Food & Drink

What’s Up With Water??

water pouring 51sGzvGJ7aL

How much water should we be drinking to stay healthy and hydrated? My husband and I were talking the other day about needed areas of improvement in managing our health. We both agreed that water intake tops this list! How much water should we drink? How much water should you drink? There are a few schools of thought/recommendations about daily water consumption that we hear from the healthcare community as well as from friends and acquaintances: 8 x 8 oz glasses, ½ your body weight in oz, always having a water bottle handy to hydrate all day. Which to follow??? Perplexed by suggestions, I decided to research this topic. Below is a summary covering… the medical community’s recommendation, children & elderly – hydration as you age, the benefits of staying hydrated, and dangers of being overly hydrated. Key take aways… every BODY is different, the amount of fluid needed to maintain hydration is individualized, and the solution is as simple as 1, 2, and 3!!

Daily water consumption – what the medical community has to say.

The amount of water we need depends on individual needs and circumstances, including activity and climate. The healthy body naturally maintains a well-tuned balance of fluid, and the thirst mechanism tells us when we need more. Water: Do we really need 8 glasses a day?

Daily recommended water consumption should not be based on an equation. It is…individualized. There are important considerations such as level of activity, sex, age, pregnancy, athlete, body mass as well as health status and existing medical issues/current medications. In addition, water is consumed in ways other than what comes out of the facet (or water bottles). A great chart listing water rich foods provided by Medical News Today, in their article…Water, Do We Really Need 8 Glasses A Day?  You can also view this chart by clicking… Chart of Water Rich Foods.

You don’t need to rely only on what you drink to meet your fluid needs. What you eat also provides a significant portion. For example, many fruits and vegetables, such as watermelon and spinach, are almost 100 percent water by weight. Water: How Much Should You Drink Every Day – Mayo Clinic 

Today, the Centers for Disease Control and Prevention (CDC) say, “There is no recommendation for how much plain water adults and youth should drink daily. However, there are recommendations about total fluid intake from all sources.” Water: Do we really need 8 glasses a day?

The medical community offers a few simple suggestions to determine if you are properly hydrated in 3 easy to remember steps; thirst, urine, and symptoms.

  1. Are you thirsty? The body signals when your body needs more water. When I eat a meal that has more sodium then what I am used to, my body needs water!! I’m thirsty! When I’m under stress, hiking, working out, or rolling through The Fascianation Method, I get thirsty! When expelling more energy and experiencing excess perspiration, have a water bottle handy to stay hydrated.
  2. What color is your urine? When properly hydrated, urine should be colorless or very light yellow and clear. If it is not, increase water consumption starting with an additional daily glass or two. Let the color of your urine guide you.
  3. Symptoms of dehydration? Your body gives off warnings such as lightheaded, confusion, headache, nauseas, fatigue, shaky along with infrequent urination and dark urine. Just one of these symptoms and your body could be telling you fluids are needed. Being at high elevation, under physical stress because of strenuous exercise/activity, or sweltering in hot weather temperatures require more than your typical fluid intake. The same applies when sick with the flu or fighting an infection, including urinary tract infections (UTIs). In these situations drink sport drinks (not to be confused with caffeinated energy drinks), Coconut Water, Propel or Gatorade to replace electrolytes. Dehydration, Mayo Clinic

 Good habits to maintain hydration? Mayo clinic guidelines:

  • Drink a glass of water or other calorie-free or low-calorie beverage with each meal and between each meal.
  • Drink water before, during and after exercise.
  • Drink water if you’re feeling hungry. Thirst is often confused with hunger.

Hydration guidelines for children and the elderly? 

Children and the elderly are at greater risk of dehydration and over-hydration, otherwise known as Hyponatremia, when the body’s blood sodium levels become diluted. The recommendation is to minimize juice for toddlers and children and instead, keep a fresh pitcher of water available. Medical News Today provides an outstanding chart covering infants through to adult, with elderly guidelines about total fluid intake. CLICK this link and scroll through to the category that aligns to your information needs. Water: Do we really need 8 glasses a day?

Elderly, when well hydrated, have been known to experience less confusion, fewer falls, regular bowl movements and fewer incidences of bladder cancer in men. The recommendation for this population is to consume total fluids, water and foods, spread-out through the day. Dehydration can quickly lead to UTIs, confusion, kidney failure and slower healing of existing wounds. Total fluid need for this age group may not require special consideration, having to consume more or less. A study conducted, Water balance, hydration status, and fat-free mass hydration in younger and older adults, compares healthy young adults with older adults in a comprehensive water balance study. The conclusion notes the results of this comprehensive water balance study in younger and older men and women suggest that chronologic age does not compromise the ability of an apparently healthy person to consume sufficient water to maintain hydration status.” Elder care must, however, consider health status, medications, activity level/sedentary, compromised kidney function, and if a diagnosed diabetic. Family practice physicians and certified nutritionists, understanding geriatric care, can best guide elderly patients as thirst may not always be an accurate means to determine their fluid requirements. This is especially true if inactive or having difficulty expressing needs. Fluid intake for this age group is, therefore, definitely individualized.

Benefits of hydration?

When you are well hydrated you are providing your body with enough fluids to function properly.

  • clearer thinking
  • balance – mind (mood) and body
  • regulates body temperature
  • removes body waste (Facianation Method – move that fluid!)
  • protects spinal cord and body’s tissues, including fascia
  • increases metabolism

According to two studies, drinking 17 ounces (500 ml) of water can temporarily boost metabolism by 24–30%. Does Drinking a Lot of Water Help You Lose Weight? Healthline

Over-hydration (Hyponatremia) warning?

If you are getting too much fluid, especially more than 34 oz in 1 hour, you risk diluting blood sodium which then moves fluids inside cells, causing cell swelling leading to serious health repercussions. When fluids exceed what kidneys can process and expel through urination, the result is over-hydration. Athletes have been the group most afflicted by Hyponatremia. Fraternity water hazing, in 2005, led to the death of Chico State student Matt Carrington, 21 years old, from water intoxication caused by brain and lung swelling shared in A Fraternity Hazing Gone Wrong. Yes, these are two extreme scenarios as we are not all athletes or Frat rushing. The examples, though, relay an important message…there are serious dangers of excess fluid intake. What works for one person should not be the guideline for another. Pay attention to balance fluids you need to maintain required hydration. As noted in the medical community recommendations  – drink when thirsty, look at your urine color, and pay attention to symptoms that could be proclaiming…it’s time to replenish. Click this article to read about the symptoms and dangers of drinking too much water…What happens if you drink too much water? Here are a few quotes…

You have a greater risk of developing water intoxication if you drink a lot of water in a short period of time. The risk is less if you drink the same amount over a much longer period of time.

The kidneys are capable of excreting up to 7 gallons (28 liters) of fluid per day. However, they cannot excrete more than 1 liter [33.8 oz] per hour. Therefore, drinking more than this is not a good idea. 

To maintain healthy hydration levels, follow the three-step approach; thirst, urine color and watch for symptoms that could be telling your body…it’s time to replenish. The water consumption of others should never be the goal for your own. Water volume consumed should be considered with total fluid intake of water rich foods, such as fruits and vegetables. Other beverages are also suitable; herbal teas and coffee (hot and cold), milk, carbonated waters such as Perrier, and sodas. Fruit Infsued Water Pitcher._SL1500_ Remember, caffeine is a diuretic, which will quickly flush out body fluids. Soda, is not the healthiest of choices. If you find water difficult to consume, as I do, find a product you enjoy. Coconut water, Nestle SPLASH and Propel have become my go-to means of hydration. Add freshly squeezed lemon juice to hot or cold water for a splash of flavor. Include fruit to water using an infuser, such as the Fruit Infuser Pitcher which has a funnel to flavor your water! Click HERE for a reasonable priced one with great reviews on Amazon. What’s up with water? Discover your individual hydration needs with a balance between fluids and foods that works best for you! Cheers to healthy hydration!!

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Life Lesson

Keeping It Simple…organizing emails so they’re seen!

