WHO IS AFRAID OF FALLING? H.Barker, Ph. D. RN

ambulance, architecture, building

Life is busy.  We rush from place to place.  Running to catch buses, taxis or trains.  There is a rush of exhilaration as I beat the train to the platform.  The good old days.  I was running late for work, but this train saved me from being tardy.  Memories of yesteryear are sweet, as I now find myself holding on to the subway rails and gingerly descending.  It is cruelty on days when these stairs are wet and slippery with ice or snow.   Youthful thoughts vanish.  I am suddenly turned into a frightened limpet, clinging tightly to my steel support.  Trusting it to bear my weight, and help me land safely.  I slide ungracefully down the last few steps and rush to the turnstile, but the train is leaving.

I know my house.  I can walk through it blind folded.  No need for a bathroom or kitchen light.   In the darkness, the furniture is familiar.  I safely walk around my electronic gadgets charging on the floor, and even take a quick peek through the window. Not this night.  I jumped out of bed rushing to the bathroom.  The room begins to spin. My back hits the bed, the wetness sliding down my legs.  What happened here?  Who slammed me in the head?  I pushed up on my elbows, but there is a universe out there floating before my eyes.  My head is in orbit.  Gravity is lost.  My senses say to lie here until everything settles down.

I do not like snow.  Sure, it is soft, warm, white and pretty when it is falling.  Give it a few days, and you are “Harry on Ice,” slipping and sliding all over the place.  Not funny anymore.   I am striding through the snow on this cold January day, when suddenly my feet are in the air and I am crashing to the pavement.  My handbag, glasses, umbrella go flying. My ears are ringing. Stars are blinking before my eyes.  I tried getting up, but my feet are useless.   I opened my eyes.  People are walking around me.  Not even looking at me.  One stranger came and helped me up.

According to the National Council on Aging, https://www.ncoa.org/news/resources-for-reporters/get-the-facts/falls-prevention-facts/, adults 65 years and over are at greater risks for falls.  Every 11 minutes an older adult is treated in an emergency room for a fall.  In 2013 the cost to treat falls was over $30 billion dollars. Falls limit mobility, increases fear and may result in permanent disability or even death. Postmenopausal women are at greater risk for falling, because of osteoporosis or weakening of the bones.

If you are afraid of falling, here are five tips that help to reduce your risks:

  1. Hold on to stairs.
  2. Walk in flat shoes or sneakers
  3. Put a mat/old towel in the bathtub
  4. Do not walk on wet slippery surfaces
  5. Check your medications for side effects e.g. dizziness

 

NATIONAL FALL PREVENTION DAY: September 22, 2017

 

 

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Domestic Violence and the Holidays Harriette Barker, Ph.D, RN

Free Stock Photo: A red Christmas present isolated on a white background

 

Each year the decorations, shopping, bright lights, Christmas cheer, and celebrations signal the holidays.   Many people are happy, but others are emotionally, financially and socially stressed

Holidays such as Thanksgiving, Black Friday, Cyber Monday, Christmas, and New Year are challenging for persons who are experiencing financial difficulty, loss or social isolation.  Many individuals also experience the “holiday blues,” a form of depression that is more prevalent during this season. Family stress may also be high.  If relationships are fragile, family gatherings may cause increased stress levels.   Partying and excessive alcohol intake are other sources of stress for many people.

Some police departments in the nation have reported an increase in domestic violence during this current holiday season.  However, a reason article in the Huffington Post on this issue suggested the idea of increased violence at holiday time is a myth, because “violence does not take a vacation.” According to The National Domestic Violence Hotline, there is a reduction in the number of persons contacting their service during the holiday season. They suggested that concerns about keeping the family together during the holidays may be the main reason for under-reporting any violence.
Domestic violence can be physical, verbal or emotional.  It may be subtle or coercive.  The abuser may use financial, restrictive, isolation or exclusionary tactics to exercise control over their victim.  For example, not allowing her to use the car to visit family or friends.  In one situation, the abuser canceled a holiday luncheon without informing his partner.

