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You wake up early every day to care for your spouse. They have been battling (Cancer, Alzheimer; ‘s, Parkinson’s, Multiple Sclerosis, COPD, etc.) for a couple of years or more, and you are their primary caregiver or care partner. You have always been there for them. Make sure that they take their medications, eat, shower/bathe, get dressed, and take them to doctor appointments. 

Lately, you have been feeling more tired than usual. You have been experiencing headaches, lower backaches and just feeling blah. You seem to be coughing more, but you think that you have a cold or your allergies are acting up. You keep going on with your day, ignoring what you are feeling. You keep hoping that all of these symptoms will go away, but they don’t. In fact, they are worsening. 

One day you are taking your spouse to the doctor and collapse in the waiting room. You are rushed to the hospital, where you are diagnosed with pneumonia and severe exhaustion. You are admitted. What has become of your care-receiving spouse? Where are they? Who is with them? Who is helping them? 

You are now forced to take a break and focus on your own health. After three days, you are released but you are still not completely healed. You are still exhausted and still have pneumonia. What will you do now? Will you take the time to rest your body and let it fully heal or will you jump right back into being the primary care giver and probably take another health hit? 

When the care giver has a health crisis the care receiver still has to be taken care of and they may have to be placed in a facility for a while or hired help will come into the home to help or other family members may help out. The care receiver may start declining more quickly. The decline may be physical, emotional, mental or all three. Cognitive decline and disorientation are real issues that may happen as well. 

If you want to provide the best possible care to your loved one, then you must prioritize your own health needs. When you neglect your own healthcare needs, you are doing your care receiver a disservice. Neglecting your own health needs can impact your ability to make good decisions and provide effective care. When you don’t feel well, you are more likely to be more irritable, more impatient, and less attentive to your care receiver’s needs. 

Understanding Family Caregiving

Being a family caregiver can be a rewarding experience, but it can also come with many challenges and health risks. Family caregivers provide unpaid care to a loved one who is unable to care for themselves due to illness, disability, or aging.

Family caregiving can be a full-time job, and it can be physically and emotionally demanding. Caregivers often find themselves juggling multiple responsibilities, such as managing medications, providing personal care, and coordinating medical appointments. This can lead to stress, exhaustion, and burnout.

In addition to the demands of caregiving, family caregivers may also be at risk for health problems. Caregiving can be a source of chronic stress, which can weaken the immune system and increase the risk of chronic diseases. Caregivers may also be at risk for depression, anxiety, and other mental health issues.

It’s important for caregivers to prioritize their own health and well-being. This includes taking breaks when needed, seeking support from family and friends, and accessing community resources. Caregivers should also make time for self-care activities, such as exercise, hobbies, and relaxation.

If you are a family caregiver, it’s important to recognize the challenges and risks of caregiving and take steps to protect your own health and well-being. By taking care of yourself, you can better care for your loved one and enjoy the rewards of caregiving.

Physical Health Risks of Family Caregiving

Increased Risk of Chronic Conditions

As a spouse caregiver, you may be at an increased risk of developing chronic conditions such as heart disease, diabetes, and arthritis. This is because caregiving can be physically demanding and stressful, which can lead to poor health behaviors such as lack of exercise, poor diet, and inadequate sleep. Caregivers may neglect their health needs to care for their loved ones.

Weakened Immune System

Caregiving can also weaken your immune system, making you more susceptible to infections and illnesses. This is because stress can suppress your immune system, making it harder for your body to fight off infections. Additionally, caregivers may be exposed to infectious diseases through their care duties.

Physical Exhaustion

Caregiving can be physically exhausting, especially if you are caring for someone who is bedridden or has mobility issues. This can lead to fatigue, muscle strain, and other physical health problems.  Caregivers may neglect their own self-care needs, such as getting enough rest and exercise, which can exacerbate physical exhaustion.

To lessen these physical health risks, it is important for care givers or care partners to take care of themselves. This includes eating a healthy diet, getting enough exercise and sleep, and seeking support from others. It is also important for caregivers to take breaks when needed and to ask for help when necessary. By taking care of your own physical health, you can better care for your loved one.

Mental Health Risks of Family Caregiving

Depression and Anxiety

It’s common for spousecaregivers to experience symptoms of depression and anxiety. According to the American Psychological Association, caregivers are more likely to have depression and anxiety than non-caregivers. This can be due to the stress of caregiving, lack of social support, and the feeling of being overwhelmed and isolated. 

Increased Stress Levels

Family caregivers often experience high levels of stress due to the demands of caregiving. This can lead to physical symptoms such as headaches, fatigue, and muscle tension. Chronic stress can also lead to long-term health problems such as heart disease and diabetes.

Emotional Burnout

Emotional burnout is a state of emotional, physical, and mental exhaustion caused by prolonged stress. It’s common for family caregivers to experience emotional burnout due to the demands of caregiving. Symptoms of emotional burnout include feeling overwhelmed, irritable, and emotionally drained. I definitely do not want you to get to this stage. 

To prevent mental health risks, it’s important for caregivers to take care of themselves. This can include seeking support from friends and family, taking breaks from caregiving, and seeking professional help if needed. Remember, taking care of yourself is just as important as taking care of your loved one. Self-care is not selfish, it is necessary. 

Social Health Risks of Family Caregiving

Social Isolation

As a spouse caregiver, you may find yourself spending most of your time caring for your loved one and neglecting your own social life. This can lead to social isolation, which is associated with negative health outcomes such as depression, anxiety, and cognitive decline.

To combat social isolation, it is important to make time for yourself and maintain social connections. This can be as simple as scheduling regular phone calls or visits with friends and family, joining a support group for caregivers, or participating in activities you enjoy.

Relationship Strains

Family caregiving can also strain relationships with other family members and friends. This is especially true if there are disagreements about the best way to care for your loved one or if some family members are not contributing to the caregiving responsibilities. Everyone’s family relationships put the “fun” in dysfunction. We all deal with this crap. 

To prevent relationship strains, it is important to communicate openly and honestly with family members about your caregiving responsibilities and needs. Set boundaries and delegate tasks to other family members to ensure that you are not shouldering the entire burden of caregiving alone. Consider seeking the help of a mediator or therapist if disagreements continue to arise.

Financial Health Risks of Family Caregiving

Being a family caregiver can have a significant impact on your financial health. In this section, we will discuss the two main financial health risks associated with family caregiving: loss of income and increased expenses.

Loss of Income

As a family caregiver, you may need to reduce your work hours or quit your job altogether to provide care for your loved one. This can result in a significant loss of income, which can be particularly challenging if you are the primary breadwinner in your household.

According to the National Center for Biotechnology Information, family caregivers who must reduce work hours, exit the labor force, and forego income and benefits can experience significant reductions in available financial resources. This loss of income can have long-term financial consequences, including reduced retirement savings and Social Security benefits.

