Sex in the senior years: Why it's key to overall health 
​
​(HealthDay)—Lovemaking isn't just for the young: Older people gain a lot of satisfaction from amorous relations as well.

But things get complicated as people age, and many folks let this important part of life drift away rather than talk about sexual problems with either their partner or their doctor, experts told HealthDay Now.

"Not many people talk about sex with their doctors, especially as we age," said Alexis Bender, an assistant professor of geriatrics with the Emory University School of Medicine, in Atlanta. "So many people do report sexual dysfunction on surveys, but they don't when they're talking to their doctors. And so it's important to have those conversations with primary care physicians."

It's worth discussing. A healthy sex life brings many benefits to seniors, experts say.
Sex has been linked to heart health, as well as overall mental and physical health. "It's definitely an association, and it's positive," Bender said.

For example, lots of beneficial biochemicals are released by the body during sex, said HealthDay medical correspondent Dr. Robin Miller. These include DHEA, a hormone that helps with cognitive function, and oxytocin, another hormone that plays a role in social bonding, affection and intimacy.

"Having sex is a really important part of overall health and happiness, and people that have it, they live longer," said Miller, a practicing physician with Triune Integrative Medicine in Medford, Ore.
Sex can actually get better as you get older, Miller added.

"For instance, for men, they can control their ejaculation better as they get older," Miller said. "Women aren't worried about pregnancy once they go through menopause, so they're freer."
Unfortunately, aging does complicate matters a bit when it comes to sex, Bender noted.

"For both men and women, we see changes in physical health such as diabetes or cardiac conditions that might limit desire or ability to have sex," Bender said. "Activity decreases with age, but interest and desire does not, for both men and women."

The changes wrought by menopause and andropause also can affect the sex lives of older men and women, Miller said.
"For women, vaginal dryness is a big issue. With men, it's erectile dysfunction," Miller told HealthDay Now.
Luckily, modern medicine has made advances that can help with these problems. Hormone replacement therapy can help women with the physical symptoms of menopause that interfere with sex, Miller said, and men have Viagra and other erectile dysfunction drugs.
"The story of Viagra is very interesting, actually," Miller said. "In 1998, they were experimenting using it as an antihypertensive. What they noticed was when they were experimenting with these men, when the nurses arrived to check on them they were all on their stomachs, because they were embarrassed since they had erections."

"That's when they realized this was a much better medicine for erectile dysfunction than high blood pressure, and that's made a big difference for men," Miller continued.
Women can take Viagra as well, "but women don't like the side effects. Men don't really like them, either, but they're willing to put up with them," Miller said.

"What I found is for women that you can use Viagra as a cream on the clitoral area," Miller said. "I call it 'scream cream.' You can get it made up at a compound pharmacy. It works like a charm. You still have to wait 40 minutes like men do, but there's no side effects, and it works, especially for women who are on antidepressants, who have trouble reaching orgasm. It really is very helpful."
So help is out there, but seniors will have to get over their hang-ups and talk to their doctor to take advantage of these options, the experts said.

"Sex and sexuality are taboo in our society," Bender said. "Especially for women, sex is highly regulated and talked about at an early age, and we're really socialized to not be sexual beings."
Miller said, "I think it's generational. Some Baby Boomers have a hard time talking about sex. My kids don't have any trouble talking about it. I bet yours don't either."
Women also face practical problems when it comes to finding a sex partner, particularly if they're looking for a man, Bender said. Women outlive men, so the dating pool shrinks as time goes on, and men tend to choose younger partners.

Through her research, Miller was surprised to learn that many women just give up on the search.
"Even though I think it's important to have a healthy sex life and healthy partnership, a lot of women don't want to reengage in partnership as they get older," Miller said.
"They've been married. They've taken care of people for a very long time. They've taken care of their husbands and their children. And they just say, I don't want that anymore. I'm happy to sit and hold hands with someone, but I don't want to get into a relationship again. And so that kind of challenged some of my generational thinking about what relationships mean over time."
More information: The Mayo Clinic has more about good sex and aging.
HealthDay. All rights reserved.

