Is 100 the new 80?

Planning to live to 100? All of us should be.

In the past 30 years, the number of people living to be 90 and above has tripled, and will quadruple by 2050. By that time, some of our numbers will already have appeared on Willard Scott’s list.  Willard himself will be 116  by then, likely still going strong from the looks of him.

The good news in all this? According to the 2008 census, only 23%of those older than 90 live in nursing homes (yay!), while some 40% of them live alone. I call that good news, because I think most of us would prefer to live independently–forever, if possible. But considering that the median income for the over-90s is $14,760, and that 80% of people living outside a nursing home have at least one disability, living a long life likely will be more like a roll in a briar patch than a walk in the park. Unless, that is, science alleviates some of the physical issues associated with being the oldest of the old. (Highly likely, it appears.)  Regardless, I doubt that we’ll end up as fit as Martina Navratilova or as

Helen Mirren also looks impossibly good in a bikini.

gorgeous as Helen Mirren. (How does she manage to look like that, anyway?)

But even Martina and Helen will have to make concessions to the indignities of failing bodies, though they’ll likely be able to hire round-the-clock staffs to see to their needs and purchase homes with every possible convenience. Most of us won’t have these choices, so I suggest we all get busy planning.

So here are some of the best ideas I’ve read to help make our old-old years more palatable:

-Move to a single story home in an affordable neighborhood with young families–they’ll help look out for us, and we can hire the teenagers to do yard work and errands. Being close to younger, caring relatives isn’t a bad plan, either.

-Put as much money as possible into our  401Ks–a decent income will help us afford in-home services or a better-quality facility.

-Work as long as we possibly can–it keeps you involved, and you’ll get a bigger Social Security benefit if you wait till you’re 70 (see above).

-Live in an area with public transportation or affordable taxi service for that dreaded day when we can no longer drive.

-Exercise, exercise, exercise, and eat healthily. Seriously, old age is not for sissies, and we’ll all be best served by long-term training to keep muscles and bones strong, joints moving, and blood pressure low.

-Stop smoking, right this minute. An oxygen tank is not the kind of fashion accessory you want to be sporting, nor is an open heart surgery scar, which spoils your cleavage. (Of course we’ll have cleavage–we been working out, and we can afford miracle bras.)

-Explore–or better still, create–new ways of living.  I, for one, would like to be part of a new movement–small houses or apartments with a central communal living area for meals and round-the-clock assistance. It could be like the current high-end retirement communities but without the high up-front cost, and controlled by the residents, not a corporation. Alternatively, I might look into forming a commune.  Remember those? We may have pooh-poohed them in the past, but a multi-generational one might be just the ticket.

Let me know what plans you have for your old-old age.  Maybe we’ll end up in that commune together, sharing our nightly glass of wine and giving our personal trainer hell. I’d like that, wouldn’t you?

Be well,

Donna

The Horizonal Hour

Saturday afternoons nearly always find me taking a nap.  I unashamedly sack out, covered with my favorite soft throw. After an hour, I wake up refreshed, ready to head to the coffee shop and write. I’d happily follow a shorter version of this ritual at work, but this, I fear, would be frowned upon.

Lest you think me lazy, let me explain. Sleep experts say that naps are good for the body.  A study of 23,000 Greek adults conducted from 2001 to 2007 showed that those who took regular naps were 37% less likely to die of heart disease.  Those who indulged in weekend naps were 17% less likely to do so.  (Good thing the research was done before the Greek economy collapsed.  I imagine insomnia and illness-producing stress are widespread there these days.)

Picky a comfy spot and, if desired, a sleep buddy.

A nap essentially re-sets some of the body’s functions.  We’re released from stress while we sleep, blood pressure drops, and our immune system improves.  All these things have the power to improve our long-term health.

In an article in the San Diego Union-Tribune, Sara Mednick, author of “Take A Nap! Change Your Life.” wrote:

Waking life also increases the stress hormone, cortisol. A recent study, however, reported that daytime napping decreases our stress and inflammatory responses, bringing a healthy balance to the strain of daily life.

