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Grief is a normal, healthy response to loss. One of the greatest losses that can occur is the death of someone you love. Other losses include the loss of your health or the health of someone you care about, or the end of an important relationship, such as a marriage. Healing from a loss involves coming to terms with the loss and the meaning of the loss in your life.
In the first hours or days after the loss, you may feel shocked, numb and confused. You may not remember what people have said to you. You may think and act as though the loss hasn’t occurred. This is called denial.
As the shock wears off, reality will slowly break through. You’ll begin to realize that the loss has happened. It’s normal to feel abandoned and angry. You may direct your anger toward God, religion, doctors and nurses, the one who has died or other loved ones, or even yourself.
Most people who have glaucoma don’t have any symptoms. You might not realize that you’re losing vision until it’s too late. Half of all people with loss of vision caused by glaucoma are not aware they have the disease. By the time they notice loss of vision, the eye damage is severe.
Rarely, an individual will have an acute (sudden or short-term) attack of glaucoma. In these cases, the eye becomes red and extremely painful. Nausea, vomiting and blurred vision may also occur.
Up to 70% of couples have a problem with sex at some time in their relationship. Most women will have sex that doesn’t feel good at some point in her life. This doesn’t necessarily mean you have a sexual problem.
If you don’t want to have sex or it never feels good, you might have a sexual problem. Discuss your concerns with your doctor. Remember that anything you tell your doctor is private and that your doctor can help you find a reason and possible treatment for your sexual dysfunction.
If you have gone through menopause or have had your uterus and/or ovaries removed, taking the hormone estrogen may help with sexual problems. If you’re not already taking estrogen, ask your doctor if this is an option for you.
You may have heard that taking sildenafil (Viagra) or the male hormone testosterone can help women with sexual problems. There have not been many studies on the effects of Viagra or testosterone on women, so doctors do not know whether these things can help or not. Both Viagra and testosterone can have serious side effects, so using them is probably not worth the risk.
Learn more about your body and how it works. Ask your doctor about how medicines, illnesses, surgery, age, pregnancy or menopause can affect sex.
Practice “sensate focus” exercises where one partner gives a massage, while the other partner says what feels good and requests changes (example: “lighter,” “faster,” etc.). Fantasizing may increase your desire. Squeezing the muscles of your vagina tightly (called Kegel exercises) and then relaxing them may also increase your arousal. Try sexual activity other than intercourse, such as massage, oral sex or masturbation.
Talk with your partner about what each of you like and dislike, or what you might want to try. Ask for your partner’s help. Remember that your partner may not want to do some things you want to try, and you may not want to try what your partner wants. You should respect each other’s comforts and discomforts. This helps you and your partner have a good sexual relationship. If you feel you can’t talk to your partner, your doctor or a counselor may be able to help you.
If you feel like your partner is abusing you, tell your doctor.
When a man can’t get an erection to have sex or can’t keep an erection long enough to finish having sex, it’s called erectile dysfunction or impotence. Erectile dysfunction can occur at any age, but it is more common in men older than 65.
How erectile dysfunction is treated depends on what is causing it. After your doctor checks you for medical problems and medicines that might cause erectile dysfunction, he or she may have you try a medicine to help with erectile dysfunction. Some of these medicines are injected into your penis. Other medicines are taken by mouth. Not everyone can use these medicines. Your doctor will help you decide if you can try them.
If the medicines aren’t right for you, you could also try using vacuum pump devices, or you could have surgery. Your doctor may send you to an urologist to talk about these options.
The body is made up of many types of cells. Normally, cells grow, divide and then die. Sometimes, cells mutate (change) and begin to grow and divide more quickly than normal cells. Rather than dying, these abnormal cells clump together to form tumors. If these tumors are cancerous (also called malignant tumors), they can invade and kill your body’s healthy tissues. From these tumors, cancer cells can metastasize (spread) and form new tumors in other parts of the body. By contrast, noncancerous tumors (also called benign tumors) do not spread to other parts of the body. Prostate cancer is abnormal cells in the prostate gland.
