CD-ROM Today (UK) (Spanish) 15/CDRT.iso/dp/0175/01759.txt

Text File | 1994-01-17 | 30KB | 511 lines

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$Title{Aging--Learn to Enjoy the Inevitable, part II}
$Subject{Aging old older ageism tired feeble confused silly indigestion
constipation denture stains arthritis bladder incontinence vision eye eyes
hearing knees joints PRESBYOPIA CATARACTS GLAUCOMA MACULAR DEGENERATION
RETINAL DETACHMENT TINNITUS senility senile mental Alzheimer Alzheimer's
disease multi-infarct dementia depression elderly Muscles ARTHRITIS
Osteoporosis Digestion digestive Diverticulitis Diverticulosis diverticula
Hemorrhoids MENOPAUSE BREAST CANCER PROSTATE cancers IMPOTENCE HEART ATTACK
ARRHYTHMIAS ANGINA Medications medication age aged geriatric geriatrics
collagen Uveitis}
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Cancer of the Prostate*0007601.scf
Benign Hypertrophy of the Prostate*0007602.scf
Diverticulosis*0010001.scf
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Copyright (c) 1991-92,1993


Health Update

by Dr. Allan Bruckheim

Aging--Learn to Enjoy the Inevitable, part II


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The Joints and Muscles

     How much your body is affected by old age depends on you.  It depends on
how you spent your youth, or misspent it, and whether you have kept active.
Although conditions such as osteoporosis and osteoarthritis increase in
incidence as we grow older, they are less severe in people who keep active and
exercise regularly.  The joints and muscles of our bodies can be compared with
door hinges.  A door that is opened infrequently creaks and complains and may
even have rusted shut.  A door used every day opens easily.  Remember that the
phrase "use it or lose it" applies when it comes to your muscles and joints.
Exercise in moderation, but if a choice is to be made, it's probably better
for you to do more than to do too little.

     ARTHRITIS

     The pain in joints that comes with age is usually a sign of
osteoarthritis, the "wear and tear" arthritis that is partially the effect of
years of use.  Osteoarthritis usually hits matching sets of joints, both your
knees, your hips, your fingers, in a symmetrical fashion, rather than one hand
alone, and there is no swelling or feeling of heat in the affected joints.  If
you have a lot of pain, or if there is swelling, it is likely that another
process is involved, and that a new diagnosis is needed.  Osteoarthritis is a
chronic disease.  While over-the-counter pain preparations may be sufficient
to control the pain and discomfort, managing all these medications may become
quite involved, so professional guidance and advice is a must.
     Even though osteoarthritis is due to wear and tear, you should exercise,
to maintain the flexibility and action of the involved joints.  Moderate
exercise will improve your muscle tone so that some of the strain is taken off
your joints.  If you're overweight, you're straining your joints more than
necessary.  Losing a few pounds may be the best thing you can do, and
increasing your level of exercise is one way to do it.
     Arthritis sufferers are always on the lookout for some new or magic cure
to relieve their pain and discomfort.  There are many unscrupulous individuals
who prey on the uninformed.  Your only defense is to rely on well-known
sources of information, including the counsel of your family doctor, to make
the appropriate decisions.

     OSTEOPOROSIS

     Osteoporosis is the thinning and weakening of bones due to calcium loss
caused by the reduced levels of estrogen and activity.  Although we think of
it as a problem that generally affects women, it also occurs in men, although
to a lesser degree over a longer period of time.  Women are affected by
osteoporosis more because they have less bone mass, and when the bones thin,
they become much more fragile.
     Thin, petite, fair-skinned women who smoke and don't exercise are more at
risk than other women, since their bones are small to start with.  One out of
four white women over age 65 develops osteoporosis.  Severe osteoporosis can
result in hips so fragile that they break if you turn rapidly, or vertebrae
that start to collapse into themselves, reducing height and even causing
breathing problems as the rib cage slowly caves in on itself.
     Prevention is the best approach to osteoporosis.  Regular exercise and a
diet rich in calcium help build strong muscles and bones.  Bone mass is at its
greatest around age 35, so preventing osteoporosis should start early.  Some
physicians recommend estrogen replacement therapy to prevent osteoporosis in
women who are at greater risk of developing it.  This may mean taking
estrogen, either orally or by wearing a skin patch, for the rest of your life.

