healthy heart
Senior Healthcare: Getting the Right Medicine & Coverage

3 Simple Steps to More Strength, Energy & Focus

I almost said “no” to the calcium score test. And then my doctor explained it to me…

After that, I never looked back.  I started ordering them for my patients.  My brother, a family practice doc started ordering it for his patients. Together we found 8 patients who were ready to have a heart attack. 

We sent them to the heart lab where they were saved from that frightful event.

Healthy hearts are important but getting started is another whole story...

  1. Moving Around Can Be Tricky: If you're a senior or you're looking after one, you might find that moving around isn't as easy as it used to be. This can make it tough to get the exercise you need.
  2. Health Issues Can Get in the Way: Sometimes, health problems like arthritis or heart disease can make it hard to stay active without feeling achy or tired. It's totally normal for caregivers to worry about making things worse.
  3. Money Matters: Eating well and staying active can cost a pretty penny. If money's tight, you might find it hard to afford healthy food or gym memberships.
  4. Thinking It Won't Work: Sometimes, you might wonder if eating better and exercising is even worth it. Will it really make a difference?

These are just a few of the worries my patients shared with me when I finally got them to open up. 

[TRUE STORY]

I remember the patient who came in with heart disease. We caught his small heart attack quickly. He got the catheterization and went into cardiac rehab in order to build his heart muscles back up. 

He left the classes with a new resolve to keep his heart happy and healthy.  He now had friends and a teacher who would support him. He could return to the classes anytime he needed a booster shot of support.

When I saw him again in my office, he was laughing and joking around. His wife of 45 years said he was a new man and the heart attack actually changed both their lives for the better. He now played golf, and pickleball. He rode his bike every day. 

He admitted that his wife was not the exercise-happy guru he was but that she enjoyed walking and pickleball, accompanying him to the pickleball court to socialize with friends. 

He had never played pickleball before but they both found that no one cared. They went to a court and started hitting the ball back and forth and the next thing they knew people were asking if they could join them. He told me, “Suzanne, we only hit the ball back and forth like 3 times before we missed.”  

"Isn’t that normal?", I asked,  "I mean if you see a professional tennis match, they never volley it over the net for very long."

And so biking, golfing, walking, and pickleball has changed this 77-year-young into a man of youth. And all of us can do it. All because our hearts say so. 

Remember, we don’t have to get it perfect…we just have to get it going.

Your 3 Stupid Simple Baby Steps

What are some baby steps you can take?

  1. The first baby step is to start stepping!  Park your car far away from the grocery store. Use the bathroom farthest from where you are. Walk for 15 minutes after supper. 
  2. Slowly remove one “bad” drink from your intake and replace with water. "Bad drinks" are anything but water. That's easy, but do it slowly. In other words, I can't drink that next soda until I have had at least one glass of water today."
  3. Eat good foods 80% of the time and go “hog-wild” on your cravings 20% of the time. Simply put good foods have labels where you can pronounce normal English words.  For example, I don't know if chicken even has a label, but if it did, it would say "chicken".  If apples had a label, it might say "apple". We can pronounce these words.  If it says, tert-butylhydroquinone, it's not a normal word. It's probably some salt or sugar-hidden chemical preservative used in our "bad" foods. (aka: your cravings). 

Don't get caught up in the BIG picture

Everyone can do baby steps.  Many of my patients thought they had to change everything all at once. They never believed that a little change can lead to a big change. 

I, myself, often get caught up in the BIG change and need to remember that I have to start somewhere.

When I was 30, I wanted to run a marathon. I started by running from my house to the neighbor’s mailbox. He lived next door in a city neighborhood.  The next day I ran 2 mailboxes. It was hard because I wanted to run more but I made myself keep it stupid simple so I wouldn’t hurt my joints, run out of breath, and become overwhelmed.

Even though I knew I could run more, I also knew I would overdo it and then the next day hurt all over and probably stop running completely. (Once I stop or skip something, it's hard for me to get back into it again.) Does this ever happen to you?

So, keep your heart healthy by keeping things simple. Walk a little bit more, drink an extra glass of water, add less "bad" food and more "good" food to your food plan.

Your heart will thank you by giving you more energy, strength, and focus to enjoy more of your life's activities. How do I know this!  We see it everyday in medicine!! 😊

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symptomatic bacteriuria
Senior Healthcare: Getting the Right Medicine & Coverage

Break the Antibiotics Cycle: Is It Really A Urinary Tract Infection?

I have a confession to make and most of your medical providers will tell you this exact same thing. Here's what's really going on.

What is Asymptomatic Bacteriuria?

For years we thought if there were bacteria in your urine then you were supposed to be on antibiotics. This was called a urinary tract infection. However, research now shows that there is something called asymptomatic bacteriuria, what this means is that the urine has bacteria in it but it's not causing you any problems.

I saw many folks in my office that were put on antibiotics and then said they were now having symptoms stop.

Enter...Margaret, a 92-year-old...

Let's take Margaret, for example. Margaret is a 92-year-old who comes in for another urinary tract infection, or is it? Margaret has been put on antibiotics since she was 70 years old for what she thought was a urinary tract infection because her urine culture came back positive showing she had bacteria in her urine. Her doctor usually gave her the same antibiotic and after a couple of days she felt better, but Margaret always felt uncomfortable taking antibiotics all the time. She didn't like the cost of them for sure and she hated waiting at the pharmacy for another prescription. She felt that her friends were always put on antibiotics and there had to be another way. She was too scared to mention what alternatives she had to her doctor. 

[Margaret is not in the medical field so she felt that the only thing she could do was trust her doctor to know what's best for her and it was all too confusing anyway. Besides, her doctor had warned her that having a urinary tract infection and leaving it untreated could put her in the hospital. So now Margaret was really scared, and the confusion was more than it was before.]

