Dr. Mauk’s Boomer Blog

/Dr. Mauk's Boomer Blog

Each week, Dr. Mauk shares thoughts relevant to Baby Boomers that are aimed to educate and amuse.

Bladder Cancer Risk Factors and Treatment

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Background

This type of cancer occurs mainly in older adults, with an average age at diagnosis of 73 years, with 9 out of 10 cases of bladder cancer diagnosed in persons over age 55. The American Cancer Society (ACS)(2012) reported that over 73,000 cases were diagnosed in 2012 and that this diagnosis rate has been relatively stable over the last 20 years. Men are three times as likely to get cancer of the bladder as women (American Foundation for Urologic Disease, 2008) and the incidence increases with age.

Risk Factors

Risk factors include chronic bladder irritation and cigarette smoking, the latter contributing to over half of cases. Male gender and age are also risk factors.

Warning signs

The classic symptom of bladder cancer is painless hematuria (blood in the urine). Older adults may attribute the bleeding to hemorrhoids or other causes and feel that because there is no pain, it must not be serious.

Diagnosis

Assessment begins with a thorough history and physical. Diagnosis may involve several tests including an intravenous pyelogram (IVP), urinalysis, and cystoscopy (in which the physician visualizes the bladder structures through a flexible fiber-optic scope). This is a highly treatable type of cancer when caught early. In fact, the ACS (2012a ) estimates that there were more than 500,000 survivors of this cancer in 2012.

Treatment

Once diagnosed, treatment depends on the invasiveness of the cancer. Treatments for bladder cancer include surgery, radiation therapy, immunotherapy, and chemotherapy (ACS, 2012). Specifically, a transurethral resection (TUR) may involve burning superficial lesions through a scope. Bladder cancer may be slow to spread, and less invasive treatments may continue for years before the cancer becomes invasive or metastatic, if ever. Certainly chemotherapy, radiation, and immune (biological) therapy are other treatment options, depending on the extent of the cancer.

Immune/biological therapy includes Bacillus Calmette-Guérin (BCG) wash, an immune stimulant that triggers the body to inhibit tumor growth. BCG treatment can also be done after TUR to inhibit cancer cells from re-growing. Treatments are administered by a physician directly into the bladder through a catheter for 2 hours once per week for 6 or more weeks (Mayo Clinic, 2012a). The patient may be asked to lay on his/her stomach, back, and or sides throughout the procedure. The patient should drink plenty of fluids after the procedure and be sure to empty the bladder frequently. In addition, because the BCG contains live bacteria, the patient should be taught that any urine passed in the first six 6 hours after treatment needs to be treated with bleach: One cup of undiluted bleach should be placed into the toilet with the urine and allowed to sit for 15 minutes before flushing (Mayo Clinic, 2012a).

If the cancer begins to invade the bladder muscle, then removal of the bladder (cystectomy) is indicated to prevent the cancer from spreading. Additional diagnostic tests will be performed if this is suspected, including CT scan or MRI. Chemotherapy and/or radiation may be used in combination with surgery. When the cancerous bladder is removed, the person will have a urostomy, a stoma from which urine drains into a collection bag on the outside of the body, much like a colostomy does. Bleeding and infection are two major complications after surgery, regardless of type, whether a TUR or cystectomy is performed. Significant education of the patient related to intake/output, ostomy care, appliances, and the like is also indicated.

For more information on Bladder Cancer, visit National Cancer Institute at:
http://www.cancer.gov/cancertopics/wyntk/bladder/

Adapted from Mauk, K. L., Hanson, P., & Hain, D. (2014). Review of the management of common illnesses, diseases, or health conditions. In K. L.
Mauk’s (Ed.) Gerontological Nursing: Competencies for Care. Sudbury, MA: Jones and Bartlett Publishers. Used with permission.

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By |2018-10-19T15:26:03+00:00October 21st, 2018|Dr. Mauk's Boomer Blog, News Posts|Comments Off on Bladder Cancer Risk Factors and Treatment

Guest Blog: Four Easy Winter Safety Tips for Seniors

For many people, winter is a magical time. They get to play in the snow, celebrate holidays with family and friends, and cuddle up by the fire. But, for some, including seniors, winter can be a difficult and even potentially dangerous time.

Between the risks of slipping and falling and arthritis pain made worse by the cold weather, many seniors find themselves dreading the winter months. If you’re in this group, there’s no need to fear the cold and snow.

Read on to learn about four winter safety tips that every senior should keep in mind as the weather cools down.

1. Avoid Slips and Falls
Your chances of slipping and falling increase dramatically in the winter.

To avoid falls and potentially serious injuries, be sure to only walk on sidewalks and walkways that have been cleared and salted. If you’re not sure, err on the side of caution and take another route.

It’s also important to wear proper winter boots with non-skid soles. Replace the rubber tip on your cane, if you use one, too.

2. Drive Safely
You also need to take extra precautions when you drive during the winter months. Have your car checked during the fall or early winter to make sure everything is operating properly. Be sure to keep your cell phone with you whenever you drive, too.

