body, happiness, health, leisure, mind, retirement, security, soul

Age Well San Diego

Yesterday San Diego’s Health and Human Services Agency, in partnership with Sharp Healthcare, AARP California, The San Diego Foundation, ABC Channel 10, and Kaiser Permanente Senior Advantage, held its 11th Aging Summit. It’s the first I had heard of and the first I attended. The woman sitting next to me said she had attended the previous one, two years ago, where the audience was so small they could be seated around a few tables in front of the stage. This year more than 2,000 people registered to attend the event in San Diego with another 500 people connected via webcast in a North County location.

I attended for two reasons: my recent injuries result from reduced bone density, a consequence of aging; and my book club’s decision to discuss Atul Gawande’s book, Being Mortal, which deals with issues of aging and what constitutes living well at the end of life at our next meeting in a week.

I can’t think of a better way to describe my reaction to the event’s program and workshops than to fall back on a boomer phrase: it blew my mind.

I had no idea San Diego was so committed to dealing with the inevitable increase in the number of people over the age of 65 in the future. San Diego not only has one of the best climates for people of all ages, it is clearly one of the most progressive places for a retiring population to live out final years.

The speakers threw out a number of facts, including the following:

  • In 1900, the average life expectancy in the United States was 47. In 2000 it was 78. A recent cover of Time magazine showed the picture of an infant with the heading, “The first child to live to 142 years of age has already been born.”
  • One speaker mentioned experiencing a serious infection and blood poisoning when she was a child and the complicated birth of one of her children. She pointed out that had those things happened just ten years earlier than she experienced them, they may have led to death.
  • Today in San Diego 21,000 grandparents live with and provide substantial support for their grandchildren while the parents remain absent.
  • For every case of elder fraud abuse we know of, there are likely another 23 cases we will not hear about because the victim is too embarrassed to tell anyone.
  • Right now 65,000 people living in America are over 100 years old. That’s four times as many people as there were in 1990. The number is expected to increase eight-fold by 2050.

The event launched the Age Well San Diego Action Plan, which focuses on five areas of concern for an aging population: Health & Community Support, Housing, Social Participation, Transportation, and Dementia Friendliness.

That last one, ensuring San Diego provides a dementia-friendly environment for the increasing number of people over the age of 65, provides a good starting point for describing the current situation in San Diego–and probably in most other urban centers.

Nick Macchione, Director of the San Diego Health and Human Services Agency which runs Live Well San Diego, reported that in 2014, the number of people in San Diego with Alzheimer’s was 85,000. He also cited an easy-to-remember shortcut regarding Alzheimer’s: 5-5-35. Those numbers translate as 5 behaviors lead to 5 health consequences which 35% of dementia patients exhibit. Studies that report on these behaviors and consequences have concluded this means that about one third of patients with Alzheimer’s could have avoided it by making different lifestyle choices.  I couldn’t write fast enough to record which studies Nick mentioned, but I found this report that corresponds closely with his points.

The five behaviors: unhealthy diet, smoking, physical inactivity, drinking alcohol, and having no friends.

The five consequences: hypertension, cardiovascular disease, cancer, type II diabetes, and depression.

The data behind these numbers explain why social participation is one of the themes of Live Well San Diego. In addition, each of the four other themes in the Age Well San Diego Action Plan include elements to address dementia.

This is the third year of the five-year Age Well San Diego program. The first two years were spent in researching and listening to the community in order to ensure the Action Plan addresses the right issues. That leaves three years for the community to work together to take the steps in the plan, which will lead to data collection so the successes can be replicated and expanded upon.

I knew San Diego is a great place to live when we moved here. But it’s an expensive place to live. And the Age Well San Diego Action Plan addresses the financial pressures on all San Diegans, including those over 65, so that the gift medicine has given us to live at least 30 years longer than our grandparents expected to live is seen as an opportunity, not a burden. San Diego is truly a wonderful place to live.

Note: The Poway Unified School District Transition Program; San Diego-Imperial Chapter, Boy Scouts of America; and San Diego Police Department Volunteer Traffic Patrol also provided assistance during the event.

 

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body, happiness, health, leisure

The Better Way to Travel for My Demographic

The doctor who diagnosed my stress fractures used a phrase that chilled my heart: “in your demographic.” The meaning was clear. I could no longer expect things to be as they were 10, 20, or 30 years ago. My husband pointed out that I need to write down what I learned from the trip because, given my demographic, I might not remember everything when I next decide to travel.

