Hospitalist – Does your hospital have your family doctor follow you in the hospital or the new “Hospitalists”?

When our doctor’s office sent out a notice that from now on they would not see us when we were hospitalized due to the hospital requiring them to use hospitalists, I was not happy.  I had to do some research into exactly what a hospitalist was and what the whole idea behind it was.

When looking it up, here is the description I found:  Hospitalists are physicians whose primary professional focus is the general medical care of hospitalized patients. Their activities include patient care, teaching, research, and leadership related to Hospital Medicine.

I did not want a stranger taking care of me, especially if it was serious enough that I was in the hospital.  I wanted a doctor who knew my history and would talk with me about what was going on and what would be the best treatment for me.  How could a stranger do that?

Would a ‘hospitalist’ have that connection with me that my doctor has? Would they spend time with me, explain things to me? I had doubts.

I even went so far as to change doctor’s offices so that I could be with a practice that did not go along with this new practice.

Unfortunately, our hospital has bought out almost every doctor’s office in our town so I had no choice but to accept it.

However, after thinking it through and living through a dangerous bowel perforation which required weeks in the hospital, I have come to the conclusion that ‘hospitalists’ are not a bad thing.

If your doctor is called to the hospital in the night to care for a critical patient and spends most of the night fighting to save their life, how exhausted are they going to be the next day? Will that mean that the care his patients get that day is not the best it could be? And, what if he gets called back that night? This could be a never ending battle which would not be good for the patients or the doctor?

The bottom line is that the ‘hospitalists’ have your files so they can be up to date with all the important information so it is not likely they will miss anything that is vital for your health. They are able to come to your room for consultation day or night as that is their only job.

They can get in touch with your doctor in case there are any questions.

The only negative I can see is that if you are in the hospital for over three or four days, you will then get a different ‘hospitalist’ as they have to have down time. I think our local hospital has 6 ‘hospitalists’ that cycle through. Unfortunately, I saw all of them of during my visit.

So, bottom line:

You are not seeing your doctor but your are seeing a doctor who is not exhausted and will see you for at least 3 – 4 days. That doctor can be in contact with your doctor at any time if needed. The ‘hospitalist’ can order any tests or meds needed immediately without having to wait while a nurse tries to get through to your doctor causing delays in your care.  I think it is a good practice.

Sometimes you have to admit when you are wrong.

Sleep Apnea – What Your Doctor Might Ask To Determine IF You Need A Sleep Study

As I mentioned in the earlier post, there are several different things your doctor will look at to determine whether he/she wants to test you for sleep apnea.   Some BUT NOT ALL are:

Weight  – If  your BMI (body mass index) is higher than 25, you are at a greater risk of sleep apnea.   This is not always the case as slender people have been know to have it.

Age – Although sleep apnea  happens at any age, it is more common among adulthood to middle age.

Male versus Female – Men have a higher chance of having sleep apnea but the risk increases in women during and after menopause.

High Blood Pressure – This is another thing the doctor will take into consideration as it is common in people with sleep apnea.

Does someone in your family have it? – Believe it or not, this is a heritable condition.  However, that is possibly due to inherited traits like weight and physical features.  Of course, some of this could be due to chosen habits like exercising and/or eating.

Family history – Sleep apnea is a heritable condition. This means that you have a higher risk of sleep apnea if a family member also has it. Inherited traits that increase the risk for sleep apnea include obesity and physical features such as a recessed jaw. Other common family factors – such as physical activity and eating habits – also may play a role.

Headaches – Another possible hint is headaches, especially morning headaches.

If you go in for any surgeries, they will go through a sleep apnea questionnaire which checks on most of the top symptoms.  Naturally they will want to know about snoring, waking up tired, gasping during sleep, etc.

If you have several of the above, your doctor may order a sleep apnea test.  There are a couple basic ways to test for sleep apnea.  In the next post, we will look at the differences between them.

Sleep Apnea – Is It Serious? What are the symptoms?

 

 

I have heard someone say that sleep apnea is not an actual medical condition.  THEY ARE WRONG!  I know for a fact that this condition is a killer and it is not just older people. I know someone who died in his early twenties.  His new wife woke up beside him to discover him dead.  He had not wanted to wear his machine because it was uncomfortable.

