, consider crossing out the part that does not allow an intention to end life. The Five Wishes form itself instructs you to cross out portions you don't agree with. (That instruction somehow went missing from the stealth anti-choice part.)

You can cross it out anyway. Initial and date the cross-out. Congratulations. You have just transformed a fish back into your own, personal end-of-life wish.

- Barbara Coombs Lee is President of Compassion & Choices, a nonprofit organization dedicated to improving care and expanding choice at the end of life.

The Joy of Dropping Dead While Running

Wed, 06 Aug 2008 23:22:07 -0400

I am well aware that this blog might make me sound pompous and self-aggrandizing, and I hope I'm neither. I am posting it anyway. It might help prove my contention that it's possible for old age to be fun, exciting and rewarding.

But there's a price you have to pay. Good health is an absolute essential and it takes lots of hard work, determination and self-discipline to stay healthy, strong and physically fit. Maintaining a positive, happy outlook on life is equally important. For me, all this involves eating sensibly, following a regular and rigorous, five-days-a-week year round running and full-body workout routine and staying very busy both mentally and physically. The rewards for me have been well beyond my wildest dreams.

Way back yonder when I had just turned 90, shortly before competing in a Senior Olympic track event, I asked my very special family physician, Dr. John Dryer, if he thought I should have a physical exam. His response was, "Why waste money on a physical? You've already had a good, long life and I can think of no better way to go than to drop dead running." I was a bit taken aback at first but soon saw both the humor and wisdom of his words. Since then, my goal has been to drop dead running but not before breaking a world record. I am now at the midpoint of my 95^th year on this planet and I've won 17 gold medals in state and national senior Olympic competitions and have broken four national NSGA records since Dr. Dryer's classic response back when I was 90, but that world record is still in my future.

You might say that to drop dead running is my long-term goal since I still have absolutely no health problems, feel great and expect to break that world record next year at the National Senior Olympics in San Francisco. If I do break it then, who's to say, if the good Lord doesn't, that I can't still victoriously cross several more finish lines before I cross that final one and drop dead?

– Jim Hammond

Get Ready for Olympic Mania

Sat, 02 Aug 2008 21:04:06 -0400

Dear Readers,

I'm ready for Olympia mania. Assuming the Chinese government doesn't flip out even more in their zeal to close websites, arrest reporters, crack down on Tibet or their own dissidents we'll be bombarded by images of amazingly gifted athletes competing in dozens of sports. I love it and can't wait.

Dave Bunnell

However, this is not to say I don't care about the politics swirling around the Beijing Olympics. I wish Chinese President Hu Jintao would meet with the Dalai Lama, withdraw his support of the genocidal generals in Khartoum and Burma, and nudge his buddy Kim Jong-il to get with the nuclear-disarmament program. And I wish they'd lighten up on the press--maybe the Chinese government needs a new PR firm. Whatever they've been doing seems to have badly backfired.

We all know China needs to end the censorship and open up its political system. And they need to seriously go after the real criminals, the ones who make fraudulent pharmaceuticals, mercury-laced makeup, carcinogenic children's candy, contaminated toothpaste, and all the rest.

But boycotting the Olympics would have accomplished none of this. I've been absolutely against this idea, and just in case any of you favored it, I'll try to explain why.

When President Jimmy Carter issued his famous ultimatum demanding that Soviet troops be withdrawn from Afghanistan by 12:01 a.m. EST on February 20, 1980 or we wouldn't go to the Moscow Olympics, I remember laughing out loud. No one believed the maniacs in the Kremlin would pay any attention to Jimmy's whimpering. And they didn't. The tanks kept rolling down the streets of Kabul. It was probably the most foolish moment of his presidency, worse than the sweater thing.

The Russians retaliated by boycotting the 1984 Los Angeles Olympics. Athletes on both sides of the Iron Curtain were shafted; they paid the price for this political tomfoolery.

People who say the Olympics are "just another sporting event" are naive or worse. Sure, the Olympics are all about sports, but at the same time they are all about politics. It is for this reason and my understanding of Olympic history that I believe the politically wise thing to do is to show up. If you want to have an impact, you need to be there.

