Friday, March 22, 2019

Our Best Friend

I have a friend who suffers from anxiety and depression. One of the things that helps him deal with things is his dog. With a cross-country move coming up, his therapist, knowing the important role the dog plays in my friend's life, designated him an emotional support animal (ESA). This way, with script in hand, he was able to have his dog fly in the cabin with him. But what's the difference between an ESA and a service dog?

Most people think of Seeing Eye dogs when they hear service animal. In the Central NY area, Guiding Eyes for the Blind has a large number of puppy raisers to help socialize the pups before they go for their service training. A service animal does not have to be a dog, but they do have to perform a service or services for the owner. This ADA FAQ explains the ins and outs of service animals. Of particular interest, there is no official certification organization and a service animal can be trained by anyone, so caveat emptor if you or a loved one is in need of a service animal. A good place to start is with a group like Psychiatric Service Dog Partners, where you can ask questions of people who are experienced with owning a service animal. Things can also get muddy as state regulations vary, so be sure to research your state regulations to see what is and is not allowed.

So back to my friend's dog. Why is it an ESA rather than a service animal? Your pet can be designated a psychiatric service animal if, according to the ADA, it is trained to, say, sense an anxiety attack and do something to lessen or prevent it. An ESA helps a person function better, but does not have specialized training to perform a service. Both of these types of animals are, for the most part, exempt from "no pets" policies, with service animals getting pretty much automatic exemptions while ESAs will need permission in certain situations. To make things murkier, we have companion or therapy animals. In terms of pet policies, these animals are legally given little slack. As the name implies, they provide companionship, which in some cases is all the person needs. Organizations like PAWS of CNY go out into the community to help with life's stresses, for example airports during peak travel times or colleges during final exams. The animals offer a calming presence by just being there to be stroked and maybe talked to. Clear Path for Veterans offers a training course for any Veteran who owns or wants to own a canine companion, while other organizations offer no-cost pets or have some financial assistance for veterinary bills.

Whatever your need, there is an animal out there to help you. As Indian author Ruchi Prabhu says: “Pets understand humans better than humans do,” and we all need a little understanding sometimes.

Tuesday, January 29, 2019

Triple A

When is a cold not a cold? No, not the start of a joke; a cold is not a cold when it could be acid reflux, asthma, or allergies. How do you tell the difference? That's for your doctor to figure out, but you can help by keeping a diary of your symptoms. Things like: how long has this been going on; is it worse at certain times of the day; do symptoms start or get worse after exercise, doing certain tasks, or eating certain foods? By being aware of how and when your body reacts, you can help your physician to zero in on exactly what ails you. First, let's look at acid reflux.

This one really seems like the odd man out until you stop to think about that air tunnel called the esophagus. When everything is working right, there are two valves that block off acid fumes and food from coming back up the pipe, so to speak. When the valves are not working, the acid can cause allergy-like symptoms such as itchy eyes, chronic cough, post-nasal drip, etc. It can be a matter of what you eat, when you eat, even how much you eat, so here's one place that diary can come in very handy.

Allergies can be to things outside our body, such as pollen or pets, or things inside our body; food allergies. If you have those cold-like symptoms year round, you may be allergic to something in your home or workplace, or you may eating something you shouldn't. With food, it may be an allergy or it may be an intolerance, and it can be hard distinguishing between the two. Particularly with an intolerance, the symptoms can be reflux like, cold like, or both, so again, a diary may help narrow down the triggers.

Asthma is more often associated with children, but adults can develop asthma and not even realize they have. Like a cold, asthma can trigger coughs and excess mucus. In the case of asthma, that cough may be around for weeks without changing; your mucus may be thicker, making it harder to breathe or swallow. Like allergies, asthma can be triggered by external stimulants like mold or animal fur, but it also can be triggered by an upper respiratory condition, further muddying the waters. Bottom line is, if your "cold" seems to linger on and on, it's time to make note of the three Ws of your symptoms: what, when, and why, then make an appointment with your doctor to discuss triple A.

Friday, January 4, 2019

"First Hang Your Hat on the Bedpost."

As often seems the way, I ended up with a miserable cold over the holidays. My father used to say he had the cure to the common cold. "First, hang your hat on the bedpost or someplace where you can see it. Second, grab a bottle of whiskey and crawl under the covers. Third, start drinking, and when you see two hats, you're cured." I don't know that there is any medical basis in his claim, but there are many home remedies out there when it comes to the common cold. One of my go-to comfort foods is Hot and Sour soup. Yes, I know, it's supposed to be Chicken soup for a cold, but actually, any warm, steamy liquid will help to keep you hydrated and thin the mucus. Tea with lemon and honey is good too, providing fluid with some Vitamin C and something for the cough.

