Senior Care it’s never too late By Karl Karch
National Nutrition Month was created by the Academy of Nutrition and Dietetics (AND) and observed in March beginning in 1980 to promote public awareness of the importance of good nutrition. This year’s theme is “Savor the Flavor of Eating Right”, a campaign designed to encourage everyone to “take time to enjoy food traditions and appreciate the pleasures, great flavors and social experiences food can bring to our lives.” I was particularly attracted to the “social experience” part of the campaign, because as the AD said: “how, when, why, and where we eat are just as important as what we eat.” Everyone knows the importance of healthy eating. But, we often overlook the power of the social experience associated with eating. When alone at mealtime, I lack the desire and initiative to prepare healthy meals. And, when I’m alone for a couple of days or more, I must admit I get tired of peanut butter or cheese and crackers every evening. As an older adult, if I were single and eating alone most or all of the time, I’m certain my eating habits would be detrimental to my health. This is a reminder for those who have single elder loved ones to share a healthy meal with them as your and their health depends on nutritious meals and socialization. Studies show that a good diet in your later years reduces your risk of osteoporosis, high blood pressure, heart diseases and certain cancers. As we age and become less physically active, fewer calories are needed to stay at the same weight. But we still need as many nutrients. Eating well isn’t just a shortterm diet, but an important part of a longterm healthy lifestyle that can begin at any age by taking small steps. Make one
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March 2016
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change at a time such as decreasing salt intake, switching to whole grain breads, seafood, or more vegetables and fruits. Studies are also finding that eating a small amount of dark chocolate daily can increase blood flow to the heart and brain. Dark chocolate is loaded with antioxidants that can also help rid the body of free radicals that cause cell damage as we age. Speaking of taking small steps, exercise is also an important part of a healthy lifestyle. My wife gave me an anniversary gift of a “Fitbit”, an exercise tracker that I wear on my wrist. I refer to it as the gift that keeps giving, albeit grudgingly as I wake each morning to walk. Being goal minded, I find this tracker gives me that extra incentive to get up and walk to reach my daily step goal. One thing I discovered is that the Fitbit registers steps by arm movement. So, when I need a few extra steps to reach my goal but don’t want to go outside in the freezing weather, I go to the cabinet, take out my single malt scotch, and let my arm do the walking as I sip away the steps. It’s never too late to improve your health. Being proactive can go a long way toward achieving better health. Make a positive lifestyle change by taking steps to improve your nutrition and physical exercise. In fact, now that I finished this article, I’m going to grab a Dove dark chocolate square (or two) and take my morning mile walk.
Karl Karch is a local franchise owner of Home Instead Senior Care, a licensed home care organization providing personal care, companionship and home helper services in the Fredericksburg and Culpeper region.
Front porch fredericksburg
Emancipated Patients Doctor Quirks
Hard to resist
by patrick neustatter, MD Better value, more love for your pet than if you kennel board him!
When I was a member of the Pratt Medical Center I was often amazed at what doozies the new doctors were. This may sound unkind – and unlikely. You’ve got to be pretty good to make it all the way through school, medical school and residency. You would think anyone having achieved all that would be a real ace. But don’t be fooled. The brilliant mind of a doctor can be sadly lacking in common sense and subject to some strange quirks – and this is a particular problem when it comes to diagnosing what’s wrong with you. And the claim is up to 40% of patients are wrongly diagnosed – which is not good as diagnosis is the very foundation. Maybe you’ve never stopped to think about what the inside of your doctor’s mind is like? Or maybe you have fantastic visions of cobwebs, cogwheels, light bulbs and dusty recesses? Something Roald Dahl might envisage. It’s more the way it works that is the problem. Making a diagnosis requires objective, computer like properties of your doctor. Computers themselves show promise – and maybe one day your doctor will not just be using a computer, but will be one. But for now, the emancipated patient needs to know about things like “anchoring,” blind spots – even how the doctor is paid. Needs to know their doctor is prone to: Anchoring - which is a form of confirmation bias, where you take note of the factors that confirms a preconceived notion and ignore the symptoms and signs that don’t. Blind spots – which are diagnoses that doctors never think about. Pulmonary embolus (blood clot in the lungs) and abdominal aortic aneurism as a
Wellness
