Morning Coffee

Last nights review on kneecap saving exercises

FALLING... A CONFESSION

CONFESSION ON FALLING                                                                                                                                                            

When I hit the ground, my first thought was: My life is over. 

Coming out of a shop, I had fallen forward at the curb.  Maybe my cane,  bag and my purchase had helped to break the fall.   A little woman insisted on helping me up and going with me to the car.

I drove myself home.

I was surprised to get up and drive.  (After all, in the American press, when older women fall down:   its assumed that parts are broken).  

 At home, did all the regular things;  there didn’t seem any broken bones and really no pain, considered a doc appointment, put veggies in the microwave. 

Had some good thoughts:  I've  had  two bone scans in TX , had an x ray when the other knee bucked, and I am on Prolia, which was credited for putting new bone on one hip.  

 You can guess the next part:  I got on line with the same med groups I’d consulted the previous week.  Re-checked the gluts exercises and decided to cut way down the amount of heavy groceries and things I would carry for a while. Keep some padding under the feet.   And lay off climbing stairs for now.  Looking for specifics on some gluts exercises found on line.  And exercise more but gently.

And the doctor gave me a week, said then if I wasn’t okay,  a cortisone shot, though he knows my feelings on steroids. I didn't need the shot. He doesn't  give me the "as we get older" sermons. --one reason I like him.

Why had I thought my life was over? Because of the news being full of "Reasons one must keep an older relative from doing anything for fear of a fall that will break many bones."  But my doctor, my friends, and my family have let me be normal, did  not panic,even sent me to get one person's meds, and live life.  Bless them all.

What has changed.  

I’m even more careful to buy less food and carry less  heavy things at one time.. But I still don't exercise gently but enough. 

 Should I be afraid to cross the street?   I've always worn sunglasses if needed, as I’m sure you do.    My reflexes are well above average for people younger than I am. Still... 
.
I have lost my loving enthusiasm for walking here at night, at least for now.  Even with a big flashlight, the sidewalk seems much more uneven than I remember, so I don't feel comfortable.  Better do the hated indoor walking for a while.  Changes, even temporary -  may be sad.

 Will I always be a bit afraid of falling?  Maybe just the right amount.

I wish you health.

   

NO, IT WASN'T A TEST FALL!

OCTOBER 14, 2019      

                          

 NO, it wasn’t a test fall!

I fell last week a few minutes after my lovely pedi and calf massage.

RESULT– Both knees banged; the knee that had already been X-rayed for buckling is now on my mind every few minutes.  The cost – at least two doctor visits so far 

And of course making me feel dumb. (Lately I’d been worried about some lumpy places in the street at the doctor’s office.)   Then a second of not watching the floor in a shopping center, and down I went!

 Treatment:  SO, back to the doctor.  I’m able to do my walks around here.  And I still do my little
exercises for my gluts. (Ask me about them.)  But I’m so aware of the knee that had buckled before….so is the Doctor.

And awareness of my body weight and what I lift or carry..   Just in time:  

Some math from Mayo Clinic reminded me to concentrate more on what I have already been doing:     “Lose weight. If you're overweight, each additional pound you carry translates to another 4 pounds of pressure on the joints.” (bold mine)  I had never realized that included knees.

Dr. Lars Richardson, an orthopedic surgeon with Harvard-affiliated Massachusetts General Hospital says, "Getting your body mass index [BMI] to a healthy range will make your knees feel better,"    Have you ever looked up your bmi (body mass index)? It’s easy; instructions on line.

I still get those three vegies plus salad every day.  I even refused to eat cheese for two weeks. Weight and water are looking better.  Hope it’s helping the knees.

)  Forecast: I need to return something to the store where I fell, but much later.  Scared!

    Tomorrow if the left knee isn’t feeling perfect, Dr. wants me back for cortisone shot.

I wish you health and days of paying close attention!

FALLING: NOT THE LAST WORD ON KNEES

True, I do want my knee to get better.  And maybe the almost important reason is:


I want that knee and all it includes to help

keep me from falling!