Speaking Up is Always OK

How many of us feel uncomfortable opening up a conversation with our doctor and questioning their decisions? Well, you're not alone because even one physician to another hesitates to question another doctor's decision.

So, when Margaret came into my office because the antibiotic she was on was not working I asked her what her symptoms were. 

She took the time to explain to me that she had a few symptoms, like confusion and didn't feel like eating. I explained that while we would look at her urine, that was not the only thing we would base her treatment plan on. I also gave her these alternatives and asked her what choices she would like to make.

She brought up the point that her doctor said she would end up in the hospital if she didn't get antibiotics and this was her real fear factor. So, Margaret and I discussed in detail how we could alleviate this problem and who we could bring him in to guide her through this. Was it her daughter or my nurse that was going to respond if she had the beginnings of any of the symptoms we talked about?

How will Margaret Know What To Do?

This opened up a whole new world for Margaret. Plus, I explained to her that the use of antibiotics is not only costly (and she agreed with that) but also there is a potential for resistance which means we have to start trying new antibiotics if the old ones didn't work anymore, the side effects might be more disastrous and her gut is full of good bacteria which we don't want antibiotics to destroy. She agreed with me that a healthy gut is the most important thing that a senior can keep.

Here's what we talked about:

  • Rarely seen before age 40. This condition is found in an estimated 20% of women aged 80 or older, and also affects older men. The older the person, the more common it is. Asymptomatic bacteriuria is even more common in nursing homes, where it’s estimated to affect 30-50% of residents. Sadly, in nursing homes, the doctor rarely comes in to examine or talk with the patient.  They tend to just call in another antibiotic prescription. 
  • Bacteriuria is not a urinary tract infection.  Instead, know the symptoms that can get you in trouble. Discuss these with your doctor so you know when or if you will need to take an antibiotic. This can lead to unnecessary — and potentially harmful — treatment with antibiotics. Dehydration or lack of sleep can make us all confused.  Don't jump right to "UTI!!" just because you see this. 
  • Know the difference between the two. Antibiotics don't treat any symptoms in asymptomatic bacteriuria because there are NO symptoms.  In fact, such treatment can be harmful: one study found that treatment increased the risk of future (real) UTIs and increased the risk of infection with antibiotic-resistant bacteria.
  • Why medical providers overprescribe antibiotics. Because they won't take the time. You have to look at other things besides just the urine. Instead, health providers must take the time to talk to the patient — or family caregiver — and ask about what symptoms are present. In a busy clinical environment, this step is all-too-often neglected.

It is always okay to speak up with your physician and ask them for an alternative or several choices.  Use these choices to guide your own treatment plan.  It is a feeling of relief to know that you are now in Partnership with your physician and you both have a voice in your health.

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diabetes
Senior Healthcare: Getting the Right Medicine & Coverage

The Reality Check: Why Type 2 Diabetes Can’t Always Be Reversed or Cured

Let’s have an honest heart-to-heart about a topic that’s been making waves on social media: type 2 diabetes and the tantalizing promise of reversal or cure. 

While the allure of a quick fix might be tempting, it’s crucial to separate fact from fiction and understand why, unfortunately, diabetes isn’t always a condition you can simply wish away.

Type 2 diabetes is often dubbed as the silent epidemic, affecting millions of individuals worldwide. Unlike type 1 diabetes, which is primarily an autoimmune condition, type 2 diabetes is largely influenced by lifestyle factors such as diet, exercise, and genetics. It’s a complex dance between insulin resistance, pancreatic dysfunction, and environmental triggers.

Now, let’s address the elephant in the room: the notion of diabetes reversal and cure.

Spend a few minutes scrolling through your social media feed, and you’re bound to come across flashy headlines touting miraculous transformations and overnight success stories. 

But here’s the truth bomb: while some individuals may experience remission or significant improvement in their diabetes management, it’s not a one-size-fits-all solution.

So, why the a discrepancy between social media hype and medical reality?

It all boils down to a few key factors:

Oversimplification: In the age of instant gratification, we crave quick fixes and easy solutions. Social media platforms are ripe with catchy slogans and eye-catching graphics promising to “reverse diabetes in 30 days” or “cure diabetes with this one weird trick.” But the reality is far more nuanced. Diabetes is a multifaceted condition influenced by a myriad of factors, and there’s no one-size-fits-all approach to managing it.

Anecdotal Evidence vs. Scientific Research: While anecdotal success stories can be inspiring and uplifting, they’re not the same as rigorous scientific research. It’s essential to approach claims of diabetes reversal or cure with a healthy dose of skepticism and critical thinking. What works for one person may not work for another, and individual experiences should not be extrapolated to the entire population.

Do you see the ads on TV for this drug or that drug that you should ask your doctor about? When they tell you the drug may cause vomiting or diarrhea, do they show you someone in an outhouse doing just this or do they show you someone laughing and playing frisbee in the park? Anecdotal evidence is selling.

Confusion Over Terminology: Let’s clear up a common misconception: remission does not equal cure. While some individuals may achieve remission of their diabetes through lifestyle changes or other interventions, it’s not a permanent fix. Diabetes is a chronic condition, meaning it requires ongoing management and monitoring. Even if someone experiences remission, there’s always a risk of relapse down the road.

Lifestyle modifications play a crucial role in managing type 2 diabetes. Eating a balanced diet, staying active, managing stress, and getting adequate sleep can all help improve blood sugar control and overall health. 

But here’s where things get tricky: while lifestyle changes can sometimes lead to significant improvements in diabetes management, they might not be enough to completely eradicate the condition. We do not cure it. We MANAGE it. 

Let’s also consider the role of genetics. Some individuals may have a genetic predisposition to type 2 diabetes, making it an uphill battle from the start. No amount of kale smoothies or spin classes can change your DNA. While lifestyle changes can certainly help mitigate genetic risk factors, they might not be enough to fully reverse or cure the condition.