cause of abdominal pain (a “blow-out” of the aorta that can tear or burst) are two examples of two notorious blind spots. Prejudice from past disasters. – like I must have ordered a whole lot of unnecessary stress tests and cardiac work ups after an incident where I was on call one night and the nurse called about a pre-op’ patient that was having “dyspepsia” and I told her, rather irritably, to “just give him some Mylanta.” But of course he was having a heart attack. Saving Face – where your doctor will “behave with poise and an aura of competence, with denial of uncertainty” even if he hasn’t a clue what’s wrong with you, notes author/doctor Jerome Groopman in his great book . How Doctors Think. Blind acceptance – not reconsidering the diagnosis made by another doctor. Even the way your doctor gets paid can make a difference. The first person to be diagnosed with Lyme Disease (Polly Murray) was only figured out when she went to a doctor who was on a salary rather than being paid fee-for-service. He was the only doctor who would take the time. So it’s good to be aware of these foibles, and not be scared to question your doctor – as well as do everything you can to help. In particular, make sure he or she has all your records, bring all your medicines in their original containers and make a list of issues to discuss before your appointment. Then go visit your quirky doctor. Patrick Neustatter is the Medical Director of the Moss Free Clinic. He is interested in stories of emancipated patients/people and would like to hear any stories of this kind from any readers. Contact him at pneustatter@aol.com
The early 1900's marked the advent of the "Antimicrobial Era" in developed nations, leading to the production and prescription of antimicrobial medications on a scale previously thought impossible. These medications enabled the medical community to effectively treat a broad spectrum of infectious diseases stemming from bacteria, parasites, and viruses. As a result, life-expectancy and quality of life measures increased dramatically in the following decades, paralleling the creation of new antimicrobials and their expanded application. Unfortunately, the era of antimicrobials as we know it may be coming to a close. While antimicrobials have served as a catalyst for increasing health and ameliorating infection, their use has also provided selective pressures for antimicrobial resistance (AMR). Medical researcher A.M. Aziz states the extensive use, misuse, and improper prescription of these medications have created the perfect storm to select for drug resistant microbes. Unsurprisingly, AMR has been on the rise in many nations, including the United States. Resistance to antimicrobials diminishes their effectiveness at treating infection and can lead to the proliferation of untreatable microbes. A 2013 study by the Centers for Disease Control and Prevention (CDC) estimates that more than two million cases and over twenty thousand deaths result from antibiotic resistant infections annually in the U.S. Resistant microbes can be transmitted in a number of ways, including consumption of antibiotic laden food animals, poor adherence or overuse of antibiotics, antibiotic treated crops, or poor hygiene practices. Although the selective pressures that are induced by antimicrobial applications cannot be eliminated, the development of AMR can be curbed. According to the National
By Dan Czajka
Institutes of Health, proper use of antimicrobials helps to slow drug resistance. Prescribed antimicrobials should be taken as instructed, with the frequency and duration noted on the bottle, unless negative side effects are experienced. Adherence refers to the degree to which a patient follows drug prescription instructions, including the frequency and duration of administration. A research article by Jessica Rinsky and colleagues found that poor adherence led to low therapeutic doses of antimicrobials, killing the weakest microbes and allowing for the proliferation of resistant strains. Limiting the use of antibiotics is another step to reduce AMR. The CDC recommends the use of antimicrobials for persistent infections which the body cannot manage without assistance. The responsibility to restrict this use is shared by the patient and clinician. Patients should refrain from requesting antimicrobial treatments before their bodies have had time to expel an infection. Similarly, clinicians should prescribe antimicrobials as needed, rather than as a first line of defense. Overuse of antimicrobials extends beyond the treatment human illness. Livestock frequently receive antimicrobials, providing a constant selective pressure for AMR. These microbes can remain in the meat consumed by humans, as well as in the feces excreted by livestock, which may be used as manure and passed on to crops. The expanded use of antimicrobials has increased the risks and exposures associated with AMR. As effective treatment options dwindle, it is imperative to curtail AMR through the proper management of antimicrobials in all applications. Dan Czajka is the Community Development Manager for the Fredericksburg Area HIV & AIDS Support Services (540) 371-7532 or www.fahass.org.
The Natural Path Holistic Health Center
~Nature’s Sunshine Products ~Quantitative Fluid Analysis ~VoiceBio Analysis ~ionSpa Foot Detox ~Zyto Bioscan Compass Natural Products for Health & Wellness
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Barbara Bergquist, CTN Board Certified Traditional Naturopath
891-6200
www.thenaturalpath.us
4413 Lafayette Blvd. Fredericksburg
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March 2016
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