Digestion

     Have you ever noticed how most of the people in advertisements for
laxatives and antacids are older?  While poor digestion can happen to anyone,
it is true that digestive problems may increase with age.
     The digestive system may start working less efficiently as the years
pass.  In addition, changes in lifestyle, such as reduced activity and changed
eating habits, can have major effects on digestion.  Poor digestion can be
helped simply by eating a better diet; adding vegetables and grains to meals
and reducing fat content.  Some people may need to eliminate certain foods
from their diet, particularly those that provoke discomfort.  Exercise can
help a great deal in keeping the digestive system working well.

     INDIGESTION

     Digestion is one of those activities that you don't notice as long as
everything is working fine.  Indigestion is pretty much any digestion that you
notice; it can include heartburn, nausea, vomiting, stomach pain, cramps,
diarrhea, excessive flatulence, bloating or early fullness.  Simple
indigestion isn't usually a serious problem; we all have some of these
symptoms occasionally, especially after too much pepperoni pizza.  But the
same symptoms may indicate an intestinal virus, emotional distress, or
blockages of the intestine; if the problem persists beyond a few days, you
should consult a doctor to rule out a more serious condition.
     Some cases of indigestion are caused by disturbances in the rhythm of the
intestinal system.  The thin muscular walls of the stomach, small and large
intestines contract and relax to more food through the system as it is being
digested.  These movements are controlled both by the nervous system and by
hormones.  Anything that interferes with either of these controls can
interfere with digestion.
     Some older people are plagued by digestive gas problems, and frequently
belch or pass gas, or suffer gas pains.  Although gas is a by-product of
digestion, the most common source of gas in the intestines is swallowed air.
People swallow air inadvertently by eating too rapidly or because of poorly
fitting dentures.  Drinking a lot of carbonated beverages is also a factor.
Certain foods, such as beans, cabbage, bran and broccoli, are also leading
offenders in gas production.  Eating slowly and chewing food well can help
reduce gas problems.

     CONSTIPATION

     Constipation is a digestive problem, but you may be surprised at what it
is and what it isn't.  Constipation is the infrequent and difficult passage of
stool.  Some people normally have a bowel movement not daily, but every second
or third day; this is normal for them, and not a sign of constipation, unless
there is also difficulty in the passage.
     There are several causes for constipation:  poor diet, insufficient
intake of fluids and lack of exercise are the leading causes, and the ones
most easy to remedy.  Regular moderate exercise appears to help constipation
by stimulating intestinal activity.  Drinking fluids does this also, as it
adds water to the intestinal contents.
     The most important "cure" for constipation is also its prevention:  a
diet rich in roughage or fiber.  Fiber-rich foods include vegetables, whole
grains and fruits.  Easy ways to add fiber to the diet include switching to
whole-wheat bread, brown rice and eating fruit instead of drinking fruit
juice.

     DIVERTICULOSIS AND DIVERTICULITIS

     Another digestive condition that occurs more frequently with age is
diverticulosis.  In some people, parts of the walls of the large intestine
weaken slightly and pouches (or diverticula) form.  Diverticulosis is the
presence of these pouches.  If the diverticula become inflamed or infected,
that is diverticulitis.
     The symptoms of diverticulosis include pain in the abdomen (usually on
the left side), bloating, alternating diarrhea and constipation, and vomiting.
Diverticulitis has the same symptoms, plus a fever.
     Diverticulosis appears to occur because of increased pressure in the
intestines.  This pressure increase can be due to constipation or use of
stimulant laxatives.  Diverticulitis occurs when bacteria in the intestinal
system enter small perforations in the diverticula, creating abscesses.  The
abscesses may heal by themselves, but sometimes the infection can spread
throughout the abdominal cavity.  In severe cases, surgery may become
necessary to remove the inflamed portion of bowel.
     Diverticulosis is managed with a diet high in fiber.  This reduces
pressure within the intestines as it speeds food through and makes passage of
stool easier.  Constipation should be avoided, so drinking plenty of fluids
and exercise are advisable.  Gas-producing foods, such as cabbage, cauliflower
and carbonated drinks should be avoided, because excess gas in the intestines
increases pressure.