Just imagine what we'd be missing if President Roosevelt had boycotted the 1936 Berlin Olympics. Jesse Owens would not be a symbol of the African-American struggle for equality. And on a lesser note, we might not have Leni Riefenstahl's great Olympia, a film that revolutionized modern editing techniques. The final gold medal tally of this Olympics, the one remembered by history: Jesse Owens 4, Hitler 0.

In 1964, the Mexican government massacred hundreds of students in the Plaza de las Tres Culturas just two weeks before the opening of the Mexico City Olympics. Yet the games went on. And in one dramatic moment, two American athletes shook the world and provided us with one of the most enduring photographs of all time, when they each lowered their heads and defiantly raised a black-gloved fist as "The Star-Spangled Banner" was played during the award ceremony.

Tommie Smith and John Carlos paid a heavy price for their theatrics; they were suspended from the U.S. team and banned from future Olympics. Back in America they and their families received death threats. But today, Smith, age 63, and Carlos, age 62, are revered across the world and considered heroes of the Civil Rights Movement. There is even a beautiful, imposing bronze statue of these two at San Jose State University, where they went to college.

Without question, the Munich Olympics were the most disastrous. Eleven brave Israeli athletes and one German police officer lost their lives at the hands of the Black September terrorists, and I suppose if this one Olympics could have been cancelled ahead of time I would have been all for it. However, there was no advance warning, no calls for a boycott. The world learned something about how horribly twisted terrorists can be, and if there was a silver lining it was the tremendous solidarity of the athletes who continued on with the games.

Certainly things aren't going as planned for the Chinese government. They are feeling the heat as millions around the globe denounce their bullying of smaller countries and their lack of regard for basic human rights. More importantly, freedom-loving native Chinese, Tibetans, Burmese, and the victims in Darfur are seeing they aren't alone. Will this translate into positive change? Perhaps not, but it's nice to see the Chinese master sweat.

I'm still mad as hell, but I say, let the games begin.

Can't Remember What I Forgot

Fri, 01 Aug 2008 17:34:58 -0400

Here's what top scientists are learning about memory.

For anyone worried about memory loss, here is a book with the greatest title ever: Can't Remember What I Forgot: The Good News from the Front Lines of Memory Research (Harmony Books, Crown Publishing Group, Random House, 2008) by Sue Halpern.

Halpern's book is a report on the current state of scientific and medical knowledge about possible preventatives or treatment for Alzheimer's and other forms of dementia.

Capturing the subtitle of her book, here is her summary of the state of good news (as of the time she wrote the book):

• The sorLA gene had been discovered, enabling scientists to use a whole new way to explain what was going on in the brains of people with Alzheimer's.
• Thanks to a new imaging technique, amyloid plaques could now be seen in a living brain.
• There was a growing open-source Alzheimer's gene bank.
• Preliminary data from a Mayo Clinic-University of Southern California study of the Posit Science program had shown that people who completed the training had significant improvements in auditory memory.
• Biomarkers in the blood and cerebral spinal fluid could show Alzheimer's nearly a decade before there are symptoms.
• Exercise had been shown to cause new brain cells to grow in old brains. That process, neurogenesis, had been shown to improve memory.
• A diagnosis of mild cognitive impairment (MCI) was not necessarily a "sentence to die from Alzheimer's."
• Memory loss in older people was normal.
• The first neural prosthesis, an artificial hippocampus, was close to being tested in living animals.
• The first round of immunizations for Alzheimer's disease had been completed, no one had gotten sick, and the method of delivery had worked.
• The majority of researchers were working from discoveries that the sticky plaques that had defined Alzheimer's for years were not the "bad guys," but that the bad guy was soluble beta-amyloid, which Alzheimer's patients had in toxic excess. "And while no one yet knew why that was," she wrote, "the retromer theory put forth by Scott Small and his associates offered a plausible explanation."

The not-so-good news, at least for me, is what Halpern was finally told after asking many scientists if working crossword puzzles helps stave off dementia or Alzheimer's.

"You know what crossword puzzles are really good for?" said Dr. Michael Merzenich, professor of integrative neuroscience at the University of California, San Francisco, and developer of a computer-based program for children with language-based learning disabilities. "Doing crosswords are really good for... doing crosswords. Do the puzzle every day and you'll get pretty good at it."