I made some good decisions before my sister and I left for Norway. But since most of my working life was spent moving from country to country every one to three years, and lots of traveling while serving at overseas posts, I thought I knew enough about preparing to travel. I was wrong. What worked during my working years wasn’t always the best option now.

Well Done!

First, the things I did right.

I knew I didn’t want to waste any time in the morning with my hair. So I took the same step as I did before embarking on my year of roving in Africa: I had my hair cut short.

Before the cut

After the cut

I loved the style before the cut, but I knew it would take at least 30 minutes every morning to get it looking right. It worked while I was in Africa. While my hair may be a bit thinner than it was then, I was confident having short hair would mean I could shower, comb my hair, and let it air dry. Total time required after the shower–about 1 minute. This was one change that being in a new demographic really played no role. I know my hair will grow back so I can have that style back.

I also had a manicure and pedicure to have my fingernails and toenails cut as short as reasonable. I wanted to sure I wouldn’t be tempted to take clippers to my toenails and risk cutting into the skin or leaving jagged edges because it’s getting difficult to bend my knees and twist my leg enough to cut the nails straight. The polish also helped prevent nail breaks, at least for the first week.

In addition to packing all my prescription medicines and recommended supplements, I brought small amount of all the medications I might need. More on that later.

woman walking in walking shoesI walked every day in advance of the trip, wearing the shoes I expected to wear to get used to them. I bought a new pair of fitness shoes which had amazing reversible insoles with bubbles on one side that would give me a foot massage while I walked. I worried that too much walking would aggravate the arthritis in my hip which I had been working on improving for the previous six months after a flareup that nearly ruined a trip my husband and I took to England the previous fall. All right, I know, that should have been enough of a warning.

I picked up a purse that had RFI shielding to protect credit card information from being stolen. The purse was also smaller than what I had been using as a “purse” for traveling on planes. That improved moving through airports, though the extra weight I used to put into my purse was now in my carryon bag.

At the last minute I made a decision to bring a camera as a backup for my phone. I didn’t think I’d need it, especially since it meant carrying one more item in my purse. But each day either my phone or camera battery ran out, making it essential to have a backup.

Needs Improvement

Now the things I didn’t do so well. In these instances, my sister showed me how I could have done it.

I brought a large suitcase, but I didn’t fill it because I looked forward to picking up items in Norway. My sister brought a smaller suitcase which opened in the middle, allowing her to separate the items and cover half of them to hold them in place

My suitcase where everything shifted every time I lifted it

My sister’s suitcase where everything was kept securely in place with a minimum of shifting of contents

Now I don’t blame my sister for giving me the things that didn’t fit in her suitcase. After all, mine had room. If I hadn’t brought such a large suitcase, we would have had to find another way to get the items home.

That brings me to the second suitcase lesson. More significant than the size of the suitcases were the number and position of the wheels on them. Mine had only two wheels so that I had to pull the weight of the case whenever we moved. Even my carryon case had only two wheels. My sister’s had four wheels so that she could roll it across the floor.

Bad suitcase

Good suitcase

I did bring two pairs of reasonable shoes for all the walking we did. But I also brought two pairs of not so reasonable shoes. One pair had no support in it, but it looks nice. The other had heels. I tried putting the latter on to go to breakfast one morning and I couldn’t even get out of the room before I realized they wouldn’t work. And I relied on the former when my heel began to hurt because the two pairs of good shoes hit just the point on my heel that hurt. Even worse, I left behind a third pair of shoes that would have been excellent for the walking. Because they were old and didn’t look pretty.

My sister also brought both a camera and her smart phone. Like me, she experienced the battery for one or the other running out. But her camera had a feature mine doesn’t–she could wirelessly download the photos she took with her camera to her tablet so she could share those while we were on the road. I could share photos I took with my phone, but those camera shots had to wait until I returned home for downloading.

I brought over-the-counter medication I thought I might need, but I overlooked the most likely problem–catching a cold. And yes, of course I caught a cold. Fortunately, my sister had brought a small first-aid kit that included both daytime and nighttime remedies for the symptoms of a cold. It got me through the remainder of the trip, though I did have to buy tissues in large quantities in Trondheim.

What have I done as a result of the lessons I learned?

