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Life Lesson

Delirium…it can happen to you!

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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.
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Borrowed from Hallucinations, Delirium In EKW Tunnel. Picture And Royalty Free Image. Image 77032017.

Delirium is defined as an acute, fluctuating syndrome of altered attention, awareness, and cognition. It is common in older persons in the hospital and long-term care facilities and may indicate a life-threatening condition. Delirium in Older Pateints_AAFP

According to the American Delirium Society approximately 7 million people hospitalized experience delirium each year. This number represents…“10-20 percent of all hospitalized adults, and 30-40 percent of elderly hospitalized patients.” Delirium, Science Daily. Is delirium becoming more common? Are you/your loved ones at risk to be among those diagnosed with delirium at some point in your life?

Growing up with elderly grandparents I never heard the term “delirium”, or sometimes referred to as “sundowners”. Fast-forward 40 years and suddenly these terms are now commonly used when elderly patients are hospitalized. I wonder, “Why? What changed?” Here are 2 individuals, one hospitalized at 95 years old treated for pneumonia with no delirium and the other 82 years old treated for bowel obstruction suffering hospital delirium, for the first of many that followed. How could one elderly patient suffer delirium and the other (elder of the two) not??

It deeply concerns me when attending healthcare professions appear to not have a solid understanding of delirium, quickly treating patients with anti-psychotic drugs for even the slightest agitation or confusion. Equally frustrating is the assumption that patients with this affliction have a psychotic permanent disease, progressive dementia, or Alzheimer’s. It is also discouraging to hear symptom comparisons to others who have been diagnosed with dementia or Alzheimer’s. This leads to mismanaging delirium as well as having a false assumed trajectory, dashing hopes of recovery and making decisions that may not be in the best interest of the patient.

This post shares facts and resources about what delirium is and what it is not, along with proactively managing the risk and onset of delirium if you or your loved one(s) suffer from this affliction. USE YOUR VOICE with hospital staff, sharing your/loved one(s) mental baseline quickly and accurately. Voice your wishes and that of your family to guard against receiving medications that might only exacerbate delirium. Your commitment first and foremost is to your well-being and advocating for the best interest of your family member. Hospital staff will appreciate your advocacy and involvement based on information that will help them best do their job.

What delirium IS and what it IS NOT.

Delirium is distinct from dementia because it develops suddenly, over hours to days, rather than months to years. And unlike dementia, delirium is usually temporary, resolving when the underlying cause is addressed promptly. Delirium also differs from the psychosis of psychiatric disease, in which orientation, concentration and attention are usually less impaired. Delirium (Beyond the Basics), October 2014.

Delirium is a sudden onset of unprecedented psychotic behavior when a patient is hospitalized.The patient becomes either unusually withdrawn or demonstrates uncharacteristic aggressive and paranoid behavior accompanied by hallucinations that are extremely difficult on the patient, the family, and hospital staff. Delirium is a temporary affliction and often when the patient returns to their familiar environment, the delirium disappears as quickly as it came, for most. Delirium can linger with a slower return to baseline if the patient already has been diagnosed with dementia, whose existing illness and physical frailty slows the healing process, or health continues to deteriorate. Delirium is especially likely to afflict hearing and visually impaired patients. A lack of knowledge and understanding about delirium by attending healthcare professionals leads to medications and care practices that can exacerbate a patient’s condition.

Delirium is not a disease. Delirium is not an indication of Alzheimer’s or dementia. One can suffer from delirium and not have either of these diseases. However, the more often and severe one suffers from delirium when hospitalized, the greater the risk of dementia. This, however, does not apply as a greater Alzheimer’s risk. A physician once shared with me the difference between age related memory loss and Alzheimer’s… cognitive memory impairment forgets facts and Alzheimer’s patients forgets function. Both can progress as the patient ages. Delirium is temporary.