So, where does that leave us? 

In a place of acceptance and empowerment. 

While type 2 diabetes may not be easily reversed or cured, there’s still hope on the horizon. Through ongoing research, advancements in treatment options, and a commitment to healthy living, we can continue to make strides in managing this complex condition.

Let’s approach the topic of type 2 diabetes with a healthy dose of skepticism and critical thinking. While social media may offer tantalizing promises of reversal and cure, it’s essential to separate fact from fiction and consult trusted healthcare professionals for guidance. Together, we can work towards a future where diabetes management is accessible, effective, and tailored to individual needs.

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Blood Pressure
Senior Healthcare: Getting the Right Medicine & Coverage

Why Does My Blood Pressure Go Up and Down?

As we age, our bodies undergo various changes, making our health even more precious.

One crucial aspect that demands your attention is your blood pressure.

Whether it's high or low, abnormal blood pressure levels can significantly impact your health and quality of life. Let's delve into why both high and low blood pressure can be detrimental for seniors like you and why it's crucial to keep it under control or stabilize it.

The Dangers of High Blood Pressure (Hypertension)

High blood pressure, or hypertension, is often referred to as the "silent killer" for a reason. It typically doesn't exhibit obvious symptoms, yet it can silently wreak havoc on your body. If you have uncontrolled hypertension, you're at a heightened risk of developing serious health complications, including:

  • Heart Disease: Hypertension strains your heart, leading to conditions such as coronary artery disease, heart attack, and heart failure.
  • Stroke: Elevated blood pressure can damage blood vessels in your brain, increasing the risk of strokes.
  • Kidney Damage: Your kidneys rely on healthy blood vessels to function properly. High blood pressure can impair kidney function over time, potentially leading to kidney disease or failure.
  • Vision Problems: Hypertension can damage the blood vessels in your eyes, leading to vision impairment or even blindness.
  • Dementia: Research suggests a link between high blood pressure and cognitive decline, including Alzheimer's disease and vascular dementia.

The Hazards of Low Blood Pressure (Hypotension)

While high blood pressure tends to receive more attention, low blood pressure, or hypotension, is also concerning, especially for seniors like you. Low blood pressure can cause various symptoms, such as dizziness, fainting, and fatigue. More importantly, it can lead to severe complications, including:

  • Increased Risk of Falls: Seniors with low blood pressure are more prone to falls, which can result in fractures, head injuries, and other serious consequences.
  • Decreased Organ Oxygen Supply: Insufficient blood flow to vital organs, including your brain and heart, can lead to organ damage and misfires.
  • Worsening of Existing Conditions: Low blood pressure can exacerbate certain health conditions, such as heart problems and neurological disorders.
  • Reduced Quality of Life: Persistent symptoms of dizziness, fatigue, and weakness can significantly diminish your quality of life, limiting your ability to engage in daily activities.

The Importance of Blood Pressure Management

Given the potential risks associated with both high and low blood pressure, effective management is paramount for your well-being. Here's why controlling or stabilizing your blood pressure is crucial:

  • Prevention of Complications: By maintaining your blood pressure within a healthy range, you can significantly reduce your risk of developing serious health complications, including heart disease, stroke, and kidney damage.
  • Enhanced Quality of Life: Stable blood pressure levels contribute to better overall health and well-being, allowing you to enjoy an active and fulfilling lifestyle free from the limitations imposed by uncontrolled hypertension or hypotension.
  • Preservation of Cognitive Function: Research suggests that controlling blood pressure may help preserve cognitive function and reduce the risk of dementia in older adults.
  • Reduced Healthcare Costs: By proactively managing your blood pressure, you can potentially reduce your reliance on medical interventions and avoid costly hospitalizations associated with blood pressure-related complications.

Tips for Managing Your Blood Pressure

Whether dealing with hypertension or hypotension, you can take proactive steps to manage your blood pressure effectively:

  • Follow a Balanced Diet: Emphasize fruits, vegetables, whole grains, and lean proteins while limiting sodium, saturated fats, and refined sugars.
  • Stay Active: Engage in regular physical activity, such as walking, swimming, or yoga, to help maintain a healthy weight and promote cardiovascular health.
  • Monitor Your Blood Pressure Regularly: Routinely monitor your blood pressure at home and report any significant changes to your doctor.
  • Take Medications as Prescribed: If prescribed medication for blood pressure management, take it exactly as directed by your doctor.
  • Manage Stress: Practice relaxation techniques, such as deep breathing exercises or meditation, to help reduce stress levels and promote overall well-being.

Whether high or low, abnormal blood pressure levels pose significant risks to your health and quality of life. By prioritizing blood pressure management through lifestyle modifications, regular monitoring, and adherence to medical recommendations, you can safeguard your heart health and enjoy a fulfilling and active lifestyle well into your golden years.

Remember, when it comes to blood pressure, prevention and management are key to maintaining optimal health and well-being.

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medications
Senior Healthcare: Getting the Right Medicine & Coverage

How many medications are safe?

How many prescriptions does the average American take? 

Data suggests that among those who take prescription medications, the average number of medications taken is four. More than 131 million Americans take at least one prescription medication.

However, taking too many prescription medications can be risky. Taking more than five medications is called polypharmacy. The risk of harmful effects, drug interactions, and hospitalizations increases when you take more medications.

In fact, most physicians use the Rule of 10.  This means that if you are on more than 10 medications, they will remove one before they put you on another. 

How do I know if I'm on too many medications?

The more medications you are taking, the higher the risk of those drugs interacting dangerously with each other. Multiple medications can cause confusion, lightheadedness, and even internal bleeding — all dangerous and injurious conditions, according to Yale Medicine.

The use of multiple medications can lead to misdiagnoses, adverse effects, and trips to the emergency room. In fact, over 70% of seniors go to the ER because of medication interactions and side effects. 

