Tips to Get Back on a School Routine

 AREFA CASSOBHOY, MD, MPH:

All families need to relax the rules sometimes and maybe let regular routines slide. But getting back into a routine is important for your child's well-being.

Kids actually thrive when they have a regular routine. It helps them predict what's going to happen in a world where they don't have a lot of say. And it also helps them organize their time, so they know what activity is appropriate for certain periods of the day.

So how do you get your child on a routine? First, decide what's important. Getting ready for school, bath time, and dinner are all critical parts of your child's day. Set aside a realistic amount of time for those tasks. Then make room for downtime like play, reading, or relaxing.

Most kids will do better if you alert them to a change in activity ahead of time. Give them a heads up when playtime is over, or bedtime is coming up. You can set timers that the kids can watch and hear.

Most important, be consistent. If your routine regularly falls apart, it creates chaos. And lax routines can even cause anxiety in children. So even if they beg to stay up a little longer, stick with the program. Sure, it's OK to be flexible sometimes. But what you want is for your routines to eventually become old habit. 

Things That Raise Your Chances of Dementia

 Age

Alzheimer’s disease is the most common form of dementia. About a third of people 85 and older show signs of the disease. The genes you get from your parents play a part at this age, but so do things like diet, exercise, your social life, and other illnesses. Dementia isn't a normal part of getting older.

Heart Disease

It could lead to a heart attack or stroke, which makes dementia more likely. Heart disease is usually caused by plaque buildup in arteries around your heart (atherosclerosis). That can slow blood flow to your brain and put you at risk for stroke, making it harder to think well or remember things. And many things that cause heart disease -- tobacco use, diabetes, high blood pressure, and high cholesterol -- also can lead to dementia.

Air Pollution

An English study found older adults who lived in areas with the highest yearly concentration of air pollution were 1.4 times more likely to get dementia than people who lived in places with cleaner air. Nitrogen dioxide (NO2) and particulate matter (micro-particles in the air you might not see but can inhale) caused the most harm.

Diabetes

Doctors aren’t sure exactly why people with diabetes get dementia more often. But they do know that people with diabetes are more likely to have damaged blood vessels. This can slow or block blood flow to the brain and damage areas of the brain, leading to what’s called vascular dementia. Some people may be able to slow brain decline if they keep diabetes under control with medicine, exercise, and a healthy diet.

Poor Sense of Smell

Older people who have trouble identifying odors are more than twice as likely to have dementia as those with a sharp sense of smell. Almost half of people in an American study who’d been diagnosed with dementia had had olfactory dysfunction 5 years before. A simple smell test can flag a need for early treatment.

High Cholesterol

High levels, especially in middle age, are linked to obesity, high blood pressure, and diabetes. All of these raise your risk of dementia, but it’s not yet clear if the cholesterol by itself adds to the problem. Some research shows that high cholesterol in midlife could raise your chances of Alzheimer’s disease later in life, but the exact link isn’t clear.

Herpes

vHerpes simplex virus 1 (HSV1), or oral herpes, usually appears as blisters or sores on or around your mouth. But the virus can also get into and infect your brain. A recent study linked HSV1 with a decline in some mental functions, but not to dementia. However, lab studies on a realistic brain model showed HSV1 triggered major Alzheimer’s signs, including swelling and clumps of protein in the brain tissue.

Depression

If you have depression, or have had it in the past, you may be more likely to get dementia. Scientists aren’t yet sure that it’s a cause. It may simply be an early symptom or a sign of other causes like Parkinson’s disease or Huntington’s disease. Talk to your doctor or a therapist if you feel down for more than 2 weeks, and right away if you think of harming yourself. Therapy and medication can help with depression. 

Eating Patterns

Super-starchy and processed foods never make the “healthy” list. But did you know eating the two together can up your chances of having dementia? French researchers found people who developed dementia often paired processed meats – i.e. ham, pepperoni, and deli meats – with high carbs like potatoes, alcohol, and baked sweets. Meanwhile, people who stayed healthy ate their share of meat – but enjoyed it with fruits and veggies.

Head Injury

A single, mild traumatic brain injury may not make you more likely to get dementia later in life. But more severe or repeated hits or falls could double or quadruple your chances, even years after the first injury. Get to the hospital if you’ve hit your head and you pass out or have blurry vision, or feel dizzy, confused, nauseated, or become sensitive to light.

Loneliness

Feeling lonely over time can increase your chances of having dementia, even when your overall risk of getting the disease – such as with genetics or age – is low, a 10-year study found. People under age 80 who reported feeling alone were twice as likely to have dementia as those who didn’t feel that way. Time is key, though. People who recovered from their loneliness didn’t have the same risk.

Obesity

If you have a lot of extra weight in middle age, you may be more likely to get dementia later in life. Extra pounds raise your risk for heart disease and diabetes, which are also linked to dementia. You can check your BMI (body mass index) online to see if it’s in the “obese” range. Your doctor can help you set a weight loss goal that’s right for you. A healthy diet and regular exercise could help you turn things around.

Genes

Dementia doesn’t have to run in your family for you to get it, but genes make a difference. A parent or sibling with Alzheimer’s raises your odds. Genes seem to matter more in some types of dementia than others. But even risky genes don’t mean you’ll get dementia. If you’re thinking about genetic testing for Alzheimer’s, ask your doctor about the pros and cons -- and genetic counseling. Doctors don’t routinely recommend those tests.

Sleep

Many people have a bad night of sleep now and then. But if it happens often -- you wake up a lot or don’t sleep enough -- you could be more likely to get dementia, including Alzheimer’s disease, or make it worse. It may help to try and keep a healthy sleep routine: Avoid alcohol, caffeine, and electronics in evening, and set up a soothing bedtime ritual with regular bedtime hours.

Smoking

It seems to put you at risk of getting dementia, possibly because it’s bad for your blood vessels. And it definitely makes you more likely to have a stroke, which can and often does damage the brain and cause vascular dementia. That might lead to problems with thinking or remembering. Talk to your doctor or a mental health professional if you smoke and want support to quit.

The Truth about Carbs

 What Are Carbs?

They’re one of three types of food that give your body energy. The other two are proteins and fats. Together, they provide the fuel your body uses to build and repair itself. Carbs break down into glucose (sugar) that you can use right away.

Your Body’s Fuel

Your body runs on glucose. Your brain, in particular, needs it to work the way it should. Carbohydrates are an almost instant source of it. Your body can break down and use fat for some of the same needs, but not all of them. Plus, fat that’s used for fuel makes compounds called ketones that can raise the level of acid in your blood, and that can be unhealthy over the long term.

Workout Prep

Because carbs are a source of energy, they can keep you going strong while you exercise. Experts recommend fueling up 1 to 3 hours beforehand with a combination of carbs and protein, like oatmeal, Greek yogurt, peanut butter, or nuts and raisins.

Full of Nutrients

The best-quality carbs -- berries, vegetables, and whole grains -- are packed with vitamins, fiber, and antioxidants that are important for good health and well-being. Whole grains have fatty acids, magnesium, B vitamins, folate, and zinc. Fruit and starchy veggies have some of those, plus phytonutrients like flavonoids and carotenoids that help prevent disease. If you skip the carbs, you lose out on those nutrients, too.

Simple Carbs

Think of table sugar as simple carbs in pure form. They’re very small molecules, which makes them especially easy for your body to break down and use. That means they raise your glucose levels (blood sugar) really fast. Things that sweeten any number of candies, pastries, and desserts are loaded with these kinds of carbs.

Complex Carbs

String together a bunch of simple carbs, and you get these larger molecules. Your body has to break them down into simple carbohydrates and then into glucose before it can use them. This takes longer, which means your blood sugar goes up more slowly and they’re less likely to be changed into fat. These kinds of carbs include multigrain breads and pasta, beans, potatoes, and other vegetables.

Storage Tank

Before your body turns leftover glucose from carbs into fat, it stores what it can in your liver in the form of glycogen. This keeps your body going between meals. But your liver can only keep a day or so’s worth at a time.

If You Have Too Many

If you overdo the carbs, your blood sugar levels can get too high. This causes your body to make more insulin, which tells your cells to save the extra glucose as fat. That can be unhealthy if you’re already carrying a few extra pounds. It can lead to diabetes and other related health issues.

If You Don’t Have Enough

If there aren’t enough carbs in your diet, you could get constipated from lack of fiber and nutrients. Your body is also forced to use protein or fat for energy. Proteins are the building blocks of the body. If you use them as fuel, you may not have enough left to make more cells and keep them healthy.

The Right Amount

The number of carbs you need can depend on your gender, size, and how active you are -- and that can change as you get older. But as a general rule, about half your daily calories should come from carbs in fruits, vegetables, grains, beans, and dairy products. Just make sure to go with healthy, complex carbs and don’t overdo the simple ones.