​https://www.seniorvoiceamerica.org/senior-health-news/sex-in-the-senior-years-why-its-key-to-overall-health
​https://www.seniorvoiceamerica.org 
KevinLeonard@SeniorVoiceAmerica.org  813-693-5511

Ask the Expert: Exercising Safely If You Take Insulin

• Effects of exercise
• Adjusting insulin
  
• Blood sugar target
• Exercises that raise blood sugar
• Intense workouts
• Signs of low blood sugar
• Preventing lows after exercise
• Overnight lows

Why is it important to balance what you eat, your insulin doses, and exercise?Healthcare professionals recommend exercise to help improve blood sugar levels and insulin sensitivity in people with type 1 or type 2 diabetes. Exercise also reduces the risk of heart disease and death.
However, exercise can cause hypoglycemia, or low blood sugar, especially in people with type 1 diabetes and, less commonly, in people with type 2 diabetes who use insulin.
Low blood sugar and the fear of going low can be barriers to exercise participation. But there are strategies that people can use to reduce the occurrence of low blood sugar, such as eating additional food and reducing insulin doses before and after exercise.
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How does exercise affect blood sugar levels and insulin sensitivity? Can different types of exercise affect these differently?Exercise increases uptake of glucose by your muscles and liver so that your body can use it for energy. Your body then takes glucose from your blood to rebuild these stores, thereby lowering blood sugar. Exercise also makes your body more sensitive to insulin, so you will need less insulin during and after activity.
However, the type, intensity, and duration of activity influences the impact on blood sugar and insulin sensitivity:

• Aerobic exercises generally decrease blood sugar levels during and after workouts.
• Endurance exercises or longer duration of exercise can result in greater blood glucose use and higher risk of hypoglycemia.
• Resistance or high intensity exercises can cause your blood sugar to rise during and after exercise.
• Mixed activities such as short bursts of high intensity in a session with moderate aerobic exercise can lead to less risk of hypoglycemia and better glucose stability.

Might I need to adjust my insulin dose before exercising?  Low blood sugar can occur during and after exercise. To help prevent this, if you use multiple daily injections, you can reduce your basal, or long-acting, insulin dose in the morning before exercising. If you use an insulin pump, you can suspend your pump at the start of exercise. It’s important that you don’t suspend it for more than 90 minutes.
Another option is to reduce your basal rate 30 to 60 minutes before exercising and continue until after you complete your exercise.
You may also need to reduce your bolus, or mealtime, insulin. If you plan to do mild to moderate aerobic exercise within 2 to 3 hours after your mealtime insulin, you may need to decrease that insulin by 25 to 75 percent based on how long you plan to exercise.
If you plan to do prolonged high intensity or anaerobic exercise, healthcare professionals don’t recommend an adjustment.
You can talk with your doctor about how to adjust your insulin dose before exercise.

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What is the goal blood sugar target before exercise? What should I do if my blood sugar is high? If it’s low?It can help if your pre-workout blood sugar is between 90 to 250 milligrams/deciliter (mg/dl). If your blood sugar is less than 90 mg/dl, ingest 15 to 30 grams (g) of a carbohydrate about 15 to 30 minutes before exercise. Choose a type of carbohydrate that your body can absorb quickly, such as:

• glucose tablets
• hard candies
• fruit
• fruit juice
• crackers

You can repeat it every 30 minutes during exercise based on repeat blood sugar testing. Exercising for less than 30 minutes or doing very high intensity exercises may not require an additional carb intake.
If your blood sugar is high, which can be above 250 mg/dl, check your urine for ketones. Do not perform any exercise if ketones are present. Correct the high blood sugar and wait to exercise until there are no longer ketones in your urine.
If there are no ketones, you can do mild to moderate intensity exercises. Avoid high intensity, however, as this can worsen hyperglycemia, or high blood sugar.

