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Health Related Issues

Questions:

My brother’s PSA is up slightly and the doctor is going to recheck in three months. What is a PSA count?
My husband suffered a stroke and depends on me for care. If I am downstairs, I cannot hear him. Are there any bed alarms that would help this situation?
I suffer from extremely dry skin during the winter months. Can you give me some basic tips on how to keep my skin hydrated?
What can I do to treat arthritic hands?
My mother has "moderate" dementia. Where can I find information regarding the stages of dementia and how the disease progresses?
What is considered to be the acceptable range for a healthy cholesterol level?
My mother has an aorta aneurysm that has enlarged in one year from 3.4 centimeters to 3.9 centimeters. What is the usual prognosis for this problem and is my loved one likely to be vulnerable to aneurysms in other areas of her body?
My grandmother has had a dramatic weight loss over the past several months, possibly related to recent loss of taste. What could be the possible causes for her loss of taste and/or weight loss?
I am currently taking some medications and am on a limited budget. Would they be as effective if the strength was doubled and then the pills were cut in half?
What are the hazards, if any, for taking oyster shell tablets to replace calcium?
My husband was recently diagnosed with congestive heart failure. What does this mean and could you provide some information on it?
I need some assistance and advice about incontinence. What are some ways to correct or better manage the problem?
Can antidepressant medications help alleviate the symptoms of neuropathy? If so, how does an antidepressant help this condition?
My father was recently diagnosed with prostate cancer. Should I be screened? What test is used to detect prostate cancer and what does the test involve? How often should I be screened?
What is the best treatment for shingles?
Do you have any information about strokes occurring on both sides of the brain at the same time?

Questions and Answers:

My brother's PSA is up slightly and the doctor would like to check it again within 3 months. Would you please let me know exactly what a PSA count is? My brother is suffering from cerebral palsy so I would like to explain it to him in a sensitive manner.
SeniorNavigator understands it can be difficult explaining this sort of information to your loved ones and commend you for seeking out information to help you with this situation.

The PSA test is one of the tests used as a method of early detection for prostate cancer. The American Cancer Society recommends annual PSA and digital rectal exams for all men beginning at age 50. Measuring the PSA levels in the patient's blood provides additional information that helps your doctor distinguish prostate cancer from non-cancer-related causes of high PSA.

The normal value for PSA is under 4.0. PSA levels greater than 10 may indicate a high probability of prostate cancer. Levels between 4.0 and 10.0 may indicate BPH (Benign Prostatic Hypertrophy), a non-cancerous swelling of the prostate.
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Since my husband's stroke he has been bedridden and is totally dependent on me. If he calls for me and needs my help while I am downstairs, I cannot hear him. I am wondering if there are there bed alarms available that could be added to his bed to solve this problem.
First, you may want to consult with a local medical equipment supply store. To locate such a store near you, go to www.seniornavigator.org, type in the topic "Medical Supplies" and your ZIP code.

We also recommend that you contact the Virginia Assistive Technology (VATS) program that helps people access all types of assistive technology. The program has a loan fund as well as an equipment exchange program that you may wish to investigate.

Lastly, depending on your budget, you may want to consider a baby monitoring system. There are some available that you can clip on and carry around with you throughout your home. Generally, they are not complicated to use and are very efficient.
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I suffer from extremely dry skin during the winter months. Can you give me some basic tips on how to keep my skin hydrated?
We have several suggestions for you:

Do NOT take hot showers, use tepid water.
Use a cream cleanser instead of soap.
Don't bathe every day unless you have to do so.
If you have any housework to do that involves water, wear gloves.
Wear gloves whenever you go outdoors.
Find an emollient cream that you like and apply to the skin frequently.
Rub petroleum jelly into skin after shower and then put on long johns, cottons gloves and socks.
Use a humidifier in your home.
Drink plenty of water unless you have a medical condition that restricts intake of water.

To learn more about how to care for dry or irritated skin or to view local health and aging resources for seniors and caregivers, visit www.seniornavigator.org
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What can I do to treat arthritic hands?
Treatments for arthritis work to reduce pain and swelling, keep joints moving safely, and avoid further damage to joints. You should consult with a physician to determine the best treatment. What follows is general information, from the National Institutes of Health that may give you and your doctor ideas about the treatment most suitable for you.