Low-Carb Diets

In theory, fewer carbs mean less sugar. And “ketogenic” diets have been shown to help some people lose weight and control their blood sugar in the short term. But these diets include lots of protein, and your body may need to use stored calcium to digest it. Plus, digesting lots of protein can be hard on your kidneys over time. You also tend to eat more saturated fat to replace the carbs, and that can be unhealthy in the long term, too.

Diabetes and Carbs

If you have this disease, you need to watch your carbs carefully because your body has trouble keeping your blood sugar at a safe level. If you have too many, your body may not be able to bring your blood sugar down quickly enough. But if your blood sugar gets too low, a glass of juice or another simple carb might be just the thing to kick it back up again. If you have diabetes, talk with your doctor about the best way to manage carbs.

Where to Get Healthy Carbs

Look for unrefined whole grains like quinoa, rye, and barley instead of highly processed white bread and pastries. Whole unprocessed fruits and vegetables are better than juices. And it’s a good idea to pass on the high-carb potato foods, especially French fries, in favor of beans, chickpeas, and other legumes.

Supplement Smarts: The Best Ways to Take Different Vitamins

 Make Food Your Plan A

With hundreds of supplements available, it’s hard to believe that not every nutrient in whole foods has been captured in a capsule. That’s why eating a variety of healthy foods is the best way to meet your health needs. But if you’re low on a certain vitamin or mineral, or just want to cover all bases with a daily MVM (multivitamin/mineral), these tips will help you get the most from it.

Timing Your Multi

You can take your MVM any time you’d like. Your body absorbs some of its vitamins better with food, so you may want to take it with a meal or a snack. You’ll also avoid the upset stomach that you can get when you take it on an empty stomach. Not a breakfast person? Have it with lunch or even dinner.

When to Take Water-Soluble Vitamins

Water dissolves them, and your body doesn’t store them, so most must be taken every day. They include C and the B’s: thiamin (B1), riboflavin (B2), niacin (B3), pantothenic acid (B5), pyridoxine (B6), biotin (B7), folic acid (B9), and cobalamin (B12). Take them with or without food, with one exception: You’ll absorb B12 better with a meal. If you also use vitamin C, put 2 hours between them. Vitamin C can keep your body from using B12.

When to Take Fat-Soluble Vitamins

Vitamins A, D, E, and K need to go with fat from a meal for your body to absorb and use them. But you don’t need a lot of fat -- or any saturated fat. The healthy plant-based kind you find in foods like avocado or nuts will do just fine. 

If You Take Iron Supplements

You absorb iron best on an empty stomach. Take it with water or, better yet, a citrus juice: Iron and vitamin C have a tag-team effect. If it makes you queasy, save it for right after a meal. But don’t mix it with calcium or high-calcium foods -- these interfere with iron. You won’t take in either one fully. Men and postmenopausal women should skip supplements with this mineral unless a doctor says otherwise. The average MVM has more than you need.

If You Take Mineral Supplements

Large doses of minerals can compete with each other to be absorbed. Don’t use calcium, zinc, or magnesium supplements at the same time. Also, these three minerals are easier on your tummy when you take them with food, so if your doctor recommends them, have them at different meals or snacks. Don’t take any individual mineral at the same time as an MVM or an antioxidant vitamin formula, like one with beta-carotene and lycopene. Also see: What is silicon dioxide and how is it used in supplements?

If You Take Vitamin A

Watch the amount of what’s called preformed vitamin A. If you’re pregnant, doses over 10,000 IU a day can cause birth defects. High levels of both A and the usually safe beta-carotene (a substance that the body coverts to vitamin A) may raise your chances of having lung cancer if you’re a smoker, and maybe even if you’re a former smoker.

Prenatal Vitamins and Morning Sickness

Extra folic acid and iron are very important for a healthy baby. They can be found in most prenatal vitamins. But some prenatal vitamins can make nausea worse, mostly because of the iron. If this happens to you, pair your prenatal vitamins with a light snack before you go to bed. Talk to your doctor about the best prenatal formula for you.

Supplements and Your Prescriptions

Even essential nutrients can interfere with many common medications. If you take a traditional blood thinner like warfarin, just the small amount of vitamin K in an MVM can cut its strength. Taking more than 1,000 mg of vitamin E per day can raise your risk for bleeding. And if you take thyroid medication, taking calcium, magnesium, or iron within 4 hours can cut its strength. Ask your doctor about how best to time it.

The Alphabet of Amounts

RDA (recommended daily allowance) is the daily amount of a nutrient you should get, based on sex and age. DV (daily value) is the percentage of a nutrient that a supplement or food serving adds to the average daily diet for all ages. UL (upper limit) is the most of a nutrient you should get in a day. Side effects from big doses range from tiredness or diarrhea to kidney stones or organ damage.

Know What’s Inside

There’s no one standard MVM formula. Some have more nutrients than recommended. Others may come up short on some RDAs. For instance, the amount of calcium you need to meet the RDA is too much to fit into a tablet that you could easily swallow. Scan the full ingredients list so you know exactly what’s in the supplement you’re considering. This will also help you know if you need to time when you take it.

Personalize Your Formula

Another way to get more of the nutrients you need is to shop for formulas geared to your age and sex. For example, many vitamins for seniors have more calcium and vitamins D and B12 than younger people need. As you get older, your body doesn’t do as good a job of absorbing B12. Women in particular often need extra calcium and vitamin D after menopause to protect bones. Men’s formulas leave out the iron.

Are Gummies Any Good?

Opinions about gummy vitamins are mixed. One study found that people who take vitamin D in gummy form get more from it than from a tablet. On the other hand, gummies can have a lot of sugar and calories. And because they taste like candy, it’s easy to go overboard and eat too many. They may even cause cavities. Also, not all brands contain all essential vitamins and minerals. Some may not even contain the amounts listed on the label.

Look for Quality Checks

Since the FDA doesn’t regulate supplements, look for brands that have been “verified” by one of the three companies that test supplements in the U.S.: Pharmacopeia, Consumer Lab, or NSF International. These testing organizations verify that what’s on the label is in the bottle in the right amounts.

Keep a Supplement Diary

If you keep a log, it can help you time out different supplements and keep track of how much you take every day. The National Institute of Health’s Office of Dietary Supplements has a form called "My Dietary Supplement and Medicine Record" that you can print out and fill in. Bring it with you, along with your medication list, when you go to doctor visits.

Psoriatic Arthritis Symptoms & Signs

 Medically Reviewed by Shruthi N, MD on June 24, 2024Written by Lori M. King, PhD

What Is Psoriatic Arthritis?

Psoriatic (pronounced saw-ree-a-tuhk) arthritis is a chronic inflammatory arthritis. Anyone can get psoriatic arthritis, but about 33%-50% of people who get it either have psoriasis themselves or have a first-degree family member (mother, father, or siblings) with psoriasis.

Keep a watch out for joint, nail, and eye symptoms if you or a close family member has psoriasis.

Both psoriasis and psoriatic arthritis are autoimmune conditions. This means that your immune system mistakenly attacks your own body tissues. Psoriatic arthritis leads to signs and symptoms in your skin, joints, and nails, as well as fatigue. Read on to learn more.

Musculoskeletal Psoriatic Arthritis Symptoms

Psoriatic arthritis can affect any joint in your body, whether that's your large joints, such as your knees and shoulders, or your small joints such as your fingers, toes, back, and pelvis. The most common musculoskeletal psoriatic arthritis symptoms include:

Joint pain and stiffness

Discoloration or redness near your affected joints

Pain or tenderness where your tendons and ligaments attach to your bones, especially at the back of your heel (Achilles tendinitis) or in the sole of your foot (plantar fasciitis)

Swelling in your fingers and toes, which your doctor may call dactylitis or "sausage fingers"

Traditionally, psoriatic arthritis has been classified as one of five types based on which of your joints are affected and on which side of your body you have symptoms. The five types include:

Oligoarticular arthritis. This type usually affects two to four joints at the same time on both sides of your body. For instance, you may have swelling and pain in one of your knees and one of your elbows. This is the most common type of psoriatic arthritis.

Polyarticular arthritis. This type looks a lot like rheumatoid arthritis, and it's the second most common type. It usually affects more than five joints at the same time, most often the same joints on both sides of your body. For example, it may affect both of your knees and both of your elbows.

Distal arthritis. This type usually affects the joints near the end of your fingers and toes, though it can affect other joints as well. With this type, you will usually also have symptoms in your fingernails and toenails. For instance, your nails might look discolored, flaky, or pitted.

Spondylarthritis. This type usually affects the joints between the vertebras in your back, as well as the joints in your hips and shoulders.

 Arthritis mutilans. This is the rarest and most serious type. It causes inflammation that is so severe, it can cause bone loss (also called osteolysis). Bone loss leads to joint deformities, especially in your hands and feet.

Symptoms of Psoriatic Arthritis in the Skin

You will usually have skin symptoms of psoriasis before joint symptoms, but they may start at the same time. Or you may get arthritis before skin symptoms. Your skin symptoms can be mild or severe, and the severity of your rashes won't necessarily match the severity of your joint symptoms.