     HEMORRHOIDS

     Hemorrhoids, while inconvenient and uncomfortable, fortunately aren't
very serious.  They are actually an inflammation of the veins found just
inside and outside the anus.  Internal hemorrhoids can prolapse, or protrude
through the anus, while external hemorrhoids can become painfully clotted.
Either kind may bleed.  The most common cause of hemorrhoids is straining
during bowel movements.  Increased abdominal pressure, due to pregnancy or
obesity, can also cause hemorrhoids.  Another factor may be spending too much
time sitting on the toilet, which allows the veins to fill with blood.
     The most common treatment for external hemorrhoids is conservative:  a
warm sitz bath and stool softeners to ease bowel movements.  Your physician
may remove a clotted external hemorrhoid if it is caught early.  Internal
hemorrhoids are removed surgically if they prolapse.  This is a simple office
procedure, in most cases.  Prevention is the best treatment for hemorrhoids.
Exercise regularly, eat a balanced diet and drink plenty of fluids to avoid
constipation and difficult bowel movements.

Women and Aging

     It has been said that women get the small piece of the pie when it comes
to getting older.  In our society men are considered mature and distinguished
in their middle and later years; women, it is said, just get old.  This is
hogwash.

     MENOPAUSE

     Women age a bit differently from men.  Rather than a gradual change here
and there, a woman's body goes through menopause, the changes associated with
the shutdown of her ovaries.  The ovaries have been working since puberty,
emitting an egg once a month and making the female hormones estrogen and
progesterone.  These two hormones made the uterus build up a special lining of
blood and tissue once a month to accept a fertilized egg.  If fertilization
does not occur, this lining is released from the uterus as menstruation.
Menopause is essentially the cessation of menstruation.
     At one time, a woman's life expectancy was such that few survived more
than a few years beyond menopause.  Today, the average life-span for women is
in the mid-70's, while average age at menopause is in the mid-50's.  A woman
can live a quarter to a third of her life after menopause.
     The ovaries stop producing eggs during menopause, but it's not a sudden
halt.  Although menstruation may have become irregular, the ovaries may still
produce a few eggs and may continue to do so for months after menstruation has
stopped.  It isn't completely unusual for a woman to have a "change of life"
baby.  For this reason, contraception should be continued for at least a year
after your last period.
     Hot flashes and night sweats--which are actually the same thing--occur
because the decreased estrogen allows capillaries in the skin to open up
suddenly.  You may feel very hot, sweat and blush for a few minutes a few
times a month.  Similarly, before your body is acclimated to the new levels of
estrogen, your heart may flutter for a few minutes every now and then.  If
these episodes are bothersome, a physician should be consulted.
     The wide-ranging effects of menopause may include weight gain, aches and
stiffness, wrinkling, and vaginal dryness and atrophy.  You may gain weight
because your body needs less food after menopause, and you may retain water
more easily.  Stiffness and wrinkles are caused by a loss of elasticity in the
body tissues that results from the estrogen decrease.  Estrogen also keeps the
walls of the vagina thick and moist, which means that after menopause you may
have some discomfort during intercourse and be more prone to vaginal
infections.
     If hot flashes or vaginal atrophy are causing you problems, your
physician may prescribe either estrogen supplements or vaginal creams that
contain estrogen.  Taking estrogen supplements won't reverse menopause and
they could increase your risk for endometrial cancer.  Your doctor will
discuss the pros and cons of estrogen supplement with you before you decide
whether to take it.

     BREAST CANCER

     Being over age 50 means that you are at greater risk for developing
breast cancer.  One in 11 women will develop breast cancer at some point in
her life.  If your mother, sister or aunt has had the disease, this increases
your risk.  We still don't know what causes breast cancer, but we do know that
the earlier it's caught, the easier it is to treat.  A professional
examination is recommended each year, but you should examine your own breasts
once a month.  Your physician will show you how.  After age 50, the National
Cancer Institute recommends having a mammography done every year.

Men and Aging

     With men, aging does not cause the relatively sudden changes that women
experience with menopause.  The effects of aging may be gradual but they are
pretty much inevitable.

