5 Things to Know About Pacemakers

Donna Lulay, a retired educator, had open-heart surgery in 2007 to replace her aortic valve due to a genetic heart valve defect, and in 2023 needed surgery to replace the valve again. The procedures were a success despite one not so uncommon complication: After the second surgery, her heartbeat was slower than it should be, putting her at risk for serious health complications.

Lulay, now 66, was told she needed a pacemaker to help regulate it. “I was so upset,” says Lulay, an avid hiker, skier, walker and all-around active individual who also happens to be my first cousin. “Getting a pacemaker when it was unexpected was a shock.” But now, almost a year later, Lulay is back to exercising and traveling, and says she feels “more confident” not having to worry about her heart functioning properly.

Here are five things to know about pacemakers and how they work.

1. Roughly 3 million Americans are living with a pacemaker.

Lulay is one of nearly 3 million people in the U.S. who has a pacemaker, a small battery-powered device that prevents the heart from beating too slowly. Terminator actor Arnold Schwarzenegger, 76, is another  

Most people with pacemakers — more than 70 percent — are 65 or older, according to Yale Medicine.

2. People with abnormal rhythms may need a pacemaker.

There are several types of cardiac devices that can be implanted, or placed under the skin just below the collarbone with wires leading to the heart. A pacemaker is one of them.

It’s needed when the heart doesn’t beat normally — it may be too slow or the electrical signals that control the heartbeat are disrupted.

The device consists of a generator with a battery that provides the electrical impulse for the heart to beat, sensors (electrodes) and wires (leads) that deliver the electrical impulse to the heart muscle. The pacemaker monitors the heart’s rhythm and if it detects certain abnormalities, it will generate an electric impulse so the heart can beat with a normal rhythm.

For many patients, a pacemaker works only when needed — if the heartbeat gets too slow, it will jump in and correct it. However, some people are considered “pacemaker dependent” and rely on the device to constantly regulate the heartbeat. 

You may need a pacemaker if you have an abnormal heart rhythm that is considered serious and is not expected to go away on its own or with other treatment. You may also need one if a less serious rhythm issue causes symptoms such as lightheadedness or fainting, or prevents you from doing your day-to-day activities.

Common reasons that pacemakers are placed include:

• Sinus node dysfunction: The sinus node is specialized heart tissue in the right atrium that initiates the electrical impulse for your heart to beat.
• High-grade block: when a section of the heart’s conduction system does not transmit the electrical signal, for example at the atrioventricular (AV) node that sits between the upper and lower heart chambers.
• Fainting due to abnormal heart rhythms.
• Damage to the heart’s conduction system after procedures such as open-heart surgery or having an aortic valve replaced using a catheter.

There are several tests that your doctor can perform to determine if a pacemaker is right for you.

Understanding the heart’s electrical system

The heartbeat is an electric signal that is generated in specialized tissue, called the sinus node, in the heart’s upper right chamber, known as the right atria. This signal causes both the left and right atria to contract.

The signal then travels to another area of specialized tissue in the heart called the atrioventricular (AV) node that lies near the border of the upper and lower chambers, finally reaching the two lower chambers (left and right ventricles) and resulting in contraction of the ventricles.  

Normal heart rates are between 60 and 100 beats per minute. 

3. Getting a pacemaker can be a quick process.

The procedure takes approximately one to two hours to complete, and you will be given medicine to make you comfortable but not put you to sleep. A small incision (about 2 inches) will be made on the chest, just below the collarbone, usually on the left side.  The generator is then inserted under the skin.  

The leads have one end inserted into the generator and the other end guided through a blood vessel to a chamber of the heart. Patients generally stay one night in the hospital after getting a pacemaker placed.

Though uncommon, there are some risks to the procedure. These include perforation (a small hole or tear) of a blood vessel or cardiac chamber, a collapsed lung and infection at the site of implantation.

After the procedure, you’ll be somewhat limited in what you can do — especially when it comes to lifting and moving your arm, even driving. But these restrictions typically last only a few weeks.

4. Your heartbeat will be regularly monitored.  

You will be set up for home monitoring once you get a pacemaker. The monitoring system may be an app on your smartphone or tablet, or a unit that fits on your bedside table. Information from your pacemaker is encrypted and then sent automatically to your doctor’s office and downloaded into your medical chart. The monitoring also shows how often your body has needed to rely on the pacemaker and any abnormal heart rhythms that have occurred. 

Regular monitoring and in-person doctor’s appointments decrease the likelihood of complications. Infections can happen, even long after implantation. If the infection cannot be cured with antibiotics, you may need to have the pacemaker removed and a new one put in.

Another potential complication is that your tricuspid heart valve — which helps blood flow between the two right chambers — could become leaky. This happens when the leads interfere with the function of the valve. It can be managed with medical treatment as well as changing the placement of the lead.

The battery life of a pacemaker is between five and seven years. Replacing the battery can be done with either an outpatient or inpatient visit. 

