A research scientist from Louisiana State University has found that consuming fish oil or omega-3 fatty acid can potentially help prevent diseases such as Parkinson’s disease, Retinitis Pigmentosa and Huntington’s disease. We know that there are genetic abnormalities that occur to cause these diseases.What fish oil does is prevent the misfolding of these abnormal genes that cause the diseases to manifest symptoms. (http://www.physorg.com/news159366745.html)

There have been previous studies in mice that had the gene for Parkinson’s disease and that were given fish oil in their diets, and it was found that they were less likely to develop the disease.This new study now suggests how this might be done.

We already know that fish oil is good for the brain, joints, and heart. Now this gives us another good reason to make sure that we have adequate amounts in our diet, particularly if there is a family history of one of the diseases mentioned above.If you are concerned about the mercury content of fish, then take fish oil supplements that you know are mercury free. If you already have a disease such as Parkinson’s disease, you might want to have a discussion with your doctor concerning fish oil and the possibility that it may be beneficial to a family member, and perhaps to you.

Parkinson’s is a disease of the nervous system which affects our movements. Michael J. Fox, the popular actor, was diagnosed with this disease in 1991, at the young age of 30, and has helped tremendously to raise awareness by telling the world about his diagnosis, and then by setting up his foundation to raise money for research to find a cure.

In people with this disease, the brain cells that produce a chemical, known as dopamine, malfunction and eventually die. This results in decreased amounts of dopamine in the brain. Since dopamine is a neurotransmitter, or messenger, to the part of the brain controlling movement and coordination, less of this chemical means a slower delivery of those messages from the brain telling the body when and how to move. The person affected will have difficulty starting and controlling her/his movements.

The cause of Parkinson’s is unknown. Although Mr. Fox developed the disease at a young age, that is not as common as developing when we are older. The risk of developing this disease increases as we age; it affects 1-2% of Americans over the age of 60. It may run in families, although people without a family history get it as well. This is an active area of research, and recent studies suggest that exposure to pesticides may play a role. Approximately 1.5 million people in the US have Parkinson’s, and 600,000 new cases are diagnosed each year.

Early in the disease there may be no symptoms. Once symptoms appear,the most common include an uncontrollable tremor, or shaking, of the hands, while at rest; slowed and difficult movement; impaired posture and balance; and rigid, or stiff, muscles. The disease is chronic and the symptoms continually worsen. There currently is no cure, although there are medications that can help in the control of the symptoms.

What can you do? Let others know the importance of this disease. Or, join the 15th Annual Parkinson’s Unity Walk in New York City on Saturday, April 25! Learn more about the disease and the ongoing research to find a cure at one of the following sites:       http://www.michaeljfox.org/index.cfm   OR  http://www.pdf.org

Have you ever believed that your mental functioning was “off” during a long period of time when you were under a lot of stress? Did you think it was all in your head, so to speak? Or, that it wasn’t real, but just in your imagination? Think again.

A recent study in the Proceedings of the National Academy of Sciences (2009 Jan 20; 106:912.) followed twenty healthy medical students for the month before and the month after their important exams, and compared them with twenty matched control students who were not taking exams or under stress. That the students preparing for exams were indeed under stress was confirmed by using a standard scale of measurement.  

After four weeks of stress, impairment was shown by MRI scan, and by testing, in the section of the brain known as the prefrontal cortex.  The specific function that was found to be impaired was that of “attention”, or the ability to prioritize mental tasks, to focus on them, and to shift the focus as the need arises. This impairment was not seen in the students who were not under stress.

Four weeks after the stress ended, the students were tested again. Those who had been under stress were no longer different from those who had not. This shows that brain function can change, and then change again. And shows that stress-induced changes are reversible.

This study confirms what we’ve thought for years: that chronic stress can indeed affect the brain so that it does not function as well as usual. And this research leads to the conclusion that we need to be on the lookout for stress-induced changes in our bodies, and that we need to de-stress in order to keep ourselves functioning well.

So, the next time you are under stress for a longer period of time than just a few days, and think that your mental functioning is not quite up to par, remember this study. It’s not all in your head (imagination)! Learn ways to de-stress. (See the prior blog)

Spring is here and stress is in the air. There are worries over the economy, unemployment, and the state of healthcare (among other things). There are ways that each of us deals with stress -both consciously and unconsciously. Some people get sick (not a great solution);others overeat; still others drink too much alcohol. But many people have learned to work it out in a healthy way using things like exercise, meditation, yoga, and talk therapy such as cognitive behavioral therapy (CBT).