Adverse drug events, or unexpected medical problems that occur during treatment with a drug or other therapy, cause 1.3 million emergency department (ED) visits in the United States each year and about 350,000 hospitalizations, according to the Centers for Disease Control and Prevention (CDC).

These medical events are most common among older people—those over 65 are nearly seven times more likely than younger people to be admitted to the hospital after an ED visit, and most of the time that visit is due to a negative drug interaction. “It only takes one unnecessary medication or a negative drug combination to cause a serious problem,” says Karen Jubanyik, MD, an emergency medicine specialist.

In many cases, you may not need all the medications you’re taking, says Marcia Mecca, MD, a Yale geriatrician who directs a “de-prescribing” program at the Veterans Affairs (VA) Connecticut Healthcare System in West Haven.  However, once on a medication, patients can’t just stop.  This could lead to death. Only the prescribing physician can tell the patient how and when to stop taking a medication. Likewise, patients should never skip a medication dose as this can be extremely dangerous to the health and life of a patient. 

See the Medication Safety Checklist to know how safe your medications really are. 

Are doctors paid or get incentives to write medications?

Federal law forbids doctors from receiving a commission for prescribing a specific drug. However, years ago, the law permitted pharmaceutical companies to offer legal incentives to doctors if they prescribe that company's drugs.

This is no longer the case. Pharmaceutical companies cannot give incentives. The only thing they can do is bring lunch to the doctor's clinic and it must be enough to feed the whole staff. Everyone who partakes in the lunch while they are listening to the representative must sign in that they agreed to sit through the lunch.  In some cases, they must also be willing to pay tax on the lunch on their tax return.. 

Are doctors compensated for writing prescriptions? No. They are paid for evaluating and diagnosing you and providing care to you. If prescriptions are indicated and appropriate, they write out the prescriptions and hand them to you.

Why do doctors prescribe so many meds?

How do I end up getting on so many meds? 

Well, there are 3 logical reasons...

Almost 90% of older adults regularly take at least 1 prescription drug, almost 80% regularly take at least 2 prescription drugs, and 36% regularly take at least 5 different prescription drugs. (Merck Manual)

Again, 5 medications is called polypharmacy. This includes your over-the-counter medications as well as medications prescribed to you. 

Reason #1: You need this medication. Your doctor has diagnosed you with a disease or disorder and the standard treatment is to prescribe a medication that will resolve the issue or manage the issue. 

Reason #2:  You go to more than one doctor. Since we all know medical records are always incomplete and wrong, one doctor does not know what the other doctor is doing. You might go to the dermatologist and get a cream, then to the eye doctor and get eye drops, and then to your primary for blood pressure medicine, 

Reason #3: and then you go to the grocery store for fungal foot powder and a pain reliever/sleep aid like Tylenol PM. Now you are on 6 medications! Tylenol PM has 2 medications rolled into one pill!

So let’s ask a few questions here:

Are there side effects to each medication? Yes.

Is there an interaction between these medications? Yes, and it may also depend on how and when you take or absorb them. 

Does the doctor know you are on 6 medications? No.

Does the pharmacist know you are on 6 medications? No. 

Do these drugs have to be broken down, eliminated, or stored by your liver or kidneys? Yes. 

Since only YOU know exactly what you are taking and when, is it any surprise that I saw so many seniors with drug interactions, side effects, liver failure, and kidney failure in the emergency room where I worked? No.  

Is it any wonder that I had to admit my seniors to the hospital to stabilize their liver and kidney functions and call the hospital pharmacist to rearrange their medications into safer drugs? No. 

Is it any wonder that pharmacists are refusing to fill prescriptions unless they know all the medications you’re on, including the over-the-counter ones?  (About 30% of prescriptions will not be filled because your pharmacist does not have complete information.) Pharmacists are there to protect the public against themselves and their medical providers. 

So, when we ask, “How many medications are safe?” 

You must first ask, 

“Do I know all the medications I take? Even those I take once in a while? 

Do all my doctors know all my medications? 

Do all my pharmacists know all my medications? 

Do all my doctors and pharmacists know my liver and kidneys' health?

When you can answer YES to the above 4 questions, then your doctors and your pharmacists believe you to be safe, and maybe, just maybe, you are safe. 

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senior medical care
Senior Healthcare: Getting the Right Medicine & Coverage

Optimize Your Well-being With Personalized Senior Medical Care

In the journey of aging gracefully, finding the right doctors can make all the difference for seniors and their caregivers. Unfortunately, the frustration of not having the right diagnosis or treatment plan can be overwhelming.

From misdiagnoses to ineffective treatments, the repercussions can affect not only physical health but also emotional well-being. Worse, it can drive a wedge between family members who want the best for their seniors but see a whole different picture.

When we find themselves facing these frustrations, it often stems from a lack of understanding or communication with our healthcare providers. Feeling unheard or misunderstood can lead to a sense of helplessness and reliance on medications as a quick fix. This reliance, however, can lead to a cycle of dependence and further health complications.

One of the primary frustrations we encounter without the right doctors is the feeling of being dismissed or unheard. When doctors fail to listen attentively to our concerns or dismiss our symptoms as a normal part of aging, it will lead to delayed or incorrect diagnoses. This delay in addressing underlying health issues can result in worsening conditions and unnecessary suffering.

My own experience...

As a physician assistant working in the urgent care clinics, I saw countless times when patients were medicated instead of finding the root cause of the problem and fixing it. Medication is never the only answer. With the internet at our fingertips, there is a vast amount of knowledge we should bring with us to our doctors and ask them for their opinions. 

Overemphasis on medication as the solution to every problem can age us quickly. While medications have their place in healthcare, relying solely on them without addressing lifestyle factors or exploring alternative treatments can lead to adverse side effects and dependency. We may find ourselves trapped in a cycle of managing symptoms rather than addressing the root cause of their health issues, mainly weight and sedentary lifestyle.