Those benefits may not be obvious to us, but others are. These are some of the things naps improve:

• Our reaction time, meaning safer driving
•  Short-term memory
• Motivation
• Patience
• Judgement
• Mood (Works for cranky adults as well as for infants.)

Not to mention that naps feel good. We live hectic lives, and need breaks. A comfy bed, a quiet room, a cozy throw. . . lovely. And, if you’re awakened at 5:30 on Sunday morning by the operatic demands of a hungry cat, as I often am, knowing you can nap later makes you less inclined to want to wring your furry friend’s neck.

While an hour is my preferred length of time to sleep, other people do well with 15 or 20 minutes (which could be accomplished under a desk in dire circumstances).

There are reasons that people don’t nap. Friends have told me it makes them groggy for the rest of the day. This occasionally happens to me, too, mostly when I’m really tired. Others, like my cousin, figure we’ll sleep when we’re dead. But I believe that a little extra sleep leads to longer life, perhaps delaying The Big Sleep by a year or two.

So do yourself a favor and give napping another try.  Find a spot and a position that works for you every time, and go for it. Bedroom or couch, hammock or lawn chair–whatever floats your boat.

All this talk of naps has made me sleepy. Yawn. I’m going to go get horizontal. See you in an hour.

Be well.

Donna

I Love/Hate My Phone

Until recently, I thought my most pressing problem with my smartphone was stroking out from frustration with the touchscreen. I’m pretty sure my blood pressure goes through the roof during extended bouts of texting.

Me + smartphone = a rocky relationship.

Today I learned there’s a more widespread concern–the dreaded Text Neck.

Dr. Dean Fishman, a Ft. Lauderdale chiropractor who created the term “text neck,” calls the problem “a global epidemic.”  Bending over a phone or tablet frequently, as many people are prone to do, can cause headaches and pain in the shoulders, arms and wrists. Over time, he says, it can lead to permanent arthritic damage. You can read more (and download an app that helps you maintain proper spinal alignment) at Dr. Fishman\’s website.

But text neck isn’t the only problem with cellphones.  Here are a few other hazards to avoid:

• Being walked into by other pedestrians as you stop in the middle of the street and try to typr a coheremt massage.
• Breaking a fingernail trying to get the freaking back off the phone to remove and replace the battery.
• Pulling your back as you lean over the toilet to retrieve the phone dropped therein.  Seriously, 19% of all people will drop their phones into unsuspecting johns.
• Getting cauliflower ear from the hours you spend on the phone with tech support trying to get the phone to perform all the amazing tricks the ads promised. (I know, I know.  I should have gotten an iPhone. Check back with me in 21 months and 20 days.)

Personally, I’m not willing to go back to a  non-smart phone (is that a dumb phone?), and will have to become more proficient at typing or learn to use the voice recognition feature–it’s one advantage my android-based phone has over all but the most-recent iPhone.

Meanwhile, please accept my apologies in advance for sending you a garbled text.  Be patient, and a clearer one will follow, i primose.

Be welk,

Domna

The Case for Bioidentical Hormones

When I made my first visit to my preventive medicine doctor,  Dr. Jim McMinn, he ordered thorough blood and saliva tests to determine what areas of my health need improvement.  Discussing the results, he pointed to my estrogen, testosterone, and progesterone levels which were basically nonexistent.  As in nada, zero, zip. I said, “But isn’t that to be expected at my age?”  He replied, “The newest research finds that the lack of hormones tends to make us age faster, and our quality of life isn’t as good.”

Vivelle Dot estradiol patch, progesterone cream (large syringe), testosterone cream (slender syringe), and progesterone capsules.

