Saturday, September 27, 2014

The Loneliness of Chronic Disease

One of the side effects of a chronic condition, often not discussed at medical appointments, is the loneliness that many experience. Treatment regiments, physical changes, restrictions in daily activities, pain, aches etc. all contribute to feelings of being isolated and alone. People also isolate because they don’t: want to be a burden; feel like they fit in; or that others will understand. Shame can also be a factor, and yes, people do stop calling or inviting you to participate in social events because of your condition. Even when you are surrounded by people that love you, they aren’t sharing your experience so feelings of aloneness can persist.

Not surprising research shows that loneliness is significantly related to total number of chronic illnesses and lower quality of life and by itself can also increase risks of becoming sicker and reducing immune function. Am. J Nurs.

It’s important to recognize the distinction between being alone versus being lonely. For some, being alone with their medical illness provides an opportunity for reflection and self-assessment while they experience connection through a spiritual practice, religion or an artistic pursuit. They may find that their alone activities support them in finding direction, meaning and control. This post is for those who are experiencing loneliness and want to change it.

Things to consider
• Your medical condition does not define you.

• You can’t change how other people think, but you change who you spend time with.  There are many different condition and other types of support groups on-line and in person you can participate in. For meetings in your area, ask about them where you receive your care. Often bulletin boards at your provider’s office will contain information, but if you don’t readily see something ask, and/or contact the local chapter of a condition specific organizations (e.g. Diabetes Association). Check out Finding Support on-line.

• Find activities that engage you and bring you joy. This can be a walk in the park, meditating, going to church or doing one of the many “takes a breaks” that are posted every Wednesday on this blog as well as to Pinterest.   T.H. White, the author of The Once and Future King, wrote, “The best thing for being sad," replied Merlin, beginning to puff and blow, "is to learn something. That's the only thing that never fails. You may grow old and trembling in your anatomies, you may lie awake at night listening to the disorder of your veins, you may miss your only love, you may see the world about you devastated by evil lunatics, or know your honour trampled in the sewers of baser minds. There is only one thing for it then — to learn. Learn why the world wags and what wags it. That is the only thing which the mind can never exhaust, never alienate, never be tortured by, never fear or distrust, and never dream of regretting. Learning is the only thing for you. Look what a lot of things there are to learn.”  

• Engage in groups doing activities that you enjoy. If you like to hike, joining a hiking club will help you meet others with similar interests. Meet Up  is a good resource to learn what’s happening in your community.

For related posts, check out:

Wednesday, September 24, 2014

Take a Break: Celebrate Oktoberfest

Held annually in Munich, Bavaria, Germany, Oktoberfest since 1810, this year it began on September 20 and will last for about 16 days. So we’re right in the middle of the festivities.

• See pictures from 2014’s Munich Oktoberfest 

• Check your local papers to see if there is a local Oktoberfest festival.

• Try some Oktoberfest beers. Many microbreweries will have special Oktoberfest beers on tap. However, the beer floats with ice cream? That’s just plain wrong.

• Enjoy some Oktoberfest music and parades
-       Oktoberfest song 
-       Oktoberfest Songs 

• Besides beer, Oktoberfest is a foodie’s delight. Try out some of the following recipes:
-       Bratwurst Sliders 

• Party Decorations: Think blue and white checkers for the main color theme and pattern, since these represent the German state of Bavaria. If you’re lucky enough to still have flowers in bloom, decorate the table with vases of fresh flowers, German flags or whatever is handy. From the pictures, table settings are minimal as this is a festival all about the food and beer. Some items you might try:
-       Beer candles 

Saturday, September 20, 2014

Journal Watch September 2014


• Fewer Painkiller Deaths in States with Medical Marijuana: Access to medical marijuana is associated with 25 percent fewer prescription drug overdose deaths each year compared to states where medical pot is illegal. The study authors believe that people suffering from chronic pain tend to rely on medical marijuana when they have that option, which reduces the risk of addiction and overdose that accompanies use of narcotic medications. JAMA Internal Medicine 8/25/14 

