What if I told you there was a serious health crisis that many people might not be aware of. That it is the leading cause of injury-related hospitalization for older adults. That every 10 minutes this event sends an older person to the hospital, and that it is responsible for 60% of head injuries. This event must be motor vehicle accidents, right? Nope. Heart attacks or strokes? Wrong again. I too was surprised to learn that the leading cause of hospitalization in older adults is a fall from a standing height.

There is no single reason why people fall. If there was, we would of course work to prevent it. In many cases, there are multiple risk factors which can increase the risk of falling. Reducing these risk factors applies to everyone, not just seniors, however with seniors, the consequences of a fall can be more severe. Falls cause 90% of hip and wrist fractures. Let's look at some of the easiest ways in which to prevent falls for everyone.

Perhaps the easiest way to prevent falls is to have your eyes checked on a regular basis. If you have vision issues or incorrect glasses, it can make judging distances difficult. It can also make obstacles, like stairs or curbs, hard to see. So visit your eye doctor on a regular basis.

Stay active. Regular exercise increases lower body strength and helps improve balance. You do not need to start jogging or swim endless laps to improve muscle strength and balance. Most community centres have low impact activities suitable for all age ranges and abilities. You can try tai-chi, chair yoga, line dancing or pole walking. The options at my nearest seniors centre had at least 20 different classes to choose from. There were also classes specifically designed for fall prevention.  Exercise is also social and can make you feel better, but this is just an added bonus.

Make your home safer. This is the best place to think about fall prevention. Take a few moments to look around your home. Or better still, have someone else evaluate safety in your home. Here are a few ideas to increase home safety:

  • Ensure there is proper lighting in all areas of the home, especially around stairs

  • Use non-slip mats in the bathroom and on shower floors

  • Use double-sided tape on the bottom of throw rugs, or better yet remove them

  • Keep frequently used items in easy to reach places; avoid using step-stools

  • Consider grab-bars or tub handles in the bathroom and around the toilet

  • Have a night-light in areas where you walk at night

  • Keep pathways wide and clear of clutter

  • If you have pets, ensure they are not underfoot before walking

Check with your Pharmacist to see if any of your medications increase your risk of a fall. Medications that lower your blood pressure might cause issues. Pharmacists often warn patients about the risk of something we call “postural hypotension.” Some medications are helpful for reducing your blood pressure, however, they can reduce your body’s ability to deliver blood when needed. This is usually noticed when you get up from sitting or lying down. It can make you feel lightheaded or dizzy. Pharmacists often recommend that people on blood pressure medications stand still for five seconds when they first stand up. This way if you do feel dizzy, you can just sit back down. Never jump up and race to answer the phone or the doorbell. Wait five seconds before you start walking.

November is fall prevention month in Canada. This is a good time to take a fresh look at hazards around the house. If you want to learn more, visit www.findingbalancebc.ca, it is a great resource for preventing falls.


Posted
AuthorMonique de Moor

About now, the summer sun is finally here! Time to get outside and soak up some rays; what could possibly be wrong with this picture? If done right, nothing. While sun exposure is great for plants and people alike, being in the sun can pose a few dangers. Heat exhaustion, sunburns and even skin cancer can be some of the drawbacks from too much sun worshiping. We are not advocating staying indoors all summer, but just be aware of all the pleasures and pains that summer can bring.

Sunlight is good for you, it helps your body make Vitamin D. Vitamin D has been in the news recently for its ability to help prevent certain forms of cancer. There is also some evidence that it might play a role in preventing type 2 diabetes and multiple sclerosis. This important nutrient is also essential for the proper development of strong teeth and bones. People thought that vitamin D deficiency was a thing of the past, after they started fortifying milk with this vitamin. A recent medical study found that approximately 25% of people who lived in Southern Arizona were considered to be vitamin D deficient. This is quite shocking because Arizona is considered to be in the 'sun belt'.

Why is too much sunlight bad for us? The main reason is that, over time, excessive exposure to sunlight can lead to skin cancer. In the short term, too much exposure to sunlight can lead to sunburns, heat stroke or heat exhaustion. So what should one do? Sunlight is just like everything else in life, enjoy it in moderation and follow these tips:

 

  • Try to limit your exposure to the sun during its most intense times, between 10am and 4pm.    

  • Seek out shade whenever possible. Some people use an umbrella to make their own shade.    

  • Wear light-coloured, long-sleeved clothes and a broad brimmed hat to protect your face.

  • Wear your sunglasses.     

  • Apply sunscreen at least 30 minutes before going out into the sun. Use a sunscreen that has a sun protection factor (SPF) of at least 15. Don’t forget to apply it to the exposed, sensitive area(s) of your body, such as your nose, ears, neck and lips.    

  • Reapply your sunscreen every 2 hours while in the sun and after swimming or excessive sweating.

