Surviving Coronavirus, Physically and Mentally

There's not much I can tell you about how to stay safe during this pandemic that hasn't already been said.  One Japanese doctor has suggested the following, for self monitoring yourself daily.  Take a deep breath, hold for at least 10 seconds.  If you can do this without coughing or feeling tightness, you probably don't have fibrosis in the lungs. If you do this simple check each day you can hopefully catch the virus before it become dangerous.  Another tip from the same source is to keep yourself hydrated.  Dry mouth can be a breeding ground for infection.  If you do happen to have contact with some who has the virus, frequent sips of water will wash the virus out of the mouth, down into the stomach where it will be killed.  I haven't heard either of these ideas from any American doctors, but that doesn't mean anything to me. Neither of them cost anything and they just may protect you.

Keeping yourself mentally fit is a bit more difficult.  If you plan to self distance yourself from crowds, you will probably be spending a lot more time at home.  Unless you plan on selling stocks at this time, don't look at your portfolio for a while.  It will only depress you.  Based on past performances, the market will come back.  Be patient.

How to keep yourself busy?  Catch up on the new shows and old ones you've missed on Netflix and Prime.  We just watched several old seasons of Curb Your Enthusiasm, and every Sunday night look forward to a new episode of season 10.  Clean out clutter in your home and garage.  If you're like me, this will take you several days, but you will feel great.  Catch up on correspondance with friends and family.  It's a good time to reconnect with people.  If you're missing your day at the bridge club, invite a few local friends over for the afternoon.  The same goes for Canasta players and Mah Jongg players.  Play with a fresh deck of cards!  Or, play games on line.  There is so much to choose from.

Visit grocery stores or pharmacies at quiet hours, to avoid the crowds.   I plan NOT to buy grapes right now.  They have been touched by too many people, and even if you wash them, there is risk.  I will try to stick with peeled fruits and apples, which can be easily washed. Reschedule doctor appointments that aren't urgent.  I just cancelled Ron's ALS checkup and my mammogram.  He is stable so I see no reason to take him into a hospital filled with sick people.  My mammogram can be done at a future time.  These are just a few of my thoughts on staying safe during this trecherous time.  If I have more, I will let you know.  In the meantime, stay safe, don't panic, and get medical help if you think you need it.  We will all get through this.

Keeping Safe From Coronavirus

Wow.  In just a week we've gone from the stock market hitting its all time high, to a week when the market lost over $3trillion.  We went from hearing about a faraway flu called coronavirus, to cases popping up in the U.S. and worldwide.  Hopefully our leaders will let doctors keep us informed as to how bad it is and what to expect.  Hoping for a "miracle" doesn't help.

We were talking about the virus at the dog park today.  One person's international trip had been cancelled, another had a Disney cruise cancelled, and I had a tour of the Amazon fulfillment center in San Bernardino cancelled.  They are not having any tours there until further notice.

The coronavirus is easily transmitted from person to person, so here are a few tips.  I went to CVS today to look for hand sanitizers.  They were all sold out.  My friend Karen gave us all a great tip to use in place of hand sanitizers.  Use rubbing alcohol, at least 70%.  Use a funnel to put it in a little bottle with a pump, and voila, you have hand sanitizer.  It will be a bit drying, but after cleaning hands, use some hand lotion.  Don't mix them together.

Wash your hands frequently, and keep things like your cell phone or phone at an office clean.  Keep your desk clean too, if you still work in an office.  Don't touch your hands to your face, mouth or nose, especially if you have been out touching things like money, shopping carts and doors to buildings.  Keep washing your hands and sanitizing with rubbing alcohol.

We need to pressure our leaders to keep us honestly informed of the situation.  Keeping us in the dark is not the answer.  Stay safe, everyone.

Locusts Wreaking Havoc In East Africa

So much is happening in the world right now, that the invasion of locusts in East Africa has been widely overlooked.  Primaries in South Carolina and Super Tuesday right around the corner, have been covered extensively.  Now the coronavirus is something on everyone's mind, both here and abroad.  So while we fight to get a possible worldwide pandemic under control, Africa, specifically the Horn of Africa, is dealing with the worst invasion of desert locusts in 70 years.  The region hit is one of the most impoverished regions in the world.  It is said to look like a huge umbrella in the sky.  The insects fly through fields of crops at an astonishing pace, decimating everything in their path.

The highly mobile creatures can travel over 80 miles a day. Their swarms, which can contain as many as 80 million locust adults in each square kilometer, eat the same amount of food daily as about 35,000 people.

Officials say the infestation poses a risk to food security, undermines economic growth and, if not controlled soon, exacerbate communal conflict over grazing land.

In addition to the 12 million people already experiencing acute food shortages in Ethiopia, Kenya, and Somalia, the locust crisis now poses a potential threat to the food security of over 20 million others, according to the Food and Agriculture Organization, a U.N. agency.

“The magnitude of the problem is just so big,” said Cyril Ferrand, who leads the organization’s resilience team for eastern Africa. “The locusts are a moving target and we are racing against time.”

Scientists know how to control it, even to erradicate it, but because of lack of money and apathetic worldwide interest, response is slow.  In an area of the world already dealing with famine, this adds to their troubles.  A chemical spray to kill the locusts is on its way, but the locusts lay eggs and reproduce quickly, so the infestation will be difficult to erradicate. 
Here is some information from a worldwide organization that tracts the infestation.