5. Pacemakers don’t mix well with some devices. 

With a pacemaker, Lulay says she worries less about her heart and doesn’t feel like the device inhibits her lifestyle. She’s back to traveling and just returned from a trip to Australia and New Zealand.

However, there are some things to be aware of if you have a pacemaker, particularly other machines and devices that can disrupt its function. Jens Cosedis Nielsen, a professor of medicine at Aarhus University in Denmark and a chairperson for the 2021 European Society of Cardiology Guidelines, says patients should stay away from equipment with magnetic forces (like an MRI machine) and direct exposure to electrical currents (like electrotherapy).

And cellphones? People with pacemakers “can use a cellphone as everybody else,” Cosedis Nielsen says. “There is no problem to use your best ear, even if this is the one closest to the pacemaker.”

Here’s a look at what will — and won’t — interfere with a pacemaker:

Note: If you have a pacemaker, you’ll want to carry your pacemaker ID card with you. This has information on what kind of pacemaker you have and the manufacturer, and can help alert health care providers and others to any special accommodations.

The following can interfere with a pacemaker:

MRI: An MRI has a powerful magnet and patients with some models of pacemakers should not enter the MRI area in a facility. They make newer pacemakers that are “MRI conditional” and are better designed to withstand an MRI scan, so long as the pacemaker is programmed to MRI settings beforehand and then checked and reprogrammed back to original settings after.

Medical procedures: Some procedures that may present a problem include radiation therapy and extracorporeal shock-wave lithotripsy, which uses hydraulic shocks to dissolve kidney stones. Transcutaneous electrical nerve stimulation (TENS) for treatment of acute and chronic pain has a lower risk for any pacemaker problems. If a medical procedure will affect your pacemaker, the device can be turned off (unless you are dependent on your pacemaker) and then back on, or checked immediately after the procedure and reprogrammed if needed. 

Metal detectors and airport screening: Metal detectors won’t damage your pacemaker, especially as you pass through in a matter of seconds, but they may detect the metal in your device. Let the TSA agent know you have a pacemaker (keep your card handy). You may need to undergo a separate security procedure, such as screening with a hand wand.

Magnets: Strong magnets especially can inhibit pacemakers, so be sure to keep at least six inches away. The same goes for headphones that have magnetic material. Avoid magnetic pillows and mattress pads.

Electric fences: Avoid or limit exposure to electric fences and electric pet containment systems.

The following are felt to pose little or no risk to a pacemaker:

• Consumer appliances and electronics
• Microwave ovens
• Home computer components
• Yard equipment, such as hedge trimmers
• Security badge scanners
• CT scans

Source

Happy Memorial Day

 

“In valor there is hope.” — Tacitus

​11 Ways to Manage Sundown Syndrome​

If your loved one has Alzheimer’s disease or dementia, you may be seeing changes in their behavior in the late afternoon or early evening — a phenomenon known as sundown syndrome, sundowners or sundowning.​

What are the signs of sundown syndrome?

According to the Alzheimer’s Association, as many as 20 percent of people with Alzheimer’s experience sundown syndrome. When your loved one has dementia (and some other conditions, as well), the approach of sundown can trigger sudden emotional, behavioral or cognitive changes. These might include:

• ​​Mood swings​
• Anxiety
• ​Sadness
• Restlessness​
• Energy surge
• Increased confusion
• ​Hallucinations​
• Delusions​

These may lead, in turn, to challenging behaviors like pacing, rocking, screaming, crying, disorientation, resistance, anger, aggression — even violence. Many people experiencing sundown syndrome feel the urgent need to go somewhere or do something, but they can’t always explain why.​​

For some, the behavior soon abates; for others it continues for hours. Some even flip their sleep schedules so they are wide awake all night and sleepy during the day.​

What triggers sundown syndrome?​

There are many theories about why sundowning happens, and the triggers seem to vary among people with dementia. For some, sundowning may be triggered by the dimming light — a sense that it’s time to change activities or “go home.” Evening and darkness may tap into fears of being unsafe and insecure. Whatever the cause, seeing their loved one with these symptoms can be a nightmare for family members.​

In what stage of dementia does sundowning occur?

Sundowning can occur at any stage of dementia, although many families observe the behaviors primarily in the middle stages of dementia and then subsiding as the disease progresses.

We first noticed sundown syndrome in my dad, who had Alzheimer’s, when he was in the disease’s moderate stage. Questions or observations that were occasional for most of the day — “What’s the plan?” “What should I be doing?” “We’d better get going!” — became more frequent, and more urgent, around 5 or 6 in the evening. As the disease progressed, his symptoms improved, and I believe that’s at least in part due to a variety of techniques we used regularly to treat and manage sundowners.

What are the ways to treat, manage and reduce sundown syndrome?

