Mar 132018
 
HEALTH March 2018

A Healthy Age

By Amy Abbott

The risk is higher for seniors, for shingles and it’s unwelcome relative, post herpetic neuralgia or PHN. Researchers, according to the National Council on Aging, have reported that our immune systems may be “awakened” by our aging bodies, triggering a dormant chicken pox virus.

Sixty-year-old M.D. Walters from near St. Louis, was baffled. Pain on one side of her head and ear caused her to lose sleep. A few days later, a rash appeared.

“It was like someone drew a straight line on my neck, and the rash ran on one side of the line,” she said. She knew about shingles, assuming that her chicken-pox free childhood liberated her from the disease. Walters thought she had pinched a nerve at the gym.

A visit to her medical provider affirmed the surprising diagnosis. When the nurse practitioner parted Walters’ hair and saw the rash on her head, she said, “You have shingles.”

Perhaps Walters had unknowingly been exposed to chicken pox from one of her three siblings in childhood. Shingles is caused by the varicella-zoster virus (VZV). The virus stays inactive in nerve cells after a bout with or exposure to chicken pox. Ninety-five percent of the Americans have the chicken pox virus, according to the Centers for Disease Control.

Nearly 1 million Americans get shingles (herpes zoster) every year. According to the National Institute on Aging, the disease packs a punch with fluid-filled blisters, sensitive skin, and mild itching to intense pain. Some unlucky people may experience hiccups, or worse, loss of vision if the virus gets in the eye. The CDC said the burning, blistering rash lasts two to four weeks, but PHN may cause pain for months. NIA notes that “something between one and five days after the tingling or burning feeling on the skin, a red rash will appear.”

The risk is higher for seniors, for shingles and it’s unwelcome relative, post herpetic neuralgia or PHN. Researchers, according to the National Council on Aging, have reported that our immune systems may be “awakened” by our aging bodies, triggering a dormant chicken pox virus.

For Walters, her medical provider affirmed her quick trip to the doctor enabled rapid treatment. She received a steroid shot as well as an antiviral drug, a steroid dose-pack, and two pain pills.

Walter’s disease process mimicked the typical patient. “The rash got ‘lumpier,’ and formed white blisters, then the blisters dried up, formed scabs, and sloughed off,” she said.

Fortunately, she did not experience any long-term effects, such as PHN. NIA reports that PHN may be the worst part of shingles for some patients with severe pain in the area where the rash erupted.

The area where shingles scab may become infected or develop a scar. NIA recommends
keeping the rash areas clean and using antibiotic cream.

How can you prevent getting shingles? Shingles are not contagious, but the chicken pox virus is. If you have shingles, you can infect someone with the chicken pox virus.

Since 2006, the FDA has approved several shingles vaccines, and the CDC recommends adults over age 60 get the shot. Shots are available through pharmacies and provider’s offices

 

Am I Covered? (CDC data sheet)

  • Medicare: Part D covers the vaccine, with a possible cost to you, depending on plan.
  • Medicaid: Dependent upon plan.
  • Private health insurance: Most plans cover for ages 60 and up. Co-pay is dependent on your plan.
  • For vaccine assistance programs: http://www.merck.com/merckhelps/vaccines/home

 

Who Can Get a Vaccine?

  • Shingles can re-occur. The CDC doesn’t prescribe any length of time between an outbreak and getting the vaccine, but recommends the rash be cleared up.
  • If you have not had the shingles, there’s no time like the present. The Advisory Committee on Immunization Practices, which advises the CDC on vaccine usage, recommended in October 2017 that all Americans 50 and older should be vaccinated with Shingrix, including those who already received the Zostavax shot (which has been on the market since 2006.)

No serious problems have been reported with the vaccine, though some patients said redness or burning the injection site and some reported headaches.

Individuals with moderate or severe chronic illness, those with severe allergies, or those with weakened immune systems should not get the shingles shot.

For more information, visit the Centers for Disease Control website at www.cdc.gov.

Amy McVay Abbott is a retired healthcare executive who writes about health care for Senior Wire News Service. She also writes humorous pieces and is featured as one of 40 humorists in the first Erma Bombeck Writer’s Workshop anthology in 2018.

Mar 132018
 

HEALTH March 2018

A Healthy Age

By Amy Abbott
 Notify your electric company you are on oxygen. In case of a power outage, you’ll be on the priority list.