Desert Locust situation update 24 February 2020

Swarms invade the Persian Gulf and continue to breed in the Horn of Africa The situation remains extremely alarming in the Horn of Africa, specifically Kenya, Ethiopia and Somalia where widespread breeding is in progress and new swarms are expected to form in the coming weeks. In the past few days, there has been a significant movement of swarms over the Arabian Peninsula, unrelated to the Horn of Africa, that reached both sides of the Persian Gulf. Kenya. Swarms continue to be reported in northern and central areas where they are mostly mature and have laid eggs. Hatching is causing an increasing number of hopper bands to form with new swarm formation expected in the coming weeks. Mature swarms are also present along the shores of Lake Turkana. Aerial and ground control operations continue. Ethiopia. The situation is similar to Kenya with widespread swarms, breeding and hatching in Somali, Oromiya and SNNPR regions, including the Rift Valley. Movements further north can be expected as well as from adjacent areas of Somalia and Kenya. Somalia. Breeding continues in the northeast where new immature swarms are expected to form in about one week or so. Uganda. A mature swarm arrived in the northeast from adjacent areas of western Kenya on 24 February. South Sudan. Only remnants of an earlier mature swarm have been seen in the southeastern county of Magwi. A second mature swarm was seen near the border on 23 February. Tanzania. No new reports of swarms. DRC (Democratic Republic of the Congo). A small group of mature Desert Locust arrived on the western shore of Lake Albert near Bunia on 21 February after crossing northern Uganda on strong northeasterly winds. The country last received Desert Locust in 1944. Saudi Arabia. Ground control operations increased against hopper bands on the Red Sea coast and immature groups and swarms in the interior. Yemen. Another generation of breeding is in progress on the Red Sea coast where hatching and early instar hopper bands are forming. Immature and mature swarms were reported in the interior during this past week. Surveys remain limited and control could not be carried out. Persian Gulf. During several days of strong winds, dense immature swarms arrived in Kuwait, Bahrain, Qatar and along the southwest coast of Iran between Bushehr and Kish Island on 20-21 February. More swarms are likely during periods of southerly winds. Control operations were immediately mounted in Iran.

What's Best For Single Seniors?

Where should a single senior in her 80's or 90's live?  Independent living in a senior community, assisted living in a senior community or in his/her own home?  I've been thinking a lot about this lately, as my mother, now in her high 90's is trying to decide where to live for the rest of her life.

Assuming money is not an issue, most seniors have several choices.  If money is an issue, it is often best to find independent or assisted living in a moderate community.  After all, independent living can range from $3-4 thousand dollars at the low end, to over $15,000 at the high end.  That's the rate per month.  I know because I just went and looked at an independent community that was $14,500 per month, and that doesn't include everything.

One of the big problems for seniors as they age, especially if they don't have family nearby, is who will care for them if they get sick?  In assisted living there will be nursing care provided.  In independent living there may also be nursing care, and if the situation calls for it, a person may be forced to move from independent to assisted living.  The problem is continuity.  You will most likely have a different nurse every time, maybe three different people in one day.  If a senior is living at home he can have the same person all the time.  Having the same nurse or caregiver all the time gives the senior a real sense of security.  I know this is true for my mom.  One of the reasons she likes living on her own is that she has the same person with her all the time. That works for her.

The most positive aspect of living in a senior community is the social life.  There are so many activities, and meals with others are certainly more fun than meals alone.

After looking at several facilities with my mom we have decided that staying in her own home is best for her.  She would love the community of a senior living facility but there are too many negatives that come with it. 

I wanted her to make the decision on where to live while she is in good health and choose her own path.  Too many people wait until they are in a situation where they live is chosen for them.  I didn't want that to happen to my mom.  I'm glad we looked at all the options.  For her, staying where she has lived for almost 70 years is best. 

Loss of Focus and Concentration in Older Adults

I was discussing with my mom recently the fact she and I both find it hard to focus and to concentrate as easily as we used to.  (Mom is 97, I'm 74).  I mentioned to her that when I read a book I often have to close my bedroom door, as I find the noise from the TV in another room very distracting.  There was a time when I could read and listen to music with no problem.  She mentioned that she no longer drives with the radio on, as she finds it very distracting.  I have noticed the same thing.  If I am carrying on a conversation while driving, my driving suffers.  It's alarming when you first notice it, but it is normal.

Older adults appear more easily distracted by irrelevant information than younger people when they experience stress or powerful emotions -- and a specific network in the brain recently identified as the epicenter for Alzheimer's and dementia may be to blame.

A USC-led study finds that seniors' attention shortfall is associated with the locus coeruleus, a tiny region of the brainstem that connects to many other parts of the brain. The locus coeruleus helps focus brain activity during periods of stress or excitement.

Increased distractibility is a sign of cognitive aging, said senior author Mara Mather, an expert on memory and professor at the USC Leonard Davis School of Gerontology. The study found that older adults are even more susceptible to distraction under stress, or emotional arousal, indicating that the nucleus's ability to intensify focus weakens over time.

Can we do anything to slow down the process or get back the focus we had when we were younger?  Yes, we can do some things, but we will probably never have the focus we had when we were young.  Accepting the fact that you are older and this happens to everyone is not the answer.  It happens quickly to some people, more slowly to others.  The key is to continue to do things that are hard for you, that cause you to challenge your brain and focus.  Do not give tasks to others that you are capable of doing.  For example, balancing your check book may be more difficult for you now, but don't give up doing it.  Keep at it.  It's good for your brain, good to challenge your brain.  Often when with a group of people, there may be more than one conversation taking place.  You may find it hard to concentrate on your conversation with the distraction of another.  Work at it, focus on the people you are talking to.  It's good for you!