Below are two videos I encourage you to watch. One video allows you to experience delirium. The other video shares a delirium occurrence by a man who was hospitalized with pneumonia and the impact on his wife, as well. These videos are great visuals that will inspire you, the readers, to act now and do what you can to reduce delirium risk for yourself and your family members.

YouTube Videos

Delirium risks…what you need to know.

According to Delirium in Older Pateints, AAFP.org, there are risk factors for delirium and AAFB.org August 2014, Delirium in Older Patients, Table 3 provides a list that will surprise you! Some of the most common risks fall under these categories:

  • Predisposing Factors – Comorbidities (alcoholism, chronic pain, history of baseline lung, liver, kidney, heart, or brain disease, terminal illness), Demographic (65+ years old), Geriatric Syndromes, Premorbid State
  • Precipitating Factors – Acute Insults and Environmental Exposures
  • Delirium-inducing medications

How to prevent and manage delirium and what to avoid.

About 40% of delirium cases are preventable. In the past decade, progress has been made in increasing awareness of the potential negative outcomes of delirium and documenting reliable methods to detect and prevent it. Prevention of delirium now focuses on eliminating or reversing as many risk factors as possible. Delirium in the Elderly

When researching delirium be sure the articles are current. Each year new information is surfacing based on patient studies, early detection, and treatment without the use of drugs.

Before a planned surgery, discuss delirium risks and best management practices with your/family member’s surgeon. Be in agreement and on the “same page” of what medications you are OK taking and which you do not want. If admitted to the ER, be sensitive to any signs of slight confusion, which could be a sign of delirium that could become worse with prolonged hospital stays. Discuss, with the attending physician, proactive non-invasive measures to best manage delirium from the start. I recently heard about hospital staff treating a delirium patient that of which is listed under what to avoid below. Be bold in sharing concerns if this might be your experience, as well. The elderly population of baby boomers is rapidly increasing in numbers and, therefore, every hospital should have up-to-date delirium training for all staff to understand and properly treat this affliction.

Delirium management suggestions. 

  • Stay calm.
  • Surround the patient with family photos as soon as possible.
  • Bring patient’s favorite pillow and/or blanket.
  • Play the patient’s favorite music in their hospital room.
  • Turn on the TV to favorite TV shows.
  • Keep window drapes open at all times so the patient can discern daytime and nighttime to maintain normal sleep cycles.
  • Carefully schedule visitors, family, and very close friends for familiarity and avoid over stimulation which could further irritate delirium.
  • Melatonin (suggested by a physician), is a natural way to calm a delirium patient and encourage normal sleep-wake cycles.

What to avoid.

  • Physical restraints
  • Foley catheters
  • Intravenous lines
  • Psychoactive and sedative agents
  • Drugs with anticholinergic effects (Anticholinergics, June, 1, 2018)
  • Daytime napping
  • Continuous questioning by hospital staff
  • Anti-psychotic drugs, whenever possible
  • Prescription sleeping aids
  • Family members correcting patient’s paranoia and hallucinations

Other suggestions.

The Hospital Elder Life Program offers a wealth of information and support for family members and medical staff. CLICK HERE for the brochure.

Below are a few quotes from…Delirium in Older Pateints, AAFP

Studies have demonstrated that a multi­component non-pharmacologic approach is highly effec­tive and reduces the number and duration of episodes of delirium. One such intervention, known as the Hospital Elder Life Program, is available at [CLICK HERE].

Non-pharmacologic prevention strategies consist of ori­entation and therapeutic activities, early and recurrent mobilization, minimizing the use of psychoactive medi­cations, promoting normal sleep-wake cycles, providing easy access to adaptive equipment for sensory impairment (e.g., glasses, hearing aids), and preventing dehydration. Orientation activities should include encouraging familiar visitors, minimizing changes in nursing staff, and ensuring that functional clocks and cal­endars are easily visualized. All caretakers should be educated on preventive approaches and encouraged to implement them. The Hospital Elder Life Program has also devel­oped the Family Confusion Assessment Method, a validated screening tool that can be used by trained family members to detect delirium. This tool has a demonstrated sen­sitivity of 86% and a specificity of 98% in one study of 58 caregivers. 

