All of this got me looking hard at some of the items I have gathered through the years – some out in the open, others tucked away in closets. I challenge each of you to start looking at your things and try to recall when and why you purchased a particular item and the last time you used it. If it hasn’t been used then consider why you still have it. Is it possible that someone else could use and enjoy your previously loved article? I am not saying throw it out, but consider your own garage sale or donating it to some local charity. The additional benefit may be a tax write-off for next year.

 
As we divest ourselves of some of the belongings that we hold on to, retain that memory of when you enjoyed using the article or piece of clothing. Many times we hold on to things in order to keep the valued moments in time, but remember that the item itself is not the memory. Before selling or donating an item that was cherished, take a photo of it and write a story about the event involving the memory to be fondly remembered by yourself or your family and friends.

How much stuff do you have that you are not using? Where are your memories? Who are you sharing them with?

Author: Cheryl A. Acres RN, CCM

Should you need oxygen or any other medical equipment, one of the first questions is how to pay for it and how much is it? Depending on the type of medical equipment, there are many suppliers out there, ranging from large home improvement stores to pharmacies to durable medical equipment providers. Even if a physician recommends that someone use medical equipment, it does not automatically mean that insurance will pay for it. The provider should be able to tell you how much, who will pay and of course, how to use the device.
 

A wheelchair, for example, is often used outside of the home, for longer distances when someone has difficulty walking or has limited endurance. Something to consider is how well it fits into a vehicle for transport, for example to a physician’s appointment. Who is the one to lift it in and out of the vehicle?
 

When home oxygen is being used, the standard, large concentrator remains in the home and a smaller portable tank is often supplied for traveling outside the home. These portable tanks can be awkward, and are limited in capacity, so may mandate how long the person can be out of the home. If you get a portable oxygen concentrator, the restrictions are far less, resulting in the adjustment to using oxygen for your health as a much easier transition.

A discussion is always recommended with your physician about options for your health and lifestyle changes. Know that you have choices about your care, and most people want the best, least intrusive yet effective care possible. What conversations have you initiated with your physician about health and lifestyle changes?

Author: Cheryl A. Acres RN, CCM

With illness or aging, the chores related to the home often fall to the wayside because there may be a lack of energy, or an actual inability to perform the cleaning and maintenance. The majority of people want to remain in their home throughout their lives, but often the reality of doing so can be a difficult thing to manage. Choices may then have to be made – if an elder person leaves their home, how do they choose where to live and then what belongings can they even take with them? That large sideboard may not fit into the floor plan of their new home, no matter how loved it is.
 

To ease this transition, often a senior move manager can be called in to help organize the belongings, arrange for an estate sale and assist with figuring out how furniture will fit into the new home or apartment. They will also either do the actual move or contract with a moving company, and even help set up and unpack in the new home. These professionals often have training in the relocation issues that occur for older adults, including having compassion for the uprooting and major change that is pending. This can take a huge burden off the family and caregivers by helping them see the situation objectively, without the emotional attachment to the household articles.
 

If you had to downsize tomorrow, how would you choose what to keep, what to sell? Would you be able to help your aging loved one do the same?

Author: Cheryl A. Acres RN, CCM

Physically – when someone laughs – it’s very difficult to keep muscles tense (unless they are your abdominal muscles when you are in the midst of a belly laugh!). At the same time, you may have your mouth open, taking deep breaths, and your eyes may even be watering from laughing so hard. All of this is happening while your immune system is being bolstered and your hormones related to stress are dropping. Endorphins -naturally produced chemicals from your body – are being released, which help with pain control, even if it is temporary.
 

If you are in a social setting, sharing the laughter can help improve or build on the relationships of the group, and help develop a shared memory of that particular moment. When social bonding occurs, that can help promote a sense of wellness and belonging. Have you ever seen someone get the giggles in a group, and everyone else tries to not laugh? It’s not always a successful venture! Laughing can help break any tensions and de-stress situations.
 

