Q&A: #108

Fragile Health
By Carol Abaya, M.A.

Question:  My mother, 71, has been gaining weight since my father died and is now ten pounds heavier than she should be.  I’ve tried unsuccessfully to get her to go on a diet.  How can I convince her that she needs to lose weight?

Answer:  You don’t say what her weight “should”  be,  her age, or her build.  All these factor into “ideal” weight.

In fact, ideal weight may be more than what most people think it should be.  I recently attended a medical conference in Phoenix sponsored by The American College for the Advancement of Medicine.  There were two days of sessions on anti-aging research and longevity.

Their studies show that a person overweight as much as 20 to 30% lives longer than a thin person.  The body needs a certain amount of fat, which overly thin people do not have.  In common sense terms, a heavier person can withstand illnesses better because weight loss at that time is not detrimental to overall health.  So, if your mother feels OK and is not depressed (thus eating too much or snacking), then back off.

The College recommendations as to diet also substantially differ from Federal Government guidelines.  Quite frankly, I am more inclined to go with The College conclusions.        

The College recommends a simple diet with low sugars and carbohydrates (even simple ones) and high protein, with fats at a moderate level.  The government pyramid of foods stresses high carbohydrates -- breads, cereals, rice and pastas.  The actual recommended “serving” size is so small it is not realistic and everyone eats considerably more.

Those at the conference issued caution warnings on high carbohydrates.  First, carbohydrates turn into sugar, and this can be harmful to those with either diabetes or  low blood sugar.  Second, breads and pastas have yeast,  and many unknowingly, (myself included) are allergic to yeast.  This means the body does not properly process it; hence weight gain instead of loss.          

New medical research is also finding that

  • Healthy fats (olive and canola oils, and certain nuts) reduce LDL (bad cholesterol) without affecting HDL (good cholesterol).
  • Monounsaturated fats are good for you.
  • Polyunsaturated fats, found in corn, safflower, sunflower, sesame and cottonseed oils, are bad.
  • Ttrans-fatty acids, found in margarine, vegetable shortening, and hydrogenated vegetable oils are the worst.
  • It’s not fat per se that should be avoided; only the “bad” kind.

Studies on longevity also indicate that:

  • Those with a slower metabolic rate live longer than those with a fast one.  A faster metabolic rate equals a lower life span.  Couch potatoes or those who engage in moderate exercise live longer than those who participate in extreme exercise. High physical activity does not necessarily add years to one’s life.
  • Yogurt helps eliminate certain harmful bacteria and helps longevity.
  • The B-vitamins especially folic acid are recommended.
  • Testosterone therapy has slowed aging dramatically.
  • Genetics is very important.
  • Chronic anxiety is a leading case of aging.   
Question:  My father, 74, was in a car accident and suffered severe whiplash.  The doctors seem to have treated this.  Now, however, he is complaining of hearing sounds in his head, even if no one else is around.  My mother says he can’t concentrate and snaps at her constantly.  Is he experiencing dementia?

Answer:   Dementia is probably not a factor.  And yes, he really is hearing sounds in his head, even if no one else hears them.

About 20% of people experience tinnitis,  which is the perception of sound even when none is present.  Often it is ringing in the ears.  Other times it can be a hissing or buzzing sound.  It can be a one-level sound and very piercing or several-level sounds.

The causes are not really clear as often there are no physical elements to identify.  It is known that certain factors can exacerbate it:  exposure to loud noises, wax build up in the ear, certain medications (even aspirin or antibiotics), ear or sinus infection, heart disease, tumor or auditory nerve damage, under active thyroid or head or neck trauma.  In your father’s case, it probably comes from the accident.

First step should be a visit to an ENT physician.  Couple that with a review of his medications; eliminate alcohol, nicotine and caffeine, and reduce stress.

More information from the American Tinnitis Association, 503-248-9985.

Question:  While my father (recently died) used to do most of the driving, my mother (75) drove regularly to run errands, meet friends, etc.  Now she refuses to drive, saying her heart starts to pound and she’s afraid of getting into an accident.  I have to run her errands, grocery shop, take her to the doctor.  I work part-time, have a family and am exhausted.  Help!

Answer:  Your mother may be having an anxiety or panic attack when she gets behind the wheel.  One theory is that the body’s normal “alarm system” - the set of mental and physical mechanisms that allows a person to respond to danger is triggered unnecessarily.  Scientists don’t know exactly why.      

Symptoms vary:  racing heartbeat, chest pains, dizziness, nausea, difficulty breathing, numbness, flushes or chills, terror, fear of losing control or even of dying.

Such attacks can seriously impact a person’s daily life - as with your mother.  Your doctor or psychologist can provide help.

Question:  My mother, 71, just had breast cancer surgery.  The doctor says all the cancer was removed, and she’s healed very well physically.  Emotionally, it’s another story.  Her friends of many years don’t know what to say to her, and so she’s losing contact with several she’s known for decades.  What can we do to help her make the emotional adjustment?

Answer:  Social isolation is a big risk factor when it comes to the rate of healing.

Find a local breast cancer support group, and take your mother.  Studies show that regular support therapies help extend the survival rate of patients.

Besides the emotional support, such groups help patients better understand the importance of taking prescribed medicine, exercising regularly, and adjusting lifestyle.

Such emotional connection help sustain those with grave or chronic illnesses. 

Also talk with her friends and explain that they don’t have to avoid discussing her situation - nor should they dwell a lot on it.  They can help her regain a good balance to her life and return to her previous lifestyle schedule.

Question:  My father, 82, has been having trouble with his hip, says he has a lot of pain, and needs help getting into and out of bed, chairs, etc.  The doctor recommends hip surgery.  My sister says he’s too old for such surgery.

Answer:  As long as your father’s basic health is good, such surgery can eliminate the pain.  No one should have to live with pain if there is help available.  Age today, given new medical technologies, should not be a determining factor.

The Mayo Clinic recently released a survey which shows that even those over 100 years old can benefit from surgery. 

Helping your father become pain-free and regain his independence will go a long way to ensuring his last years are better.

Question:  My uncle, 76, has to have a tumor removed from his elbow.  The doctor recommends he go to a nursing home for a week or two afterwards.  He doesn’t want to go to a nursing home.  How can we convince him?

Answer:  Depending on the extent of surgery, he may not need a nursing home.

Elements to evaluate include:  is there someone at home to help him dress, bathe and fix meals?  Or can he hire someone?

He probably will need physical therapy.  He can get home visits via Medicare or at a hospital on an outpatient basis or by a private licensed therapist.

Studies show that people, especially the elderly, generally recover faster at home.  They are more comfortable in a known and familiar environment.

Even, if the surgery is extensive, the visiting nurse can regularly change the dressing and monitor his condition.  However, when a chronic illness is factored in and which needs to be controlled, a rehab or acute care nursing home might be advisable.

Question:  My parents, in their 70s, were in a car accident and badly bruised - nothing broken.  My father continues to have pain in his elbow and refuses pain medicine or physical therapy, as suggested by the doctor.  His complaints are getting my mother down.

Answer:  No one should have to experience constant pain when medicine and help, such as physical therapy, are available.

After such an accident, time has a way of healing what was bruised.  However, because of the pain, your father is probably using that arm less, which means the muscles get weak very quickly.

Physical therapy can help strengthen the muscles around the elbow and coupled with time should help a full recovery.  The therapy may be painful and tire him out, but in the long run can be very beneficial.  Someone else should drive him and stay with him during the session, and over the counter pain relievers can provide the comfort he deserves.

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