Unfortunately, Dr. Merzenich concluded, crossword puzzles don't do anything for memory.

What? You mean remembering that "adit" means "mine opening" doesn't mean I have a great memory? Rats!

Talking Openly About Rectal Cancer

Wed, 30 Jul 2008 15:44:39 -0400

Q. I've noticed that today people talk openly about rectal cancer. This isn't something you used to discuss in polite company. Why is this?

A. There is a new attitude that protecting your life is more important than protecting your sensibilities. I think the new openness is helping to reduce cancer deaths.

This reminds me of my friend, Pete, who has a "colonoscopy rule." He insists that, if a bunch of us geezers are talking about aches, maladies and visits to the doctors, everyone has to change the subject as soon as someone uses the word "colonoscopy." Usually we switch to grandchildren, which is a lot more fun.

Colorectal cancer—cancer of the colon or rectum—is the second leading cause of death from cancer in the United States. Early detection of colon cancer is especially important because, if it is found in its early stages, it can be cured nine out of ten times.

Who's at risk? The chances of getting it increase with age. But other risk factors include polyps, your history, diet and whether you've had ulcerative colitis.

Polyps are benign growths on the inner wall of the colon and rectum. Not all polyps become cancerous, but nearly all colon cancers start as polyps.

Colorectal cancer seems to run in families. And, someone who has already had colorectal cancer may develop this disease a second time. So greater vigilance is a good idea if you or your relatives have had it.

This form of cancer is more likely among people on a diet high in fat, protein, calories, alcohol, and both red and white meat. Low-fat, high-fiber diets seem better for the colon.

Ulcerative colitis is a condition in which there is a chronic break in the lining of the colon. Having this condition increases a person's chance of developing colorectal cancer.

The following are some symptoms of colorectal cancer: blood in the stool, diarrhea, constipation, stools that are narrower than usual, frequent gas pains or cramps, unexplained weight loss, unrelieved fatigue, vomiting.

Go to your doctor if you have symptoms. The medical profession has many detection tools. These include: a test to check for hidden blood in the stool; a sigmoidoscope, a lighted instrument for examining the rectum and lower colon; a colonoscope, a lighted instrument to examine the rectum and entire colon; a barium enema with a series of x-rays of the colon and rectum; a digital rectal exam to feel for abnormal areas.

Two recent studies showed that colonoscopy can find many pre-cancerous polyps that sigmoidoscopy misses. Another major advantage of the colonoscopy is that it enables the doctor to remove any polyps found during the procedure.

There is a "virtual colonoscopy," a minimally invasive procedure. Doctors are able to see the entire colon using 3-D computer graphics from a computerized tomography scan, or CT scan. Known as "CT colonography," this exam is an alternative for patients who are at risk of complications from colonoscopy such as patients who are frail. If a virtual colonoscopy finds significant polyps, they have to be removed by conventional colonoscopy.

About Fred Cicetti:

Healthcare writer Fred Cicetti has been a professional journalist for more than 40 years. Fred's sources are the National Institutes of Health, the academies for medical specialties and the leading medical institutions. His articles are not intended as a substitute for professional medical advice; please talk to your doctor about your specific health issues.

If you would like to ask a question, please write to fred [at] healthygeezer [dot] com. Learn more about Fred at healthygeezer.com.

Steps to Preventing Alzheimer's

Tue, 29 Jul 2008 22:39:40 -0400

Q. What can you do to prevent Alzheimer's disease?

A. "If you have a family history of Alzheimer's, or simply if you are older, you may want to make a few lifestyle changes.

Mental stimulation and creative activities, regular exercise, social interaction, a healthy diet that includes fruits and vegetables high in antioxidants (the darker the better), cold-water fish high in omega-3 fatty acids, and nuts (which contain vitamin E) all can play a protective role.

Also, take care to maintain a healthy weight. In a long-term study of 1,500 adults that was presented in 2004, researchers from the Karolinska Institute in Stockholm found that those who were obese in middle age were twice as likely to develop dementia in later life."

– Stephen Wong, Ph.D., is chief of medical physics and director of bioinformatics at The Methodist Hospital Research Institute in Houston, Texas.