     THE PROSTATE

     One of the most common effects of aging in men is enlargement of the
prostate gland.  The prostate gland is about the size and shape of a chestnut
and is located at the bottom of the bladder.  The urethra, the tube from the
bladder to the outside passes through it.  In about half of all men past age
50, the prostate enlarges.  The enlargement itself isn't a problem, but it can
cause more frequent urination or difficulty in urination.
     If the enlargement begins to block the urethra, surgery may be necessary.
This operation removes all or part of the prostate using a tube that is passed
down the penis.  The procedure may impair the ability to ejaculate and can
cause impotence in a certain number of cases, but most men have no problem
with their sexual functioning.
     Sometimes the prostate may become infected or inflamed.  As with other
infections, you may have a fever, chills and pain.  Prostatitis is usually
treated with antibiotics and is generally not serious unless it recurs
frequently.
     Prostate cancer, however, is very serious.  After lung cancer, it is the
second most common cancer among men.  It is usually detected during a rectal
exam, which is why such exams, although unpleasant, are necessary.  The
earlier prostate cancer is caught, the easier it is to treat and beat.  The
normal treatment for prostate cancer is removal of the prostate, which
sometimes results in impotence.  Prostate cancer that has spread to other
organs grows faster in the presence of the male hormone testosterone.  Some
patients must undergo removal of the testicles or estrogen therapy in order to
treat advanced cases of prostate cancer.

     IMPOTENCE

     One of the greatest fears about aging that men have is that they'll
become impotent and their sex lives will be over.  One in every 10 American
men suffers from continuing or chronic impotence.
     The causes for impotence can be divided into two categories,
psychological and physical.  At one time, it was thought that most cases of
impotence were caused by psychological stress:  worry, anger, frustration and
performance anxiety.  Now, with better diagnostic methods, researchers have
discovered that more than half of all impotence is due to physical problems.
     To determine whether the impotence is caused by physical or psychological
reasons, a complete physical examination and several other medical tests are
necessary.  One test involves monitoring for nocturnal erections that normally
occur in healthy men while they sleep.  If erections occur, then it is
probable that the cause of impotence is psychological.  If the erections don't
occur, physical problems probably exist.
     An erection depends on several factors.  The penis enlarges and becomes
firm when blood fills two chambers that run its length.  The blood must flow
in and stay there, and then flows out after the sexual urge passes.  All of
the elements in this complex system must work for proper function.
     There are several physical causes for impotence.  The arteries that
supply the penis with blood are about the same size as the coronary arteries.
It should come as no surprise that if the coronary arteries are blocked or
thickened, the same condition may be affecting the penile arteries, which
could cause impotence.  Diabetes, chronic kidney disease and other conditions
can also impair these arteries.  In addition, drug abuse, alcoholism and
certain medications (notably high blood pressure and antidepressant drugs) can
adversely affect the nervous system and/or the hormones governing erection.
     For some of these physical causes, the cure is relatively easy:  stop
abusing drugs or alcohol, or talk to your doctor about changing medications.
Some hormonal causes for impotence can be treated with medications.  For
physical impotence that cannot be so treated, a penile implant may be
considered--a device surgically implanted into the penis that allows a man to
have an erection.
     Psychological impotence often can be treated with professional
counseling, which also can be important in treating physical impotence.
Remember:  A strong, loving relationship depends far more on how your emotions
and mind function, than on how a body part functions.

Sexuality

     Sex is an important part of life that age may gradually change.  Our
youth-oriented society tends to view sexual relationships as the territory of
the young and ignores or derides the sexual functioning of older people.  Many
women once saw menopause as the end of their sexual functioning and some men
assumed that after a certain age their genitals would cease to function.  Both
of these ideas are silly myths.
     Most older people have satisfying sexual relationships until the end of
their lives.  This does not mean that an older man has the sexual stamina he
had when he was 18, nor does it mean that a woman's sexual response is exactly
the same.  Men may take longer to achieve an erection.  Women generally have
less flexibility and lubrication in their vagina.
     Some disabilities may interfere with a fulfilling sexual life, but that
doesn't mean these problems cannot be overcome.  If arthritis makes certain
sexual positions uncomfortable, try others.  A heart attack may mean that sex
should be curtailed during the recovery period, but it can usually be safely
resumed after several weeks, depending on your doctor's advice.  Heart attacks
rarely occur during sexual activity, so put this worry from your mind.
Essentially, you should think of sex as a healthy, normal part of your life,
whatever your age.