There have been some studies on Zinc, and like Vitamin C, it seems to help some people and do nothing for others. I had a bag of lozenges containing Zinc, which I won at a health fair. I didn't like the aftertaste and it left my throat feeling dry. Natural therapies have been around as long as man, but proving if they really work or not is difficult. The National Institute of Health has a division just for studying these: the National Center for Complementary and Integrative Health. This is always a good place to start if you have a question about traditional therapies. You can find if they have been researching a particular therapy, the current findings, and if there are side effects or interactions with medications you are currently taking. Those last two are really important, as you don't want to try to help one illness while causing problems with your treatment for another. So if you are under a physician's care for any condition, be sure to speak to your physician and/or pharmacist before taking any over-the-counter medication, natural or not. I hope you remain cold-free this season and if not, be sure to have a spare bottle of your favorite tipple handy.

Tuesday, November 27, 2018

Pie in the Sky

My mother loved cookbooks, and in an early American cookbook, she found a pumpkin pie recipe. The recipe made about a dozen pies so she worked it down to a filling that would make 2-3 pies, depending on their size. Our daughters associated pie with grandma to the extent that, when my mom died, our older daughter saw a hand holding out a piece of pie in the clouds on the way home. Everybody, including a good friend from high school, loved that pie, but she did not want to share the recipe she worked so hard on. As she got older and the holiday baking was passed on to me, she finally relented and said I could share the recipe. My friend was very happy, but as often happens with recipes, they never quite come out the same when someone else does them. At Thanksgiving, I bake pies for my sister and our kids and mail them out. This year, I had a spare I was going to give away at Christmas, until I heard from that high school friend’s daughter that she had ovarian cancer. I packed up that pi, mailed it out, and surprised her with it. To say she was happy was an understatement, but what really made me happy was her comment that it was just what she needed. 

Anyone dealing with a chronic disease or medical condition needs acts of kindness, cancer patients more so than some. A Fellow from the Institute for Healthcare improvement stated that “simple acts of kindness can be a potent antidote to negative emotions and may improve outcomes for those experiencing the frightening journey called cancer.” If you play to your strengths, there are so many ways you can help someone get through their therapy. Life happens every day no matter how someone feels, and having a friend come by to cook, clean, garden, chat, or whatever you can do to help is much appreciated. 

For those who like to knit or crochet, there are many projects you can do. For example, not all breast cancer patients can afford a prosthesis after their lumpectomy or mastectomy.  One woman put her hands to work and knitted knockers were born. Any cancer patient undergoing chemotherapy appreciates a chemo cap, not only for the warmth, but often as a fashion statement. Prayer shawls are also a popular item to make, warming both the person who made it and the person who received it. 

Knitting and other hand crafts are also good for the patient, providing a meditative project to get their minds off of their treatment. One small company partnered with Lion Brand yarns to provide knit kits to young adults. If your friend/family member is interested in some other craft, make up your own kit to give them. And don’t forget books, DVDs, puzzles, etc. They all provide much needed relief. When life gives a friend lemons, think about making a lemon meringue pie and serve them with love.

Wednesday, October 31, 2018

Mighty Mite

I have been on allergy meds for many a year, but this year, I started having trouble with my ears. The simple act of blowing my nose would cause my ears to clog up, and they often felt like I had climbed a large elevation. No amount of chewing, yawning, or other tricks did any good, so it was off to the ENT. Since I have no clue as to what exactly I am allergic, testing seemed appropriate. If you have never had this done, consider it good training if you are thinking of getting a tattoo.

After all the poking, the result showed only two things: cat and dust mites. Since the cat said he was going nowhere, I decided to see what could be done to mitigate the dust mites. My big takeaway was that maybe my husband should do the housecleaning, but that's probably not going to happen either, but here's what experts have to say.

Dust mites are related to spiders and ticks, and they live in our homes year round, happily munching on the dead cells we keep flaking off as well as those dust mites who have passed on. Their favorite places to hang out are pretty much the same as ours: beds, upholstered furniture, carpets. For those of you with an inclination to leather, here's your excuse to buy that leather suite you've been longing for. I wonder if it could be called a medical tax deduction, but I digress.

There are many things you can do to cut down on the mite population. Luckily for me, we do not have carpets, so that's one less thing to worry about. For the bed, you want to at least use mattress and pillow encasings that are made for the job. There are also certified sheets and blankets, but simply washing those once a week in hot water should do the trick. And keep the pets and stuffed animals off the bed, unless you want to be washing them weekly also You will want to wash your curtains in hot water more frequently than the seasonally that I tend to do, and if you can get rid of the wall-to-wall carpeting, all the better. Throw rugs can be used if you're willing to wash them frequently.