The skin symptoms include:

Rash plaques. Plaques are rashes that look raised, thickened, and discolored (silver or gray), and they most often form on your knees, elbows, scalp, and lower back. The rash is also scaly and will flake off easily. Your skin may bleed when the scales flake off.

Itchy skin

Painful skin

Symptoms of Psoriatic Arthritis in the Nails

About 80%-90% of people with psoriatic arthritis will get nail symptoms. You may get symptoms in your fingernails and toenails that can be uncomfortable or painful. The severity of your nail symptoms often matches the severity of your skin and joint disease.

These symptoms include:

Discoloration of your nail beds (the skin under your nails). The discoloration is often yellow, pink, red, or brown. You may also get splinter hemorrhages, which are thin, red to reddish-brown lines of blood under your nails. They run in the direction of nail growth.

Pitting or denting. Your nails may have pits that are the size of a pin tip or dents that are as big as the tip of a crayon. You may have only a couple of pits or many across your nail.

Nail structure changes. This can include:

Horizontal grooves across the surface (Beau's lines)

Thinning of the nail that leads to crumbling

Separation of your nail from your nail bed (onycholysis)

Signs of Psoriatic Arthritis in the Eyes

About 7% of people with psoriatic arthritis will also develop uveitis (pronounced you-vee-eye-tis). Uveitis causes inflammation in the middle layer of your eye. Symptoms of uveitis include:

Eye redness or irritation

Eye pain

Blurred vision

Light sensitivity (photophobia)

Swollen conjunctiva, which is the thin, clear membrane that covers the inside of your eyelid and the white of your eye

Managing Psoriatic Arthritis at Work

Other Common Symptoms of Psoriatic Arthritis

Some people with psoriatic arthritis also:

Feel very tired or low energy (fatigue)

Have inflammatory bowel disease (IBD), which causes inflammation in your digestive system

What Are the Early Signs of Psoriatic Arthritis?

Psoriatic arthritis has a variety of symptoms, and they vary from person to person. So, there's no one sign or symptom that will point to psoriatic arthritis.

If you have psoriasis or family members with psoriasis, watch out for the signs and symptoms of psoriatic arthritis. You're looking for a pattern, not just one or two signs or symptoms.

You may be more likely to have a flare-up of symptoms after a triggering event, such as:

Stress

Infections or injuries

Smoking or exposure to tobacco smoke

Cold weather

Drinking a lot of alcohol

What is the difference between signs of rheumatoid arthritis and psoriatic arthritis?

Both rheumatoid and psoriatic arthritis are autoimmune conditions that cause chronic inflammation of your joints. They have very similar joint symptoms. However, with rheumatoid arthritis, you will usually have symptoms in the same joint on both sides of your body. For instance, you might have symptoms in both wrists at the same time. With psoriatic arthritis, you will usually have symptoms in different joints on both sides of your body. For instance, you might have symptoms in your left wrist and your right knee around the same time. Also, if you have psoriatic arthritis, you will most likely have skin and nail symptoms in addition to joint symptoms.

Possible Complications of Psoriatic Arthritis

Having psoriatic arthritis can make you more likely to develop other conditions over time. Some of the most common conditions you may be at increased risk for include:

High blood pressure

High cholesterol

Obesity

Diabetes

Depression

Anemia

Muscle weakness

Many of these complications may be the result of the ongoing effects of inflammation. In addition, painful joints and fatigue can make it challenging to be physically active, which also increases your chances of developing obesity, diabetes, high cholesterol, and high blood pressure. Ask your doctor about activities you can do that won't put as much strain on your joints. They may recommend walking, aqua therapy, or yoga as good ways to stay active without stressing your joints.

When Should I See a Doctor?

Go see your doctor if you notice rashes or other skin symptoms or if you have joint pain.

Also, talk to your doctor if you have psoriatic arthritis and you have symptoms that are new, changing, coming on more frequently, or becoming more severe.

Takeaways

Psoriatic arthritis is a long-term inflammatory arthritis. It causes symptoms such as pain, stiffness, redness, and swelling in your joints and where your tendons and ligaments attach to your bones. You may also have skin rashes, pitting and discoloration in your nails, and redness and swelling in your eyes. If you have skin rashes and joint symptoms, go see your doctor. Untreated psoriatic arthritis can make you more likely to have complications, such as diabetes or high blood pressure.

Psoriatic Arthritis Symptoms FAQs

Can lifestyle changes prevent psoriatic arthritis?

It's difficult to say if lifestyle changes can prevent psoriatic arthritis because researchers don't know exactly what causes it. However, making some lifestyle changes can improve your health overall and reduce general inflammation in your body. So, there's good reason to believe that a healthy lifestyle may help prevent all types of arthritis or make management easier if you develop it. Your doctor will likely recommend you:

Avoid tobacco products

Follow a healthy diet and exercise plan

Do low-impact exercise

Use equipment that protects your joints when doing any activity that could cause an injury

SOURCES:

Tiwari, T. Psoriatic Arthritis, StatPearls Publishing, 2024.

National Institute of Arthritis and Musculoskeletal and Skin Disorders: "Psoriatic Arthritis."

National Health Service: "Psoriatic arthritis."

Cleveland Clinic: "Psoriatic Arthritis," "Psoriasis," "Nail psoriasis," "Uveitis."

Mount Sinai: "Splinter hemorrhages."

National Psoriasis Foundation: "Eye Inflammation and Psoriatic Arthritis."

UCLA Health: "Early signs of psoriatic arthritis."

RMD Open: "Distinguishing rheumatoid arthritis from psoriatic arthritis."

Arthritis Foundation: "Psoriatic Arthritis," "Psoriasis and Psoriatic Arthritis Linked to Increased Gout Risk."

Current Rheumatology Reports: "Arthritis mutilans."

The Journal of Rheumatology: "Acute Presentation of Arthritis Mutilans."

The Psoriasis and Psoriatic Arthritis Alliance: “Why do I feel so tired?"

Older Adults Redefine Love to Combat Loneliness

 Written by Donavyn Coffey

Aug. 13, 2024 -- Eight years ago, Lori, a 64-year-old retiree living in Maine, was beside herself with grief as her daughter moved away. Afraid of the impending loneliness, she called the one person she knew she could live alongside: her ex.

In her 17 years as a divorcee, Lori – who asked that her last name not be used -- occasionally browsed an online dating site and has been in two long-term relationships. But after the last breakup, “I realized I didn’t mind doing life by myself, doing what I wanted to do when I wanted to do it,” she said. Soon after, she invited her ex to move back in.

For almost a decade the two have shared costs, a garden out back, and friendship but no romance. The arrangement may seem unusual, but Lori says it staves off loneliness and still affords her the independence she’s come to love. Not to mention it's easier on a fixed income. She’s still open to dating if it happens, but looking for love is no longer a priority. And she’s not alone.

According to Pew Research, 39% of women and 25% of men 65 and older aren’t married, living with a partner, or in a committed relationship. They’re the largest group of older adult singles in history. And most of them aren’t dating or looking. Only 16% of singles 65 and older are looking for dates or a relationship.

Don’t Let Loneliness Harm Your Health

Medically Reviewed by Poonam Sachdev on August 30, 2023

The health impacts of loneliness have only recently gotten the attention they deserve. In 2023, the surgeon general declared an epidemic of loneliness and isolation, citing serious health consequences like increased risk of dementia, heart disease, and certain cancers.

One meta-analysis even found loneliness was linked to a 14% increase in the risk of early death. Social isolation increased the risk to 26%. Older single adults are particularly vulnerable to isolation and loneliness, especially as they age and lose mobility. Harris said there could be long-term negative outcomes from not re-partnering.

Spouses have traditionally been the primary companions and caregivers of older age, but current older adults say they aren’t looking to date or remarry. Older adults are at a stage when many can afford to design the life they want — and romantic partnership doesn’t meet the needs of every person, experts told WebMD. Dating options, shifting priorities, finances, and family all factor into their decision. But if they continue to age solo, who will see them through an epidemic of loneliness and help them age in place?

A Numbers Problem

In the 60-plus dating pool, the most straightforward deterrent to dating is the gender ratio: Women have a numerical disadvantage. Because women tend to outlive men, single females aged 60 to 64 outnumber men 1.3 to 1, based on 2022 US Census data. By 75, the ratio is skewed more dramatically: 2.8 women for every man.

“For every single man there's 21 women lined up to date him,” said Rene Roy, a 61-year-old from southern Kentucky, about her church. Though she’s never been married, Roy remains open to dating and marriage. However, meeting new men in a small town is a challenge — and it’s only compounded by the comparatively outsized number of single women, she said.

Some women may express less interest in dating or re-partnering simply because they experience a lack of good options, said Lauren Harris, PhD, assistant professor at the University of New Hampshire, who studies romantic relationships and aging.

Newfound freedom

Most single seniors; however, appear to be content with their relationship status. Older adults, in general, tend to have more self-confidence and are more at ease being single. And in the Pew report, the most common reason respondents gave for not dating was enjoying being single and other priorities.