Tips to reduce holiday abuse

  • Clear communication is the key in helping to prevent abuse.
  • Expressing your feelings calmly but firmly is important.
  • Head off situations that are escalating by leaving the room.
  • Eliminate provocative arguments
  • Take time to cool down.
  • Make a budget written in stone. No changes.
  • Monitor alcohol intake
  • Refrain from attention seeking behavior
  • Reach out to a resource when overwhelmed.

You can suddenly find yourself in an abusive situation.  It is important that you have a plan for getting help.  Family, neighbors or friends may be your first sources, but in abusive situations, it is better to contact 911.    Do not accept that your abuser is experiencing seasonal stress.   Do not use excuses to defend your abuser.

If you live in an abusive situation, holiday stress may easily exacerbate any interactions with your abuser.  There are a variety of resources in your community such as shelters, hotlines, churches, non-profit organizations and the police that will offer help.  You should keep a list of them and their contact numbers.  Domestic violence is often difficult to detect, so family and friends should be vigilant for any signs of its’ occurrence during this period.

 

National Domestic Violence Hotline  Number

24/7 at 1-800-799-SAFE (7233). All calls are confidential and anonymous.

 

Tart: An Acquired Taste

I had a little problem  a few weeks ago and a friend recommended that I drink Cranberry  Juice.  I do not drink juices but went to the supermarket.  The cranberry juices were in different varieties.  Finally, I chose one but after drinking some of it, decided that it was too sweet for my taste.  I went to the health food store and picked up  the same size but it cost three times the price.  The recommended serving was three ounces, which I poured into a glass added four cubes of ice.  On my way back to the living room I took a mouthful and instantly was spitting it all over the place.  Tart!! Sharp!!Acidic!! Hold on a minute.  Who drinks this stuff?  I swear it is going to burn a hole in my stomach.

I was visiting my daughter and took  it with me.  So my teenage grandson wanted to try it.  I told him how acid it tasted, but he still wanted to try.  I watched in amazement as he drank about three ounces of the juice.  What? Is his stomach lined with lead or something? “It is an acquired taste, grandma,” he tells me.

So then I started to think.  As I grow older I cannot tolerate any food or drink that is too acidic.  I remember my school days when  I could eat fruit such as gooseberries, golden apples, tamarinds, lemons, all I needed was some salt sprinkled on the top.  I cannot do this anymore.  With age the stomach acids begin to decrease and the lining is easily irritated.  Back to my cranberry juice, over several days I manage to tolerate it better.  The problem cleared up so I guess that it was worth it after all.

 

Food Adventure: Bugs Anyone? Harriette Barker, Ph. D, RN

Free Stock Photo: Close-up of Mexican fruit flies on a grapefruit

 

I do not like creepy-crawly things and cannot stand bugs of any kind.  Growing up in the Caribbean with its wide variety of insects and crawlies, I could never think of any insect or worm as food.  Culturally we are a meat and fish-eating people.  I am not adventurous with food.  I prefer to stick to things that I know.

Many years ago, visiting the island of Tobago, I was encouraged to try some of their meat delicacies such as Agouti, Manicou, Armadillo, and Iguana.  I passed.  I could not imagine them going down my throat.  I am also picky about fish.  I only like those with scales and cannot tolerate shark, or shellfish (allergic).  No shrimp, conch, sea eggs or lobster for me.

With my limited food choices in meat and fish, my eye caught an article in a science magazine about eating bugs.   Apparently, insects like grasshoppers are nutritious, iron rich, and comparable to the nutrients in beef.  They could become an alternative source of inexpensive protein that is good for everyone.  Instead of cattle farms, we would now have insect farms that are more sustainable and friendly to the environment.

Entomophagy is the correct name for eating insects.  There are many countries in Africa, Asia, and Europe where this practice is an important part of their diet.  Many westerners are not keen on eating these bizarre foods.  However, they are specialty restaurants who are enjoying a new interest in these foods from their patrons.

Image result for free pictures of insect meals

http://www.phuket.com/magazine/eating-insects.htm

I think of the bugs that grow in the Caribbean, roaches, centipedes, lizards, beetles, butterflies, caterpillars, millipedes, and none of them begin to make my taste buds water.  In fact, most of them I cannot tolerate.  I am a fan of bizarre foods, but sometimes I cannot watch the host eating his delicious choices of insects.  I remember one episode where he had a large Louisiana centipede on a plate.  I just ran from the room.

