Speeding Recovering from Surgery

A sudden fall. A serious diagnosis. Surgery isn’t always something you can plan for. Even so, you can take steps to make recovery at home a little faster and safer. You just might need to depend on others for extra help. With the benefit of advance planning, of course, do what you can before the day of surgery.

Simplify. What felt easy before surgery may suddenly feel a little like mountain climbing. Take a few simple steps now to eliminate steps later.

• Stock up on food and other supplies. Buy ready-made meals or prepare and freeze single meals.
• Put items you use often within easy reach—between waist and shoulder level.
• Make sure your bed is firm enough to support you while you recover.
• Stay on the same floor as a nearby bathroom. Or buy a portable commode to put by the bed.
• Put a portable or cell phone within easy reach. Keep handy the numbers you will need to call, like the doctors office, neighbor, relative and pharmacy.
• Place a firm-backed chair in rooms you use most often.
• Use a fanny pack to carry items with you around the house.1 inside incase you fall and need to call for help.

Ask for help. If not now, when? Remind yourself that most people feel good about helping out. So when someone says, “What can I do?” be specific. You might say something like this: “I need help getting the dog walked twice a week.” “A home-cooked meal tomorrow would be terrific.” “If I give you a list, can you run to the store for me once a week?” Will you need help with basic things like bathing and transportation, but don’t have anyone at home who can help? Ask the doctor, nurse, or social worker how to find trained caregivers.1 Safe-proof the bathroom. Unless you make a few changes, this room can be downright dangerous.

• Consider buying an elevated toilet seat and a shower or bath chair.
• Install grab bars vertically or horizontally. Don’t ever use towel racks as grab bars.
• Add non-slip suction mats in the tub and a non-skid mat outside the tub.
• Place soap and shampoo where you won’t need to reach for it.1

Remember that you can purchase some of these special items in our store. Prevent falls. Do what you can to remove tripping hazards. Remove loose wires, cords, and throw rugs in walkways. Add extra lighting, for example, nightlights to hallways and bathrooms. Keep your hands free when moving from room to room.

Practice using crutches, a walker, or wheelchair. Also, have someone show you the safe way to go up and down stairs and get in and out of the shower.

1. Follow instructions. After surgery, you’ll likely go home with special instructions on incision care. To prevent infections, make sure you understand how to care for your incision. For example, call the doctor if you see pus or the incision becomes really painful.
2. Place the phone Also, take medications exactly as prescribed. If you have questions about any of this, remember that I’m here to guide you in the proper use of your medications. Remember that pain control can help you get moving, which can speed your healing and help prevent complications. Let your doctor and me know if pain medication isn’t working or is causing side effects.
3. Nothing herein constitutes medical advice, diagnosis or treatment, or is a substitute for professional advice. You should always seek the advice of your physician or other medical professional if you have questions or concerns about a medical condition. 

There’s no reason to suffer in silence!

Sources

1. MedlinePlus: “Getting your home ready – after the hospital.” Available at: http://www.nlm.nih.gov/medlineplus/ency/patientinstructions/000432.htm Accessed March 10, 2014.
2. CDC: “Frequently Asked Questions About Surgical Site Infections.” Available at: http://www.cdc.gov/HAI/ssi/faq_ssi.html Accessed March 10, 2014.
3. American Academy of Family Physicians: “Caring for Your Incision After Surgery.” Available at: http://familydoctor.org/familydoctor/en/prevention-wellness/staying-healthy/first-aid/caring-for-your-incision-after-surgery.printerview.all.html Accessed March 10, 2014.
4. University of Southern California: “A Patient’s Guide to Heart Surgery.” Available at: http://www.healthinaging.org/resources/resource:eldercare-at-home-helping-with-recovery-from-illness/ Accessed March 10, 2014.