Increased Expenses

Providing care for a loved one can also result in increased expenses. You may need to purchase medical supplies, pay for transportation to medical appointments, or hire a home health aide to provide additional care. These expenses can quickly add up and put a strain on your finances.

The Centers for Disease Control and Prevention notes that caregivers can be at increased risk for negative health consequences due to the financial stress associated with caregiving. It is important to carefully track your expenses and explore options for financial assistance, such as government programs or community resources.

Prevention and Relief Strategies

Self-Care Practices

Taking care of yourself is ESSENTIAL to being a good caregiver. Here are some self-care practices you can use to reduce stress and promote your own well-being:

• Exercise regularly: Exercise can help reduce stress and improve your mood. Try to get at least 30 minutes of moderate exercise most days of the week.
• Eat a healthy diet: Eating a balanced diet can help you maintain your energy levels and promote your overall health.
• Get enough sleep: Getting enough sleep is essential to your physical and emotional health. Try to get at least 7-8 hours of sleep each night.
• Take breaks: Taking regular breaks can help you recharge and prevent burnout. Try to take short breaks throughout the day and plan for longer breaks when possible.
• Practice relaxation techniques: Relaxation techniques like deep breathing, meditation, and yoga can help reduce stress and promote relaxation.

Support Networks

Having a support network can help you manage the challenges of caregiving. Here are some ways to build and maintain a support network:

• Join a support group: Joining a support group can help you connect with other caregivers who understand what you’re going through.
• Reach out to family and friends: Family and friends can provide emotional support and practical assistance.
• Consider respite care: Respite care can provide you with a break from caregiving responsibilities and give you time to recharge.

Professional Help

Sometimes, professional help may be necessary to manage the health risks associated with caregiving. Here are some resources you can turn to for help:

• Talk to a healthcare provider: Your healthcare provider can provide guidance on managing your own health and well-being.
• Seek counseling: Counseling can provide emotional support and help you develop coping strategies.
• Consider hiring a professional caregiver: Hiring a professional caregiver can provide you with additional support and allow you to take a break from caregiving responsibilities.

By taking steps to prevent and lessen the health risks associated with caregiving, you can take care of yourself and provide better care for your loved one.

Conclusion

Being a family caregiver can be a rewarding experience, but it can also be a challenging one. As you have learned, there are several health risks associated with being a caregiver. These risks can affect your physical, mental, and emotional health.

It is important to recognize these risks and take steps to lessen them. This may include seeking support from other family members or friends, joining a caregiver support group, or seeking professional help from a therapist.

Remember, taking care of yourself is just as important as taking care of your loved one. By prioritizing your own health and well-being, you can ensure that you are able to provide the best possible care for your loved one.

Below is a summary of the main health risks associated with being a family caregiver:

By being aware of these risks and taking steps to reduce them, you can ensure that you are able to provide the best possible care for your loved one while also taking care of yourself.

Believe it or not, some people like doing errands and chores. For them, it is like getting on top of things. They like to be organized and prepared. Some of these organized and prepared people are also control freaks. I said, some of them. Let’s take a look at why other folks hate running errands. The chores thing is called adulting.

August 24, 2022

Let’s knock out chores first. I don’t personally know anyone that likes doing chores. I like the end result of a clean house and well-kept yard, but I don’t like to do them. That being said, I don’t hate doing them either. It is more of a matter of fact. The house needs to be cleaned, the yard needs to be mowed, the laundry needs to be done, the bills have to be paid, the car has to have an oil change, dinner has to be made and the dishes cleaned, etc. If you have to do it anyway, then do a great job. Be proud of your work.

I have heard about folks that will do a half-assed job, so they don’t have to do it again. I say, make them do it again and again until they get it right. They will learn to do it correctly the first time or they can keep doing it until they get it right. They will learn that doing it right the first time is easier and quicker. If you have children, remember when they tried to half-ass clean? Hopefully, you made them keep doing it until they got it right. After they had to do it three times before they could go play, they learned to do it right the first time.

Everyone, just do your chores! Take pride in the end result. Then, go out and play or enjoy the rest of your day. Check your attitude because little ones (and big ones) are watching you. Teamwork makes the dream work.

Men’s brains are wired differently than women’s brains. Women can multitask and men do one thing at a time. Men compartmentalize into boxes and nothing spills over into the boxes. Don’t ask a male child 3 questions. You will only get 1 answer. Men are task-oriented (one task at a time). Women can plan a list of things to do, put it in route order, and get it done while planning dinner. I asked my youngest son what he was thinking one day. Guess what he said? “Nothing.” Now, I cannot believe this. I am thinking “stuff” all of the time. However, I saw a scientist explain this very thing. At first, I called bullshit, but then did some research. Turns out males can think about “nothing.” Females cannot think about “nothing.” Everything is connected (somehow) to everything in a female’s brain. Women tend to “care” and men tend to “not care.”

The above paragraph is in general. We all have male and female tendencies. The goal for us is to realize the deficits that we have and improve on them. Women can focus on the one task before them and only that. Men can learn to think ahead, make lists and plan dinner.

If you ask a man to watch the kids, that is all he will do. He will do nothing, except watch the kids. When a woman watches the kids, she does the laundry, cleans the kitchen, and does a quick pick-up. If you want a man to do the little things, you have to give him a list, in the order that you want it done, and place the word “Tasks” on top of the list. Be specific and time-oriented or you will get “I’ll handle it. Or I’ll get to it.” It will then be on their timetable and not yours.

This article has taken a turn that I had not intended, but here we are.

Nothing is 100%, there are a few men that can multi-task and there are a few women that compartmentalize. Learn how to communicate with your significant other, they do not think like you. Assuming gets everyone into trouble. If you think or say, “why can’t he…” or “why can’t she…” then you are not communicating effectively.

I saw these things on Parenting. See if you can relate.

• Women see the big picture.
• Men have tunnel vision.
• Women tend to talk more than men.
• Men tend to condense their feelings and say a few words.
• Women revisit memories more and tend to ruminate more.
• Men tend to think about issues briefly, analyze quickly and move on to something unrelated.
• Women can identify emotions quicker and are more tuned in to emotions.
• Men tend to rely on facts and logic.
• Women are more empathetic and tend to brood.
• Men tend to turn to problem-solving mode.
• Women have better memory power than men.
• Men don’t pay a lot of attention to details (other than sports crap). Men have to make an effort to remember.
• Women need a combination of things to get aroused.
• Men need visuals to get aroused.
• Women are better at learning languages.
• Men are better with numbers (sports crap, again).

Managing your time better may help you to hate running errands and chores a lot less. Don’t jam-pack your schedule. Allow for “what-if time”. Find what works best for you. It may be a pick one day of the week to do the errands. It may be that you pick one room a day to clean. What if you could use errand day to reconnect with someone? Have someone go with you, a kid, a friend, or even your spouse. Be grateful that you can run errands. Not everyone has the money to run errands. Not everyone can physically go and do the errands.