1. Observe and minimize triggers

Watch for fatigue and other things that seem to bring on sundowning behaviors. Afternoon transitions and activities that you consider normal can be anxiety producing for your loved ones.​​

For example, does the household get chaotic and noisy as people get home from work? Does the TV get switched to something loud or intense, like a crime show or the news? Is there are a lot of cross talk during mealtimes? Is there a caregiver shift change?​

Watch, too, for nutritional triggers, and adjust eating and drinking schedules. Cut back on caffeine and sugar, which can be too stimulating, and limit liquids later in the day, as they can cause increased toileting needs.​

2. Maintain routines and structured activities

Maximize activity earlier in the day and minimize napping (especially if your loved one isn’t sleeping well at night). Try to avoid challenging, stressful tasks around dusk and at night. Keep to a regular daily routine — there’s security in the familiar.

3. Simplify surroundings

Environmental chaos can be difficult for a person with dementia to process. Too much sensory stimulation can cause anxiety and confusion, worsened by changing light. Remember: Their brain is being damaged by dementia and it can be very challenging for the brain to view and process visual information. It may feel completely overwhelming to see a lot of “stuff” in a room, and this can cause sundowning behaviors as the person struggles to understand and organize that visual stimulation. 

4. Modify the sleep environment

Try to minimize physical, visual and auditory clutter in your loved one’s bedroom.​​

At night, keep the room calm and comfortable for sleeping (experts often suggest a temperature between 60 and 67 degrees), and dark (try light-blocking curtains or an eye mask, plus dim night-lights for safe navigation). Evaluate your loved one for sleep disturbances such as sleep apnea.​​

5. Validate and distract

Simply trying to reason with someone in the midst of sundowning probably won’t work. Instead, try to validate your loved one’s feelings (even if they don’t make sense to you) to let them know you are listening. Try to draw them away from troubling thoughts and anxieties by diverting or redirecting attention to favorite activities, foods, animals and people.​​

6. Adjust light exposure

Some experts theorize that our hormones and body clocks are regulated by exposure to light, and too little exposure throws us off. If adequate exposure to direct sunlight isn’t possible, try a light box and use bright lights in the room.​​

As it gets dark outside, increase indoor and even outdoor lighting. 

7. Play music and calming sounds

We used music throughout the day for Daddy — instrumental music as he woke up, sing-along favorites or show tunes to activate him, and calming music when sundowning set in. I recommend trying solo piano or classical guitar, or creating a “relaxation” or “spa music” channel on a music app such as Pandora, Spotify or Amazon Prime Music.

8. Use essential oils

Lavender, rose, ylang-ylang, chamomile, blue tansy, frankincense and other essential oils can be soothing. If you want to encourage waking up and staying active during the day, try bergamot, jasmine, peppermint, rosemary or citruses such as grapefruit, lemon or orange. Test which scents your loved one responds to.​​

Essential oils also can be used in various ways, including for aromatherapy. Consult with a doctor or other professional to ensure you are using essential oils safely, whether topically or as aromatherapy. They can be potent, so be sure to use appropriate amounts and dilutions.​​

9. Give healing touch

Never underestimate the value of a hand or foot massage to relax tense muscles and increase feel-good hormones. A loving hug or holding hands can be physically calming and emotionally reassuring for your loved one, breaking the cycle of anxiety.​​

10. Try complementary medicine

For example, traditional Chinese medicine (TCM) involves acupuncture, Tui na massage, Chinese medicinal herbs and other techniques. Acupuncture has been used to treat anxiety and depression for many generations and is increasingly being accepted by Western medicine. Talk with your loved one’s doctor about this option, and find a traditional Chinese medicine doctor who understands dementia.​​

11. Use herbs, supplements and medications wisely

Ask the doctor about medications that might help with symptoms, such as antianxiety drugs and antidepressants. Be sure to ask about and monitor possible side effects; for some people with dementia, sedating drugs can cause the opposite effect. A geriatric psychiatrist is an excellent resource.​​

Also ask about herbs and supplements, such as lemon balm, valerian, chamomile, kava and holy basil. There are many supplements that claim to be calming and stress reducing, including melatonin, magnesium, and B, C and E vitamins. Some research studies have indicated that taking melatonin at night can lessen sundowners behaviors. Ask your loved one’s primary doctor or dementia-focused practitioner about the use and dosage of melatonin and other supplements.

Managing sundown syndrome requires creativity, flexibility, empathy and strong observational skills as we try to determine what triggers our loved ones and how to address the behaviors. No two people with dementia are exactly alike, so be prepared to test different approaches and treatments. Some may not work, but others will. Successes might be temporary or intermittent. But even a little bit of success can greatly ease your loved one’s anxieties, as well as your own stress. Source

Learn About Alzheimer’s Disease and 8 ways to Lower Your Risk of Getting It

Alzheimer’s disease is the most common type of dementia. Alzheimer’s disease involves parts of the brain that control thought, memory, and language. It begins with mild memory loss and can lead to losing the ability to carry on a conversation and respond to the environment. If not treated, it can affect a person’s ability to go about their normal routines.