REPLY email images

Communications can be tricky whether conducting business in a work environment, managing family affairs, or participating in everyday social interactions. This is especially true when we depend on smart phones to align communication needs with our  “busy-on-the-go” lifestyles. Technological advances and savvy tech updates meant for good can sometimes upset our “comfort cart“, complicating life rather than simplifying.

A perfect example of this is email threading on iPhones. This email organizing function combines messages with the same subject from different people, viewed under one heading, with the oldest email shown first. When responding to volume emails organized by subject, you might discover you didn’t reply to the most recent received. When this feature was first introduced, I admit, being confused about its purpose and benefits. This past week I experienced how email threading can cause confusion and lead to emotional distress, not quite reflecting effective or efficient communications. Am I the only one who feels this way? After a quick Internet check I’m in good company with Hoda Kotb, TODAY Co-Host, who feels the same way! I’m just a little behind the times discovering the frustrating side of emailing threading

You know when you’ve upset Today Show co-host Hoda Kotb that you’ve crossed a line. That’s exactly what Apple did by changing up threaded emails in iOS 10’s Mail app, which has people across the internet befuddled. What’s with all the scrolling to read messages? Why is the oldest message on the top of the thread? I know it’s perplexing, but these annoyances are easily fixable—and if you want to disable Mail threading altogether, you can do that, too. How to fix threaded emails in Mail on iOS 10.

How can email threading lead to problems? 

  • It’s easy to miss emails when “incoming” messages are hidden in threaded groupings along with those previously received. The result can leave you feeling out-of-the-loop and misinformed.
  • Oldest email is shown first on threads, which requires extra work scrolling for the most recent email (even with the blue dots!). This is especially true for subjects that generate high volume responses.
  • Email replies can reflect assumptions rather than facts when you are not in sync with that, of which, has already been accomplished and/or decided. This elicits more emails for clarification, time consuming and CONFUSING!!
  • There is a risk that you could address a concern to the wrong person in the email thread. OUCH!! 

How to revert back to individual email viewing? Easy!!

Go to: Settings…Mail…scroll to Threading category. Under THREADING…

CLICK OFF:fullsizeoutput_52a1

  • Organize by Thread
  • Complete Threads

CLICK ON:

  • Collapse Read Messages
  • Most Recent Message On Top

If you are experiencing other issues organizing email on iPhone, iPad, iPod Touch…you might find this resource helpful… Find and organize emails on your iPhone, iPad, or iPod Touch.

In our modern world of seeking better, faster, clearer and more efficient, I am grateful to the technology companies who provide options to disable updates. What works for some definitely doesn’t work well for everyone because we all have our own concept of ideal organization. You, however, can prevent that awkward feeling as if you’re walking through the FUN HOUSE of crazy mirrors, struggling through distorted communications because of missed incoming messages. Consider changing your email settings as I have successfully accomplished on my iPhone. It works! And… I’m feeling quite good having something in common with Hoda Kotb, who tweeted, “Is anyone else pulling their hair out over iPhone update when it comes to reading emails? Huh?? #scrollscrollscroll 

Resources

 

Life Lesson

Fascianation Discovery! Redirecting the trajectory of your health and well-being!

Healthy Life...Healthy Mind

This past June, after boarding a plane heading to California, I experienced a failed attempt to place carry-on luggage into the overhead bin. My right hand simply collapsed from lack of strength and pain. After a few more attempts and a growing line of anxious passengers, a gentleman across the isle offered to help. When I finally settled in my seat, I began to obsess about what the problem could be. The lower part of my right palm and alongside my thumb has been sensitive. To suddenly lose the ability to lift luggage, however, is deeply concerning.

Returning home a week later, I began to consider next steps for medical diagnosis and treatment. During this time I also decided to try out a new class at the gym, The Fascianation Method. I found the class description intriguing…

Do you have pain in your feet, hips, lower back, shoulders or neck? Do you have arthritis, carpal tunnel syndrome, tennis elbow, chronic headaches? You don’t have to suffer! Tight fascia is the root cause of most musculoskeletal dysfunction. Come learn The Fascianation Method of self-myofascial release with Master Trainer, Bonnie Mahler.

After purchasing the The Fascianator Self-Myofascial Release Roller (not to be confused with a foam roller), attending a few classes and home use, the pain was gone. Strength was back. In fact, I forgot I even had a problem!! This class is filled to capacity and hoping for another scheduled time slot to meet demand. It’s obvious word is spreading about how this method of rolling is personally making a difference to many! This blog post shares facts about The Fascianation Method, fascia and its impression on overall health/well being, and why fascia has become a topic of study and discussion within the medical community.

What is The Fascianation Method?

The Fascianation Method was founded by Anthony Chrisco, BS, ACE, NASM PES, a Founding Member of the Fascia Research Society. The Fascianator website (Click HERE) describes this method as total body myofascia release through self-massage rolling. The goal of this method is to stimulate movement of fresh water/fluids through the complex web-like fascia system. By doing so, old fluids do not become stagnant inflammatory waste, which in turn can effect mobility and trigger pain. This method also prevents fascia from drying out, causing stiffness. If the fascia becomes blocked, medical issues can result. Drinking water alone is not the solution. Fascia must be stimulated to direct the movement of water/fluids through our pneumatic system.

Processed with MOLDIV
Processed with MOLDIV

The Fascianator Self-Myofascial Release Roller, available in 12 colors, is intentionally designed in firmness and size (3” diamenter and 20” length) to work specific areas of the body for effective placement and pressure. Do not confuse this roller with foam rollers, which are not firm enough and too large to properly roll fascia. Certified instructors of The Fascianation Method are qualified to guide students for precise roller placement and pressure to stimulate fascia. To prevent injury, avoiding contact with ligaments, joints and tendons is critical!

What is myofascial release (MFR)?

Myofascial release is the movement of fascia fluid through techniques such as myofascial massage or as in The Fascianation Method, a unique myofascial release rolling technique.

Myofascial Release is a safe and very effective hands-on technique that involves applying gentle sustained pressure into the Myofascial connective tissue restrictions to eliminate pain and restore motion. Myofascial Release, MFR Treatment Centers and Seminars

What is fascia and why is fascia maintenance so important??


Fascia and its layers including the interstitium fascia could be the largest organ in our body, replacing skin in this esteemed category. It is the connective spider web-like tissue below our skin. This matrix of collagen bundles and elastic fibers is surrounded by fluid that crosses over our entire body, from head to toe. Fascia is a sheath that binds nerves, arteries, veins, lymph nodes, lymphatic vessels, muscles, bones, organs and joints to support fluid and tissue movement. An analogy often used is the comparison of fascia to the white pulp-like Orange-good-for-health-with-vitamin-Csubstance that appears between an orange skin and the fruit. Fascia can hold up to four gallons of water on average depending on your body size and represents 70% of our nervous system. It encompasses 70 trillion cells! When fascia becomes tight, dry and brittle (preventing fluid movement of fresh water for fascia hydration), 2000 lbs of pressure per square inch can be afflicted on pain sensitive areas causing limiting mobility along with numbness or tinkling. Dry fascia is also where cancer cells can embed. Fascia is 100% sensory and can respond 3 times faster than nerves. The Fascianator, Anthony Chrisco, Founder BS, ACE, NASM PES

What does the medical community say about fascia? 

At the first International Fascia Research Congress in Boston (2007), fascia was broadly defined as:

“… the soft tissue component of the connective tissue system that permeates the human body, forming a continuous, whole-body, three-dimensional matrix of structural support. It interpenetrates and surrounds all organs, muscles, bones,and nerve fibres, creating a unique environment for body systems functioning. The scope of our definition of and interest in fascia extends to all fibrous connective tissues, including aponeuroses, ligaments, tendons, retinaculae, joint capsules, organ and vessel tunics, the epineurium, the meninges, the periosteal, and all the endomysial and intermuscular fibres of the myofasciae.” (Findley and Schleip, 2007). Fascia Research 2015 – State of the Art 

US National Library of Medicine, National Institute of Health, Fascia: a morphological description and classification system based on literature review.