Calcium

Taking calcium—either through diet or supplements—is a little like making deposits into a bone bank account. If you keep a healthy balance of this mineral, your body is able to build and maintain bone, which is a living, ever-changing tissue. Not only does calcium keep bones and teeth healthy, it also helps with clotting blood, sending signals between nerves, and regulating heart rhythms.1,2

But if you fail to make calcium “deposits,” your body starts to pull calcium out of your bones and “overdraws your account.” Worse than a painful overdraft fee, however, this calcium imbalance can cause porous, weakened bones. This condition is called osteoporosis. In the U.S., it affects 8 million women and 2 million men, resulting in 1.5 million fractures each year.1

How much calcium do you need? It varies, depending on your age. Your preteen or teen needs more. Banking calcium at this stage is really like making an early investment in “retirement.”
The National Academy of Sciences recommends:

• 1,300 mg/day for children ages 9–18
• 1,000 mg/day for men and women ages 19–50
• 1,200 mg/day for men and women ages 50 or older1,3

Some guidelines suggest 1,500 mg for postmenopausal women who don’t take estrogen.2 That’s because—due to a loss of estrogen at menopause—women start to have bone loss earlier than men.1

If you take calcium supplements, it’s best to divide the dose. Take half in the morning and half at night.2 Let me know if you have questions about different types of calcium. I can also discuss any medications that might interfere with calcium absorption. And I can give you tips on how to handle any calcium side effects, such as constipation or indigestion. To limit side effects, be sure to take no more than 2,000 mg daily.2

Foods rich in calcium include dairy products, dark leafy greens, dried beans, nuts, and calcium-fortified foods, which may include orange juice, cereal, and bread.1,3 Some recent studies suggest that food sources of calcium may be better than supplements. A study reported on in the American Journal of Clinical Nutrition showed that participants who got most of their calcium from diet had better bone density than those who got most it from supplements.4 It’s too soon to know why, but it might have to do with better absorption or other food compounds that enhance bone health.

What else can you do to prevent bone loss as you age? Try weight-bearing exercise, such as walking or running, and get enough vitamin D.3 This vitamin helps your body absorb calcium. To get enough of it, you can spend at least 15 minutes in the sun several times a week.5 You can also take supplements or get food sources of vitamin D—in salmon, tuna, or fortified milk, margarine, or cereal.6 Try to get 800 International Units (IU) daily, but no more than 2,000 IU, which can be toxic.2

Nothing herein constitutes medical advice, diagnosis or treatment, or is a substitute for professional advice. You should always seek the advice of your physician or other medical professional if you have questions or concerns about a medical condition.

Sources

1. Harvard School of Public Health Web site. “Calcium & Milk.” http://www.hsph.harvard.edu/nutritionsource/calcium.html
2. UpToDate Patient Information Web site. “Patient information: Calcium and vitamin D for bone health.” http://patients.uptodate.com/topic.asp?file=endocrin/5283
3. CDC Web site. “Bone Health.” http://www.cdc.gov/nccdphp/dnpa/nutrition/nutrition_for_everyone/bonehealth/
4. Science Daily Web site. “Dietary Calcium Is Better Than Supplements At Protecting Bone Health.” http://www.sciencedaily.com/releases/2007/06/070614112433.htm
5. American Dietetic Organization Web site. “Calcium and Vitamin D: Essential Nutrients for Bone Health.” http://www.eatright.org/ada/files/Tropicana_Fact_Sheet.pdf
6. Office of Dietary Supplements Web site. “Dietary Supplement Fact Sheet: Vitamin D.” http://dietary- http://dietary-supplements.info.nih.gov/factsheets/vitamind.asp

Stress & Heart Disease

If managing stress is a challenge for you, take heed: More and more research is pointing to stress as a contributor to heart attack and other forms of heart disease. From natural disasters1 to the death of a sibling2 to the daily grind of modern-day life, stress can have a big impact on your heart. In fact, some studies show it harms your heart as much as smoking at least five cigarettes a day.3

Adding insult to injury? If you do have a heart attack, the prognosis may be poorer with chronic stress.4 And heart patients with high anxiety can double their risk of dying. Throw depression into the mix—and it’s a triple whammy.5

Why does stress have such a big impact? Stress produces lots of physiological changes affecting your heart. For example, you pump out more adrenaline, which can make your blood pressure rise and your heart race. If these changes keep up over time, they can damage your heart’s arteries.6

Of course there’s also some good news. Although you can’t control all the stressors in your life, you can take steps to better manage your responses to stress. Cultivating a positive, optimistic frame of mind has even been linked to better levels of cholesterol and other markers of heart health.7

Okay, so where do you start? Find methods for managing stress that work well for you. Here’s just a sample. You might have other ideas to add to this list.