Playing Video Game May Boost MS Patient’sBalance: It appears that patients who use the Wii Balance Board five days a week -- moving to snowboarding or dance games, for example -- may help reduce their risk of falls and boost certain brain connections, possibly because they're coordinating their movements with a figure on a screen. Radiology 8/26/14 

 Yoga Relieves MS Symptoms: A specialized yoga program is beneficial to everyday living for those with multiple sclerosis, a study concludes. After an eight-week trial, the researchers found that participants had better balance, fine motor coordination, an improved quality of life and a decrease in pain and fatigue. Science Daily 

Benefits, risks of yoga found for bipolar disorder A survey of people with bipolar disorder who practice yoga have identified benefits and risks of the practice. The information, plus a pilot clinical trial currently underway, could help psychologists develop yoga as an adjunctive therapy for the condition. Journal of Psychiatric Practice

• Approves Trulicity to Treat Type 2 Diabetes 
• Approves Movantik ofr Opioid induced constipation 
• Approves weight-management drug Contrave 
• Allows marketing of the first test to assess risk of developing acute kidney injury
• Approves Keytruda for advanced melanoma 
• Allows marketing of first ZnT8Ab autoantibody test to help diagnose type 1 diabetes 

• Is Baby Aspirin the New Apple? Interesting review of low dose aspirin as a preventive medicine. Scientific American 

• Antibiotic Might Raise Heart Risks forSome: Taking the widely used antibiotic clarithromycin may boost some patients' odds of dying from heart-related causes, a new study suggests. BMJ, news release, Aug. 19, 2014 

 Exercise May Guard Against Irregular Heartbeat in Older Women: Physically active postmenopausal women had a 10 percent lower risk of developing atrial fibrillation, compared to women who were more sedentary, researchers report in the Aug. 20 issue of the Journal of the American Heart Association. 

• Good Neighbors Are Good For Your Heart: Having good neighbors may reduce your heart attack risk, new research suggests. Specifically, a single unit increase in neighborhood social cohesion was associated with a 17 percent reduced risk of heart attack, according to the findings published online Aug. 18 in the Journal of Epidemiology & Community Health. 

• Train Your Heart to Protect Your Mind: Exercising to improve our cardiovascular strength may protect us from cognitive impairment as we age, according to a new study. "Our body's arteries stiffen with age, and the vessel hardening is believed to begin in the aorta, the main vessel coming out of the heart, before reaching the brain. Indeed, the hardening may contribute to cognitive changes that occur during a similar time frame," explained the first author of the study. Neurobiology of Aging 

• Second hand e-cig smoke compared to regular cigarettes:Scientists studying secondhand smoke from e-cigarettes discovered an overall 10-fold decrease in exposure to harmful particles, with close-to-zero exposure to organic carcinogens. However, levels of exposure to some harmful metals in second-hand e-cigarette smoke were found to be significantly higher. Environmental Science: Processes & Impacts, 2014 

• Up to 3,000 times the bacterial growth on hollow-head toothbrushes: Solid-head power toothbrushes retain less bacteria compared to hollow-head toothbrushes. "Toothbrushes can transmit microorganisms that cause disease and infections. A solid-head design allows for less growth of bacteria and bristles should be soft and made of nylon. It is also important to disinfect and to let your toothbrush dry between uses. Some power toothbrushes now include an ultraviolet system or you can soak the head in mouthwash for 20 minutes."Journal of Dental Hygiene Aug 2014 

• An hour of moderate exercise a day may decrease heart failure risk: In a new study reported in the American Heart Association journal Circulation: Heart Failure, researchers say more than an hour of moderate or half an hour of vigorous exercise per day may lower your risk of heart failure by 46 percent. 

