Category: Health

Hiking for Health, or Just For Pure Joy

Hiking is a great activity for seniors! I’m 72 and really enjoy it. Several of my fellow hikers are in their upper 70’s and are still going strong. One, at 83, still hikes five miles on the beach several times a week.

Some people hike mainly for exercise and walk vigorously hoping to work up a good sweat. Others prefer a more leisurely pace and stop often to take pictures, enjoying their commune with nature. While you can see much from your car as you drive along the highways, you can only see the finer details of nature while walking. And there are many sights not available from your car, such as hidden waterfalls, moss covered trees, and the colorful hills in the center of Haleakala Crater.

You can choose from a wide variety of hikes ranging from easy to difficult. On the easy end of the scale are simple beach walks or strolls along scenic country roads. My favorite Maui hike, moderately strenuous, is the Pipiwai Trail within Haleakala National Park. It has a wonderful stretch of bamboo forest with three-inch thick stalks, 50 feet high. The 11 mile Haleakala Crater hike may be difficult, but well worth the effort. Scenery within the crater is wonderful and truly otherworldly. While 20-somethings may do this hike in four hours, I myself plan on at least eight hours.

Bob Chang, Bev Brill, Ginny Kiick and Diana Douglas of Mauna Ala Hiking Club take a welcome rest in Haleakala Crater.

There are several books that list hikes in Hawai‘i, but it is even better to find local groups to hike with that can provide guidance and companionship.

You can join meetup.com on the internet to find hiking groups in your area. Sierra Club, www.sierraclubhawaii.com/groups.php, leads hikes on all four main islands. Contact the hike leader to make sure the hike is right for you.

Never hike alone on isolated trails; if you slip and injure yourself, you could be in serious trouble. Wear proper shoes and clothing, hat and sunscreen. Bring a snack and lots of water. While cell phones won’t work in some areas, they can help you out of trouble in others.

Hiking is a great activity for seniors! I’m 72 and really enjoy it. Several of my fellow hikers are in their upper 70’s and are still going strong. One, at 83, still hikes five miles on the beach several times a week. Some people hike mainly for exercise and walk vigorously hoping to work up…
Constipation in Seniors
Constipation affects approximately 2 percent of the population in the US; the elderly are more commonly affected. Constipation refers to bowel movements that are infrequent or hard to pass. According to the National Institutes of Health (NIH), constipation is defined as having a bowel movement less than 3 times a week.

Laxatives can help relieve constipation. Overuse of certain laxatives can lead to dependency and decreased bowel function. In general bulkforming laxatives, also referred to as fiber supplements, are the gentlest on the body and safest to use long term. However, seniors must remember to drink adequate amounts of water when taking fiber supplements like Metamucil.

Seniors need to call their physicians immediately if they have sudden constipation with abdominal cramps and are unable to pass gas. It is important to seek help if seniors have blood in the stools, constipation lasting more than 2 weeks, require use of laxatives for several weeks, experience rectal pain, unexplained weight loss, or severe abdominal pain–these may be signs of a serious underlying medical condition.

What causes constipation?

Not drinking enough liquids

Low-fiber diet

Lack of physical activity

Ignoring the urge to have a bowel movement

Stress

Travel

Medical conditions — affecting the gastrointestinal, endocrine, or nervous system

Medications — iron or calcium supplements, narcotics, antidepressants, anticonvulsants, and certain medications to lower blood pressure.

Which tests may help diagnose the cause of constipation?

Based on history and physical examination, a physician may order some of the following tests:

Blood tests including a complete blood count and basic metabolic profile

Colonoscopy

Proctosigmoidoscopy

Barium enema

Stool studies

X-rays of the abdomen

Anorectal manometry (pressure measurements of the anus and rectum)

What are the complications of chronic constipation?

Hemorrhoids

Anal fissures

Fecal impaction

Bowel obstruction

Rectal prolapse

How can seniors prevent constipation?

Drink at least 8 glasses of water each day

Eat lots of fiber

Exercise regularly

Do not ignore the urge to use the restroom

Eat foods that promote bowel movement: prunes, apples, papaya, banana and cabbage
Constipation affects approximately 2 percent of the population in the US; the elderly are more commonly affected. Constipation refers to bowel movements that are infrequent or hard to pass. According to the National Institutes of Health (NIH), constipation is defined as having a bowel movement less than 3 times a week. Laxatives can help relieve…
Know Your Numbers

You may have seen a report late last year explaining that Hawai‘i was the healthiest state in the nation. While good health is certainly good news, the story involved a summary of limited information, and did not reflect the current state of kidney disease in America.

