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Resources2018-05-18T09:03:15-05:00

Guest Post: Why dieting isn’t sustainable

 Close-up of Fresh Vegetables and Fruits

A diet is simply a way of eating. Some people diet with too much food, some people with too little food. But for most people, it’s just the wrong foods. However, one thing is for sure, diets don’t work. They never had and they never will. Just ask anyone who has been on any of the well-known, celebrity-endorsed diet plans for any length of time.

Note: Check out this guide to flexible dieting on how to escape the dieting life!

Dieters are often excited about the quick weight loss, but invariably, the diet doesn’t last forever and they quickly find that not only did they gain back all they lost, but they have taken on extra pounds too.

Dieting in the typical sense actually sets you up to fail in your attempt to lose those extra pounds. Immediately on any diet plan, your caloric intake is limited. That in itself isn’t a bad thing. Most meal portions have become unnecessarily large these days and actually need to be kept in check.

When you limit the number of calories consumed to get quick weight loss results on your diet plan, your body has to compensate for this loss. That’s when it begins to break down muscle tissue so as to maintain energy levels. The body also adjusts its requirements for energy and slows down its rate of metabolism.

But what happens when you go back to eating the way you did before? Well, your body is still functioning in diet mode. Your metabolism has slowed, so all that extra food is stored as fat. So you end up heavier than you were before you started dieting.

It’s also important to stress that activity can play a vital role in this too. If you can maintain your normal activity while dieting then you’re one of the few. Take a look at athletes for example. They follow a nutrition plan that that’s heavy in calories as activity like rugby training needs to be fueled. Dieting wouldn’t be an option for athletes and they do not put on unnecessary weight. The point here is that you need to also try and be active to help with your new lifestyle, dieting makes it even harder.

Aside from calorie restriction, here are other reasons why dieting isn’t sustainable for most people;

Too Restrictive – frankly speaking, diets are depressing. They take away all the fun foods and all of a sudden you can’t have chocolate anymore. Oh, now all you see is chocolate, it’s everywhere and everyone is having a bite… except you. Then, you cheat and go right back to square one.

Your Body Rejects It – your body likes eating and wants to eat. Denying your body means your body fights you to get more food. It forces you to cheat and go right back to square one.

The ‘fad diet of the week‘ is not right for your metabolism – your body needs certain nutrients. Your cravings match those nutrients. When you force your body to eat a way it doesn’t like, it slows downs, becomes clogged, and sick. You don’t even need to cheat and you’re worse now then you were at square one.

So how do you really lose fat and keep it off for good?

Getting down to your ideal weight and maintaining it means eating a balanced diet and getting plenty of exercise. It doesn’t mean a severe restriction in calories and spending hours at the gym. Simply pay more attention to the foods you eat and move around more.

Easy exercises like walking, cycling and swimming can go a long way to shaping a leaner, healthier you. Even walking 5 minutes per day is enough to get started. Then, work up to better and better exercises until you are exercising every day, alternating between strength training, cardio, and stretching.

Attaining and maintaining a healthy weight is as much about adjusting your self-concept and attitude as it is your lifestyle.

When you change the way you see yourself, it’s easy to make those necessary changes. In fact they often happen subconsciously. Your weight is governed by your self-concept. When you change the assumptions about yourself and your body, you change the results. That’s how you master weight loss forever.

 

By |April 19th, 2019|Categories: Dr. Mauk's Boomer Blog, News Posts|Comments Off on Guest Post: Why dieting isn’t sustainable

Four Ways to Help Seniors Manage Anxiety

Anxiety is a serious issue for older adults. Between three and fourteen percent of seniors experience symptoms that meet the criteria for diagnosable disorders like generalized anxiety disorder, panic disorder, and obsessive-compulsive disorder.

Even though they don’t have a diagnosable disorder, another 27 percent also experience symptoms of anxiety on a regular basis that have a significant impact on their day-to-day functioning.

