Supplement With That?

Do you, or does someone you know, use nutritional supplements? How about supple-ments and meds? Assume nothing about the safety of supplements, particularly in combination with prescription or over-the-counter medications.
Supplements have traditionally drawn fire for lack of scientific study, purity and for cost versus efficacy. Nonetheless some are so effective, no-one can pry them out of our weathered hands. For many of us who grew up in the 1960s and '70s nutrition and supplementation are either revered or considered a necessary evil. Virtually no-one of a "certain age" is neutral about nutrition and health. Combining certain innocent-sounding ingredients, however, can prove fatally toxic. The list is enormous and growing. 

There are so many ways to heal. Arrogance may have a place in technology, but not in healing. I need to get out of my own way if I am to heal.   Anne Wilson Schaef     
     

     AARP publishes up-to-date advisories concerning prescription drugs, supplements and interactions available on the AARP website. In a 2012 survey the AARP Public Policy Institute polled people 50 years old and older, asking whether they had used nutritional supplements the previous month. More than half said they had, and 52 percent reported daily use. 

      Here's the kicker. Fewer than half of the people giving a positive response said they talked to their doctors about the pills they took. Did they look elsewhere for information about the possible dangers of their supplements, or about possible interactions with prescriptions they were taking? We can only hope.

     Everyone needs to know: 1) the terms natural, homeopathic, holistic, botanical and organic have nothing at all to do with safety or efficacy;  2) "over-the-counter" and "no prescription required" refer to drugs; i.e., anyone who takes them, is taking drugs;  3) supplements poison users, children and pets, at least as often as prescription drugs, so treat them and safeguard them as the potentially toxic substances they are; 3) as pharmaceuticals are developed and marketed, the danger of interaction grows incrementally; 3) the less medical providers know about supplements a patient takes, the greater the danger of permanent injury or death. 

    With regard to prescription drugs, here is a link regarding particularly dangerous pharmaceuticals other than supplements: 
http://www.huffingtonpost.com/richard-w-besdine-md/medication-safety_b_1186690.html

       I urge every reader to keep an up-to-date list of all nutritional supplements, prescription and over-the-counter medications. FamilyDoctor.org recommends taking everything along to an annual physical checkup. Here is a link to this group's advice for the prevention of medical errors: http://familydoctor.org/familydoctor/en/healthcare-management/self-care/medical-errors-tips-to-help-prevent-them.html
   
Regardless of how one feels about alternative versus conventional medicine, we are our own best advocates. Never be less cautious with supplements than with prescription drugs!

Do No Harm

Like most people, I try not to dwell on or talk about illness. In fact a strong background in Christian Science, when I was a young child, made it a prohibited subject. We've all known people, particularly elders, who could speak of little else. It seems nothing is off limits any longer, not even for the faint of heart.

The wish for healing has always been half of health.  Seneca

     In spite of a reluctance to speak of extremely personal matters, and with very little of my life spent in front of television screens, here goes. Have you witnessed a recent bombardment of advertisements on television concerning the use of vaginal mesh products in surgical repair procedures? Repelled and fascinated, a thrill of relief went through me, as I watched one of these personal injury ads. Suffering from minor pelvic damage, I'd discussed surgery as an option with a highly recommended Gynecologist, who proposed to use one of the very products condemned in the ads. I absolutely turned it down, dodging this particular bullet, but I was not, suffering, in severe discomfort or in a socially embarrassing condition. Otherwise the decision in favor of surgical repair, would have been hopeful, to say the least.

     What I did not escape is a lingering fear of dire consequences from medical intervention. People often cannot, simply, heal and move through injury inflicted by physicians and hospitals. Here is a link to a Pro Publica article, which speaks to the subject:  http://www.propublica.org/article/when-harm-in-the-hospital-follows-you-home. 

       This is just a brief blog entry, and decades have passed, since the subject of patient rights became a hot button issue. Volumes have been written since, and iterations of Patient Bill of Rights have come and gone. With Affordable Health Care, came changes in patients' rights. As as important as it is to read the legislation,  much has been published concerning the changes. Current information is available state-by-state, or on Healthcare.gov.  http://www.healthcare.gov/law/features/rights/bill-of-rights/index.html 

     I cannot urge readers strongly enough, regardless of age, to access, print and read this information, and to be their own best advocates. It may not spare us terrible accidents, not even those of us who are both proactive and highly skeptical about patient care, but it is essential.