Can certain types of exercise raise my blood sugar? If so, should I take a correction insulin dose during my workout?Sustained high intensity workouts can raise your blood sugar levels. This is due to the release of stress hormones such as adrenaline and cortisol, as well other counter regulatory hormones such as glucagon, which raise blood sugar by stimulating your liver to release glucose. Your blood sugar may be high during and even after your workout.
It’s important not to give a correction dose during your workout. After you finish, to lower your blood sugar, you can hydrate with water or do a light aerobic cooldown. If this does not work, you can then give correction, but half of what you would usually give for the same blood sugar level.

What might happen if my workout is longer or more intense than I anticipated?If your workout is longer or more intense than you planned, you could be at risk for hypoglycemia while exercising. Try to check your blood sugar every 30 minutes during longer periods of exercise. If your blood sugar is less than 90 mg/dl, have a snack containing 15 to 30 g of carbs and continue with your workout.
If your blood sugar is less than 70 mg/dl, you may start to have symptoms of hypoglycemia. In this case, stop exercising and treat the low blood sugar. Do not restart your exercise until the low blood sugar corrects.

What signs of low blood sugar should I be aware of during or after exercise? How can I correct low blood sugar?Hypoglycemia occurs when your blood sugar is less than 70 mg/dl. Symptoms can vary from person to person, so the only way to know for sure is to check your blood sugar. Some early symptoms include:

• feeling shaky
• sweating
• clamminess
• hunger
• increasing heart rate

As blood sugar continues to drop, you may experience:

• irritability or anxiety
• dizziness
• sleepiness
• slurred speech
• weakness
• blurred vision

With severely low sugar, usually less than 40 mg/dl, there can be:

• confusion
• seizures
• loss of consciousness
• death

If you have symptoms of low blood sugar and cannot test, go ahead and treat. We use the “15-15 rule” to treat mild to moderate hypoglycemia. This is taking 15 g of carbohydrates and waiting 15 minutes before testing blood sugar. If blood sugar is still less than 70 mg/dl, repeat the process.
Severe low blood sugars are medical emergencies. Your family members, friends, or workout partners can call 911 if you’re unconscious or give you emergency glucagon to raise your blood sugar.

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How long after exercising do blood sugar levels continue to drop? Will I need to adjust my insulin doses during this time?Blood sugar can continue to drop 4 to 8 hours after you complete exercise. This is because muscles use up their glycogen stores during intense, prolonged activity and need replenishing. You can help prevent low blood sugar by eating carbohydrates after exercise that absorb slowly, such as a granola bar or trail mix.
You may also need to decrease your insulin dose after exercise.
A small 2013 study found that decreasing the bolus dose of insulin by 50 percent at the meal following exercise helped to prevent early-onset hypoglycemia up to 8 hours after exercise.
If you use multiple daily injections, reducing basal insulin by 20 percent that day can help prevent low blood sugar. If you use an insulin pump, decreasing your basal rate by 20 percent for 5 to 6 hours after exercise can reduce your risk of going low during the night.
Many factors can affect your insulin dose adjustments. You can talk with your doctor about how to adjust your insulin after exercise to help prevent low blood sugar.

Is it safe to exercise at night if I take insulin? How can I reduce my risk of overnight lows?If you exercise at night, especially after you eat dinner with the usual insulin dose at the meal, you can often be at an increased risk of low blood sugars overnight.
However, if this is best time for you given your lifestyle, you can reduce your risk by decreasing your evening insulin doses and having a post-exercise snack.

by University of California - Berkeley

As the chords of Pink Floyd's "Another Brick in the Wall, Part 1," filled the surgery suite, neuroscientists at Albany Medical Center diligently recorded the activity of electrodes placed on the brains of patients undergoing epilepsy surgery.
The goal? To capture the electrical activity of brain regions tuned to attributes of the music—tone, rhythm, harmony and words—to see if they could reconstruct what the patient was hearing.
More than a decade later, after detailed analysis of data from 29 such patients by neuroscientists at the University of California, Berkeley, the answer is clearly yes.
The phrase "All in all it was just a brick in the wall" comes through recognizably in the reconstructed song, its rhythms intact, and the words muddy, but decipherable. This is the first time researchers have reconstructed a recognizable song from brain recordings.