Alzheimer’s disease and related dementias can seriously affect a person’s ability to carry out daily activities. This memory loss is not a normal part of aging.

Scientists don’t know what causes Alzheimer’s. However, like other chronic conditions, it is probably a result of several things.

How many people have Alzheimer’s disease?

Nearly 6.7 million people in the United States have Alzheimer’s disease. By 2060, that number is expected to grow to 13.9 million.You may have a friend or loved one who has been diagnosed with Alzheimer’s disease or another type of dementia.

Most people living with Alzheimer’s disease are 65 or older. People younger than 65 can have Alzheimer’s disease, but it’s uncommon.

Is there a cure for Alzheimer’s Disease?

There is no cure for Alzheimer’s disease at this time, but there are things you can do to help lower your risk.

• Controlling high blood pressure
• Maintaining a healthy weight
• Quitting smoking
• Being physically active
• Eating healthy meals
• Getting enough sleep
• Avoiding alcohol or drinking alcohol in moderation
• Managing diabetes

You don’t have to make these changes all at once. For example, getting an extra 30 minutes of sleep at night, getting an annual physical exam, or simply taking a walk every day may make a big difference in brain health.

If you notice that your memory is changing or getting worse, you should talk to a medical professional.

Source

Aging and Sleep

Aging is tied to numerous health concerns. Poor sleep can contribute to many of these problems, reducing quality of life in people as they get older.

Why Does Aging Affect Sleep?

It is common for older adults to experience changes in the quality and duration of their sleep. Many of these changes occur due to changes in the body’s internal clock. Located in a part of the brain called the hypothalamus, this internal clock is made of around 20,000 cells that form the suprachiasmatic nucleus (SCN).

The SCN controls 24-hour daily cycles, called circadian rhythms. These circadian rhythms influence when people get hungry, when the body releases certain hormones, and when a person feels sleepy or alert.

As people get older, their sleep changes due to effects of an aging SCN Deterioration in the function of the SCN can disrupt circadian rhythms, directly influencing when people feel tired and alert.

The SCN receives information from the eyes, and light is one of the most powerful cues for maintaining circadian rhythms. Unfortunately, research shows that many older people have insufficient exposureto daylight, averaging around one hour each day. Daylight exposure may be even more restricted for people who live in nursing homes as well as those with Alzheimer’s disease.

Changes in production of hormones, such as melatonin and cortisol, may also play a role in disrupted sleep in older adults. As people age, the body secretes less melatonin, which is normally produced in response to darkness and helps promote sleep by coordinating circadian rhythms.

Health Conditions and Sleep

Mental and physical health conditions may also interfere with sleep. Conditions that commonly affect sleep in older people include depression, anxiety, heart disease, diabetes, and conditions that cause discomfort and pain, such as arthritis.

The relationship between physical health and sleep is complicated by the fact that many older adults are diagnosed with more than one health condition. Those with multiple health conditions are more likely to report getting less than six hours of sleep, having poor sleep quality, and experiencing symptoms of a sleep disorder.

Sleep issues may also be related to the side effects of medications. Almost 40% of adults over the age of 65 take five or more medications. Many over-the-counter and prescription drugs can contribute to sleep issues. The interactions of multiple medications may also cause unanticipated effects on sleep.

Lifestyle and Sleep 

Poor sleep quality in older adults can be related to the lifestyle changes that often come with aging. For example, retirement may lead to a less structured sleep-wake schedule. Other significant life changes, such as loss of independence and social isolation, can increase stress and anxiety, which can also contribute to sleep issues.

How Does Aging Affect Sleep?

Aging affects people differently. While some older adults may have no significant disruptions in their sleep, others complain about getting less sleep and having worse sleep quality. Experts have found several common sleep disturbances in older adults.

Shifting sleep schedule: As people age, the body’s circadian rhythms actually shift forward in time. This shift is called a phase advance. Many older adults experience this phase advance as getting tired earlier in the afternoon and waking up earlier in the morning.

Waking up at night: Research has also shown that as people get older, they often experience changes in their sleep architecture. Sleep architecture refers to how people cycle through the different stages of sleep. Older adults spend more time in the earlier, lighter stages of sleep and less time in the later, deeper stages. These shifts may contribute to older people waking up more often during the night and having more fragmented, less restful sleep.

Longer recovery from changes in sleep schedule: Alterations in how the body regulates circadian rhythms make it more difficult for older people to adjust to sudden changes in their sleep schedules, like during daylight saving time or when experiencing jet lag.

Daytime napping: Research estimates that about 25% of older adults take naps, compared with around 8% of younger adults While some experts suggest that a short daytime nap may be beneficial, many agree that extended napping and napping later in the day can make it harder to fall asleep at bedtime and create nighttime sleep disruptions.

Sleep Tips for Older Adults

Research has shown that older people can take steps to improve their sleep. These steps often involve focusing on improving sleep hygiene and developing habits that encourage quality sleep. 