 Statins MayHelp Prevent Diabetes-Related Nerve Damage: Although the drugs are known to lower the risk for heart attack and stroke among those with type 2 diabetes, Danish researchers report statins may also help protect against diabetes-related damage to small blood vessels in the body that can lead to blindness and amputations. Sept. 9 in The Lancet Diabetes & Endocrinology 

• Short Walks Can Offset Long Stretches of Sitting: Taking really short but frequent walks can counteract the harm caused by sitting for long periods of time, a new study suggests. The researchers found that even just a five-minute stroll can help. Medicine & Science in Sports & Exercise 9/8/14 

• Almost Everyone Needs a Flu Shot: The CDC is urging that everyone 6 months and older receive the flu shot. MMWR 

 Health Lifestyle Changes Linked to Reduced Risk for Dementia: Managing diabetes, quitting smoking, controlling high blood pressure, exercising and maintaining a healthy weight can reduce the risk for dementia -- even late in life, according to new research. Alzheimer's Disease International website 

• Treating insomnia in elderly reduces inflammation, lowers risk for chronic diseases: Insomnia can cause chronic inflammation, which can lead to hypertension, diabetes, heart disease, and more. This study finds that curing the insomnia reduces the inflammation and hopefully reduces disease. It also found the best way to cure lack of sleep is through the use of a common psychotherapy treatment—cognitive behavioral therapy. 

Can a Dietary Support Supplement Treat a Concussion? No! Exploiting the public's rising concern about concussions, some companies are offering untested, unproven and possibly dangerous products that claim to prevent, treat or cure concussions and other traumatic brain injuries (TBIs). FDA 

• Low Carb Beats Low Fat for Weight Loss and Heart Health : In a study of 148 men and women, after one year, the people on the low-carbohydrate diet lost more weight and had greater decreases in fat mass and other cardiovascular risk factors than those on the low-fat regimen. Reductions in LDL or bad cholesterol were similar in both groups. But HDL or good cholesterol levels increased more in those following the low-carb diet. Annals of Internal Medicine 

 Comparison of Named Diet Programs Finds Little Difference in Weight Loss In an analysis of data from nearly 50 trials including about 7,300 individuals, significant weight loss was observed with any low-carbohydrate or low-fat diet, with weight loss differences between diet programs small, findings that support the practice of recommending any diet that a patient will adhere to in order to lose weight. JAMA 

 Science on Diets is Low inEssential Information: Good article on the scientific study of diets in view of the two previous studies listed. NPR 

• Drinking tea reduces non-cardiovascular mortality by 24%: Drinking tea reduces non-cardiovascular mortality by 24 percent, reveals a study in 131,000 people. "Tea has antioxidants which may provide survival benefits. Tea drinkers also have healthier lifestyles so does tea drinking reflect a particular person profile or is it tea, per se, that improves outcomes.” ESC Congress 

• Potassium Rich foods cut stroke, death risks among older women: Older women who eat foods with higher amounts of potassium may be at lower risk of stroke and death than women who consume less potassium-rich foods. The health benefits from potassium-rich foods are greater among older women who do not have high blood pressure. Most older American women do not eat the recommended amounts of potassium from foods. American Heart Association 

 Vitamin E, Selenium Supplements Don’t Seem to Prevent Cataracts: Daily supplements of selenium or vitamin E don't seem to protect against the development of age-related cataracts among men, a new study indicates. JAMA Opthalmology 

• Artifical Sweeteners May Raise Blood Sugar Levels: Artificial sweeteners can potentially make blood sugar levels rise despite containing no calories, researchers found in human and mouse studies. That's because saccharine and its counterparts appear to alter the bacteria residing in the intestines in 

• The benefits and dangers of supplements: From multivitamins to supplements that pledge to help with everything from depression to treating athlete’s foot, whole stores are filled with these alternative medications. With so many options out there it can be difficult for patients to know what is beneficial or even where to start. 