CBT is a process that looks at a person’s beliefs, and helps to change negative thought patterns.It is like teaching people to look at the cup as half full, rather than half empty.A recent study has found that ten sessions of CBT significantly improved worry in older individuals with generalized anxiety disorder.CBT has also recently been shown to have an impact on depression and health outcomes in those who have undergone cardiac bypass surgery.

If you are stressed out, you are not alone.We suggest that you look to healthy ways to deal with stress and worry.If you feel you need help and would benefit from talking to someone, you might want to find a therapist who does CBT.And of course, you can always exercise too! Are you sick of hearing that from us yet?!

How many times have you thought this over the years. And now that you’re older, and hopefully taking a bit – or a lot- of time out for yourself, are you still feeling that way? Should you be? Is it normal? How do you know when the fatigue is simply from doing too much and when it indicates a serious illness?

This is a question that comes up a lot in both our practices, especially from women. And though you’d think that women younger than us would have less of a problem with fatigue, and that we midlife women are entitled to be chronically tired, that isn’t the case. To illustrate this, I’m sure you know of one (or many) women in midlife and older who have so much energy that they almost never need to rest. I certainly know women like this in their 70s, 80s and even 90s. So, by that fact alone – ie, that there are some women who never slow down no matter their age – we know that humans are not necessarily programmed to lose energy and be more easily tired as we age.

In fact, what it boils down to is what is normal for you, and whether or not there has been a change in your fatigue levels over a short period of time. (This is true of virtually any symptom that you get too.) To know if your fatigue is abnormal and indicative of an underlying illness, such as thyroid dysfunction or anemia or a low-grade infection, ask yourself these questions:

Am I needing more sleep on a regular basis than I ever did in the past?

Do I never feel rested or energized no matter how much sleep/rest I get?

Do I feel incapacitated by the fatigue?

Am I having to change my exercise routine because I now get tired doing the same amount that I’ve done for ages?

Does any exercise, or any physical activity, make the fatigue symptoms immediately worse?

Am I taking more “time outs” or rest periods during my day, and not able to keep up my usual schedule?

Am I getting less done because of my increased need to sleep or rest?

Am I turning down activities in the evenings that I used to do regularly because of  fatigue?

Am I drinking more caffeinated fluids or taking “pep” pills just to get through the day?

Is there an element of physical fatigue to how I feel, or is that I “just don’t feel like getting up and going”, but feel physically ok?

Once you’ve asked yourself these questions, take a look at your daily calendar for this month and compare it to the past several months. Are there many less activities planned?

Most illnesses that start with fatigue do so over a fairly long period of time; that is, weeks to months rather than days to weeks.  If you notice that you are unusually tired for longer than a month or two, you should see your primary healthcare practitioner. One very common cause of fatigue is depression, for which there are  good treatments available. 

If the incapacitating fatigue goes on for 6 months or longer, with no other illness being found as an explanation for it, you may have Chronic Fatigue Syndrome, or CFS (sometimes also known as Chronic Fatigue and Immune Dysfunction Syndrome). This is an illness that has a very specific definition; the diagnosis of CFS cannot be made unless your symptoms meet that definition.  For more information on CFS, visit here: http://www.cdc.gov/CFS/

In my experience, most women who are unusually fatigued do not have CFS, but rather another illness or explanation for their symptoms. Most of the time, this symptom is correctable. The important point is that you recognize what amount of fatigue is abnormal for you, and take action to get medical help for it. Remember that the earlier an illness is diagnosed, the quicker and more easily it can be treated. Don’t ignore fatigue, or think “it goes with the territory” of aging. It doesn’t.

I just got an update today from my excellent online medical journal service, JournalWATCH, and thought I’d pass it along to you asap. This is something you really need to know. My service reported that the FDA has just approved Salmonella, noting that it’s safe and that everyone should enjoy it. So, no more worries about peanuts and peanut butter, nor about keeping your kitchen counter germ-free as you prepare, say, raw chicken for that great chicken dinner! What a relief!

