Avoiding Falls and Spills in the Home

People of any age can have trouble getting around the house – a teenager recovering from a sports injury, a baby boomer in rehab from a heart attack or surgery, an elderly person with arthritis or balance problems. Whether your limited mobility is temporary or permanent, there are many things you can do to make your home safer and your life easier.

Modifying your home can be as simple as rearranging some furniture or putting in a few handrails in strategic locations. But it also includes more substantial measures that can be worthwhile if you have long-term mobility issues.

Preventing Falls: Make a Smooth Entrance

Building entrances can be safety hazards, especially in bad weather. And when it’s difficult to get around, even a step or two can seem like a mountain. Make sure the path from the street to your front door is well lit and clear of objects.

If you have stairs, make sure there’s a sturdy handrail -- on both sides, if that helps. Adding a second banister on the other side can make a huge difference, especially if one side of the body is more impaired than the otherEven if there’s just one step that is difficult to negotiate at the front door, consider installing a grab bar. You can also rent a ramp for walkers and wheelchairs if you need a temporary solution.

Home Safety: Be Creative in the Kitchen

Use simple solutions that minimize stretching, bending, lifting, and carrying:

· Don’t leave things hanging. Put pans on a countertop rack -- or simply leave them out on the stove -- instead of hanging them or putting them in a drawer. Store plates, bowls, cups, and other heavy-use items in a single, easily accessible drawer or shelf, not spread around the room. Try to reserve high shelves for things you don’t need often.

· Invest in a reacher. These clever, inexpensive tools have multiple uses around the house. You can retrieve items from the floor without bending over and from high shelves without using a footstool, which can be a safety hazard. In the kitchen, you can use a reacher to wipe up spills while seated or standing.

· Stay seated. Put sturdy chairs with arms in strategic kitchen locations so you can sit when you cut vegetables or do other kitchen tasks

· Let shelving do the heavy lifting. Slide-out shelving or a Lazy Susan -- a round, revolving tray -- in corner cabinets and refrigerators can make things easier to reach. A wheeled cart such as a tea cart is a little more of a financial investment but can provide extra storage and help move heavy items safely and easily. For example, use it to move a pot from the refrigerator to the cooking range.

· Keep the floor dry. Kitchen floors are prone to spills. Have paper towels and a reacher handy for cleanup.

Keeping Balance in the Bedroom

Your bedroom is your sanctuary. To keep it that way:

· Make your bedroom easily accessible. Going up and down stairs can be exhausting -- and dangerous -- if you have impaired mobility or balance problems. Consider converting a room on the main floor of your home into a bedroom if your bedroom is upstairs. Then move your bath and grooming products to a downstairs bathroom.

· Make your bed comfortable. Extra pillows can help if joint pain makes it difficult to get comfortable in bed. If you have trouble getting in and out of a bed that is too low, put it on risers to make it easier.  If it’s still tough to get up, add a bedside grab rail.

· Keep essentials handy. Put drinking water, pills, a flashlight, a telephone, and important phone numbers on a nightstand -- on your side of the bed. If it might be necessary to summon help from a caregiver nearby in the house, keep a bell on the nightstand, too. Or buy an inexpensive wireless doorbell if the person is farther away. Just knowing that it’s possible to get help in the middle of the night can be very reassuring.

· Be ready when nature calls at night. If you usually wake at night to use the bathroom, install a night-light or two to help you get there safely. If you’d rather not venture that far at night, it may be worthwhile to purchase a portable commode for your bedroom. An even more convenient and less expensive option for men is a plastic urinal -- an appropriately shaped container with a lid -- which can be used in bed.

· Make dressing easier. Sitting in a sturdy armchair to dress and undress can be more stable than sitting on a bed or standing. And you can use the arms to steady yourself when you sit down, reach, or stand up. Use a long-handled shoehorn to put on shoes without bending over. A dressing stick – essentially a stick with a hook at the end – can help you pull on pants or skirts, take off socks, and reach clothes that are hung up high.

Making the Bathroom a Slip-Free Zone

Bathrooms are hot spots for falls and injuries. Fortunately, many bathroom safety measures are simple and inexpensive:

· Don’t rush in the bathroom. Hurrying can make you less careful. Don’t wait too long before going to the bathroom.