In another blog I will give you some actual exercises that can be done to help focus and concentration.  The old saying, "Use it or lose it" applies to our ability to focus.  The more you work at it, the less likely you are to lose it.  

Why You Shrink As You Age

Have you noticed that you're shorter than you were a few years ago?  Your pants may suddenly be too long on you and you look in the mirror and realize you are shrinking.  I have lost 2 inches in height over the past 20 years.  My mom has lost about 4 inches over the years, and another friend of mine just got measured at the doctor's office and discovered he had lost 4 inches in height.

Average people lose 1/4 to 1/2 inch every decade after age 40 or 50, with losses increasing in later years, and women generally losing more than men.  It varies a lot, some people losing a lot at one time, others not losing any height until they're in their 60's or 70's.  So why do we shrink?

People lose height because the discs between the vertebrae in the spine dehydrate and compress.  The agine spine can also become more curved, and vertebrae can collapse due to loss of bone density.

Losing height can be an indicator of health problems. The greater the shrinkage, the greater the risk of hip and other nonvertebral fractures.  Also, shrinkage can be a result of osteoporosis.

There's not too much you can do to prevent shrinkage, since genetics plays a big role.  However, even in later years you may be able to slow shrinkage by taking steps that will help protect your bones and muscles, such as doing weight bearing exercise, consuming adequae calcium, vitamin D and other bone healthy nutrients, not drinking alcohol in excess, and above all, NOT SMOKING.

Can Stem Cell Therapy Replace Knee Replacement?

Six months after a total knee replacement I am still not where I should be.  Weakness and pain, and an inability to get back to my normal activities are just some of my problems.  So, when I started talking to the woman sitting next to me on the plane ride from San Diego to Denver and she told me she was just returning from Tijuana where she had stem cell therapy, my ears perked up.

She had gone to a Tijuana clinic last year for her left knee, and her results we so good that she went back to have her other knee injected.  She explained the process to me.  It's a minimally invasive procedure, where one's own stem cells are removed from your body, either through the hip or the belly button, then injected into the knee.  It takes several months to evaluate the results.  Researchers believe that stem cell therapy for the knee works by developing into essential cartilage cells, thwarting the inflammation that can worsen arthritis, and releasing proteins called cytokines that slow degeneration of cartilage and reduce pain.

Stem cell therapy is available in the U.S., but is not covered by insurance yet.  The same procedure is done in Tijuana and other locations outside the U.S, at a fraction of the cost.  The cost in Tijuana is around $2,500 per knee, where the same procedure in the U.S. is about $20,000.

Most experts feel stem cell therapy will be covered by Medicare and other health companies in the near future.  This is very promising procedure for those with osteoarthritis.

EAT: Equine Assisted Therapy

Since the ancient Greeks, horses have been utilized as a therapeutic aid for people with all kinds of ailments.  Hippocrates discussed the therapeutic value of riding in his writings.  More currently, Hippotherapy was developed in the 1960's, when it began in Germany, Austria and Switzerland.  It was used as an adjunct to traditional physical therapy.  Therapeutic riding began with Liz Hartel from Denmark.  Her legs were paralyzed from polio, but with therapy was able to win  the silver medal for dressage in the 1952 Olympics.  Therapeutic riding has been used in the U.S since the 1960's, when it was used to address orthopaedic dysfunctions like sciolosis.  Today it is used for all kinds of disabilities, from blindness to mental illness.

Horses are trained and selected specifically for therapy before being integrated into a program.  Any breed of horse can be used, but the horse must be calm, even-tempered, gentle and serviceably sound.

Today, equine-assisted therapy is used by medical professionals such as occupational therapists, physical therapists, speech-language pathologists, psychologists, social workers and recreational therapists.  It has been shown, along with more traditional methods of treatment, to improve the quality of life for those receiving it.

Do You Know What Medical Benefits You Are Entitled To?

I thought I knew about the benefits of my health care plan, but I really only knew the basics, like deductibles, co-pays and prescription costs.  There is much more to know, as I am quickly finding out.  I feel that every patient with a terminal disease needs an advocate.  The advocate may be a spouse, friend or other relative, or a professional.

As terminal diseases progress, the patient needs more care, more equipment, more of everything, especially nursing or some kind of home health care.  How do you find out what you're entitled to?  I started by asking the home care social worker, who led me to the ALS Clinic, who led me to the social worker who dealt only with ALS issues.  If you have Parkinson's or MS or Alzheimers, there are specific people that can help you.  The social worker will tell you what you are entitled to with the insurance you have, and help you get exactly what you need.

I thought I knew a lot, but I didn't.  Did you know that each city (San Diego for us) has grant money that can be given to help patients with specific diseases?  If you have Alzheimers, there is a lot of money available.  If you have ALS, there is no grant money available.

Pallitive care is something that most people can take advantage of.  You just have to know who to ask and what to ask.  There is help out there for everyone.  It's a matter of getting to the right person who can guide you.  I talked to neighbor of mine last month.  His wife has both Alzheimer's and MS.  He and his daughter have been doing all the caregiving for his wife, when he could be taking advantage of grants and home health care to assist.  We have to advocate for ourselves and our loved ones.  There is a lot of help out there, if you know where to find it.