It is difficult to gain an appreciation for the true appearance of fascia, aside from basic structure, in embalmed cadavers. Direct observation of fascia’s appearance and behavior in a living, hydrated body, has been conducted with recent fluoroscopic imaging under the skin of the dorsal forearm, shedding new light on how this sliding collagenous system works. These observations demonstrate that fascia incorporates a water dense vacuolar system able to slide independent of the rate of contraction in muscle around it and able to conduct structures like capillaries throughout sections of myofascia. 

Each region of the body contains multiple categories, suggesting that every region of the body has a complex mixture of different fascial types. To illustrate this concept, the thigh is an example of a body region which contains all four fascial categories: Illiotibial band (Linking), perimysium of the quadriceps femoris muscle (Fascicular), fascia lata (Compression), and subcutaneous tissue (Separating). 

Business Insider,The largest organ in the body may have just been discovered — and it could reshape our understanding of human anatomy with reference to Structure and Distribution of an Unrecognized Interstitium in Human Tissues, Scientific Reports/Nature.com

In between the spaces in our bodies — beneath the skin, lining the gut and lungs, surrounding blood vessels and fascia between muscles, and more — there’s a fluid-filled network of tissue. The idea that there’s tissue and fluid in these spaces isn’t new; interstitial fluid is one of the significant types of fluid in the body, though we didn’t know it was contained in these structures. But the authors of the new study say this tissue has a unified structure and function throughout the body that makes it an organ. Using that definition, it could be the largest organ in the body, taking up a bigger volume than even our skin. This organ might help protect the rest of our organs and tissue. It could also explain the spread of certain cancers, as well as how a number of diseases progress in the body. The largest organ in the body may have just been discovered — and it could reshape our understanding of human anatomy. 

Are there available scientific medical studies to prove benefits of myofascial release?

Yes, however, from the articles and online studies viewed there appears to be consensus that further research and controlled studies are needed for a scientific conclusion about fascia function and manipulation/release benefits on human health, aging and disease. Below are a few quotes…

Conclusions: New hypotheses regarding the role of fascia in musculoskeletal force transmission, mechanoregulation, and neuromuscular control and its dysfunction in musculoskeletal and systemic ailments, including cancer and arthritis, are emerging. Carefully considered research designs and innovative measurement techniques are required, however, to adequately test many of these new hypotheses. There is a particular need for coordinated and well-controlled prospective studies to further advance our understanding of the function of fascia and to enrich the range of effective treatment options. Fascia Research 2015 – State of the Art 

Conclusions: This study demonstrated that massage-myofascial release therapy reduces the sensitivity to pain at tender points in patients with fibromyalgia, improving their pain perception. Release of fascial restrictions in these patients also reduces anxiety levels and improves sleep quality, physical function, and physical role. Massage-myofascial program can be considered as an alternative and complementary therapy that can achieve transient improvements in the symptoms of these patients. Benefits of Massage-Myofascial Release Therapy on Pain, Anxiety, Quality of Sleep, Depression, and Quality of Life in Patients with Fibromyalgia Evid Based Complement Alternat Med. 2011; 2011: 561753.  Published online 2010 Dec 28. doi:  10.1155/2011/561753B

Conclusions: The literature regarding the effectiveness of MFR was mixed in both quality and results. Although the quality of the RCT studies varied greatly, the result of the studies was encouraging, particularly with the recently published studies. MFR is emerging as a strategy with a solid evidence base and tremendous potential. The studies in this review may help as a respectable base for the future trials. Effectiveness of myofascial release: Systematic review of randomized controlled trialsJan 2015 Author links open overlay panel M.S.AjimshaMPT, ADMFT, PhDNoora R.Al-MudahkaPT, MBAJ.A.Al-MadzharPT

Health issues that may benefit from myofascial release?

A summary of health issues that could benefit from myofascial release are listed below,  as noted in Myofascial Release, Problems MFR Helps.

Back Pain, Bladder Problems, Birth Injuries, Bulging Disc, Bursitis, Carpal Tunnel Syndrome, Cerebral Palsy, Cervical and Lumbar Injuries, Chronic Fatigue Syndrome, Chronic Pain, Degenerative Disc Disease, Endometriosis, Emotional Trauma, Fibromyalgia, Herniated Disc, Headaches or Migraines, Infertility, Interstitial Cystitis, Menstrual problems, Myofascial Pain Syndrome, Neck Pain, Osteoarthritis, Pelvic Pain, Plantar Fascitis, Pudendal Nerve Entrapment, Scars (hypertrophic, hypersensitive, painful, burn scars, mastectomy scars), Sciatica, Scoliosis, Shin Splints, Tennis Elbow, TMJ Syndrome, Trigeminal Neuralgia, Vulvodynia, Whiplash

Myofascial Release Risks? Warnings and precautions?

Before you begin any new method of treatment for existing ailments, meet with your physician for guidance. Myofascia release, rolling or massage, may not be a good option if you are currently suffering from burns, recent or ongoing injury, painful open wounds, bone fractures or brittle bones from osteoporosis or osteopenia, deep vein thrombosis or vein issues, and if you are currently taking blood-thinning medications. Possible risks if you suffer from any of these conditions could be fractures, internal bleeding, temporary paralysis or difficulty moving muscles including nerve damage. What Is Myofascial Release and Does It Work? Healthline

Where can you take a The Fascianation Method class?

Be sure to work with a certified instructor for proper use of the The Fascianator Self-Myofascial Release Roller. Do not do begin by watching a video and rolling on your own.  This rolling method can initially be difficult and awkward. Slightly off target placement as well unintended pressure on a joint, bone or tendon could cause injury. To locate a certified instructor in your area, click HERE – Affiliate Listing. If your location is not listed, contact The Fascianator directly (click HERE) and request a referral to your nearest certified trainer. In your email you can reference my certified instructor, Bonnie Lee Mahler, Fascianation Method Practitioner.

Conclusion

I am fascinated by The Fascianation Method! Grateful for cutting edge medical technology that has allowed physicians and medical scientists to view the inner workings of our bodies, LIVE. These visuals have revealed a sheath-like fluid web that connects every cell and all parts of our body. It’s exciting to know the medical community is interested to pursue ongoing research and well-controlled prospective studies about fascia, which could lead to breakthroughs in how medicine is practiced today. In the meantime, I’m inspired to regularly practice the Fascinator self-myofascial rolling technique after personally experiencing the healing benefits. Amazing Fascianation discovery, rolling to redirect the trajectory of health and well-being!

This report is not a substitute for medical advice and treatment. 
Never diagnose or treat yourself or a family member. 
See your doctor. Use your voice. Ask questions. 

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Food & Drink

Mobile Phone App to Organize Healthy Living!

vegetables

Healthy living has been Modify’s theme this year. Various healthcare topics have been explored and what you might want to know has been posted. If you are now inspired to change-up your food selection and menu choices, how are you planning to keep track of life changing information and new recipes??

Modify is about keeping life simple. What is noted below shares how you can easily manage nutritional information specific to your needs, favorite healthy meals and recipes available 24/7 wherever you go and organized for quick access and shopping!! A kale recipe that my grandmother frequently made, is also included in this post. She lived to be just shy of 100 years old, sharp as a tack and walked as straight as a pin! Not able to eat meat because of a severe food allergy, her menu consisted of fresh seafood, vegetables, fruits, eggs and breads. Her weakness was ONE chocolate truffle following dinner each evening, however dark chocolate in moderation has its benefits, too. To strive for the same healthy mind and body as my grandmother, this could be a nutrient-rich lifestyle you consider. Let’s look at how you can plan and organize nutritional choices to give healthy living a good chance for success!

Getting Organized!

These past few months, for me, has been information packed about healthy food choices and new recipes, yet I found myself struggling to find information and recipes when needed! Being addicted to phone apps, I went to the iphone app store and found a gem…Recipe Gallery! This app cost $2.99. It has 3.6 thousand ratings with an average of 4.8 starts and is #17 in Food and Drink. The app is compatible with IOS 10 or later; iPhone, iPad and IPod Touch. If you have a smart mobile device that is not Apple, look through available recipe apps on your mobile app store and check reviews to find one suitable for you. When you discover a great option, it will be worth your search time!