Treatments include medicines, special exercise, use of heat or cold, weight control, and surgery. Medicines help relieve pain and reduce swelling. Exercise, such as a daily walk or swim, helps keep joints moving, reduces pain, and strengthens the muscles around the joints. Rest is also important for the joint affected by arthritis. Physical therapists can develop customized, personal programs that balance exercise and rest. Many people find that soaking in a warm bath, swimming in a heated pool, or applying heat or cold to the area around the joint helps reduce pain.

Controlling or losing weight can reduce the strain on joints and can help avoid further damage. When damage to the joints becomes disabling or when other treatments fail to reduce pain, your doctor may suggest surgery. Surgeons can often repair or replace joints that are damaged with artificial joints.

For more information and local support services, visit, www.seniornavigator.org and type in the topic, arthritis, and your zip code.
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I am looking for an overview regarding the stages of dementia and how the disease progresses. My aunt believes that she can care for my mother who is in the "moderate" stage of dementia. Although my aunt's intentions are good, I am concerned that she cannot handle caring for my mother as her condition worsens. Can you please provide me with some information that I can share with my aunt?
Dementia is a varying speed deterioration of the brain that is unique to the individual and the type of dementia. Depending on the determined stage, one can, in some cases, predict the length of the disease and the rate of progression. A general sketch of the stages of dementia is as follows:

Stage 1: mild memory lapses; difficulty with attention span; little interest in immediate surroundings or personal affairs
Stage 2: obvious short-term memory lapses; great hesitancy in verbal responses with attempts to hide memory problems; disoriented to time; frequent losses of objects
Stage 3: disintegration of personality; disoriented to self, time and place; wandering behavior
Stage 4: terminal state with severe physical and mental deterioration; incontinence; loss of ability to communicate; no recognition of family or self; swallowing problems

Depending upon your aunt's support system at home, she may be able to care for your mother through Stage 2 and possibly into the beginning of Stage 3. However, by Stage 3, safety is a major issue and the tendency to wander can be a major problem. Progressing through Stage 3 and Stage 4, the person cannot be left alone. Personality changes with dementia coupled with the constant burden of care can result in extreme stress for the caregiver.

To ask an expert about your own caregiving concerns, visit www.seniornavigator.org.
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What is considered to be the acceptable range for a healthy cholesterol level?
Total blood cholesterol is the most common measurement of blood cholesterol; it is the measurement you normally receive for test results. Cholesterol is measured in milligrams per deciliter of blood (mg/dL). According to the American Medical Association, "one's blood cholesterol will fall into one of three categories: Desirable--less than 200 mg/dL; Borderline--high risk 200-230 mg/dL; High risk--240 mg/dL and over.

Knowing your total blood cholesterol level is an important first step in determining your risk for heart disease." If you are concerned about your cholesterol, please consult your primary care provider. For more information or to view local health and aging resources for seniors and caregivers, visit www.seniornavigator.org.
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My mother has an aorta aneurysm that has enlarged in one year from 3.4 centimeters to 3.9 centimeters. What is the usual prognosis for this problem? Is she likely to be vulnerable to aneurysms in other areas of her body?
An aneurysm is a widening of the vessel; the average diameter of the abdominal aorta is 2cm. Back and abdominal pain are the most common symptoms associated with an aneurysm.

The natural history of an aneurysm is to get larger. The possibility of the aneurysm rupturing increases as it becomes larger in size. The risk of an aneurysm that is less than 5cm rupturing is much less than one that is greater than 5cm.

There is no evidence that the presence of an aortic aneurysm will suggest disease in other arteries. There are, however, several types of connective tissue disorders that will affect all types of blood vessels. As always, it is best to consult with your mother's primary physician for specific information about your mother's condition.

For more information or to view local health and aging resources for seniors and caregivers, visit www.seniornavigator.org.
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My 72-year-old grandmother has had a dramatic weight loss over the past several months. I think it is related to the fact that she has recently lost her sense of taste. What could be the possible causes for her loss of taste and/or weight loss?
The loss of taste may very well be unrelated to any medical conditions. However, it is also possible that the loss of taste can be related to a condition that may include a neurological problem such as a stroke.

