Dr. Bob's Top 10 List for Healthy Living

Spring 2006 CSANews Issue 58  |  Posted date : May 27, 2007.Back to list

The following article summarizes the presentation given at the Snowbird Extravaganzas and CSA Winter Information Meetings held throughout the southern states this winter. In response to requests for copies of the presentation, Dr. MacMillan, medical director of Medipac International, Inc., has provided this summary.

When we stop to think about our health status and what diseases or conditions we might develop as we age, we should be aware that many of the common ailments suffered by seniors are the direct or indirect result of their own choices in life. True, there are serious illnesses for which there are no specific causes identified, nor are there any profound treatments or cures once the condition has developed. Three such diseases are Alzheimers disease, multiple sclerosis and pancreatic cancer.

But there are a multitude of conditions whose onset can be thwarted, or even if they do develop, certain lifestyle changes can minimize the symptoms and complications. Within this group, there are those conditions which a) a physician can detect through examinations and screening, often altering the outcome by early intervention; or, b) you yourself can prevent or minimize through your own personal conduct and lifestyle choices. Three examples of diseases in this group are hypertension, diabetes and obstructive lung disease.

To best describe these two categories, the following Top 10 List (as used by David Letterman) addresses the initiatives which we can take to promote health, prevent illness and maintain good health as we age.

Tip 10 - Avoid Cigarettes
This health risk is so well-known by now that it only needs to be highlighted for those few seniors who have still been unable to break the habit. The high risk of developing lung cancer or chronic obstructive pulmonary disease (COPD) overshadows the significant increased risk of developing stoke, heart attack and many other cancers, especially gastrointestinal cancers.

Recent studies reveal that some types of macular degeneration, the most common cause of vision loss in seniors, is more common in smokers. Many stop-smoking programs are available to assist individuals and are often successful. Unfortunately, it often happens when the damage is done, such as after a major heart attack or the development of irreversible lung disease.

Tip 9 - Avoid Excesses
There are many activities and habits which we pursued as younger individuals that we did not relate to health hazards. But many of these activities may be health risks in our senior years.

Excessive sun exposure is one example. The three most common types of skin cancer (basal cell, squamous cell and the very serious malignant melanoma) are all increased with injudicious exposure to sun. Although there continues to be controversy over "sun blocks," most experts agree that prolonged, unprotected sun exposure not only increases the risks of these cancers, but also irreversibly damages and ages the skin. Sunlight is healthy in moderate amounts and is the source of vitamin D, which is essential .togood health. Keep your exposure to a reasonable level. The days of lying for hours in our bathing suits on the chaise lounge or beach should be over.

While physical activity is important to good health, sudden excessive exertion is risky for seniors. While most snowbirds do not have to face sudden snowstorms and shoveling, this is one activity for which there is a documented serious risk of sudden heart attack from such heavy exertion combined with cold temperatures. Don't try to accomplish such a sudden and heavy physical activity, especially if you do not exercise regularly. Also, don't attempt any activities to which you are unaccustomed or that make youhuff and puff.

The debate over alcohol consumption and its effect on our health continues, but most experts agree that moderate alcohol consumption (maximum of one or two beverages a day) does not jeopardize our health and, in the case of red wine, a glass with dinner may be beneficial to our cardiac health. But excessive consumption increases our risk of developing many medical problems, including liver cirrhosis, heart disease, mental deterioration and certain cancers, as well as an increased risk of accidents. Some snowbirds may be especially vulnerable to this risk as they often have a more sociable winter with friends and fellow travellers.

Taking holiday trips to mountainous regions may be hazardous to your health if you happen to have a heart or lung condition. Excessive elevations are associated with decreased oxygenation of the air and this poses a risk for those with arteriosclerotic heart disease or any chronic lung disease. Such individuals further compromise their need for good oxygen supply and can suffer heart or lung failurequite quickly, landing themselves in a remote healthfacility often requiring an air evacuation.

Probably the excess which we all most commonly face is overeating. The risks of this sporadic or daily activity are so important that they are discussed separately.