The future diagnosis of delirium.

Anti-psychotic drugs are often quickly administered to hospital patients today who show signs of confusion/agitation. According to US National Library of Medicine, Feb, 2013…No antipsychotic drugs have been approved by the U.S. Food and Drug Administration (FDA) for the management of delirium, despite the reality that antipsychotics are routinely used in the management of symptoms related to delirium. 

Another resource, Critical Care Nurse – AACN Journals, indicates a similar message shared twice, as noted below, from article Assessment and Management of Delirium Across the Life Span, 2016 and Delirium Assessment and Management, 2012

No drug has been approved by the FDA to treat delirium. In fact, the FDA has issued an alert that atypical antipsychotic medications are associated with mortality risk among older patients, and another analysis has reported that haloperidol had an even higher mortality risk in non-ICU older patients than atypical antipsychotics.

There is hope. Blood Test May Help Predict Confusion After Surgery, January 2017, indicates a blood test has been identified that could predict the onset of delirium. (Quote below.) Early and accurate detection could encourage proactive and proper ways to work best with at-risk-patients, avoiding the use of pharmaceutical drugs whenever possible.

This study is a step toward preventing postoperative delirium,” said John Krystal, Editor of Biological Psychiatry. “With information about delirium risk, doctors can take steps before, during, and after surgery to reduce that risk,” for example, by reducing inflammation in patients with higher levels of CRP. 

What can you do now to minimize your risk?

Share concerns about delirium risk with your doctor, if you are suddenly hospitalized or perhaps someday face the need for surgery. Review all prescription medications with your doctor to identify those that could increase delirium risk and alternative options to consider. AAFB.org August 2014, Delirium in Older Patients, Table 3 is a great chart for discussion with your physician. If a prescription drug lists confusion, hallucination, and cognitive memory impairment as possible side effects, I would want to consider an available alternative and you may as well.

Stay healthy. Exercise and eat a well balanced diet. If you feel you are falling short in this area, begin today! Good health will minimize your need for prescription medications, which will reduce delirium risk. Get the help you need. Wellness Changer, Jeanne Wisniewski offers information packed videos and custom nutritional consultations to help you. View videos HERE and HERE.

Watch alcohol intake. Drinking heavily (more than 1 glass per day for women and 2 glasses per day for men), can also increase delirium risk. Over 65 years of age…one drink per day maximum for men and women. See Alcohol Consumption Limits by Moderation Management

Conclusion

If you watched the videos listed above, you will never want to experience delirium and/or see your loved ones suffer from this affliction. Earlier in the article I refer to two individuals; a 95-year-old with no delirium and an 82-year-old who suffered with hospital delirium. What is the difference between the two patients? The 95-year-old was fortunate to enjoy great health and therefore never had to be on prescription drugs other than a light dose of blood pressure pills. Through life, this individual had one surgery and two hospital stays to treat infections. The 82-year-old patient suffered from autoimmune disease, was on many prescription medications, and went through 12 surgeries in life. Advances in research and pharmaceutical development have saved lives, but, are we the generation experiencing unwanted side-effects from all the prescription drugs available today? Is delirium one of those side-effects?? Be informed. Use your voice. Ask questions. And, speak candidly with hospital staff about your treatment options and/or advocating for the care of your loved one(s). Delirium can be preventable if this temporary affliction is understood and managed for what it is. Be proactive now because delirium…can happen to you!

Additional Note:

The Communication Failure In Medical Record Keeping, September 28, 2018 by ILANA YURKIEWICZ and UNDARK, The Atlantic, is an interesting article about the hole in medical records. The quote below shares how a doctor often feels seeing a patient in the hospital, for the first time. Use your voice and always share accurately with attending physicians to help them, help you, and/or your family member. 