Puzzled? I was too. Reading further down the piece, I then noted…Happy April Fool’s Day! Same to you! (And you thought most doctors and medical researchers were stuffy and humorless)

So, you do need to follow the news about what foods have been recalled; Salmonella is definitely NOT safe. A new report this week said that Salmonella was found in some pistachios, and recommended that we avoid both the pistachios themselves, as well as foods with pistachios in them until further notice.

More news and tips to follow.

JH: March is almost over, and we haven’t finished going through all the highlighted diseases like we promised at the first of the month. We do have time this month to talk about one more – liver disease – but will have to do Chronic Fatigue Syndrome in April.

RM: Sounds good. One thing though. We should say that March is the month that liver disease is highlighted in Canada, while October is Liver Awareness Month in the US. 

JH: But since it’s so important to us all year round, we’ll talk about it now, and again in October.  First question: is there anything that women our age especially need to know about the liver?

RM:  One thing that I think is important to know is that alcohol is not the only thing that can cause liver disease.

JH: Good point. Many of my patients who don’t drink heavily are surprised when they are found to have a problem with the liver.  I then tell them that many other things can harm the liver in the same way that alcohol does.

RM: Like what?

JH:  There’s a condition known as “fatty liver” in which fat accumulates within the liver.

RM: Yes – and isn’t it also called “nonalcoholic fatty liver disease” ?

JH: That’s right. What’s frightening about it is that the fat may cause no damage to the liver, but the condition can progress to cause inflammation, and even go on to cirrhosis, just like liver disease caused by excess alcohol.

RM: That is frightening because cirrhosis – a term that means hardening or scarring of the liver in which the normal functioning liver cells are replaced with scar tissue – can lead to liver failure. 

JH: Then, one would eventually need a liver transplant because we can’t survive without a functioning liver.  So, alcohol is definitely not the only cause of cirrhosis and liver failure.

RM: Back up just a minute. Why can’t we survive when the liver no longer functions?

JH:  I had a professor in medical school who described the liver’s function in our bodies in an easy-to-remember short phrase: “The liver is the metabolic brain of the body.”  It metabolizes, or breaks down, most of the substances that come through the body so that the useful parts can be used, and the toxic parts can be eliminated.

RM: So if the liver isn’t functioning, all the toxins and waste build up somewhat similar to what happens when both kidneys fail. The difference is that dialysis can sustain us when we have kidney failure, and there’s no similar treatment for liver failure.

JH: What are some of the things that can lead to fatty liver?

RM:  High cholesterol, high triglycerides in the blood, obesity, malnutrition, gastric bypass surgery, rapid weight loss, and Type 2 diabetes are some risk factors, just to mention a few. But important to remember is that not everyone with one of these abnormalities or diseases gets fatty liver. The cause of fatty liver is not fully understood yet.

JH:  The other thing that some people don’t realize is that some medications can cause liver damage, and even liver failure.  This is called “drug-induced liver disease”. 

RM:  What are some of those drugs?

JH: There are many: isoniazid – a drug used to treat tuberculosis; niacin – used to treat high cholesterol; nitrofurantoin – an antibiotic often used to treat urinary infections; and acetaminophen – that’s the generic name of Tylenol.

RM: Tylenol? You mean that if we take that routinely for a headache, we can get liver disease?

JH:  No – not if it’s taken as directed on the bottle which says that we shouldn’t take more than  8 Extra-Strength pills  in a twenty-four hour period.  Most of us don’t do that, so it’s not so much of a worry.

RM: But what if we take some Tylenol and take a few drinks of alcohol, which we know can damage the liver. Can both of those together in smaller doses add up to cause liver damage?

JH: Absolutely. Great point.  Someone who drinks more than two alcoholic beverages a day should not take more than 4 Extra-Strength pills in a day.  Taking more Tylenol than that, in addition to the alcohol, can hurt the liver.

RM: So, to keep our livers healthy, we shouldn’t be taking in lots of different substances?

JH: Exactly right. Which makes it so important that we always follow the directions on pill bottles, and that we educate ourselves as to which common substances we put in our bodies can hurt the liver.

RM:  I’m getting tired here, so I know our readers are too. Quickly, what are the other things that can cause liver damage?