Tip 8 - Avoid Accidents
About 15% of calls to our Assistance Centre during the winter season come from snowbirds, not because of illness, but rather as a result of accidents. Arm and hip fractures, lacerations, head injuries, sprained ankles, burns and back strains are the most frequent. Slips and falls are the most common causes. Car accidents often involve multiple injuries. Precipitating factors include carelessness, gait problems, visual impairment, poor lighting, inebriation and night driving. Most of these accidents were preventable, in hindsight. Seniors should be especially vigilant in trying to avoid such incidents. Travelling to a destination often involves staying in different motels. Always carry a flashlight and use it at night. Watch out for loose bedding. Keep luggage and obstacles out of the way.

Watch your step carefully in unfamiliar surroundings and use a cane or someone's assistance if you are visuallyor physically impaired. Be careful of hotliquids and cooking activities. Be sure to inspect your new destination to ensure its safety. Rearrange furniture if necessary, check for working smoke and carbon monoxide detectors, readjust hot water temperatures if too high and generally be sure that you have a safe environment inside and outside your new abode.

Slips and falls are of particular concern for seniors. In addition to visual and balance impairments being more common, we also have thinner bones and are subject to a higher risk of fractures if we do fall. Pay special attention to where you walk inside and outside your dwelling; be careful when climbing, carrying, and descending stairways. Check for safety and pay special attention to mats, lighting, bathtubs and handrails.

Avoid night driving if possible. According to the U.S. National Safety Council, traffic deaths are three times greater at night than during the day. Night driving is more risky for a number of reasons. In addition to the higher incidence of alcohol-related collisions, darkness severely limits vision and fatigue is more common. With aging, night vision and reflex times are not as acute as they once were.

Tip 7 - Know Your Meds
Especially when travelling away from home, it is important that you know your meds. You should have a list of the name, strength and dosage for each nd every drug that has been prescribed for you on a small card in your wallet or purse. At the stressful time at which an emergency room doctor asks you or your spouse for such information, you may not remember such details. Furthermore, outside Canada, drugs may not be known by the same trade name and the physician will need the exact name and strength in order to look up the foreign equivalent. Make your list today! Also, ask your doctor for a copy of your electrocardiogram (ECG) to carry with you. This would greatly assist any new physician who might have to assess you for chest pain.

You should know the purpose of the drug, as well as potential common sideeffects. Ask your doctor before you leave home. If you are on Coumadin (Warfarin) for a heart or vascular condition, be sure and follow the routine blood tests (INR) as recommended by your doctor when you are away. Most U.S. laboratories will accept an order for these tests from an out-of-state physician if the order for the test appears on your doctor's personal pad, with your name, the diagnosis, the test to be performed and the frequency and duration of the testing. Knowing your doctors fax number will enable the lab to fax the results directly to your Canadian physician, thereby relieving you of physician costs in the U.S. The same can be done for routine blood sugar levels for diabetic patients.

Tip 6 - Have an Annual Health Exam
We often become complacent about the annual health exam and wonder whether or not it is necessary. This annual evaluation is especially important to seniors, as there are many conditions that can be identified and rectified before it is too late. In addition to the history and physical examination, which can detect heart murmurs, vascular narrowing, aneurysms, tumours, skin cancers and many other conditions, the blood, urine and investigative screening tests can detect many other abnormal findings resulting in early intervention. Such conditions include high blood pressure, early diabetes, cardiac disease, high cholesterol levels, carotid artery narrowing, anemias, prostate disorders, and breast and colon cancer to name a few. Some of these conditions can be fatal unless caught in their early stages. Colon cancer, a major lethal tumour, is 90% preventable if one is properly screened, including having a baseline colonoscopy. Early detection and nipping of colon polyps can prevent the development of a full-blown lethal cancer. Talk to your doctor about scheduling this examination. Mammography for the detection of female breast cancer and the PSA test to detect early prostate cancer are two more examples of important annual tests.

Try to cycle your annual exam in the spring or summer months. In that regard, due to the 90-day stability clause which appears in most health insurance policies, any testing or drug modifications for your conditions will not affect your winter travel insurance.