When a patient with a complex medical history like Michael’s arrives under my care, it’s like opening a book to page 200 and being asked to write page 201. That can be challenging enough. But on top of that, maybe the middle is mysteriously ripped out, pages 75 to 95 are shuffled, and several chapters don’t even seem to be part of the same story.

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Life Lesson

Olivia’s Gift…Be Still

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My husband and I just returned from an 11-day Maui vacation, a trip I have soooo been looking forward to! My luggage was packed 2 weeks before plane takeoff!! Leading up to this vacation we discussed how to best enjoy these 11 days. Planning vacations can be a slippery slope wanting to see and do it all. Shortly before our trip, however, while selecting good reads for our flight, I purchased the current issue of the Gaines magazine, The Magnolia Journal. At that time, little did I know how the article, Made for This by Joanna Gaines, would prepare me for what was about to happen on our trip. Sometimes circumstances force us to slow down and rest…”and really rest” as Joanna shares. For Joanna it was pregnancy. For us it was Tropical Storm Olivia and we had no idea we would soon meet Olivia on our Maui vacation when we boarded the plane on Saturday, September 8th. This post shares how unexpected twists can be life changing, highlighting needs rather than wants when we become still, with an emphasis on introspection, relationships, and being “present” to be in awe of small joys.

“I love the seasons of rest and hiddenness because they reveal the small joys that are only noticed in quiet.” Joanna Gaines, Made for This, The Magnolia Journal

Go With The Flow

God grant me the serenity to accept the things I cannot change, courage to change the things I can, and wisdom to know the difference. The Serenity Prayer

By the time we checked-in to our resort late afternoon Saturday, we realized that some excursions might not actually happen, such as golf, visiting up-country and stopping at the small town of Makawao, which peaked our interest on a previous trip trying to find our way to Pa’ia. The storm that appeared far from Hawaii was moving westward at 17 miles per hour with news reports (Pacific Basin as Category 1 Hurricane) of Olivia passing over the islands between 72 and 96 hours. Shear winds to bring this Category 1 hurricane to a Tropical Storm, wasn’t happening. Weather reports dominated weekend news. The start of our vacation became a time of acceptance that this year was going to look different. Sunday became storm preparation and grocery shopping, grateful for a kitchen we had in our unit. A leisurely beach walk in the afternoon became an opportunity for what might not be possible in the coming days. I give credit to God’s timing reading Made for This, inspiring the benefits of quiet and still as protection against easily succumbing to feelings of gloom and doom when anticipating the impending storm heading right over us. We have been to Maui many times and Olivia was about to bring us a new island-life experience.

Be Prepared

Sometimes it means acknowledging my lack, understanding my limits, knowing the strengths of those around me and graciously receiving help when they’re willing to step in. Joanna Gaines, Made for This, The Magnolia Journal

Through the years my husband and I have both come to appreciate that it’s best not to act like an expert in areas of which we have no previous experience. Island bound during a tropical storm/hurricane makes this list. Even though we have weathered through some pretty nasty storms in Colorado, we chose to follow all guidelines and preparation tips shared on Maui news and communicated through the Westin Villa management team. Westin Olivia Preparedness letter was issued Monday and we followed instructions. We also prepared for in-room downtime; reading books, talk time together, in-unit exercising to replace gym, and respecting each other’s need to be alone. Fear was replaced with adventure while still accepting the seriousness of what could be, especially concerned about Hurricane Florence happening on the other side of the globe. On our way back to the grocery store to comply with the 48 hour recommended stock-up, we asked a resort security person (good to learn he was a Maui native) for advice including about our rental car…safest outside (trees falling?) or under the garage (flooding?). Glad we did! Underground garage is equipped with pumps and a back up generator but falling trees cannot be anticipated or prevented. We were able to park our rental car underground while spaces were still available. The power of effective leadership was also demonstrated throughout this experience. The governor of Hawaii frequently made news appearances about the state preparing for the worse and expecting the best. News updates also reported specific preparations underway, evident by the emergency supply containers remaining in parking lots after the storm passed. Each storm update came with calm assurance providing us with a feeling of our own calm, confidence, and trust. Our take-away from the state’s proactive preparedness is two fold. First, being thoroughly prepared, covering all possibilities, is wise. Yet, often times in life, although different circumstances, such thoroughness can appear as an over-reaction or being foolish. Be wise. Second, leading with confidence and calmness is contagious. This is a good thing!