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What I love about this app?

Organization

  • I can use Recipe Gallery pre-set categories and I can create my own.

You can organize recipes by major holidays under one category to include appetizers, menu courses and desserts as well as your favorite holiday drinks!!

  • The categories can be sorted by date added, recipe title or recipe rating.
  • Sort order by A-Z or Z-A.
  • Recipes can appear in more than one category, if you choose, such as Holiday and individually under each actual heading, such as Pastas.
  • Gluten-Free baking can be tricky. I now have a category called, GF TIPS.
  • Wellness Changer/Jeanne Wisniewski created awesome summer videos about nutrition covering a number of topics to proactively manage your health. The information shared can be added as a category, for example, BONE Health, to be reminded of food choices and recipes that can keep your bones healthy! Ditto to be reminded of those foods that cause inflammation under such a category, if inflammation is a concern to you.

Adding Recipes – SO Simple!!

  • You can take a screen shot of a magazine recipe(s) and easily add to Recipe Gallery under your preferred category. A great idea is to create a category titled…NEW TO TRY. When you have time, cook/bake recipes saved in this category and if you love the results place add under the appropriate food heading or delete it. WOW!!! Love this!! No more saving magazines with dog-eared pages, which I can never find when I need it!!
  • There are many recipe saving options on this app. I find Photo Image or copy and paste as a Text Note the easiest. (I wasn’t a fan of the Web Site capture feature, as it doesn’t “capture” everything.) When I copy and paste a recipe using my iPhone and return to the app it will ask…Recipe On Clipboard. Would you like to make this text into a new recipe? When click YES, the recipe is automatically added and the only remaining next steps is adding the recipe title, category and picture. Another WOW!!

Sharing Recipes

Often times someone will ask for a recipe. And, just as often I forget to forward the recipe because I’m not at home at the time of the request or logged on to my desktop. If I add the task to my calendar, forwarding a recipe easily gets overlooked. Recipe Gallery makes sharing so easy! When you click on the recipe, the FORWARD ICON appears. Click the ICON and you have a few ways to SHARE: Share Recipe Gallery Document, Share a PDF, Share or Save Images, Print. I use Share a PDF. The options to share then appear –  Message, Email, LinkedIn, Pinterest, etc. I can now instantly share information/recipes upon request, wherever I am!

Protecting Your Recipes

The app has an informative Tips and FAQs page, which notes that most recipes take less than half of one MB. The app will handle the number of recipes up to the capacity of your iPhone. Recipe Gallery does recommend backing up recipes through iCloud.

Healthy Old World Recipe – Zelje/Vegetable greens

Zelje 10622933_10204965591441810_5971292976352658730_nMy mom was born in Croatia on the island of OLIB, which is located within a cluster of islands in the northern part of the Adriatic Sea. My grandmother, mom, and uncle came to the USA in 1950 to join my grandfather who was already in San Francisco working to make a living for his family. Fortunately, many old world traditions accompanied them to America and Zelje is among one of the recipes that continues to be shared with family members and younger generations. This dish can be made with collard greens or kale. We make it with kale. If you purchase fresh, the ideal kale is flat leaf that is stripped from the spine, finely o9JTRvg9T%KVZNgSyjiFsQchopped, and placed in boiling water with a teaspoon of baking soda to make the leaves tender and green. I found a simple way to make Zelje using frozen kale already finely chopped. Click Zelje for the PDF recipe.

How healthy is kale?

Kale is a great source of fiber, K12 and Vitamin A, rich in many vitamins and minerals, including IRON. Kale is also low in fat, sodium, and calories. When compared to spinach, kale does perform equally as well and slightly better in value across the nutritional board. Kale vs Spinach: Which is Healthier gives a good comparison of the two types of powerhouse greens.

As with everything, balance is the key. Kale is so rich in Vitamin K that if taking blood thinners one can be at risk for blood clots, so…speak to your doctor before consuming kale daily or changing your daily diet to be rich in leafy greens.

Warfarin, the main medication prescribed to those with a history of blood clotting disorders, works by specifically decreasing the amount of vitamin K in the body, thus lengthening the time it takes for a clot to form. Eating large quantities of food especially high in the vitamin [K] can reverse this affect and put patients in danger for experiencing a life-threatening blood clot. Kale has one of the highest amounts of vitamin K per serving size available naturally, but spinach’s vitamin K levels are also impressively high. Battle Of Superfoods: Which Is Better For Your Health, Kale Or Spinach? Jul 20, 2015 08:00 AM By Dana Dovey, Medical Daily 

Best intentions for healthy living can go by the wayside if we don’t have a simple and efficient means of acquiring, saving, and retrieving information. Recipe apps easily organize nutrient-rich food choices and recipes for healthy living to be possible and consistent to all those using mobile devices. Whether at home, traveling, gathering at neighboring homes or family get-togethers, your favorite menus are one click away to view and share. It is so easy to access and share your favorites, saving time from filtering through your desktop files or digging through recipe cards and old magazines. Begin today and make life simple, building your menu gallery! You can start by adding Zelje to your repertoire. Enjoy!!

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Life Lesson

Prescription and OTC medications impacting mental clarity?

Presciptions & OTC Impacting Mental Clarity?

This report is not a substitute for medical advice and treatment. Never diagnose or treat yourself or a family member. See your doctor. Use your voice. Ask questions and share prescription concerns, if any, with your physician. 

Two weeks ago the blog posting Gut Health and Antibiotics…what you might want to know revealed certain antibiotics that could trigger neurological issues, such as delirium among the elderly, as sited by Dr. Shamik Bhattacharyya of Harvard Medical School and Brigham and Women’s Hospital, Boston, Link Between Antibiotics and Delirium Strengthened. Last week’s posting, Statin Facts and Dementia Risks? may have put readers at ease, initially believing these drugs could negatively impact memory. Studies revealed NO increased risk of dementia when taking cholesterol reducing drugs! The question remains, which prescription and over-the-counter (OTC) drugs could pose a higher risk of memory loss?

The following summarizes prescription and OTC drugs, after being evaluated in controlled case studies and concluded a higher risk of memory loss.

The conclusion of case studies conducted to date have not been part of Random Controlled Trials (RCT) according to Harvard Health, Two Types of Drugs You May Want to Avoid for the Sake of Your Brain. Studies, therefore, have yet to prove pharmaceutical and OTC medication risks for memory loss, dementia and Alzheimers conducted within RCT.

What was discovered?

In two separate large population studies, both benzodiazepines (a category that includes medications for anxiety and sleeping pills) and anticholinergics (a group that encompasses medications for allergies and colds, depression, high blood pressure, and incontinence) were associated with an increased risk of dementia in people who used them for longer than a few months. In both cases, the effect increased with the dose of the drug and the duration of use. Two Types of Drugs You May Want to Avoid for the Sake of Your BrainHarvard Health

 Which two population studies?

  1. BenzodiazepinesBenzodiazepine use and risk of Alzheimer’s disease: case-control study, British Medical Journal Sept 2014

Conclusion:  Benzodiazepine use is associated with an increased risk of Alzheimer’s disease. The stronger association observed for long term exposures reinforces the suspicion of a possible direct association, even if benzodiazepine use might also be an early marker of a condition associated with an increased risk of dementia. Unwarranted long term use of these drugs should be considered as a public health concern.

  1. AnticholinergicsCumulative Use of Strong Anticholinergics and Incident Dementia A Prospective Cohort Study, University of Washington, Adult Changes in Thought (ACT), a long-term study conducted by the University of Washington and Group Health, a Seattle health care system, March 2015

Conclusion: An increased risk for dementia was seen in people with higher use of anticholinergics. Our findings suggest that a person taking an anticholinergic, such as oxybutynin chloride, 5 mg/d, or doxepin hydrochloride, 10 mg/d, for more than 3 years would have a greater risk for dementia. Prescribers should be aware of this potential association when considering anticholinergics for their older patients and should consider alternatives when possible. For conditions with no therapeutic alternatives, prescribers should use the lowest effective dose and discontinue therapy if ineffective. 