Reverse Mortgages: Fact Versus Fiction

Tue, 29 Jul 2008 14:00:52 -0400

Fueled by an escalating number of Americans who are reaching their retirement years and finding that Social Security benefits are not enough, reverse mortgages are becoming more popular than ever. The loans, which allow seniors 62 and older to tap the equity in their home, do not have to be repaid until the owner dies or sells the home. For this reason, reverse mortgages are appealing, especially for people with small nest eggs.

The FHA's Home Equity Conversion Mortgage (HECM) is the most popular reverse mortgage program and is federally insured. All reverse mortgages are regulated by the Department of Housing and Urban Development (HUD), which requires recipients to obtain a certificate from a credit counseling agency before gaining approval from the lender.

Even with these safeguards, some eligible consumers are hesitant to take advantage of the reverse mortgage opportunities because of negative stories they have read or heard.

To explain what reverse mortgages are all about, here are clarifications:

Fiction: A reverse mortgage is no better than a traditional home loan.

Fact: Unlike a conventional home loan, a reverse mortgage requires no monthly payments. Instead, it is a loan against your home that you are not required to pay back as long as you live there. The loan is repaid from the borrower's estate or the eventual sale of the home when the last surviving borrower no longer lives in the home. You can receive the money through a lump sum, monthly payments or a line of credit. To qualify, consumers must own and live in the home, and be 62 or older.

Fiction: A person 62 or older might have a difficult time qualifying for a reverse mortgage.

Fact: There are no income or credit requirements for a reverse mortgage. There is also no risk of default, and borrowers can receive payments and remain in their homes until they die or are no longer physically or mentally able to reside there. The amount you can borrow in a reverse mortgage is determined by your age, your home's value and interest rates. The older you are, the more you can borrow.

Fiction: The lender will own your home.

Fact: The bank never takes over the deed unless there is a default. Defaults can occur if the taxes and insurance are not paid current.

Fiction: Only the poorest of homeowners can benefit from a reverse mortgage.

Fact: Today, many homeowners with more expensive homes are turning to reverse mortgages to eliminate larger payments and free up cash in order to invest, travel, pay for college educations among other expenses.

Fiction: If the homeowners outlive the equity in their house, then they have to pay the mortgage or leave their house.

Fact: Once a reverse mortgage is executed, the residents can never outlive their equity, and the home can not be taken from them. On each reverse mortgage there is an upfront mortgage insurance premium paid to ensure that that never happens and the bank doesn't lose their money either.

Fiction: If, through a reverse mortgage, I receive more than my home is worth, my heirs or the estate will be responsible for overages.

Fact: Reverse mortgages are non-recourse mortgages, meaning that the heirs or the estate will never be responsible for any over payouts to the residents.

Fiction: Reverse mortgages cost significantly more than other types of home loans.

Fact: Typically, a reverse mortgage costs approximately one percent more than normal forward mortgages. Compared to most conventional mortgages with monthly payments, reverse mortgages can cost much less in origination fees.

- Mike Scarantino is a mortgage industry veteran and a motivational speaker for real estate agents. He is co-founder and CEO of Florida Household Mortgage and Southern Tier Home Loans.

Aging is NOT a Medical Event

Tue, 29 Jul 2008 12:51:51 -0400

Let me say it out loud: "Aging is not a medical event!" Normal aging does not require hospitalization. It is a natural process, a part of life. In fact, most people live their entire life at home.

But what happens when an older adult gets sick? Usually, they continue to stay at home. And they recuperate with much less risk of infection and a higher level of satisfaction than is possible in a hospital.

The limits to aging in place have more to do with safety, nutrition and security than medical events. Is the house or apartment a safe place that is designed to minimize the possibility of falling? Is there proper provision for nutrition so that regular healthy shopping and eating are a part of the aging lifestyle? Is there a risk for fire or for crime to occur? And is the older adult still driving when it is past the time when they can accomplish it safely?

Then there is the question of social life. Is the older adult alone too much of the time? Is this leading to despair and possibly even depression and thoughts of death?

The answer to these questions or limits doesn't have to do with buildings or building material. It doesn't have to do with a physician or a nurse. Rather, it has to do with human care and kindness.

For years family members have helped their elders as they got older. In some cultures elders have even been given a special place of honor so they are included as important components of the society. But that is not how it is in contemporary America. It is important that we come to terms with the difference.