I agree that in the beginning those machines suck.  At least to me, mine did.  I did not like having something on my face at night.  I hated being connected to the hose so that when I turned over I had to drag it along with me.  It just plain sucked.  BUT, I am still here to complain about it!

There are many varieties of sleep apnea.  There are many different symptoms your doctor might consider including:

1,  Snoring – this can be as dramatic as the kind when you stopped breathing for a few seconds and then snort awake.  I think most of you have seen/heard this happen. The person is basically snoring, gasping and almost choking.  But, it doesn’t have to be that dramatic to still be sleep apnea.

2.  Sleep problems – either having trouble going to sleep or staying asleep.  Insomnia can be caused by stress but it can also be sleep apnea.  It is possible that the person’s brain is aware that they are not breathing right while asleep so it keeps waking them up.

3.  Waking up with a dry mouth or sore throat.  People with sleep apnea may be mouth breathers in a effort to get enough air in.

4.  Weight gain or excessive weight.  Sleep is critical for weigh maintenance (or loss) as our bodies produces leptin which tells us to quit eating.  So, when we are not sleeping, we are not getting enough Leptin so we tend to eat more.

When we don’t get enough deep sleep, our bodies produce an excessive amount of a hormone called ghrelin.  Ghrelin tells our bodies that they need to eat.

Not enough sleep also cause problems with insulin.  It makes our bodies insulin-resistant, which  then causes additional insulin production.  When too much insulin is produced, the body craves unhealthy foods.

So, lack of sleep hits us with too little ghrelin,  not enough leptin an insulin-resistance causing us to want to eat.

However, not all people with sleep apnea are heavy set.

5.  Being sleepy during the day or waking up exhausted.

6.  Being forgetful or not being able to concentrate.  Sleep apnea makes it hard to focus.  It can be extremely hard to learn in school or on the job.

7. Not sleeping can lead to depression, irritability, and impatience.,   Chronic fatigue that people with sleep apnea  experience can develop into full-blown depression.  Irritability and impatience are also common symptoms because the mind is unable to focus on everyday tasks.  An inability to focus initially leads to feelings of frustration, which later morph into short, but powerful, bouts of irritability and impatience.  There are studies that have proven a direct link between sleep apnea and mental problems.

Of course, there are many other symptoms and you do not have to have all of these.  If you have any of these it might be time to talk with your doctor.  There are also several other things your doctor will look at but that is for another post.

I will make more posts to explain what the doctor may do to help decide if they want to do a sleep study (home or in the hospital).  I will also discuss how the tests goes in either place.

 

Aging – Does It Scare You?

I was in a conversation with a couple of friends who are all in their fifties and sixties.  We got to talking about health issues and the future.  One asked me why I wasn’t afraid of what was to come.

I had to really think about it.  Although I do worry from time to time about health issues, I plan on enjoying every minute I can and prefer not to waste it worrying.  As someone said…we are in the downhill slide of our life so why not enjoy it!

Although recently when a friend became ill, it made me think. I am one of “the older generation”.

A friend had told me a long time ago that is really made her think when she was filling in a form and it asked her age.  She had to go up to the next age bracket and it bothered her.  Of course since then we have been up several brackets.

All the posts I made in the beginning were about my parents age people basically.  But, now it becomes about my generation.  Everything I said for them applies to us also.  All the legal documents, family decisions, etc.

As we get older time goes by faster.  It just makes sense.  When you are five, you have only lived 1/20th of you life.  When you are 50, you have lived half.  (I know, I am planning on living to be one hundred in these examples.

So, should you let death scare you?  I don’t think so but I think we all have to be realistic and know that it is coming.  Make plans, live the way want, enjoy what you want you, say the things that need to be said, etc.

Don’t be afraid!

 

That Dreaded “D” Word – DIET

When I use to hear that word, I just shuddered.  You mean eat all that stuff that had no flavor, no sugar, no fun?