Which prescription and OTC medications are included in the above classifications?

A comprehensive chart is provided by Harvard Health listing Benzodiazepines and Anthicholinergics drugs along with possible alternatives. This would be a great chart to discuss with your physician. CLICK this link for the PDF…Two types of drugs you may want to avoid for the sake of your brain – Harvard Health and scroll to the bottom of the article.

Defining the Classifications.

Anthicholinergics drugs block (acetylcholine) the body’s chemical messenger from passing on signals that instruct the body to function, impacting how you feel. Acetylcholine function to the brain involves learning and memory and if blocked, become impaired. To the body, anthicholinergics affect the stimulation of muscle contractions. The following health conditions are treated by Anthicholinergics.

Benzodiazepines slow the activity of brain neurons by making GABA. These types of medications promote sleep or are used to help calm and relax individuals having panic attacks, agitation, or suffer from anxiety. Benzodiazepines treat the following health conditions.

  • Insomnia
  • Muscle spasms and need for muscle relaxers
  • Panic attacks
  • Anxiety
  • Seizures
  • Psychological and neurological disorders

Benzodiazepines are effective for treating a range of psychological and   neurological disorders, due to its effects on the neurons that trigger stress and anxiety reactions. The Benefits and Risks of Benzodiazepines, January 5, 2018, Medical New Today

A team of researchers from France and Canada linked benzodiazepine use to an increased risk of being diagnosed with Alzheimer’s disease. In the study, the greater people’s cumulative dose of benzodiazepines, the higher their risk. The type of drug taken also mattered. People who were on a long-acting benzodiazepine like diazepam (Valium) or flurazepam (Dalmane) were at greater risk than those on a short-acting one like triazolam (Halcion), lorazepam (Ativan), alprazolam (Xanax), or temazepam (Restoril). Two Types of Drugs You May Want to Avoid for the Sake of Your Brain, Harvard Health

Memory loss reversal?

In some cases, cognitive impairment was reversed once the individual ceased taking the drug. However, if the prescription and/or OTC drugs were taken for many years, (perhaps several medications within the Benzodiazepines or Anticholinergics classifications and over the age of 65) reversal of cognitive impairment was less likely. Often times such common drugs and their cognitive memory effects are overlooked and therefore the ability to reverse symptoms by discontinuing the medication does not become a considered option.

What about PPI Proton Pump Inhibitors to treat chronic acid reflux and acid related gastrointestinal disorders?

I have heard rumors that PPIs are linked to memory loss. Is this true?

Conclusion: Proton pump inhibitor use was not associated with dementia risk, even for people with high cumulative exposure. Although there are other safety concerns with long-term PPI use, results from our study do not support that these medications should be avoided out of concern about dementia risk. Proton Pump Inhibitor Use and Dementia Risk

How to reduce the risk of cognitive decline with age?

Living a healthy lifestyle that reflects good eating habits, exercise, mental stimulation, social interaction, and proactively managing cholesterol, diabetes and hypertension can lessen the risk of cognitive decline that leads to dementia. It is, however, being diligent in ALL good habits practiced that can impact mental agility, and not just one lifestyle area. Remember…reading also keeps your mind active and agile as noted in the Modify post article, Be Inspired…Read To Good Health!

The evidence has started to mount that lifestyles can change your risk for cognitive decline and various dementias,” Dean Hartley, PhD, director of science initiatives at the Alzheimer’s Association, noted in an interview with Medscape Medical News. “We are still looking for that full evidence-based information but in aggregate there is a lot of good news. There are things people can do now to lower their risk of dementia and promote brain health. Things like exercise, cognitive training, but also managing comorbidities like diabetes, hypertension and high cholesterol. No Magic Bullet To Prevent late-Life Dementia, Megan Brooks

10 Ways to Love Your Brain by Alzheimer’s Association also lists ways to lower memory loss risks as you age. A summary of this article states; exercise, read/learn, smoke-free, heart health, protect your head from injury, healthy whole food diet, sleep, good mental health, social life, and mentally challenging yourself.

One Third of Dementia May Be Preventable With Lifestyle Change, Sue Hughes, notes…

“Our results show it is never too early or never too late to make lifestyle changes that will make a difference.” This article lists midlife hearing loss, lack of early life education, later life smoking, later life depression, physical inactivity, life social isolation, hypertension, later life diabetes, mid-life obesity, all these factors combined contribute to a 35% risk of dementia.

Can vitamins, supplements, and natural remedies improve memory?

Be careful! Unless you or someone you advocate for is vitamin or mineral deficient, for example as in B12, supplements may not improve memory. A physical examination is necessary along with blood tests that can reveal vitamin and mineral deficiencies, if any. Be sure to avoid duplicity by checking labels and read ingredients listed in ALL supplements taken, as noted in the Modify article Planning for a Healthy New Year? Read Those Labels! Toxicity is possible when taking supplements, especially in the family of B vitamins and Folic Acid. And, just because a supplement may be touted as “natural” doesn’t mean it is safe. Be CAUTIOUS around super supplement claims for mental clarity. Recently, Quincy Bioscience, the makers of Prevagen was sued by two government agencies for fraudulent claims about memory improvement and failing to release reported side effects (…seizures, strokes, and worsening symptoms of multiple sclerosis, which were reported to Quincy Bioscience after the use of Prevagen products. Additional reports to the FDA on side effects of this supplement also included chest pain, tremors, fainting, and other severe symptoms.) The lawsuit was dismissed because…“They [FTC] had no evidence that the claim was not supported, but only showed there was a possibility that the study results did not support Defendants’ claims.” Read about the lawsuit at FDA Law BlogAlso click video titled… Lawsuit claims Prevagen doesn’t boost memoryCBS NewsWhen there is controversy around a supplement, think carefully about taking it and speak to your physician for guidance. Be aware. Be responsible. Be Safe.

Work towards sharpening mental agility as you age and be aware of prescription and OTC medication side effects you are now taking. Speak to your doctor about possible alternative options, if concerned. Although we all would like a quick fix to prevent memory loss, be wary of “too good to be true” supplement claims. To maintain mental clarity the general recommendation is for a healthy lifestyle that includes sleep, exercise, good eating habits such as vegetables, nuts, whole grains, olive oil, beans, fish and poultry. Keep red meat, sugars and fried foods to a minimum. If you feel overwhelmed by nutrition and supplement choices, consider working with a licensed nutritionist to guide you, such as Wellness Changer/Jeanne Wisniewski, Nutritional Therapy Practitioner. Jeanne’s brief yet information packed summer video series shares life changing nutritional choices. Click here for the summer video menu…Wellness Changer Summer Videos. And, add in those challenging mental activities to keep your mind sharp. Read novels that bring you on an enjoyable adventure, a great way to manage life stresses!! A healthy and balanced life and proactively supplementing to meet your body’s needs could negate the need for prescription and OTC medications! Choose a healthy life for a healthy mind!

Resources

Life Lesson

Statin Facts and Dementia Risk?

Brain-picture

This report is not a substitute for medical advice and treatment. Never diagnose or treat yourself or a family member. See your doctor. Use your voice. Ask questions and share prescription concerns, if any, with your physician. 

Recently, whether enjoying conversation in a social setting or small talk among acquaintances (including the recent friendly exchange with a car salesperson during a vehicle test drive!) the subject about statin drugs and its increased risk of dementia frequently comes up. Knowing enough people who are on statin drugs, I decided to research this topic to unveil the facts and connection between memory loss and cholesterol lowering prescription drugs. Do statins cause memory loss? Read below for information about statins and why the short answer to this question is “NO”.

What are statins and when are they prescribed?