Exercise: Older people who exercise regularly fall asleep faster, sleep longer, and report better quality of sleep. Exercise is one of the best things older people can do for their health. 

Reduce bedroom distractions: Televisions, smartphones, and bright lights can make it more challenging to fall asleep. Keep the television in another room and try not to fall asleep with it turned on. Move electronics out of the bedroom and reserve the bedroom for only sleeping and sex.

Avoid substances that discourage sleep: Substances like alcohol, tobacco, caffeine, and even large meals late in the day can make sleep more challenging. Consider quitting smoking, reducing caffeine intake, and eating dinner at least four hours before bedtime.

Keep a regular sleep schedule: Aging can make it more difficult to recover from lost sleep. Avoid sudden changes in sleep schedules. This means going to bed and waking up at the same time every day and being careful about napping too long or too close to bedtime.

Develop a bedtime routine: Find activities that help you relax before bed. Many older people enjoy taking a warm bath, reading, or finding some quiet time before getting into bed.

Source

7 Ways to Preserve Hearing When You Already Have Hearing Loss

If you already are one of the millions who use hearing aids, you know their value: You can hear your family members more clearly or enjoy dinner conversation with friends without saying “What?” all the time.

According to the National Institute of Deafness and Communication Disorders, 30 percent of adults ages 65 to 74 and approximately 50 percent of adults older than 75 have diminished hearing. Hearing loss is on the rise in the United States and is expected to increase by 67 percent by 2060. But you still need to take steps to protect your hearing once you have hearing aids. Unfortunately, aging, plus the noisy world in which we live, can further impair the hearing of those who use hearing aids.

Essentially, hearing aids are designed to compensate for a person’s hearing loss and to operate in difficult listening environments, says Ayasakanta Rout, a professor of audiology and director of the Hearing Aid Research Laboratory at James Madison University in Harrisonburg, Virginia. He says hearing aids “do not improve the existing damage already in the inner ear.”

To help prevent additional hearing loss and the problems associated with it, here are seven suggestions that can help.

1. Wear your hearing aids — even when you are at home alone.

“In most cases of age-related hearing loss, there is a slow progression of the degree of hearing difficulty despite the use of hearing aids,” Rout says. “It is critical that hearing aids are programmed exactly to the need of the individual user so that soft sounds are audible, medium sounds are comfortable, and loud sounds are tolerable. If a hearing aid is too loud, it could induce additional hearing loss. That is why the best practices in hearing aid fitting recommend verification of the actual sound levels produced by the hearing aid when worn in the user’s ear.”

Rout adds that hearing aids are designed to make sounds audible and comfortable without being too loud. The aids can selectively reduce background noise.

Individuals with hearing loss should consistently use properly fitted hearing aids, Rout says. That includes when you are at home.

“If you need them and don’t use them, your comprehension of speech will decline,” he says. 

“Think of all the things you would not enjoy if you decided not to wear your hearing aids,” says Richard S. Tyler, a professor in the Department of Otolaryngology at the University of Iowa. He adds that hearing aids can improve the user’s quality of life: “Hearing is critical to communication, interacting, appreciating and learning from others. This certainly can impact socialization, friendship and cognition.”

2. Keep in touch with your hearing care providers.

Clare M. Villanueva, an audiologist affiliated with NYU Langone Medical Center in Brooklyn, New York, recommends that hearing aid wearers see their hearing specialists at least once a year — sooner, if necessary — for a reevaluation of their hearing needs.

“Hearing aids might need to be adjusted, especially if the hearing care provider does another hearing test and finds the results differ from earlier ones,” Villanueva says. The hearing care provider might also determine that the hearing aids need servicing or should be replaced.

Over-the-counter (OTC) hearing aids became available in 2022 for those with mild to moderate hearing loss. They tend to be much less expensive than prescription hearing aids. If you are using over-the-counter hearing aids, follow the manufacturer’s recommendations about the possible need for adjustments. You also may need to contact an audiologist to have your hearing aids adjusted.

3. Use protective earmuffs.

Earmuffs like the ones worn by airport workers on the tarmac can be helpful for protecting your hearing during trying situations — concerts, busy airports, planes or trains or subways, and even when you or a neighbor mows the lawn or uses power tools. (Furry earmuffs will keep your ears warm, but you need the ones designed to cancel out harmful noise.)

Be aware that noise-canceling headphones are not earmuffs and should not be used in their place. Earmuffs, which cover the ear completely, can cost from less than $20 up to hundreds of dollars depending on their noise reduction rating (NRR), which represents the average decibels of sound it can reduce if worn properly. “The higher the NRR the better. Look for an NRR of around 30 dB. You always see airport workers and often construction workers wearing them to preserve their hearing,” Rout says. If you wear hearing aids, “remove them when using the earmuff,” he says.