The Wisdom of the Crowd

Dr. Lisa Sanders, longtime author of a medical article in the New York Times Magazine, is on to something.  She is trying to find a diagnosis for individuals with rare diseases.  She has a new show on Netflix, called Diagnosis, and I am hooked.

Dr. Sanders seeks out the most unusual cases that doctors are stumped by and puts them out on the internet.  She feels the wisdom of the crowd will help if not find a cure, at least give the patient a diagnosis.  Dr. Sanders puts the information out, hoping people with similar symptoms, or researchers from around the world that may be working on an unusual disease, to see her post, and speak out.  Often an individual case will get thousands of responses, with doctors and lay people offering their opinions.  Through the use of the internet, Dr. Sanders has brought families with rare conditions together so they have a community of people who understand what they're going through, even if there is no cure.  In other cases, the internet helped a young woman from Las Vegas find a cure for her chronic extreme muscle pain, from a team in Turin, Italy, who just happened to be researching her specific condition.

To me, this is one of the great uses of the internet.  It has become a resource and an informational source like no other.  People from all over the world can contribute in a big way to solving medical mysteries.  There is nothing more frustrating than going from doctor to doctor to try to get a diagnosis on your condition.  I know this first hand from the 6 months it took for Ron to get an ALS diagnosis, and this is a disease doctors know a little about.  Take a rare condition that doctors may have never seen, and the situation becomes much worse.

If you have the time, check out Diagnosis on Netflix.  I have watched four episodes, and can't wait to watch the next one.  Episode one is my favorite.  It shows the power of persistence, the awesome reach of the internet, and it has a happy ending.

Warnings About Sugar

I don't usually read Good Housekeeping, but I was waiting for my physical therapy appointment the other day, and picked up the magazine.  As I thumbed through it, I noticed a small picture of something that had first been published in their magazine in 1927.  It was a skull and crossbones, with a bag of sugar.  They knew then that too much sugar was not good for you, and here it is, 90+ years later, and we're still having the same conversation.  I guess it takes a long time to get the message out to the public.

We all know the negatives of sugar.  Weight gain, diabetes, heart disease, you name it.  Sugar can be a contributing factor.  In 1927 when Good Housekeeping first told us of the dangers of sugar, the average American was eating 100 pounds of sugar a year.  Can that be right?  It sounds like a lot, and I thought that with artificial sweeteners Americans would be eating less sugar today, but that is not the case.  Americans are eating about 150 pounds of sugar per person today.  I guess that's because some form of sugar is in almost everything we eat, from crackers, to canned veggies, to cereal.  It was not this way years ago.

Corn syrup, another form of sugar, was identified years ago as a culprit in making America fat.  Most manufacturers have reduced or eliminated corn syrup from their products.  (Ocean Spray led the way on this).  Is artificial sweetener a better choice?  There are opinions on both sides.  The real answer is to eliminate as much processed sugar as possible and get back to eating and enjoying real, natural food.

5 Weeks Post Op

I haven't felt like blogging for weeks now,but now I am back and ready to write a little.  My recovery from total knee replacement has been more difficult than I imagined.  My first knee surgery was a partial, which is so much easier.  When I went to see Dr. Bugbee a few days ago he said, "Now you know why I do a partial whenever possible."  Total replacement is so much more invasive, thus recovery is slower.

My biggest issue has been sleep.  I sleep for maybe two hours, then wake with pain or stiffness, and never get back in a deep sleep the rest of the night.  I had to get off the Norco, as it was making me feel fuzzy in the head and tired all the time.  I no longer have that extreme fatigue, but I am just plain tired from lack of sleep.  I have tried to control pain with Aleve and Tylenol, but it's just not doing the job.  I now have a 15 day prescription of Celebrex, an anti-inflammatory, that I 'm hoping will help.

The doctor says I'm healing well, the knee looks good, so why do I still feel so bad?  I need more time, he says, so I will try to be patient.  Everyone's different, and I just have to accept that my body is taking more time to heal than others.  The fact that I have additional stressors in my life probably contributes to slow healing, but I can't do much about that.  I'm just hoping that I will feel stronger soon.  We want to go out to dinner, and I'm not quite up to that yet.  For now, I will stay close to home, go out and do one thing each day (haircut today), nap, and try to get stronger.  As the old saying goes, "This too shall pass."

What Do Dates On Grocery Items Mean?

Our country wastes close to 30% of food purchased, for a variety of reasons.  One reason is consumers buying too much food, that ends up going bad.  Another reason is the dates printed on food items that tell consumers things like, best used by, expires on, and other terms that end up making consumers think the food is no longer edible.  Most of those terms do not mean what people think they mean, so here is a little info on how to determine freshness in food.  Don't throw food out until you know what that date means.  In some cases, it's there for the manufacturer, to rotate shelf food.

Key Terms and Phrases to Know

Open Date uses a calendar date on a food product. The Open Date is not a safety date, instead, this label tells how long to display the product for sale at the store.

Best if Used By (or Before) date is recommended for best flavor or quality. This is not a date to purchase by, nor is it an indication that the product is unsafe after this date.

Use By date is the date recommended to use the product by in order to have the best quality. This date has been determined by the manufacturer of the product. Even after the Use By date, a food should remain safe and wholesome if it has been properly stored and handled. The Use By date is required on infant formula because, over time, formula can separate and clog the bottle’s nipple. Do not use infant formulas or similar medicinal food products such as oral nutritional supplements or meal replacements after its Use By date.