Statins are prescription drugs that can lower cholesterol in patients who have been diagnosed with heart disease, at high risk of a heart attack/stroke or whose cholesterol levels (results shown from a blood test) are higher than the norm of below 200 mg/dL, combined LDL and HDL. Prescription statins block the production of cholesterol in the liver, can flush cholesterol already formed within artery walls and reduce blood vessel inflammation lowering risk of blood clots.

LDL (Low-density lipoprotein) is the bad cholesterol that sticks to artery walls contributing to blockage (heart attacks) and clots (strokes). The ideal level is below 130 mg/dl and for those who have suffered a heart attack or stroke, the recommendation is to keep LDL below 100 mg/dl. High risk for heart attack or stroke? Your physician may be looking for LDL below 70 mg/dl.

HDL (high-density lipoproteins) is the good cholesterol that acts as a garbage collector, carrying cholesterol from all parts of your body to dispose/process through your liver. A good HDL level is 60 mg/dl or higher. An HDL level that is 40 mg/dl or less is consider low. Medical and environmental factors can negatively impact HDL levels, such as smoking, obesity, Diabetes II and inflammation. High alcohol consumption especially hard liquor, dessert liquors, mixed drinks high in sugar, beer, and excess wine, can have negative effects; “drinking more than what is considered moderate (daily women 1 glass and men 2 glasses), however, has an opposite effect, because it can raise both cholesterol and triglyceride levels.” Can Drinking Alcohol Affect Your Cholesterol Levels? Healthline

To keep HDL high, choose foods with unsaturated fats, low carbs and low sugar and enjoy a healthy lifestyle that reflects regular exercise, moderate alcohol consumption and smoke free. 11 Foods To Increase Your HDL, Healthline, offers great suggestions. There are some prescribed medications that can effect and lower good cholesterol so especially be mindful of your diet if taking these drugs.

Medication that can effect/decrease HDL…Beta blockers, a type of blood pressure medicine, Anabolic steroids, including testosterone, a male hormone Progestins, which are female hormones that are in some birth control pills and Hormone replacement therapy, Benzodiazepines, sedatives that are often used for anxiety and insomnia. HDL The Good Cholesterol, Medline Plus.

Statins are available in fat-soluble or water-soluble. Noted below is a list of such statin prescriptions available in the USA. How are they different? In a study conducted between the two types of statins… No difference was observed between various clinical coronary artery disease settings. Fats Vs Water Soluble Statins by Gerti Tashko, MD.  

Lipid Statins (fat-soluble) pass through the liver with a greater chance of being absorbed in muscle tissue. There is, therefore, an increased risk of liver damage as well as muscle and joint aches with fat-soluble statins.

Lipid Statins/Fat Soluble – pass through the liver

  • Atorvastatin (Lipitor) – most potent of statins
  • Lovastatin (Altoprev)
  • Pitavastatin (Livalo)
  • Pravastatin (Pravachol)

Hydrophilic/Water Soluble – pass through the body and not the liver

  • Rosuvastatin (Crestor)
  • Simvastatin (Zocor)

Side effects: headaches, nausea, and muscle and joint aches. More serious side effects include: increase blood sugar/diabetes 2, muscle cell damage, cognitive memory loss, liver damage.

What is the connection between statins and cognitive memory loss?

As a result of reports from some consumers claiming cognitive memory loss while taking statins, the FDA (2012) required all statin drug labels to include a warning about the risk of memory problems with short-term statin use. Studies conducted (as shown in the quotes below) reveal no direct link between memory loss and statin use. Other considerations could effect memory, such as; patient age, drug interactions, quantity of daily prescription drugs taken and perhaps taking some prescription drugs that are in fact linked to higher dementia risk reported by conducted studies. If you or a family member of whom you advocate are experiencing noticeable loss in memory, speak to your physician.

A study conducted out of John Hopkins in 2013, Statin Medications May Prevent Dementia and Memory Loss With Longer Use, While Not Posing Any Short-Term Cognition Problems,  concluded “no threat to short-term memory, and that they may even protect against dementia when taken for more than one year.” The study also reveals…”In contrast, they say that when the drugs are taken for more than one year, the risk of dementia is reduced by 29 percent.”

While statin users have reported memory loss to the FDA, studies haven’t found evidence to support these claims. Research has actually suggested the opposite — that statins may help prevent Alzheimer’s disease and other forms of dementia. Healthline, Statins and Memory Loss: Is There A Link? 

Conclusion –  In patients without baseline cognitive dysfunction, short-term data are most compatible with no adverse effect of statins on cognition, and long-term data may support a beneficial role for statins in the prevention of dementia. Mayo Clinic Proceedings, November 2013

How can a statin actually decease the risk of memory loss? Dementia/cognitive memory loss can be the result of blockages in small blood vessels that could prevent blood flow and oxygen to certain areas of the brain. The effect of statins to reduce plaque and inflammation would therefore remove blockages and increase blood flow, reducing memory loss risk. John Hopkins, Statin Medications May Prevent Dementia and Memory Loss With Longer Use, While Not Posing Any Short-Term Cognition Problems

Although memory loss/confusion warnings are listed on the label of statin drugs, studies conducted to date do not support a higher risk of dementia when taking these drugs. The next time you attend a social gathering or are talking with an acquaintance and the concern about statins and memory loss comes up, you have some facts to share. Eliminate fears and enjoy the party!!

Next week’s blog post will discuss common prescription drugs that have been associated with higher risk of memory loss. The drug listing has been compiled after conducted studies and conclusion of risk factors.

Resources

Life Lesson

Gut Health and Antibiotics…what you might want to know

This report is not a substitute for medical advice and treatment. Never diagnose or treat yourself or a family member. See your doctor. Use your voice. Ask questions and share prescription concerns, if any, with your physician. 

The purpose of this blog post is to reveal the reality of antibiotic overuse and misuse. This writing is to also encourage communication with your doctor when antibiotics are prescribed to you or the family member you advocate/share in health care responsibility.

Recently someone dear to me, “Barbara” was tested for a UTI. Barbara did not have UTI symptoms. Her bladder, however, appeared to be on a nighttime schedule with the inability to urinate during the day. The initial urinalysis revealed bacteria in the urine and her doctor insisted she be put on antibiotics ASAP, that day.

On the surface, following through with the physician’s request may appear as the only and best option for the patient. However, digging dipper, this was not the case. Barbara recently had C-DIFF (C. difficile/C-DIFF is a toxin-producing bacteria that causes antibiotic-associated colitis, Mayo Clinic…Antibiotic Associated Diarrheafollowing surgery, which extended her stay at a skilled nursing facility by 3 weeks. She experienced horrific symptoms of both, C-DIFF and the necessary antibiotic treatment. There is a HIGH probability of C-DIFF reoccurring when a patient is prescribed antibiotics, in this case treating a possible UTI. Question to the doctor…Knowing Barbara had C-DIFF a few months ago, can we wait for the full culture results before considering antibiotics??” It is not uncommon for some bacteria to appear in urine, especially in the population 75 years old+. The doctor agreed, stating, “I think that it’s reasonable to wait until the cultures come back, but it looks like a real infection based on the cell counts.” Three days later the culture results indicate…NO UTI.  The doctor emailed…The final urine cultures are back and surprisingly did not grow out any specific bacteria. So I would not give her the antibiotics. I would continue to monitor her symptoms. I would only recheck her urine if she is having symptoms.” If Barbara had a reoccurrence of C-DIFF, a high risk “serious symptom infection” possibly triggered by taking the prescribed antibiotic, she would have had to leave the comfort and familiarity of assisted living (very contagious). The C-DIFF treatment administered would have required admittance to either a hospital or skilled nursing facility, in contact isolation. Life would not have been pleasant for Barbara or her family, the aftermath of being treated for a UTI she didn’t have.

A key lesson from Barbara’s experience, communicate with your doctor. Express concerns by using your voice and take ownership to know options in order to make wise decisions for you and your family. The following shares antibiotic facts, its impact on the elderly and what you can do nutritionally to be “gut healthy” reducing side effects from antibiotics as well as some non-antibiotic drugs, to help prevent superbugs and antibiotic resistance (CDC: About Antimicrobial Resistance).