The reasoning for this is twofold. First, if you wear an earmuff over the hearing aid, there is a greater likelihood of hearing audible feedback (squealing). Second, in loud environments, for example when lawn mowers are used and at construction sites, hearing aids are not effective in amplifying speech over the noise, Rout says.

4. Keep ear protection, such as earplugs, in your purse or pocket.

For those times when noise becomes uncomfortable or unbearable — such as on a subway, at a ballgame or in an amusement park — take out your hearing aids and use foam or silicon earplugs to reduce the noise. Inexpensive ones are available at drugstores. Another option is to use more expensive noise-reducing earplugs, which many musicians use. If you’ve been to a live concert recently and up close to the stage, you might notice that most of the musicians wear ear protection.

5. Reduce the volume on your headphones.

Do you really need to have music blasting in your ears to enjoy it?

Villanueva recommends “reducing the volume on your iPods or other listening devices and using them for short amounts of time. Find the lowest, most comfortable sound setting on your device. Be aware a specific setting on one device is not necessarily the same on another device.”

6. Check your medications.

Check with your health care provider to see if any of the medications you are prescribed can cause hearing loss (if they are ototoxic). These can include some antibiotics as well as nonsteroidal anti-inflammatory drugs (NSAIDs), diuretics and chemotherapeutic agents. Ask of other drugs might be prescribed instead.

If you have a sudden change in your hearing, see an otolaryngologist, often known as an ear, nose and throat (ENT) specialist, as soon as possible, Villanueva says.

7. Make sure you don’t have too much earwax.

One common cause of increased hearing loss is simple earwax, according to Sreekant Cherukuri, M.D., an ear, nose and throat specialist at St. Mary Medical Center in Hobart, Indiana.

“As we age, earwax gets dryer and harder, so it can easily build up without our knowing it and cause some hearing loss,” he says.  The use of hearing aids or earplugs also can push earwax down the ear canal.

Cherukuri recommends cleaning your ears regularly with an over-the-counter ear wash system — not Q-tips — and having your physician or health care provider “look in your ears and check for wax buildup at your next checkup.”

National Asthma Awareness Month

Asthma is a disease that affects your lungs. It causes repeated episodes of wheezing, breathlessness, chest tightness, and nighttime or early morning coughing. Asthma can be controlled by taking medicine and avoiding the triggers that can cause an attack. You must also remove the triggers in your environment that can make your asthma worse.

CDC’s National Asthma Control Program works to help Americans with asthma achieve better health and improved quality of life. The program funds states, school programs, and non-government organizations to help them improve surveillance of asthma, train health professionals, educate individuals with asthma and their families, and explain asthma to the public.

More than 100 million people in the United States have asthma and/or allergies. Some people may have more than one of these conditions.

• More than 27 million people in the U.S. have asthma (more than 22 million adults and 4.5 million children).1,2
• About 20 million people in the U.S. have food allergies (16 million adults and 4 million children).3,4
• About 81 million people in the U.S. have rhinitis due to nasal allergies, also called “hay fever” (67 million adults and 114 million children).3,4

There is no cure for asthma or allergies.

These numbers paint a picture of how many people in the U.S. are managing asthma and allergies. But they don’t paint a picture of the overall impact these diseases have on people, their caregivers, and communities.

Source

What Your Grip Strength Means for Your Overall Health — and Exercises To Improve It

As we age, our muscles naturally weaken. Wear-and-tear impacts your whole body, including your knees, hips, back and more.

Keeping up a regimen of strength-training exercises is important to counter these effects. But one part of your body you may not consider actually matters more than you may think.

It turns out, your grip strength — the amount of force you have when you clench your hand around an object — is a huge indication of your overall health.

That’s right. Your grip strength is important for more than having a strong handshake and being able to open a pickle jar. Researchers call grip strength an “indispensable biomarker for older adults.” In other words, the strength you hold in your hands, wrists and forearms says a lot about how healthy you are. It’s also an indication of your risk for injury, mental health conditions and more.

“Grip strength naturally begins to decline around age 50, and maybe even earlier,” says geriatric medicine specialist Ardeshir Hashmi, MD. “People who maintain their grip strength age more slowly. They stay healthier longer and are stronger throughout their bodies.”

Dr. Hashmi explains why that is, as well as how your grip strength is related to your well-being, and what you can do to improve it.

How grip strength is related to your health

Grip strength is measured by a device called a hand dynamometer. It’s a handheld device you squeeze as hard as you can.

It’s generally understood that a higher grip strength is associated with better health, and a lower grip strength is associated with poorer health. The exact cutoffs are still up for debate and differ based on age, BMI and other factors. Researchers in at least one study define weak grip strength as:

• Less than 26 kg (57 pounds) for men and people assigned male at birth (AMAB).
• Less than 16 kg (35 pounds) for women and people assigned female at birth (AFAB).

Until you begin to lose strength in your hands, you probably never really think about how important your grip strength is.

Our hands are critical for so many of our daily tasks. If you want to button your shirt, eat with a fork, write with a pen — it all requires a certain strength and dexterity in your hands and fingers.