There are also multiple causes for weight loss including thyroid problems, occult malignancy, decreased food intake, and depression. If your grandmother has not been under the regular care of a physician, a thorough physical examination and lab testing would be a good place to start in addressing her weight loss. The serious nature of weight loss also depends upon the individual's weight before he/she began shedding pounds (i.e., if he/she was overweight initially, more pounds lost may not be as serious). Any senior, however, who has lost 10 pounds or more in a 6-month period without attempting to do so should seek immediate medical assistance.

To ask an expert about your own care giving concerns, visit www.seniornavigator.org.
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Currently, I am taking the medications, Lipitor and Bextra. Would these be just as effective if the strength was doubled and then the pills were cut in half? I am on a limited income and am trying to find ways to reduce the amount of money I spend on my prescriptions.
Because these medications are slowly released into the body, they should not be broken in half. Therefore, splitting the pills is not an effective or suitable method for reducing the cost of your prescriptions. However, many pharmaceutical companies and local organizations have prescription assistance programs that will work with you to reduce the amount you are spending on prescription drugs.

For more information about prescription assistance programs, visit www.seniornavigator.org, type in the topic Prescription Assistance and your ZIP Code.
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What are the hazards, if any, for taking oyster shell tablets to replace calcium?
There are many different sources of calcium; oyster shell being one option. Many factors should be taken into account when selecting a calcium supplement. Select one that is a known brand name with proven reliability. Look for labels that state "purified" or have the USP (United States Pharmacopeia) symbol. Since applying for the USP symbol is voluntary, many reliable and good quality products may not display this symbol. Specifically, oyster shells may contain ingredients other than calcium, such as mercury or lead that should be avoided.

Avoid supplementing calcium with unrefined oyster shell, bone meal or dolomite without the USP symbol; these have historically contained higher levels of lead or other toxic metals. Some calcium supplements are labeled lead-free. Your pharmacist can assist you in choosing a lead-free supplement. For more information regarding calcium supplements, visit www.seniornavigator.org and type in the topic Calcium and your ZIP Code.
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We just found out that my husband has congestive heart failure. I do not know exactly what that means. Can you please shed some light on this?
Systolic Dysfunction
Occurs when the left ventricle of the heart does not contract well and the heart fails to pump enough to get blood into circulations. This can result in a build up of fluids in the lung, abdomen and ankles. Systolic dysfunction is often seen in people with a history of heart attacks.

Diastolic Dysfunction
Occurs when the ventricle becomes thick and does not relax. Unlike systolic heart failure where the heart is unable to pump blood out, diastolic heart failure results when the heart cannot relax enough to fill up with blood. This is occurs most often in people with long standing high blood pressure that was not treated aggressively.

Vavular Dysfunction
Results when the valves of the heart stop working properly. The heart has four valves which connect the four chambers. Sometimes these valves become defective from disease such as rheumatic fever. A defective valve can lead to congestive heart failure. This is seen most commonly in the aortic and mitral valves.

To ask an expert about your own caregiving concerns, visit www.seniornavigator.org.
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I am an 89-year-old woman who needs some assistance and advice about incontinence. This is an on-going problem that causes me much embarrassment. I am looking for ways to correct or better manage the problem.
There are four types of urinary incontinence:

Stress incontinence Occurs when urine leaks during exercise, coughing, sneezing, laughing, lifting heavy objects, or other body movements that put pressure on the bladder. It is the most common type of incontinence and can almost always be cured.
Urge incontinence Occurs if one cannot hold his/her urine long enough to reach a toilet. Although healthy people can have urge incontinence, it is often found in people who have Diabetes, Dementia, Parkinson's disease, Multiple Sclerosis, or have suffered a stroke. It can also be a warning sign of early bladder cancer.
Overflow incontinence Small amounts of urine leak from a bladder that is always full. Some people with diabetes have this problem.
Functional incontinence Happens in many older people who have relatively normal urine control but who have a difficult time reaching the toilet in time because of arthritis or other crippling disorders.

To correct or manage the problem, there are several steps that can be taken. The first step is to see your primary physician to determine if there is a treatable medical condition which is causing the incontinence. If the incontinence continues and it is determined that it is not treatable the following suggestions would be helpful:

Use the bathroom every two hours during waking hours and at least once during the night.
Wear a pad in your underwear, a pull up brief, or a full diaper.
Wear cotton underpants as opposed to nylon. Cotton is preferable over nylon as it is more breathable, therefore, reducing the risk for infection.