Closed or coded dates are packing numbers for use by the manufacturer.

Packaged on, Manufactured on or Prepared on. Packaging dates are closely related to best before dates and are intended to give consumers an idea of how long a product will maintain it’s quality. These dates are used on food products with a shelf life of 90 days or less.

Sell by or Freeze by dates are other voluntary markings used in Canada specifically, and can help the consumer make decisions about purchasing and storing food.

Canned foods are safe indefinitely except when they are exposed to freezing temperature or temperatures above 90° (32.2°C). A general rule is if the cans are not rusted, dented or swollen, they are safe for consumption; however, the following canned items are best used by the dates outlined below.

• Canned tomatoes –  use within 12-18 months of purchase
• Canned fruit –  use within 12-18 months of purchase
• Canned vegetables – use within 2-5 years of purchase
• Canned meat and fish – use within 2-5 years of purchase

Eggs

Purchase eggs before the Sell By or Expiration (EXP) date on the carton and use within 3-4 weeks of purchase. Refrigerate them in the original carton and store in the coldest part of the refrigerator, not in the door.

Robyn Barefoot, a registered dietitian and expert in reducing food waste, shared these guidelines for meat, fish and poultry:

Meats

Fresh meats such as beef, pork and lamb should be used within 2-4 days and kept refrigerated at 4 °C (40 °F). If it is brought home and placed directly in the freezer, it should be frozen at – 18 °C (0 °F) for up to 8-12 months. Ground meat and fresh seafood are an exception – due to their smaller surface area and increased exposure to oxygen, ground meats and fish such as scallops and shrimp should be kept in the fridge only 1-2 days before consumption and can last in the freezer for 2-3 months.

Fish

Lean and fatty fish (cod, flounder, salmon) should be used within 3-4 days when refrigerated. If freezing fish, lean white fish can be frozen up to 6 months but fatty fish such as salmon and trout only 2 months.

 Poultry

Use poultry within 2-3 days of purchase or freeze for 2-3 months.

Hopefully these guidelines will help you waste less food.  Prisons, for example, buy almost nothing but food with expired dates.  The food is still safe to eat, but possibly not at its peak.  Buy less, and use what you  have before buying more.  If your freezer looks like mine, it has little bags of bread, meat, chicken and leftovers that have been around for months.  I should use it up before buying more, but that's hard to do.  Anyway, I hope these hints will help you waste less food and lower your food bill.

Remembering Past Events: Write It Down!

By sheer accident I was checking my blog today, when up popped a post I had written on August 8, 2014, four weeks after the partial knee replacement of my left knee.  I couldn't believe what I had written.  I remember correctly the positive part of the surgery and recovery, and completely forgot all the negative.  What I wrote 5 years ago, was that the first 10 days went very well, and I was back to the gym and thought everything was going easily.  When I got to week three, I experienced lots of pain, difficulty getting off the Norco, not feeling well, and not sleeping, all the things I am now experiencing.  What a shocker if was for me to read this.

It has been 17 days since my surgery, as I write this blog.  My physical recovery has again been quick.  The physical therapist released me, as my movement and range of motion are all above normal.  My problem is pain.  I want to get off Norco, because it makes me feel bad, no appetite and fuzzy in the head, so I have switched to Aleve and Tylenol PM, as my basic pain relievers.  This time around I have an additional problem, and that is lower back pain on occasion.  It's hard to get rid of, and sometimes the only thing I can do is sit in a straight chair in the kitchen in the middle of the night until it subsides.  Really interrupts my sleep.

So, here's my advice.  If you really want to remember an event, document it either by writing about it or taking a video.  You won't remember it correctly years later.  The mind protects us, I think, from negative experiences and pain, otherwise why would anyone ever have more than one child?  So glad I read this old blog this morning and realized that what I am going through now, is not all that different than what happened 5 years ago.  I will keep on my pain med regimen, and hope, in another 7-10 days that most pain will subside.

What is Arnica?

Many people, from my sister to nurses and physical therapists in the hospital, recommended I add arnica to the list of meds I was taking after surgery.  I had tried it before and was unimpressed, but I decided to try again.  It couldn't hurt.

Arnica is an oval-shaped leaf with a bright yellow, daisy-like flower, that when dried, is primarily used to reduce bruising and pain from wounds.  Arnica is classified as an unsafe herb by the US Food and Drug Adminstration.  (why am I even thinking of taking it?).

The flowering heads of arnica have been used medicinally for hundreds of years.  Aarnica was used extensively in European folk medicine and alcoholic tinctures were produced by early North American settlers to treat sore throats, as a fever reducer, and to improve circulation.  Homeopathic uses include the treatment of surgical or accidental trauma, as a painkiller, and in the treatment of postoperative inflammation of the vein caused by a blood clot.  It has been used externally for bruises, acne, sprains, and muscle aches.

Overall, there does not appear to be sufficient evidence to support the use of arnica as an anti-inflammatory or pain relief agent, or to prevent bruising.  However, differences in doses and delivery forms in clinical studies make generalizations difficult.

My personal experience with arnica is that it does absolutely nothing.  It has not reduced inflammation or pain, nor has reduced bruising.  It is listed by the FDA as toxic because it unsafe to ingest orally.  Many people seem to believe in the this homeopathic treatment, but for me, no.  As with so many homeopathic medications, the testing is spotty.  Fortunately there are no serious side effects, so there is little harm in trying it.  I have a tube of it if anyone wants to try it.