Be Still

Be still, and know that I am God… Bible Psalm 46:10, NIV

The quieter you become, the more you can hear. Ram Dass

We tucked in Tuesday and Wednesday. Since we couldn’t explore the island and we didn’t know anyone, we had an opportunity to have conversations that explored our marriage relationship, future goals, and motivations as well as having alone time and a few good laughs, too. This tuck-in opportunity brought us to a deeper level of introspection, individually and as a couple. Being still allows accumulating “soot” left over from a lifetime of trials, challenging experiences and relationships to surface in order to be released. Such residue could be unspoken hurt, disappointments, resentments and resulting insecurities built-up through the years that weigh on us, distracting from life’s small joys. Being still can be a cleansing process although it is initially uncomfortable, especially facing the truth of one’s own contribution to life’s debris. And, as Tropical Storm Olivia passed my hope is the debris collected over time and now successfully processed, blew away with Olivia, too. Being still did alter our vacation plans because after the storm made its way westward, we chose to keep this vacation still. Other than attending the Friday night Warren & Annabelle’s Magic Show (perfect comedy and magic following storm week) as well as a Saturday drive to Wailea, we did nothing. Nothing is exactly what we both needed on this trip that we would never have previously considered, especially considering the high cost of vacations and realistically wanting to get the most out of our $$$. Nothing, can be healthy! On our last night while having dinner at Duke’s, the sun was setting, and we were awed by the first spectacular sunset since our arrival on September 8th. I was taking photos when my husband noticed a sailboat approaching on the horizon. It was the most beautiful image playing out right before our eyes. This image was a vacation highlight, a gift from God to us! And, I believe we noticed because of our vacation of doing nothing; not exhausted by busyness or blinded by other vacation highlights to interfere with this simple joy. Fortunately, I was able to capture the sailboat perfectly passing in front of the setting sun as illustrated on this blog post.

What was Olivia’s impact on Maui?

The landfall was historic, according to National Weather Service officials. It was the first time since modern records have been kept that a tropical storm has made landfall on Maui. County Officials Begin Assessing Damage From Tropical Storm Olivia, Maui News

The Maui News, September 23rd, reported an assessment of Tropical Storm Olivia’s impact on Maui, County Officials Begin Assessing Damage From Tropical Storm Olivia. Residents and businesses in Waihee Valley and Honokohau experienced flooding and water-related damages, including vehicles that had washed away. Approximate 700 customers experienced power loss with a few still remaining without electricity. Although most parks are now open, some remain closed including state forest reserves because of downed trees and erosion. Fortunate that Olivia’s direct hit to this island did not result in what could have been even greater loss and damages. Olivia’s impact on the local people, especially natives of Maui, runs deep. Speaking with resort staff, (before, during and after the storm passed), they feared the worst. One staff person told us a few days after Olivia that to experience storms on a small island in the middle of the Pacific Ocean triggers fear. Limited land offers limited options in every aspect of safety and rebuilding if the worse happens. Serious. Life-threatening. It is no wonder when we approached house-keeping on Tuesday, September 11, requesting she skip working our room to return home sooner to family, that she became emotional. We passed on housekeeping the remainder of our stay.