· Install skid-free mats. Low-pile, non-skid bathmats can prevent falls on wet and slippery floors.  Non-slip mats or appliqués are also helpful in the tub or shower.

· Put in extra seating. If your bathroom is big enough, put a sturdy chair by the sink so you can brush your teeth and groom yourself while seated. Safety chairs designed for use in the shower may be helpful.

· Don’t bend and stretch. Bending over to pick up a shampoo bottle or soap is another hazard. Instead, put in a bath organizer, shelf, or wall-mounted dispenser for shampoo, conditioner, and liquid soap. A long-handled scrub brush makes it easier to wash feet, legs, and other hard-to-reach places. A standing toilet paper holder can help if it’s difficult to reach a wall-mounted holder.

· Make it easy to get up. A toilet seat riser or toilet safety rails (with or without a toilet seat) are helpful if you have trouble getting up or down from the toilet. A grab bar or two next to the toilet is another option.

Our Physical Therapy and Occupational Therapist can assist you in making your home safe. Call Shepard’s Crook Nursing Agency at 806-665-0356 or 800-542-0423 and we can assist you with equipment needs or home modification ideas to meet you changing health needs.

Blood Pressure, Blood Sugar and Cholesterol Levels

Blood pressure levels

Two numbers are used to describe blood pressure:

• Systolic. The systolic pressure (the higher and first number) measures the force that blood exerts on the artery walls as the heart contracts to pump out the blood.
• Diastolic. The diastolic pressure (the lower and second number) is the measurement of force as the heart relaxes to allow the blood to flow into the heart.

Blood pressure is measured in millimeters of mercury (mm Hg). A blood pressure reading is written like this: 120/80 mm Hg, where 120 is the systolic, and 80 is the diastolic blood pressure.

Blood pressures are now categorized as normal, prehypertension, hypertension stage 1, or hypertension stage 2. The categories are defined in this table:

Blood lipids, including cholesterol

Lipoproteins are protein spheres that transport cholesterol, triglyceride, or other lipid molecules through the bloodstream. Most of the information about the effects of cholesterol and triglyceride actually concerns lipoproteins.

The cholesterol-carrying lipoproteins are commonly referred to as cholesterol. They comprise the low density lipoproteins (LDL), often called the "bad" cholesterol, and the high-density lipoproteins (HDL), referred to as the "good" cholesterol. The triglyceride-carrying lipoproteins are intermediate in density, and together with very-low density proteins, carry triglycerides.

• Desirable total cholesterol: below 200 mg/dL (5.17 mmol/L)
• Optimal LDL ('bad') cholesterol: below 100 mg/dL (2.6 mmol/L)
• Optimal HDL ('good') cholesterol: over 60 mg/dL (1.56 mmol/L)
• Normal triglyceride: below 150 mg/dL (1.7 mmol/L)

Dividing the total cholesterol by the HDL cholesterol levels gives a Total/HDL ratio:

• The ideal ratio is 3.5 or below.
• A ratio of 4.5 carries an average risk for cardiovascular disease.

Blood Sugar Levels

Normal blood glucose levels typically register between 70 and 150 mg. The level in someone's body will change during the day and is affected by many factors including what time of day it is as well as what your most recent meal was (or was not). There is danger associated with levels either below or above the range. If your level is below 70, you most likely have a condition called hypoglycemia or more commonly called low blood sugar. Other symptoms of hypoglycemia include lack of energy, focus and irritability. You can even lose consciousness if your glucose is too low.

If the level of sugar in your blood is over 150 mg, then you are considered to be hyperglycemic, also more commonly known as having high blood sugar. If you have persistent high sugar, then you are at risk for diabetes which can result in serious organ damage to your eyes, kidneys and other organs. If you do not have normal blood glucose levels, you should take all necessary steps to reverse the condition by calling you physician.

Glycosylated Hemoglobin: This test examines blood levels of glycosylated hemoglobin, also known as hemoglobin A1c (HbA1c). Measuring A1c is useful for determining the severity of diabetes. The test is not affected by food intake so it can be taken at any time. In general, measurements suggest the following:

• Normal HbA1c levels should be below 7%.
• A level of 8% indicates diabetes, in 98% of cases.
• Levels above 11% indicate poor control of carbohydrates.