JH: The different types of viral hepatitis – Hepatitis B and Hepatitis C can lead to chronic liver damage, but do not always do that.  In addition, certain hereditary diseases, like Wilson’s disease, can lead to liver damage.

RM: So, to keep our liver healthy, we need to be aware of : 1) a family history of liver disease; 2)  exposure to one of the hepatitis viruses; 3) the medications we take  and whether they can damage the liver; 4) our weight and cholesterol level in order to be checked for fatty liver if they are high; 5) how much alcohol we are drinking per day.

JH: Right. And, we need to be able to tell our healthcare provider all of that. We need to know that early in its course, liver disease may cause no symptoms at all, or may just cause severe fatigue or itching. By the time other symptoms appear, such as swelling in the legs or abdomen, the disease is advanced.

RM: And that liver disease can be diagnosed through simple blood tests, known as the liver function tests.

JH: And that a diet of nutritious foods, maintaining a healthy weight, and drinking alcohol in moderation will go a long way in keeping the liver healthy.

RM: Whew! Huge topic, and we could talk about it for an even longer time.

JH: But we’ll table this discussion for now. It’s very appropriate that next we’ll talk about Chronic Fatigue Syndrome because that’s almost where I am right now!

To learn more about your liver and how to take care of it, go to:

http://www.liverfoundation.org/

http://www.cdc.gov/hepatitis/index.htm

RM: Hey there! Long time no chat!

JH: You’re so right – we haven’t chatted on our blog in ages. That’s because of all those “disease-a-month” topics we’ve had to cover.

RM: But aren’t we doing that with today’s blog anyway?

JH: Sure are. We’re talking about kidney disease in older women. But I thought it might be more fun for both of us to chat about it.

RM: Ok, then. What do we older but cooler ladies need to know about kidney disease?  Are you going to start by telling us how to stay leak-free?

JH:  That’s a big one at this age, but no, we’re not talking about urinary incontinence today.  (We do have an entire chapter on it and its treatment in our book though). We’re going to move higher up the urinary tract and talk about the main organs of that system – the kidneys.

RM:  You mean, the mothers of the urinary system?

JH:  Good analogy! The kidneys in fact do create the urine, by removing the toxins and waste matter from our blood, while maintaining the body’s fluid and electrolyte balance, and then send that urine on down the rest of the urinary tract and out into the world. So, they do the same type of work, and every bit as important, as mothers do.

RM:  Cool. So at this age, what are the main things that can go wrong with the kidneys?

JH: At our age, and as we continue to get older, the most common of the kidney diseases are chronic kidney disease and kidney failure. 

RM:  And exactly what do you mean by chronic kidney disease and failure?

JH:  Exactly as they sound. Chronic disease of the kidneys is a term indicating that the kidneys are not functioning as well at their job of removing toxins and waste products, and maintaining the body’s fluid and electrolyte balance.  Kidney failure occurs when neither kidney is functioning at all.  When someone has kidney failure, the next step is dialysis to, in essence, perform the job of the kidneys. And eventually, many people on dialysis can get kidney transplants.

RM:  Then those kidneys just get pooped out after all those years of disease?

JH:  That’s right.  What’s even more frightening about chronic kidney disease is that it is silent, or has no symptoms; so most people with it don’t know they have it.   There are an estimated 26 million people in this country with it, and most are unaware of it.  Also, it is the 9th leading cause of death in this country.

RM: Do we know of any risk factors for kidney disease, since we know risk factors for heart disease and many other diseases?

JH:  This may surprise our readers, but the three major risk factors for kidney disease  are also risk factors for heart disease and stroke:  high blood pressure, diabetes, and a family history of the disease in question, in this case – kidney disease.   In addition, smoking cigarettes and weight gain may increase the risk for chronic kidney disease.

RM:  Is there are a difference between men and women in how often they get it?

JH:  Great question.  Yes there is.  Women have what’s been called “the female advantage” regarding chronic kidney disease; that is, they get it much less frequently than men do.  The only group of women who do not have this advantage are diabetics.

RM:  So, are you saying that our not getting kidney disease has something to do with our hormones?

JH:  It’s a real possibility since postmenopausal women tend to be diagnosed more frequently with chronic kidney disease than are younger women, but still less than men.  But that needs to be studied further.

RM: Any difference between ethnic groups as to who gets chronic kidney disease?