For more information or to view local health and aging resources for seniors and caregivers, visit www.seniornavigator.org.
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My dad is a diabetic and is suffering from neuropathy. One of my friends told me that antidepressant medications can help alleviate the symptoms of neuropathy. I am wondering if this is true, and if so, how does an antidepressant help this condition.
Diabetic neuropathy is a condition which can result from long periods of high blood sugar. Most likely, the breakdown products of sugar in the bloodstream lead to damage of the nerve fibers. Approximately 30% of people with diabetes suffer from the symptoms of neuropathy. The type of neuropathy known to affect the feet and hands is called polyneuropathy and is the most common form. The symptoms may include burning pain, loss of sensation, or tingling/numb feeling in the feet or hands.

There is no conclusive evidence that proves that antidepressant medications help treat symptoms of neuropathy, however, it is clear that there is no cure for this condition and no medicine can reverse it. Researchers believe that the reduction of symptoms is related to the medications' ability to increase nerve transmitting chemicals in the body, resulting in less burning/tingling and pain.

To ask an expert about your own caregiving concerns, visit www.seniornavigator.org
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My father was recently diagnosed with prostate cancer. Because of this, I am wondering if I should be tested. What test is used to detect prostate cancer and what does the test involve? How often should I be screened?
According to the American Cancer Society, it is recommended that the prostate-specific antigen (PSA) blood test and digital rectal examination (DRE) be performed on men yearly, beginning at age 50. Men at high risk, such as African Americans and those who have a first degree relative (father, brother, son) diagnosed with prostate cancer at an early age, should begin testing at age 45. Although the PSA blood test is not perfect, it is currently the most accurate test available for early detection of prostate cancer. Since doctors began using this test, the number of prostate cancers found at an early, curable stage has increased. Because most men receive normal test results, they can be reassured that they are unlikely to have prostate cancer, especially if their DRE result is also negative.

The American Cancer Society recommends that men who are 50 and older (as well as younger men with high prostate cancer risk) should also have a procedure called the digital rectal exam (DRE) as part of their annual physical check-up. During this examination, a doctor inserts a gloved, lubricated finger into the patient's rectum to feel for any irregular or abnormally firm areas. The prostate gland is located next to the rectum, and most cancers begin in the part of the gland that can be reached by a rectal exam. While it is uncomfortable, the exam causes no pain and only takes a short amount of time.

The DRE is less effective than the PSA blood test in detecting prostate cancer, but can sometimes discover cancers in men with normal PSA levels. For this reason, it is recommended that both the DRE and PSA blood test be performed on men who choose to undergo testing for early prostate cancer detection.
To ask an expert about your own caregiving concerns, visit www.seniornavigator.org.
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What is the best treatment for shingles?
Another name for shingles is herpes (varicella) zoster, the same virus involved with chicken pox. Individuals in the initial stages of the disease respond nicely to antiviral drugs. While there is no cure for shingles, these medications will likely decrease the number of lesions and will also typically decrease the time interval of the disease. Incidentally, antiviral treatment should begin within 72 hours of the rash's appearance. To find the best treatment option for yourself, always consult your doctor or your primary care provider.

For more information, visit www.seniornavigtor.com type in the topic "Shingles" and your ZIP code.
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I just found out that my dad had a serious stroke. I was told that the stroke occurred on both sides of the brain. I don't think that this is a normal type of stroke. Do you have any information about strokes occurring on both sides of the brain at the same time?
A stroke is damage to the brain caused by an interruption in blood supply. Strokes are classified by two categories. The most common type occurs when the blood supply is blocked, by a clot (that has broken off from another part of the body and traveled to the vessels in the brain) or clogged vessels (from fatty deposits, like cholesterol). A leaky or ruptured vessel, also called a cerebral hemorrhage, causes the second type of stroke.

Although it is rare, a stroke can occur simultaneously in both sides of the brain. A CT scan or MRI can determine whether the stroke was from obstruction or bleeding. Medications, such as Coumadin, may cause the vessels to be more prone to bleeding and increase the chance of brain bleeding if a head injury were to occur. For more information about the prevention and treatment of strokes, visit www.seniornavigator.org type in the topic "Stroke" and your ZIP Code.
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