When a head-on bicycling crash with an SUV crushed my spine and left me a paraplegic in 2011, I found very little inspiration from my very broken body. That is, until I realized how my broken body could be the impetus to help fix America’s broken home care system.
When the family of Bobby Glenn Tweed made the difficult decision to have him admitted to a nursing home in January 2013, little did they realize he would have just months left to live. While diagnosed with dementia, Tweed, 78, was still a vigorous man.
But without his family’s consent, Tweed was given psychotropic drugs that are known to be fatal among older patients with dementia. In 10 months, he was dead. Read more
Medications and Foods to Avoid if You Have Heart Disease
Every 42 seconds, someone in the United States has a heart attack. Each minute, another person in the country dies from a heart disease-related condition. For both men and women, heart disease is the leading cause of death in America, killing 25 percent of all people.
February is American Heart Month, a reminder to protect heart health and make small lifestyle changes to control blood pressure, eat well and exercise — all steps that can add up to a lifetime of good heart health.
High LDL cholesterol, high blood pressure and smoking are chief risk factors for heart disease, and the Centers for Disease Control and Prevention (CDC) reports that almost half of Americans have at least one of these three risk factors. Obesity, diabetes and excessive alcohol use also increase the likelihood for heart conditions such as heart attack, stroke, arrhythmia, peripheral artery disease and cardiac arrest.
“For many people, heart disease can be successfully managed with wise health habits and medications,” said Gregg Simons, Owner of Right at Home, NYC. “But those who have heart disease do not always realize that some common foods, nutritional supplements and other medications can cause serious complications.”
A number of drugs and foods counteract heart medications and should be avoided or consumed in lower amounts, Simons notes. These include the following:
- Certain fruits and vegetables. Grapefruit and pomegranate are culprits in interacting with medications to lower high cholesterol (Lipitor, Zocor). Leafy, green vegetables rich in vitamin K such as spinach and kale pose problems for people on blood thinners. Individuals taking anti-coagulant medications including Coumadin or its generic name Warfarin need to find a careful balance of what and how much of high-K veggies they can eat. High-sodium and high-fat foods including aged cheese, bologna, sausage and pepperoni also can raise blood pressure.
- Vitamins and herbal/nutritional supplements. Many physicians and nutritionists recommend that a wholesome, varied diet is the best way to benefit from a well-rounded amount of vitamins. If you do have a heart condition and take vitamins or herbal/nutritional supplements, beware of which ones cause blood pressure to rise and can interfere with heart medications. Popping a multivitamin may cause more harm than good.
- Nonsteroidal anti-inflammatory drugs (NSAIDs). Some common NSAID medications for arthritis and overall pain relief, including aspirin, ibuprofen (Advil, Motrin) and naproxen (Aleve), may cause the body to retain fluids and blood pressure to elevate. Higher blood pressure and slower-working kidneys can trigger a heart attack or stroke. An anti-inflammatory option is acetaminophen (Tylenol), but ask your doctor what’s best for your body. Never take more than the doctor-prescribed amount of aspirin to prevent a stroke or heart attack.
- Cough and cold medications. These products may contain NSAID ingredients and decongestants that are known to raise heart rate and blood pressure or prevent some heart medications from working correctly. Check the dosage instructions for over-the-counter (OTC) drugs prior to purchasing them, because warnings are now included on some products to not take them if you have high blood pressure.
- Antibiotics. The U.S. Food and Drug Administration (FDA) warns that Zithromax, commonly called a Z-pack, may lead to abnormal — and sometimes fatal — heartbeat changes in people at risk for heart problems.
- Weight-loss drugs. Appetite suppressants are stimulants that increase blood pressure and put more stress on the heart. Heart patients should always consult with their doctor about taking any weight-loss supplements.
- Migraine medications. Some migraine medicines can narrow blood vessels throughout the body. Tightened vessels push blood pressure higher, even to dangerous levels.
- Alcohol. For some people, consuming a low or moderate level of alcohol can protect against heart disease and stroke, but heavy drinking or binge drinking can damage the heart muscle and cause heart failure. Anyone with a history of cardiovascular disease should seek professional medical advice before using any amount of alcohol.
Simons recommends that heart disease patients be in regular communication with their doctor regarding diet, prescription and OTC medications, vitamins, and supplements. Cardiovascular patients are also advised to be extra diligent during holidays and other celebrations when food and alcohol moderation tends to wane.
Ever since President Lyndon B. Johnson in 1964 declared February as American Heart Month, the annual campaign brings to the forefront that heart disease can often be prevented with regular physical exercise, a balanced diet, and an awareness of foods, medicines and other products that heighten cardiovascular risks.
The current medical reimbursement landscape is changing and is being heavily
influenced by a patient-centric model. The key: keep individuals healthy while not
needing to readmit them into hospitals. It is now a well-documented reality in modern
civilization that medication prolongs, and in many cases, saves lives. However, the sad
truth today is that roughly half of the prescriptions written in the United States go unfilled
every year, which leads to the inference that this rate is much higher in the developing
– Many patients are simply unaware that their medicine is due for a refill
– The pharmacy or physician never informs them
– Patient decides on an alternative medication therapy
As a result, all too many individuals go without potentially lifesaving medication on a
daily basis, and this is a tragedy of the system as it currently stands.
A report from the Robert Wood Johnson Foundation shows that “One in eight Medicare
patients were readmitted to the hospital within 30 days of being released after
surgery in 2010, while one in six patients returned to the hospital within a month of
leaving the hospital after receiving medical care. Patients were not significantly less
likely to be readmitted in 2010 than in 2008.” Furthermore, this report points out that
many readmissions can be avoided.
USNews and World Report stated in 2015 that “Half of U.S. Hospitals Face Medicare’s
Readmission Penalties” and that “Hospitals that readmit patients within a month of their
discharge face penalties under Medicare that cost them more than $400 million.”
This can all change with the rapid implementation of the pharmacy electronic medical records. Read more…
Keeping Seniors At Home
I have created a survey of technology, low and high, readily available that affords greater independence to seniors in their daily lives. You can see it at Keeping Seniors at Home with Help of Technology. These technologies provide safety to them as well as comfort to those that care for them. They are, by and large, affordable and will emerge as a democratizing force in the society. At this moment, aide is available for the poorest (vis-à-vis the entitlement structure) and the wealthiest. However, a great mass of American elders fall into a gap wherein they emerge receiving sub-par care, live lives with greater risk than necessary or are forced out of their homes to institutions that otherwise would not be indicated.
-Mark Zilberman, LCSW