• Practice positive self-talk at least once a day. This can work wonders at turning around a negative frame of mind. An example of negative self-talk is this: “I hate when this happens.” An example of positive self-talk is this: “I can handle this. I’ve done it before.”
• Do something pleasurable JUST FOR YOU at least 15 minutes a day. Maybe it’s taking a bubble bath, strolling in the park, or listening to your favorite music. You might be amazed at how much this can turn around a day that feels like it’s gone all wrong.

Use emergency stress stoppers. These are great for those situations where you feel like you’re going to burst! Try methods like these:

• Count to 10 before you speak. Take a few deep breaths. Go for a walk. Give someone a hug. Smile at a stranger. Give yourself extra time to get ready in the morning so you won’t be running late.
• Practice a daily relaxation method such as deep breathing. And when I say relaxation, I don’t mean just sitting and watching TV. You need to actively calm the tension in your mind and body. Other great methods of relaxation are yoga, tai chi, and meditation. Try out a variety of methods, but give yourself time to practice and learn.8
• Cultivate healthy habits. Get enough sleep, don’t forget to laugh, exercise, slow down, accept what you can’t change. Taking steps like these will make a big difference in how well you manage stress.9

Good luck with your changes. When you’re in the store, stop by and see how your blood pressure is responding!

Nothing herein constitutes medical advice, diagnosis or treatment, or is a substitute for professional advice. You should always seek the advice of your physician or other medical professional if you have questions or concerns about a medical condition.

Sources

1. HealthDay: “Katrina, Other Crises Boost Heart Attacks: Studies.” Available at: http://www.nlm.nih.gov/medlineplus/news/fullstory_134696.html Accessed March 23, 2013.
2. HealthDay: “Sibling’s Death…” Available at: http://www.nlm.nih.gov/medlineplus/news/fullstory_134434.html Accessed March 23, 2013.
3. Nursing Times: “Stress raises heart attack risk.” Available at: http://www.nursingtimes.net/nursing-practice/clinical-zones/cardiology/stress-raises-heart-attack-risk/5053106.article# Accessed March 23, 2013.
4. Reuters: “Chronic stress tied to worse heart attack prognosis.” Available at: http://www.reuters.com/article/2012/10/05/us-chronic-stress-idUSBRE89415220121005 Accessed March 23, 2013.
5. HealthDay: “Anxiety, Depression May Triple Risk of Death for Heart Patients; Study.” Available at: http://www.nlm.nih.gov/medlineplus/news/fullstory_135077.html Accessed March 23, 2013.
6. University of Kentucky: “Reduce Stress and Heart Attack Risk.” Available at: http://uknow.uky.edu/content/reduce-stress-and-heart-attack-risk Accessed March 23, 2013.
7. Reuters: “Mid-life optimism linked to healthier cholesterol.” Available at: http://www.nlm.nih.gov/medlineplus/news/fullstory_134633.html Accessed March 23, 2013.
8. American Heart Association: “Four Ways to Deal with Stress.” Available at: http://www.heart.org/HEARTORG/GettingHealthy/StressManagement/FourWaystoDealWithStress/Four-Ways-to-Deal-with-Stress_UCM_307996_Article.jsp Accessed March 23, 2013.
9. American Heart Association: “Fight Stress with Health Habits.” Available at: http://www.heart.org/HEARTORG/GettingHealthy/StressManagement/FightStressWithHealthyHabits/Fight-Stress-with-Healthy-Habits_UCM_307992_Article.jsp Accessed March 23, 2013.