Always Changing

I had my first partial knee replacement almost 5 years ago.  I was 69 years old, in excellent physical shape, and was back at the gym in 12 days.  5 years later I underwent a total knee replacement (other knee), was not in great physical shape, and am suffering the consequences.  Right now I am 18 days post surgery, and still having a difficult time.

Yes, I realize that 5 years makes a big difference, but I feel the physical shape I was in for my first knee replacement had a great deal to do with my quick recovery.  I had been taking spin classes for several years, three times a week, prior to surgery.  Now, most of activity is walking.  Walking is good, but it doesn't build the muscles around the knee as spinning does.  I will be patient, knowing that within a few weeks I will be feeling better.  It's hard to wait.

Hospital procedures are always changing, and I noticed a big difference in the way things are done now, and the way they were done 5 years ago.  What hasn't changed, is the days in the hospital.  It's usually one night, sometimes two nights, and if Medicare requires, three nights.  A friend of mine had her surgery done at Kaiser and she had surgery and came home in the same day.  That's quick, I think.

Even prior to arrival I was swabbed for Mersa.  This is a change from five years ago.  In addition to special soap for washing that was used five years ago and is still used, an added level of cleanliness is added.  Right before surgery, my entire body was swabbed with antibacterial towels.

I was surprised when I went to skilled nursing after one night in the hospital that the  first thing they did was give me a TB test.  They wanted to make sure I didn't pick up anything in my 24 hours in the hospital.

Because of high rates of infection in hospitals and skilled nursing facilities, cleanliness is at the top of their priority list.  I still can't figure out with all the anti bacterial procedures they use that infection would be a problem, but it is.  The best thing to do, is to avoid the hospital.  It's a catch 22.  They want to get you in and out of the hospital as quickly as possible, often risking other complications because of the short hospital stay.

Stay in shape.  It's your best chance for a quick recovery.  I am paying the price now, with a slower recovery.  I know in a few weeks I will be feeling better, but for now, most of my time is spent resting and sleeping.

Finaly, Feeling Better

It's been 13 days since I had my right knee replacement.  This is the first day I have gotten up and felt human again.  Actually, day 1 and 2 were fine.  That nerve block they give you makes you feel invincible.  But, being a veteran of several surgeries, I knew what was to come.

On day 2 I moved to Seacrest Village for rehab.  I was there because going home and taking care of Ron was out of the question.  Dan, our nurse, driver, dog walker, cook, housekeeper and all round fantastic companion, was home to help Ron.  That worked out better than I could have imagined.  Ron was happy and well taken care of, and I could comfortably rehab at Seacrest without worry.

I spent 7 days at Seacrest, working hard at physical therapy, visiting with lots of friends, and resting.  Not much sleeping, but lots of resting.

I walked out of Seacrest  on May 10, and I have been recovering at home ever since.  A full replacement, I would find out, is a lot harder than a partial.  I am now on  day 13, am taking meds every 6 hours, doing PT at home (Iknow all the exercises) and sleeping.  Finally, I sleeping better.  I think the lack of sleep is due to the Norco, which makes me edgy and unsettled.  The sooner I get off it, the better I will sleep.

I will have more to say about the surgery, the meds, the rehab, and the incredible support I've gotten from family, friends and neighbors, in future blogs, but for now, I just wanted to let you know that I'm back among the living, feeling good, but not great.  As if knee surgery weren't enough, I have a torn rotator cuff too, which the doctor has been treating with every 3-4 month cortizone shots.  It's been 4 months since my last shot, I'm really hurting, so I'm off to Scripps Rancho Bernardo this morning for a shot.  I know I will be smiling when I leave Dr. Alberton's office.  More later.

You're Never Too Old To..........

Have you ever wanted to do something you've never done before, learned something you've always wanted to learn?  A new language?  Piano or guitar?  Ballroom dancing?  Painting or sculpture? We've all done this, and often the answer we give ourselves is "I'm just too old."  That is just not so.

Some Friday mornings I teach bridge at the Solana Beach Library.  Most of the students are in their 50's, 60's, and 70's.  I was teaching one Friday morning and was introduced to a 100 year old woman named Mimi, who has just started learning bridge!  Imagine that.  I was surprised, not only because she looked to be in her mid 80's, but her attitude in general was so youthful.  She has been coming every Friday for several months, and although she'll never be Charles Goren, she is learning, progressing, keeping her mind active, and above all, having fun.

So when you think you're too old to try something new, think of Mimi, and get out and give whatever it is, a try.  You may surprise yourself.

Why Are We Getting So Fat?

There is no simple answer, but after watching a documentary about Dr. Giles Yeo and his study of genetics in the UK, I realize that genes, environment and diet influence your weight.  Why people eat more is complex, but statistics show that people are so much heavier than ever before.  It's important to know your BMI.  If it's more than 25, you are overweight.  60% of Brits are now overweight, and it's much higher in the U.S.  Fast food is a big contributor.  Fast food restaurants have increased 45% in the last 20 years, and living near fast food outlets doubles your chance of being obese.

Genetics plays a big role in obesity.  Your FTO can be measured, which will tell you whether you have risk variants for obesity.  If you have two FTO's you are more likely to be obese, as you will gravitate to foods high in fat and carbs, and low in fiber.