Exercise & Blood Sugar

Exercise may cause low blood sugar numbers or high blood sugar numbers due to an increase in metabolic demands and due to the activity of insulin. Here are some ways to help prevent low or high blood sugars in diabetics who exercise:

• Avoid injecting insulin into parts of the body which will be exerted during exercise, as exercise may prolong or shorten the time of insulin reaction.
• Avoid exercising at the peak of insulin activity. Insulin should be administered approximately one hour before you begin exercising.
• Avoid alcohol and beta blocker drugs around the time of exercise because they may cause low blood sugar.
• Eat a snack just before and during exercise, and monitor your blood sugars before, during, and after exercise.
• Keep simple carbohydrates, such as fruit juice or hard candy, and other food available. Also keep some extra insulin with you in case of emergencies.
• If you experience pain in your chest, nausea, heart palpitations or severe shortness of breath during exercise, stop and consult your doctor.

New Year, New You:

16 Top Health Tips

1. Stepped-Up Breast Health

What’s the best way to reduce your risk of breast cancer? “Buy a pair of sneakers,” says Susan Love, MD, president of the Susan Love Research Foundation. “Cardio exercise, even more so than diet, has been shown in multiple studies to reduce the risk of breast cancer by 20%, on average, in both pre- and postmenopausal women.”

Brisk walking, biking, swimming, or jogging -- all will raise your heart rate for your long-term breast health. And for women over 40, a yearly mammogram is also a must.

2. Family Fit Fun

Between 16% and 33% of children and adolescents in the United States are overweight or obese -- all the more reason you need to raise kids to be physically fit in the new year.

“Make it a family affair,” says WebMD’s pediatric expert Steven J. Parker, MD, co-author of the 7th edition of Dr. Spock’s Baby and Child Care guide. “Set a good example for your kids by eating healthy and exercising yourself, and they’ll follow your lead.”

Where should you start? Walk to the park or store instead of hopping in your car, and enforce a no-TV rule in your house after school and before homework to make sure your kids are outside playing instead of sitting on the couch, suggests Parker. And if you’re the head chef in the house, plan nutritious, low-fat, low-junk-food meals served up in moderate portion sizes for the kids -- and you.

3. Adult Time-Outs

When the going gets tough in your relationship with your significant other in 2008, take a break to temper your anger or anxiety.

“Time-outs aren’t just for kids,” says Jenn Berman, PhD, author of The A to Z Guide to Raising Happy, Confident Kids. “Adults in romantic relationships can get into intense discussions, and as they progress, we tend to say things we regret.”

Rather than letting a discussion spiral out of control into a full-blown fight, suggests Berman, step away for a breather when your emotions start to turn a darker shade of negative, and then pick up where you left off when you’ve both cooled down.

4. Oral Report

“More than 40% of Americans avoid the dentist at all costs,” says Michael Kahn, DDS, chair of the department of oral and maxillofacial pathology at Tufts University School of Dental Medicine in Boston.

The cost could be your teeth. You should have a professional cleaning, have your dentist check for and treat tooth decay and gum disease, and be screened by a dentist for oral cancer -- especially if you’re a guy; men face twice the risk of oral cancer as women -- at least once a year.

"If you refuse to go the dentist, then at the very least screen yourself for oral cancer,” says Kahn. “Check your mouth once a month for bright white or red patches. If the spots won’t rub off and they are still there after about a week, see your doctor right away.”

5. Order in the House

Are you hoping to make 2008 as stress-free as possible? Then you need to channel your inner planner.

“Try to order your life so you can limit stress,” Use Sunday nights to plan your week with your partner so you can see what’s coming.

During your Sunday night strategy session, schedule dedicated time throughout the week to relax, exercise, and straighten up your bills, suggests Farrell.

Better yet, don’t forget to work in some well-deserved time off.

6. Smoke Out

OK. This is the year. "Smoking is the biggest health threat out there,” So if you do smoke, stop; if you don’t smoke, don’t start; and avoid all types of tobacco, including secondhand smoke.

When people think cigarettes, they think lung cancer; health experts estimate 87% of lung cancers result from smoking or breathing secondhand smoke. But smoking also increases your risk of developing head and neck cancer and pancreatic cancer.