It’s not uncommon for either gender to decide they’re “not interested in negotiating and collaborating” with a partner any longer, said Pebble Kranz, MD, a sexual medicine specialist and medical director of the Rochester Center for Sexual Wellness in upstate New York. Older adults may prefer any number of relationships or pursuits; grandchildren, hobbies, and friends can all take priority over romance.

This is especially true for women. By the time they are single and in their 60s, “many women are done,” said Sharon Sassler, PhD, a sociologist and family demographer at Cornell University in Ithaca, NY. Having spent much of their life caregiving, either for children, parents, or a past spouse, many women aren’t looking to partner again.

Harris said that her female survey respondents often say things like, “I finally can do whatever I want, and I want to keep that” or “I had a marriage. My husband was great. I just don’t want that again.”

And they do well relationally without a partner. Women are considered kinkeepers, adept at networking and maintaining social bonds, Harris said. They often don’t feel the need for a partner because they already lead rich social lives filling their time with family, volunteer work, church, pickleball leagues, tennis clubs, and book clubs, she said.

In contrast, single older men are more interested in significant commitment from a partner. Men tend to be more emotionally dependent on their partner, and one study found that widowers with low or average social support remarry sooner. Romantic relationships may be more essential for them to stave off loneliness.

Leading up to a recent knee replacement, Roy, in Kentucky, worried over her recovery: Who would help her? Who would she talk to in the weeks home alone? But over the course of her recovery, her friends from church and volunteering stocked her fridge, drove her to appointments, and made regular visits. “God provided me a little family of my friends,” she said.

Keeping It Casual

Whatever their relational needs, seniors often find unique ways — that don’t always fit into neat categories of single, looking, or partnered — to meet people.

Take Lori’s living situation with her ex-husband. Or Tom in Aiken, SC. In 14 years of singleness, he’s been in three dating relationships that lasted multiple years. All were on-again-off-again and not quite exclusive, but they were good companions and travel partners at the time, he said.

While Tom – who also asked that his last name not be used -- said he’s not against remarriage, it has some financial downsides — legally entangling his business and his children’s inheritance. “Financially ... it makes more sense for me to stay single,” he said.

Many seniors agree, avoiding marriage and cohabitation because they don’t want to move, entangle finances, deplete their children’s inheritance, or be responsible for caregiving.

5 Ways for Seniors to Get Fit

From hikes to hula hoops, there are several ways to stay in shape through the years.

At this stage of life, there’s far less emphasis on looking for someone to complete you or to build your life with, Harris said. Dating for older adults is more casual — less about marriage and cohabitation and more about “parallel companionship,” she said.

 “They want the love, companionship, and sexual relationship without the hassle of entering a legal union,” said Deborah Carr, PhD, a sociologist who studies later life at Boston University.

Meeting New People Online and Off

While many older people have reasons for not dating, many are also still open to love. But finding it may take some strategy.

“Whether [you are] 25 or 65, there might be a gap in what you want in your romantic life and what you have,” Carr said. Older adults, of any gender, may want to date but not be a part of activities or comfortable with the technology that allows them to meet new people.

Social circles can reinforce the seeming lack of options because they can be so gendered. Women tend to be very social, but common activities like volunteer work, church, and book clubs are largely female. Men may spend more time with family, golf buddies, or neighbors.

In either case, meeting potential dates often requires some strategy and willingness to deviate from your social circle, Sassler said. She studies how couples meet and said women, for instance, will have more luck meeting single men doing active activities like bird watching or volunteering for the Sierra Club. “You have to stay active and think hard about where the sex ratio is more balanced,” she said.

For those who feel they lack in-person options, online dating continues to grow. The number of single seniors who have used online dating increased from 3% in 2016 to 13% in 2019, according to the Pew Research Center.

Older adults can also be targeted on these apps. A Pew survey reported that almost half of online daters over 50 believed they had encountered someone trying to scam them. While that’s not a reason to avoid online dating, Carr recommends looping in a child or similar support if you do decide to try the online route.

They don’t need to vet every person you swipe right on, she said. But before you meet or share personal information, share the profile and conversation with a second set of eyes and ears.

“One of the beauties of old age is you gets to do whatever the heck you want. You have earned it,” Kranz said. “You have earned being single. You have earned an exploring partnership. And people should embrace whatever they want to do with this very important part of life.”

SOURCES:

 Lauren Harris, PhD, assistant professor, University of New Hampshire.

Sharon Sassler, PhD, sociologist and family demographer, Cornell University, Ithaca, NY.

Tom, Aiken, SC.

Deborah Carr, PhD, sociologist, Boston University.

Pebble Kranz, MD, sexual medicine specialist and medical director, Rochester Center for Sexual Wellness, New York.

Pew Research Center: "Dating at 50 and up: Older Americans’ experiences with online dating," "1. Americans’ personal experiences with online dating," "15% of American Adults Have Used Online Dating Sites or Mobile Dating Apps," "For Valentine’s Day, 5 facts about single Americans."

Journal of Marriage and Family: "The Desire to Date and Remarry Among Older Widows and Widowers," "Kinkeeping in the Familial Division of Labor."

mind.org.uk: "Men twice as likely as women to have no one to rely on for emotional support."

Psychology and Aging: "Satisfying singlehood as a function of age and cohort: Satisfaction with being single increases with age after midlife."

Psychological Bulletin: "Development of self-esteem from age 4 to 94 years: A meta-analysis of longitudinal studies."

U.S. Census Bureau: "B12002 | Sex by Marital Status by Age for the Population 15 Years and Over."

Nature Human Behavior: "A systematic review and meta-analysis of 90 cohort studies of social isolation, loneliness and mortality."

National Academies: "Social Isolation and Loneliness in Older Adults."

Is It Aging or Alzheimer's?

 Is Your Memory Slipping?

We all forget things sometimes, especially when life gets busy. You may start to notice this happening more often as you get older. Mild memory loss can be a normal part of aging. It doesn't necessarily mean you're going to have dementia. Only 1% of people over age 65 with normal age-related memory issues will get dementia each year.

When Forgetfulness Is a Problem

If memory loss makes it hard for you to handle your daily tasks, that's a sign you shouldn't ignore. Are you forgetting things you only just heard? Asking the same question over and over again? Relying on lots of paper or electronic reminders just to get through the day? Talk to your doctor if you or your family notices that happening to you.

Hard to Plan or Solve Problems?

Everybody makes a mistake sometimes. Maybe you made an error in the checkbook last month or paid the wrong amount on a bill. That's normal stuff we all do. But if you are really struggling to do things like follow directions in a familiar recipe or keep track of bills the way you used to do, it could be a warning sign of memory problems.

Struggle with Everyday Tasks

Having trouble using that TV remote? Forgot how to set the microwave? If you need a little help now and then with those kinds of things, it's likely nothing to worry about. But if you have problems doing regular activities you're used to doing, like driving to places you always go, playing favorite games, or finding your way at the grocery store, it may be a sign of a more serious memory issue.

Where Did I Park?

We've all had it happen. You come out of the store and think, "Now, where'd I leave my car?" It's normal to forget where you parked now and again. If it happens regularly, though, check with your doctor. It could be a warning sign of dementia.

Can't Find Your Keys

Most of the time when you forget where you've left something, like your keys or your glasses, you should be able to think back, retrace your steps, and find whatever it is. If you notice you're losing things all the time and you can't go back and spot them, which are a common sign of a bigger memory problem.

Losing Track of Time

Most of us have woken up and thought to ourselves, "What day is it?" It won't take you too long to figure it out. But if you are often losing track of dates, seasons, or the passage of time, that's another sign of real memory trouble.

How Did I Get Here?

If you walk into a room and can't remember what you were doing, that's not cause for concern. It happens to all of us. But people with Alzheimer's disease sometimes forget where they are. Or they find themselves somewhere and don't remember how they got there. If that's a problem you have, it's a good idea to get help.

What's the Word for It?

It's normal to have trouble finding the right word sometimes. Or you might use a word the wrong way. Not to worry. But people with Alzheimer's disease often start to have real trouble talking or writing. They might find it hard to recall the right term for familiar objects or the name of somebody they know well. If you're struggling with names, words, or what to say next, it may be a sign of more serious memory loss.

Withdraw From Friends and Family

Are you avoiding friends, family, or co-workers? Is it hard to carry on or follow a conversation? When memory problems become more severe, it's common for people to lose interest in hobbies, social events, or other activities they used to like doing. If that sounds like you, it's time to talk to someone about it.

Take a Memory Test

If you aren't sure if what you're going through is just regular aging, a doctor can help you figure it out. They'll know if the memory loss you have falls within the normal range or not. Your doctor will ask you questions and may ask you to take a series of tests. They may also check you for other problems that can look like dementia, such as medication side effects or depression.

Is There Anything I Can Do?