Furthermore, the lack of personalized care and attention can leave seniors feeling disconnected from their doctor.  How many times have our caregivers heard their parents exclaim, “Oh, what’s the use of going to the doctor? He’ll only give me another pill!”. Without a doctor who takes the time to understand their unique needs and preferences, seniors feel like just another number in a system focused on treating symptoms rather than a human being.

Don't put all of this on your doctor

But to be fair, this is not entirely your doctor's fault. The healthcare system they are employed by pushes doctors, physician assistants, and nurse practitioners to see more and more patients so they can make a profit. What once was a 45-minute meeting is now a 10-minute visit. In fact, it takes the same amount of time to drive through a fast-food restaurant and get your food as it does to see a doctor. 

But, when seniors and caregivers take charge of their health and actively participate in their care, the benefits are profound. By seeking out the right doctors who prioritize personalized care, seniors can experience a transformation in their overall well-being.

This is proven over and over again in our fast-growing “solo” practices of direct primary care where the doctor is not driven by employers but works for her patients. She is not paid based on the visit but receives a monthly fee (often less than a cell phone bill).  Our patients can call, visit, or text their personal doctors as often as they like. 

3 Secrets to Finding the Right Doctor

One of the secrets to incredible medical care lies in communication. Seniors and caregivers should feel comfortable discussing their concerns, preferences, and goals with their doctors openly. This open dialogue fosters a trusting relationship and ensures that the medical care provided aligns with their individual needs.

Another secret is the importance of preventive care. Instead of waiting until health issues escalate, seniors should prioritize regular check-ups and screenings to catch potential problems early. With proactive medical care, seniors can address health concerns before they become more serious, leading to better outcomes and improved quality of life.

Additionally, the third secret is YOU! Seniors can stay young by prioritizing lifestyle factors such as nutrition, exercise, and social engagement. The right doctors will emphasize the importance of these factors in maintaining overall health and well-being. By adopting healthy habits and staying active, seniors can promote longevity and vitality as they age.

It's essential to recognize the pitfalls of excessive medication and reliance on external devices. While medications have their place in managing certain conditions, seniors should be cautious of overprescribing and explore alternative treatments when appropriate. Likewise, while assistive devices can provide support, they should not replace physical activity or independence.

And finally, seniors are living longer. We are staying healthier and being serious about our longevity and happiness. We are determined to avoid the pitfalls of overprescribing and misdiagnoses. 

Come join us at the Senior Freedom Club, where all things are moving in the right direction. 

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hearing loss
Senior Healthcare: Getting the Right Medicine & Coverage

10 Signs You Might Need A Hearing Test

It is not uncommon for us seniors to suffer a slight hearing loss.  As we age, our hearing needs to be tested every year. 

To get the fastest and easiest tests, just go to Costco Hearing Center. They do not work off commission and will not try to sell you over-the-top the latest and greatest hearing devices either. They can test you quickly and then go to whoever you trust to get simple hearing aids. For more tips on how to select a device and the tricks audiologists use to sell you hearing aids, see my Senior Freedom Club

Here are some of the situations which stresses a hearing test: 

Difficulty Understanding Speech: One common sign of hearing loss is difficulty understanding speech, particularly in noisy environments. For example, imagine you're at a crowded restaurant trying to have a conversation with friends. Despite your best efforts, you find it challenging to follow the conversation amidst the clattering of dishes and the chatter of other diners. You frequently ask your friends to repeat themselves or nod along without fully comprehending what they're saying. 

Increasing Volume: Another sign of potential hearing loss is the need to consistently increase the volume of electronic devices. For instance, you might notice that you're regularly turning up the volume on your television or radio to levels that others find uncomfortably loud. Additionally, you find that the TV is unusually load in the morning, after your ears have rested. You may be using Closed Caption thinking you cannot understand the actors. No, you need your hearing tested. 

Social Withdrawal: Hearing loss can lead to feelings of isolation and social withdrawal. For example, you might decline invitations to social gatherings or avoid participating in group conversations because you struggle to hear and follow along. Over time, this avoidance of social situations can impact your relationships and overall quality of life. If you find yourself thinking people talk too low, time to get that hearing checked. 

Ringing in the Ears (Tinnitus): Tinnitus, or ringing in the ears, is another potential indicator of hearing loss. Imagine experiencing a persistent ringing or buzzing sound in your ears, similar to the sound of cicadas on a summer evening. This constant noise is distracting and disruptive, making it difficult to focus on tasks or relax. While tinnitus can have various causes, it's often associated with hearing loss. If you're experiencing this, your hearing may be impaired and it’s time for a test.

Difficulty Hearing High-Pitched Sounds: Difficulty hearing high-pitched sounds is a common symptom of age-related hearing loss, but is also common for people of all ages. Young children are very hard to understand when they are upset. Their voice seems to go up two octaves. Also, you may think to yourself, the songbirds aren’t singing like to used to. Hmmm. They really are out there. Times to get your hearing checked. 

Muffled Speech and Sounds: Hearing loss can make speech and other sounds seem muffled or unclear, like a bad McDonald’s drive-through window. For instance, imagine you're having a conversation with a friend, but their words sound distorted or garbled as if they're speaking through a filter. You might find yourself constantly asking them to repeat themselves or guessing at what they're saying based on context. This perception of muffled speech, even when people are speaking directly to you, could indicate the need for a hearing evaluation.

Struggling in Group Settings: Difficulty following conversations in group settings is a common challenge for individuals with hearing loss. For example, imagine attending a family gathering where multiple conversations are happening simultaneously. Despite your efforts to focus, you cannot hear when there is background noise. This is very common in restaurants where they blast the music right over your table. Ask the service to turn the music down or find another table. If the problem persists, then get that hearing test. 