If you have a parent or loved who may be struggling with anxiety, keep these four tips in mind to help them manage symptoms in a healthy way.

1. Recognize the Signs
The first step to helping a loved one manage anxiety is being able to identify their symptoms. Common signs of anxiety disorders include:

• Excessive fear or worry
• Refusing to do activities they used to enjoy
• Being obsessed with a routine
• Avoiding social interactions
• Sleep troubles
• Muscle aches and tension
• Shakiness or weakness
• Self-medicating with alcohol or drugs

2. Let Them Know You’re There for Them
Many seniors are hesitant to talk about their struggles because they don’t want to be a burden. If you think your parent or a loved one is dealing with anxiety, it’s important for them to know that you’re there for them and aren’t judging them.

3. Prevent Falls
As they age, seniors typically struggle with impaired balance, which can cause a lot of anxiety and make them worry about falling and getting hurt.

One way to show the senior in your life that you support them is to take steps to prevent falls and help them feel safe in their homes. Some ways you can do this include:

• Installing grab bars in the bathroom
• Removing loose rugs and other slip hazards
• Rearranging cupboards and cabinets so items are within easy reach
• Investing in a medical alert system

4. Encourage Them to Seek Professional Help
You should also encourage your parent or loved one to work with a professional.

Make an appointment with their doctor and let them know what you’ve noticed. You may also want to schedule an appointment with a therapist or hire a home care aide to come in and check on them a few times a week.

There are lots of things you can do to help a parent or loved one manage their anxiety in a healthy way. If you’re not sure where to begin, start with these four tips.

By |April 18th, 2019|Categories: Dr. Mauk's Boomer Blog, News Posts|Comments Off on Four Ways to Help Seniors Manage Anxiety

Hypothyroidism Warning Signs and Treatment

 

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Background

Hypothyroidism results from lack of sufficient thyroid hormone being produced by the thyroid gland. Older adults may have subclinical hypothyroidism, in which the TSH (thyroid-stimulating hormone) is elevated and the T4 (thyroxine or thyroid hormone) is normal; 4.3–9.5% of the general population has this problem (Woolever & Beutler, 2007). In this condition, the body is trying to stimulate production of more thyroid hormone. Some older adults with this condition will progress to have primary or overt hypothyroidism. This is when the TSH is elevated and T4 is decreased. Hashimoto’s disease is the most common cause and represents 90% of all patients with hypothyroidism (American Association of Clinical Endocrinologists [AACE], 2005; Woolever & Beutler, 2007), though certain pituitary disorders, medications, and other hormonal imbalances may be causal factors.

Warning Signs

Older adults may present an atypical picture, but the most common presenting complaints are fatigue and weakness.

Diagnosis

Diagnosis should include a thorough history and physical. Bradycardia and heart failure are often associated factors. Lab tests should include thyroid and thyroid antibody levels (common to Hashimoto’s), and lipids, because hyperlipidemia is also associated with this disorder.

Treatment

Treatment centers on returning the thyroid ¬hormone level to normal. This is done through oral thyroid replacement medication, usually L-thyroxine. In older adults with coexisting cardiovascular disease, starting with the usual doses may exacerbate angina and worsen the underlying heart disease, so it is important to start low and go slow. Titration should be done cautiously, with close monitoring of the older adult’s response to the medication. The does should be adjusted on 6- week intervals until normal levels of thyroid hormone are achieved. Once the TSH is within normal limits, then checking the TSH should be done every 6 to 12 months to monitor effectiveness and blood levels, because hyperthyroidism is a side effect of this therapy and can have serious implications on the older person’s health.

Patients need to learn the importance of taking thyroid medication at the same time each day without missing doses. Sometimes older adults have other problems associated with hypothyroidism, such as bowel dysfunction and depression. Any signs of complicating factors should be reported to the physician, and doctors’ appointments for monitoring should be religiously kept. Strategies for managing fatigue and weakness should also be addressed, because some lifestyle modifications may need to be made as treatment is initiated.