After many previous Maui trips, this vacation will have lasting impact. Olivia gave us a gift…to be still. This stillness led to ditching the vacation plan list, waking each morning with nothing on our to-see-list, communicating with resort staff as friends instead of employees – listening to their stories and concerns, and most importantly… we are inspired to notice and appreciate small joys. Unexpected disasters happen. Our heart especially aches for lives lost and the mounting destruction from Tropical Storm Florence. When possible, accept what you cannot change, follow professional/expert advice and be prepared even if you personally feel such thorough steps may not be necessary and…be still. My prayers during difficult transitions has and continues to be…if I’m going to journey through this, Lord, make the most of it! Allow stillness to be a life-changing opportunity. My husband and I are looking forward to marveling at the amazing small wonders of this world that we would otherwise not notice. We are also hoping for many more incredible sunrises and sunsets with the timing of yet another sailboat crossing on the horizon!

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Get Ready To Roll…at your own pace!

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It’s that time of year when kids are back to school. Whether you are a parent, grandparent, uncle, aunt, friend or neighbor, everyone experiences that “back to school” feeling. Even road traffic picks up, as parents drive kids to and from school, until car-pooling begins to make sense. It has been a while since my son went through grammar, junior high, and high school. All too well I remember this season filled with mixed emotions; anxious rushed mornings, awesome expectation of learning opportunities to be experienced and that pit-in-the-stomach feeling anticipating sign-up sheets for volunteer required hours, fundraising requests, sports and extra-curricular activities that somehow must squeeze into LIFE. So…leaving the long lazy days of summer and suddenly thrust full throttle into the new school year can feel scary and overwhelming!! The following will share how to be proactive and practice healthy boundaries before the first back-to-school meeting, for your child’s well being as well as your own. School years should be memorable so when you pack that last brown bag lunch, your tears will be reminiscent of joy-filled times.

Healthy Boundaries For The Family

Boundaries keep relationships healthy and protect both marriage and family from being fractured. In May 2017 I wrote a blog article titled Thriving Relationships, which shares how my marriage was saved once focus was redirected from fulfilling the wants of others to the needs of family, where it belongs. If you haven’t read this post, I encourage you to do so. The trajectory of our family unit would have looked very different had we not stepped back, communicated honestly spouse to spouse, also giving our then 8-year-old son a voice. I acknowledge the power of prayer through this time and the inner voice of guidance I could not have had on my own. There is a misconception in our culture that busy is great and being over-committed is socially healthy. Don’t buy in to this fallacy. It is simply…not true. Trying to conform to cultural norms (assumption thereof) leads a family in different directions, of who then become people living under the same roof. Accept that what may work well for other families, may not work well for you or your child/children and nor should it. My parents often gave this advice…compete with yourself and not with others to be the best you can be. In other words, don’t let the lives of others be your benchmark or you could be selling yourself short.

Before all the sign-up sheets for sports, school-church-community activities and parent expected involvement begin, set-aside family time to meet and discuss what works best for your family. This applies to families led by single parents and those with spouses and families of one child or those of many children. Identify realistic goals that meet your family needs. Make choices and plan the year ahead, accordingly. Give your children a voice with consideration to realize what is time reasonable and what is not feasible. Their own realization, age appropriate, is far more powerful than a parent’s mandate. This process is also a life teaching experience. Be sensitive to their passion(s) and avoid imposing your own aspirations. Authentic Success is a brief video by Madeline Levine, PhD, that speaks directly to the importance of getting to know your child/children, authentically, which is impossible to do if every one is running in different directions, reactive instead of proactive. This process may also include parent school week expectations such as… no video games or social media use along with bed time for needed rest. Be sure to incorporate generous “down-time” together so when kids leave the nest your family has fond bonding memories to reflect upon. Remember, the habits you model today are the habits your children will embrace throughout their lives. Make them good habits!

Managing Volunteer Requests

So often the analogy Rocks, Pebbles, and Sand is shared to promote managing time for a healthy well-rounded life serving a purpose. This analogy loses me when it’s so tightly packed that even air space is filled with sand, to the top of the jar. If the jar is that tight where is the breathing room? If you can’t breath you will not serve yourself or others well, especially your family where priorities rest. If your child/children are working through tight schedules with no breathing room, what is the effect on them emotionally and physically?? Life Balance, Modify, November, 2017 relays an important message… if you don’t assume the role of managing your/family calendar, others will, and the results could be detrimental to health and relationships.