How do you find humor? There are many ways to do this on a regular basis, which include:

1. Reading humorous stories
2. Playing with a child or a pet
3. Watching funny movies
4. Finding upbeat people to hang out with

Don’t take yourself too seriously – see how you can create your own smile factory. Try brushing your teeth with the opposite hand – it may not be pretty, and it will likely make you smile!!! Think of small steps that bring fun into your life, share them with others, everyone will be better for it.
 
What are some of the best ways to get you laughing?

Author: Cheryl A. Acres RN, CCM

There has been a lot of research confirming how negativity and high stress can impact one’s health in a harmful way, for the short as well as long-term. To that end, then how does one stay positive and upbeat to reap those rewards of better health? There is an old saying that laughter is the best medicine, and when it’s shared, it’s even better. Have you ever tried not to smile at a giggling baby or at a baby animal learning to walk? Try to count how many times a day you actually laugh out loud. Do the same thing for children and see for yourself how much more they laugh. Of course, they don’t have the same responsibilities and stressors that adults do, but so often children laugh at the most seemingly inconsequential things.
 

Keeping a positive attitude can be challenging at times, but consider the small things in life that are good and enjoyable. Some people keep gratitude journals, listing 2-4 items every day that they are grateful for, no matter how small they may seem. Many of us tend to be grateful for a cup of hot coffee to get us going in the morning, others for the smell of cooking bacon, or even going on a leisurely walk with a friend.
 

What are you grateful for? What makes you smile and laugh out loud? Make your own list and on one of those days when things aren’t perfect, reflect back on those days where the sun was shining a little more brightly.

Author: Cheryl A. Acres RN, CCM

In reality, we plan for many life events – college, marriage, having kids, buying a house, managing a career and much more. But the question is, how many of us plan for aging or illness, not only for ourselves, but our loved ones? Human nature and culture often pressure us not to consider illness or the end of our lives, but inevitably, there is no fountain of youth and we will all reach our end point in this world.
 

On the other hand, if the right side of the heart is damaged, then the blood trying to enter the heart backs up to the liver and the lower body. The back up usually continues to the legs, so you will see swelling in the legs and feet. Additional symptoms associated with heart failure include fatigue, shortness of breath, weight gain and limited endurance.
 

Ask yourself, how have you prepared for yourself and loved ones? Do you have a Last Will and Testament? Is there a Medical Power of Attorney in place so that someone can express your healthcare wishes if you are unable to? Are there Advanced Directives, especially if someone has very specific wishes already? Do you have long term care insurance to cover costs that are not covered by health insurance? Many more questions need to be asked and answered by each one of us.

Frequently, once a health event occurs, we ask ourselves and medical professionals “What Now?” Maybe the better question is “What If?” Answers to this question will help guide us through some of the passages that actually become gifts to ourselves, and our families.

How have you prepared for aging – both for your parents and for yourself?

Author: Cheryl A. Acres RN, CCM

One other common cause of CHF is long-standing high blood pressure or hypertension, which causes the heart to strain and work harder. Someone who is diabetic, or who has kidney or thyroid disease are at a higher risk of causing this stress on the heart. There are several valves in the heart, which can be damaged either from infection or a birth defect, which result in the valves not fully opening or closing fully. Any combination of these conditions can result in CHF. So when you think of these moving parts, keep thinking of your heart as the machine that it is.
 

On the other hand, if the right side of the heart is damaged, then the blood trying to enter the heart backs up to the liver and the lower body. The back up usually continues to the legs, so you will see swelling in the legs and feet. Additional symptoms associated with heart failure include fatigue, shortness of breath, weight gain and limited endurance.
 

So now what – how do you treat or manage CHF? Your physician will be one of your primary guides here, as there may need to be specific testing done to determine what type of heart failure you have, and to what degree. That information will then point the physician in the direction of how best to treat the CHF. Often there is a combination of treatments, which include lowering salt intake, limiting fluid intake, monitoring weights every day or two, and even doing aerobic exercise. In addition to these lifestyle changes, the physician will often prescribe a combination of medications to lower blood pressure, control cholesterol and even fluid retention. Again, all treatments, including exercise, should be done under the auspices of a physician.