The reconstruction shows the feasibility of recording and translating brain waves to capture the musical elements of speech, as well as the syllables. In humans, these musical elements, called prosody—rhythm, stress, accent and intonation—carry meaning that the words alone do not convey.
Because these intracranial electroencephalography (iEEG) recordings can be made only from the surface of the brain—as close as you can get to the auditory centers—no one will be eavesdropping on the songs in your head anytime soon.
But for people who have trouble communicating, whether because of stroke or paralysis, such recordings from electrodes on the brain surface could help reproduce the musicality of speech that's missing from today's robot-like reconstructions.

"It's a wonderful result," said Robert Knight, a neurologist and UC Berkeley professor of psychology in the Helen Wills Neuroscience Institute who conducted the study with postdoctoral fellow Ludovic Bellier.
"One of the things for me about music is it has prosody and emotional content. As this whole field of brain machine interfaces progresses, this gives you a way to add musicality to future brain implants for people who need it, someone who's got ALS or some other disabling neurological or developmental disorder compromising speech output. It gives you an ability to decode not only the linguistic content, but some of the prosodic content of speech, some of the affect. I think that's what we've really begun to crack the code on."
As brain recording techniques improve, it may be possible someday to make such recordings without opening the brain, perhaps using sensitive electrodes attached to the scalp. Currently, scalp EEG can measure brain activity to detect an individual letter from a stream of letters, but the approach takes at least 20 seconds to identify a single letter, making communication effortful and difficult, Knight said.
"Noninvasive techniques are just not accurate enough today. Let's hope, for patients, that in the future we could, from just electrodes placed outside on the skull, read activity from deeper regions of the brain with a good signal quality. But we are far from there," Bellier said.
Bellier, Knight and their colleagues reported the results in the journal PLOS Biology.

Reading your mind? Not yetThe brain machine interfaces used today to help people communicate when they're unable to speak can decode words, but the sentences produced have a robotic quality akin to how the late Stephen Hawking sounded when he used a speech-generating device.
"Right now, the technology is more like a keyboard for the mind," Bellier said. "You can't read your thoughts from a keyboard. You need to push the buttons. And it makes kind of a robotic voice; for sure there's less of what I call expressive freedom."
Bellier should know. He has played music since childhood—drums, classical guitar, piano and bass, at one point performing in a heavy metal band. When Knight asked him to work on the musicality of speech, Bellier said, "You bet I was excited when I got the proposal."
In 2012, Knight, postdoctoral fellow Brian Pasley and their colleagues were the first to reconstruct the words a person was hearing from recordings of brain activity alone.
More recently, other researchers have taken Knight's work much further. Eddie Chang, a UC San Francisco neurosurgeon and senior co-author of the 2012 paper, has recorded signals from the motor area of the brain associated with jaw, lip and tongue movements to reconstruct the speech intended by a paralyzed patient, with the words displayed on a computer screen.
That work, reported in 2021, employed artificial intelligence to interpret the brain recordings from a patient trying to vocalize a sentence based on a set of 50 words.
While Chang's technique is proving successful, the new study suggests that recording from the auditory regions of the brain, where all aspects of sound are processed, can capture other aspects of speech that are important in human communication.
"Decoding from the auditory cortices, which are closer to the acoustics of the sounds, as opposed to the motor cortex, which is closer to the movements that are done to generate the acoustics of speech, is super promising," Bellier added. "It will give a little color to what's decoded."
For the new study, Bellier reanalyzed brain recordings obtained in 2012 and 2013 as patients were played an approximately 3-minute segment of the Pink Floyd song, which is from the 1979 album, The Wall. He hoped to go beyond previous studies, which had tested whether decoding models could identify different musical pieces and genres, to actually reconstruct music phrases through regression-based decoding models.
Bellier emphasized that the study, which used artificial intelligence to decode brain activity and then encode a reproduction, did not merely create a black box to synthesize speech. He and his colleagues were also able to pinpoint new areas of the brain involved in detecting rhythm, such as a thrumming guitar, and discovered that some portions of the auditory cortex—in the superior temporal gyrus, located just behind and above the ear—respond at the onset of a voice or a synthesizer, while other areas respond to sustained vocals.
The researchers also confirmed that the right side of the brain is more attuned to music than the left side.
"Language is more left brain. Music is more distributed, with a bias toward right," Knight said.
"It wasn't clear it would be the same with musical stimuli," Bellier said. "So here we confirm that that's not just a speech-specific thing, but that's it's more fundamental to the auditory system and the way it processes both speech and music."
Knight is embarking on new research to understand the brain circuits that allow some people with aphasia due to stroke or brain damage to communicate by singing when they cannot otherwise find the words to express themselves.
Other co-authors of the paper are Helen Wills Neuroscience Institute postdoctoral fellows Anaïs Llorens and Déborah Marciano, Aysegul Gunduz of the University of Florida and Gerwin Schalk and Peter Brunner of Albany Medical College in New York and Washington University, who captured the brain recordings.