FALLING Don't Shoot the Throw-rug

 Rug story:    

During WW2,  Mom and Grandma sewed badly-worn clothes into long strips and sent them to a woman who made throw rugs.  We needed several for our kitchen and its long hallway.  

Two women and sometimes Daddy doing all kinds of work with scrub water and dangerous boiling water from cooking, and steaming water from pressure cooking. There was danger.  And then I learned to cook. Why do I tell you this?

Because no one fell down. 

Why not?   What worked?  

Usually sensible adults…  

Mostly, they had fewer distractions, no tv, phone on wall, one radio on each floor. Wet linoleum had newspapers on it to avoid slipping. No dogs in house.

Big safe feature: carpet in the rest of the  of house including stairs , and sturdy rubber mats on basement stairs and in the laundry and chicken-cleaning room. 

Then the world invented new hazards. TV in so many places you might sit on it by accident.  Stuff we want is in pictures on the new phone.  New, pretty (and sometimes slick) floors in kitchen and bath. Shoes;  Comfy (maybe), pretty, desirable but rarely safe shoes for ­­­­both sexes worn all day for everything.  

 We are moving oftener, for jobs or better schools, or whatever.  So rugs may be practical.

In the last 15 years, no apartment was desirable without nice wood or faux wood floors, despite noise from rooms with area rugs (including noise of people falling.)     

Nobody checks  pretty floors for safety. Luckily, my apartment has carpet.  

                                       SO HOW DO WE AVOID FALLING?

Balance IS NOT A GUESSING GAME: 

At my request, my MD found a very detail-oriented Physical therapist who first tested to make sure I have the levels of balance to help protect from falls everywhere at home. He was strong enough to catch me when I barely passed the test. Then he cheeked even stepping off curbs en route to the coffee  shop. .)  By the way, I was trained in acute rehab for stepping off curbs; if we don’t practice, we have to learn again.

He walked with me, even on a grassy area to see how I do.  (I would like more work like that, since some grass area is lumpy between me and Starbucks  

He also checked my gait.  (You need someone who KNOWS how to do that, not just someone who works in a foot doctor’s office.)  My gait varies a lot so I need to (have to say it) practice and pay attention to it.

My REFLEXES are surprisingly good.   Any idea how yours are?

SHOES Guys are silly as women about shoes.  I no longer wear heels – a slight  wedge on my Clarks.(once, a senior female relative pitched a noisy fit in a store about giving up fashion heels.)  Don’t be her.

    We listen if someone tells us we’re not being careful.­­   We can learn to pay attention as we  move around.

It isn't easy.  It doesn't feel young and capable.  We have to.

         

BONES - Care and feeding of

Tomorrow is my oncologist apptmt. (I really like him.)   Prolia is bound to enter the conversation. Two days ago I gave billing office entire Medicare deductible for year for Jan. Prolia inj.

I hate the things I don't know about Prolia.

   I don't know if the people referred to my dentist for ONJ were taking Prolia or the pills
   I don't know if Prolia is even strengthening my bones, since I haven't had another scan
   I don't know if science has learned more about possible effects on the rest of my body
   I don't know if there's more research since the 2012 NCBI article I've saved
   Have enough women been saved from fracture?

  I don't know whether to have the next Prolia injection.  I'm sure Dr. will want me to.  He doesn't want me to fall and break a bone.

Speaking of falls:  Mayo Clinic has put out much info on balance problems. They focus a lot on inner ear problems, and their balance team.  Physical therapy has done me much good without a team.
Balance problems can make me fall, and Prolia may/may not keep a bone from breaking.