Gut bacteria, of which we all have somewhere around 100 trillion in our body, can also have an influence on weight.  Donor feces is now being studied (fecal transplant) that will replace the ad bacteria one may have with good bacteria.  Also, using the feces of lean donor as opposed to overweight donors, has been found to influence GLP1, an important hunger hormone.  It's all complicated, and there are no easy answers, but science has determined that the Mediterranean diet is probably best overall.  It consists of a variety of foods, lots of fresh fruits and veggie, yogurt (good for the gut), olive oil, olives, fish and lean animal protein.  Scientists now think that bacteria may be the key to weight control.

One scientist felt sure that in the next ten years there will be a hormone injection available that will be easy, inexpensive, and pretty much end obesity.  In the mean time, millions of people world wide are struggling, many thinking it's their fault that they're fat, when in fact there are many other factors that may be contributing to their problem. 

Heroin Addiction

• “In your mind, you can be O.K., you can just do one. But one is too many, and a thousand is never enough.” — Bruce Cherry, 58, Pennsylvania
• “In the beginning, it feels really good. You’re paying to get high. And toward the end, you’re feeling really stupid, because you’re paying not to be sick.” — Raj Mehta, 51, Michigan
• “Do not believe the hype. Do not believe your eyes. In the end, it’s not worth it.” — Jasmine Johnson, 29, Pennsylvania

A Visual Journey
Through Addiction

Why do people start taking opioids and why can’t they stop? Through interviews with users and experts, The New York Times created a visual representation of how these drugs can hijack the brain.

Written by SHREEYA SINHA illustrations by ZACH LIEBERMAN and LESLYE DAVIS

DECEMBER 18, 2018

The opioid epidemic is devastating America. Overdoses have passed car crashes and gun violence to become the leading cause of death for Americans under 55. The epidemic has killed more people than H.I.V. at the peak of that disease, and its death toll exceeds those of the wars in Vietnam and Iraq combined. Funerals for young people have become common. Every 11 minutes, another life is lost.

So why do so many people start using these drugs? Why don’t they stop?

Some people are more susceptible to addiction than others. But nobody is immune. For many, opioids like heroin entice by bestowing an immediate sense of tranquility, only to trap the user in a vicious cycle that essentially rewires the brain.

Getting hooked is nobody’s plan. Some turn to heroin because prescription painkillers are tough to get. Fentanyl, which is 50 times more potent than heroin, has snaked its way into other drugs like cocaine, Xanax and MDMA, widening the epidemic.

To understand what goes through the minds and bodies of opioid users, The New York Times spent months interviewing users, family members and addiction experts. Using their insights, we created a visual representation of how the strong lure of these powerful drugs can hijack the brain.

Dr. Pedro Mateu-Gelabert, one of the nation’s top opioid researchers, said this work brings “an emotional understanding” to the epidemic but “without glamorizing or oversimplifying.”

We invite you to share your experiences at the end of the page.

If you or someone you know is struggling with opioid addiction, call 1-800-662-HELP.

Stage 1 Gateway

“It’s like being hugged by Jesus.” — Amanda Ryan-Carr, 24, Pennsylvania

“I remember feeling like I was exhaling from holding my breath for my whole life. Just intense relief from suffering.” — Matt Statman, 48, Michigan

You naturally produce endorphins, the body’s own version of opioids, which act in the reward circuits of the brain to make you feel good after you work out, hug a friend or eat your favorite foods.

A drug like heroin creates a tidal wave in the reward circuits of the brain. To an outsider, it looks as though you have passed out. But on the inside you feel like a master of the universe, like you’re being “hugged by Jesus,” as one user said; there’s peace in your skin and not a single feeling of pain.

You may remember this exact moment for years to come: where you were, what you wore, what you saw and what you heard. You may chase this feeling for years.

As the high wears off, the brain regains its balance – but not for everyone. That’s the opioid trap for many people: In the beginning, no serious ill effects are apparent. But the brain rewires little by little with each use.

Stage 2 Tolerance

“It was like the high put on blinders to everything and made me not care about anything in the world, other than the heroin.” — Brandon N., 26, Pennsylvania

“Any time you start to feel like you’re getting antsy or anxious or a little stressed, your body says it knows exactly how to get out of this, and it’s telling you to just go get a little bit more of that heroin.” — Ivana Grahovac, 42, California

You’re chasing the siren of the first high by taking more. But even a thousand more doses will never bring back the experience of that first time.

The brain balances its own endorphins like a thermostat. When an external source keeps flooding the brain, it throws that system off.

Like other drugs, opioids produce a surge of dopamine, a chemical messenger that tells the brain that “taking this drug is good, repeat it.” The brain’s response to opioids and the surges in dopamine they cause can rewire circuits in the brain.

The brain’s response to these chemical changes make life difficult without the drug. Stress and irritability creep in, so you take more opioids to cope. Soon, nothing else in life provides any satisfaction.

The pleasure and reward cycles flip: You get less pleasure from the drug, but want it all the more. The more you seek and take the drug, the more the brain adapts to the drug and demands more.

Stage 3 Withdrawal

“It’s like a demon crawling out of you. You’d rather just die and be done with it than go through that.” — Jasmine Johnson, 29, Pennsylvania

“Everything hurts. It hurts to comb your hair. It hurts to shave. You have no energy. You feel weak. You feel a sense of desperation. You have constant impending doom and anxiety, because you realize that with one pack of dope you can change how you feel within a matter of 10 seconds.” — Raj Mehta, 51, Michigan

The final trap of addiction is laid when you muster the courage to stop. You may not even realize you are physically dependent until you experience withdrawal for the first time.