5 Bonus Benefits of Exercise

For as long as you can remember, you’ve been hearing about the benefits of exercise: Weight control, chronic disease management, stronger muscles and bones, to name a few. But the list of exercise benefits just keeps getting longer. If you could package it in a pill, you might have a multi-million dollar product!

Maybe these less touted benefits will offer the motivation you need to make exercise a regular part of your daily routine.

1. Improve your immune system. Seem like you catch every bug in the book? Maybe exercise can help. Researchers are finding that as little as 30- to 45-minute brisk walks five times a week can greatly boost your immune system. It does this by increasing the levels of natural killer cells that fight off infections such as colds or the flu.1,2
2. Influence aging. Early research indicates that exercise may partly reverse the aging process caused by stress. How do we know this? Shorter telomeres are a sign of aging, and researchers have found that exercise lengthens them. Telomere is a fancy name for the strands of DNA at the tips of chromosomes.3
3. Enhance your mood. You may already know that exercise can improve self-confidence, distract you from negative thoughts, and help you feel fitter. Increasing body temperature may have a calming effect. Exercise also releases brain chemicals that may relieve tension and ease depression and anxiety. Some studies have even shown that exercise may be as effective as an antidepressant.4,5
4. Boost your brain. Exercise increases growth factors in the brain, which help the brain make new brain cells and new connections between them. This may enhance memory, attention, and concentration, helping with learning.6 Some studies have even begun to show a link between exercise and grades on math and reading tests.7 But the benefits aren’t limited to kids in school. Exercise may also greatly reduce the risk of developing Alzheimer’s disease, a form of dementia.8
5. Sleep better. A recent poll conducted by the National Sleep Foundation uncovered some interesting connections to exercise. Those who exercised—no matter what time of day—reported better sleep than those who didn’t, even when they slept the same length of time. Sedentary people were also about twice as likely to be sleepy during the day and were more likely to have sleep apnea, a disorder that interrupts breathing while you’re asleep.9

So how much do you need to reap benefits like these? Experts recommend getting at least two hours and 30 minutes each week of moderately intense aerobic activity or one hour and 15 minutes weekly of vigorous aerobic exercise.10 It’s best to combine this with muscle strengthening two times a week.10 But remember: short stretches of physical activity throughout the day can bring many of the same advantages as a structured gym workout.11

If you’re not sure where to begin, I may be able to help. Before you start a new routine, it’s also best to have a talk with your doc.

Sources

1. Nieman DC, et al. Med Sci Sports Exerc. 2005 Jan;37(1):57–62. Available at: http://www.ncbi.nlm.nih.gov/pubmed/15632669 Accessed March 23, 2013.
2. Nieman DC, et al. Br J Sports Med. 2011 Sep;45(12):987–992. Available at: http://www.ncbi.nlm.nih.gov/pubmed/21041243 Accessed March 23, 2013.
3. Puterman E, et al. PLoS ONE. 2010. 5(5): e10837. doi:10.1371/journal.pone.0010837. Available at: http://www.plosone.org/article/info%3Adoi%2F10.1371%2Fjournal.pone.0010837 Accessed March 23, 2013
4. MayoClinic: “Depression and anxiety: Exercise eases symptoms.” Available at: http://www.mayoclinic.com/health/depression-and-exercise/MH00043 Accessed March 23, 2013.
5. Harvard Health Publications: “Exercise and Depression.” Available at: http://www.health.harvard.edu/newsweek/Exercise-and-Depression-report-excerpt.htm Accessed March 23, 2013.
6. HealthDay: “Short-Term Exercise Might Boost Young People’s Self-Control.” Available at: http://www.nlm.nih.gov/medlineplus/news/fullstory_134655.html Accessed March 21, 2013.
7. HealthDay: “When Kids Exercise More, Their Grades Might Rise Too.” Available at: http://www.nlm.nih.gov/medlineplus/news/fullstory_134464.html Accessed March 21, 2013.
8. Head D, et al. Arch Neurol. 2012;69(5): 636–643. Available at: http://www.ncbi.nlm.nih.gov/pmc/articles/PMC3583203/. Accessed March 23, 2013.
9. HealthDay: “Exercise Leads to Better Sleep: Pool.” Available at: http://www.nlm.nih.gov/medlineplus/news/fullstory_134557.html Accessed March 21, 2013.
10. U.S. Dept. of Health & Human Services: “2008 Physical Activity Guidelines for Americans Summary.” Available at: http://health.gov/paguidelines/guidelines/summary.aspx Accessed March 23, 2013.
11. HealthDay: “Everyday Activities May Have Same Health Benefits as Going to Gym.” Available at: http://www.nlm.nih.gov/medlineplus/news/fullstory_133890.html Accessed March 21, 2013.