Overall, for your heart’s health, please consider discussing your risk factors for developing heart disease and CHF in order to see if you can make some lifestyle changes now. The payback may be huge – a happy, healthy heart! Have you or a loved one recently experience any mild or serious heart problems? What treatment are you (they) actively pursuing?

Author: Cheryl A. Acres RN, CCM

So what happens as a result of CHF?
Well, once the heart’s pumping becomes ineffective, the blood can back up and create “congestion”. If the left side of the heart is not working as well, then the congestion occurs in the lungs, creating something called pulmonary edema. This is because the blood that goes to the lungs to pick up fresh oxygen will then return to the left side of the heart to be pumped out to the rest of the body. As a result, it can be more difficult to breathe, especially when lying down to sleep. If severe enough, someone may need oxygen therapy while sleeping – and even during waking hours if the degree of CHF is bad enough.  

On the other hand, if the right side of the heart is damaged, then the blood trying to enter the heart backs up to the liver and the lower body. The back up usually continues to the legs, so you will see swelling in the legs and feet. Additional symptoms associated with heart failure include fatigue, shortness of breath, weight gain and limited endurance.
 
CHF cannot be cured, but it can often be controlled. It is also one of the most common reasons for admission into a hospital for those over the age of 65. Do you know of anyone who suffers from CHF?
Stay tuned for Part 2, which details CHF causes, treatments and how best to manage this heart problem.

Author: Cheryl A. Acres RN, CCM

No matter your age or gender, I encourage everyone to take a strong look at their own state of health or illness and consider what you can do to make it better. Drastic changes don’t always last, but if you make some small, minor changes and see success, then you are well on your way. 

Depending on where you look for the definition, wellness can be an absence of disease OR it can be a state of health – physically, emotionally, spiritually, mentally and socially. It is quite a mouthful, for sure…. but I think most agree that wellness means you are not “sick”. At the same time, someone can be living with a chronic condition such as asthma or chronic obstructive pulmonary disease (COPD), they may be on oxygen, but still are not “sick”. If you ask that person if they are well, they may just say “yes”. Like beauty and art, wellness may just be in the eye of the beholder!
 
According to the Centers for Disease Control and Prevention (www.cdc.gov/), there is a national obesity rate of 35.7%, which varies by state. The medical costs related to obesity continue to rise. Health problems linked to obesity include diabetes, high blood pressure, stroke and even cancer. These are pretty serious conditions that affect not only the individual, but their families, their ability to earn a living, and even their life expectancy.

Do you routinely walk the dog around the block for your exercise? What else can you do to find ways to stay well?

Author: Cheryl A. Acres RN, CCM

You may have sleep apnea, which means that there are short periods of not breathing (apnea) or having a breathing pattern that is very shallow many times during an hour while asleep. This often occurs during the deepest period of sleep, which is supposed to be the most restful or restorative level. When the apnea periods happen, the oxygen levels in the blood drop low enough so that the body tries to compensate by coming out of that deep sleep in order to take deeper breaths, and restore the oxygen level back to a normal range. Even though the sleep pattern has been changed, the person is not “awake” enough to realize this, and unfortunately, this then creates that feeling of being tired during the day.
 
Sleep apnea is often referred to as obstructive sleep apnea (OSA) because it usually is the tongue and back of the throat closing or “obstructing” as someone sleeps on their back. It is the most common type of sleep apnea and it can have some significant consequences. It is often the reason for daytime accidents due to drowsiness, as well as putting someone at risk for high blood pressure, chronic heart failure, stroke and other problems related to the cardiovascular system. It is far more than just being tired!!
 
Who has it? Most often, OSA is seen in men over 40 and those who are overweight. It usually needs to be diagnosed by a study in a sleep lab and can be managed sometimes by just losing weight or not sleeping on the back. If weight loss is not an issue, one treatment may consist of a positive airway pressure machine, which forces air into the back of the throat opening it up.

So if you know someone that is a heavy snorer, and is constantly tired, they may have OSA and not even realize it. Wishing all of you a restful sleep!

How’d you sleep last night? And what is your plan for getting a better night’s sleep tonight?

Author: Cheryl A. Acres RN, CCM