 A recent study has shown that there may be at least 48,000 deaths a year linked directly to hospital infections. And this doesn’t even include accidents and mistakes that regularly occur. So, we, at Senior Voice want to bring you 10 Tips on How  To Stay Safe in the Hospital

1.    Patient Advocate: Enlist a family member, friend or professional to act as your advocate. Ask this person to show up on a regular basis and get involved to oversee and monitor your care. He or she will act as your eyes and ears while you are in the hospital.
2.    Keep a log: Record your daily progress, medication names and dosages, procedures, treatments, and list medical professional’s names and contact info. Take notes on conversations with doctors and nurses. Few people, if any, can remember everything that is discussed.
3.    Create a patient checklist:  When you encounter any new medical professional such as when you are transferred to another part of the hospital for tests, procedures or surgeries, carry your patient checklist with you. It should list your full name, birth date, your primary physician’s name, your diagnosis, list of medications and dosages and your allergies to medications. Show your checklist to any new medical professionals that are treating you and ask them to check the information with their records before they proceed.
4.    Log Your Medication: Medication errors are among the most common medical errors, harming at least 1.5 million people every year (Institute of Medicine). Write down your medications and dosages. List what the medication looks like, the shape and color of any pills, the names on the labels of bottles or IV bags. Create a detailed description as labels and bottles can look alike. If you don’t recognize the medication when it is administered, ask questions. Be assertive. Don’t trust that the professionals read all the of the chart. When the introduction of any new medication occurs, repeat any allergy information to your primary nurses and physicians.
5.    Sign Says: “Please wash your hands before touching me.” To prevent hospital-acquired infectious diseases, among the most common are MRSA, C.diff and pneumonia, ask every person who comes in contact with you, including the physicians and nurses, to wash their hands or put on a fresh pair of disposable gloves before touching you. Place antibacterial gel next to your hospital bed and ask everyone to use it.
6.    Concur with the Surgeon: To prevent surgery on the wrong body part. Be-fore you enter the operating room, you or your advocate should ask to see the surgeon to go over your name, birth date, type of surgery, and the correct site on your body to be operated on. If the surgeon is not available, ask to see the anesthesiologist and nurses involved in your case and repeat this same checklist with each one.
7.    Prevent falls:  Enlist the help of family members or friends to sit with you if you may be at risk for falling. If you have had surgery, are ill, or are medicated, you are at risk for falling. If someone cannot be with you 24/7, hire a sitter or private duty nurse to fill in. Your hospital should have referrals.
8.    Prevent misdiagnoses: Ask your doctor why he/she thinks a certain diagnosis is appropriate for you. Ask if there is anything else that could be attributed to your symptoms. Research any diagnosis on credible websites such as medical societies (American Cancer Society) or those ending in .edu. or .org. Get a second opinion or a third. Ask questions. Be assertive.
9.    Off hours lead to medical mistakes: Medical errors increase at these times, nurse-to-patient ratios increase and doctors are less likely to be available. Ask your advocate to be with you as much as possible or hire a sitter, companion or private duty nurse to fill in.
10.    Build a team: If your advocate cannot be with you 24/7, ask that another two to three family members or good friends share shifts to be at your bedside. Keep the notebook in your room and ask that everyone share the task of taking notes and acting as watchdogs.