Your Heart

     Heart disease is the No. 1 killer in the United States, with all forms of
cancer coming in second.  Older people are at greater risk for heart attacks,
strokes and high blood pressure.  In general, it isn't so much the added years
that increase the risk, as the way those years have been spent.  We are a
nation of who smoke, eat too much fat and salt, and get too little exercise.
The years of mistreating your heart add up.  This may sound like a broken
record, but eating a low-fat, high-fiber diet, exercising regularly and not
smoking are the keys to a healthy heart.  There is no getting around it.

     HEART ATTACK

     About two out of three deaths from heart disease are due to heart
attacks.  A heart attack occurs when the blood vessels (the coronary arteries)
that supply blood to the heart muscles become blocked with cholesterol
deposits or stiffen up.  These arteries can be up to 75 percent blocked before
symptoms such as chest pain occur, which means that the first sign of coronary
artery disease can be sudden death.
     Most heart attack victims are men because the female hormone estrogen
apparently has a protective effect.  But after menopause, the decrease in
estrogen means that older women run the same risk of heart attack as men.
     The symptoms of a heart attack include chest pain, weight or pressure on
the chest, pain in the upper arms, weakness and shortness of breath.  If you
think you might be having a heart attack, don't think twice.  Go to the
hospital immediately.
     Some people who have blocked coronary arteries are good candidates for
coronary bypass operations.  In this procedure, a surgeon uses pieces of vein
from the legs or artificial grafts to bypass the blocked coronary arteries and
bring blood to the muscles of the heart.

     ARRHYTHMIAS

     For some people, the problem may not be blockage of the arteries but
disturbances in the rhythm of the heart's pumping action.  The heart
synchronizes its pumping through a tiny system of electrical pulses.  If the
system goes awry, the heart may beat too fast, too slowly, or without a
rhythm, any of which is called arrhythmia.  Disturbances in rhythm may occur
after a heart attack if parts of the heart involved in that electrical system
are damaged.
     To overcome a poorly functioning electrical system, cardiologists can
insert a pacemaker, a tiny, battery-powered device that artificially causes
the heart to beat in the correct rhythm.  The pacemaker is placed in a pouch
of the skin over the chest and is connected to one or two wires that are
threaded through a blood vessel into the heart.

     ANGINA

     The chest pain that accompanies certain heart conditions is called
angina.  It is caused by a partial blockage or narrowing of the coronary
arteries that results in too little blood reaching the muscles of the heart,
reducing the amount of oxygen necessary for their proper contraction.  This
narrowing can be due to clogging by cholesterol deposits or by spasms of the
artery walls.
     Angina may come and go for years without getting worse or it can presage
a heart attack.  Some people's angina is worse when they exert themselves or
are in a stressful situation, while others have pain for no reason.  In
general, being overweight, having high blood pressure, smoking and not getting
enough exercise are all risk factors for angina.
     Your physician may prescribe medications for your angina.  Some are pills
that are taken at regular intervals or patches that must be worn, while others
are preparations that are used when you have the chest pain.

     HIGH BLOOD PRESSURE

     High blood pressure is a risk factor in heart disease and stroke.  Like
an overfilled balloon, too much pressure placed on the blood vessels could
cause them to burst.  Burst blood vessels can destroy vision, result in brain
damage or even cause death, depending on whether they occur in the eye, the
skull or the heart.
     High blood pressure, or hypertension, is a risk factor for many diseases,
but has few symptoms by itself.  The only way you may find out you have it is
by regularly having your blood pressure monitored.
     If you have high blood pressure, cutting down on the amount of salt in
foods you eat, losing weight and getting regular exercise may help.  If your
physician prescribes medication for your high blood pressure, take it
regularly, no matter how you feel.  If you are bothered by side effects, talk
to your doctor before stopping your medication.