Full Culture Results 

Whenever possible and with physician agreement, request a full culture before taking prescribed antibiotics.

Antibiotics –How They Work, Classifications, When Administered 

Antibiotics are pharmaceutical prescribed medications administered to heal or slow down the growth of bacteria resulting in infections. Click this link for a complete antibiotic guide and their use…Antibiotics Guide, Medically reviewed on Aug 23, 2016 by L. Anderson, PharmD.

Antibiotics are known by these classes: Penicillins, Tetracyclines, Cephalosporins, Quinolones, Lincomycins, Masrolides, Sulfonamides, Glycopeptides, Aminoglycosides, Carbapenems.

Antibiotics are used to treat these top 10 common infections: Acne, bronchitis, Conjunctivitis (Pink Eye), Otitis Media (Ear Infection), Sexually Transmitted Diseases (STD’s), Skin or Soft Tissue Infections, Streptococcal Pharyngitis (Strep Throat), Traveler’s Diarrhea, Upper Respiratory Tract Infection, Urinary Tract Infection (UTI).

Additional details and supporting information can also be found at… Antibiotics: All You Need to Know by Medical News Today, By Christian Nordqvist, Jan. 2017. Article highlights…

  • Alexander Fleming discovered penicillin, the first natural antibiotic, in 1928.
  • Antibiotics cannot fight viral infections.
  • Fleming predicted the rise of antibiotic resistance we see today.
  • If antibiotics are overused or used incorrectly, there is a risk that the bacteria will become resistant
  • Antibiotics either kill bacteria or slow its growth.
  • Side effects can include diarrhea and feeling sick.
  • In some cases, antibiotics may be given to prevent rather than treat an infection, as might be the case before surgery. This is called ‘prophylactic’ use of antibiotics. They are commonly used before bowel and orthopedic surgery.

Before bacteria can multiply and cause symptoms, the body’s immune system can usually kill them. Our white blood cells attack harmful bacteria and, even if symptoms do occur, our immune system can usually cope and fight off the infection. 

Antibiotic Side effects and FDA Warnings

What are common antibiotic side effects?

Common side effects of antibiotics include rash, soft stools, diarrhea, upset stomach, fungal (yeast) infections (like thrush). Contact your doctor immediately if  you are experiencing; severe allergic reaction that includes difficulty breathing, facial swelling (lips, tongue, throat, face), severe watery or bloody diarrhea or stomach cramps, vaginal yeast infection with white discharge and severe itching, mouth sores or white patches in mouth or on tongue. Common Side Effects from Antibiotics, and Allergies and Reactions Medically reviewed on Mar 5, 2017 by L. Anderson, PharmD.

Your intestines contain about 100 trillion bacterial cells and up to 2,000 different kinds of bacteria, many of which help protect your body from infection. When you take an antibiotic to treat an infection, these drugs tend to destroy some of the normal, helpful bacteria in addition to the bacteria causing the infection. Without enough healthy bacteria to keep it in check, C. difficile can quickly grow out of control. The antibiotics that most often lead to C. difficile infections include fluoroquinolones, cephalosporins, penicillins and clindamycinC. Difficile Infection by Mayo Clinic

Which Antibiotics Are Most Associated with Causing Clostridium Difficile Diarrhea? On the basis of the available data, clindamycin should absolutely be avoided among patients who are at risk for C difficile infection, particularly in elderly patients and those with frequent antibiotic exposure or hospitalizations. Given the available data, it’s clear that clindamycin is a well-deserving candidate of its boxed warning specifically for C difficile risk. Box Warning can be read by clicking this LINK.

Clindamycin is prescribed most often to treat medical conditions as listed in …What Conditions Does Clindamycin Hcl treat?  Other options that have a reduced risk of triggering C-difficile?

For community-acquired pneumonia, it has been suggested that a tetracycline may be substituted in place of azithromycin (or another macrolide) among elderly patients at higher risk for C difficile infection. In fact, data suggests that tetracyclines may NOT increase risk of C difficile infection at all, with a non-significant odd ratio of 0.9 versus no antibiotic exposure.
 
In patients hospitalized with severe infections who require anti-Pseudomonal coverage, the available data suggests that penicillins (such as piperacillin/tazobactam) may have a lower risk of C difficile infection versus cephalosporins (such as cefepime) or carbapenems (such as meropenem). While this risk is certainly relevant to the selection of antimicrobials, local resistance patterns should also be considered when selecting an agent.
 
Knowledge of high-risk and lower-risk antibiotics for C difficile infection is important, particularly in patients who are already at a higher risk for C difficile infection, such as elderly patients. Avoidance of these high-risk antibiotics when other first-line alternatives exist in certain patient populations should be an antimicrobial stewardship intervention for pharmacists to reduce the risk of C difficile infection both in the inpatient and outpatient settings.

Antibiotic Warnings

Fluoroquinolones are antibiotics that kill or stop the growth of bacteria. While these drugs are effective in treating serious bacterial infections, an FDA safety review found that both oral and injectable fluroquinolones are associated with disabling side effects involving tendons, muscles, joints, nerves and the central nervous system. These side effects can occur hours to weeks after exposure to fluoroquinolones and may potentially be permanent.

Types of Fluoroquinolones that are FDA approved but which fall into this warning include levofloxacin (Levaquin), ciprofloxacin (Cipro), ciprofloxacin extended-release tablets, moxifloxacin (Avelox), ofloxacin and gemifloxacin (Factive). FDA updates warnings for fluoroquinolone antibiotics

Non-Antibiotic Drugs and Similar Antibiotic Side Effects

Antibiotics are known to trigger digestive issues and diarrhea, eliminating both the good and bad bacteria in our guts. There are also prescription non-antibiotic drugs that share similar harsh gut symptoms (as antibiotics) such as anti-diabetics (metformin), proton pump inhibitors (PPIs), non-steroidal anti-inflammatory drugs (NSAIDS) and atypical antipsychotics (AAPs). Use the hyperlinks to see the listing of medications that fall within each category.

Non-antibiotics with antibiotic effects – Some non-antibiotic drugs have been associated with changes in gut microbiome composition, but the extent of this phenomenon is unknown. Athanasios Typas and colleagues screened more than 1,000 marketed drugs and observed that a quarter of them inhibited the growth of at least one bacterial strain in vitro. Scrutiny of previous human cohort studies showed that human-targeted drugs with anticommensal activity have antibiotic-like side effects in humans. The new data provide a resource for future drug-therapy research.  Extensive impact of non-antibiotic drugs on human gut bacteria, Published: 19 March 2018

The Elderly and Antibiotics 

UTIs are known to be common among the elderly and often the symptoms are not as visible making it difficult to know when a UTI exists. However, there appears to be a growing problem with over prescribed use of antibiotics especially for UTIs.

Consensus guidelines have been published to assist clinicians with diagnosis and treatment of urinary tract infection; however, a single evidence-based approach to diagnosis of urinary tract infection does not exist. In the absence of a gold standard definition of urinary tract infection that clinicians agree upon, overtreatment with antibiotics for suspected urinary tract infection remains a significant problem, and leads to a variety of negative consequences including the development of multidrug-resistant organisms. Urinary tract infection in older adults, NCBI 

The elderly are prone to UTIs and other infections but are they being treated more often than not when an infection is actually not present? Antibiotics do not treat frequent urination nor does this infer a UTI. Antibiotics can cause serious symptoms in elderly, weakening those that are already frail; fever, rash, diarrhea, nausea, vomiting, headache, tendon ruptures, and nerve damage. Information above about clindamycin specifically refers to the elderly, along with alternative options for infection treatment.

Elderly have an increased risk to antibiotic resistant bacteria, superbugs. 