If you feel like your Saturday is another complete workday, maybe you would be better off doing a little during the week. Don’t make yourself miserable. Prioritize and focus. Stop wasting your mental energy. Batch the things that can be batched. Delegate what can be delegated. Be flexible.

Couples fight about chores and cleaning almost as much as they fight about what to do with money. Destress your house. Never assume who will do what at the house. Talk it out and decide who will do what and how often. Develop a partnership in running the household. If you both hate and I mean hate,  not dislike a chore then you have to alternate it. Switch it up occasionally, to make sure it is still fair. Reevaluate and change when needed. If you have kids, teach them early and make sure they do a good job. Teamwork makes the dream work. More free time, coming up.

Pat

Sometimes, we are so stressed that we give up more of our power than we need to around scheduling. Sometimes, we are thrust in to a role without our prior permission. Other times, it is assumed that we will do X,Y or Z at A, B and C time and there is no way that we can make that work with our schedule. Talk about stress levels rising.

August 17, 2022

Before you are thrust in a role, have the tough conversations. Discuss who will be POA (power of attorney) for healthcare and for financial matters. It may or may not be the same person. It is much better to have these tough conversations with everyone who is to be involved, present at the meeting. No excuses, be there in-person, via telephone call or a Zoom meeting.

Decide who will be the point person or the one with the overall knowledge of what is going on and what will need to happen. Next, we need volunteers to take loved one(s) to doctor appointments, therapy appointments, pharmacy pick-ups, grocery shopping, cleaning the house, barbershop appointments and hair dresser appointments.

During an unexpected crisis or emergency, whoever is available or can take off, will have to step up and handle the appointment. Any time there is to be an initial appointment, you will probably have to take what you can get. After that, you can set the appointment day and time that works best for the patient and the companion or the driver. Decide what days and time are best for you to help your loved one. Maybe, you have one or two days during the week that are easier for you to take off work, come in late or leave early. Treatment Tuesdays, Wednesday Errands, Hair Thursdays, or Manic Mondays (get everything done on this day) are some examples.

Get the first appointment of the day, the appointment right after doctor’s lunch or the last appointment of the day. These are the most on-time appointments. Overall, most doctors are scheduling better and wait times are in the 20-minute range, if there is a wait time. Yes, your time is valuable and as you respect the doctor’s time by getting there 15 minutes early to check-in and update your information, if needed, your time needs to be respected as well.

I hear your voices in my head. The, “I had to wait 45 minutes passed the appointment time.” I get it , I have done it before too. I no longer do that. I give them 15 minutes and then I am back up at registration, checking out the situation. Oftentimes, you get back to a room at your scheduled time and then you have to wait for the doctor to come in. There is no easy solution with this type of situation. It could have been that two or three previous patients needed more time than what they were scheduled for. It could have been that the doctor got interrupted by an insurance company call. Before you get all pissed, give them the benefit of the doubt. There may come a time when you need more time with them and someone else will have to wait.

My appointments go smoothly because I am prepared. I get there 10 minutes early and check-in with insurance card and ID. Sign or fill out paperwork, if needed and I am ready to go. The assistant comes out and does the preliminary stuff. Takes down the notes for today’s visit and then I wait for my doctor. When he comes in, I have my list of medications out and ready. I have a list of meds that needs to be refilled ready to hand him. At the bottom of my list, are the  3 things that I want to talk about or have checked. If I am sick, I write down my symptoms in bullet points, how long it has been going on and what I have done or tried at home.

By the time he has read this, we are ready to discuss treatment options or next steps. He may have a few questions that need to be answered. I answer, he checks out what needs to be checked out, orders what lab tests needed and electronically sends off prescriptions to be filled at my pharmacy. We discuss whether a follow-up is needed and I am out the door.

It is great to like your doctor and I hope that you do. Any good relationship is a mix of give and take. Do you want more respect, attention and help from your doctor? Then be prepared for your visit. They no longer have the time to shoot the breeze, they just don’t. I believe that they want to do a good job and help you. Remember, this is a business relationship. The business is your personal health. It is important and we all need a doctor that we can work with for our best quality of life.

On your sheet of paper list, the following:

• Name
• Date of birth
• Current Medications, Why taking, Who prescribed it?
• Current over-the-counter (OTC) medications, herbal supplements, vitamins, etc.
• Chief complaint – what brought you to the doctor today?
• Signs & Symptoms you are having
• How long has this been going on?
• What have you tried or taken to help?
• What refills you need?

If you think your medications are not working or helping, state that and why you think that.

If you are having problems or unbearable side effects of your medications, tell your doctor.

If you haven’t been taking your medications, tell your doctor. What is the reason? Be honest.

Write out your questions. I know that you think that you will remember, but you won’t. You will talk about everything else and then your appointment time will be over.

Stay focused on why you are there for that visit. There is such a thing as an extended visit, and maybe you need to ask for one of those for next time. If you have your all of your information and questions written down and ready, you may be surprised that you do have time left over.

Doctors like bullet points or statements of facts. Save the story for later, if you have time. Find out how the doctors like to be contacted. Email, leave a message, make an appointment, etc.

Mistakes happen. Things get dropped or missed. Yes, it is frustrating and sometimes maddening. Take a chill pill, your amygdala just hijacked your emotions. Breathe and let the cortisol dump dissipate a little before you make phone calls and yell. Whatever has been dropped or missed has been dropped or missed. Move to next steps and when. Never ever assume that the doctor’s office will call you about test results. You make the call and leave a message that you are waiting on results and have not received them yet. Sometimes, you may be told that the office will call you, if anything is wrong. They may mean to, but crap happens. It is your health so you be responsible for calling them.

Have you ever sent an email to someone and waited on a reply. But, you got no reply and now it is a week later. You are mad or disappointed. You either write another email or forget the whole thing. Guess what? They may have never received your first email. It may be in their Spam folder or something screwy may have happened and they did not get it at all. Give them a call and ask.

Don’t assume your texts are going through either. Follow-up with a call. Strange things happen all the time.

Set and keep your follow-up appointments. If you are dealing with chronic health conditions, you may have multiple doctors and will need regular check-ups. Usually, 3 or 4 times a year. These follow-ups are not punishments. They are to keep you healthy and on track to have the best quality of life possible. For follow-ups, you pick your days and time. Maybe Tuesdays are best for doctor appointments. Tell the scheduler, what day you want and what time will work for you and they can search for openings.

See your dentist twice a year too. It isn’t just about your teeth and gums; it is also about heart health. If you have a fear, they have gas.

Get better at describing how you feel and what is going on with you.