“I wish peace and affluence to all my friends and a piece of effluence to all my enemies”

    
    Following the conversation we began last week, it seems appropriate to talk about the essentials ... what needs to be done, to avoid conflict, confusion and having our last wishes not followed. Some apparently obvious factors are not so obvious, even to the most capable people. Presumably, if you have money, your estate plan is smart and up-to-date. Maybe, though, it is time for a review. 

     For younger women who read my blog, a classic error is not starting young enough. Young is, by far and away, best. For elders the most common error is not keeping an estate plan current. Keep in mind legal expertise is so very important, but the quality of advice is not necessarily tied to the amount of money invested. Any woman, who would not touch a copy of Forbes, for example, should. It's a little like an axiom my mother used, "If you do not know how to manage a household, you will be unable to supervise anyone who works in your household." For most of us, this sounds to be straight out of an episode of Downton Abbey. It does, though, translate in terms of financing lives.

     Whether there is a great deal of money, or very little money in the bank, a living will, living trust, (including powers of attorney, one for medical matters, one for financial matters) are key. No matter how often we see stories unfold, in which the critically ill or dying person has no "plans," it is difficult to want to develop the plan. It is not just for your sake, however; it is for the sake of others, who may have to deal with end-of-life decisions under enormous pressure. Publications such as The Five Wishes, can be very helpful. Sometimes, we are compelled to take this form of living will with us for certain procedures at hospitals. Be certain your wishes are expressed in the correct legal form (laws vary from one state to another.)

     Trust is a separate issue, and I've seen it go awry, living in elder housing. Appointing people to carry out our medical and financial wishes is an extremely serious business, regardless of our financial status. It is especially tricky for people who have outlived or are estranged from family. One particularly important rule is never to give medical/legal powers or decision making discretion to a manager in housing. It may sound farfetched, but I've seen this happen. Housing management companies should prohibit this practice among employees.  

     When in doubt, consult a professional. The National Gerontological Society, or your state's equivalent, is a good place to start.

In Death As In Life

Mortality whispers to us from dark corners. Two women, friends of mine, brought me a windfall of business clothing recently, some of it wonderful and current. All the clothes belonged to another friend, who died tragically of an inoperable brain tumor. Inheriting anything is a unique experience for me. For nearly all my adult life, I have earned good money; work was rarely in short supply. Family was always in short supply. So it was a bit discomfiting to think about the source of my good fortune, and the fate waiting in the shadows. 

It did not help to find a little scrap of paper in a navy blue blazer; the scrap was a reminder to my unwitting benefactor from herself. It said, simply, "Remember appointment for MRI." One of my daughters recently witnessed the end of a much younger woman than I, and the message came as a roar. Her close friend suffered a massive stroke, after giving birth to twin babies.

It is a curious thing, the death of a loved one. We all know that our time in this world is limited, and that eventually all of us will end up underneath some sheet, never to wake up. And yet it is always a surprise when it happens to someone we know. It is like walking up the stairs to your bedroom in the dark, and thinking there is one more stair than there is. Your foot falls down, through the air, and there is a sickly moment of dark surprise as you try and readjust the way you thought of things. -Lemony Snicket, Horseradish: Bitter Truths You Can't Avoid

What can we do, have we done, about the whisper and roar, the certainty of death? What is a good death, not to most people, but to you? Next who is entitled to expectations surrounding your death and its aftermath? These are questions much more worthy of consideration than having your financial health and final wishes in order. The latter are important, absolutely, but they so often take precedence over the larger questions. Have a living will, a living trust, powers of attorney; these are no less important for someone in financial need than for someone with less limited resources. On the contrary. Figure out, however, how you really feel about the end game. 

People with money will be able to pay for expert advice regarding the money, not to say money protects anyone from blunders. On the contrary, when the money takes precedence, many blunders ensue, ranging from the sublime to the ridiculous. It is critical to trust the experts and the advice, but equally critical to consider your personal legacy. Money can be a powerful insulator, a weapon or an instrument of good. It can bring enmity to a conclusion, or further judgment, anger and vengeance. I leave you with this thought. An inheritance can be bitter fruit indeed.