But your grip strength is important for more than your day-to-day activities. Dr. Hashmi breaks down a few ways your grip is related to aging all over your body.

Muscle strength

Grip strength is an easy-to-measure indication of how strong the rest of your body is. And keeping muscle strength throughout your body is important for your mobility, balance, endurance and more.

A strong body means you’re able to get out of the house more, get more exercise in your life and generally keep up with the world around you.

“The common denominator is that you lose strength as your muscle is replaced by fat tissue. It’s called sarcopenia,” Dr. Hashmi says. “If you’re losing strength in your hands and arms and, therefore, having a weaker grip, it’s an indication that’s happening all over your body.”

In one study, researchers found a relationship between grip strength and walking or climbing stairs. Men had more mobility issues when their grip strength was less than about 82 pounds. For women, it was 46 pounds.

And it’s a vicious cycle. Decreased mobility makes you less likely to be able to move your body in ways that will build up your muscle strength. And so your muscles continue to weaken. That leaves you at a greater risk for falls and fractures.

Immune health

As you age, your immune system declines, leaving you more prone to infection. The word for that process is immunosenescence. It’s a fancy way of saying that the process of aging affects your ability to fight off infections.

A lowered muscle mass means your body loses some of its ability to mount a response to the viruses and bacteria that get you sick.

Research shows that poor grip strength is an indication of a weaker immune system, which can leave you more vulnerable to getting sick.

“Good grip strength is associated with immune system benefits,” Dr. Hashmi notes. “A weaker grip strength can be a sign that you’re more prone to infectious diseases, like COVID-19, RSV or the flu.”

And people who have a weaker grip strength are more likely to have more serious symptoms and complications from those illnesses. So, they’re at higher risk for hospitalization, too.

Chronic disease risk

Dr. Hashmi says weak grip strength can also serve as a warning sign of a higher risk for chronic diseases. That’s in part because a lowered muscle mass makes it harder to exercise, leading to a sedentary lifestyle and a higher risk for frailty. That raises your risk of chronic conditions like:

• COPD (Chronic Obstructive Pulmonary Disease).
• Diabetes.
• Heart disease and heart failure.
• Obesity or underweight.
• Mental health

The repercussions of decreased grip strength can be seen across your body. And they affect your mental state as well.

It makes sense: Weak grip strength is an indication of reduced muscle strength across your body. That leads to reduced mobility. And reduced mobility can lead to loneliness.

“We know that physical limitations can have a really negative impact on your mental health,” Dr. Hashmi says. “If you can’t go out and spend time with your friends and family, you can’t get out and do things that make you happy, you become more isolated. And isolation has a negative effect on your cognitive (brain) and emotional health.”

Researchers have connected weak grip strength to conditions like:

• Cognitive impairment (like confusion, memory trouble and slower processing).
• Depression.
• Problem sleeping.
• Longevity

When you add it all up, your grip strength is essentially an indication of your overall health and longevity. In a way, your grip strength can almost predict your future health.

“I don’t think it’s too extreme to say that grip strength can be a predictor of life expectancy,” Dr. Hashmi states. “Lowered grip strength is a sign of frailty and associated with a high risk for dangerous complications. As those conditions and hospitalizations rack up, it takes its toll.”

The opposite is (encouragingly) also true. People with a strong grip strength are more able to stay active well into their older years. And there are some easy exercises that can help you maintain, and even improve, your grip strength.

Dr. Hashmi calls exercise the “penicillin against premature aging.”

“The more you maintain your grip strength, the slower the cells age,” he explains. “If you don’t maintain your grip strength, the cells actually start to metabolize and age faster. And that shows in what you’re physically able to do, or not do.”

So, how do you keep your grip strong?

Hand exercises

Improving your grip strength is pretty simple: Grab a racquetball or squash ball and start squeezing. Dr. Hashmi says the goal should be to squeeze your hand and forearm muscles as much as you can, aiming for twice a day for at least 10 minutes per hand.

The size and material of the ball are important here. Dr. Hashmi says things like tennis balls are too big and may actually be damaging. Other kinds of squeeze balls may be too squishy to give your forearms the proper work. They don’t give you the right resistance.

Hollow squash balls and racquetballs, on the other hand, will do the trick just right.

There are other options on the market for grip strength that Dr. Hashmi says can work as well. Some are like resistance bands. Others are handles that you grip and squeeze. These products come in different sizes and resistances. Dr. Hashmi encourages first-time users to start with low resistance and work their way up to higher strengths to avoid injury.

As you get close to age 50, these daily hand exercises become increasingly important. But Dr. Hashmi suggests that any age is a good age to start.

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Aging Well No Matter Your Age

We’ve been hearing a lot lately about our aging political leaders, specifically the current and former U.S. presidents, and what that means in terms of their physical and mental health.

But even more importantly, what about our aging body? How can we, regardless of our age, keep our body and mind in good shape?