Focus on how your life is being affected by what is going on. Be specific. Don’t say, I get tired easily. Tell what you are specifically doing. For example, I am having trouble drying my hair with a blow dryer, I feel weak and tired. My back hurts, here (point it out) and describe the pain (achy with movement, dull pain all the time, sharp pain when I do this.) and what makes it feel better and what makes it worse.

Which of the following would be better information? My right knee hurts. OR …My right knee feels like it is giving out and it aches in the evening. In your mind, you know that your knee hurts and you know what you have done and tried. You also know what has worked and what has not worked. You are also concerned that it will give away and you may fall. Your doctor does not know all of this and they cannot read your mind. You have the clues that they need to help make an accurate diagnosis or treatment plan. Maybe, you are having trouble climbing stairs or going down stairs. Describe the trouble and how your knee feels.

Use a metaphor or simile  to describe what is going on. Be descriptive.

• My legs feel like I am carrying 20-pound weights on each leg as I walk.
• My stomach is in knots.
• This pain feels like I am being stabbed.
• I have jackhammers in my head.
• My neck feels like rocks grinding together with bits and pieces chipping off.
• I am itching so badly, that I wish I could dig my fingernails in and  pull out the affected area.
• I feel like barbed wire is wrapped around my foot.
• My headache is on one side and it is continuous with occasional lightning bolt zaps.
• My stomach feels empty and gnawing about an hour after I eat.

Rarely, but it does happen, you have to say… “ I am not right. This is what I have observed and felt.” You may not have any concrete signs or symptoms, but you know that your body is not right. Be observant about your body and how it feels, be observant about your thoughts and what you are thinking.

Things to help you write out your notes for your appointment:

Questions to ask yourself about your symptoms:

• What exactly are my symptoms?
• Are the symptoms constant? If not, when do I experience them?
• Does anything I do make the symptoms better? Or worse?
• Do the symptoms affect my daily activities? Which ones? How?

Go through the story in your mind and pick out the relevant information, remember, doctors like bullet points.

Just because your doctor can’t make a diagnosis does not mean that there is nothing wrong with you. In too many cases missed diagnoses happen. Be persistent about what is going on. Get a second or third opinion.

Missed diagnosis, also called delayed diagnosis or failure to diagnose, means that the medical professional did not realize a medical condition that a patient presented with signs and symptoms of. This may be because the doctor did not recognize a constellation of symptoms that should have prompted them to test for a certain condition, or because symptoms that might indicate a serious condition are also associated with a number of other, minor health issues.

Misdiagnosis means that a person with one medical condition was diagnosed by a doctor with another condition that they do not have. In the best-case scenario, a misdiagnosis results in a little frustration and the waste of some time and money. In the worst-case scenario, the treatment for the wrong condition could further sicken or kill the patient, or delay diagnosis of the true condition until it is too late for it to be successfully treated.

Common missed diagnoses  and misdiagnoses in women:

• Heart attack
• Heart disease
• Autoimmune diseases (there are about 100 of these and too often the symptoms are not specific enough and you may be labeled a chronic complainer)
• Endometriosis
• Polycystic ovary syndrome
• Sleep apnea
• Breast cancer
• Ovarian cancer
• Lupus
• ADD (attention deficit disorder) & ADHD (attention deficit and hyperactivity disorder)
• Stroke
• Fibromyalgia
• Chronic fatigue syndrome
• Multiple sclerosis

Common missed diagnoses and misdiagnoses of men:

• Depression
• Fibromyalgia
• Lung cancer
• Colon cancer
• Parkinson’s disease
• Pulmonary embolism
• Multiple sclerosis
• Lyme disease
• Migraines
• Lupus
• Obsessive compulsive disorder

Be diligent regarding your own health. You are not crazy and you are not a hypochondriac (well, most of you aren’t). Be as factual as you can be and understand that you have the clues. Get your symptoms across to your healthcare provider.

Pat

Why is managing your own or a loved one’s medications important? Because to get the maximum benefit, you need to know so much more than just when to take them.

August 10, 2022

So often you hear about the adverse reactions, the terrible side effects, and the meds not working, but what about the successes?  Actually, getting better and feeling better. What is your part and responsibility in that area? Have you ever thought that you had a part in that? You do.

Medications are not going to fix everything; you will have to do your part. Medications have risks. Medications may have side effects, cause adverse reactions or not work at all for you.

What if we treated our health like a project we wanted to do? With ideas, goals, and successes. Those things along with medications would help you to have the best quality of life possible.

Questions to ask about medications

• Why has this medication been prescribed?
• How does this medication work in the body?
• What are the most common side effects?
• Are there any serious or rare side effects that I should be aware of?
• Will this medicine interact with others that I am taking now?
• When will this medication begin to work?
• What should I do if I miss a dose? What if I  accidentally take more than prescribed?
• Should I take this medication with food or water?
• Are there other drugs, vitamins or supplements that I should avoid while taking this medicine?
• Are there activities that I should avoid while taking this medication?
• Are there any foods that interact with this medication?
• Is it safe to drink alcohol while on this medication?
• How long will I  have to take this medicine?
• Do you have written information about this medicine that I can take home with me?

Tools you can use to manage and organize your medications

• Weekly pill box – best for taking your medications all at once
• AM/PM Weekly pill box – best for those that have morning meds and evening meds
• Four times a day weekly pill box – best for those that have to take meds multiple times per day
• Automatic pill dispenser – has a clock timer and can be set to dispense only at certain times & it is locked
• Reminder Apps – best if you keep your phone with you all the time and need a reminder
• Pre-packaged meds from your pharmacy – can be customed packaged
• Pre-packaged meds from online pharmacy – see each site for rules/regulations

Medication List – Keep it current, update it after every change in medication

Get an Index card, you can use paper, but you will be mad when it gets wet and rips or tears.

This is the minimum information that you need,  Drug name and strength, How you take it? (times per day), Why you are taking it?, Prescriber name

Fold it up and keep it in your wallet.

Take your medications as prescribed. If you are having problems, contact your prescriber. Maybe your dose has not had time to work. Maybe you are underdosed? Maybe, you are overdosed? Talk with your doctor. Start Low and Go Slow is a good motto when beginning new medications. It may have to be increased to get to the maximum dose and maximum benefit.

Know if you are taking a medication “off-label.” Off-label means that a medication has been prescribed for a use other than its intended use. For example, Seroquel® (quetiapine) or Risperdal® (risperidone). These two medications are intended to be used as antipsychotics. Most of the time they are used for behavioral problems or sleep.

Changes in our bodies as we age also contribute to how we metabolize and excrete medications.. As we get older, what we took in our 40’s may be too much for us in our 50’s+.

**Note**  Any symptom in someone 60+ years and older should be considered a medication side effect until proven otherwise. **Note**

Determine your goals for treatment. Your personal goals. Your medication goals. What if we all treated our health like a work project? One we actually wanted to do. We could use the SMART goals.