OTHER THINGS MAKE ME FALL and RISK BONES

Culprits:
Muscle relaxant pills and strong pain pills
Dehydration fainting.  911 tech made me drink a bottle of water
Bad sandals with soles that's won't let me turn on smooth floors - almost fell
Bad shoes poorly made - my feet slide around in them or out of them
A little vertigo getting out of bed or off exam table at times (but I haven't fallen)
Mild vertigo but I haven't fallen if I suddenly look left and down.
Careless motorists (some but not all young) backing up without looking
Sudden changes in sidewalk or street or hallway floor level.
Sitting way too long and getting up stiff

Solutions:
A cane hooked on the nightstand for night walking
A chair near bed holds my flashlight
Some neat sox with extra padding if shoes seem too loose some days
Giving up wearing heels.
Remembering to pick up my feet since I need  a "throw" rug in kitchen door
Using the railing on stairs
Not using stairs when a heavy bag unbalances me
Shout if necessary, bang on fender when careless motorist backs toward  you
Walk as PTh told me - weight on f'wd heel, feet not too close together


A very smart lady lawyer  once said in an article on falling:

The worst cause of falls may be the FEAR of falling!

I'm sure that's true, because physical therapy had to cure my fear of going down stairs.

I wish you health.

WHY I FELL - The Risk The Doctor May Not Mention

Many decades ago, a doctor wrote a scrip for Great-Aunt Blanche:  Buy a case of Vernor's Ginger Ale.

They couldn't really afford the gas they burned to drive across the state line to a Vernor's distributor, but at least she had something important to talk about for weeks:  Dehydration.

I remembered that story a few years ago at work, when a fabric rep refused my offer of coffee: "I only drink it in the morning now; coffee is just too dehydrating - it ruins your skin."  (And his skin is fine, worth pampering.)

Not too long after that, at a company outing to a fabulous evening open house, I suddenly felt weak, sunk gracefully to the sidewalk, and passed out for a few seconds.  I was outside in crisp, cool air and hadn't had any symptoms before I fell. The fire dept. EMT made me drink a bottle of water; I got up and walked to the car with no more symptoms.  Turns out half a tiny plastic glass of wine had been no protection against dehydration.  You'd think I would learn.

My writing ritual was always a cup of coffee right next to the computer (part of my inner image as the busy writer, or at work, the busy computer jockey.)  But I don't have the habit of drinking enough water.

Fast forward:  A couple of weeks ago, I felt a bit dizzy and tired at the keyboard, put head between the knees, and all.  Suddenly I knew:  dehydration..  Since my recent bout with pre-diabetes, ginger ale is not an option, so I drink all the coffee I want instead of the water I need. Adding my green tea from the dental protection regimen should make me drink even more water.  Ugh.

I was lucky to have those symptoms.  Aunt Blanche apparently didn't notice symptoms, but her doctor did.  (One thing I'm learning; different writers from the same big hospital may have slightly different opinions on a subject like dehydration.) Alas, several of them agree that getting older may add to the danger; we may not notice thirst and may not eat foods that bring in moisture.

Today I learned that dehydration could also be a factor in my (expletive deleted) chronic eyelid disease!
http://www.bopss.co.uk/public-information/common-conditions/blepharitis/

Why am I telling this:  With summer ending, school will start, days will get colder in most places. Coffee is warm and kind while water is just ... water.  Grownups will head to a place with hot coffee. We will forget summer warnings to drink enough water.  We may get dehydrated from so much caffeine.  Osteoporosis, taking more medicines than usual, or just being sick may increase our danger of falling.

Writing this really makes me want more mid-morning coffee,  It should come with a glass of water. Secretly, I'm buying bottled spring water, but so far not putting it in the coffee maker.  The big pint-and-a half bottle makes me aware of how much I drink.  Or don't.  I need to get some squatty little water bottles that fit perfectly under the dash in my car.  And I must not keep them in the fridge - a splash of icy water on my leg when I brake could cause problems at least as bad as dehydration.

As for the day recently when I felt a bit dizzy at the computer..(and my need for noon naps):
https://medlineplus.gov/dehydration.html#summary:

" Signs of dehydration in adults include

• Being thirsty
• Urinating less often than usual
• Dark-colored urine
• Dry skin
• Feeling tired
• Dizziness and fainting"

And of course, I'm in TX so summer warnings still apply.