 Let’s start with the experts at Blue Zones®, who have studied regions of the world where people live long healthy lives. They identified nine “lifestyle habits of the world’s healthiest, longest-lived people.”

 The common qualities are:

1.) They move naturally, such as regular walks for errands and gardening

2.) They have purpose, such as volunteering and caring for others

3.) They downshift, such as napping, meditating and yes happy hour

4.) They follow the 80% rule, i.e. they stop eating when 80% full

5.) They eat a more-planted based diet, more beans and less meat

6.) They drink wine moderately and with food and friends

7.) They belong to some type of faith-based community

8.) They put loved ones first – aging parents, spouses and children

9.) They have a “right tribe” or social circle that promotes all of the above

 “To make it to age 100, you have to have won the genetic lottery. But most of us have the capacity to make it well into our early 90’s and largely without chronic disease. As the Adventists demonstrate, the average person’s life expectancy could increase by 10-12 years by adopting a Blue Zones lifestyle,” according to Blue Zones.

If we want to practice the Blue Zones positive approach to aging we have to let go of the myths about aging. The National Institute on Aging identified 10 myths to growing old.

 The common misconceptions are:

•  Depression and loneliness are normal in older adults. Yes, depression and sadness are real but they are not a normal part of aging and can be effectively treated.
• Older people need less sleep. Older people may have trouble sleeping (and there are effective treatments for that too) but they need the same amount of sleep as all adults – 7 to 9 hours nightly.
• Older adults can’t learn new things. While cognitive changes often come with aging, studies show that older adults who take up a new hobby or learn a new skill improve their memory.
• Dementia is inevitable. Although the risk of dementia grows with age, many people live long lives without dementia, which is different from common mild forgetfulness.
• Older adults should avoid exercise to prevent injuries. “Almost anyone, at any age and with most health conditions, can participate in some type of physical activity,” NIH advises.
• Alzheimer’s disease is hereditary. While family genes – which we can’t change -do increase our risk, exercise and diet and other lifestyle behaviors – which we can change – decrease our risk.
• Older adults have to give up driving. Natural changes, such as reduced mobility and vision, can affect driving, but putting away the car keys is about ability not age.
• Osteoporosis is only a concern for women. While it is more common in women, this disease that causes bone fractures affects men too.
• I’m too old to quit smoking. Some of the benefits of becoming a non-smoker, such as improved circulation and fewer colds and bronchitis, are almost immediate no matter your age.
• I can quit medication now that my blood pressure is under control. No, that means the medicine and lifestyle changes are working.

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May is Skin Cancer Awareness Month

Skin cancer is the most common cancer in the United States, with over 5 million Americans diagnosed with skin cancer each year. In fact, 1 in 5 Americans will develop skin cancer in their lifetime. It is estimated that nearly 9,500 people in the U.S. are diagnosed with skin cancer every day. People of all colors and races can get skin cancer.

Some people have a higher risk of developing skin cancer than others, risk factors for skin cancer include: light colored skin, skin that burns or freckles rather than tans, blonde or red hair, blue or green eyes, more than 50 moles, irregular shaped or darker moles, used or use indoor tanning devices as well as history of sun exposure from outdoor activities.

There are many different types of skin cancer, basal cell carcinoma (BCC) and squamous cell carcinomas (SCC) are the most common forms, melanoma is the most deadly. With early detection and proper treatment, the cure rate for BCC and SCC is about 95 percent. When melanoma is detected before it spreads, it also has a high cure rate. On average, one American dies from melanoma every hour. Despite all the advances in the treatment of melanoma, early detection and prevention are still our best weapons to save people from this deadly cancer.

Regular self-skin exams and a yearly professional examination help people find early skin cancers. 

The most important signs to look for: ABCDE of melanoma.

A: Asymmetry (one half is unlike the other half.)

B: Border (irregular, scalloped or poorly defined borders)

C: Color (varied from one area to another; has shades of tan, brown or black, or is sometimes white, red, or blue.

D: Diameter (more than 6 mm or the size of pencil eraser)

E: Evolving (changing in size, shape or color)

Any spot that looks different from all the others or that is changing, itching or bleeding needs to be checked.

Prevention is better than medicine: Always remember that sun exposure is the most preventable risk factor for all skin cancer including melanoma. Always seek shade and wear protective clothing (long sleeved shirt, pants, wide brim hat and sunglasses when possible), apply water-resistant broad spectrum sunscreen with SPF30 or more, reapply the sun screen every 2 hours even when cloudy and also after sweating or swimming. Avoid tanning beds.

Everyone should begin a lifelong routine of regular skin checks. Routine monitoring is the best means to early detection of skin cancer, leading to a great prognosis for successful treatment. Patients should also remember that skin color doesn’t give them a free pass. Everyone can get skin cancer.

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Exploring caregiving challenges facing the "sandwich generation"

CBS News launched a new series examining care for our nation's aging population.