An old cliché says, “as easy as breathing.” For millions of seniors, breathing doesn’t come easily without the assistance of oxygen therapy. Our body needs about 22% oxygen, so our cells work correctly, says the American Thoracic Society. Individuals with compromised lungs may not get enough oxygen into their blood and need help.

According to Grand View Research, advances in technology and rising prevalence of the respiratory disease will result in increased growth in the oxygen therapy business. Chronic Obstructive Pulmonary Disease (COPD), will be the world’s third leading cause of death by 2030.

COPD, and other diseases like asthma and congestive heart failure, may worsen enough to require the patient need oxygen therapy.

As someone suffering from chronic bronchitis and asthma for more than 25 years, I had no idea that supplemental oxygen was in my future. When I shared a range of diverse, new symptoms with my pulmonologist last May, he ordered a battery of tests. Only hours later, a home medical technician was at our home with a confusing array of equipment. Like most people, my experience with supplemental oxygen was limited to hospital stays and observing a relative with congestive heart failure.

My husband and I were utterly unprepared for the change in our lives. Nearly a year later, I’ve adjusted, and for the most part, it has not adversely affected my life. And I can breathe easier!

 

Equipment

At-home oxygen concentrator: The at-home concentrator, about the same size as R2D2 from Star Wars, is the source for your home oxygen. My machine is loud and hot, summer or winter. I keep mine in my home office close to a wall outlet.

I wear my oxygen all night, and sometimes during the day, depending on weather conditions (extreme heat and cold bother my lungs.)

  • The concentrator requires little maintenance; I wash the two filters monthly with dish soap.
  • Tubing: Tubing (from 50 down to six feet) connects to your concentrator on one end, and a cannula on the other. The cannula fits in your nose.
  • Emergency tank: Power can go out anytime, so most home medical suppliers provide an emergency tank. Mine is a 12-hour tank (based on the oxygen I use). I have yet to use it. The home medical supplier told me it will be replaced once a year, even if still full.
  • Portable oxygen: Initially, the home medical provider brought me multiple portable oxygen tanks, each with four hours’ worth of oxygen, and each weighing 25 pounds.

Still working at the time, I struggled. I needed three tanks with me in the car. Lifting 75 pounds into the car every morning when my oxygen is usually at its lowest was a deal-breaker. As a hospital marketing executive, I attended meetings and facility visits in the community, which meant dragging a tank in and out of the car multiple times a day. This wasn’t going to work for me.

I asked for another option, and now rent a portable oxygen concentrator that makes oxygen from room air. My unit weighs about five pounds and is far superior to the bulky green tanks.

You can rent your device (check with your insurer) or purchase one.

 

Some Insider Tips

  • Purchase a pulse oximeter so you can monitor your own oxygen use. Some phones have oxygen apps, like the Samsung Galaxy series. Check with your physician.
  • Notify your electric company you are on oxygen. In case of a power outage, you’ll be on the priority list.
  • Place a sign “Oxygen in use” near your front door. Smoking and oxygen therapy go together like kindling and a match.
  • Watch your electric bill and turn the lights off because you’ll see an increase in usage from your at-home concentrator.
  • Tubing and cannulas need to be replaced every few weeks. I pick up a month’s worth from the home medical office. You can also buy them online or in durable medical equipment stores. You may want to try different cannulas as some are softer to the nose than others.
  • Oxygen may dry out your nasal cavities and lead to nosebleeds in some people. Make sure your home is well-humidified or use nasal saline or gel.
  • Always consult with your physician.

Going on oxygen does not mean you are imprisoned in your home. I don’t plan to let it cramp my style. And sometimes it has benefits. Climbing the steep, curvy stairs of a New York theatre recently, I bested my husband to the top (with my portable tank on). That wouldn’t have happened before!

Disclaimer: Your home medical provider may offer you a slightly different set-up or equipment. My choices are not meant to be prescriptive, only descriptive.

 

Amy McVay Abbott is a retired healthcare executive who writes about health care for Senior Wire News Service. She also writes humorous pieces and is featured as one of 40 humorists in the first Erma Bombeck Writer’s Workshop anthology in 2018

Feb 242018
 

February 2018

A Healthy Age

By Amy Abbott

Blister packs reduce the chance a pharmacist will provide the wrong amount of medicine, and make it difficult for illegal operators to substitute bogus products. With blister packs, there is also a reduction in contamination risk.