Your Medications

     Older people take more medicine than any other sector of our society.
Medicines are a great boon, but they can be misused and abused.  No drug works
absolutely the same for everyone every single time.  Sometimes drugs have side
effects and cause adverse reactions.  When we speak of drugs, or of life in
general, there is no such thing as complete safety.
     Because older people receive more prescriptions, and because their
eyesight and hearing may be diminished, they are more apt to become confused
about what drugs they are taking and when they should be taken.  In addition,
they may be receiving prescriptions from several health professionals, who may
not know what the others are prescribing.  These medications could interact
with each other, or even with foods, producing effects that could be dangerous
or deadly.
     You can avoid many of these problems.  Know what drugs you are taking.
Never take any medication without asking questions.  Ask your physician what
the name of the drug is, what it is supposed to do and why you need it.  Ask
how long it will be before the drug takes effect.  Ask how often you must take
the medicine and what side effects will occur.  Make sure your doctor knows
what other medications you are taking.  If possible, always go to the same
pharmacist to fill a prescription, so that a record of all your prescriptions
exists.  Make sure you understand when you have to take a medication and for
how long.  If an antibiotic should be taken for 10 days, do it.  This ensures
that the infection is truly gone.  If your medication is to be taken every six
hours, ask whether it is necessary to get up in the middle of the night.  And
never, under any circumstances, share your medications with other people or
take someone else's prescription.
     All medications have a generic name, while some have a generic and a
brand name.  For example, ibuprofen is the generic name and Motrin is a brand
of prescription ibuprofen.  If you are on a tight budget, it may be possible
for your physician to substitute a generic medication in some situations.  A
frank discussion could save you dollars without risking your health.  A
generic version may vary in size, shape or color of the tablets or capsules,
so if you're ever confused or have questions, ask your pharmacist.
     Always ask questions about your medications and your health care.  Never
feel that your physician will be bothered by your questions or that they are
silly.  To make sure you don't forget to ask an important question, bring a
written list with you to office visits.  Make sure your doctor answers your
questions in language you can understand.
     If your doctor isn't willing to answer your questions, switch to another
doctor.  You are paying your doctor for health care, and part of health care
is information.  At the same time, listen to what your physician tells you.
You and your physician must work together for you to receive the best health
care.

     It's been said that growing old isn't for sissies.  Actually, growing old
doesn't take courage as much as it takes patience, knowledge and a healthy
sense of humor.  No matter how old you get, with a little luck, you'll get
older, so preparing for it is the best defense.  Aging isn't so bad when you
consider the alternative.  The best is yet to be.

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Research for this Issue of Health Update by Valerie DeBenedette; Consulting
Editor Robert DeMarco, M.D.

 SUGGESTED BOOKS

     Care Giving:  Helping an Aged Loved One, by Joe Home.  Scott Foresman &
Co., 1865 Miner St., Des Plaines, Ill.  60016.  An all-in-one reference for
care givers for $15.70.  (Note:  AARP members can get this book for $11.70.)
     Successful Aging, by Anne Averyt.  Contains national hot-line numbers,
home safety checklist, sample of living will and much more.  Ballantine Books
($9.95).
     The Age Care Sourcebook, by Jean Crichton.  A book covering the
financial, medical and emotional issues of aging.  Simon & Schuster ($9 .95).
     Who Cares?  An 80-page compilation of helpful hints for caregivers from
Andrus Volunteers, Andrus Gerontology Center, USC University Park MC0191, Los
Angeles, Calif. 90089.
     The Consumer Health Information Source Book, 2nd Edition, Rees & James
R.R. Bowker Co., New York & London, P.O. Box 1807, Ann Arbor, Mich.  48106.
     Complete Guide to Prescription & Nonprescription Drugs, by H. Winter
Griffith, M.D.  A book on side effects, warnings and vital information for the
safe use of drugs.  Available in most bookstores for $12 .95.
     A Healthy Old Age.  A source book for health promotion among older
adults.  A gold mine of information and list of resources for improving the
health of the elderly.  Requests for copies can be sent to the Superintendent
of Documents, United States Government Printing Office, Washington, D.C.
20402.

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The material contained here is "FOR INFORMATION ONLY" and should not replace
the counsel and advice of your personal physician.  Promptly consulting your
doctor is the best path to a quick and successful resolution of any medical
problem.