If your memory is OK but you're still worried, there may be something you can do about it. People who spend time reading, solving puzzles, or otherwise staying engaged are less likely to get Alzheimer's. It's possible that these activities can help you to keep your mind sharp. It's also a good idea to lower your stress, eat right, and exercise.

How to Boost Your Metabolism with Exercise

 Medically Reviewed by Tyler Wheeler, MD on July 18, 2023Written by Stephanie Watson

Your next workout could set you up for a speedier metabolism.

Your metabolism includes all the things your body does to turn food into energy and keep you going. Some people have a faster metabolism than others.

Some things that affect whether your metabolism is speedy or sluggish include things you don't control, like your age, sex, and genes. Sometimes a sluggish thyroid could decrease your metabolism. But once you find out that it is normal, speeding it up is up to you. Focus on what really does make a difference: exercise.

Muscle cells need a lot of energy, which means they burn a lot of calories. In fact, they burn more calories than fat cells, even when you're not exercising. So the time you spend working out reaps benefits long after you stop sweating.

Exercise becomes even more important as you get older. You naturally lose muscle mass with age, which slows down your metabolism. Working out can stop that slide.

It's simple. You need to challenge your muscles often in these two ways:

1. Amp up your workout. Any kind of aerobic exercise, whether you're running or doing Zumba, burns calories. Make it more intense, and your body will burn more calories.

Try intervals. You can do them with any type of cardio. The basic idea is to switch back and forth between higher and lower intensity. You make it really challenging, and then back down your pace, and repeat.

For example, do as many jumping jacks as you can for 1 minute, and then walk in place for 2 minutes. Repeat for 15 minutes.

2. Lift weights. Because muscle uses more calories than fat, strengthening your muscles will make you into a more efficient calorie-burning machine, even when you're at rest.

You'll be doing more than just helping your metabolism. Your heart, bones, and even your mood will benefit. It's a win all around.

SOURCES:

National Health Service: "How Can I Speed Up My Metabolism?"

Perry, C. Applied Physiology, Nutrition, and Metabolism, December 2008.

American Council on Exercise: "Trimming Off the Fat."

Lee, P. Cell Metabolism, February 2014.

Guide to Ulcerative Colitis

 What Is Ulcerative Colitis?

Ulcerative Colitis is a type of bowel disease that causes long-term inflammation of the cells that line your rectum and colon (also called the large intestine). This may lead to sores called ulcers that can bleed and keep your body from digesting food like it should. You can take medicine to calm the inflammation and learn ways to ease its effects on your daily life.

Warning Sign: Abdominal Pain

A belly ache and diarrhea with blood or pus in it could be warning signs of ulcerative colitis. Some people have mild symptoms every once in a while, but others have worse symptoms more often.

Warning Sign: Weight Loss

The long-term inflammation that comes with UC can cause digestive problems. These could lead to:

Weight loss

Poor appetite

Nausea

Lack of growth in children

Other Warning Signs

Some people with ulcerative colitis have symptoms outside the digestive system. These may include:

Joint pain

Skin sores

Fatigue

Anemia (low red blood cell count)

Frequent fevers

Ulcerative Colitis or Crohn's?

Ulcerative colitis symptoms are similar to those of another inflammatory bowel condition called Crohn's disease. UC only affects your large intestine. But Crohn's can happen anywhere in your digestive tract. It can cause symptoms from your mouth to your anus. Another disease called irritable bowel syndrome can cause long-term belly pain and diarrhea, but it doesn't lead to inflammation or sores in your intestines.

What Causes Ulcerative Colitis?

The exact cause isn't clear. But researchers think your immune system -- which defends you from germs -- is involved. When you have UC, your immune system may not react like it should to bacteria in your digestive tract. Doctors aren't sure whether this triggers the condition or results from it. Stress and your diet can make your symptoms worse, but they don't cause ulcerative colitis.

Diagnosing Ulcerative Colitis

To diagnose ulcerative colitis, your doctor will do a colonoscopy. They’ll insert a tiny camera into your rectum to get an up-close look at the inside of your colon. This helps them spot inflammation or ulcers in the area. A colonoscopy can also help your doctor rule out other conditions like Crohn's disease and cancer.

Do UC Symptoms Go Away?

Your UC symptoms will come and go. The disease can go into remission, which means you may have no symptoms for long periods of time. Remission can last for months or years, but the symptoms will return.

Medications for Ulcerative Colitis

Medications can calm the inflammation inside your colon. The first one you’ll usually try is from a group called aminosalicylates. If that doesn't help, your doctor might prescribe a steroid like prednisone. A third option is an immune modifier, which lowers inflammation by changing the activity of your immune system. It can take up to 3 months before you feel the benefits.

Biologic Therapies

If other medicines don’t help, your doctor may suggest one of a group of medications called biologics. They help your body destroy proteins linked to inflammation. You usually get them in an IV. Another type of treatment is JAK inhibitors, which travel quickly through your bloodstream to block inflammation. You’ll take these as a pill.

Surgery for Ulcerative Colitis

Up to 45% of people with ulcerative colitis will need surgery, either to repair a tear or remove a severely damaged colon. Your UC won't come back after the surgeon removes your colon. Newer surgical techniques mean you may not need a colostomy bag to get rid of waste.

Urgent Care for Ulcerative Colitis

The disease can sometimes cause problems that send you to the hospital. These may include a bleeding ulcer or severe diarrhea that causes dehydration. If this happens to you, doctors will stop the loss of blood and other fluids. If there’s a tear in your colon, you may need surgery to fix it.

Ulcerative Colitis and Colon Cancer

Your risk for colon cancer goes up if you have UC. It depends on how much of your colon is involved and how serious it is. The odds also rise after you've had UC for 8-10 years -- and they go up over time. Treatment that puts your UC in remission may also make cancer less likely. Colonoscopy screening helps doctors find colon cancer early, when it's easier to treat.

Use websites and cellphone apps to find restrooms in airports, train stations, or other large venues ahead of time.

Carry extra underwear and wet wipes.

Bring enough medication to last the entire trip, along with copies of your prescriptions.

Tell your doctor about your plans to see if you need to take other precautions.

Other Health Problems

Some people with ulcerative colitis get conditions like osteoporosis, arthritis, kidney stones, and eye problems such as uveitis. It’s rare, but UC can also lead to liver disease. Researchers think these problems result from the widespread inflammation. They may improve when you treat your UC.

Living with UC: Reducing Flares

Triggers like stress, smoking, missing doses of medication, and eating certain foods can make your symptoms worse. Once you know your triggers, you can avoid them. If flares continue, talk to your doctor about a change in your treatment plan.

Living With UC: Diet Changes

Diet doesn't cause ulcerative colitis, but some foods may make your symptoms worse. Common ones include dairy, fatty foods and foods with too much fiber, which can trigger diarrhea. It can help to keep a journal of what you eat and any symptoms you have. Look for links and avoid triggers. If you lose a lot of weight, you may need to work with a dietitian to come up with a healthy diet.

Living With UC: Supplements

Ulcerative colitis often causes bleeding in your colon, which can lead to a shortage of iron in your body. Some medications you take to treat UC can affect the way your body absorbs nutrients like folic acid and calcium. Ask your doctor if you need to take supplements.

Living With UC: Probiotics

These "friendly" bacteria are similar to those that live in your intestine and prevent the growth of too many harmful bacteria. We need more research to know if probiotics can help with ulcerative colitis. You can find probiotics in some yogurts, milk, tempeh, and soy beverages. Or you can buy them as supplements.

Living with UC: Staying Hydrated

Long-term diarrhea puts you at risk of dehydration, which can lead to weakness and kidney problems. To stay hydrated, drink plenty of water. Check with your doctor to see how much fluid you need.

Living With UC: Relationships

You don't have to let ulcerative colitis get in the way of intimacy. Talk to your partner about how your symptoms affect you and any concerns you have. You might want to see a therapist who specializes in long-term illness. Talk to your doctor if sexual problems become an issue.

Living With UC: Travel

With a little extra planning, most people with ulcerative colitis can travel comfortably. Follow these steps:

Use websites and cellphone apps to find restrooms in airports, train stations, or other large venues ahead of time.

Carry extra underwear and wet wipes.

Bring enough medication to last the entire trip, along with copies of your prescriptions.

Tell your doctor about your plans to see if you need to take other precautions.

Guide to Multiple Myeloma

 What Is It?

This blood cancer forms when plasma cells -- white blood cells that fight germs -- start to grow out of control. They’re found in marrow, the spongy tissue inside some of your bigger bones. Sometimes these abnormal plasma cells, known as myeloma cells, form a single tumor. That's called a solitary plasmacytoma. If you have more than one of these tumors, it’s called multiple myeloma.

Why Do You Get It?

Like many cancers, multiple myeloma has no known cause. However, there are some things that can raise your chances. Age plays a role: Most people who have it are over 65. It’s twice as common in African Americans and slightly more likely to affect men than women. If someone in your family has it, you're more likely to get it, too. 

Can It Be Prevented?