Fatigue or Stress from Listening: Straining to hear and understand conversations can be mentally and physically exhausting. For example, imagine attending a workshop where you struggle to hear what's being discussed despite your best efforts to sit up front. Worse, the speaker talks in a soft voice. As the workshop continues, you find yourself daydreaming until someone asks a question, everyone claps, and you wonder what just happened. Get that hearing test soon. You’re missing out. 

Remember, hearing loss had many causes and takes on many different shapes and sizes. The only way you’re going to know if you are one of “them” is to be tested and see if you have lost your range of frequencies. 

By addressing hearing loss early, you can improve your quality of life and prevent further damage to your hearing. Your friends and family will thank you. Show them you are a super-ager and will live the healthiest lifestyle you can. Get that hearing test. 

Our members, super-seniors and super families who care for super seniors know that hearing is just one of nine ways we stay healthy, happy, and vibrant. Come join us!

senior freedom club


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Senior Hospital Care Tips
Senior Healthcare: Getting the Right Medicine & Coverage

Senior Hospital Care Tips

Are Hospitals Safe?

From my experience as a physician assistant, I have first-handed witnessed countless medical errors.  I have seen who the good doctors, nurses, and medical assistants are. I have seen those who hold back and do their job with less enthusiasm.

Therefore it is up to the seniors and their families to take notice and advocate for themselves. This means questioning every action and why it is being done. 

Avoid Hospitals in July. 

For seniors undergoing complex procedures, hospitalization during July poses heightened risks because new medical students with very little training are coming in to direct care and surgeries. 

I had one Chief of Emergency Room Services tell me he takes the whole month of July and August off.  When I asked him why, he said, “Because I can’t stop these new residents from killing patients and I prefer not to have my name on their charts.”

Sadly, he is not wrong. Medical students come out book smart, not experienced and so many of their missed diagnoses and treatment options are fatal to our patients. 

If you have to go to the ER during July and even August, demand an intern.  They have at least one year under their belts. 

Listen to Nurses About Doctors

I found my nurses and medical assistants knew more about what was going on than the doctors did. They were in the thick of patient care. Make sure you keep a journal with your patient. No medications are given to this patient unless a full explanation is given to you and the diagnosis or reason behind it is also given.  

I saw one woman ask this and told she had schizophrenia and needed the pill. She was not the right patient. Had she not asked this, she might have left the hospital with the wrongful diagnosis of schizophrenia which was never hers to begin with. 

Verify Who You're Speaking With

As I’ve said so many times before when you talk to someone, make sure it is the right person. When calling in the phone, you are usually talking to a central location call center who has never laid eyes on you or your patient.  If they are a nurse or medical assistant they may not have access to your chart. They cannot give you the needed information. Make sure you are getting answers from the doctor.

Senior Freedom Club Caregiver

I’ve seen countless patients discuss concerns with their doctor and then call in with a question.  The answer comes back totally different than what was discussed with the doctor.  Our members at the Senior Freedom Club have been trained that this is a reg flag.  Someone who is not the doctor is answering questions for them.

This is poor medicine and can rapidly lead to medical errors.  Only your doctor should be answering your questions. 

Keep a Detailed Journal

Maintaining a detailed journal during hospital stays is invaluable for tracking interactions with medical staff, documenting treatments received, and recording decisions made regarding your older adult's care. This journal serves as a comprehensive record that can aid in understanding medical bills, tracking the effectiveness of treatments, and facilitating communication with healthcare providers. Additionally, the journal can serve as a source of empowerment, enabling family members and advocates to actively participate in decision-making processes and advocate for their older adult's needs.

Engage the Social Worker Early

Social workers play a vital role in discharge planning and post-hospital care arrangements for seniors. By engaging with the social worker early in the hospitalization process, you can ensure that appropriate plans are in place for your older adult's ongoing care needs. This proactive approach helps to avoid rushed or inadequate discharge decisions and ensures that your older adult receives suitable placement and support for their recovery and rehabilitation.

Question the Necessity of Procedures

It is essential to advocate for your older adult's well-being by questioning the necessity of tests and procedures recommended by healthcare providers. Some doctors may be influenced by financial incentives, leading to unnecessary or excessive medical interventions. 

Remember, your patient rights say that you can refuse any procedure you do not want. By asking critical questions about the potential benefits and risks of procedures, you can ensure that you or your loved one get the care they need.

The reason is this so important is that many hospitals have “protocol”.  This means they have developed a template for all patients entering the hospital with let’s say, “Stomach pain.”  Now you may have other issues causing stomach pain and that is not why you’re there at all.  However once the protocol is in place, you will get a myriad of unnecessary tests and procedures if you do not ask why these tests and procedures are being done. Do not let anyone tell you because the doctor ordered it. Only the doctor can tell you why it was ordered so seek them out. 

Next Steps

If you like this information, want to age healthy and fit, and keep yur family relationships on a high note, then join the Senior Freedom Club where we give BOTH seniors and their adult children the best tips we know on aging.

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Senior Healthcare: Getting the Right Medicine & Coverage

Heart Matters: Understanding Cholesterol, Obesity, and Longevity

According to the CDC, the leading risk factors for heart disease and stroke are:

  • high blood pressure
  • high low-density lipoprotein (LDL) cholesterol
  • diabetes
  • smoking 
  • secondhand smoke exposure
  • obesity
  • unhealthy diet
  • physical inactivity

Several other conditions like your family history can increase your risk for heart disease. These are called risk factors. About half of all Americans (47%) have at least 1 of 3 key risk factors for heart disease.

Some risk factors for heart disease cannot be controlled, such as your age or family history. But you can take steps to lower your risk by changing the factors you can control.