After discussing the pros and cons, he recommended that I start using bioidentical hormones, which are compounded to match the hormones that we aren’t making anymore. They’re different from traditional hormone replacement therapy (HRT), which has been linked to increased risk of breast cancer, stroke, and heart disease. Most of these, including Premarin and Prempro, are made from pregnant mare urine (hence the name Pregnant Mare uRine), bringing in questions of animal cruelty–mares are kept in stalls, pregnant, for most of their lives.

But bioidenticals, made from plants, can have a ton of benefits for those of us who are post-menopausal.  Estradiol, a form of estrogen, helps with brain fog, prevents bone loss (hopefully leading to fewer hip fractures), reduces incidences of Alzheimer’s, and may help us live longer.  Testosterone improves the libido, and decreases vaginal dryness.  (Translation we’ll not only be friskier, but will enjoy sex more.  Who can argument with that?) Progesterone is good for your skin and immune system, as well as helping with libido.  It also is a natural antidepressant, and helps burn fat. Most importantly for me, anyway, it helps you sleep better.  Dr. McMinn wrote a blog entry listing the benefits of bioidentical HRT on his website. Read To Menopause or Not To Menopause here. (Note: his other posts are informative and thought-provoking as well.)

Bioidentical hormone replacement isn’t for everyone, though.  I have friends who can’t use hormones because of blood pressure issues or sensitivity to the base used for compounding them. And, frankly, there have not been a lot of studies to prove that bioidenticals are safer than traditional HRT. (I don’t need to remind you that most studies are funded by Big Pharma, and they’re not inclined to support research of non-pharmaceutical products.) But there’s good information at American Academy of Anti-Aging Medicine, an organization of preventative medicine physicians. You might also  check out Suzanne Somers’s book Breakthrough, which has interviews with physicians in the forefront of hormone research.

Cost can be an issue, though. Insurance rarely pays  for compounded hormones, which aren’t regulated by the FDA, but it does cover Novartis’s Vivelle dot, a small estrogen patch like I wear.  You’re pretty much on your own paying for progesterone cream and capsules and testosterone cream. Also, you’ll need access to a good compounding pharmacy to go bioidentical.  I’ve recently learned you can also have hormone pellets inserted under the skin.  I don’t know much about them, but understand they’re fairly pricey, again, not covered by insurance. A friend who recently had some inserted reports nearly-immediate improvement in her ability to sleep and to her frame of mind (which is a good thing). As with any medication, you’ll need to monitor how you feel and let your physician know if there are issues. For example, I’m on half the dose of estrogen and testosterone cream originally prescribed by Dr. McMinn.

One thing I can say for certain: bioidentical hormones won’t bring those not-so-desirable aspects of being a woman–menstruation and PMS–back into your life.  You may see a recurrence of breast tenderness and vaginitis, and, unless you want to look like my mustachioed Italian great-aunt, you’ll likely need more-frequent lip-waxes. I plan to continue using bioidentical hormones as long as I can still afford them, and I don’t have any ill health affects. They make me feel more energetic and clearer-headed, and, well, friskier.

I’ll be happy to answer any questions–but right now I’m off to the nail salon. I’ll be the one having my lip waxed.

Be well.

Donna

Statins? I’ll Pass, Thanks

A few weeks ago, I watched a tantalizingly titled CNN special, “The Last Heart Attack.” Dr. Sanjay Gupta visited several doctors known for helping heart patients regain good quality of life and avoid future cardiac episodes.  The experts were interspersed with interviews of recovering heart patients, including Bill Clinton. The cheeseburger-loving ex-president is now a born again vegan, thanks to Dr. Dean Ornish.

Perhaps the most compelling physician was Dr. Caldwell Esselstyn, who pegs heart disease as a “food borne illness,” that can be prevented or reversed by following his strict regimen:

-Eat a vegan diet “nothing with a mother, nothing with a face”  and any products from animals, such as dairy products and eggs.

-Cut out all oils, nuts, and processed grains and sugar.

-Take statins if you have high cholesterol.

