Articles of Interest
Dehydration
Heart Awareness
Broken Heart Syndrome Is Real!
Floaters and Flashers in the Eye
Getting a Good Nights Sleep
What You Should Know About Advance Directives
Dehydration
What is dehydration?
Dehydration can be a serious heat-related disease, as well as being a dangerous side-effect of diarrhea, vomiting and
fever. Children and persons over the age of 60 are particularly susceptible to dehydration.
Dehydration is a serious concern not only in warmer months but also in the
colder months.
What causes dehydration?
Under normal conditions, we all lose body water daily through sweat, tears, urine and stool. In a healthy person, this
water is replaced by drinking fluids and eating foods that contain water. When a person becomes so sick with fever, diarrhea,
or vomiting or if an individual is overexposed to the sun, dehydration occurs. This is caused when the body loses water
content and essential body salts such as sodium, potassium, calcium bicarbonate and phosphate. Occasionally, dehydration can
be caused by drugs, such as diuretics, which deplete body fluids and electrolytes.
In the winter, some people just don't feel thirsty and don't take in enough
water. In addition, colder weather saps much needed moisture from your body. Whatever the cause, dehydration should
be treated as soon as possible.
What are the symptoms of dehydration?
The following are the most common symptoms of dehydration, although each individual may experience symptoms differently.
Symptoms may include:
- thirst
- less-frequent urination
- dry skin
- fatigue
- light-headedness
- dizziness
- confusion
- dry mouth and mucous membranes
- increased heart rate and breathing
How do you treat dehydration?
If caught early, dehydration can often be treated at home under a physician's guidance. In cases of mild dehydration,
simple rehydration is recommended by drinking fluids. Many sports drinks on the market effectively restore body fluids,
electrolytes, and salt balance. For moderate dehydration, intravenous fluids may be required, although if caught early
enough, simple rehydration may be effective. Cases of serious dehydration should be treated as a medical emergency, and
hospitalization, along with intravenous fluids, is necessary. Immediate action should be taken.
How can dehydration be prevented?
Take precautionary measures to avoid the harmful effects of dehydration, including:
- Drink plenty of fluids, especially when working or playing in the sun.
- Make sure you are taking in more fluid than you are losing.
- Try to schedule physical outdoor activities for the cooler parts of the day.
- Drink appropriate sports drinks to help maintain electrolyte balance.
- For infants and young children, solutions like Pedialyte will help maintain electrolyte balance during
illness or heat exposure.
- Do not try to make fluid and salt solutions at home for children.
Heart Awareness
Call 911 if you or someone you know experiences any of the
following symptoms. Getting help immediately is the best survival tactic!
Heart Attack symptoms:
- Feeling of discomfort in the chest that lasts
more than a few minutes, or goes away and comes back. This discomfort could feel
like squeezing, pain, uncomfortable pressure or fullness.
- Pain or discomfort in other areas of the body, jaw, back, one or both arms or
stomach.
- Shortness of breath that can occur with or without a feeling of discomfort
in the chest.
- Feeling nauseous, lightheaded and/or breaking out in a cold sweat.
Cardiac Arrest symptoms:
- Sudden loss of responsiveness, even to gentle shaking.
- No normal breathing for several seconds.
- No movement, pulse or coughing.
Stroke symptoms:
- Sudden weakness or numbness that occurs in the face, arm, or leg, usually on one side of the body.
- Sudden confusion, difficulty speaking or understanding, or confused speech.
- Sudden difficulty seeing in one or both eyes.
- Sudden problem with walking.
- Dizziness.
- Loss of balance or coordination.
- Sudden severe headache.>
For more info: www.stroke.org or
www.americanheart.org
Broken Heart Syndrome Is Real!
by Maeve Ostrowski, RN
We’ve all heard the phrase, she broke his heart or, he died of a broken
heart! Recently, I read an article in the Baltimore Archdiocese newspaper, The
Catholic Review, Feb 16, 2006) that pondered the question, Can love really
weaken your heart? I was immediately riveted to the page, number 27. I quote,
"The heart is more than a muscle that pumps blood, it is also a messenger to and from
the brain." Studies show that heart conditions can change after a great
emotional event.
The scientific explanation offered by Johns Hopkins physicians
is that when the body is hit with a huge stressor such as grief, fear, anger or
migraine, the heart is stunned with a huge amount of adrenaline. This causes
chest pain, shortness of breath and related signs and symptoms that can mimic a
heart attack.
Doctors named the broken heart syndrome based on the fact that
intense emotional or physical stress causes temporary yet severe heart
weakening. For 5 years they have seen enough patients to cause them to chronicle
an actual syndrome. While people robbed at gunpoint, being in an auto accident,
surprised by news of a sudden death have been afflicted, doctors say that over
the course of the 5-year study, no one has experienced the syndrome a second
time. Although , they report that nearly half of the patients who arrive at the
ER, believing themselves to be suffering a heart attack, have lost a loved one
recently and are in real cardiac distress.