Goal – A statement that describes in broad terms what you will learn from a particular treatment. It is a behavioral outcome statement.

Specific – Be crystal clear on your goal. Not, I want to lose 20 pounds over the next year. I will lose 0.4 of a pound each week by decreasing my food intake and increasing my exercise output to equal 1,400 calories. Not, I want to feel better. Be specific, what will you do for yourself to feel better?

Measurable – Track the small tasks within each goal, especially for long-term goals. For example, track the calories you consume and track the calories that you burn in a normal week. You have set your goal to lose 20 pounds in 1 year. Whatever your normal week numbers are, you can decide to decrease your calorie intake by 200 calories per day or you can burn 200 calories per day in exercise or a combination of both. You cannot outwork a bad diet.

Attainable – Set goals that are challenging, even difficult at times, but within your reach.

Relevant – Decide what is most important to you in your life and work. What qualities or changes do you most desire? It has to be something that you want to do. You may not want to do the “tasks,” but you really want the result so you will do the tasks. If you say to yourself, “ I should” or “I need”  or “ So and So wants me to” then just stop. You will not be successful. When you can get to, “I want” or “I would like to” statements then you can be successful.

Timed – Every goal has to have a timeline to keep you on track and progressing toward success.

A goal without the parameters of the SMART goals is just wishing.  Your willpower will give out, and all you will have is your discipline.

Use this template to practice your goal setting.

SMART Goal

Action Plan

What steps do you need to take to get you to your goal?

Potential Obstacles and Solutions

Pat

November 24, 2021

It is that time of year. We go to visit our parents and/or other family members for more than three hours. Maybe you haven’t seen them for a few months or since last year. Sure, everyone is on their best behavior, for a while. “For a while,” is the key. Covering up and hiding things can be done for a few hours. The conversations are general. The house is clean (in the living room, dining room and probably kitchen). What about the rest of the house? What do the cars look like?

When you haven’t seen someone every week, you notice things that are amiss much better. Nothing major, but a lot of little things. I get it. Holidays, family dynamics, travel, cleaning, cooking, pressures at work, etc. It is stressful. Even if it is a good and loving family time, it is still stressful.

This is also a good time to stealthily check things out and observe. This is not the time to be rapid fire questioning or even questioning at all. Just look, listen and observe. It is troubling when our loved ones begin to lose their independence due to a health condition or aging. It is a big stressor for us when we realize what is happening. No matter how hard it is to look for possible issues, it will be even harder to ignore them and get blindsided at the most inopportune time.

Physical heath changes – Have they lost weight?

                                         Have there been any changes to their medications?

                                         Are the taking their medications correctly?

                                         Are they walking differently?

                                         Are they hesitant to get up and walk?

                                         Does it seem they are unsteady or have a fear of falling?

                                        Do you notice any cuts or bruises on forearms or legs especially?

Behavior changes – Have they lost interest in things they used to enjoy?

                                 Have sleep patterns changed? Napping more, less or sleeping more or less

                                 Do they seem to be sad or angry? They may deny it, but how do they look?

                                 Are they repeating the same stories?

                                 Are they giving money to things or people that they have not done before?

                                 Are they not bathing regularly?

                                 Are they wearing the same clothes day after day?

                                 Are they losing track of time?

                                 Are they showing an increase in agitation?

                                 Are you noticing verbally or physically abusive behaviors?

Environment – Is there a lot of unopened mail laying around?

                        Is there more clutter than you remember before?

                        Do you see spoiled food or past expiration date food in the refrigerator?

Are there any small things undone? Ex. Burnt out light bulbs, laundry overflowing, crumbs or grime on counter tops?

Are there any dings in the car? Scratches?

Is the yardwork being kept up?

Does the cookware have burn marks in it or on the outside?

The exterior of the house is not being maintained. Gutters, spigots, painting, etc.

Cognition, Memory or Judgement – Missing appointments?

                                                           Getting lost while walking or driving?

                                                           Trouble finding the right words?

                                                           Unable to complete sentences?

                                                           Unable to recall names of familiar people or objects?           

Unless they are in immediate danger, do not make a fuss. Plan for a time to meet later and talk. When you meet, express your concerns and your observations, they will probably become defensive. Do not get personal. Re-state your observations and how all of you can work together for solutions.  Maybe they need a check-up with their doctor? Maybe they are having issues or problems with their medications?

Your aging parents are not going to share things with you. They may not lie, but they are keeping secrets. Spouses will cover for each other. What one may no longer be able to do or handle the other one will step in and handle it.

High on the priority list will be an eyesight check-up and a hearing test. They may not be able to clean as well, because they cannot see as well. They may have fights or spats because they cannot hear each other and neither of them understands what is wrong with the other. Hearing also affects their balance.

Some secrets that they keep – They are falling sometimes

                                                They are in pain

                                                They are short on money

                                                They may go on spending sprees

                                                They may be drinking more

                                                Someone is financially abusing them

                                                Someone is physically or emotionally abusing them

 These conversations can be very awkward and they may deny that anything is happening to them. Tread lightly. You want them to trust you to help and not to blame them or hurt them further by how you act towards them. Ask them if you can talk about XYZ. Share an article with them about it happening to someone else and ask their opinion and insight. If they refuse to talk or share with you then you may want to find someone else that they will talk to. Their doctor, pastor, a friend of theirs, someone they will be comfortable talking with.

You may not get anywhere with them. They may stub up and say no to your help. You can’t make them; you can only try to help them. If they are of sound mind, they get to make the decisions, even if they are the wrong decisions.                                 

What two legal documents do you need?

July 28, 2021

How can you make sure that your business, your financial accounts, your bills are taken care of should you become incapacited for a period of time or for the rest of your life?

The two legal documents that you need are:

1. Durable Power of Attorney for Finances

  2.  Durable Power of Attorney for Health care

Now, all states are not the same so make sure that the forms are legal in your state.

Stop the fighting before it starts. And, you know that there will be fighting about who is taking care of what and how they are going to handle it. Choose someone who wants to be the durable power of attorney for health care and finances. It may not be the same person.

The reasons may be many for not choosing your spouse or another family member. They may not want to or even be able to be the power of attorney. Finances are just not their expertise. You can’t trust them to do what you want. They piss you off, or whatever the reason. It does not matter; it is your choice.

If you do not make a choice or you do not have these powers of attorney, then the courts will decide conservatorship for you. You do not get to have any input or a say and it will take a lot of time, money and stress. Your money. A conservatorship takes a lot of time and a lot more money than getting these taken care of by a lawyer. You can even use one of the prepaid legal plans for your will and durable powers of attorney, if you are concerned about the cost. I would like for you to consider this an investment in you, your wishes and needs to be handled and done as you want them to be handled and done.

Make your wishes known, fill out your living will and then get on with your life.

