Independence Day...and When to Give t Up

If you know an aging independent-living senior, most likely his or her greatest concern is maintaining that INDEPENDENCE. In a perfect world, we would all be able to mentally and physically care for ourselves as we age. Unfortunately, especially with all the advances in medicine that prolong our lives, that is too often NOT the case.

Driving is probably the hallmark of independence. As long as we can find our keys to GET to the car, we feel a strong sense of freedom. Getting groceries, heading to a doctor's appointment, visiting a friend or attending church is simple, because we simply get in the car whenever we feel like it. No one wants to give up driving, but here are some issues to consider:
Hearing
Vision
Limited neck mobility
Slowed reflexes/stiff muscles in arms

If you have trouble hearing, you may not hear that siren or warning honk, or even the loud motorcycle approaching.
Decreased vision (think cataracts and macular degeneration)- well, this seems obvious, but you can see cars with pretty poor vision. However, you need to be able to read SIGNS, too, as well as see colors of lights.
Stiff neck? You can't turn your head to check your blind spots.
Slow or stiff muscles- you can't manuever your car quickly enough to react to sudden changes.

Please check out an earlier blog on Driving Safely while Aging Gracefully.
BOTTOM LINE: There are many options to driving yourself that do NOT involve giving up your independence. Please do NOT wait to give up or limit your driving until you've hurt your car, yourself or another person.

Doc, Have You Heard of This New Drug?

Often patients ask me about a new drug they heard or read about, and would like a prescription to "try it out". Sometimes, the new drug works wonders, but most of the time, there is no such luck. Obviously pharmaceutical companies are spending more money on direct advertising to the public, and it's working! Our country spends staggering amounts of money on drugs.
Today I'd like to share a pneumonic from the AAFP that helps doctors assess new medications: STEPS.

S: Safety- what are the drug interactions and side effects?
T: Tolerability- how many people stop taking the drug because of side effects?
E: Effectiveness-this may seem obvious, but really: does this drug not only change a LAB VALUE (or blood pressure, etc.) but DOES IT IMPROVE PATIENT QUALITY OF LIFE or HELP PATIENTS LIVE LONGER?
P: Price: Is it worth the cost?
S: Simplicity: How many times per day is it required? With or without food? Can it be taken with other medications?

BOTTOM LINE: Together with your doctor, discuss these issues before you add another medication to your daily routine. </span>

Don't be a Donor-cyclist!

What's a "donor-cyclist"? Anyone who rides a bike- motorcycle or 10-speed- WITHOUT a helmet. Everyone in medicine, especially ER staff, all refer to these as "donor-cycles" because without a helmet to protect their heads, these folks become organ donors after major accidents. Last week, there were two serious auto-bicycle accidents in my Austin neighborhood. Yesterday, while driving in Houston, I saw a man sprawled on the ground in front of a car, his motorcycle tossed to the side (and ambulance fast-approaching.) The most recent statistics (from 2008) showed that there were over 52,000 traffic accidents involving pedaling cyclists, and 716 deaths. Add motorized bikes and the numbers skyrocket.

I am not writing to discourage people from riding- quite the contrary. I simply want to reiterate that HELMETS save BRAINS and save LIVES. PLEASE WEAR THEM! Bikers- wear reflective or at least brightly colored shirts. Be aware that drivers have more distractions than ever as they zip down the road. If you are driving, put away that cell phone and watch out for our fellow travelers on two wheels. They can easily slip in and out of our blind spots, especially at dawn and dusk.

BOTTOM LINE: If you're riding on two wheels, make sure a helmet is protecting your head!