Time blocking on a calendar is an effective and efficient means of staying on track, managing tasks and activities to function at our best. Have you heard or read the analogy of Rocks, Pebbles, and Sandin a jar? It was written to help people understand how best to prioritize life. This example never quite worked well for me because my rocks need wiggle room. A jar so tightly packed gives me anxiety just thinking about it!!! When you block time, consider what YOU need to function at your finest. What works for others may not work for you nor was it ever meant to. Self-care is identifying how you best function and allocating down time that nourishes YOUR mind and body.

Volunteering is a good life habit to model to our youth. Being able to choose volunteer opportunities for an ideal schedule fit, however, is wise to role model, too. Realize that schools, churches, and volunteer based organizations would rather hear a “no” than a “yes” from an overly committed person who then fails to fulfill their assigned role. And, don’t be that person who takes on so many obligations only to ultimately recruit family and friends to assume the work. Determine in advance the time you, the parent(s), can realistically commit. Include your children to practice this approach as well. Prepare responses beforehand so when approached to take on additional volunteer duties, you can speak with confidence. When not prepared, the need to say “no” will become a reluctant “yes” and the wants of others will overshadow you/family.

Be A Voice For Change

Change is good yet often leaders fall into routine comfort and meeting status quo, which blocks what can be accomplished more effectively. The old adage, “why fix what 38769191_10217305418416412_7114180251386642432_n
isn’t broken” can actually blind leaders to what might really be broken. Parents, if you have an idea to share with the school, do so, in writing, to give school leadership a chance to think about your suggestion at a time that works best to be thoroughly considered. A perfect example is explained in this article Alabama School’s Hilarious ‘Opt Out’ Fundraising letter Goes Viral, which appeared on Fox News last week about the Alabama high school giving families an option to traditional fundraising. Parent Teacher Organization (PTO) President, Emmy Sorrells – Aurburn High School, pursued a solution ‘outside the box’ and the results are amazing! To your right is the letter that was included in the “home” brown envelopes. Good humor along with several choices considers the diverse financial means and time crunch families experience today. This novel approach just might bring in more school funds then what companies compensate schools to sell cookie dough, wrapping paper, gift items, etc. The amount of time and volunteers needed to coordinate fundraisers can be drastically reduced/eliminated, perhaps allowing more parent volunteers in classrooms assisting teachers. Share your ideas with the school board and teachers. In turn, be willing to consider teacher assessments and suggestions, especially offered for the well being of your children. A school that works together, thrives together!

Conclusion

The start of the school year doesn’t have to be scary or overwhelming. Plan a workable schedule with extra-curricular activities to keep kids engaged and the right amount of parent volunteer hours to offer needed school support. Focus on family needs and avoid the temptation to use the goals and calendar of others as a benchmark for your own. Recognize the unique skills of your children and encourage them to compete with themselves instead of with others, striving for personal best. Support your child/children’s voice, offering the opportunity to determine activities they wish to participate in and to take ownership of the time impact of such choices. Suggest “out of the box” ideas to the school board that will make school years memorable in that reminiscent and special way!! Get ready to roll as you enter the start of the new school year…at the perfect pace for you and your family!!

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Life Lesson

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

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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…

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  • 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 

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

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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 trials, Jan 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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Life Lesson

Prescription and OTC medications impacting mental clarity?

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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 Brain, Harvard Health

 Which two population studies?

  1. Benzodiazepines– Benzodiazepine 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. Anticholinergics– Cumulative 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 Blog. Also click video titled… Lawsuit claims Prevagen doesn’t boost memory, CBS News. When 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!

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Life Lesson

Statin Facts and Dementia Risk?

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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.

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