The concept made me ponder my own heart health, so  I  ordered Esselstyn’s book, “Prevent and Reverse Heart Disease.” It makes a strong argument for following such a hard-core diet, but both the show and the book left me with questions.  Lots of them.

The most critical one–how do we know if we have heart disease? It’s a serious question, as sudden death is often the first indication that a person has heart disease. Personally, I’d rather have a little advance warning.

Esselstyn reports that people whose total cholesterol is less than 150 do not have heart attacks.  But no mention was made of the effect of the so-called “good” cholesterol, HDL, on heart attack risk.  For example, my cholesterol is high, somewhere around 230, but my HDL regularly clocks in at 60, which is also fairly high.

But using cholesterol as the only indicator of forthcoming heart attacks doesn’t seem to tell the whole story. Conflicting studies have shown that very elderly people with very high cholesterol were less likely to die from any cause. (Did I mention that my mother is 97 and healthy?)  And some researchers and physicians believe that if your HDL is half as high as your triglycerides, then you’re golden.  http://www.healthiertalk.com/i-m-proud-my-high-cholesterol-4235  Others point to the many factors (including genes) that contribute to the development of arterial plaque and lack of flexibility. Dr. Ron Rosedale is one of these. He writes:

The fixation on cholesterol as a major cause of heart disease defies the last 15 years of science and deflects from real causes such as the damage (via glycation) that sugars such as glucose and fructose inflict on tissues, including the lining of arteries, causing chronic inflammation and resultant plaque.

He’s got me there–I definitely have a sweet tooth.

While Dr. Esselstyn convinced me maybe I should take statins, reminding myself of other research brought me back down to earth. After all, I have no other risk factors–I’ve never smoked, my blood pressure is great, weight is good, I exercise religiously, my c-reactive protein levels (they reflect your level of arterial inflammation) are fine, and an artery calcium scan 6 years ago was clean as a whistle.

While statins are very effective at lowering cholesterol and at reducing inflammation, which researchers think may be an even bigger predictor of heart disease, they have some heinous side effects. Lipitor, Zocor, Crestor, and other such drugs can cause liver damage, muscle pain, weakness, and deterioration, nausea, and brain fog (as if we need any help with that). So while I believe Esselstyn is on to something for those who have heart disease, I think I’ll wait for more proof until until I jump on his draconian bandwagon.

That being said, if anything changes, I may be forced to give up red meat, cheese, and my nightly light ice cream. But you can bet I won’t go gentle into Esselstyn’s no-doubt healthy but thoroughly depressing diet or those dastardly statins.

Be well.

Donna

The Healing Power of the Pool

It’s 8:40 on a Saturday morning, and I’m late (again) for water aerobics. But no matter—I’m here, and that’s the important thing. I slide into my usual spot to join the mostly 70- and 80-somethings in jumping jacks, cross-country skiing, and running in place.  The heart rate is up, the limbs are moving, and we’re trying to keep up with our high-energy instructor. It’s wellness as usual in the Lakeshore Foundation fitness pool.

I’m the new kid on the block here, with only a couple of years under my flotation belt. It’s long enough to have worn out several swimsuits, and to know most people’s names, but not all of their histories. At 61, I’m one of the youngest in the group, but I feel a kinship with all my pool pals.  Must be something in the water.

Or maybe it’s this place.  Designed to help people with severe disabilities improve mobility, Lakeshore is a hub for everyone from arthritic seniors to young people encumbered by cerebral palsy and neurological diseases. Most recently, the Foundation has developed programs for injured returning veterans. It’s breathtaking to watch individuals who are confined to wheelchairs on land become swimmers and walkers in the water.  In the pool, we are all able.

This sense of community is pervasive here.  People chat freely during the classes, though most are working hard at the routines.  The instructors are used to this lack of respect, and focus on those of us who are paying attention. We are all here to further our well-being in one way or another, whether to strengthen damaged hearts, rebuild atrophied muscles, or loosen joints.  But for some, the social interaction is as critical as the movement, perhaps more so.