Senior Freedom Club Caregiver

For a complete guide on how to age well, you might look at our "Super-Ager's" Senior Freedom Club.  Our monthly membership allows both seniors and their family members to live happy healthy lives with great relationships. 

We address all 12 categories from medical care to self-care with legal and financial and physical wellness strategies to make living stress free. And let's include family relationships so we enjoy one another as we age. 

So let's look at these top two and what we can do about them

High blood pressure is a major risk factor for heart disease. Why?  Because the heart has to pump harder to get the blood to circulate around your body. When a pump, any pump has to work harder than it should, it’s going to burn out sooner. The pressure in your arteries is your blood pressure, and the higher it is, the harder the heart has to pump OVER that pressure to get the blood to flow. 

Cholesterol is a waxy, fat-like substance made by the liver or found in certain foods. Your liver makes enough for your body’s needs, but we often get more cholesterol from the processed foods we eat.

If we take in more cholesterol than the body can use, the extra cholesterol can build up in the walls of the arteries, (oops, there goes the blood pressure again!)  including those of the heart. This leads to the narrowing of the arteries and can decrease the blood flow to the heart, brain, kidneys, and other parts of the body. All tissues have to have blood flow to get their oxygen and stay alive.

There are two main types of blood cholesterol: LDL (low-density lipoprotein) cholesterol, which is considered to be “bad” cholesterol because it can cause plaque buildup in your arteries.  I told my patients to think that LDL stands for “Lousy, so we must keep it low”.

HDL (high-density lipoprotein) is cholesterol considered to be “good” cholesterol because higher levels provide some protection against heart disease. My patients would remember HDL as “Healthy, so we want it high”.

High blood cholesterol usually has no signs or symptoms. The only way to know whether you have high cholesterol is to get your cholesterol checked with a lab.

OK so here’s the best way to explain how this good and bad cholesterol works:

Let's say your arteries are like a road.  The blood (cars) run over it every second of every day.  So, these roads need repairing after a while.  They have cracks and potholes.  Here comes the bad cholesterol.  It’s great at fixing these potholes.  It’s like pouring concrete in these holes and cracks. But let's say your road workers don't smooth it out. What a mess.  Now you have bumps in the road instead of potholes. 

Bad cholesterol doesn’t stop there when you eat too much of it.  After all, it has to have somewhere to go.  So this bad cholesterol not only overfilled the potholes but now hangs out on the road, likes speed bumps.  Now your (arteries) roads look like a thousand speedbumps. Your poor blood is getting pushed and shoved around likes it's off-roading.

Well, good news!

Here comes the good cholesterol, HDL!  It’s similar to a roller or a putty knife.  It cleans off the excess bad cholesterol and smoothes the road back down again. Imagine a nicely paved smooth ride.  That’s what the blood vessels get with HDL, our healthy cholesterol. Woo hoo! By smoothing out the blood flow, our blood pressure may go back down and better yet, our hearts will love us!

But the problem is, our HDL tends to decrease as we age.  So how do we keep it high?  

Lifestyle changes are known to increase HDL, such as moving more, quitting smoking, or improving your diet,and have been shown to lower the risk of heart attacks, according to the Mayo Clinic.  However, medications that specifically increase HDL levels have failed to reduce the rate of heart attacks.

So, the best way is to not overload your vessels (roads) with too much bad cholesterol in the first place.  Remember, your liver makes enough and just the right amount.  Don’t add to it by eating the processed unhealthy American foods pushed on us in most ads. 

Which brings me to…

Obesity is excess body fat. Obesity is linked to higher “bad” cholesterol and triglyceride levels and to lower “good” cholesterol levels. Obesity can lead to high blood pressure and diabetes as well as heart disease. 

Why is obesity so bad for us?  Well, several reasons…

  • Increased Risk of Chronic Diseases: Obesity is a major risk factor for various chronic conditions, including heart disease, stroke, type 2 diabetes, and certain types of cancer. Why? Because the body has to repair and renew more tissues which means overloading their metabolism and mistakes can happen, engines (I mean organs) can begin to fail. 
  • Cardiovascular Health: Obesity is closely linked to high blood pressure, high cholesterol levels, and atherosclerosis (hardening of the arteries). We covered this but what happens when we start packing more weight?  Just like when a city expands to the suburbs, you’ve got to have the “roads” (arteries) to carry the people (blood) to those outer-lying areas.  This means the heart now has to pump harder for more coverage. Ugh!
  • Type 2 Diabetes: Obesity is a leading cause of type 2 diabetes. Excess body fat, especially around the abdomen, can lead to insulin resistance, where the body's cells do not respond effectively to insulin, resulting in elevated blood sugar levels. Why are sugar levels so bad for us?  Have you ever eaten cotton candy?  It’s pure sugar blown through air. It’s sticky.  Now your arteries and veins are sticky and the blood doesn’t flow, it sticks like bubble gum on the bottom of your shoe.
  • Joint Problems: The added weight from excess body fat can put stress on the joints, particularly in the knees and hips. This may lead to joint pain, osteoarthritis, and reduced mobility. And then there's our backs.  If we have a large breast, well, our core strength has to work extra hard.  If we have a large belly hanging over our underwear, well there goes the lower back. Back pain is no fun. 
  • Respiratory Issues: Obesity is associated with respiratory problems, including sleep apnea, asthma, and reduced lung capacity. Sleep apnea, in particular, is more common in individuals with obesity and can lead to interrupted breathing during sleep. Let’s face it, your body needs oxygen for energy.  This energy in your cells and tissues allows them to live healthy happy lives. We all need oxygen. So, if we can’t breathe, we become tired and irritable.  Our heart, brain, and GI tract are no different. They get mad, too.
  • Liver Disease: Non-alcoholic fatty liver disease (NAFLD) is more prevalent in individuals with obesity. It can progress to more severe conditions, such as non-alcoholic steatohepatitis (NASH) and cirrhosis. Can’t live without our liver. 
  • Psychological and Social Impact: Obesity can have psychological and social consequences, including low self-esteem, depression, and discrimination. People with obesity may face stigmatization and challenges in various aspects of life. Some people feel great in their bodies.  Others love hearing how great we look!  “What did you do to look so good?” or “Have you lost weight?”
  • Reduced Quality of Life: Here's the kicker – carrying extra weight might mean a shorter stay on this planet. People with obesity tend to have a bit of a reduced life expectancy compared to those keeping things balanced. Mobility issues, chronic pain, and the burden of managing associated health conditions can impact a person's daily life, especially our joy to get out, socialize, and be around others. 