Unfortunately, incidence of the disease has more than doubled in the past decade and is projected to double again in the next 10 years. Here in Hawai‘i, the incidence of kidney disease is approximately 30 percent higher than the national average: 1 in 7 people have the disease — often without realizing it during the early stages.

Chances are, unless you are already diagnosed with kidney disease, you do not “know your numbers” for healthy kidneys. Results from a simple blood test and urine analysis requested by your doctor will help you know if your numbers are good. One way to know your kidneys are healthy is to “know your numbers”— so ask your doctor. If you haven’t seen your doctor for a while, now is a good time to get a checkup. Ask your doctor about your glomerular filtration rate (GFR). Your GFR number tells you how much kidney function you have. As kidney disease worsens, kidney function declines and the GFR number decreases. Early detection can allow you to slow down or even stop the disease from worsening, by changing your lifestyle and following your doctor’s advice.

Help us reverse the trends associated with kidney disease by helping yourself. “Know your numbers.”

National Kidney Foundation of Hawaii
808-589-5976 | jeff@kidneyhi.org
For Planned Giving: www.kidneyhawaii.org
Main: www.kidneyhi.org | www.kidney.org

You may have seen a report late last year explaining that Hawai‘i was the healthiest state in the nation. While good health is certainly good news, the story involved a summary of limited information, and did not reflect the current state of kidney disease in America. Unfortunately, incidence of the disease has more than doubled…
All-On-4: The Modern Solution
Many patients today with missing teeth have opted for the All-on-4 treatment as a viable solution to permanently replace missing teeth.

All-on-4 dental implants offer you many important advantages:

A cost effective solution. Your new replacement teeth require only four implants for each jaw. Reducing the number of implants means lowering the cost of tooth replacement.
Reduced need for bone grafting. The special tilting of two of the implants ensures a secure and stable anchorage for the replaced arch, typically making bone grafting unnecessary.

Faster treatment and healing time. Your replacement arch can be attached to your implants immediately. There is no need to wait for healing time between surgery and tooth replacement. Prosthesis options. You can choose fixed (one with highest durability and chewing function, but cannot be removed) or removable (one you can remove for easy cleaning).

Scientifically proven and documented. All-on-4 is supported by good clinical outcomes in studies where four implants were proven to support a full replacement arch.
If you feel that your dentures make chewing difficult and prevent you from enjoying the foods you love, you may want to explore the possibility of implants — in particular, an All-on-4, option.

Hawaii Center for Cosmetic & Laser Dentistry
808-526-0670 | www.smilepower.net
Many patients today with missing teeth have opted for the All-on-4 treatment as a viable solution to permanently replace missing teeth. All-on-4 dental implants offer you many important advantages: A cost effective solution. Your new replacement teeth require only four implants for each jaw. Reducing the number of implants means lowering the cost of tooth…
Hospice and Palliative Care
Dame Cicely Saunders (founder of the first modern hospice in London in 1968) summed up the hospice philosophy best when she told her patients:“You matter to the last moment of your life, and we will do all we can, not only to help you die peacefully, but to live until you die.” Hospice care is a model for quality compassionate care for people facing a life-limiting illness. It is a team approach to expert medical care, pain management, and emotional and spiritual support tailored to the patient’s needs and wishes.

Who is eligible for hospice care?

When the goal of treatment begins to shift from cure to providing comfort, it may be time to consider hospice for persons facing terminal cancer: end-stage heart, lung, kidney or liver disease; severe dementia; severe Parkinson’s disease; or stroke. A physician must certify that the person is in the last stages of a terminal illness.

Where is hospice care provided?

Most hospice care is provided in a person’s own home. Hospitals, nursing homes, assisted living, care or foster homes are other possible settings.

What services are covered under hospice care?

Nursing: pain and symptom management

Personal care/home health aide

Social services

Spiritual counseling

Volunteers

Respite care

Bereavement support

Who pays for hospice?

Medicare, Medicaid and all medical insurances offer hospice benefit. Durable medical equipment and medications related to the terminal diagnosis are covered. Little or no co-payment is required.

What is palliative care?

According to the World Health Organization (WHO), palliative care is an approach that improves the quality of life of patients and their families facing the problem associated with life-threatening illness, through the prevention and relief of suffering by means of early identification and assessment and treatment of pain and other problems, physical, psychosocial and spiritual.

How is hospice different from palliative care?

Palliative care is specialized care for persons with life-threatening illness, regardless of life expectancy. Hospice is a type of palliative care that occurs at the very end of a person’s life.

What is supportive or concurrent care?