You may wonder if there was anything you could have done to avoid this cancer. The answer is no. It doesn’t result from lifestyle choices, and you can’t discover it with early screening tests. In fact, multiple myeloma is hard to find early. Symptoms usually don’t show up until you’ve had it a while. Scientists learn more about what causes it every year, and new drugs are in the pipeline.

Symptom: Low Blood Counts

Plasma cells aren’t the only ones formed in your bone marrow. Other white blood cells, red blood cells, and platelets are created there, too. But multiple myeloma cells crowd out these other normal cells. That can lead to:

Anemia (low red blood cells), which can cause fatigue

Thrombocytopenia (low platelets), which can cause bruising or bleeding

Leukopenia (low white blood cells), which raises infection risk

Symptom: Bone Fractures

Myeloma cells are a major enemy to bones. Believe it or not, your “old” bone is constantly being dissolved by cells called osteoclasts. Meanwhile, cells known as osteoblasts are making new bone. These things normally happen together. Myeloma cells speed up the breakdown process, and the tumor cells take over the bone. The result: Your bones get weak and can fracture easily.

Symptom: Infections

Plasma cells make antibodies, which fight germs. If you get a cold, they can create an antibody to attack the virus that’s making you sick. Abnormal plasma makes monoclonal antibodies that aren’t directed at a particular virus or bacteria, so they don't fight infections. Myeloma cells multiply and quickly crowd out your healthy plasma cells, along with other white blood cells that protect you from infection.

Other Things to Watch For

Multiple myeloma can lead to health problems like:

Confusion and dizziness

Numbness or muscle weakness in your legs

Kidney problems

Because your bone dissolves faster than normal, you may have a high level of calcium in your blood. You might also feel really thirsty and dehydrated.

How Is It Diagnosed?

Blood tests can check for many red flags, like low blood cell counts and high calcium levels. Then an SPEP and UPEP are done with immunofixation. These are serum tests that tell you if there is a monoclonal antibody present. If monoclonal antibody is found, then a bone marrow is done. But the most important test for this cancer is a bone marrow biopsy. A doctor will insert a special needle into your bone and remove a tiny piece of tissue. They'll look at it with a microscope to see if you have myeloma cells.

Should I Get Treatment?

It sounds crazy, but if you don’t have symptoms yet -- a stage called smoldering myeloma -- the doctor may tell you not to. Many people wait months or years before they start treatment.

Are There Medications?

Yes. If you do need treatment, there are many types. You might try traditional cancer drugs like chemotherapy and corticosteroids. Or your doctor could try one of several new options:

Immunomodulating agents: affect your immune system, but doctors don’t know how

Proteasome inhibitors: stop cells from breaking down proteins

Monoclonal antibodies: attack cells that are a threat

Other Treatment Options

If you’re under 65, or over 65 and otherwise healthy, your doctor may suggest a stem cell transplant. Before it, you’ll get a high dose of chemo or radiation to kill cells in your bone marrow. Then you’ll get a transplant of healthy stem cells -- the ones that create new blood. You might get your own cells. The doctor will call this an autologous transplant. Or they could come from a donor. This is known as an allogeneic transplant.

Related Health Issues

Drugs and blood transfusions improve anemia (low red blood cell counts) and the extreme fatigue it causes. There’s a special procedure that thins your thickened blood, a problem that can result in dizziness and confusion. Another treatment, intravenous immunoglobulin (IVIG), will help your body fight infections. You might also take drugs called bisphosphonates to lower your risk of bone fractures.

Questions to Ask Your Doctor

It’s always a good idea to bring up concerns and ask questions at your office visits. Put these on your list:

How can I stay healthy?

Are there ways to ease my pain?

What stage is my disease in, and what does it mean for me?

Does my treatment have side effects?

Should I get a second opinion?

Should I join a clinical trial?

Guide to Lymphedema

 What Is It?

In a word, swelling. Extra fluid builds up in your tissue when your lymphatic system isn't working well, usually because your lymph nodes were damaged or removed. It's often a side effect of cancer treatment and can show up years later.

What Happens

The lymphatic system is part of your immune system. It moves fluid through your body, picking up waste, bacteria, and viruses. Your lymph nodes filter out the waste and flush it from your body. When something goes wrong, the fluid backs up in your tissue. Most often, your lymph nodes got damaged. Sometimes the vessels get blocked. But lymphedema can also happen without a clear reason.

Symptoms

It can happen anywhere in your body, including your chest, head, and genitals, but it's usually in just one arm or leg. The swelling might be so minor that you barely notice, or so severe it makes it hard to move that part of your body well. A limb that feels full or heavy, skin that seems tight, and jewelry and clothes that are suddenly snug can be from lymphedema. You could be achy or have hardened skin in the affected area.

Who Is Likely to Get It?

Many people with it had surgery to remove lymph nodes to check for the spread of breast cancer or treated their cancer with surgery or radiation. Being older, overweight or having rheumatoid or psoriatic arthritis raises your chances. You could also get it from an infection while traveling in certain tropical countries. Rare disorders passed in families can affect the development of the nodes and vessels in the lymph system, too.

Prevention

After surgery or radiation involving your lymph nodes, keep the affected arm or leg above your heart. Don't apply ice or heat to it. Skip tight clothing and jewelry. Don't cross your legs while sitting.

If swelling starts or you get other symptoms, let your doctor know. Early treatment of lymphedema makes a difference.

Diagnosis

Your doctor will rule out other causes of swelling, such as infections and blood clots. They'll measure the swollen area and compare it with a similar unaffected one. Tests that check for blockages and see how your lymphatic system is working include MRI and lymphoscintigraphy, which follows special dye injected into your body as it moves through the lymph vessels. Grades (1-4) or stages (I-III) describe how severe lymphedema is.

Treatment

Lymphedema can't be cured, but you can control the swelling and keep it from getting worse. Getting to and staying at a healthy weight may make it better, but "water pills" usually won't. Specialized lymphedema therapists can also help you manage the condition. If it's severe, your doctor may want to do surgery to remove some tissue so there's less swelling. Stage I may go away without treatment.

Bandages

Wrap them tightest near your fingers and toes and looser along your limb so fluid flows toward your torso. The pressure also stops fluid from building up again once the swelling has gone down. A therapist can show you how to arrange the layers of liners, padding, and bandages.

Exercise

Gentle movements that squeeze the muscles in your affected limb can help fluid drain and make it easier to do everyday things. Activities that get your heart pumping and make you breathe a little harder can also bring down the swelling. Talk to a lymphedema specialist about what's best for you.

Compression Garments

A special cloth sleeve or stocking puts pressure on your arm or leg to help fluid move through and out of your swollen limb. Make sure to wear it when you exercise and when you travel by plane, since sky-high altitude can make lymphedema worse. You may need a prescription to get one with the right fit.

Massage Therapy

We're not talking about your standard spa service. This special, light-handed type of massage is called manual lymph drainage. A trained professional rubs, taps, and strokes your body to try to move fluid away from the swollen area. You can learn to do it yourself, too.

Compression Device

A trained therapist can use a machine kind of like a blood pressure cuff to help move lymph fluid out of your arm or leg. They'll put a sleeve or boot with a series of chambers over the swollen area. A pump fills the pockets with air and then deflates them over and over in a specific pattern to squeeze the lymph back toward your body.

Avoid Infections

Take care to prevent cuts, scratches, and burns to the affected area. Have shots and blood draws done elsewhere. Those tiny injuries can be entry points for infections. The trapped fluid in your tissue will allow bacteria to grow, and it can quickly become serious. Call your doctor if you get red skin or a rash, you have flu-like symptoms, or the pain or swelling gets worse.

Guide to Atrial Fibrilliation

 What Is AFib?

Atrial fibrillation is a condition that disrupts your heartbeat. A glitch in the heart’s electrical system makes its upper chambers (the atria) beat so fast they quiver or fibrillate. This causes the lower chambers (the ventricles) to beat out of sync.

AFib can be dangerous because it raises your risk of stroke and heart failure.

Not a Normal Heart Rhythm or Rate

Usually, the atria and ventricles work together so the heart pumps blood in steady rhythm. But in AFib, they don't. The irregular beats can cause a fast, fluttering heart rate -- 100-175 beats per minute -- instead of the normal 60-100 beats per minute.

Warning Signs

For many people, AFib symptoms aren't obvious. But when there are, they'll often include:

An uneven pulse

A racing or pounding heart

A feeling that your heart is fluttering

Chest pain

Feeling short of breath

Lightheaded or dizziness

Effects

When your heart is in AFib, your blood doesn't move well throughout your body. You may feel:

Dizzy or faint

Breathless

Weak and fatigued

 When It's an Emergency

AFib isn't always a cause for alarm. But you should call 911 if you have:

Chest pain

Uneven pulse and feel faint

Signs of a stroke, such as numbness or slurred speech

And let your doctor know whenever something doesn't feel right.

Greater Risk of Stroke

When your heart isn't pumping like it should, the slow-moving blood can pool inside, which makes it easier for clots to form. If that happens, and a clot travels through the bloodstream to your brain and gets stuck, you could have a stroke. People with AFib are five times more likely to have one.