Super-aging seniors and their families know all this.  They choose happy healthy lives no matter where they are right now.  

Come join us!

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Senior Healthcare: Getting the Right Medicine & Coverage

Healthcare vs Medical Care: Knowing the Difference is Powerful

We seem to hear a lot in the news about "Healthcare". When I hear the news say "Healthcare for everyone", I cringe because we really don’t want Healthcare, we want Medical Care.

Let’s look at the differences between the two.

Medical Care has never been better.

Getting MEDICAL CARE means everything to you. Medical Care brings us new procedures, new remedies, new medications, and surgeries we never dreamed possible. Not to mention the vaccinations that are constantly coming out to protect us from disease and cancer in the first place.

And on top of that, we also have the incredible ability to prevent diseases like cancer when we never thought we could.  It used to be that your doctor knew everything about you.

We could talk to our doctors about anything for as long as we wanted. They found the solutions to what ailed us. This was the foundation of Medical Care.

Medical Care is a profession, an actual service and the trust lies between patient and doctor.

Healthcare has never been worse.

Healthcare is not a profession. It is a FOR-PROFIT business.

Healthcare is about administration costs, CEO salaries, insurance denials, and insurance premiums. It is a business that hires doctors, nurses, billing clerks, hospitalists, medical assistants, etc.

The one person who actually brings in the revenue for this company is the doctor, PA, NP.

The office visits and the orders they generate bring in the revenue. All others, from CEO salaries to nurses, maintenance, billing clerks, and ads are at the mercy of what these three people can bring in.

Let's look at these real-life examples:

Example 1: Exceptional Medical Care

Dr. A has her own practice.  She is not part of a healthcare system. This is called a "solo" practice. Her patient, Mary, sees her. She knows all of Mary's medical conditions. Mary always gets "same-day visits" or a phone call back from Dr. A. Office visits are 45-60 minutes on each visit with Mary. She knows Mary's family caregivers, too. This doctor has only a receptionist.

Here's the KEY: she runs her own practice. If Dr. A wants to spend hours with you, she can. Now she may take your insurance, which typically pays 10% of what she charges. (Don't we wish we could do this at the grocery store!) or Dr. A could take a monthly fee of $125/month from you.

Doctors who charge a monthly fee are called Direct Primary Care. This monthly fee is paid automatically, like a gym membership.  Mary can see, call, or text Dr. A as often as she wants. The fee is dependent on age, not phone calls, visits, or texts, and ranges from $18 to $150 a month. Dr. A will call in prescriptions and take phone calls because she does not need Mary to come into the office to be paid. Those are insurance rules and she does not take insurance. Mary still keeps her insurance in case she needs specialists or hospitalizations.

NOTE: Dr. A is not "concierge" medicine but a practice modeled after pre-insurance days called "direct primary care".  Concierge medicine doctors take insurance like healthcare doctors do.  The fees are typical $500 - $5000 a month. This gets you house calls or phone calls promptly returned. These fees are high in order to cover what insurance doesn't pay for his/her "regular" patients. 

Example 2: Questionable Healthcare

Dr. B works for a large healthcare company. He gets a salary (plus a "bonus" commission) for his production.  If he orders more tests, more procedures, sees more patients, he gets a bigger "bonus commission", but this is a "carrot" to get the doctor to produce more. He is required to see more patients and see them faster.  He gets "written up" if he doesn't do this. By seeing more patients, the logic is that he will generate more orders. In most healthcare systems, he is required to refer you to only those services within his own healthcare system.  

The office has a staff of 3-4 receptionists, 1-2 billing and insurance clerks, 5-6 nurses or medical assistants, one office manager, the boss who reviews everyone's evaluations, salaries and the people above the boss who make policy and profit for the company, the CEOs.

Therefore, he must work harder and longer to support all these employees in the company. Robert is a patient of Dr. B's. He waits 3-4 months to get in to see him because Dr. B must be booked to see 20-30 patients a day. Robert will see him for 6 minutes. Dr. B may order more tests, and ask Robert to come back for another visit. Robert will still pay his deductible or co-pays and his insurance premiums.

These "healthcare" doctors are burning out at an alarming rate. They didn't get into medicine to "chase the bonus carrot", but to help you.  Most of them have medical school debt, leaving them no choice.

Here are the resources: Why physicians burn out.  I find it ironic that the studies to prevent burnout are suggesting the exact thing direct primary care physicians already do.

Healthy aging seniors have personal doctors.

So you have three choices:  

  • Find a physician who is in a solo practice, takes your insurance, and runs their own practice with a focus of putting you first. 
  • Find a Direct Primary Care doctor in your area, and pay a monthly fee to get the time, trust, and care you expect. 
  • Find a physician in your healthcare system who doesn't care about bonuses and spends more time with you and not on orders and a computer. (And hope they won't quit or get fired.)
Super Ager's Starter Guide for Seniors

If you are a senior who wants exceptional medical care then pick up a FREE copy of The Senior's Starter Guide.  On page 7, you'll find 11 very smart questions you should be asking about Medicare. After all, shouldn't we get the best?

Another article you might like: Communicate Like A Pro When You Understand These Dementia Stages

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