Check with your bank about what they need to have in place so someone else can-do banking on your behalf using your accounts. If a durable power of attorney is over three years old, some banks will not honor the power of attorney for fear that it may have been revoked or someone else is the current power of attorney. Also, if you have a safety deposit box, make sure you have two or more people on the signature card to access the box. If not, good luck with getting into that box. It will be locked down tighter than Fort Knox.

Pick one to three people that you trust and set them up as your powers of attorney. Ask them first, then make your wishes known. What gets written down gets done. Who is the best person or persons to make medical decisions for you? Who is the best person or persons to handle your finances and bills?

If you have had these in place for over 5 years, do you need to change them or update some information?

Pat

Dementia, Alzheimer’s disease = Brain failure

Many people know the terms dementia and Alzheimer’s disease, but what do those words actually relate to so that we can understand what is happening?  I believe that the most appropriate phrase is brain failure.

Areas of the brain are failing.  The brain cannot function properly.  Some of the nerve cells stop functioning, lose connections with other cells and eventually die.

There will be “moments” that they are in the present and aware of what is going on around them. They may even be aware that “something is just not right” with them.  And the family gets all excited and tries to keep them oriented to person (themselves, friends and family), place (where they are), and time (knows day/date).  The clarity may last for a few minutes, to an hour or more. But, then it always reverts back.  And the family is sad, frustrated, angry and all of the other emotions that arise.  Grieving rears its ugly head too.

I know that everyone is looking and waiting for the next “moment of clarity.” What if it never comes again?  Your loved one is living in their moment, whatever that may be for them.  They cannot live in your world, the “real” world.  It’s not that they don’t want to, they can’t, their brain is failing and you have to go to their moment.  Stop trying to orient them to time, place, & people.  Just meet them where they are.  Look for the good (anything positive or good) where they are, at the moment.  Stop correcting, stop questioning, and stop getting frustrated in their presence.  They WILL pick up on your feelings of frustration, anger, sadness and anything else you are feeling.

Some have asked about why they are seeing different things in their loved one versus another person’s loved one.  Because the part of your loved ones brain failure may be in a different place than another’s.

Look at the diagram below for names and areas of the brain.

Parts of Human Brain

The following information is from Very Well Mind, Kendra Cherry 4/4/2019

The cerebral cortex can be divided into four sections, which are known as lobes (see image). The frontal lobe, parietal lobe, occipital lobe, and temporal lobe have been associated with different functions ranging from reasoning to auditory perception.

• The frontal lobe is located at the front of the brain and is associated with reasoning, motor skills, higher level cognition, and expressive language. At the back of the frontal lobe, near the central sulcus, lies the motor cortex. This area of the brain receives information from various lobes of the brain and utilizes this information to carry out body movements. Damage to the frontal lobe can lead to changes in sexual habits, socialization, and attention as well as increased risk-taking.
• The parietal lobe is located in the middle section of the brain and is associated with processing tactile sensory information such as pressure, touch, and pain. A portion of the brain known as the somatosensory cortex is located in this lobe and is essential to the processing of the body’s senses.
• The temporal lobe is located on the bottom section of the brain. This lobe is also the location of the primary auditory cortex, which is important for interpreting sounds and the language we hear. The hippocampus is also located in the temporal lobe, which is why this portion of the brain is also heavily associated with the formation of memories. Damage to the temporal lobe can lead to problems with memory, speech perception, and language skills.
• The occipital lobe is located at the back portion of the brain and is associated with interpreting visual stimuli and information. The primary visual cortex, which receives and interprets information from the retinas of the eyes, is located in the occipital lobe. Damage to this lobe can cause visual problems such as difficulty recognizing objects, an inability to identify colors, and trouble recognizing words.

The cerebellum – Sometimes referred to as the “Little Brain,” the cerebellum lies on top of the pons behind the brain stem. The cerebellum is comprised of small lobes and receives information from the balance system of the inner ear, sensory nerves, and the auditory and visual systems. It is involved in the coordination of movements as well as motor learning.

The cerebellum makes up approximately 10 percent of the brain’s total size, but it accounts for more than 50 percent of the total number of neurons located in the entire brain. This structure is associated with motor movement and control, but this is not because the motor commands originate here. Instead, the cerebellum serves to modify these signals and make motor movements accurate and useful.

For example, the cerebellum helps control posture, balance, and the coordination of voluntary movements. This allows different muscle groups in the body to act together and produce coordinated fluid movement.

In addition to playing an essential role in motor control, the cerebellum is also important in certain cognitive functions including speech.

Behaviors

Can Behaviors be managed Without Medication?  What are the Pro’s & Con’s?

Medications are not without risks.  There are no approved medications for behavior management in a dementia.  The medications that are being used are being used “off-label.”  That means that they are probably being used for a side effect that they cause and not the intended or approved use.  Does that make it right or wrong?  Each of us has to decide that for ourselves.  As long as you understand the risks versus benefits, make the best decision for yourself and know what to look out for as far as other side-effects and adverse reactions.  Adverse reactions are things that happen that we do not expect.

In my opinion, it is always better to use non-drug approaches whenever possible.  Yes, it will take time and effort, but with consistency behaviors will get better or at least not worsen.  Will some eventually need medication?  Possibly to Probably.  That’s the thing with a chronic illness, there are no absolutes and situations and needs change so be open to the possibility of making other decisions when needed.  What is the best decision that you can make, right now, with the information that you have, right now?

Behaviors have a reason

Drug side effects

Infections

Pain

Discomfort

Uncorrected problems with vision and hearing

How you act and react matters – your attitude and feelings are what they pick up on

You become the detective:  Do they have a fever?  If yes, call doctor.  Do they need to go to the bathroom?  Have regular toileting schedule.  Are they too hot or too cold in their clothing?  Are they bored?  Have they had enough exercise during the day? Are they drinking enough?

“DICE” model, Dr. Helen Kales

• “D” reminds us to “describe” a disruptive behavior. What is it? When does it occur and with whom? What is the patient perspective on the behavior? How much distress does it cause patient and caregiver?
• “I” reminds us to “investigate” the causes of the behavior. Is it an indicator of unrecognized pain, frustration, fear, or boredom? Does it represent medication side effects or an undiscovered medical or psychiatric condition? Is it the result of sensory changes and functional limitations? Does it represent an inappropriate caregiver expectation or a cultural issue?
• “C” reminds us to “create” an intervention that addresses the behavior directly. This may include diagnosing and treating pain-inducing physical conditions such as constipation, using a behavioral analysis to craft a behavioral treatment plan, supporting the caregivers, simplifying tasks, finding meaningful activities, or increasing/decreasing stimulation in the environment. Individualized music therapy, for example, can take into account a person’s musical preference and provides soothing music through headphones and an MP3 player. When appropriate, the created intervention may include use of an appropriately chosen and monitored medication.
• Finally, the very important “E” reminds us to “evaluate” the effect of the intervention, noting whether it has helped and also whether there have also been unintended consequences or side effects of the intervention.