“Supportive” or “concurrent” care is a type of palliative care that encompasses all the extra care provided in addition to regular medical care by a full team of physicians, nurses, social workers, chaplains, and aides who specialize in caring for people facing serious illness. This means that somebody with a serious illness can have all the benefits of comfort care and still receive life prolonging treatments.

Who pays for Supportive or Concurrent Care?

Hawaii Medical Service Association (HSMA) offers supportive care services for homebound members who have advanced cancer, advanced heart failure or emphysema. University Health Alliance (UHA) offers concurrent care services to persons with any serious illness. HSMA and UHA have partnered with local hospices to offer this innovative program.
Dame Cicely Saunders (founder of the first modern hospice in London in 1968) summed up the hospice philosophy best when she told her patients:“You matter to the last moment of your life, and we will do all we can, not only to help you die peacefully, but to live until you die.” Hospice care is…
The Hawai’i Neurotrauma Registry

We’ve had lots of positive feedback on our first article about the Hawai‘i Neurotrauma Registry. In the last two years, we’ve given out information on neurotrauma injuries (stroke, traumatic brain injury, spinal cord injury) at 60 events and presentations to approximately 6,500 people.

There is a lot of information on patients with stroke, spinal cord injury or traumatic brain injury while they are in the hospital or rehabilitation facility.But what happens once they get home? What problems are they having? What kind of help do they need?

The Hawai‘i Neurotrauma Registry wants to know so the Hawai‘i Department of Health, Developmental Disabilities Division can make appropriate plans and policies.

We currently have 81 individuals with neurotrauma injuries who have registered. They took more people — especially from the Neighbor Islands — and younger people. The registry is voluntary and open to any resident of Hawai‘i, any age, who has had a neurotrauma injury at any point in his or her lifetime.

You can fill out the confidential survey online at www.svy.mk/1qybSHZ.Call us (there’s a tollfree number for Neighbor Islands) to receive a copy by mail or to schedule assistance completing the survey. Email us with any questions, as well. With your help, the registry will be a success. Mahalo.

University of Hawaii at Manoa
John A. Burns School of Medicine, Pacific Basin RRTC
677 Ala Moana, Suite 202, Honolulu, HI 96813
808-692-1375/1372 | 1-866-447-9023
HawaiiNT@hawaii.edu

We’ve had lots of positive feedback on our first article about the Hawai‘i Neurotrauma Registry. In the last two years, we’ve given out information on neurotrauma injuries (stroke, traumatic brain injury, spinal cord injury) at 60 events and presentations to approximately 6,500 people. There is a lot of information on patients with stroke, spinal cord…
Taking the Pain Out of Physical Therapy

The letters “p” and “t” for physical therapy should NOT be confused with “pain” and “torture.” Unfortunately, many people will share their horror stories of how painful their experiences were. The old-school approach of “no pain, no gain” has been scientifically disproven. Stretching a muscle until it hurts will not get good results. Pain is the body’s way of telling the brain that tissue damage is occurring. When you experience pain, your body’s protective mechanisms take over, often inhibiting the strength and mobility of the damaged area. Believing that suffering has to get worse before it can get better may even make your injury worse.

Ironically, one of the goals of physical therapy is the reduction of pain. Many injuries and postsurgical conditions by their nature are painful, although appropriate physical therapy treatments should be designed to relieve those symptoms and improve function. So just remember, while temporary soreness can be a normal response to therapy sessions involving exercise and manual treatment, a correctly designed program should not make your injury or painful condition worse.

Moon Physical Therapy, LLC
320 Ward Avenue, Ste. 107, Honolulu, HI 96814
Aquatic, Land-based and Manual Therapy and Cardiopulmonary Rehab Programs
808-597-1005 | www.moonpt.com

The letters “p” and “t” for physical therapy should NOT be confused with “pain” and “torture.” Unfortunately, many people will share their horror stories of how painful their experiences were. The old-school approach of “no pain, no gain” has been scientifically disproven. Stretching a muscle until it hurts will not get good results. Pain is…
What is Osteoarthritis?
Osteoarthritis (OA) is one of the most common forms of arthritis. About 27 million people in America have osteoarthritis. It is a chronic condition in which the material that cushions the joints, called cartilage, breaks down. This causes the bones to rub against each other, causing stiffness, pain and loss of joint movement.

Common risk factors include increasing age, obesity, previous joint injury, overuse of the joint, weak thigh muscles, and genetics.

Osteoarthritis symptoms usually develop gradually. At first, there may be soreness or stiffness that seems more like a nuisance than a medical concern.

Common symptoms include:

Sore or stiff joints — particularly the hips, knees, and lower back — after inactivity or overuse.

Stiffness after resting that goes away after movement.