Avoid driving on icy roads whenever you can, and stick to well-plowed, bigger roads when snow hits. They’re usually cleared more quickly than backroads.

3. Minimize Joint Pain
If you suffer from arthritis or joint pain, you mind find that it gets worse during the winter. Some things you can do to relieve your pain and stay comfortable include:

Dress warmly
Find ways to exercise indoors
Eat a balanced, anti-inflammatory diet
Use balms or creams to relieve knee pain
Soak in a warm bath or hot tub to loosen up your joints

4. Fight Seasonal Affective Disorder
Finally, keep in mind that Seasonal Affective Disorder, also known as SAD or winter depression, is also common among seniors, especially seniors who live alone and don’t socialize as much during the winter.

If you find yourself feeling depressed or isolated when the weather cools down, seek out new ways to connect with loved ones. Schedule daily or weekly phone calls, or arrange for family members and friends to come and visit you.

By |2018-10-19T15:27:14+00:00October 19th, 2018|Dr. Mauk's Boomer Blog, News Posts|Comments Off on Guest Blog: Four Easy Winter Safety Tips for Seniors

The Sandwich Generation: Make it a Triple Decker!

We have all heard of the “sandwich generation” – those middle-aged adults who are still caring for their own children and also an aging parent. Well, here is an emerging trend that I will call the Triple Decker Sandwich generation: Baby Boomers who help care for aging parents, who still have children at home of their own, and who find themselves also taking on full time care of their small grandchildren. Yes, that is a sandwich of an entirely different kind. That is a Triple Decker.

Pew Social Trends (2013) revealed that many adults in their 30s and 40s were caring for ailing older parents and also providing some type of financial support for grown children. This resulted in reports from the sandwich generation in feeling in a hurry, rushed, and not having enough time for all of their expected duties. Now, add to those statistics another emerging trend: grandparents caring for grandchildren. I am not referring to the occasional or even regular hour babysitting or childcare that loving grandparents provide. Instead, this is the 24/7 responsibility for grandchildren who live with them, or whom they have adopted. The 2015 Profile of Older Americans from the Agency on Aging found that “in 2014, about 554,579 grandparents aged 65 or more had the primary responsibility for their grandchildren who lived with them”. Now, please note that this is only those grandparents aged 65 an over. What about all the others in their 50s and early 60s doing the same? I imagine that each person reading this can think of at least one or two grandparents who are raising small grandchildren. The implications of this on the health of aging persons is enormous. So, here are some tips to survive the Triple Decker Sandwich generation.

Pace yourself

If you have this many people in your life to care for, you must pace yourself. Avoid the temptation to give 100% all the time. It isn’t possible. Something in your life will suffer – and often this is your own health. Think of this task of caring for multiple generations as running a marathon. Develop skills, train, get into a good rhythm that you can maintain for the long haul.

Set priorities

You might have been able to juggle 4 kids and a job when you were in your late 20s or early 30s, but maybe now you are in your 50s with aging parents, teenagers, and a grandbaby to care for. Flexibility is a key to success. You just can’t do everything the same way if you are caring for small children again. Decide what is most important. Set reasonable and attainable goals. Make small goals for each day and celebrate those accomplishments.

Accept help

Even if you were used to being able to do it all yourself when you were younger, the amount of care that a Triple Decker generation person takes on requires some help at times. Let your adult children watch that baby to give you a break. Let the teens in the house help with the childcare. It is a good time for them to learn these skills for when they are parents. Tag team with your spouse to share the burden if you have a little one in the home. Church friends are happy to help if you need a night out.

Take time to rejuvenate

Being part of a Triple Decker sandwich is tough. Take time to rejuvenate to avoid burnout. You can’t care for anyone if you become ill or incapacitated yourself. For each person, renewal comes in different forms. For men, this might mean playing a sport or watching games on TV without interruption, or having a quiet private place in the house that is off limits from the noise of the household. For moms, this might be shopping alone or getting a manicure or pedicure. Sometimes talking on the phone, or meeting with friends for lunch provides a needed break. Know what you personally need to recharge and refocus and then allow yourself this (without guilt) on a regular basis. You may not be able to change your circumstances, but you can change how you deal with them.

Don’t expect too much

Chances are, if you find yourself in the Triple Decker mode, you are aging yourself. You can remember how you balanced work, life, kids, and higher education by yourself years ago. Now you wonder how you did it all. Well, you were 20 or 30 years younger then, so cut yourself some slack. Be sure to get enough sleep. Take breaks as needed. Exercise and eat right. Cut out the unnecessary things you did before to fill time and focus on those priorities that you set, without neglecting your own health.

Triple Decker Sandwich persons are tough and resilient. Congratulate yourself that you have been able to make it all work and care for your many loved ones. You sacrifice many things such as an easy and comfortable retirement and the ability to travel. But, you have given a great gift to those you love by sharing your care for them. In the end when you reflect back on your life accomplishments, you might very well find that this was one of the greatest.