But, diet is now a way of life for a lot of people.  If you stop to think of it, our ancestors did not eat like we do and they had a much more active life than we do.  So, basically, we are going back to the way it was when life was simpler.

There are so many diets out there that I wouldn’t even think of saying what the right one was.  Some people do the no carb one, some do the vegan one, some do the one where nothing can come out of a box.  You have to research and pick the best one for you and your lifestyle.

I recently went through several of my fast food store’s websites so that I could pick the least harmful thing to eat.  It might really surprise you what sandwiches are actually less calories than that salad you were going to eat.  I made some notes in a little book I keep in my purse and then when I know I am going somewhere I can check it out and make a wiser decision.  I can’t wait until I am in line and then hold the line up while I am trying to read the calories on the order board.

Another thing that just stunned me was portion sizes.  I thought we had been eating somewhat healthy until my nutritionist showed me plastic models of what 1 serving was.  I think everyone would be shocked.  Just google it some time.  I think we were eating at least 2 – 3 times more pasta than what we should have been.

I am not going to sit here and tell you that we have made all the life changes we need and now are down to the correct weights.  That would be a BIG lie.  We are making small changes which include portion control.  I even bought one of those sets off Amazon where it gives you different size and colored containers so you know how much of each type of food you should eat.

But, bottom line, we probably all could stand to lose some weight.  We all have different reasons.  For me it is about the fear of someone having to take care of me at my current size.

Losing weight gets harder the older you are. So, for us, the time is now.

So, if you pass that overweight woman walking or riding a bike while you are driving your car, just remember, at least she is off her tush and trying to do something about it.

 

What diets of lifestyle changes have you made to become healthier?  Share with us your knowledge so we can all become healthier.

 

Just Do It – Lose Weight

We have probably all said it many times – “I need to lose some weight, get in shape,  exercise,etc.  But do you ever do it for a long enough period of time to make a difference without going back to your old habits?

This has been a battle for me for the last 15 or more years.  I could give you all sorts of reasons but that would not change the fact that I obese, not just fat…..OBESE!  The first time someone said I was morbidly obese, I wanted to punch them.  Surely I was just fat but then I looked at the standards doctors go by and yes, I am obese.

  1.  I think we all need to look at the reasons why we want to change and find one that is important enough to do the changes we need to do.
    1. For me it is a combination of things.  I am not getting any younger.  It is harder to lose weight the older you get.
    2. My children and grandchildren.  It is hard to keep up with them sometimes.  I do not want them ever to be ashamed of me for my weight.   do not want to die early and leave them with a hold in the hearts.
    3. I do not want to be a burden to anyone.  Having taken care of some aging adults, it was much easier to care for the ones that did not carry the extra pounds.
    4. I just want to live.  Period.  I may be on the downhill side of life but I plan to enjoy the slide.
  2. Why are you avoiding it?
    1. My health has been a problem for me but that can be a reason to avoid it OR a reason to get with it.
    2. I am just plain lazy.  When I get home from work, I do not want to do anything more that I have to.
    3. Fear of having people watch me exercise.  Have you ever been the fat one in a class full of skinny people?  It is not fun.
    4. Fear of failure – but if you never start, you have already failed.
  3. Start small so it is doable.
    1. For me this is an appointment I have soon where I will tour a women only gym.  It is a 24 hour gym so I can go anytime.  They have people that can help with the machines and teach you the right way to do it.  It is affordable as it is only $26.00 a month and I could easily spend more than that on junk food.
    2. Pick one thing to remove from your diet.  For me it has to be sweets.  I can sit down with a box of cookies and just absently minded eat until they are all gone.  Then I am disgusted with my self.   I am not an expert but have been told that sugar just makes you want more sugar so I am going to do my best to just completely stay away from it.
    3. Have a friend help you.  It could be your husband, fitness coach or just a friend who might have similar goals.  My husband is going to help me and also a lady from work.  Maybe you need an exercise buddy.
  4.  Get your supplies together.
    1. This can be as simple as buying more fruits and vegetables.
    2. Maybe you need to get some books on whatever diet you want to try.
    3. Perhaps you want to buy some home workout equipment like weights or a bike.
    4. There are free programs out there you can log your food intake or exercise on that will help you make good decisions and track your progress.
  5. Now just MAKE the time.
    1. We all have extra time.  It is just how we choose to use it.