https://www.seniorvoiceamerica.org/senior-health-news/10-tips-on-how-to-stay-safe-in-the-hospital
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Dr. Louis F. McIntyre says seeing an orthopaedic surgeon can help you live a more pain-free life.

If you or someone you care about is a weekend warrior, maturing man or exercise enthusiast, you might want to bone up on these facts about health and safety.
The Problem

As men get older, over-exercise or make sudden changes in activity, they may experience injuries, stiffness, discomfort or pain in their bones, joints and muscles. Instead of ignoring these symptoms which can lead to more issues, it’s a good idea to see an orthopaedic surgeon who can prevent, diagnose and treat such problems.

Some Answers
To help you understand how much orthopaedists can do for you, Dr. Louis F. McIntyre, Chief Quality Officer for U.S. Orthopaedic Partners (USOP), a platform of over 250 orthopedic providers across Mississippi, Alabama and Louisi­ana, offers four tips: 
•    As the weather gets warmer, people are more inclined to get out and start exercising. However, if you have a previous injury, you can do more damage.

•    Many people don’t realize you don’t need to have an injury to visit an orthopaedist. As people age, they experience more aches and pains and joint damage.
•    Orthopaedists can prescribe treatments, assist with rehabilitation, and help develop long-term strategies to deal with specific injuries. 
•    In addition to injuries, orthopaedic surgeons can assist with arthritis and sciatica, knee, back or shoulder pain, reduced range of motion, and numbness in limbs. 
No one wants to live with long-lasting pain or be limited in their daily activities. Orthopaedists can help address the issue and get you back to living a pain-free active life.

Learn More

For further facts on orthopaedics and how it can help you, visit www.us-orthopartners.com.

 "Seeing an orthopaedic surgeon can help you live a more pain-free life, says Dr. Louis F. McIntyre, Chief Quality Officer for U.S. Orthopaedic Partners (USOP) in Mississippi, Alabama and Louisiana."

Seniors learn self-defence with Cane-Ki-Do
All too often, many seniors that need the assistance of a walking device – such as a walking stick, or cane – often feel like they’re easy targets. Many say they have a fear of becoming a victim of theft, or some other act of senseless violence. Safety Specialist and Martial Artist, Bryant Harrell, has created a self-defense program, to help teach and empower senior citizens, showing them techniques and skills they can use - to no longer walk in fear. It’s called Cane-Ki-Do, which teaches seniors various
ways to use their cane, and do basic blocks, strikes, jabs, and hooks – that could protect them, in a physical assault. Bryant, a 10th degree Black Belt, teaches the program, along with his wife, Leotte Harrell – a 6th degree Black Belt. Together, they teach and inspire their senior citizen students, to dig deep, and tap into an inner strength that they forgot they had. That’s the “Ki” in Cane-Ki-Do – channeling that

energy, a learning to turn that fear into fuel. Many seniors - despite the fact that they may need it -
do not use their canes – because they’re afraid of looking vulnerable. However, once they’ve taken the Cane-Ki-Do class, they use their cane with pride, and confidence! Not only is it an assistive device – it is also an amazing self-defense tool! And, it is one of the only self-defense tools, that
can be taken everywhere – without question. The FDA, in their Federal Code of Regulations - have certified canes to be “medical devices”, and therefore, can be kept with you – at all times. Unlike a walking stick, which does not have the same medical exemption. This class is exciting, invigorating, and inspiring! The Harrells do an excellent job of taking time to address, and work with, each person in class. They modify and adjust certain techniques – to be able to reach and teach each
person, at their individual level of physical mobility. The inspiration for the Harrells to create this program, came from incidents involving two of their Martial Arts teachers, Professor Bill Brown Sr. and Grandmaster Joseph S. Harrell Sr. On two separate occasions, they both used their training and skills, to ward off attacks from potential thieves, using their canes. They both showed, that
just because you may be disabled, or a senior citizen – it doesn’t mean you have to be a victim.
If you, or someone you know, would like to train in this awesome cane self-defense class, please out and try a class – the Introductory class is free!   Membership to the Sunshine Center is required for participation in the classes. For more information – please call: 727-893-7101