Invest in a vacuum with a HEPA filter and an upholstery attachment. It will only get the surface mites off the sofa but it's better than nothing. Dusting is best done with a cloth that is damp or sprayed with furniture polish. This way less dust ends up in the air. If you can't convince someone else to do your cleaning, purchase some face masks to wear while you work.

Mites like the same temperatures we do, 65 to 80ish, but one thing you can do is to change your furnace filter often (at least every 3 months) and purchase minimum efficiency reporting value (MERV) filters of 11 or 12. If your furnace has a humidifier, set it below 50, as mites like it moist. 

Some folks can get by with over-the-counter allergy medications such as Allegra or Nasacort. If this type doesn't do the trick, allergy shots may be your next step, although the FDA has just released a new under-the-tongue medication that has seen success. The neti pot is also your friend, especially after you have finished doing anything that stirs up the dust. And remember, your symptoms may be all in your head, but that doesn't mean you're nuts.

Friday, September 28, 2018

Hold, two, three, and breathe.

My family has been long-time members of the Syracuse area YMCA. I go at least once a week to do a hydrorun class and maybe another day for some cardio on the bike, but mostly, I get try to get out for a walk. As the former running coach said: "get out for 15 minutes, 6 days a week; then you can build from there," and I was mainly in the prebuilding stage. So I was never a big exercise buff, until that cancer diagnosis. Then, I started taking a closer look at what general shape I was in. Where I might have slacked on the walking, I would push myself out the door, mentally chanting "15 15 15." And luckily for me, the YMCA has two great programs for people with cancer. Livestrong is a program that many Ys across the country have. It's a 12-week group exercise program that gives you a well-rounded routine that includes cardio, balance, core work, weights, and stretching. The National Cancer Institute's fact sheet on physical activity and cancer talks about the many ways exercise, along with a healthy diet, help not only during the treatment process, but afterwards, possibly reducing the risk of some types of cancer. At the Syracuse area Ys, participants receive free, family membership during the 12-week course. Most Ys also have financial assistance if you want to continue membership, so don't let money stand in the way of your health. A program that's special to Syracuse area Ys is Laurie's Hope. This one is for breast cancer patients only, giving a free, one-year family membership, along with support programs and a restorative yoga class, as long as you go to the Y at least once a week.

No matter where you live, if you have cancer, be sure to reach out to the groups and programs in your area, particularly if you have a Livestrong program. There's an extra bit of strength you gain working out with other people who have "been there, done that," as far as cancer is concerned. And be sure to set yourself a goal. One Livestrong graduate had a simple goal; he wanted to be flexible enough to touch his toes. Took him the full 12 weeks, but he did it. I've never, ever done a chin-up, but every year at the state fair, I walk by the Marine's booth and see folks taking the chin-up challenge. My goal is to become strong enough to go to that booth next year and do one chin-up. See you there. Oorah!

Thursday, August 2, 2018

Can You Hear Me Now?

I finished my radiation on Friday the 13th, which puts me in the "this is an auspicious day" camp. Mostly when you have radiation, you see the technicians, but the physician schedules a few visits  to keep tabs on how the treatment is affecting you. This usually involves a check of the skin being irradiated and questions on your fatigue level, etc. When asked how I was doing, I replied: "Fairly tired, as predicted, and my IBS (irritable bowel syndrome) has started acting up." Both doctor and nurse looked at me like I was speaking in tongues and he said: "The radiation doesn't go near your stomach." I knew what area was being irradiated, and I have the tattoos to prove it, but I resisted whacking him upside the head, he being young enough to be my son, and said: "Yes, but my body is now under stress, and stress is a trigger for IBS." He just kind of made a note of that, which is an acknowledgement of sorts, and I went home and took a peppermint oil capsule, which seems to work for me. This exchange made me think that specialists can be too specialized, and that physicians need to remember that many patients are pretty in-tune with their bodies and how they work, so they need to at least consider what the patient sees as real. That is a matter of building good communication skills. Communication is a two-way street, talking and listening, and the Amputee Coalition of America has a great article on how a patient can do just that.

As it is a two-way street, physicians also need to learn and practice the art of effective patient communication. If you want to increase your odds of getting a whole-body approach to your health care, you can check to see if there is a practitioner of  osteopathic or functional medicine in your area. These MDs are trained to look at the sum of your parts with an eye towards the preventative rather than just treating individual symptoms. Many of us, though, are happy with our physicians, so it is up to us to help them along with understanding what is going on in our bodies. Always write up a list of questions you want to discuss: some patient portals have this option in the appointment confirmation feature so you don't have to worry about leaving your list at home. If it's an issue that has been going on for awhile, try to keep a journal of what symptoms happen when. Providing your physician with whatever relevant information you have can go a long way in getting the conversation started, and getting you back on the road to good health.