Infant and toddlers should not be exposed to direct sunlight. Sunscreen use is not recommended for little ones under the age of 6 months.

So what else should one think about when out in the sun? The first thing we always tell people is to wear proper sunglasses. Sunlight can play a role in the development of various eye disorders including cataracts, cancer of the skin around the eye, and may contribute to age-related macular degeneration. Whenever you are out in the sun, you should be wearing sunglasses, especially your children. My little one has been wearing sunglasses since she was 6 months old. Some eye care experts believe that 50% of our lifetime sunlight exposure occurs before age 18. This does make sense; kids are told to go outside and play. When choosing a pair of sunglasses, look for a pair that states that it blocks 100% of both UV-A and UV-B light. It is very hard to find sunglasses in Canada that do not block both kinds of UV light. For maximum protection look for the kind that 'wrap around', this will prevent light from getting in from the sides. Basically, if you are outside and squinting, you should be wearing sunglasses. You don't need to get an expensive pair of sunglasses for them to be effective. More expensive pairs might be a little more fashionable or use better quality glass or plastic for the lenses. To all the Grandparents out there: if you can't think of a good gift to give your little treasures, why not give a pair of cool-looking sunglasses?

Another concern about summertime is sunstroke. What normally happens when we get too hot is that our bodies produce sweat in an attempt to cool off. This works just fine, but if this system is overwhelmed it can cause the body's core temperature to rise. This rise in core temperature can be quite serious. Mild increases in temperature can cause symptoms of confusion, dizziness, fainting or headaches. The blood vessels become dilated in an attempt to lower body temperature, thus giving the skin a bright red colour. As the body's temperature rises further, dehydration may occur and symptoms of chills, shivering, nausea, vomiting and loss of consciousness may be seen. At this point medical attention is essential.

Prevention of heat exhaustion is easily done. Make sure you drink plenty of water if you are outside in the heat. The key word here is 'water', not coffee, beer or sports drinks. Wear light, loose fitting clothing, which will allow sweat to evaporate. During the hottest times of the day try to stay cool and avoid strenuous activities or exercise. One major cause of heat stroke is being trapped inside a car during a sunny day. On days where the temperature is 32C outside, the interior of car can reach 51C in 20 minutes. At these temperatures, heat stroke can occur within minutes. This can prove to be fatal for young children and pets. On average, 38 children die every year from being trapped inside cars on hot days. The same is true for the family pet, usually dogs. Never leave children or pets unattended in a car; leaving the windows slightly rolled down will not help.

You should still plan to enjoy the sun this summer, but be safe about it. Put your big hat on; stay in the shade when possible and try to avoid being in the sun between 10am and 4pm. Wear your sunscreen with 30SPF, especially on the feet, back of the hands and neck. These are very common places to get sun burnt. But don’t forget to get some sun exposure, it can keep your spirits up and help your body make vitamin D. Whenever you are in the sun just remember to ‘Slip, Slap, Slop’. Slip on your long sleeved T-shirt, slip into the shade, slap on your hat, and slop on your sunscreen.
 

Posted
AuthorMonique de Moor

What if we told you it was possible to visit your local Heart Pharmacy less often. And when you arrived at the Pharmacy, we knew you would be coming. To make things even better, you would have a shorter wait time to pick up your prescription. Is this possible? It can be with something call medication synchronization.

The idea of medication synchronization is meant to make your life, Pharmacists workflow and your Doctor’s visit more productive. With medication synchronization, your Heart Pharmacist ensures that all your regular medications are ready to be picked up at the same time. No more does your thyroid medication run out in June, your blood pressure tablets in July and that blood thinner medication in August. During a quick visit, your Heart Pharmacy team can find a plan to have all your medications run out at the same time. You would only make one visit to the Pharmacy in August to pick up all three medications.

So why is this a good idea? There are a few reasons. The first is that you will never run out of your medications. Your Heart Pharmacy team will know when you will need more tablets and have them ready before you run out. We might even give you a phone call to give you a specific time when you can pick them up. Secondly, there will be fewer trips to the drugstore. We will still be there for you. When you visit, we can discuss important health questions and not routine medication pick up matters. Another good reason is you will visit your Doctor’s office for refill requests only once.

So what are you and your Pharmacist going to do with all this extra time on your hands? I will admit, it does not seem like that great of a time saver, but you would be surprised. Perhaps that extra time would be best spent with a Heart to Heart chat about your medications, medical conditions or other aspects of your health. With all your medications already prepared, your Heart Pharmacist can schedule an appointment time for you to pick them up. Let us help you get your medication schedule simplified.  Ask about medication synchronization with your Heart Pharmacist.

 

Posted
AuthorMonique de Moor

This week's article came from a patient medication meeting. This patient was concerned that her levels of iron were dropping, despite her regular iron supplementation. She was wondering if her medications or diet were causing this low iron status. After a sit down with her Heart Pharmacist we did find a potential cause. It involves the fact that certain minerals require stomach acid for absorption. This is of interest for anyone who is taking medications to reduce the amount of acid your stomach produces.