Tip 5 - Keep Mentally Active
In a previous article, I stressed the importance of remaining mentally active as a part of staying healthy. Snowbirds have a great opportunity to take advantage of many of the activities which keep us mentally challenged and alert. In addition to the individual activities in which you can indulge, such as puzzles, hobbies, games and reading, you have the weather and milieu to partake in social activities, volunteering, sports, cards and recreational activities with other retired persons. Do things, get involved and keep active in your senior years. It's good for your health!

Tip 4 - Control Blood Pressure and Sugar
These two afflictions, so very common amongst seniors, bear special importance. The reason is that for many, the onset of these two conditions resulting in the need for specific medicinal therapy can often be prevented, or at least delayed. Regarding high blood pressure (hypertension), although there is a hereditary factor, weight control, salt restriction, avoiding stressful situations and exercising are important in preventing its onset or severity. If specific treatment is still needed, the strength, dosage and number of drugs needed to control it will be reduced if the above measures are followed. It is generally accepted that one's blood pressure should be below 140/90 most of the time, and for diabetics, 130/80 or below. Home BP monitors or drug store readings are especially valuable for travellers away from their own medical services. Follow the directions precisely, record the levels and take the recorded levels to your own physician upon your return. There are thousands of Canadians who are not treated or who are under-treated. Don't be one of them. The consequences, including heart attack, stroke and renal disease, are too great a risk!

Weight control is the most important goal for preventing the onset of type 2 diabetes. The majority of seniors who develop diabetes (and the serious risk of cardiovascular events and kidney damage) have gained too much weight. We all have a tendency to gain weight as we age and, if not disciplined in what we buy and eat, excessive weight gain predisposes us unnecessarily to developing diabetes.

If drug treatment is necessary for established diabetes, travellers should remain vigilant in monitoring their blood sugars and managing their diabetes while travelling. Almost all diabetic persons require a cholesterol-lowering drug as well as medication to maintain normal blood pressure. Be sure to do your own glucose monitoring as well as obtaining periodic laboratory measurement, and contact your physician early if any problems arise.

Tip 3 - Control Your Weight
In addition to weight control being so important for blood pressure and sugar control, it is well documented that excessive weight gain is associated with increased problems with gait, mobility, arthritis and heart disease. Recent studies show a marked correlation to men with central obesity ("beer belly") and arteriosclerotic heart disease and heart attack.

Eating out can be challenging, however, you and your spouse have the opportunity to choose wisely for your home meals and snacks. Dont buy high-calorie foods that you dont need.

Tip 2 - Pay Attention to Diet, Vitamins and Minerals
As well as monitoring our caloric intake to maintain or achieve a more normal weight, our diet must be balanced, with plenty of fresh fruits, vegetables, hole grains and fibre. Consuming omega fatty acids (as contained in fish) and avoiding unnecessary saturated fats (as contained in meat and dairy products) has been proven beneficial in the prevention and management of arteriosclerosis.

Because many of our foods have been fortified with vitamins and minerals, the only required daily additions for most individuals are vitamin C in the order of 1,000 mg, vitamin D 400-600 International Units (I.U.), magnesium 200-400 mg, and calcium 1,000-1,500 mg. Dosage will vary depending on your diet, your age and your sex. Talk to your doctor.

Tip 1 - Exercise
The top single individual determinant of good health in the elderly is exercise. Research shows that dedicated daily exercise has a profound effect on improving blood pressure, sugar control, weight reduction, cholesterol levels and cardiovascular and pulmonary health. In addition, persons who exercise just feel better.

The American Heart Association and The Canadian Heart and Stroke Foundation both stress that about 25-30 minutes of brisk but comfortable exercise most days of the week is ideal. Walking is most popular but, if there are physical limitations, choose any exercise which gets your muscles, your heart and your lungs working.

Snowbirds in particular should heed these recommendations as their opportunity to partake in meaningful exercise, as well as other healthy lifestyle habits, prevails throughout the year. They can provide no winter excuses!

Take control of your health. Try and adopt some of these tips, if you do not already get a full score.