The physician who hired me decades ago was a leader. It took his entire career but against a great deal of resistance, he built a premier healthcare system. Even so, he always had time for me. Whenever I stopped by, he would always pull up a chair. It was as if my activities and ideas were just as important as his. There’s something else I remember. I became his healthcare provider not long after he developed Parkinson’s Disease. He ended up being a frequent user of the healthcare system he built. He had many falls. […]
Three Pillars of Dignity: Dr. Warren joins Amy Goyer on Facebook Live
Amy Goyer has taken care of her mom, dad, and sister all at the same time. She is the real deal, a sandwich generation caregiver. Amy is author of the book: “Juggling Life, Work, and Caregiving”. She also hosts the AARP Caregivers Discussion Group on Facebook. Amy and I had a strong connection ever since we met in Hawaii during pre-Covid days. Last week, we finally had a chance to videochat with her caregivers group. We decided to talk about a particularly important topic: dignity. Why dignity? Because it’s one thing to take care of […]
Asleep All Day and Awake all Night
Joan is a retired elementary school teacher. She is the kind that students remember with great fondness. Now she’s 84 years old and life has changed. She has Alzheimer’s Disease and lives with her daughter’s family. Although she can still hold a conversation, she is anxious. She falls asleep for long periods during the day but is frequently awake at night. Then she goes from room to room switching on the lights and searching for her cat. Her PCP prescribes a sedative. However, one night, Joan’s search for the cat leads her outside, and she […]
YOUR Path to Good Sleep
The last several posts have been about the importance of sleep and the barriers that older adults face. We’ve all seen ads for expensive beds that will miraculously improve sleep. But buying an expensive bed is not the right way to start. It’s also not the correct first step to ask a health care provider for a sleeping pill. A logical, calm, and customized approach is needed. This post is about finding YOUR path to the best sleep possible. Sleep clinics consistently start with a sleep journal Journals examine sleep patterns over a period of […]
Are medicines making it hard for me to sleep?
Are medicines making it hard for me to sleep? I was asked this question after my last post. Many people, including seniors, need more and better sleep to feel good and live well. National Sleep Week (March 12-18, 2023) highlighted that sleep is a health issue in a sleepless world. There were 3 points I emphasized in my post about the importance of sleep. Sleep is different from rest. The body and brain do important work that occurs only with sleep, not with rest. Good sleep means more than a recommended number of hours. Quality […]
How did you sleep, Honey?
I say this to my wife almost every morning. It’s my way of showing affection because sleep is very important. We are lucky in three ways: 1) Despite our many ups and downs, we have a good marriage, even better over the years. 2) Our sleep clocks are quite similar and 3) We are good sleepers …. most of the time. Every once in a while, because of life stresses, one of us doesn’t sleep well. The result? We’re tired and maybe a bit grumpy. Eating, sleeping, and bowel movements (E-S-BM) are essential. I call […]
Constipation: Help, I’m stuck
Fecal impaction is when a large amount of poop is stuck inside the rectum. The poop can be soft or hard. Chronic constipation is the most common cause of impaction. Constipation is due to 1) the inability to push stool out 2) the persistent habit of holding bowel movement inside or 3) small stools that pile up. Impaction is often, but not always, uncomfortable. Frail seniors are at higher risk. Sometimes caregivers are surprised to hear that a patient has an impaction. What are signs of impaction? Impaction is likely when a patient feels full […]
Constipation Relief … What’s the Scoop?
Constipation can have an awful impact on quality of life among frail seniors. First of all, it increases urinary tract infections. Then, at its worse, it results in fecal impaction and incontinence. This increases caregiver burden and stress. Ultimately, the person ends up being unable to live at home. What a disaster. That’s why I think it’s so important to avoid constipation. The goal should be a solid, medium-sized, bowel movement with complete evacuation. In addition, at a regular time every day. That’s constipation relief!! Now, what’s the scoop? Step 1: Are medicines causing the […]
Constipation? I Have Two Questions
“There’s Nothing Like a good Bowel Movement” made the point that chronic constipation is all too common and distressing among seniors. In the past, doctors defined constipation as having fewer than 3 bowel movements a week. Anything else was considered “normal”…hmmm…really?? Obviously, the patient was much more uncomfortable than the physician. We now evaluate constipation more broadly, starting with the patient’s perspective. Here are two important questions: Question 1: What bothers the patient the most? Different answers mean different problems. A. It’s very painful to have a bowel movement. Sometimes only small pieces of stool […]
There’s Nothing Like a Good Bowel Movement
There are 3 questions that I always ask my patients. They are about “E, S, B&M”: How well are you eating? How well are you sleeping? How are your bowel movements? These are questions that patients are glad I ask. They show that I care about life’s most basic needs. It’s a doctor’s more specific way of asking “how are you doing?” ESBM are important in childhood, adult life and as people get older. The answers to these questions are “life” vital signs. Just like heart rate or respiratory rate, they give me clues about […]