JH:  Yes. African Americans, Hispanic Americans, and American Indians are more than twice as likely to develop this disease than are CaucasianAmericans.

RM: So, what can we do to prevent kidney disease?

JH:  The better our high blood pressure and diabetes are controlled, the less likely it is that we will get chronic kidney disease and kidney failure.  For those of us with a family history, the best thing we can do is to be proactive: take good care of ourselves, and make sure our clinician knows there is a family history of kidney disease, so we can be screened for it regularly.  Since diabetes and high blood pressure can often have no symptoms, we should have our healthcare provider check us regularly for those diseases.  And I know I’ll sound like a broken record here, but women who smoke need to stop!  Also, we need to try to maintain a healthy body weight.

RM:  Aren’t those tests you just mentioned checked for routinely anyway? And, another question, how is kidney disease diagnosed?

JH:  Easy – kidney disease can be diagnosed most often by labwork done on the blood – specifically, the creatinine and BUN levels. In addition, oftentimes, a urinalysis can help with the diagnosis. And yes – both of these studies, as well as a test for blood sugar and checking the blood pressure and weight should be a routine part of health screening.

RM:  Ok then, so we need to get a check up regularly, keep our blood pressure and blood sugar under control, stop smoking, and try to maintain a healthy weight. Nothing really new here!

JH: You got it.

RM: Oh yeah – and one other thing: be good to our mothers!

JH: And our kidneys!

For more information, go to:http://kidney.niddk.nih.gov/kudiseases/pubs/chronickidneydiseases/

Colon cancer is the third leading cause of cancer death in both men and women in the U.S. Of all women in the U.S., African American women have the greatest chance of developing it, followed by Caucasian women, then Native American and Asian American women. Hispanic women have the lowest incidence of colon cancer.

That’s the bad news. The good news is that this cancer can not only be detected early – increasing the chance of a cure – but also may be completely prevented in many cases. Why and how can that be done? Because nearly all colon cancers start as polyps, and most polyps can be detected by colonoscopy, a procedure that is done using a scope or tube that has a camera on one end and the doctor on the other end. When this tube, which is nearly 6 feet long, is pushed up into the colon while the patient is sedated or under anesthesia, the doctor is able to see the colon directly. If she/he sees a polyp or growth, it can be removed at that time. Removing polyps and growths before they become cancerous is the goal. Not all polyps are cancerous, but again, nearly all cancers of the colon start as polyps.

Who should get a colonoscopy? Since the odds of getting colon cancer is greatest in people who are 50 and older, and increases with age, a screening colonoscopy is recommended when you turn 50 years old or soon after. If you have a first degree relative who has had colon cancer, then you are greater risk of getting it, and colonoscopy should be done 10 years prior to the age that that first degree relative was diagnosed with colon cancer.  For instance, if your father had a colon cancer diagnosed at age 45 then you would need your first colonoscopy done at age 35. After your first colonoscopy, you will need to have one every five to ten years thereafter as recommended by your doctor.

The “bottom” line is that if you haven’t had your colonoscopy yet, it is time to arrange it now.  Think of it as the ultimate spring cleaning! It can save your life.

In our book, there is a lengthy discussion of colon cancer, all the risk factors – including diet, and how both of us prepare for our colonoscopies in the most “pleasant” way possible (if that is possible at all!) Also for more information, go to:
http://nihseniorhealth.gov/colorectalcancer/toc.html

Since March is also National Kidney Month, the next blog will discuss kidney disease and how to prevent it at this age.

When we first started this blog – and even before, when we were thinking on what we’d write about – we never dreamed that our topics would be chosen for us each and every month by the Disease-a-Month club! Of course, there’s no such thing, but it surely seems that each and every month now has a specific disease (and this month, a first – FOUR diseases) associated with it.  I knew about the longstanding ones, February as Heart Disease month, and October as Breast Cancer Awareness month. but imagine my surprise when, for fun, I googled March, and came up with the above diseases as being highlighted this month!

So, this month, we will be talking about each of the above, but also will discuss topics that we want to talk about like:  diets (which ones work best – there are new studies on this); Salmonella (are you safe from it by just avoiding peanuts and peanut butter? No!); resveratrol (is it really anti-aging?); and a few more.

So stay tuned.