The best eight bugs recommended in an article in the National Geographic are beetles, butterflies, moths, bees, wasp, flies, mosquitoes, water boatmen, backswimmers and stink bugs.  The online magazine alternate daily.com narrowed these down to the three best bugs.  How nutritious are bugs?   They are high in protein, fatty acids such as omega-3s, calcium, and B 12.

Rich in protein and low in fat, Insect Burgers on sale at Jumbo supermarkets in 400 stores across the Netherlands, Stock Photo

Are insects good for your health?  Yes, per the United Nations.  They can help to alleviate world hunger, reduce the risks of anemia, stimulate metabolism, boost the immune system, and are handy in emergency situations.

I do not plan to eat any insects, so I felt good about myself until I came across this information.  Apparently, a lot of our foods have in insect parts.  Peanut butter, tomato ketchup, coffee, packaged food, some red food dyes and chocolate to name a few.  Now I am feeling squeamish.

We have been eating insects since birth.  Before you start gagging, the FDA knows all about it.  They accept that a certain level of bugs in our food is good.  Okay, so what shall I do?  I am thinking of a way to quieten my stomach which is beginning to feel queasy.

I am still curious wanting to find out if there are any entomophagy cookbooks.  I found eat-a-bug and bug-a licious and more.  Such recipes  as Cabbage, Peas ‘n’ Crickets and Bee-LT Sandwich,  may tempt your appetite.  If you are adventurous and looking for food excitement, then you may want to venture into the world of bugs. “If it looks good, eat it,” the host of Bizarre foods encourages us.  Maybe the day is coming when we take his advice seriously.

Interested in bugs cookery you can get a free cookbook at http://cookbook.pestaurant.com/

 

 

Triple Negative Breast Cancer

Breast cancer ribbons patterns

Last Friday, I received the sad news that my friends’ thirty-two-year-old daughter had died from breast cancer.  She was battling this disease for the past ten years.

Breast cancer rates in black/African-American women have increased by 20% when compared to those of white women.  The rate of disability and death is 42% higher for this group.  However, the number of diagnosed cases is lower.

There are different subtypes of breast cancers.  One subtype that is problematic for black women is called Triple Negative Breast Cancer.

 

Understanding Triple Negative Breast Cancer

Estrogen and progesterone are female hormones.  The her-2 gene helps in the growth of healthy cells in the breast. Triple Negative Breast Cancer is diagnosed when these hormones and gene are absent in a breast biopsy (hormone negative).

Many breast cancers are hormone positive and respond well to drugs such as Tamoxifen and aromatase inhibitors (hormone therapy). Triple negative breast cancer may not respond to hormone therapy, is more aggressive, difficult to treat, may recur and has a poor prognosis.  However, in the early stages, it may respond much better to chemotherapy.

Facts about Triple Negative Breast Cancer

  • Black/African American women are more likely to be diagnosed with this type of cancer than white or Hispanic women.
  • Death rate is higher than other groups of women
  • Tend to be diagnosed at a late stage
  • Have lower survival rates
  • Approximately 30%of breast cancers are Triple Negative
  • Many women are not regularly screened
  • Follow-up may be lacking
  • Limited access to quality treatment

 

 

 

Risks for Triple Negative Breast Cancer:

Persons at risk for Triple Negative Breast Cancer are

  • Younger people – women and men
  • African Americans
  • Hispanics
  • Women with a BRAC 1 mutation BRACA 1& 2
  • Men with a BRCA 2 gene mutation
  • Using birth control pills for one year or more

Important factors that influence outcomes:

  • Early detection and treatment
  • Early prevention strategies
  • Quality and resources of the facility

Treatment:

  • Lumpectomy – removal of the lump
  • Radiation therapy
  • Chemotherapy

Prognosis:

  • Poor during 3-5 year period
  • Does not respond well to treatment
  • Likely to recur

Prevention Strategies:

Black women can make sure that breast cancer is diagnosed and treated at an early stage by:

  • Getting a yearly mammogram if you are forty years and over and have risk factors
  • Genetic testing for BRCA if there is a family history of breast cancer
  • If your risks factors are high screening should begin earlier
  • Performing monthly breast self-examination
  • Regular breast examinations by a healthcare provider
  • Reporting any concerns to your doctor