  • We now have spinner suitcases with four wheels and hard sides, three sizes: carryon, medium, and large.
  • The doctor who diagnosed my stress fractures recommended a store that specializes in providing good quality shoes. It was the same store I bought one of the pairs I brought with me. I now have a second pair which do not twist at all. I bought them for their support, not for their appearance. I plan to remove shoes that do not provide my feet with enough support from my closet and go back to the same store, not DSW, when I need a new pair of shoes.

The rest are just plans–plans to replenish a first aid kit with more remedies for common maladies, plans to include spare batteries for my camera, plans to buy a new camera with wireless downloading possibilities.

But first, my heels need to heal. And I’m glad to say that my hip didn’t bother me at all.

Have you had to make changes in your routine due to age? What has been the most difficult?

 

Image credits:
Featured Image: Tommaso Pecchioli
Manicured nails: Sarah Cervantes
Shoes: Grant Ritchie

two women having wine at a table outside a restaurant
body, health, the alternative

Getting to Know You

I’ve lived with my body for almost 70 years, but recent events have made me feel I’m getting to know myself all over again. Let me explain.

Gokstad Viking ship in the Viking Ship Museum in Oslo, Norway

In May I traveled with my sister to Norway for ten days. It was my first trip there and my sister’s second. We didn’t want to be part of a large tourist group, so we used a company to plan an entirely customized tour just for the two of us. We didn’t travel to the typical sites–fjords along the west coast. My sister had already seen those sights. Instead we traveled to parts of Norway that we know our ancestors came from, inland areas.

It was an absolutely wonderful trip.

We walked all over Oslo, Lillehammer, Røros, and Trondheim. Well, we walked less around Trondheim because my right heel hurt from all the walking we had done before. My self-diagnosis was tendonitis. I ruled out all the other possible causes for heel pain because I thought I knew what was involved in each of them. I wrapped my foot in ice packs, took anti-inflammatory drugs, and elevated my foot whenever we were in our hotel room. By morning my foot felt fine. I thought my heel just needed time to get better.

But I was wrong. By the time I returned home and saw a doctor, both heels hurt. The diagnosis was stress fractures in both my heels. For at least six weeks, I must cut back my activities, stay off my feet while they heal, and rely on a wheelchair when I must get around.

That’s when I was introduced to my new body. The almost 70-year-old one that I had been ignoring. The one where lowered calcium levels in my bones puts me at greater risk of more fractures. One where reduced muscle tone from decreased activity level, along with the number of prescription drugs I take, puts me at greater risk of falls–and broken bones.

The doctor who diagnosed the stress fractures introduced me to my new body. But the real learning came from a book for my book club: Being Mortal by Atul Gawande. In his book, Gawande points out that the changes I am just beginning to see are part of the normal process of living when life expectancy extends beyond what we now call middle-aged. It wasn’t all that long ago that 40 or 50 years was all most people got to live. At some point, later for the lucky ones, something struck individuals that caused a rapid decline and death. People lived–until they died.

But medicine has changed so much that we have treatments for those “somethings.” Now, treatments allow people to recover from any number of accidents, conditions, and illnesses that previously were fatal. And that means the lucky ones live longer but have to deal with the conditions and illnesses–and their consequences.

We live long enough for our bones to lose the calcium needed to keep them strong. The enamel of our teeth, made of the hardest substance in the body, wears away. Our blood vessels, joints, the muscles and valves of our hearts, and our lungs absorb the calcium our bones stop accepting, causing stiffness. And because the vessels the blood flows through are among those that become hardened, lined with mineral deposits, the heart must work harder to move the blood throughout the body. The heart muscles thicken. But the rest of our muscles become thin.

And then there’s the brain. I knew ten years ago I started having trouble remembering names and sometimes even words. But I hadn’t realized that the brain actually shrinks over time. By my 70s, my brain will have shrunk enough that there will be an inch to spare between my brain and my skull. That leads to a greater risk of cerebral bleeding if the head is injured, such as during a fall.

Even worse, according to Gawande, “By age eighty-five, working memory and judgment are sufficiently impaired that 40 percent of us have textbook dementia.”

This is the new body I am getting to know. How you met yours yet?

If you’d like to know more about the company we used to plan our trip to Norway, add a comment to ask for details. I’ll get back to you.

Image credit for featured image: Jez Timms

body, health

I’m Baaack!