Our patient was taking a medication to help treat ongoing heartburn. In her case, she was taking a medication called a PPI (proton pump inhibitor). Medications in this drug family include Losec, Pariet and Nexium. These medications help to reduce the amount of acid produced by your stomach. For many people these medications can reduce symptoms of heartburn or gastric distress. With reduced stomach acid and symptoms of heartburn gone, why would there be an issue? This is a good question. Our bodies still need stomach acid for digestion and absorption of certain vitamins and minerals.

There are certain nutrients that require stomach acid for proper absorption from the gastrointestinal tract. The most notable are the macro minerals, calcium, iron and to a lesser extent magnesium and zinc. Vitamin B12 can sometimes be an issue as well. This is why taking PPIs is associated with an increased risk of osteoporosis. Your body requires stomach acid to make calcium more absorbable. If you can’t absorb calcium, you might be at greater risk for osteoporosis. This is why I recommend my patients that are taking a PPI to take adequate vitamin D (2000iu per day) and calcium citrate. Calcium citrate has better absorption for people taking a stomach acid reducing drug.

Iron is another story. There are many factors that interfere or enhance the absorption of iron. Things that help iron absorption are healthy stomach acid and vitamin C. Things that reduce iron absorption are low stomach acid, food, wheat and other grains, other minerals and tea. So you can see many factors work against iron absorption. So talk with your Heart Pharmacist to see if there is a way to help increase your iron absorption or if iron conflicts with your current medications.

If you are low in iron and your Physician or Pharmacist recommends that you take more, here are few tips we offer our patients. In theory, iron is best absorbed on an empty stomach, but this might cause some distress. In which case, take with a small meal or snack. If you can tolerate taking iron before bed, that is optimal. Watch out for iron’s four main side effects: stomach upset, constipation, constipation and a fourth which I seem to forget. Right, the fourth is also constipation. If this happens, don’t take your iron for a few days and regularity should return. For some people, constipation can be lessened by taking it every other day or twice weekly. Also take your iron supplement away from breads and cereal and tea. Also with iron absorption you do get what you pay for. The most expensive naturopathic and heme-based iron formulations are better absorbed, but their cost is significantly more.  Do not take iron at the same time as other vitamin supplements or antacids.

 

Posted
AuthorMonique de Moor

June is usually a month of sun, gardening and planning for vacations. Not for your Heart Pharmacist. June is stroke awareness month. I think every month should be stroke awareness month. It is thought that over 12,000 deaths a year are attributed to strokes. What shocked me was that 10% of all stroke deaths occurred in people under 65 years old. This is why all months should be stroke awareness month. Let’s look at the signs of a stroke and what you should do.

How can you tell if you or someone you know might be having a stroke? There is a very handy word you learn about the signs of a stroke. It is called F.A.S.T.

F- Face. Is one side of the face drooping or does not look right

A- Arms. Often a person who is having a stroke can not raise both their arms at the same time

S. Speech. Is the person's speech slurred, jumbled or are they unable to speak?

T. Time. Speedy treatment is essential. Time to call 9-1-1 right away.

Don’t worry if you forget this word. It is written on the side of every BC ambulance.

There is often some question as to whether you should give an aspirin to someone you suspect is having a stroke.  The current thought is that you should NOT give an aspirin. It is recommended to give aspirin for heart attacks but NOT for a stroke. This is because there are two types of strokes and it is hard to determine which type a person might be having. There is the ischemic stroke where a blood clot has obstructed blood flow in the brain. Then there is the hemorrhagic stroke. This later type of stroke is where a blood vessel has ruptured and blood is leaking out. Giving a blood thinning aspirin to someone with a hemorrhagic stroke might complicate treatment. So only give aspirin for heart attacks, chew one regular strength or two low dose aspirins. Just in case you forgot.

What is a T.I.A.? Some people call them mini-strokes. TIA stands for Transient Ischemic Attack. This is caused by a blood clot partially blocking or only temporarily, an artery . Many people recover fully from these events so they might be tempted to think that they are no big deal. This is not a good idea. Think of a TIA as a “warning stroke”. Something is not going well with your blood circulation in the brain and should be brought to the attention of your Doctor promptly. A TIA could suggest that a full stroke might occur in the near future.

There are many ways to reduce your risk of having a stroke. The greatest benefit comes from stopping smoking, getting to a healthy weight, make healthy food choices and reducing your intake of caffeine and alcohol. Another way to prevent strokes, or heart disease, is to check your blood pressure regularly. Untreated high blood pressure is perhaps the greatest risk for your cardiovascular system. Check your blood pressure at any Heart Pharmacy. And don’t forget about F.A.S.T.

 

Posted
AuthorMonique de Moor