In America we rely on caregivers to provide support for aging adults. They are either family members or paid caregivers who provide the safety, security, nutrition, transportation and socialization that seniors need to live a normal live.

These caregivers offer kindness and companionship, help in preventing falls, do driving, cleaning and cooking—and generally make it possible for seniors to continue to live alone in their own homes despite factors of age and frailty. With all this, it is safe and sensible for seniors to continue to age in their own home without thought or need for institutionalized medical care.

- Kathy Johnson is the Ceo and co-founder of Palo Alto, CA, based Home Care Assistance, which specializes in 24/7 live-in care and customized programs for hourly, daily and weekly care in locations throughout the United States and Canada. You can read more about Kathy and her company at HomeCareAssistance.com.

Don’t Beware of Greeks Bearing Gifts

Mon, 28 Jul 2008 14:01:41 -0400

I have a passion for travel, whether it's solo, with my husband or with my grandchildren. This is how I nourish my mind and discover and embrace history, cultures, architecture and landscapes. Sometimes, a travel experience is absolutely indelible.

While on a Greek Islands cruise aboard the beautiful and very Italian ship, Costa Classica, I saw fertile, pine-clad valleys, sleepy olive groves and hilly, goat-trodden terrain. I explored the ruins of Doric temples and fragments of statuary fashioned from limestone and legend. For me, the most enchanting port was Kithera.

Mythology dictates that Aphrodite sprang from the waters of Kithera, an island of goat farmers, old churches and narrow, sand-and-rock beaches lying at the crossroads of the sea routes to the Ionian, Aegean and Cretan Seas.

Here, the smell of fresh-caught fish wafts from old wooden boats. At the tavernas, tourists eat al fresco beneath striped umbrellas. Royal blue shutters and red flowers in window boxes give a vibrant flush of color to the white stone houses along steep paved streets. I passed a narrow alleyway garden bordering a modest house.

Behind the garden gate, three middle-aged women dressed in black cotton dresses were gathered around a wooden table laden with bowls. The women were shelling nuts. One woman, a grandmotherly sort with an apron around her waist, noticed me standing by her gate. I held up my camera and pointed to it. She smiled, rose from her chair, scurried to the gate, and gently took hold of my wrist to draw me into her garden.

"Do you speak English?" I asked. She shrugged. She asked me a question in Greek. I shrugged. Ignoring the language barrier, the woman laughed and turned my hands palms upward. She dipped her hand into the bowl of almonds and scooped the nuts into my palms. The other two women laughingly dropped nuts into my skirt pockets. I kept saying, "Thank you." I snapped a picture of the women.

The woman wearing the apron patted my back as she accompanied me to the gate. Silently, we nodded, smiled and waved goodbye. With one generous gesture in a Greek garden, we had bridged opposing cultures to connect in a moment of friendship. Here's what I think: If grandmothers ruled the world, there would be peace.

Kithera is accessible via ferry from Athens. Tripadvisor.com gives a great review to a B&B in Kithera: Hotel Pelagia Aphrodite (Agia Pelagia, Kythira, Lakonian Islands; 00 30 27360 33926; kythira.com).

– Roberta Sandler is an award-winning writer/author. Her newest book is A Brief Guide to Florida's Monuments and Memorials, published by University Press of Florida. She and her husband live in Wellington, FL.

The Need to Be Right

Mon, 28 Jul 2008 13:42:36 -0400

Dr. Phil often asks, "Do you want to be right or happy?" Although I am not a big fan of either/or thinking, I understand what he means.

Lately, I am noticing people's need to be right everywhere I turn. For example, last week I helped throw a baby shower for my Goddaughter whom I dearly love. Although I wanted to take charge of the party so she could just show up and enjoy it, she was uncomfortable with this arrangement. Believing that no one could or would do it as well as her, she insisted on choosing the decorations, planning the menu, cooking some of the food, setting up the room and micromanaging every detail of the party. When a friend of hers commented on how lovely the decorations were she said, "If I hadn't gone to the store to buy them we wouldn't have had them." "That's true," I replied. But you would have had decorations which were equally as lovely."

A few days later, I received feedback from colleagues of a scientist I am beginning to coach. "She's too forceful in her opinions," they said. "When we try to show her another perspective, she gets loud and aggressive. She acts like she's the only competent one in the room."