It has been quite awhile since I last posted here. I’ve been posting on my other blog, one devoted to reading and writing, not health, wealth, and all that makes life better than the alternative. But August has been a tough month and has brought me back here, to celebrate what’s better than the alternative.

At the end of July, my husband wasn’t feeling well. I suggested we go to the urgent care clinic closest to our house where he was diagnosed with an infection. Something minor. Something easy to treat. Or so we thought.

He did have an infection. I had had the same infection a few months back, the reason I recognized his symptoms. In my case, a quick test confirmed the infection and a trip to the pharmacy to pick up an antibiotic, followed by a long nap, was all I needed to get better. We expected the same would apply to him.

But he didn’t get better. In fact, he got worse. So much worse that when he saw his primary care physician a week after that trip to urgent care, the doctor sent him straight back to urgent care, this time at the hospital our doctor is associated with.

The doctors there discovered his blood contained a very high level of potassium. They ordered an EKG to see if his heart was in trouble. It wasn’t.

 

But his kidneys were.

After I had hung around the urgent care intake rooms for hours, the doctors and nurses urged me to get something to eat and reassured me they would get him into a room while I was away. They told me to come back once I had eaten.

When I returned, they gave me his room number–Room 15 in the ICU. ICU. That’s Intensive Care Unit. Not exactly what I had expected when they said they would get him into a room.

My first reaction was to wonder if the hospital was so full they could only find space for him in the ICU. That’s the denial phase. He couldn’t be so ill that the staff needed to monitor him 24/7, could he?

It turns out, he was that ill. His kidneys were no longer functioning. The culprit, the doctors were 95% certain, was the antibiotic he was prescribed for that minor infection. The same antibiotic I was prescribed for the same minor infection eight months before.

Apparently, he is allergic to that drug. At any rate, we’re going to consider him to be allergic because we don’t want to repeat the exercise to confirm it.

The first week of August centered around his treatment in the hospital. They did a biopsy of one of his kidneys to rule out more serious causes. You know, like cancer. The doctors said the biopsy results were good, indicating the problem was typical of an allergic reaction. But good is relative.  His kidneys were not functioning. He needed dialysis to help his kidneys do their work. And the kidneys need time to heal.

The next two weeks of August centered around dialysis and follow-up with doctors. Twice a week we made a thirty-minute trip to a dialysis center where we sat in a room for the three to four hours needed to filter his blood through a machine.

Along with dialysis comes a limited diet. Foods with high levels of potassium were not permitted. And you can be sure that everything he wanted to eat, now that his appetite was back, was on the list of foods with high potassium levels. Vegetables were particularly difficult to work into his meals. Vegetables low in potassium are ones that have little color and even less flavor: bean sprouts, celery, cucumbers, eggplant, mushrooms, onions.  And most things he wanted to add for flavor–salt, soy sauce, salsa–are also high in potassium.

At the end of the second week and after four out-patient dialysis sessions, the doctors concluded his kidneys are functioning sufficiently to eliminate the dialysis. But his need for a daily dose of strong medicine to help the kidneys heal will likely remain for several weeks, if not months. One doctor finally used words that made us both sit up and listen. “You’re not ill,” she told my husband. “You are very, very ill.”

He’s no longer on the dialysis diet. Now we’re on the more varied diabetes diet. The drug he needs to treat the kidneys elevates the level of blood glucose, making it necessary for him to watch what he eats as well as to take insulin since most medications to treat diabetes in pill form are not advisable when kidneys are compromised.

Have I learned anything from all of this?

First, I will always step up to the Consultation window at the pharmacy when picking up a new drug. I did when I picked up my husband’s medication and am so glad I did. Not because the pharmacist warned of the side effects my husband experienced. There was no warning. Kidney failure is not a listed side effect on any of the information available about that drug. So I know I didn’t ignore a warning. Had I not taken the time to wait to speak with the pharmacists about the medication, I would have wondered if I should have known to bring him to urgent care again.

And second, I will pay much closer attention to my husband’s complaints when he isn’t feeling well. He doesn’t get sick often. He usually just plunges forward in his usual day if he feels a cold or even the flu coming on. So when he stayed in bed for days at a time, I should have realized he was really not well.

In support of that second lesson, I am happy to point to the fact that married men are healthier and live longer than single men. This Harvard study only hints, in the final paragraph, that wives insisting their husbands see a doctor is a positive factor in the health of men. Personally, I think it’s the main reason.