Pain that is worse after activity or toward the end of the day.

Osteoarthritis, or OA, may also affect the neck, small finger joints, the base of the thumb, ankle, and big toe. The pain may be moderate and come and go, without affecting the ability to perform daily tasks. Some people’s OA will never progress past this early stage. Others will have their OA get worse. The pain and stiffness of more severe osteoarthritis may make it difficult to walk, climb stairs, sleep, or perform other daily tasks.

If you have symptoms of osteoarthritis, the doctor will ask questions about your medical history and perform a physical exam and, possibly, take X-rays to confirm the diagnosis.

There is no cure for osteoarthritis, but there are medications to help relieve pain, when needed. The doctor may recommend physical therapy (PT) or occupational therapy (OT) to help improve strength and function. When pain is severe and frequent or mobility and daily activities become difficult, surgery may be considered.

Staying physically active and maintaining a healthy weight are the keys to living well with osteoarthritis. Too little movement can lead to stiffness and weak joints. Losing one pound can take four pounds of pressure off your knee joints. Overall fitness improves health in many ways. Strong muscles protect joints. An OA management plan also involves eating a nutritious diet, managing stress and depression, and getting a good balance of rest and activity each day.\

Hawai‘i Pacific Health—Straub Clinic & Hospital
808-22-3469
www.hawaiipacifichealth.org/GetAGrip
Osteoarthritis (OA) is one of the most common forms of arthritis. About 27 million people in America have osteoarthritis. It is a chronic condition in which the material that cushions the joints, called cartilage, breaks down. This causes the bones to rub against each other, causing stiffness, pain and loss of joint movement. Common risk…
What Is Ai Chi?
If starting a new exercise routine is part of your self-improvement plan this year, you may want to consider Ai Chi.

Ai (meaning “love”) Chi (“breath/essence/ being”) is a graceful form of aquatic exercise that involves a series of movements performed in a slow, focused manner using deep breathing and accompanied by relaxing music and low lighting. It combines Tai Chi and Qi Gong concepts of positioning and controlled motion, carried out while standing in shoulder-deep warm water. Ai Chi is an efficient program that:

Increases oxygen and caloric consumption through correct positioning in the water

Relaxes tension

Relieves stress

Improves mobility, strength and balance

Boosts mental alertness

Suzanne Whitehead, a certified Ai Chi instructor since 2011, teaches one day a week at Moon Physical Therapy. She says the body is often thrown into a fight-or-flight response, which, over time, may become toxic to the body, mind and spirit. Combining correct breathing with the slow, soft movements of Ai Chi can restore the being to its full potential. Her clients’ comments include, “a soothing experience,” “mind and body relaxation,” and “a symphony for my body.”

So try Ai Chi as part of your wellness program this New Year. Improve physical and mental health, and minimize the effects of stress.

Moon Physical Therapy, LLC
320 Ward Avenue, Suite 107, Honolulu, HI 96814
Aquatic, Land-based and Manual Therapy and
Cardiopulmonary Rehab Programs
808-597-1005 | www.moonpt.com
If starting a new exercise routine is part of your self-improvement plan this year, you may want to consider Ai Chi. Ai (meaning “love”) Chi (“breath/essence/ being”) is a graceful form of aquatic exercise that involves a series of movements performed in a slow, focused manner using deep breathing and accompanied by relaxing music and…
Gum Disease In Seniors
Periodontitis is a serious gum disease that damages soft tissue and destroys the bone that supports the teeth. Periodontitis is the primary cause of tooth loss in seniors, often leading to a need for dentures. It also increases a person’s risk for heart attack or stroke. Many seniors may have gingivitis, which is a common and mild form of gum disease that causes irritation, redness and swelling of the gums.

What causes periodontitis?

Poor dental care leads to plaque and tartar buildup at the base of the teeth. Inflammation from this buildup causes an empty pocket to form between the gums and the teeth that fills with plaque and tartar. Soft tissue swelling traps the plaque in the pocket. Continued inflammation damages the tissues and bone surrounding the tooth. The plaque contains bacteria; hence, infection is likely. Infection only increases the rate of bone destruction.

What are the symptoms?

Bad breath

Gums that bleed easily

Loose teeth

Swelling of the gums

What is the treatment?

What is the treatment?

Dental cleaning to remove plaque and tartar from teeth will remove pockets in the gums. This reduces inflammation. Sometimes surgery may be necessary to treat deep pockets in the gums and loose teeth may need to be supported. Severe periodontitis leads to tooth loss and extraction; often, seniors may need to use dentures.

What is the best way to care for removable dentures?