Women and Smoking: Bad News, Good News

You’ve come a long way, baby. But really, now, who wants this kind of progress….? Women who smoke are at much greater risk of death from lung cancer and chronic obstructive pulmonary disease (COPD) than they were 20 years ago. In fact, deaths from smoking are at an all-time high among women in the U.S. Why? Probably because women have started smoking earlier, are smoking longer, and smoke more each day than women did in the past.1

A large American Cancer Society research study also links smoking to breast cancer. During about a year of follow-up, the rate of new cases of invasive breast cancer was 24 percent higher in smokers than in nonsmokers.2

These are just a couple of new findings. You probably already know that smoking increases the risk for lung and other cancers, as well as the risk for infertility and low birth weight in babies.3
Against this troubling backdrop, however, there is something positive to report. People who quit smoking between ages 25 and 34 can gain back a decade they otherwise would have lost as lifetime smokers. Even quitting later in life can buy back some time.1

There’s other encouraging news: Your chances of a heart attack or stroke go down if you quit. The benefits of being smokefree can add so much life back into your day to day activities.

That’s all fine and well, you might say, but quitting is easier said than done. Of course, that’s true. But you’ve got more help at your disposal than ever before. Aside from counseling, quit-smoking support groups, and smokefree smartphone apps, you can also take advantage of quit-smoking products we carry in our store. Let me know if want to discuss our available products.

If you’ve tried to quit more than once, you might want to try a prescription medication such as varenicline (Chantix) and the antidepressant bupropion (Zyban). Some people also combine one of these medications with a nicotine patch such as Nicoderm.5 I can walk you through options like these. Or, if your doctor has written a prescription, I can answer any questions you may have.

Here are some other tips that may make it easier for you to quit smoking:

• Get rid of all tobacco products and ashtrays ahead of time. 
• Ask others not to smoke around you or to leave evidence of cigarettes where you can see them. Also tell them not to buy you smokes after you quit, even if you ask them to. 
• Change your routines for a while so you’re less likely to trigger the desire to smoke. 
• Find relaxation techniques that work well for you. But minimize drinking alcohol. It may actually derail your efforts.6 
• When you feel an urge coming on, find a way to distract yourself—make a phone call, go for a walk, or come talk to me. I’ll cheer you on! 3

Sources

1. HealthDay: “Women’s Smoking Deaths at All-Time High in U.S.” Available at: http://www.nlm.nih.gov/medlineplus/news/fullstory_133362.html Accessed March 20, 2013.
2. American Cancer Society: “Study Links Smoking to Breast Cancer Risk.” Available at: http://www.cancer.org/cancer/news/news/study-links-smoking-to-breast-cancer-risk Accessed March 20, 2013.
3. CDC: “Commit to Quit Smoking in 2013.” Available at: http://www.cdc.gov/Features/smokingcessation/ Accessed March 20, 2013.
4. Reuters: “Quitting smoking helps hearts, even with weight gain.” Available at: http://www.nlm.nih.gov/medlineplus/news/fullstory_134864.html Accessed March 20, 2013.
5. HealthDay: “Drug May Help Women Who Quit Smoking Avoid Weight Gain.” Available at: http://www.nlm.nih.gov/medlineplus/news/fullstory_132595.html Accessed March 20, 2013.
6. HealthDay: “Drinking Can Derail Women’s Efforts to Quit Smoking.” Available at: http://www.nlm.nih.gov/medlineplus/news/fullstory_134073.html Accessed March 20, 2013.