• Deep Brain Stimulation Safe for Older Parkinson’s Patients: The risk of complications when implanting deep brain stimulation devices in the brains of people with Parkinson's disease is no greater in older patients than younger ones, a new study shows. JAMA Neurology 8/25/14 

• Cutting Back on Carbs, Not Fat,  May Lead to More Weight Loss: Turns out eating foods with fat-everything from avocados and nuts to dairy fat doens’t make us fat. But eating too many carbohydrates — particularly the heavily refined starches found in bagels, white pasta and crackers — does our collective waistlines no favors. The low carb, healthy fats approach has been shown to cut the risk of heart disease. Annals of Internal Medicine 

• Talk Therapy Plus Meds May be Best for Severe Depression: Four out of five people suffering from severe depression for less than two years experienced full recovery when treated with cognitive therapy plus antidepressant medication, researchers found. On the other hand, the combination didn't work much better than drugs alone in helping people with mild depression or those with severe and chronic depression lasting longer than two years. Aug. 20 in JAMA Psychiatry 

 Three-quarters of depressed cancer patients do not receive treatment for depression; new approach could transform care: Three papers reveal that around three-quarters of cancer patients who have major depression are not currently receiving treatment for depression, and that a new integrated treatment program is strikingly more effective at reducing depression and improving quality of life than current care. The Lancet 8/27/14 

• Marijuana Compound May Offer Treatment for Alzheimer’s: Extremely low levels of the compound in marijuana known as delta-9-tetrahydrocannabinol, or THC, may slow or halt the progression of Alzheimer's disease, a recent study from neuroscientists shows. Journal of Alzheimer’s Disease 

• Electric Current to Brain Boosts Memory: Stimulating a region in the brain via non-invasive delivery of electrical current using magnetic pulses, called Transcranial Magnetic Stimulation, improves memory. The discovery opens a new field of possibilities for treating memory impairments caused by conditions such as stroke, early-stage Alzheimer's disease, traumatic brain injury, cardiac arrest and the memory problems that occur in healthy aging. Science Aug 29 

• Family Squabbles Can Derail Recovery from Cancer Surgery: Cancer patients burdened by stress and family conflicts before surgery may face a higher risk for complications following their operation, a new study suggests. Investigators found that patients with a so-called quality-of-life "deficit" appeared to have a nearly three times greater risk for complications compared to those with a normal or good quality of life. Journal of Gastrointestinal Surgery 

• Combo Therapy Best for COPD: COPD patients who received a combination of long-acting beta agonists and inhaled corticosteroids were less likely to die or require hospitalization because of their breathing disorder, compared to people receiving only one of the two medications, Canadian researchers report. JAMA 

• Optimizing Health for Persons with Multiple Chronic Conditions: Recently, the Centers for Medicare & Medicaid Services (CMS) released new data resources on chronic conditions among Medicare fee-for-service beneficiaries to better define the burden of chronic conditions among beneficiaries and the implications for the US health care system. In response to this public health challenge, the US Department of Health and Human Services (HHS) released its report “Strategic Framework on Multiple Chronic Conditions” in 2010. The strategic framework, developed with private sector input, provides HHS and its partners with a roadmap for improving the health status of persons with multiple chronic conditions across 4 overarching goals. Within the first few years of implementation, the strategic framework has led to the following selected actions and continues to offer additional opportunities for further collaboration. JAMA 

 People with AB Blood Type More Likely to Have Memory Loss: People with blood type AB may be more likely to develop memory loss in later years than people with other blood types, according to a study published in the online edition of the journal Neurology.

• Grief Can Weigh on Immune System: The balance of stress hormones during bereavement changes with age, British researchers say. As a result, older people who are grieving are more likely to have weakened immune systems and develop infections, a new study found. Immunity and Ageing 

• 1 in 5 US Men Admits to Violence Against Women: A nationally representative study from the University of Michigan revealed that such violence is more prevalent than diabetes. This violence includes pushing and shoving, grabbing, throwing objects, slapping and hitting, kicking, biting, choking, burning or threatening their partner with a weapon, the researchers said. There are a number of telltale signs among men that are associated with a higher risk of intimate partner violence including; irritable bowel syndrome; insomnia; history of substance abuse; history of experiencing or witnessing violence as a child. Journal of the American Board of Family Medicine