Downsizing your resolutions

health pancakes

“How few there are who have courage enough to own their faults, or resolution enough to mend them.” — Benjamin Franklin

 It’s January 2 or thereabouts. Have you kept your New Year’s resolutions so far? Although Ben says our numbers are few, nearly half of us (45 percent) make resolutions every year to make important changes. But only eight percent of us succeed, according to a 2012 study by the Journal of Clinical Psychology of the University of Scranton.

I am among the 38 percent who don’t even bother with resolutions (the remaining 17 percent makes them, but infrequently) because I know I’ll never keep them. Why make a promise to myself that I know I’ll break?

A new year, with its fresh, pure calendar, is a popular time for people to want to start new healthy habits or breaking unhealthy ones (although relationships and money are common themes as well). Of the ten most popular resolutions three are health-related: to lose weight (38 percent), to get in shape, and to quit smoking. Gyms are packed with people whose intention is to keep going all year, not stop by February. Actually, three-quarters of resolution-makers make it through the first week of the good behavior. By the end of the second week the number has dipped to 71 percent, and by the six-month mark it is only 46 percent.

So why bother if we’re doomed to failure? That urge to be healthier is undaunted, and actually making resolutions makes you more likely to succeed at your goals, ten times more likely, actually, per the same study. But you won’t know if you don’t try, and there are ways to make success more probable.

Managing Parkinson’s

Hitler had it, and so did Mao Zedong, and others still living or departed: Yasser Arafat, Billy Graham, Janet Reno, Charles Schultz, Salvador Dali, Bob Hoskins and Muhammad Ali. Actor Michael J. Fox is its most prominent spokesperson. It killed my grandmother.

While not necessarily fatal, Parkinson’s disease is incurable, and differs from person to person in its severity and the scope of its symptoms. Its rate of progression varies, customizing it for each of its million-strong sufferers in this country. There are 50,000 or more new diagnoses each year.

For most of us, the symptom that sums up Parkinson’s disease is the tremor, a visible, usually obvious, shaking of the hand, the jaw or another body part. There is also often stiff, slow movements, or changes in speech, handwriting, or the sense of smell.

Because other conditions and medications cause symptoms similar to Parkinson’s, and because there is no definitive diagnostic test, it may go undiagnosed and untreated. People may think they have it when they don’t.

Sometimes symptoms begin on one side of the body only, and travel eventually to the other side. The first sign that something’s up may be when the person is sitting or standing still and a hand starts to shake. Or it may be an arm, a leg, the tongue, chin or lips.

This can be a symptom of other things, however, like other movement disorders or reaction to a medication. This is called Parkinsonism. Another symptom that can mean other things is Parkinson’s slow, shuffling, labored gait, with some sufferers feeling frozen in place, like their feet are stuck to the floor. Arms may not swing properly when walking. Difficulties with balance can lead to falls, forward or often backward.

A stooped posture is another symptom. Difficulty getting up in the morning or out of a chair can mean arthritis or other ills, but could be Parkinson’s. Cramps and pain may be associated with it as well.

With Parkinson’s disease, even minor muscle movements like smiling, blinking, swallowing, gesturing or writing may be impaired. Speech may slur or decrease in volume or inflection. The disease’s effect on the muscles can make the face seem mask-like, with a look that others may interpret as being depressed or vacant.

Down the road, the person with Parkinson’s may also experience irritability, anxiety, hallucinations, insomnia, depression, personality changes, incontinence, constipation, excessive sweating of hands and feet, drooling, oily skin or dandruff. Symptoms typically appear between ages 50 and 60 — and more in men than women — but in rare cases can be much sooner.

What causes this disease, with its insidious set of symptoms? Science is not really sure what makes the nerve cells in the brain that control body movements stop working so well. We’re still not sure whether it’s heredity or environment. If there is Parkinson’s in your family it doesn’t mean you’ll get it. Likely not, though if there is a lot of Parkinson’s in your immediate family your chances may be higher. Some blame viruses or toxins like pesticides, or trauma, such as from boxing or use of illegal drugs. Many experts blame a combination of factors.

A multi-disciplinary approach focused on medication and lifestyle changes is recommended. Helpers include maintaining social contacts, remaining involved in enjoyable activities as much as possible, from classes to travel to community activities, and perhaps a support group. Essential are aerobic exercises like walking or swimming, plus rest and stress reduction, maybe stretching, yoga, tai chi, massage or meditation.

Music therapy and acupuncture have also received accolades as being helpful. Some swear by coenzyme Q10. A healthy, balanced diet is key. Help can come through a variety of experts, like nutritionists, occupational or physical therapists, social workers, and especially a good neurologist who specializes in movement disorders.

The most common medication for Parkinson’s is levodopa, which your brain converts to the dopamine that it has stopped making. It may cause involuntary muscle movements and lose efficacy as years pass. It needs to be monitored closely by a good doctor.

Dopamine agonists like pramipexole (Mirapex) and ropinirole (Requip) mimic the effect of dopamine in your brain and may be prescribed in combination with levodopa. Side effects can include hallucinations, sleepiness, or supposedly, compulsive behaviors such as hypersexuality, gambling and eating. MAO B inhibitors, COMT inhibitors and anticholinergics may also be prescribed, along with other drugs specific to the symptoms. In some cases surgery in the form of deep brain stimulation (DBS) may be tried.