If nothing physiological is the problem, distract and redirect.

How do you handle issues with other family members wanting to “try” supplement “X, Y or Z?”

As we age, we cannot metabolize and clear medications and supplements as well as we once could and they can and do built up in our bodies.  So, the dosage we took in our 50’s may be way too much for us in our 60’s, 70’s and beyond.  Supplements can & do cause real harm to people.  Don’t be misled by the claims of “Natural,” “Proven,” or even “Improves cognition.”  There have been NO large scale, repeatable studies that can prove to the scientific community any supplement or herbal product will help once a person has a dementia.  I understand the want, the desire the need for something to help, but that is just not possible at this time.  The time to consider using supplements is way before a diagnosis has been made.  U.S. National Library of Medicine https://www.nlm.nih.gov/

You can find and research for legitimate studies there with the results of the studies.  Let the doctor be the “bad guy” if you need help.  Family dynamics, they are usually interesting and quite trying at times.  Keep the main thing the main thing, appropriate care and compassion for your loved one.  Their bodies cannot metabolize and clear as well as they once did and we are not going to tax the body any more than we have to.  Acknowledge their well- meaning ideas and concerns, but state that at this point they need – visits, love, just being with you and sitting or talking.  If that doesn’t work then you can just pull out the “Hell to the no!”

Medications

Medications used for depression, anxiety, aggression & restlessness:

Citalopram (Celexa®), Mirtazapine (Remeron®), Sertraline (Zoloft®)

Side Effects

Less common:

• Decreased or increased movement
• mood or mental changes, including abnormal thinking, agitation, anxiety, confusion, and feelings of not caring
• shortness of breath
• skin rash
• swelling

Medications used for severe aggression & restlessness:

Anticonvulsants or Mood Stabilizers – Divalproex sodium (Depakote®), Carbamazepine (Tegretol®), Oxcarbazepine (Trileptal®)

Side Effects

Less common:

• Abnormal dreams
• anxiety
• bloody nose
• blurred vision
• bruising burning, crawling, itching, numbness, prickling, “pins and needles”, or tingling feelings
• change in personality
• change in walking and balance
• dizziness, faintness, or lightheadedness when getting up from a lying or sitting position suddenly
• lip smacking or puckering
• loss of bladder control
• loss of strength or energy
• muscle pain or stiffness
• muscle tension or tightness
• rapid or worm-like movements of the tongue
• rapid weight gain
• restlessness
• seeing, hearing, or feeling things that are not there
• shakiness and unsteady walk
• slurred speech
• unsteadiness, trembling, or other problems with muscle control or coordination
• yellow eyes or skin

Medications use to treat agitation:

Lorazepam (Ativan®),  Clonazepam (Klonopin®), Alprazolam (Xanax ®), Oxazepam (Serax®)

These medications cause sleepiness and possible confusion and an increase risk of falls & dizziness

You want to use the shorter acting ones which are all but the Clonazepam.

Side Effects

Symptoms of overdose:

• Changes in patterns and rhythms of speech
• increased sweating
• loss of strength or energy
• low blood pressure
• nightmares
• shakiness and unsteady walk
• slurred speech
• trouble in speaking
• unsteadiness, trembling, or other problems with muscle control or coordination
• unusual drowsiness, dullness, tiredness, weakness, or feeling of sluggishness
• unusual excitement, nervousness, restlessness, or irritability
• unusual paleness unusual weak feeling

Medications used to treat paranoia, hallucinations, severe aggression, and severe agitation:

Antipsychotics – Risperidone (Risperdal®), Quetiapine (Seroquel®), Olanzapine (Zyprexa®)

Less common:

• changes in patterns and rhythms of speech
• drooling
• fever, muscle aches, or sore throat
• inability to move the eyes
• inability to sit still
• increased blinking or spasms of the eyelid
• lip smacking or puckering
• loss of balance control
• rapid or worm-like movements of the tongue
• restlessness
• shakiness in the legs, arms, hands, or feet
• shuffling walk
• slowed movements
• slurred speech
• sores, ulcers, or white spots on the lips or in the mouth
• uncontrolled twisting movements of the neck, trunk, arms, or legs

These medications should only be given when the doctor thinks the issues are severe.  These have been known to increase mortality in folks with dementia.

Medications used for sleep:

Zolpidem (Ambien®), Ezopiclone (Lunesta®), Zaleplon (Sonata®)

Note – these should only be used if absolutely needed and for only a short amount of time.  The person may become more confused and they are at a higher risk of falling.

Side Effects

Less common or rare:

• Anxiety
• bladder pain
• bloody or cloudy urine
• burning, crawling, itching, numbness, prickling, “pins and needles”, or tingling feelings
• chills
• crying
• decreased awareness or responsiveness
• dizziness, faintness, or lightheadedness when getting up from lying or sitting position
• dry mouth
• euphoria
• fainting
• irregular heartbeats
• irritability
• lower back or side pain
• paranoia
• quick to react or overreact emotionally
• rapidly changing moods
• restlessness
• seeing, hearing, or feeling things that are not there
• shakiness in the legs, arms, hands, or feet
• shortness of breath

Medications that people with AD should not take:

Medications with strong anticholinergic (AC) side effects, such as sedating antihistamines, are well known for causing acute cognitive impairment in people with dementia.

Analgesics – Meperidine (Demerol®)

Antiarrythmics – Disopyramide (Norpace®),

Antidepressants – Amitriptyline (Elavil®), Doxepin (Sinequan®), Imipramine (Tofranil®),

Antiemetics – Promethazine (Phenergan®), Dimenhydrinate (Drammamine®), Meclizine (Antivert®), Cyclizine (Marezine®),

Antipsychotics – Chlorpromazine (Thorazine®), Pimozide (Orap®), Thioridazine (Mellaril®)

Antihistamines – Chlorpheniramine (Chlor-tri-me-ton®), Cyproheptadine (Periactin®), Diphenhydramine (Benadryl®), Hydroxyzine Hcl (Atarax®)

Gastrointestinal & Urinary Antispasmodics – Hyoscyamine (Levsin®), Dicyclomine (Bentyl®), Flavoxate (Urispas®), Oxybutinin (Ditropan®), Tolterodine (Detrol®)

Muscle Relaxants – Carisoprodol (Soma®), Chlorzoxazone (Parafon Forte DSC®), Cyclobenzaprine (Flexeril®), Metaxolone (Skelaxin®), Methocarbamol (Robaxin®), Orphenidrine (Norflex®)

Older adults may be more sensitive to anticholinergic effects in the central nervous system because of age-related changes in pharmacokinetics and pharmacodynamics, reduced acetylcholine mediated transmission in the brain, and increased permeability of the blood-brain barrier. Anticholinergics are known to cause confusion, memory loss, and worsening mental function in people who are older than 65 years.