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.

For more information on Hypothyroidism, visit the NIH:
http://www.nlm.nih.gov/medlineplus/ency/article/000353.htm

 

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By |April 16th, 2019|Categories: Dr. Mauk's Boomer Blog, News Posts|Comments Off on Hypothyroidism Warning Signs and Treatment

Parkinson’s Disease

 

Background

Parkinson’s disease (PD) is one of the most common neurological diseases, affecting at least 1.5 million people in the United States (American Parkinson Disease Association {APDA}, 2010). The average age of onset is about 59 years of age (APDA, 2010), and the likelihood of developing PD increases with age (National Institute of Neurological Disorders, 2008). It affects both men and women, particularly those over the age of 60 years (American Parkinson Disease Foundation, 2012). Parkinson’s disease was first described by Dr. James Parkinson as the “shaking palsy,” so named to describe the motor tremors witnessed in those experiencing this condition.

Parkinson’s disease is a degenerative, chronic disorder of the central nervous system in which nerve cells in the basal ganglia degenerate. A loss of neurons in the substantia nigra of the brainstem causes a decrease in the production of the neurotransmitter dopamine, which is responsible for fine motor movement. Dopamine is needed for smooth movement and also plays a role in feelings and emotions. One specific pathological marker is called the Lewy body, which under a microscope appears as a round, dying neuron.

Signs and Symptoms

Parkinson’s disease has no known etiology, though several causes are suspected. There is a family history in 15% of cases. Some believe a virus or environmental factors play a significant role in the development of the disease. A higher risk of PD has been noted in teachers, medical workers, loggers, and miners, suggesting the possibility of a respiratory virus being to blame. More recent theories blame herbicides or pesticides. An emerging theory discusses PD as an injury related to an event or exposure to a toxin versus a disease. Interestingly, coffee drinking and cigarettes are thought to have a protective effect in the development of PD (Films for the Humanities and Sciences, 2004).

The signs and symptoms of PD are many; however, there are four cardinal signs: bradykinesia (slowness of movement), rigidity, tremor, and gait changes such as imbalance or incoordination. A typical patient with PD symptoms will have some distinctive movement characteristics with the components of stiffness, shuffling gait, arms at the side when walking, incoordination, and a tendency to fall backward. Not all patients exhibit resting tremor, but most have problems with movement, such as difficulty starting movement, increased stiffness with passive resistance, and rigidity, as well as freezing during motion (NINDS, 2012). Advanced PD may result in Parkinson’s dementia.

Diagnosis

Diagnosis of PD is made primarily on the clinician’s physical examination and thorough history taken from the patient and/or family. Several other conditions may cause symptoms similar to PD, such as the neurological effects of tremor and movement disorders. These may be attributed to the effects of drugs or toxins, Alzheimer’s disease, vascular diseases, or normal pressure hydrocephalus, and not be true PD. There is no one specific test to diagnose PD, and labs or X-rays rarely help with diagnosis.

Treatment

Management of PD is generally done through medications. Levodopa, a synthetic dopamine, is an amino acid that converts to dopamine when it crosses the blood–brain barrier. Levodopa helps lessen most of the serious signs and symptoms of PD. The drug helps at least 75% of persons with PD, mainly with the symptoms of bradykinesia and rigidity (NINDS, 2008). One important side effect to note is hallucinations. A more common treatment, and generally the drug of choice, involves a medication that combines levodopa and carbidopa (Sinemet), resulting in a decrease in the side effect of nausea seen with levodopa therapy alone, but with the same positive control of symptoms, particularly with relation to movement. Patients should not be taken off of Sinemet precipitously, so it is important to report all of a patient’s medications if they are admitted to either acute or long-term care. Dopamine agnoists trick the brain into thinking it is getting dopamine. This class of medications is less effective than Sinemet, but may be beneficial for certain patients. The most commonly prescribed dopamine agonists are pramipexole (Mirapex) and ropinirole (Requip) (Parkinson’s Disease Foundation, 2012). Medications such as Sinemet show a wearing-off effect, generally over a 2-year period. During this time, the person must take larger doses of the medication to achieve the same relief of symptoms that a smaller dose used to bring. For an unknown reason, if the medication is stopped for about a week to 10 days, the body will reset itself and the person will be able to restart the medication at the lower dose again until tolerance is again reached. This time off from the medication is called a “drug holiday” and is a time when the person and family need extra support, because the person’s symptoms will be greatly exacerbated without the medication. The earliest drugs used for PD symptom management were anticholinergics such as Artane and Cogentin, and these medications are still used for tremors and dystonias associated with wearing-off and peak dose effects (Parkinson’s Disease Foundation, 2012).