It’s time to quit, so choose your weapon: support groups, nicotine replacement therapy or other medications to help smoking cessation, or one-on-one counseling. talk to your doctor to find the right solution for you.

7. Best Shot

Young women, pay attention: Getting vaccinated against the HPV virus is a new way to guard your health. Not only does it protect against genital warts, but it also can help prevent infection with some of the common types of HPV viruses. These types are spread through sexual contact and can cause cervical cancer.

“If everyone were vaccinated, it would have a huge impact on cervical cancer rates,” says Robert Barbieri, MD, chief of obstetrics and gynecology at Brigham & Women’s Hospital in Boston. “But parents and young women need to understand, the vaccine will not work if you’ve already been infected.”

So getting the vaccine early is key: The recommendation, explains Barbieri, is for all girls or women between the ages of 9 and 26 to be vaccinated against HPV. His strategy for parents? Take your daughters out to lunch and talk to them about safe sex and the health benefits of the HPV vaccine.

8. Pap Power

In the era of the HPV vaccine, women still need to appreciate the value of a Pap smear for the detection of cervical cancer.

“Even if you have been vaccinated against HPV, you are still at risk for some types of cervical cancer,” says Denise Jamieson, MD, MPH, gynecological practice committee chair for the American College of Obstetricians and Gynecologists. “If you haven’t been vaccinated because of your age, then an annual Pap smear is a must.”

All women ages 21 and older should schedule a yearly Pap smear or within three years of becoming sexually active. Since all females are in this one together, pick a few gal pals and make your appointment with your gynecologist for the same day -- then dedicate the rest of the day to yourselves.

9. Cancer Control

“This is a disease that is preventable, treatable, and beatable,” says David A. Johnson, MD, president of the American College of Gastroenterology. “So don’t sit on your colorectal cancer. Get screened.”

Getting screened for colorectal cancer starting at age 50 should be at the top of your to-do list, whether it’s a fecal occult blood test or a digital rectal exam; a sigmoidoscopy, which examines the lower part of your colon; or a colonoscopy, during which polyps or suspicious lesions can be removed. Ask your doctor which is right for you.

If you have a sigmoidoscopy or a colonoscopy on the calendar for 2008, fasting 24 hours before the test is required. So when it's over, “Have your spouse or a friend pick you up for a nice lunch or your favorite flavor of ice cream and treat yourself,” says Johnson. “You’ve earned it.”

10. Lovely Bones

Moms and daughters, unite! Make a pact to remind each other of your daily calcium needs for your long-term bone health.

“You build bone mass during growth years, and then you spend the rest of your life losing it,” says James Beaty, MD, president of the American Academy of Orthopaedic Surgeons.

By eating foods rich in calcium -- such as milk, yogurt, and broccoli -- or with supplements, women should be getting at least 1,000 milligrams of calcium a day, along with vitamin D, depending on their age. And if you’re a woman older than 65, schedule a bone mineral density test, which will help your doctor measure the strength of your bones.

11. Balanced Diet

More than 70% of Americans tried to diet in 2006, according to an American Consumer Opinion survey. If you’re among the masses in 2008, the creator of the South Beach diet offers a simple tip to do it right.

“Don’t starve yourself, “says Arthur Agatston, MD. “This leads to weight gain as soon as you relax your intake and then to yo-yo dieting. Attaining and sustaining an optimal weight is a marathon, not a sprint.”

Set a six-month plan with a friend who wants to lose weight, eat well, and exercise, then treat yourself to a spa day together when you meet -- or exceed -- your goals.

12. Eye Spy

Almost 30% of 1,000 people surveyed by the American Optometric Association indicated they don’t get their eyes checked by an eye doctor or an eye care specialist at least every two years. That might explain why 3 million Americans today are living with undiagnosed glaucoma.

Don’t wait until the world has gone blurry. By then it might be too late to prevent or treat vision loss from diseases such as glaucoma, which can be symptom-free in its early stages, says H. Dunbar Hoskins Jr., MD, executive vice president of the American Academy of Ophthalmology. Get screened by an optometrist if you are between ages 40 and 50 to make sure your eyes are healthy and your vision crystal clear.