Women over 60 account for 95% of patients, a phenomenon doctor's can not
yet explain. But, because the condition can last for a few weeks, doctors caution anyone
sitting at home with severe chest pain and/or shortness of breath to seek treatment at a hospital
immediately. For, while none of their patients has died from broken heart
syndrome, severe symptoms left untreated may well cause death.
The good news is that the large amount of adrenaline flowing through the body and causing the
heart attack symptoms is usually resolved quickly, unlike the real thing that
can damage the heart muscle permanently. For those afflicted with a broken
heart, you won't die from one, but that kind of broken heart may strike again.
What remedy is there for you? In the words of Henry David Thoreau, There is no
remedy for love, but to love more.
What do Floaters and Flashers in the Eye Indicate?
Sometimes you may see small specks or clouds moving in your field of vision.
They are called floaters. You can often see them when looking at a plain
background, like a wall or the blue sky.
Floaters are actually tiny clumps of gel or cells inside the vitreous humour,
the clear jelly-like fluid that fills the inside of your eye. While these
objects look like they are in front of your eye, they are actually floating
inside your eye. What you actually see are the shadows they cast on the retina.
The retina is the nerve layer at the back of the eye that senses light and
allows you to see. Floaters can have different shapes: little dots, circles,
lines, clouds, or cobweb shapes.
Floaters are caused when the vitreous humour or gel starts to thicken or
shrink. The vitreous gel pulls away from the back wall of the eye, causing a
posterior vitreous detachment. It is a common cause of floaters. This usually
starts to happen when people reach middle age. Posterior vitreous detachment is
more common for people who:
- Are nearsighted, meaning they can?t see far away
- Have undergone cataract operations
- Have had YAG laser surgery of the eye
- Have had inflammation inside the eye.
The appearance of floaters may by alarming, especially if they develop
suddenly. You should see an ophthalmologist right away if you suddenly develop
new floaters, especially if you are over 45 years of age.
The retina can tear if the shrinking vitreous gel pulls away from the wall of
the eye. This sometimes causes a small amount of bleeding in the eye that may
appear as new floaters. A torn retina is always a serious problem, since it can
lead to a retinal detachment. You should see your ophthalmologist as soon as
possible if:
- Even one new floater appears suddenly
- You see sudden flashes of light.
Other symptoms, like the loss of side vision, should also occasion a trip to
the doctor.
Floaters can get in the way of clear vision, which may be quite annoying,
especially if you are trying to read.
You can try moving your eyes, looking up and then down to move the floaters
out of the way.
While some floaters may remain in your vision, many of them will fade over
time and become less bothersome. Even if you have had some floaters for years,
you should have an eye exam immediately if you notice new ones.
Flashing lights or lightning streaks are caused when the vitreous gel rubs or
pulls on the retina. You may have experienced this same sensation if you have
ever been hit in the eye and seen stars.
The flashes of light can appear off and on for several weeks or months. As we
age, it is more common to experience flashes, but the sudden appearance of light
flashes, should nonetheless, be taken as a warning sign.
Some people experience flashes of light that appear as jagged lines or heat
waves in both eyes, often lasting 10 to 20 minutes. These types of flashes are
usually caused by a spasm of blood vessels in the brain, which is called a
migraine.
If a headache follows the flashes, it is called a migraine headache. However,
jagged lines or heat waves can occur without a headache. In this case, the light
flashes are called ophthalmic migraine, or migraine without headache.
When an ophthalmologist examines your eyes, your eyes will be dilated with
drops. During this painless examination, your ophthalmologist will carefully
observe your retina and vitreous. Because your eyes have been dilated, you may
need to make arrangements for someone to drive you home afterwards.
While not all floaters and flashes are serious, you should always have a
medical eye examination by an ophthalmologist to make sure there has been no
damage to your retina.
Deborah L Bohlman, RN, compiled this article from an article by The American
Academy of Ophthalmology.
Getting a Good Nights Sleep
Older adults need about the same amount of sleep as young adults–
between 7-9 hours each night. But older adults tend to go to sleep earlier
and get up earlier than they did when they were younger. And they may nap
more during the day. If you sleep too much during the day, it may be hard
to fall asleep at night. Also, feeling sick or being in pain can make it
hard to sleep. If you don’t get a good night’s sleep, the next day you may be:
irritable, forgetful, depressed, and/or likely to have more falls or accidents.
There are two kinds of sleep– REM (rapid eye movement) sleep and non-REM sleep.
We dream Mostly during REM sleep, and have the deepest sleep during non-REM sleep.
As people get older, they spend less time in deep sleep, which may be why older
people are often light sleepers.
Being older doesn’t mean you have to feel tired all the time.
There are many things you can do to help you get a good night’s sleep.
Here are some ideas.
- Follow a regular schedule. Go to sleep and get up at the same
time each day, even on weekends. Napping in the late afternoon or
evening may keep you awake at night.
- Develop a bedtime routine. About 30-45 minutes before bedtime each night, do the same things
so your body will know that it’s time to sleep. Some people watch television, read a book, listen
to soothing music or soak in a warm bath.