What Causes It?

The most common triggers are conditions that strain your heart, including:

High blood pressure

Coronary artery disease and heart attacks

Heart failure

Problems with heart valves

Sometimes, AFib may be set off by thyroid disorders or serious infections like pneumonia.

Who Gets AFib?

Your chances of having the condition are higher if:

You are male and white.

You are over 60.

A close family member had or has it.

Triggers You Can Control

It's also been linked to things you can do something about:

Being overweight or obese

Drinking too much alcohol

Smoking

Using stimulants, including some illegal drugs

Taking certain prescription drugs, such as albuterol

After Heart Surgery

A coronary artery bypass or other type of heart surgery can trigger AFib. If it happens, you're more likely to have other complications, too. Fortunately, this type of AFib usually doesn't last long.

Lone AFib

When it happens without an obvious trigger, it's called lone AFib. This is more common in people younger than 65.

You'll need treatment if a rapid heartbeat causes troubling symptoms. Doctors may also recommend treating it to lower the chances of stroke for people already at risk.

Diagnosed With ECG

The way to confirm AFib is with an electrocardiogram (EKG). The machine detects and records the electrical activity of your heart, so your doctor can see problems with its rhythm. You can do it in the doctor's office, or you may need to wear a device that keeps track of your heart's activity for a longer time to catch an episode. The device can be worn from 24 hours to 2 weeks, and sometimes longer.

Other Tests

If an EKG shows AFib, your doctor may want to learn more about your heart. An echocardiogram or ultrasound can show valve damage or signs of heart failure. A stress test can reveal how well your heart does when it's working hard.

Your doctor may also want tests to look for conditions that could have triggered your AFib.

How Long It Lasts

When you first develop AFib, it may come and go. Your irregular heart rhythm may last anywhere from a few seconds to a few weeks. If a thyroid problem, pneumonia, or other treatable illness is behind it, AFib usually goes away once that cause is better.

But for some people, their heart rhythm doesn't return to normal.

Cardioversion

Your doctor may try to restore a normal heart rhythm with electric shock or medication. But if you've been having AFib for more than 48 hours, the procedure could increase your chance of a stroke. You may need to take a medicine called a blood thinner for several weeks before your doctor tries cardioversion, as well as afterward.

Medication

If your symptoms are mild, or if AFib comes back after cardioversion, you may be able to control it with medicine. Rhythm-control drugs help keeps the pattern of your heartbeat steady. Rate-control medications keep your heart from beating too fast.

Daily aspirin or drugs called anticoagulants or blood thinners can help prevent clots and lower some people's chances of having a stroke.

Ablation

A doctor feeds a small probe through a blood vessel to your heart and uses radiofrequency energy, a laser, or intense cold to zap the tissue that sends out the bad signals. Although you won't need open heart surgery, the procedure has some risks. It's only for people who have serious symptoms that cardioversion and medications haven't helped.

Surgery

In the maze procedure, the doctor makes a pattern of small cuts on your heart to create scar tissue. These scars can't pass electrical signals, so they stop AFib. Usually you'd have this done during open heart surgery, but some medical centers can do it with smaller openings that cause less stress on your body.

Pacemaker

A small, battery-powered device can send out electrical signals to control your heart rate. It can help people whose hearts beat very slowly. And it can relieve symptoms like fatigue and breathlessness. You may need one after ablation, depending where the tissue was.

Getting a pacemaker put in your chest is considered minor surgery, and it usually takes about an hour.

Living with AFib

Many people find that AFib has no impact on their daily lives. But some have to manage troubling symptoms like weakness, shortness of breath, or fainting.

Prevention

The same healthy habits that protect against heart disease will protect you against AFib:

Eat a nutritious diet that includes fish.

Exercise regularly.

Control your blood pressure.

Don't smoke, and avoid secondhand smoke.

Decrease or avoid alcohol.

Check Your Pulse Monthly

AFib can lead to a stroke or another serious problem before it causes symptoms you'll notice. To catch an irregular heartbeat early, the National Stroke Association recommends you check your pulse once a month -- especially if you're over 40 or have other risk factors for stroke. If your rhythm seems unsteady or you have any concerns, call your doctor.

Getting Fit While You're Overweight

 Fitness: More than a Number on a Scale

When it comes to overall health, your fitness level may matter more than the number on the scale. Being overweight sets you up for health problems like heart disease and diabetes. But focusing on weight loss alone tends to cause an up-and-down weight cycle that can be dangerous for your health. Researchers are finding that even if you don’t lose weight, exercise has important benefits. And if you also happen to lose some weight, great!

Benefits of Exercise

Physical activity lowers your blood pressure, cholesterol, and blood sugar levels. It helps keep your bones strong, boosts your brain power, gives you energy, and helps you sleep better. It lowers your chances of heart disease, stroke, type 2 diabetes, dementia, and some kinds of cancers. Besides all this, exercise can reduce stress, boost your mood, and make you feel better about yourself.

Where Do You Start?

The last thing you want to do is hurt yourself right out of the gate. Tell your doctor you want to start a fitness program. Ask if you need to take any precautions. They can suggest some workouts that are right for your health and fitness level. For example, you should probably stay away from high-impact exercise like jogging at first. The main thing is to just get moving -- any amount of activity is better than none.

Go Slow at First

Start with small steps you can build on. Park at the far end of the parking lot or take the stairs. Try 10-15 minutes of physical activity every other day and see how you feel. Be sure to rest when you need to and listen to your body. Gradually work up to 30 minutes to an hour of moderate exercise, 5 days a week, plus two sessions of resistance or strength training. This is the amount of exercise that experts recommend for adults.

Check with an Expert

Everyone needs to use good form when they exercise. But it’s even more important when you’re overweight. Extra weight can throw off your center of gravity and change the way you hold your body. It also puts extra stress on your joints. Book an appointment or two with a trainer or physical therapist who knows about weight issues. They can show you the right posture and help you build up your balance so you can exercise safely.

Exercise Options

The best exercise is something you enjoy and will stick with. Try different things that interest you, and see what you like. Remember that a well-rounded program includes both cardio and strength training. Check out the options at your local gym or community center. If you find a class or teacher you like, become a “regular.”  If you’re uncomfortable working out in front of other people, there are lots of DVDs and online programs to try.

Start With Cardio

This is exercise that gets your heart pumping. Walking is one of the easiest kinds. You can do it just about anywhere and anytime, and all you need are comfortable clothes and a good pair of walking shoes. If you have sore joints, try biking, either stationary or outdoors. It puts less stress on your hips, knees, and ankles. So does exercising underwater. See if there’s a pool near you where you can try aqua jogging or water aerobics.

Add Strength Training

Working out with weights or other resistance equipment makes your muscles stronger, and that makes everyday tasks easier. The weight machines at the gym control the way you move and help keep you in the right form. But make sure they’re comfortable and can support you. If you’re not sure how to use the equipment, ask a trainer for help. You can also use free weights, kettlebells, or resistance bands at the gym or at home.

Include Flexibility and Balance

Exercises like yoga, Pilates, and tai chi help build muscle mass too. But they also keep you flexible and build your balance, which can protect you from falls and injuries. And they make it easier to do everyday things like bending over and reaching for things. Balance and flexibility are especially important as you get older.

Use a Chair if You Need It

If it’s hard for you to walk or stand for long periods of time, start your fitness program with exercises you can do sitting down. Remember, any amount of activity is better than none. You can get cardio with chair aerobics or a portable pedal device. Weight or resistance training and stretching are easy to do while seated.

Plan for Success

It may take a while, but if you stick with it, fitness can become a lifelong healthy habit. You may have an easier time staying motivated if you make a plan and track your progress. Set specific, achievable goals you can celebrate, like adding a quarter-mile to your walk or 10 minutes to your bike ride every week. A fitness tracker, diary, or app can help keep you accountable. So can working out with a friend or in a group.

Head Off Setbacks

It’s easy to overdo it when you’re starting a fitness program. Take a couple of days off if you’re really sore. But if you think you’re hurt, see your doctor. Your body will fight to keep the status quo, so don’t be surprised if you feel extra hungry or tired at first. Be sure to fuel yourself with healthy foods.

Take the Long View

A fitness routine is like any habit: It takes time to make it part of your life. Know that there will be days that you won’t feel like working out. Fight boredom by switching up your routine. And if you miss a day or two, don’t stress. Just get back to it as soon as you can. Your goal is to stay active for life.

Gender Gap: 8 Ways Women's Heart Attacks Are Different from Men's

 Women and Heart Attacks

For both men and women, heart disease is the number one cause of death in the United States. Still, there are key differences in how it develops, presents, and is addressed between the sexes.

Heart disease has a major impact on many women’s lives, but awareness about it has typically focused more on men than women.