Acetylcholine is essential for memory and anticholinergics block the release of the neurotransmitter acetylcholine in the central nervous system and the peripheral nervous system.

The way to remember the effects of anticholinergic medications is using the mnemonic Hot as a hare, blind as a bat, dry as a bone, red as a beet, mad as a hatter.

• Hot as a hare: increased body temperature
• Blind as a bat: mydriasis (dilated pupils)
• Dry as a bone: dry mouth, dry eyes, decreased sweat
• Red as a beet: flushed face
• Mad as a hatter: delirium

5 Reasons you are not getting relief from your chronic pain & then what you can do to get relief!

1. You are still mad about it and are fighting it.
2. You are only trying one approach to finding relief.
3. You have given up control of your treatment options because you feel so bad.
4. You may have been misdiagnosed.
5. You have accepted that nothing else can be done and you just need to learn to live with it.

Think about it.  What happens to your body when you are mad or angry about something?  You tense up your muscles, you shallow breathe, and you are on edge and ready to pounce on anyone and anything that dares to cross your path.  You are in the midst of fighting a battle; unfortunately it is with your own body.  Let that sink in.  Ponder that thought for a few minutes and while you are pondering, breathe, just breathe, deeply. Breathe in through your nose for a count of 6 and breathe out through pursed lips for a count of 6.  Concentrate on your breathing for three minutes. Notice how your body feels and what is happening.  This is a no judgement zone.  You are just to observe and be curious about how your body is feeling.  Do your deep breathing exercises five times a day.

When you use more than one approach to an issue you increase your chances of success.  What would your life look like if you were more successful in decreasing your pain level?  Enjoying family and friends?  Enjoying going out and doing more of the things that you want to enjoy?  Can you even remember a time when you felt good enough to enjoy your life?  Look, you may not be able to become completely pain free, but you certainly can lessen the pain and have a better quality of life.

Could it be that you are not taking the appropriate medication(s) for your particular needs?  Could it be that you haven’t thought of or been given the option of using multiple integrative treatment approaches?  Maybe your medications were working at one time but now they are no longer working.  What has been shown to improve pain relief?  Acupressure, Acupuncture, Mindfulness Based Stress Reduction, Stretching routines, Yoga, Breathing exercises, Massage, Far infrared heat, Migun bed treatments, talk therapy and guess what?  None of the things mentioned included more medications!  In fact, you may be able to decrease the medications that you are currently on and have better pain relief.  You are more than welcome to throw the bullshit flag, I certainly have, but I must admit I have had more success with the breathing exercises, far infrared heat and Migun bed treatments than I had with medications and I am a pharmacist by trade.

When you hurt for so long your nerves are just shot and you really can only do what you absolutely must do. That is all the energy that you have.  I get it.  You relationships begin to suffer, your work begins to suffer and you just feel stuck.  Pain wears your body out and you do feel tired and exhausted much of the time.  If you could think rationally, you might be able to look into other treatment options.  Everyone deserves options because the same things do not work for everyone. Maybe you have tried a few things but they did not work or you weren’t willing or able to give them enough time to work. People that are in chronic pain cannot think rationally and logically they just want the pain to stop.  Unfortunately, there are people out in the marketing world that know this and they use that knowledge to manipulate people in chronic pain to buy “X” or try “Y.” None of it works.  Then what happens?  When the chronic pain patient is approached by other options and ideas they don’t want to try them. Why? Because they tried things before and spent a lot of money and nothing worked.  They don’t want to waste any more money and they sure don’t want to get their hopes up only to be dashed again when it might not work.  Integrative health approaches are science based and they won’t put you in the poor house.  If anyone tries to tell you that something will take away all of your pain, they are lying.  You goal is to lessen the pain and get your life back.

What if your doctor was wrong in the diagnosis?  It happens.  Doctors are human and it is called the practice of medicine not the certainty of medicine.  You may not know or even have an exact cause of your chronic pain, there are things you can do to lessen the pain.  Notice that I said, “You can do.”  That is correct; it is up to you to help yourself.  You cannot be passive in your treatment.  It takes engagement and work to get better.

Have you been told “You just have to learn to live with it.”?  If you have, I am sorry.  I do not agree with that and what it means is that they don’t know what else to do for you.  That is just unacceptable and a disservice to you.  It is one thing to know and to accept that you will be living with a chronic pain issue, but it is quite another thing to not lessen the severity of the pain and to improve quality of life.  Everyone deserves a better quality of life no matter what the circumstances.

Pat

5 Things you can do, right now, to improve your quality of life:

1. Eat two fruits every day and drink at least 32 oz. of water during the day.  Decide how much liquid you can drink in one sitting, 2 oz., 4 oz., etc. Do you like it cold, room temperature, iced, hot, add lemon, lime, or an orange if you need a flavor.  Alternate your favorite beverage with a glass of water.  Other liquids count (except for alcohol and fruit juices/sugary drinks), but they are not the best..
2. Walk.  If you do not currently walk, start low and go slow.  5 minutes daily then increase by 2 minutes every week until you can get to 30 minutes per day.  You can do 10 minutes three times a day. Some days may be better than others, be kind to yourself and get back on track as soon as possible.
3. Strengthen your legs.  One exercise is to do chair stands, place a pillow on the back of the seat and sit down and then stand up (you may need to use a chair or table to steady yourself).  Do 5 repetitions twice a day two times per week.  Three times per week, when you get stronger.  Goal is 8 to 12 repetitions without having to use a chair or table to steady yourself.  Ankle circles (10 rotations each way while seated),  Knee flexion (stand behind a chair and lift your leg up towards your bottom- 6-10 each leg), Knee extension (Seated in a chair extend knee as straight as possible, hold for 3 to 5 seconds and slowly relax back down to floor), Calf raises (use a chair for balance and raise up onto your toes, hold for 2 seconds and go back down & do 6 to 12 reps)

When strengthening – slow, deliberate and controlled movements are needed

4.   Breathe.  Practice lying down until you are comfortable with this exercise.  Should you become dizzy or light headed,                 stop.  Place your hand or a magazine on your belly, take in slow deep breaths (4 count), you want your belly to rise                   and not your chest.  Breathe out through pursed lips (4 to 6 count).  Do for 5 minutes two or three times per day.

5.  Take charge of your healthcare needs.  Get educated and learn what your best options are (use reliable health                            information). Get organized, have your powers of attorney completed, make your wishes known, have the talk with  loved ones and get on with living.  When you say or think to yourself, “I can’t,” get rid of that phrase!  At least make it in to “I can’t, right  now, but I will get there.” Listen to your body. Remember, you are a part of your healthcare team and all team members need ti  be working towards optimal health.