- Your bedroom should be dark, a good temperature for you, and as quiet as possible.
- Exercise regularly, but not within 3 hours of your bedtime.
- Be careful about when and how much you eat. Large meals close to
bedtime may keep you awake, but a light snack in the evening can help
you get a good night’s sleep.
- Stay away from caffeine late in the day. Caffeine (found in coffee,
tea, cola, and hot chocolate) is a stimulant that can keep you awake.
- Drink less liquid in the evening. Waking up to go to the bathroom and
turning on a bright light breaks up your sleep.
- Remember that alcohol won’t help you sleep. Even small amounts make it harder to stay asleep.
- Use your bedroom only for sleeping. After turning off the light give yourself about 15 minutes to
fall asleep. If you’re still awake and not drowsy, get out of bed. When you feel sleepy,
go back to bed.
- Try to set up a safe and restful place to sleep. Make sure there are smoke alarms on each
floor and lock up the house before going to bed. Other ideas for a safe night’s sleep are:
- Keep a telephone with emergency numbers by your bed.
- Have a lamp that turns on easily within reach.
- Put a glass of water next to the bed.
- Use nightlights in the bathroom and hall.
- Don’t smoke, especially in bed.
- Remove area rugs so you won’t trip if you get out of bed in the middle of the night.
- Don’t fall asleep with the heating pad on; it may burn.
There are some tricks to help you fall asleep. You don’t really have to count sheep–
just try counting slowly to 100. some people find that playing mental games makes them
sleepy– tell yourself it’s 5 minutes before you have to get up and you’re just trying
to get a few extra winks. Other people find that relaxing their body puts them to sleep.
You might start with your toes, and tell yourself that your toes are relaxed and sleepy.
Work your way up the rest of the body saying the same words. You may drift off to sleep
before getting to the top of your head. If you feel tired and unable to do the things you
usually do for more than 2-3 weeks, see a doctor. Sleep problems can cause you to feel bad,
but there are changes you can make to get a better night’s sleep.
Excerpt from Age Page, “A Good Night’s Sleep”, by the National Institute on Aging
What you should know about Advance Directives
Everyone has the right to make personal decisions about health care. Doctors ask whether you
will accept a treatment by discussing the risks and benefits and working with you to decide. An
advance directive speaks for you if you are unable to and helps make sure your religious and personal
beliefs will be respected. It is a useful legal document for an adult of any age to plan for future
health care needs, and can make things easier for your loved ones by helping to prevent misunderstandings
or arguments about your care.
What can you do in an advance directive?
An advance directive allows you to decide who you want to make health care decisions for you
if you are unable to do so yourself. You can also use it to say what kinds of treatments you do
or do not want, especially the treatments often used in a medical emergency or near the end of
a person’s life.
1. Health Care Agent. Someone you name to make decisions about your health care is called
a “health care agent” (sometimes also called a “durable power of attorney for health care,” but,
unlike other powers of attorney, this is not about money). You can name a family member or someone
else. This person has the authority to see that doctors and other health care providers give you
the type of care you want, and that they do not give you treatment against your wishes.
2. Health Care Instructions. You can let providers know what treatments you want to
have or not to have. (Sometimes this is called a “living will,” but it has nothing to do with
an ordinary will about property.) Examples of the types of treatment you might decide about are:
- a. Life support – such as breathing with a ventilator
- b. Efforts to revive a stopped heart or breathing (CPR)
- c. Feeding through tubes inserted into the body
- d. Medicine for pain relief
Ask your doctor for more information about these treatments. Think about how, if you become badly
injured or seriously ill, treatments like these fit in with your goals, beliefs, and values.
How do you prepare an advance directive?
Begin by talking things over, if you want, with family members, close friends, your doctor, or
a religious advisor. Many people go to a lawyer to have an advance directive prepared. You can also
get sample forms yourself from many places. There is no one form that must be used. You can even
make up your own advance directive document. To make your advance directive valid, it must be signed
by you in the presence of two witnesses, who will also sign. Maryland law does not require the
document to be notarized. You should give a copy of your advance directive to your doctor, who will
keep it in your medical file, and to others you trust to have it available when needed. Copies are
just as valid as the originals. You can also make a valid advance directive by talking to your doctor
in front of a witness.
How do you prepare an advance directive?
Usually, your advance directive would take effect when your doctor certifies in writing that you
are not capable of making a decision about your care. If your advance directive contains health care
instructions, they will take effect depending on your medical condition at the time. If you name a
health care agent, you should make clear in the advance directive when you want the agent to be able
to make decisions for you.
Can you change your advance directive?
Yes, you can change or take back your advance directive at any time. The most recent one will count.
Where can you get forms and more information about advance directives?
There are many places to get forms, including medical, religious, aging assistance, legal organizations,
the internet, and at the Health Group Office.
The Maryland Attorney General’s Office
Phone: 410-576-7000
Website:
http://www.oag.state.md.us/healthpol/advancedirectives.htm
(Source: In part from the Maryland Department of Health and Mental Hygiene’s Advance Directives Information Sheet.)
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