Smaller Hearts and Blood Vessels

There are differences in male and female bodies that affect how heart disease develops. For example, women have smaller hearts and smaller blood vessels. This difference is significant because sometimes smaller vessels don't show up well on an angiogram — a picture taken of the blood vessels of the heart — so signs of blockages can be missed in some women.

Women also tend to develop heart disease in the smaller blood vessels of the heart instead of the large coronary arteries commonly seen in men.

Risk Factors

Female reproductive health history and heart disease are closely related. Women with endometriosis were found to be three times more likely to develop some form of heart disease than women without it.

Women who develop gestational diabetes during pregnancy or preeclampsia, a complication of pregnancy that causes high blood pressure and places stress on the organs, may also have an increased risk for heart attacks.

Symptoms

Many of the “classic” heart attack symptoms — like crushing chest pain — are based on research done on men. Women may experience chest pain, but may also have flu-like symptoms including:

Nausea

Vomiting

Dizziness

Shortness of breath

 However, almost two-thirds of women who die suddenly from heart disease had no prior symptoms.

Symptom-Mimicking Conditions

Women are more likely than men to develop several diseases that have symptoms similar to a heart attack, like chest pain and shortness of breath.

Coronary spasm. In this condition, a vessel that supplies blood to the heart clamps down. This temporarily constricts the blood flow, mimicking a heart attack.

Coronary dissection. This is when the wall of a coronary artery tears. Patients are frequently women who may not have any history of heart disease.

Takotsubo cardiomyopathy. Also called broken syndrome, this is an inflammatory condition that causes the heart to enlarge after a period of emotional distress.

Some of these look-alike conditions can be less severe than a heart attack, but others are just as dangerous, so it's always important to check with your doctor if you're experiencing any symptoms.

Medications

Women are less likely to be prescribed drugs that control blood pressure or lower cholesterol after having a heart attack than men. Women are also less likely to be prescribed baby aspirin, a medication widely recommended for people with a history of heart attack.

More research is needed to determine why women are less frequently prescribed these guideline-recommended medicines.

Diagnostic Testing

The cardiac troponin test is a common tool used to determine if a heart attack has occurred. This test measures the levels of troponin — a protein that indicates the presence of damaged heart muscle — in the blood.

Medical providers are beginning to understand that women need a lower level of troponin in the blood to indicate a heart attack. If providers are only going off the old standard that looked at results in men, women experiencing a heart attack could be told they are fine because their troponin wasn’t high enough.

Treatments

Women may need a different approach to treatment to get the best outcomes compared to men. For example, women have higher mortality rates for coronary artery bypass surgery, a type of open heart surgery that fixes blocked arteries in the heart. A more conservative approach to treatment may be more successful for some women.

Medical Bias against Women

When being treated for a heart attack, women are more likely to experience medical bias.

There is evidence that physicians may be less aware of risk factors of heart disease in women and some women feel their concerns are not taken seriously.

Foods that Are Bad for Your Heart

 Sugar, Salt, Fat

Over time, high amounts of salt, sugar, saturated fat, and refined carbs raise your risk for a heart attack or stroke. If you’re worried about your heart, you’ll want to keep these out of regular rotation.

But rather than fixate on any one bad food, it’s wise to focus on your overall diet. You can still have these things if you mostly eat heart-healthy fruits and vegetables, whole grains, lean protein, and low-fat dairy.

Bacon

More than half of bacon’s calories come from saturated fat, which can raise your low-density lipoprotein (LDL), or bad cholesterol, and boost your chance of a heart attack or stroke. It’s full of salt, which bumps up your blood pressure and makes your heart work harder. High amounts of sodium (the main part of salt) can lead to stroke, heart disease, and heart failure. Bacon’s added preservatives are linked to these issues as well.

Red Meat

Eating too much beef, lamb, and pork may raise your odds for heart disease and diabetes. It may be because they’re high in saturated fat, which can boost cholesterol. More recent studies point to how gut bacteria process a part of the meat called L-carnitine. Limit your portions. Also, look for lean cuts like round, sirloin, and extra-lean ground beef.

Soda

Having small amounts of added sugar isn’t harmful, but a can of soda has more added sugar than experts recommend for a whole day. Soda drinkers tend to gain more weight and are more likely to be obese and have type 2 diabetes, high blood pressure, and heart disease. And while the science is still fuzzy on diet drinks, some research links them to weight gain and strokes. Your best bet is plain, carbonated, or unsweetened flavored water.

Baked Goods

Cookies, cakes, and muffins should be rare treats. They’re typically loaded with added sugar, which leads to weight gain. They’re also linked to higher triglyceride levels, and that can lead to heart disease. Their main ingredient is usually white flour, which may spike your blood sugar and make you hungrier. Make healthier treats: Swap in whole-wheat flour, trim the sugar, and use liquid plant oils instead of butter or shortening.

Processed Meats

Hot dogs, sausage, salami, and lunch meat are the worst types of meats for your heart. They have high amounts of salt, and most are high in saturated fat. When it comes to deli meats, turkey is better for you than salami because it doesn’t have the saturated fat. But it still has a fair amount of sodium, so it isn’t as heart healthy as fresh sliced turkey breast.

White Rice, Bread, and Pasta

Rice, bread, pasta, and snacks made from white flour are missing their healthy fiber, vitamins, and minerals. Refined grains quickly convert to sugar, which your body stores as fat. A diet high in refined grains can cause belly fat, which studies link to heart disease and type 2 diabetes. Try to get at least half your grains from whole grains like brown rice, oats, and whole wheat. When you shop, look for the words "100% whole grain."

Pizza

Pizza can be healthy if you make it the right way, but most take-out pizza and frozen pies have staggering amounts of sodium, fat, and calories, all of which can raise your risk of a heart attack. When you order out, opt for a thin crust (whole wheat if possible), ask for less cheese, pile on the veggies, and skip the pepperoni or sausage, which are loaded with salt. For the most heart-healthy pizza, make it yourself.

Alcohol

Moderate drinking won’t harm your heart unless you have high blood pressure or high triglycerides, a type of fat in your blood that can boost your odds of heart disease. Heavy drinking, on the other hand, can lead to high blood pressure, heart failure, strokes, and weight gain. So if you don’t already drink, don’t start.

Butter

Butter is high in saturated fat, which can raise your bad cholesterol and make heart disease more likely. You're better off to replace butter with olive oil or vegetable oil-based spreads, which contain heart-healthy mono- and polyunsaturated fats. If you have high cholesterol, a spread with stanol is even better. Regular use can help lower your LDL cholesterol levels.

Flavored, Full-Fat Yogurt

Yogurt can be a super source of nutrition. Eating it regularly might protect you from high blood pressure. But watch the kind you buy. Flavored yogurts are full of added sugar, with its links to weight gain, high blood pressure, inflammation, and heart disease. For the healthiest choice, get plain low-fat yogurt and add your own fresh fruit, cinnamon, or vanilla for flavor.

French Fries

The deep-fried potatoes from restaurants and fast-food places have lots of fat and salt, which is bad news for your heart. One study found that people who ate French fries or hash browns 2 to 3 times a week were more likely to die early. If you indulge, get the smallest portion possible or split your order. Even better: Make your own oven-baked fries with heart-healthy olive oil. They’ll be even better for you if you use sweet potatoes.

Fried Chicken

Deep-frying chicken adds calories, fat, and sodium to an otherwise healthy food. Studies have linked fried food with type 2 diabetes, obesity, and high blood pressure -- all of which raise your odds of heart failure. For a crispy but healthier choice, bread skinless chicken breasts in whole-wheat flour and bake instead of frying.

Canned Soup

Soup can be an easy way to get more vegetables, protein, and fiber. But watch out for unhealthy ingredients. Canned soup often has lots of sodium, which can cause high blood pressure, heart attack, stroke, and heart failure. And any cream-based soup has unhealthy saturated fat. The healthiest way to enjoy soup is to make it from scratch with a low-sodium broth. If you do buy prepared soup, check the label for the least salt and fat.

Ranch Dressing

The main ingredients of this popular dressing are typically buttermilk, salt, and sugar. This makes it high in fat, sodium, and calories. None of that’s good for your heart. You can make a healthier version of your favorite creamy dressings by blending low-fat sour cream or cottage cheese with low-fat buttermilk and fresh herbs like dill, tarragon, or chives.

Ice Cream

Ice cream is high in sugar, calories, and saturated fat, so save it for a special treat. Eating foods loaded with fat and sugar leads to weight gain. It can also drive up your triglycerides and lead to a heart attack. Cut your calories and fat by choosing sorbet, low-fat or nonfat frozen yogurt, or frozen fruit bars. Check the label for the least amount of sugar and saturated fat.

Potato Chips

Potato chips are one of the foods that contribute most to weight gain. And not only are they loaded with saturated fat, but they’re also covered in salt -- which is also linked to heart disease. Skip the lower-sodium or low-fat potato chips. They’ll just leave you hungry again. The most nutritious snacks combine healthy proteins, carbs, and fats, like whole-grain crackers with low-fat cheese or homemade popcorn tossed with olive oil.