13. Men’s Health

Almost 80% of 2,282 men surveyed  by the American Academy of Family Physicians described their state of health as “good” or “excellent.” But, guys, just because you’re not sick doesn’t mean you’re living well.

“Even if your blood pressure and cholesterol are normal, you still need to create a lifestyle that is going to improve your state of health over time,” says Steven Lamm, MD, clinical assistant professor at NYU School of Medicine. “Otherwise you are just waiting to get ill.”

What’s a man to do? Pursue wellness aggressively, says Lamm. Understand which tests you need annually, such as a testicular exam starting after puberty or a prostate-specific antigen (PSA) test starting at age 50. Keep track of your cholesterol and blood pressure levels, and create a healthy diet plan. Exercise regularly and, if you’re married, give your wife permission to offer friendly reminders when your best attempts get off track.

14. Tan Ban

While baking your body to a golden bronze might look good, you’re not helping your health: More than 90% of skin cancers are caused by sun exposure.

“The best way to protect your skin from premature wrinkling and skin cancer is to apply sunscreen every day -- no matter what the weather,” says Diane R. Baker, MD, president of the American Academy of Dermatology.

Protection is important, but so is early detection. Keep an eye on your own skin -- and your spouse’s or partner’s -- for new moles that look suspicious or changes in an existing mole or, and once a year have your skin examined by your doctor.

15. Nap Time

If you’re among the 39% of Americans who get less than seven hours of sleep each weeknight, here’s a short-term tip: Take a nap.

“Overcome your sleep deprivation with a good nap during the day,” says Bill Anthony, PhD, author of The Art of Napping. “It’s a no-cost way to better health, performance, and mood.”

The key to a good snooze is to get over your guilt of checking out in the middle of the day, explains Anthony. Then find a quiet spot where you won’t be interrupted and spend 20 minutes in la-la land. Still, your long-term solution to exhaustion should be some regular one-on-one time with your pillow for at least seven to nine hours a night to help reduce your risk of diabetes, heart problems, and accidents and increase your attention span and ability to remember.

16. Flu Fight

You’re young, you’re healthy -- you don’t need the flu vaccine, right? Think again.

“We used to recommend that only individuals who are at high risk -- like the elderly and people with asthma -- get the flu vaccine,” says Isadore Rosenfeld, MD, Rossi Distinguished Professor of Clinical Medicine at Weill Cornell Medical Center in New York City. “Now we recommend it for almost everyone.”

And that includes kids, he says. If you’re not looking forward to dragging your child to the doctor for another shot, you can relax: Kids older than 2 years old (and adults) can get a nose spray vaccine as an alternative to a needle, with similar levels of antibodies to protect against the flu virus.

And Finally ...

One last to-do from our nation’s top medical experts.

Tip No. 17: Have a happy, healthy New Year -- one and all.

Originally published the January/February 2008 issue ofWebMD the Magazine.

Dark Chocolate Takes Bite Out of Stress

Researchers found that eating the equivalent of one average-sized dark chocolate candy bar (1.4 ounces) each day for two weeks reduced levels of the stress hormone cortisol as well as the “fight-or-flight” hormones known as catecholamines in highly stressed people.

The findings add to a growing number of recently discovered potential health benefits of dark chocolate. For example, cocoa has been found to be rich in a class of antioxidants called flavonoids, which have been linked to a number of health benefits.

Researchers are also investigating other compounds in dark chocolate that may offer other health benefits, such as improved insulin sensitivity, reduced blood pressure, and improved mood.

Stress-Busting Chocolate Fix

In the study, researchers looked at the effects of eating 1.4 ounces (40 grams) of dark chocolate every day for two weeks on blood and urine measures of stress in 30 healthy adults. Half of the chocolate was eaten midmorning and the other half was eaten midafternoon.

The participants’ anxiety levels were determined at the start of the study, and blood and urine samples were collected and analyzed at the beginning and end of the two-week study.

The results showed that eating dark chocolate daily reduced stress hormone levels in those who had high anxiety levels.

Researchers also say dark chocolate appeared to have beneficial effects on the participants’ metabolism and microbial activity in the gut.

The study appears in the Journal of Proteome Research and was conducted by researchers at the Nestle Research Center in Lausanne, Switzerland. By Jennifer Warner
WebMD Health News