At first, I pooh-poohed the efficacy of working out in the pool.  It seemed. . . soft. . .not the kind of thing to build muscles, burn fat, and promote elder-athlete conditioning. If I’m going to make the effort to work out, I want it to count! But I learned that while the water supports your weight, protecting joints, you’re also working against its pressure, producing results similar to those gained by holding light weights during dry-land workouts.  Use foam barbells in the water, and you get extra resistance. The hydrostatic pressure also makes your kidneys work harder, which is why you usually need to hit the bathroom immediately after you climb out the pool.  (Repeat after me—use the bathroom, not the pool!)

The trick to water aerobics, as with any exercise, is that you have to do it regularly, and do it right. So suit up, and come join us in the pool. And don’t feel bad if the 80-year-olds show you up-you’ll catch up with them eventually.

Be well.

Donna

Exercise: the No-Medicine Medicine

Exercise can keep you young! Well, not this young. . . .

There have been so many studies on the health benefits of exercise that it’s surprising more people don’t run right out to the gym.  The most recent study, out last week in the Archives of Internal Medicine, shows a clear link between regular moderate to vigorous exercise and the prevention of cognitive impairment (which I take to mean Alzheimer’s). The introduction to the study spells it all out:

Physical activity appears to be one of the more promising preventive strategies against cognitive impairment in the elderly population. In most studies, people who are more physically active in midlife and late life have lower rates of dementia and cognitive impairment in late life. In addition, people who participate in higher levels of physical activity have slower rates of cognitive decline compared with those who are less active.

In other words, working out can either keep you from suffering dementia or Alzheimers, or, at the very least, slow its progression. If a plant growing in the rainforest had these properties, drug companies would be scrambling to turn it into a highly profitable drug. Instead, it’s a drug-free drug that we can all have just for the doing. How amazing is that?

We already know that exercise helps prevent heart disease and cancer, lowers blood pressure (thus helping prevent strokes), relieves stress, has a measurable effect on diabetes, helps with weight maintenance,  improves depression,  and lessens arthritis symptoms. It even appears to slow the aging process dramatically at the cellular level.  In short, it’s good for pretty much anything that ails us, while helping us live longer and better.

So what are you waiting for? Wait, don’t tell me.  I think I know the excuses, err, reasons you’re about to give.

Sure, exercise can be a pain–literally.  Assuming you put a lot into it (why bother, otherwise?), it’s hard, time-consuming, and sometimes expensive.  For example, I work out 4 to 5 days a week, at least 3 of those in Jazzercise classes.  After an hour of strenuous working out, by time I take a shower and eat supper, it’s nearly 9 before I settle in for the evening. If I plan to have dinner with a friend or go to an event, I have to rearrange my workout schedule accordingly. On Sunday mornings, I often walk, and Saturday mornings, I’ll sometimes take in a water aerobics class just to change things up. All in all, a pretty substantial time commitment, which I consider an investment in my well-being and long-term mobility.  You may not have the time flexibility that I do, but you can still manage some kind of exercise, even if it’s only a walk at lunchtime.

Think about it, please.

Exercise Pros: Helps prevent almost every serious disease or health condition. Keeps you mobile. Is good for your brain.

Exercise Cons: It takes effort.  Can cost money (though walking and running are basically free.) Time consuming.

Reasons for not Exercising: None, unless your doctor forbids it, and if he/she does, maybe you should seek a second opinion. I’ve seen stroke victims, paraplegics, extremely obese people, amputees, sufferers of MS, and people nearly crippled from arthritis working out at my gym. And you’re going to say it’s inconvenient or too much effort? Oh, wah.

Conclusion: Shift your derriere into gear today!

Read more:  http://www.washingtonpost.com/wp-dyn/content/article/2008/01/28/AR2008012801873.html

http://www.time.com/time/health/article/0,8599,1956619,00.html

Be well.

Donna