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By |2018-10-15T18:28:35+00:00October 15th, 2018|Dr. Mauk's Boomer Blog, News Posts|Comments Off on The Sandwich Generation: Make it a Triple Decker!

Guest Blog:Technology in mobility, a smarter outlook!

In a world where technology seems to pervade every aspect of our lives, we take a look at how technology can make a positive contribution to care and making the lives of your loved ones easier and more dignified in later life.

Many people will be familiar with the term ‘Aids To Daily Living’.  This simply describes a category of products that do exactly what the term implies. Usually associated with smaller products that help in the home or the garden, these products are at the forefront in the push for technological breakthroughs as manufacturers look for the next big seller!

This relentless drive has meant that the Living Aids sector has grown massively from just a few lines of products in the early eighties, to quite literally thousands of product lines and growing today.

Examples of some Daily Living Aids include easy grip cutlery; can and bottle openers, long handled tools, the list is almost endless and there are new innovations being developed daily.

Technology has pushed the advancement of lightweight materials including new plastics, metals alloys and electronic components that have revolutionised many products. A good example of this is the walking stick, formerly made of cane in a one-size-fits-all configuration; the walking stick now has many types, materials, colours and setting options. Many of the enhancements have been borrowed from the world of high end sport, F1, military and even space!

Further evidence of this technological boundary breaking has been in the field of medical prosthetics where both mechanical engineering and state of the art electronics mean that disabled people are now receiving much greater movement options as bio and electronic systems become ever more intertwined.

The care sector has always been hungry for new technology, as most readers will be aware it is the smaller sometimes mundane tasks that affect our loved ones and that require specialist products that can help. The search for these products can be challenging but the internet can be a valuable resource to locate Daily Living Aids that can be most useful.

It is usually a good idea to start with the problem when looking for new products, i.e. ‘problems reaching high shelves’ – searches like this will often bring up some product based results and technology based answers. Another good resource is forums where new technology is discussed and you can canvas the experience of other product users.

A greater range of Daily Living Aids products can mean more independence as more tasks become available through the tools available. It can make a big difference to self-esteem as the person can continue to feel they can perform ordinary tasks, albeit with a little help in the right direction, and sometimes a little push to get them to adopt something new!

As with all technology, it will continue and this will mean that in the future we can look through to even more discoveries that can contribute to increased mobility and independent living of our loved ones; this can only be a good thing and is a great example of using technology in a positive way, for the benefit of all.

This post was written on behalf of Andrew Atkinson. Andrew is a director of mobility products specialists MobilitySmart and has written many articles on providing health and mobility tips .

 

 

 

By |2018-10-12T16:52:39+00:00October 13th, 2018|Dr. Mauk's Boomer Blog, News Posts|Comments Off on Guest Blog:Technology in mobility, a smarter outlook!

Four Things Seniors Need to Know about Total Ankle Replacement Surgery

If you suffer from a severe form of ankle osteoarthritis, you may be curious about the benefits of a total ankle replacement surgery.

Total ankle replacements can be common. In fact, surgeons perform thousands of them each year.

This surgery can be quite effective and can significantly improve your quality of life. But, if you’re considering it, it’s important to know exactly what you’re getting yourself into.

Listed below are four essential things seniors need to know before undergoing a total ankle replacement surgery.

1. The Ideal Candidate for an Ankle Replacement
Surgeons typically prefer to perform ankle replacements on patients who are older and less active.

This is because an ankle replacement usually is not as durable as a hip or knee replacement. Because younger patients tend to be more active, there’s a greater chance of them putting too much strain on the new joint.

2. Recovery Takes a While
After your surgery, you’ll likely only need to spend one night in the hospital recovering.

Once you return to your home, you’ll have to rest for 4-6 weeks before you try to move around on your new ankle joint. It also takes about three months of physical therapy for your ankle to fully heal.

3. You’ll Need to Use Mobility Aids
While you’re recovering, you’ll need to rely on mobility aids to help you get around without putting any strain on your ankle.

In the beginning, your doctor will likely recommend using crutches and wearing a boot to stabilize your ankle. You may also be able to use a knee walker scooter as an alternative to crutches if you prefer.

4. Most People are Satisfied with Their Results
Ankle replacement surgery is a relatively new procedure compared to knee and hip replacements.

They may not be as stable as their counterparts, but ankle replacements tend to yield very high patient satisfaction ratings. In fact, research shows that 90 percent of patients were satisfied with the results of their surgery within the first four years.

Final Thoughts
As you can see, there are some important factors to take into account before deciding if a total ankle replacement is right for you.

But, if you seem like an ideal candidate and are okay with a few months of downtime post-surgery, you’ll likely be very satisfied with the end result.

By |2018-10-11T11:30:39+00:00October 12th, 2018|Dr. Mauk's Boomer Blog, News Posts|Comments Off on Four Things Seniors Need to Know about Total Ankle Replacement Surgery