DEAR DR. ROACH: My husband has been diagnosed with cardiac amyloidosis. The doctor has started him on Vyndamax, a very expensive drug. Without this drug, he is lucky to live, at the most, two years. Is this drug a miracle, and does it guarantee that he will live many more years? — T.W.
ANSWER: There are several types of cardiac amyloidosis — a disease in which abnormal proteins are depos-ited in many tissues, including the heart, where the protein interferes with heart function and leads to heart failure.  Tafadamis (also known by its brand name, Vyndamax) is used in transthyretin amyloid cardiomyopa-thy (ATTR, of which there are two types that both get treated with tafadamis).
Subjects in the trial on tafadamis were followed for two-and-a-half years. Half of the group were given tafadamis, while the other half were given a placebo, which looked like the real drug but had no activity. Of those who got the inactive placebo, 43% died in the two-and-a-half-year time span of the study, but of those who received tafadamis, 30% died. Thirteen percent, or about one in eight people, who received tafadamis lived, when they were expected to die. In addition, there were fewer hospitalizations and less loss of ability to exercise in those taking tafadamis, com-pared with the placebo. There were no serious side effects that were more frequent in the tafadamis group.
Tafadamis definitely affords a big improvement in the outcome of people with ATTR-CA. However, I would not call the drug a “miracle,” nor is there a guarantee of living many more years. To me, a miracle is when someone recovers when no doctor expected them to. I have seen a few in my career, and they are very powerful. I have seen many treatments that have incremental improvements in outcomes, and over time, that has led to dramatic improve-ments in many diseases.
Dr. Roach regrets that he is unable to answer individual questions, but will incorporate them in the column whenever possible. Readers may email questions to ToYourGoodHealth@ med.cornell.edu.
© 2023 North America Synd., Inc.
All Rights Reserved

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                                Foot and Ankle Safety Tips for the Summer Months
(StatePoint) From the beach to the backyard, taking care of your feet and ankles in summer is essential.

“Nothing ruins summer fun faster than a problem with your feet. However, a few smart precautions can help keep you healthy and safe,” says Gretchen Lawrence, DPM, AACFAS, a board-certified foot and ankle surgeon and an associate member of the American College of Foot and Ankle Surgeons (ACFAS).

To help you understand some of the most common summer risks to feet and how to avoid them, ACFAS is sharing these insights:

• Puncture wounds: Millions of Americans go barefoot every summer, and thousands will sustain cuts and puncture wounds. To prevent injury and infection, wear shoes whenever possible and get vaccinated against tetanus. If you do get a puncture wound, see a foot and ankle surgeon within 24 hours and don’t swim until it’s healed. Bacteria in oceans and lakes can cause infection.

• Pool problems: Always wear flip flops or other footwear in locker rooms and on pool decks to prevent contact with bacteria and viruses that can cause athlete’s foot, plantar warts and other problems.

• Sun damage and skin cancer: Don’t overlook your feet during your sun protection routine. Feet get sunburned too, and melanoma on the foot or ankle is more likely to be misdiagnosed than on any other part of the body. A study published in “The Journal of Foot & Ankle Surgery” reported the overall survival rate for melanoma of the foot or ankle is just 52%, in sharp contrast to the 85% survival rate for melanomas on other areas of the body. Apply sunscreen to the tops and bottoms of feet and limit sun exposure. Dr. Lawrence notes, “If you spot abnormal moles or pigmented skin, including under toenails, visit a foot and ankle surgeon. Early detection and treatment could save your life.”