Then last night at my Zen study group, a well-intentioned student told me that the energy work I learned through aikido and have practiced for thirty years was unimportant. Without knowing what the work consisted of, she likened it to seeing auras and advised me to forget everything I have studied and just meditate in silence.

In the past, I would have defended my years of energy awareness training and educated her about its benefits. Recently, however, I have noticed that my need to grapple for the top-dog position is beginning to dim. Truth is, I see the need to be right within myself and as Gandhi said, I know that the change I seek begins with me. Thus, I have been reflecting on this tendency. Here is what I have come up with so far...

Most of us believe that our way of seeing the world is objectively correct and that those who dare to see the world differently are in some way defective. They are not smart, experienced or wise enough we may conclude. Categorizing others allows us to dismiss them and in so doing, we get to hold on to our feelings of safety and superiority. This kind of thinking separates people into them and us and damages the very relationships we most cherish. On a global level, it is the root cause of wars, genocide and other horrific acts of humanity.

Although I realize my view of the world is only a slice of the pie called reality, I'm so used to it that I rarely question its veracity. However, instead of assuming that my view is the Absolute Truth, would owning it as a preference open my mind to new possibilities? Would it deepen my connection with others?

Furthermore, instead of assuming that I understand what the other person is saying and then rush off to show the limitations of that thinking or to provide advice, I take a pause to immerse myself in the other person's way of seeing the world. That may mean asking questions to elicit more information. Since my mind moves so quickly and is so results-oriented, slowing down the conversation may be challenging. Yet, isn't it in the slowness, the moment to moment living, that true connection occurs? Isn't this the birthplace of compassion?

A friend told me this story. A client goes to her psychotherapist office and doesn't say anything. The therapist sits in silence with her, finally telling her that if she wants to talk, he is there to listen. Still she says nothing. After a while, tears begin to stream down her cheek and she starts to sob. Still the therapist says and does nothing. After a while, he reminds her that if she wants to talk, he is there to listen. At the end of the session, the woman thanks him profusely for being there for her.

What do you make of all this?

– Aimee will be providing a tele-class in August on The Enneagram, a personality tool that describes nine ways of thinking, being and behaving in the world. For more information, contact her at aimee [at] openmindadventures [dot] com

Use of BNP to Diagnose Heart Disease

Sun, 27 Jul 2008 11:24:12 -0400

A CASE STUDY

A 60-year-old man came into the office complaining of abdominal bloating and gas. He also had intermittent shortness of breath and a vague shoulder discomfort. He said that Pepto-Bismol made him feel better. There was a prior history of heart attack several years before.

His blood pressure was normal and his pulse was not increased. His electrocardiogram (EKG) revealed evidence of old cardiac damage from the prior heart attack, but no new cardiac event.

Because of his history of heart problems I ordered an immediate BNP (B type natriuretic hormone) blood test, even though it seemed like his problem was intestinal. Our lab can run this test in 10 minutes. The BNP was elevated at 200 (normal less than 100). He went to the hospital, where other studies indicated a heart attack, and he was admitted.

Without the BNP test, this patient would certainly have gone home, since his symptoms did not suggest a heart problem. He was much safer in the hospital, where he could be treated, and monitored for complications.

BNP is a hormone produced by the heart muscle in increasing amounts when the heart is under stress, such as during a heart attack or heart failure. The test should be available in more private offices, as the machine to run it is relatively inexpensive and very easy to use. BNP can be followed as an indicator of cardiac muscle strength. If it is normal, it is likely that a patient with chest pain is not having a heart attack.

If you want to clarify your cardiac status, especially if you are having chest discomfort, request a stat (immediate) BNP. It could save your life.

Reaching for Creativity

Sat, 19 Jul 2008 11:24:12 -0400

Once upon a time, we were all children. We played, talked, painted with abandon. Those stick figures never seemed awkward when we drew them, we did not have the consciousness of exactitude or photographic imaging. We had pride in our work and went back again and again to draw more.