I am happy to say I took the time and checked out the gym.  I am joining on Monday and my goal is to go 3 times a week at the minimum.  That for me will be easier than staying away from the sweets.

What are you going to do?  Do you have any suggestions for others how to achieve their goals?

The fear of “catching” your parent’s disease

Today I felt it for the first time…the agony of watching my food flying off my spoon as I tried to take a bit.

My mom had been young when she noticed her hand shaking. Although she wasn’t much for doctors, the next time she went she asked about it. “No worries” he said. “Those are just familial tremors.” Well after many years they finally diagnosed it as Parkinson’s. That is what I believe finally killed her although it was a complication of it.

I use to go to back home and we would always go get ice cream. She loved her ice cream. Slowly the shakes took that away from her. At first she would laugh about spilling some on her shirt but eventually she refused to out for anything to eat or drink as she said it was too embarrassing. Of course, we would all assure that we didn’t care but it was obvious that she did.

Soon, she couldn’t write any longer. Reading was hard because she couldn’t hold the book steady. This disease slowly trapped her in a world with little she could do.

I was at a dinner yesterday and noticed how bad the shakes had become in my right hand. They have been there on and off for quite a while but just like mom, my doctor assured me they were just familial tremors.   I think she is wrong but pray she is right.

I was having trouble keeping my corn on my spoon and finally just gave up. I know that no one was watching but I still very self-conscious.

When this all started for mom, I researched everything I could. I found weighted silverware that was supposed to help. I ordered them right away and took them down. Mom acted grateful but after she passed, I found them still in their original package.

I believe she just didn’t want to accept what this disease does. Who would?

My shakes come and go and they are not horrible but the idea that I will suffer the same fate as mom horrifies me. I think everyone who has lost a parent to a horrible disease worries about the same happening to them.

Maybe it was just a bad day and it won’t happen again for a long time. Maybe not.

The "joys" of Parkinsons

The “joys” of Parkinsons

When you know you have done well.

I am not the best cook, and I freely admit it. For the first 10 years of our relationship my husband did about 95% of the cooking because I was horrible at it and by the time that I got home from work it was dinner time. If it came out of a box or with detailed instructions, I could usually do alright but that was about it. The running joke was: Oh boy it is Mom’s turn to cook so we will be getting pizza or take out. My husband could grab something out of the fridge and whip something great up with no recipe or directions.

But in the last 10 months or so that I have been home full time, I have gotten much better. Now, I think that it is mostly due to the fact that I have the time to find recipes that I like and that I have the confidence to actually do it.

My first major success is when my husband found a breadmaker at a garage sale. I thought this can’t be that hard.. you just  put all the ingredients in and push the button. No problem and it would be so nice to have fresh rolls and bread with dinners. So I make my first batch of rolls ever and get them all baked.  I set them on the counter to cool as I get the second batch in the oven. (I have a large family so I almost always double everything) and when I get back I notice that the pan is empty and all of my family have this innocent look on their face.  Apparently my husband decided to test one.  Then, of course, everyone had to test one. I was so happy that they turned out good enough to that I had to make more. That just increased my desire to cook more.

Now when I decide to try something new in the kitchen the family usually changes their plans so that everyone is home at dinner time. You know you have the good life when your family asks for a repeat appearance of a dinner you tried for the first time. I will be posting about some great successes that I have had so that you may try it with your family if you want. Of course if there is something specific you would like to see let me know. I have a great group of testers here!!!

 

 

Reorganizing while adding more contributors, categories and fun!

I have decided that I cannot write enough about caregiving to maintain a blog about just thought.  Life is caregiving in itself.  You care for others, your home, your garden and many other things.

So, we are going to add several new post segments.  We will blog about plants, pets, household tips, essential oils, subjects dear to the world of veterans and their families and probably many thing we haven’t thought of.

This will be a multigenerational blog now with a mother and daughter posting at different times.

There are so many things going on in the world that you never know where this will take us.

Come along on our journey!