The word Parkinson’s comes from James Parkinson, a doctor who published a paper in 1817 on what he called “the shaking palsy.” While not directly fatal, the debility it causes can lead to dangerous falls or aspiration that leads to pneumonia or other illnesses.

But it’s a dodgy disease. About a quarter of diagnoses are incorrect, even from knowledgeable neurologists. So if you suspect that you or someone you love may have it, get checked out and seek a second opinion if you have doubts. And if you get a reliable diagnosis, please arm yourself with information and a battle plan to manage the malady.

Now I lay me down to sleep


Photo by Alan Carey
Photo by Alan Carey

Your perfect pillow should provide a comfy good night’s rest, but what to get? Cuddledown of Maine sells an “heirloom” cream silk pillow filled with eiderdown hand-collected from abandoned nests in Iceland and Scandinavia, for $6199 for a king-size (yes, for one pillow!), or you can just stuff a couple of folded old towels under your head. Or you can choose something in between.

That covers a lot of territory, as there are multitudinous kinds, stuffed with everything from wool to water, from buckwheat hulls to fake down. Which one is right for you?

“It depends on the sleeper,” says Bob, from Sleepy’s at 1140 Ulster Avenue in Kingston, who asked that his last name be left out of this article. Everyone has different needs for that nighttime or naptime head pad. “For example, if they have pains in their shoulders and if they’re a back sleeper,” Bob added, “we ask if it hurts more when they lie flat or if their head is elevated a little bit.”

When you sleep, your head, neck and spine should be in a natural neutral alignment. That back sleeper needs a thinner pillow to make that happen, so a medium-density pillow with neck support is ideal.

The side sleeper needs something a little thicker and firmer. For that good alignment, the space between your neck and the bed should be filled. A plump pillow, on the firmer side, is what you need. And stomach sleepers need a very thin pillow, super soft, barely there.

“People should really come in and test them out. It’s a very personal thing,” says Bob. Sleepy’s has beds to try out, but if you’re in a store without them, you can put your body up against the wall in your sleeping position and test the pillow out. It should feel comfortable, and your head, neck and spine should be straight, with minimal bends.

Now that you’ve got your perfect pillow’s thickness and firmness figured out, what should it be stuffed with?

What is hip?

[wide]hip[/wide]How ironic that the task of being the editor of our special section on Health, Sports and Fitness should arrive as the process of collecting necessary materials hits high gear in my preparation for hip replacement surgery.

So my hip mentor, Charley Rosen (who writes in this issue about his last comeback — part 1 —on the basketball court, with his own new one implanted) has provided me with pertinent hardware, to wit, a walker (I challenged my 92 year old mother in law to a race, even though she’s got wheels on hers), a cane, and a raised toilet seat (you can’t crouch low enough without it after the operation, for a while.) The other stuff? Still need crutches (the Woodstock Rescue Squad Loan Closet will help); a shoehorn with a long handle, because you won’t be able to bend down to tie your shoes for a few weeks; one of those long grabbing tools to reach for things; slip on shoes, etc.

Astonishingly, I’m told that the surgery lasts only an hour, with the good Dr. Lombardo of Orthopedic Associates of Dutchess County presiding (the operating room is only booked for an hour and a half); it’s followed by three days in the hospital (surgery on a Tuesday, home by Friday), with a gradual emergence from medicated haze taking place as a slowly evolving rehab schedule gets under way.

I’ll be getting a Zimmer hip, with a ball and a socket, to replace parts long worn out.

Who goes without medical care?

The U.S. Census Bureau recently reported that working-age adults made an average of 3.9 visits to doctors, nurses or other medical providers in 2010, down from 4.8 visits in 2001. Among those with at least one visit, the average number of visits also declined, from 6.4 visits in 2001 to 5.4 visits in 2010.

Perhaps Americans are getting dramatically healthier. Or perhaps they can’t afford to go to the doctor.

“The decline of the use of medical services was widespread, taking place regardless of health status,” said Brett O’Hara of the Census Bureau.

But people lacking insurance were far less likely to go to doctors. Just 24 percent of the uninsured went to a doctor at least once in 2010, compared with 72 percent of the general population of working age adults, the census report found.

The census data contradicts the common-sense supposition that people in bad health would be more likely to avoid being uninsured. People under 65 whose health was poor, fair or good were more likely to be uninsured than those with very good or excellent health.

Spending a night in a hospital has become a rare event. The chances of spending no nights in a hospital ranged from 96 percent for children to 83 percent for people 65 or over.

Among people in poverty, 38.6 percent went without seeing a medical provider over the previous year, compared with 19.1 percent of people whose family income was greater than 400 percent of the poverty threshold.

Clearly, a lot of sick people don’t get government assistance — even when they can’t afford medical care. So they go without doctor visits, lab work and medications.

In an article, Ruth Fishbeck, director of the Health Initiative in Potsdam, recently described the serious health consequences of a lack of affordability in St. Lawrence County in the far northwestern corner of the Adirondacks. “People are dying,” she said. “We rank in health 58th or 59th out of 62 [New York counties], and that means premature death and sickness. And a lot of it is simply the lack of money to get adequate health care.”