There might be crippling pain, vomiting, insomnia, spasms, hot and cold flashes, goosebumps, congestion and tears. All this on top of debilitating anxiety and depression. You might feel like you’re having the worst flu of your life, or like a demon is crawling out of your skin.

This misery could last for weeks.

Dying from withdrawal is uncommon, but it doesn’t feel that way at the time. These harsh symptoms can make quitting seem impossible.

Stage 4 Addiction

“It’s like a time bomb. You’ve got 24 hours to get heroin, or you’re going to be really sick. You wake up, and your whole life is just based around it.” — Raj Mehta, 51, Michigan

“I felt like all my relationships were very surface-level, and really I was holding people hostage. No one was really my friend. I just wanted to take things from them.” — Mandy McCandless, 23, Pennsylvania

“I would see an old lady on a Mac and would think, ‘I could grab her pocketbook for cash.’ That was probably the beginning of the end.” — Jim Pietrowski, 57, Pennsylvania

The brain screams for more. Scoring the next fix feels like a race against the clock of withdrawal. You may feel like only a fix can save you. It makes no sense, but this compulsion takes over all logic, judgment and self-interest. You may do things you never thought you could.

Sell your body. Abandon your child. Steal from your mother. You might lose your job. Lose your home. Lose your loved ones. In this sad stage, families are torn apart.

Sharing needles can make things even worse, and bring about hepatitis and H.I.V.

A shadow of your former self lives in shame.

You’re now addicted to opioids and you no longer take the drug to get high, but to escape feeling low. The brain has adopted a new form of compulsion that can reassert itself even after years of sobriety.

Stage 5 Treatment

“My brain felt like it was rewired. My body, mind and soul. It's a day at a time. I can do anything for a day. Once I bought into that and made some other friends, things started to change for me.” — Jim Pietrowski, 57, Pennsylvania

“There was a push factor, which was the misery and the self-hatred and the depression and the cops, and then there was a pull factor, which was this amazing hope from this community of people who I knew understood me in a way nobody else in the world could.” — Matt Statman, 48, Michigan

You hit rock bottom, perhaps after a run-in with the law. You fear withdrawal. You dread confronting why you started and who you have become. Willpower alone may not be enough, and quitting cold turkey could increase the risk of overdose.

You may not have access to treatment. You may not be able to afford it. Or you’ve heard that quitting is impossible and that taking medication to help is simply swapping one drug for another.

Treatment centers that promote abstinence are at odds with the medical standard of care — long-term use of medications, like buprenorphine, methadone and naltrexone. But only about 25 percent of outpatient centers provide them.

These medications soften the cravings without causing euphoria. They help reset the brain’s thermostat, so it can stop thinking about opioids 24/7 and the hard work of recovery can begin.

Every person is different, and underlying issues, such as mental health problems, can affect a treatment plan. But therapy and community help increase the chances you stick with it.

Stage 6 Relapse

“A lot of times in your addiction, things are getting better. You see a light at the end of the tunnel. And it ends up being the freight train coming at you.” — Jasmine Johnson, 29, Pennsylvania

“That old impulse comes back, that old habituated response, which is: ‘This is hard. You’re going to fail. Don’t even try to get well. You’re just going to end up back in it. So just go get high right now.’” — Ivana Grahovac, 42, California

Relapse is a normal part of recovery, but it also brings dangers. After abstaining from the drug, your tolerance decreases even if the cravings remain intense. The same amount of the drug that you took before can result in overdose, especially if it’s laced with fentanyl or mixed with benzodiazepines and alcohol.

In an overdose, your body is unable to handle the drug and your breathing slows or stops.

Seventy-seven percent of opioid overdose deaths occur outside medical settings, and more than half occur at home. This year, the surgeon general advised Americans to carry naloxone, a life-saving medication to resuscitate victims.

Once revived, you may feel anger and shame, or face stigma and judgment, which can fuel the cycle.

For the families of those who are addicted, life has become a rollercoaster ride.

Stage 7 Recovery

“Colors get brighter and smells are more intense and emotions just are much more powerful, because opiates numb them.” — Dove Henry, 26, Montana

“I didn’t have interests or hobbies or anything. So finding what I really liked doing was really beneficial to me. Because if you don’t have fun, then you’re not going to stay sober.” — Rebecca Ronning, 24, Minnesota

“From now on, I have to guard my sobriety with my life, because my life depends on it.” — Ivana Grahovac, 42, California

Recovery is complicated and takes time, but it’s not impossible.

Experts say treatment could require six months to 20 years. One expert says the average person could relapse four or five times over eight years to achieve a single year of sobriety.

Some people may have to remain on medications indefinitely; for others, a doctor may taper them off. But doctors don’t know when the brain has reset itself and is no longer at high risk for substance use.

Factors like health insurance, housing and income can determine how long you remain on medication. Like a child, you also need to learn new behaviors and rebuild your life. It’s a journey to accept, control and heal the feelings that led to addiction.

Only one in five people who need treatment for drug use actually receive care, and only about half of those are given medication, experts say. Those given medications rarely receive them for long enough.

This article was taken from the New York Times on December 23.  Having seen how heroin can affect the person and the family close up, I felt compelled to copy this article in its entirety, in the hopes that some of you will read it.  Heroin is unlike other drugs, as it rewires your brain.  We have an epidemic in this country, and no solution in sight.  We all the rehab centers we have, no one has really figured out how to treat heroin addiction.  Hopefully this article will give you a better understanding.