Remember:

National Breast Cancer Awareness Month  -October 2016

Metastatic Breast Cancer Day (MBC) October 17

Harriette Barker, Ph. D, RN

 

BLACK BOOMERS: Ten tips to keep you hydrated

Free Stock Photo: A glass of cold water with ice cubes

Keeping the body well hydrated is a problem for many older adults.  Dehydration, (not enough fluid) may cause the blood pressure to drop, and the person is at risk of falling.  It may also cause poor coordination, loss of balance, confusion, disorientation, constipation and heart problems.

During hot weather, people tend to drink more to avoid becoming dehydrated, but this is a problem that can occur at any time.  Besides hot weather, you may become dehydrated if you are taking water pills, (diuretics), blood pressure or heart medications, are on dialysis or have a medical condition such as diabetes.

The flu, a high temperature, constipation or a bout of diarrhea can cause dehydration.  Some persons do not like to drink because they fear wetting accidents, lack access to bathroom facilities, are physically disabled or have memory problems.  Some signs of dehydration are dry mouth, muscle cramps, weakness, headache, fainting, sunken eyes, and passing small amounts or no urine.

An easy test for dehydration is checking your urine.  Normally urine is light yellow in color.  Dark, concentrated urine is e an early warning sign of dehydration.  Another test is pinching the skin on the back of your hand, abdomen or chest.  The skin will form into a little tent which should return to normal within five to ten seconds.  If the skin is wrinkled and remains in folds, this indicates dehydration.

Dehydration can be serious and life-threatening if not treated immediately.  Some complications are seizures, brain swelling, low blood volume (hypovolemic shock), acute kidney failure, coma, and death.

Tips for Staying Hydrated

  • Increase your fluid intake – to at least eight glasses of water daily.
  • Eat fruit and vegetables with a high water content e.g.cucumbers, watermelons, celery
  • Drink fat-free or skim milk
  • Drink water before and during meals
  • Try teas, herbal, iced, coffee – limit caffeine
  • Try sports drinks – check for high calories, sugar, and sodium
  • Coconut water – be aware of high sugar content
  • Set up a hydration schedule
  • Carry bottled water
  • Add lemon or orange slices to water
  • Limit diet sodas (high salt) and energy drinks(high sugar)

 

Resources:

http://www.parentgiving.com/elder-care/dehydration-a-hidden-risk-to-the-elderly/

http://dailyburn.com/life/health/healthy-foods-stay-hydrated-without-water/

http://www.mayoclinic.org/diseases-conditions/dehydration/basics/

Harriette Barker, Ph. D, RN, CHC

 

Black Boomers: No Magic to Weight Loss

Closeup of an older woman wearing a blue sports bra and watch : Free Stock Photo

One of my students presented me with a watch-like gadget.

“What is this?” I asked her

“It is to help you track your steps.  10,000 steps each day to keep you fit.”

A few days later my friend called me.  She was walking home from the train station trying to complete her targeted steps for that day.  Many persons are using technological devices to help lose weight and get into shape.  As I take my daily walk/jog, I see these fitness trackers on the arms and wrists of persons trying to get fit.  Some people swear that the gadgets help them in their goals to be fit.  I often questioned about those 10,000 steps.  It is like drinking eight glasses of water a day.  Good to do, but who is to say that more or less may not be just as effective.

A new study about weight loss and fitness trackers has indicated that technology alone does not aid in weight loss.  The two-year study compared standard behavioral weight loss interventions such as diet, exercise, tips, and counseling with the addition of fitness trackers.  The results indicated that adding a fitness device tracker did not make a significant difference.  It looks great wearing a tracker on your wrist or arm.  However, moderation and consistency in the diet are still the basics of weight loss goals.

Is there a place for technology such as fitness trackers in the battle of the bulge?  I believe that these devices can play an important role in helping persons to become motivated to achieve their goals.  However, this technology is not magic.  Those persons who are trying to lose weight must commit to healthy lifestyle changes that help to promote and sustain their weight management goals.

 

JAMA. 2016;316(11):1161-1171. doi:10.1001/jama.2016.12858.