• Pains and sprains: Summer sports can lead to arch pain, heel pain, ankle sprains and other injuries. Proper footwear with heel cushioning and arch support is essential, particularly on uneven surfaces, such as sandy beaches or hiking trails. If injury occurs, use the RICE approach: rest, ice, compression and elevation to ease pain and swelling. Any injury that doesn’t resolve within a few days should be examined by a foot and ankle surgeon.

• Mower risks: Some 25,000 Americans sustain injuries from power mowers annually, according to the U.S. Consumer Products Safety Commission. Many of these injuries are preventable. Always cut the grass in protective shoes or work boots and keep children away during this chore. Never mow a wet lawn or pull the mower backward, and always mow across slopes, not up or down them.

• Travel concerns: Sitting for long stretches can increase the risk of dangerous blood clots. “Whether road tripping or flying, regularly stretch your legs and pump your feet to circulate blood. Wearing compression socks for longer travel is also a good idea,” says Dr. Lawrence.

• Diabetes complications: If you have diabetes, prolonged hot and humid weather can lead to numerous foot woes. Any type of skin break has the potential to get infected if it isn’t noticed right away, and exposure can cause dry, cracking skin. Inspect your feet daily and wear closed shoes whenever possible. Swelling is another hot-weather risk, potentially making shoes fit tighter which can cause blisters. Compression stockings may not sound appealing in hot temperatures, but they can reduce swelling and help prevent poor circulation. Finally, never go barefoot in summer. Impaired nerve sensation can make it hard to detect just how hot surfaces are. Just a few minutes walking barefoot on pavement to grab the newspaper can cause third-degree burns.

For more information and to find a foot and ankle surgeon near you, visit FootHealthFacts.org, the patient education website for the American College of Foot and Ankle Surgeons.

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 ​ANSWER: I’m afraid I don’t have a good answer for you. It is true that most authorities recommend an intensive breast cancer surveillance program for women at a high risk of breast cancer, in the range of a 20% to 25% lifetime risk. (The average risk for developing breast cancer for a woman born today is estimated to be about 13%.)
The Tyrer-Cuzick model of esti-mating breast cancer risk tends to give higher estimates than the other commonly used models, such as the BRCAPRO. Other models may not put you over the threshold for inten-sive screening with MRIs, which is usually combined with mammograms.
The question about gadolinium (the chemical element used in the contrast dye for MRIs) is important because some people do store gadolinium in various tissues, including the brain, but the clinical significance of this is unknown. (People with kidney disease can develop a skin disease due to
gadolinium, so they aren’t recommended have MRIs with gadolinium.)
Although gadolinium can stay in the body for months or years, there has been no evidence of harm from gad-olinium in brain tissue, despite these agents having been used for many years. Some agents have less retention than others. The U.S. FDA has man-dated patient guides for these contrast agents, which relay the information above.
Given that there is a probable benefit to intensive screening for breast cancer in your case due to your high genetic risk, and no more than a theoretical risk from gadolinium, I believe that the benefits outweigh the risks, but I can’t say that with complete certainty.

ANSWER: There are animal studies suggesting benefit from oral cannabidiol , a component of cannabis (hemp) that has no psychoactive component (it’s the THC in cannabis that gets peo-ple “high”). I found some small studies showing pain relief from topical CBD in people with neuropathy , but not for arthritis. Several people, like you,  have written to me with reports of pain relief.
Topical CBD is probably very safe. Even oral CBD should be safe, but studies have found that many products labeled CBD have trace, or more than trace, amounts of THC, enough to make a urine test positive for cannabis.

Until there is some evidence of effectiveness, I can’t recommend it, but people can try it based on safety and anecdotal reports.

Dr. Roach regrets that he is unable to answer individual questions, but will incorporate them in the column whenever possible. Readers may email questions to
ToYourGoodHealth@ med.cornell.edu.
© 2023 North America Synd., Inc. All Rights Reserved

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