But as we matured, a different consciousness took hold. We had an awareness of the visual experience and our capability to replicate it. For some, this provided an exciting challenge to learn the nuances of representational art, yet for others, it encouraged avoidance behavior. But there is a big chasm here. There is an opportunity to release your inhibitions and creatively express yourself. Look at the differences in the work of Picasso, Jackson Pollack, Dali and others who defied classic portraiture and explored colors, shapes, and brush strokes to communicate their vision. Don't use rules—use your energy and find your passion. Sure, some of us are born with more intuitive visual talent or sharper music skills but all of us can benefit from taking the plunge to being creative and maintaining creativity in our lives.

The Linden Center for Creativity and Aging within the Gerontology Institute at Ithaca College is less than a year old and was established to understand the involvement between aging and creativity and ways that people, institutions and our society can benefit. "There is a growing recognition among those who study aging that involvement in creative activities such as the arts can contribute significantly to well-being across a person's life span," said John Krout, professor of Gerontology and director of the Gerontology Institute at Ithaca College. "The fact is, an older person doesn't have to be Picasso to embark on new creative pursuits or continue lifelong creative endeavors."

Can you learn to be creative? David Perkins, a Harvard scholar, has written The Eureka Effect, a book about "breakthrough thinking" which is thinking creatively and thinking outside-the-box. He confirms that for some of us it comes more easily than for others and says much is in attitude. "It's sort of like running:" Perkins says" anyone can do it, but you can learn to do it better."

It is always the right time to reevaluate, reinvent and renew ourselves. In the third stage of life, we should feel excited to fill our life journal with new experiences and challenges met. Think outside the box because it is the creative spirit that empowers us to be free of rigid constraints and engages us to invent and inspire positive experiences.

As George Burns said "You can't help getting older, but you don't have to get old."

Getting Back in the Dating Game

Tue, 08 Jul 2008 13:36:35 -0400

Many of us are wary about starting to date again after divorce or the death of a spouse. We may tread lightly, even fearfully, into this brave new world that barely resembles the world we grew up in. The rules have changed, the venues are unfamiliar (online dating? cybersex? speed dating?), and certainly we have changed.

Here are some tips for getting back in the dating game safely and successfully. Good luck—and please let me know your stories!

1. Don't date until you're really ready—before that, go out with friends, go dancing for the pleasures of physical touching, and have buddies of both genders whose company you enjoy and to whom you can talk honestly and deeply.

2. Engage in activities you really enjoy where you'll meet other people (friends or potential dates) who also like your favorite activities, like hiking, book discussion groups, and dancing.

3. Try online dating. Some people have great luck with it. Others don't. Keep in mind that people often describe themselves inaccurately and sometimes (often?) lie about their age, looks, marital status, finances, and their emotional stability. So have plenty of email talk and then phone conversations before you decide to meet, and then be sure to follow #4, 5, and 6 below.

4. Meet new people for coffee or a walk in a public place. Don't go on a "date" before getting to know him/her. Trust your gut if you feel uneasy, and end the meeting politely but firmly.

5. When you go out on a first date, be sure a friend knows where you're going and with whom, and when to expect a call from you. Call your buddy when you get home or, if you can do this discretely, from the date venue. If you decide to go somewhere else with your date, call your buddy about the change in plans.

6. When you're ready to have sex again, use condoms every time. Don't believe someone who tells you, "I'm safe, we don't need to use condoms." If she/he's willing to go to bed with you without protection, then how many other people has she/he done this with? It's a hassle, sure, but it's a myth that only young people are at risk for HIV or other STDs. (Please see my blog post, How Do You Handle Sex and Dating.)

– Joan Price is the author of Better Than I Ever Expected: Straight Talk about Sex after Sixty. Visit her website at joanprice.com and her sex and aging blog at betterthanieverexpected.blogspot.com.

Listen to Joan's Podcast

Tue, 08 Jul 2008 13:31:16 -0400

I was honored to be invited to be a part of the marvelous Seal Press "By Women For Women" podcasts, presenting interviews with Seal authors. Please click here to listen to the podcast, where I discuss some lively strategies for keeping sex spicy and satisfying.

After you listen, I hope you'll comment here and share what you think.

The podcast mentions a free download of a nicely formatted, print-worthy .PDF of my Tips for Hot Sex After Sixty. To receive the Tips, please email me at joan [at] joanprice [dot] com with your request and I'll send the tips to you as a .PDF attachment.