Remove and rinse dentures after eating

Clean the mouth after removing dentures

Brush dentures daily

Soak dentures overnight

Rinse dentures before putting them back into the mouth

Is periodontitis preventable?

The good news is that periodontitis is preventable. Regular brushing, flossing and dental cleaning will reduce a person’s chance of developing periodontitis, and increase the chance of keeping his or her teeth for an entire lifetime.
Periodontitis is a serious gum disease that damages soft tissue and destroys the bone that supports the teeth. Periodontitis is the primary cause of tooth loss in seniors, often leading to a need for dentures. It also increases a person’s risk for heart attack or stroke. Many seniors may have gingivitis, which is a common…
Sleep Well Tonight, Live Better Tomorrow
Nearly 50 percent of Americans today suffer from the effects of disruptive snoring or sleep apnea.

This very common condition causes you to stop breathing for 10 seconds or more, many times during the night. During these periods, your body compensates for lack of oxygen with a quickening pulse, by raising blood pressure and even waking you up. Untreated, it can lead to brain fog, irritability and serious health problems, including:

Stroke

Heart Attack

Diabetes

Obesity

Hypertension

Fibromyalgia

Acid Reflux

Loss of Libido

Impotence

Short-term Memory Loss

Standard treatment is Continuous positive airway pressure (CPAP) machines, which keep the airway open with mild air pressure delivered through a face mask. Patients unable to tolerate (CPAP) now have the option of dental devices using Continuously Open Airway Therapy (COAT), that reposition the tongue and jaw to open the airway during sleep. Mandibular advancement devices (MAD) stabilize the jaw and give many patients relief.

If you suffer from sleep apnea and are intolerant of CPAP, contact a qualified sleep apnea specialist. A dentist specializing in MAD can recommend and fit a dental device to help you sleep soundly, so you’ll wake up feeling refreshed every day.
Nearly 50 percent of Americans today suffer from the effects of disruptive snoring or sleep apnea. This very common condition causes you to stop breathing for 10 seconds or more, many times during the night. During these periods, your body compensates for lack of oxygen with a quickening pulse, by raising blood pressure and even…
Steps To Emergency Preparedness
Emergencies and disasters can strike quickly without warning. You are especially vulnerable if you live alone, are confined to your home or forced to evacuate. Physical limitations put you at risk. The likelihood of recovery from an emergency tomorrow often depends on planning and preparation done today. Practice these three steps: Get a Kit; Make a Plan; Be Informed.

Disaster Supplies Kit Checklist

You should have a kit packed and ready in one place before a disaster strikes.

Water — one gallon per person, per day (3 day supply for evacuation, 2 week supply for home)

Food — non-perishable items (3 day supply for evacuation, 2 week supply for home)

Can opener

Flashlight — do not use candles

Radio (battery-powered or hand crank)

Extra batteries

Cell phone with chargers

Multi-purpose tool

First aid kit

Medications (7 day supply) and medical items

Emergency blanket

Sanitation and personal hygiene items

Copies of personal documents, keep in a water proof container for quick and easy access

Family and emergency contact information

Extra cash

Extra set of keys

Pet or service animal supplies

Specialized items including extra wheelchair batteries, oxygen, catheters etc

Make a Plan

Planning ahead reduces anxiety. 85,000 Social Security check recipients lost mail service after Hurricane Katrina. Switching to electronic payments is one simple solution to protect you.

Here are things to plan and prepare:

Create network of neighbors, friends, etc. for aid

Develop a family communication plan

Carry family contact information with you

Discuss needs and operation of heavy equipment

Post emergency numbers near all phones

Arrange someone outside to check on you

Ask for emergency plans from your homecare agency or case manager

Know your community response and evacuation plans and shelters

Plan for evacuation transportation

Prepare durable medical equipment (wheelchairs, walkers, etc.) for easy access

Keep copies of vital family records and about emergency procedures close by. Store documents such as birth and marriage certificates, social security cards, passports, wills, deeds, and financial, insurance and immunizations records in a fire safe or safe deposit box.

Be Informed

Ask how local authorities will notify persons during a disaster and how the community will get information, whether through local radio, TV, or NOAA Weather Radio stations or channels.

For more information, visit these useful websites:

American Red Cross: www.redcross.org

Dept. of Homeland Security: www.ready.gov

National Oceanic & Atmospheric Administration: www.noaa.gov

Federal Emergency Management Agency: www.fema.gov
Emergencies and disasters can strike quickly without warning. You are especially vulnerable if you live alone, are confined to your home or forced to evacuate. Physical limitations put you at risk. The likelihood of recovery from an emergency tomorrow often depends on planning and preparation done today. Practice these three steps: Get a Kit; Make…