From Senior Wire News Service — At dinner last evening, my husband asked me, “Did I take my pills yet?” He pulled his little silver case out of his pocket, and sure enough, he had already taken them. Any senior’s daily dance with medications is only a snapshot of a larger societal issue. We make mistakes, and worse, news reports frequently cite the dreadful track record for medication errors by hospitals, pharmacies, and others in the system.

According to a 2016 article in the journal Community Hospital Internal Medicine Perspectives, adverse drug events (ADE) happen during 3.5 million office visits and 1 million emergency department visits annually.

“Preventable medication errors impact more than 7 million patients and cost almost $21 billion annually across all care settings,” reported the authors, “About 30% of hospitalized patients have at least one discrepancy on discharge medicine reconciliation. Medication errors and ADEs are an underreported burden that adversely affects patients, providers, and the economy.”

Enough to make one reach for the jar of leeches the next time you become ill, isn’t it? The Food and Drug Administration (FDA) notes the major causes of errors:

  • Poor communication in a multi-layered system.
  • Ambiguous product names, directions, or use of medical abbreviations not commonly understood.
  • Poor procedures or techniques.
  • Patient misuse because of misunderstanding product use directions.

Across the prescribing chain, mistakes happen – in the initial packaging, repackaging, dispensing, administering, and even in the wrong use by a patient.

A federal agency, known as the Center for Drug Evaluation and Research (CDER) is, according to the FDA, charged with preventing medication errors before a drug’s approval. They also evaluate, monitor, and act on reported medication errors, educating health professionals, and sharing information with those invested in preventing errors.

The bottom line is that errors can happen at any link in the chain – during a pharmaceutical trial before the release of a new medication, or in your bathroom when your partner hands you tonight’s medication.

 

Technology May Be a Game-Changer

Two uses of technology may reduce medications errors and provide designer drugs for individuals. Writing for the American Enterprise Institute’s “AEIdeas,” Roger Bate suggested that improved packaging may reduce errors.

“My criticisms of individual pill distribution is not with the pharmacist. All humans make mistakes, but the U.S. approach treats the patient as largely passive in the whole process.” He continued, “With professional packaging and branding, patients are more likely to see if the medicine is not what they were told it should be by the prescribing physician.”

Bate suggested that blister packs reduce the chance a pharmacist will provide the wrong amount of medicine, and make it difficult for illegal operators to substitute bogus products. With blister packs, there is also a reduction in contamination risk. Bate noted that Amazon recently announced it was jumping into the pharmaceutical pool, selling medicine in the blister packs popular elsewhere in the world.

My question is, will a drone deliver my eye drops? I was reticent to move to mail order, fearing what would happen to the drops on a postal truck in a humid Ohio River Valley summer. Now I will worry that the drone will drop my drops on my roof, necessitating a ladder adventure that surely isn’t good for my health.

Seriously, with the 800-lb gorilla presence of Amazon in our economy, this could be a game-changer. A recent US News report outlined how DNA-specific medication can help doctors treat a patient’s condition based on changes in their genetic make up. The MyCode Community Health Initiative, based at Geisinger Health Systems in Pennsylvania, catalogs the DNA of 150,000 volunteers. If genetic changes are found in conditions associated with a patient’s particular DNA mix, patients are notified.

The source used the example of a 58-year-old Pennsylvania homemaker who had her DNA tested in April 2016. The My Code Community Health Initiative notified her that she was a carrier of a gene that might cause breast and ovarian cancer. The patient had her ovaries removed, and doctors found a golf-ball sized tumor. She had been asymptomatic.

While this illustration is only anecdotal, the point is made that technology offers space-age options that we could not have imagined as children. Designer drugs, made especially for us, can reduce the margin of error, but we still have to take the right pill at the right time.

For further information see http://www.go60.us/health/item/2430-keeping-yourself-safe-from-medical-errors discusses ways to prevent personal medication errors.

 

Amy McVay Abbott is a newly retired healthcare executive who writes about health and wellness issues. Visit her at www.amyabbottwrites.com

http://go60.us/health/item/3182-medication-errors-are-pervasive-what-can-be-done

 

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