Antibiotics may help “drug-resistant” bacteria grow, causing illnesses that are harder to cure and more costly to treat. Your doctor may have to try several antibiotics for treatment. This increases the risk of complications. The resistant bacteria can also be highly contagious/passed on to caregivers, family members and others. Antibiotics for urinary tract infections in older people When you need them—and when you don’t 

A study conducted by The Ottawa Hospital Regional Geriatric Program of Eastern Ontario Geriatric Refresher Day, Rosemary Zvor, Antimicrobial Pharmacy Specialist, (Research on Elder infections with charts zvonar_use_of_antibiotics) found an increase exposure within the healthcare system, antimicrobials, along with decreased immune system and functional status resulting in poor hygiene, as well as the increase use of invasive devices and close contact with other residents and medical staff that could be carriers.

Some antibiotics carry specific risks to the elderly. The article Adverse effects of Antibiotics in the Geriatric Patient Population lists precautions to consider, which you might share the elderly patient’s physician, of whom you advocate.

“Elderly patients have several unique issues related to antibiotic therapy. In addition to age-associated physiological changes and drug-drug interactions, adverse drug reactions are also a noteworthy concern specific to this population. 

  • Aminoglycosides-renal and auditory toxicity 
  • Trimethoprim and sulfamethoxazole-induced hyperkalemia and blood dyscrasias
  • Fluoroquinolone-related seizures and QT prolongation 
  • Doxycycline-related esophageal ulcerations & strictures 
  • Acute liver injury secondary to prolonged amoxicillin/clavulanate therapy”

Antibiotics – Impact On Brain Function 

This article, Link Between Antibiotics and Delirium Strengthened by Tim Newman, February 18, 2016, Medical News Today, explores an interesting discovery that “antibiotics are known to cause neurological issues in some cases, but the interaction has not attracted much study in the past.” Among the neurologic issues is delirium, which can include hallucinations, agitation and confusion, especially among the elderly. Since infection and antibiotics both can trigger delirium, more work and research is needed to measure and understand this relationship but something to discuss with physicians. Delirium can increase the risk of death in critical care cases.

“The antibiotics react not only against the bacteria but also have ‘off-target’ effects by interfering with normal signaling within the brain. Different antibiotics affect the brain differently, hence causing varying patterns of toxicity.”

“Dr. Shamik Bhattacharyya, of Harvard Medical School and Brigham and Women’s Hospital in Boston, MA, conducted a retrospective review using historical patient data. He found that links between antibiotics and delirium might be stronger than previously thought.”

Cranberry Supplements – Heal Or Prevent UTIs?

The Mayo clinic gives good advice about cranberry and UTI prevention in the article… Urinary Tract Infection (UTI)

“Many people drink cranberry juice to prevent UTIs. There’s some indication that cranberry products, in either juice or tablet form, may have infection-fighting properties. Researchers continue to study the ability of cranberry juice to prevent UTIs, but results are not conclusive. If you enjoy drinking cranberry juice and feel it helps you prevent UTIs, there’s little harm in it, but watch the calories. For most people, drinking cranberry juice is safe, but some people report an upset stomach or diarrhea. However, don’t drink cranberry juice if you’re taking blood-thinning medication, such as warfarin.”

Good Gut Health! Building a good gut…prebiotics and probiotic rich foods.

Be proactive and select foods that are high in probiotics and prebiotics for good gut health. The more good bacteria in your gut the less chance of bad bacteria that can cause irritating digestive system issues or trigger uncomfortable symptoms often experienced with autoimmune disorders such as Crohn’s, ulcerative colitis as well as irritable bowel syndrome. Can you take a probiotic supplement? Yes. Supplements, however, are not FDA regulated and you can’t be certain that what is listed on the label is actually in the capsule. I choose to follow wise advice given many years ago when I attend a Celiac Disease conference led by Dr. Peter Green. He shared that the body better absorbs whole foods rich in vitamins, minerals and in this case probiotics and prebiotics rather than taking capsules. If you eat right and skip processed foods, you won’t need to spend the extra dollars on supplements. As we get older and appetites wane, supplements may be needed and this is a conversation reserved to take place with your doctor or a clinical certified nutritionist. Also, probiotic dietary supplements may not be safe, as noted in What are Probiotics?, which may pose risks if you…

  • Get infections often
  • Have a weakened immune system
  • Are allergic or sensitive to the sources of the probiotics (dairy, for example)

What are prebiotics? 

Prebiotics, simply put, are food for probiotics. “They’re necessary in order for the good flora to flourish,” says Kristi King, R.D., a spokeswoman for the Academy of Nutrition and Dietetics. 6 Foods That Are Good for Gut Health 

Prebiotics encourage the growth of good and healthy bacteria in your gut. Prebiotic foods include fruits and vegetables that are loaded with complex carbohydrates, fiber and resistant starch that pass through the digestive system, which feed good bacteria and other micorbes. Prebiotic foods include: legumes such as chickpeas, lentils, navy beans; raspberries and blackberries; barley, bran and bulgar (being gluten free I search for whole grain gluten-free breads). 6 Foods That Are Good for Gut Health, Consumer Reports

The lining of your gut, like every surface of your body, is covered in microscopic creatures, mostly bacteria. These organisms create a micro-ecosystem called the microbiome. And though we don’t really notice it’s there, it plays an oversized role in your health and can even affect your mood and behaviorPrebiotics, probiotics and your health

Vegetables offer the best impact for your gut when uncooked to preserve fiber. Cooking transforms the fiber, lowering fiber content. Prebiotic Food List

What are probiotics? 

Probiotics are live culture bacteria which are found in foods or supplements that promote microorganisms for our guts known to benefit our health, body and brain. Probiotics could also benefit immune function and suggested as an aid for digestive issues, reducing the risk of diarrhea with antibiotic use, lessens risk of C-DIFF infection, and aids in food poisoning and stomach virus. Yogurt, such as non-flavored Greek yogurt, is a great source of probiotics and contains on average per serving 100 million probiotics. Simple… eat a serving of yogurt per day! Some yogurts are marked specifically to contain probiotics, such as Activa. Watch sugar levels in fruit flavored yogurts. Other fermented food products known to contain probiotics; kefer, sauerkraut, tempeh, kimchi, miso, kombucha, pickles, traditional buttermilk, nato and certain cheeses. Click Probiotic Food List for information on probiotic rich foods. Some fermented foods do have gluten, so for GF readers…read the labels.

NOTE: Kombucha bottles are not always well labeled to instruct recommended use, at least on the bottle I purchased. Internet checking I’ve seen serving recommendations at 4 oz and not to be consumed daily. The health benefits claimed have not been proven. Many brands contain alcohol and caffeine since it is fermented tea, therefore not for CHILDREN. There have been resulting health issues reported, such as liver damage, and the recommendation is to purchase from reputable sources and pass on homemade Kombucha. Not all Kombucha is created equal so if specifically looking for the benefits of probiotic and live cultures, look for labels with these ingredients noted. Some Kombucha can be high in sugar or use alternative sweeteners such as stevia. Check the label and choose those low in natural sugar. This video by Dr. Oz that aired Feb 2018 is a great resource about Kombucha in a comparison study to other food products rich in probiotics, titled, The Hype Behind Probiotics and Gut FoodsAnother good resource…What is kombucha tea? Does it have any health benefits? Mayo Clinic, Answers from Brent A. Bauer, M.D.

Conclusion 

Antibiotics rank as one of the greatest discoveries of our time, healing bacterial infections and saving lives. Fast forward 90 years and we are the generation experiencing repercussions of antibiotic overuse and misuse, especially within the elder populous leading to severe side effects, life threatening antibiotic resistant bacteria and superbugs. Failing to complete prescribed antibiotics and its dose recommendation, taking the wrong antibiotics for the wrong infection, borrowing another’s medication when feeling ill, or being prescribed antibiotics when an infection doesn’t exist, can lead to unwelcomed side affects and serious health issues. What can you do? Prepare now and be gut healthy choosing foods naturally rich in prebiotics and probiotics. Communicate prescription concerns with your healthcare provider and explore alternative options when possible. Use your voice and be an advocate for elderly family members. Antibiotic drugs can still be effective and the preferred drug to treat bacterial infections. The responsibility lies with you to know the facts, use your voice, and be proactive by feeding your gut well!

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