There are many other treatments for Parkinson’s disease being explored. These include deep brain stimulation (DBS), with electrode-like implants that act much like a pacemaker to control PD tremors and other movement problems. The person using this therapy will still have the disease and generally uses medications in combination with this treatment, but may require lower doses of medication (NINDS, 2012). Thalamotomy, or surgical removal of a group of cells in the thalamus, is used in severe cases of tremor. This will manage the tremors for a period of time, but is a symptomatic treatment, not a cure. Similarly, pallidotomy involves destruction of a group of cells in the internal globus pallidus, an area where information leaves the basal ganglia. In this procedure, nerve cells in the brain are permanently destroyed.

Fetal tissue transplants have been done experimentally in Sweden with mild success in older adults and more success among patients whose PD symptoms were a result of toxins. Stem cell transplant uses primitive nerve cells harvested from a surplus of embryos and fetuses from fertility clinics. This practice, of course, poses an ethical dilemma and has been the source of much controversy and political discussion.

A more recent development includes the use of adult stem cells, a theory that is promising but not yet well researched. Cells may be taken from the back of the eyes of organ donors. These epithelial cells from the retina are micro-carriers of gelatin that may have enough cells in a single retina to treat 10,000 patients (Films for the Humanities and Sciences, 2004). In addition, cells modified from the skin of patients with PD can be engineered to behave like stem cells (NINDS, 2012). Both of these alternatives present a more practical and ethically pleasing source of stem cells than embryos.
Other research includes areas include those related to alternative therapies. For example, Tai Chi has been shown to be effective in improving balance and reducing falls for PD patients (NINDS, 2012). Rehabilitation units have been using Tai Chi for similar benefits in other patients with neurological deficits. Simple interventions such as using Wii games to promote activity and exercise may be explored. The role of caffeine in PD is also being examined. In a small randomized control study of 61 patients with PD, caffeine equivalent to 2–3 cups of coffee per day was given to subjects and compared with a control group of those taking a placebo. Those patients receiving the caffeine intervention showed little improvement in daytime sleepiness, but modest improvement in PD severity scores related to speed of movement and stiffness (Postuma et al., 2012). Further study with larger groups was recommended by the researchers.

Much of the nursing care in PD is related to education. Because PD is a generally chronic and slowly progressing disorder, patients and family members will need much instruction regarding the course of the disease and what to anticipate. Instruction in the areas of medications, safety promotion, prevention of falls, disease progression, mobility, bowel and bladder, potential swallowing problems, sleep promotion, and communication is important. Most of the problems seen as compli¬cations of PD are handled via the physician as an outpatient, but certainly complications such as swal¬lowing disorders as the disease progresses may require periods of hospitalization. When persons suffer related dementia in the final phases of the disease, they are often cared for in long-term care facilities that are equipped to handle the challenges and safety issues related to PD dementia. In ¬addition, access to resources and support groups is essential.

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. Burlington, MA: Jones and Bartlett Publishers. Used with permission.

For more information on Parkinson’s Disease, visit the Michael J. Fox Foundation Website:
https://www.michaeljfox.org/

 

By |April 15th, 2019|Categories: Dr. Mauk's Boomer Blog, News Posts|Comments Off on Parkinson’s Disease