Like many types of cancer, prostate cancer can be aggressive. This means it grows quickly and can spread to other parts of the body. (When cancer spreads, doctors say the cancer has “metastasized.”) Prostate cancer can also grow more slowly.
If you have prostate cancer, it is important for your doctor to monitor the growth of your cancer carefully. If left completely unchecked, the cancer can grow quickly and spread to other organs in your body. This makes treatment much more difficult.
Eating enough fiber and drinking enough fluids are key to treating constipation. They help your stools move through your intestines by increasing the bulk of your stools and making your stools softer. Increasing how often you exercise will also help.
Talk to your family doctor if:
Eat plenty of fiber. At least 2 cups of fruits and 2 1/2 cups of vegetables per day is recommended. It is suggested that men age 50 and younger consume at least 38 grams of fiber per day, while women age 50 and younger should consume at least 25 grams per day. Add extra fiber to your diet by eating cereals that contain bran or by adding bran as a topping on your fruit or cereal.
If you are adding fiber to your diet, start slowly and gradually increase the amount. This will help reduce gas and bloating. Make sure to drink plenty of water, also.
Laxatives should usually be avoided. They aren’t meant for long-term use. An exception to this is bulk-forming laxatives.
Bulk-forming laxatives work naturally to add bulk and water to your stools so that they can pass more easily through your intestines. Bulk-forming laxatives can be used every day. They include oat bran, psyllium (one brand: Metamucil), polycarbophil (one brand: FiberCon) and methylcellulose (one brand: Citrucel).
You must use bulk-forming laxatives daily for them to work. Follow the directions on the label. Start slowly and drink plenty of fluids. Gradually increase how much you use every 3 to 5 days (as your body gets used to it) until your stools are softer and easier to pass.
You can help bulk-forming laxatives taste better by mixing them with fruit juice.
You may notice some bloating, gas or cramping at first, especially if you start taking too much or increase the amount you’re using too quickly. These symptoms should go away in a few weeks or less.
Mineral oil should generally be used only when your doctor recommends it, such as if you’ve just had surgery and shouldn’t strain to have a bowel movement. Mineral oil shouldn’t be used regularly. If it is used regularly, it can cause deficiencies of vitamins A, D, E and K.
Enemas aren’t usually necessary to relieve constipation. It’s better to let your body work naturally.
You may have to retrain your body to go without laxatives or enemas if you’ve been using them for a long period of time. This means eating plenty of fiber, possibly using a bulk-forming laxative, drinking plenty of water, exercising and learning to give yourself time to have a bowel movement.
If you’ve used laxatives and enemas for a long time, your family doctor may suggest that you gradually reduce the use of them to give your body a chance to return to normal. Be patient because it may take many months for your bowels to get back to normal if you’ve been using laxatives or enemas regularly. Talk with your family doctor about any concerns you have.
If you have type 2 diabetes, your body’s tissues do not get enough insulin. This results in high blood sugar levels. Some people who have type 2 diabetes don’t make enough insulin. Other people make enough insulin but their bodies are not able to use it properly.
Some people who have type 2 diabetes need to take insulin in shots to help control their blood sugar levels. Most take pills by mouth (oral medicine) to help control their diabetes. Some people take insulin and oral medicines.
Fecal incontinence is the inability to control of the bowel movements. This leads to stool (feces) leaking from the rectum (the last part of the large intestine) at unexpected times. This problem affects as many as more than 5.5 million Americans. It is more common in women and in the elderly of both sexes.
Many people with fecal incontinence are ashamed to talk about this problem with their doctor. They think that nothing can help them. However, many effective treatments for fecal incontinence are available.
You may find it helpful to make some changes in your diet. Alcohol, caffeine, foods high in acid (such as tomato or grapefruit), and spicy foods can irritate your bladder. Talk to your doctor if you think your diet may contribute to your incontinence.
Some people find that limiting how much they drink before bedtime helps reduce nighttime incontinence.
Losing weight if you are overweight can also help reduce incontinence.
Many women experience emotional symptoms during menopause. These symptoms may include sadness, anxiety and mood swings. For some women, symptoms can be severe. If you find that you’re having emotional problems, talk to your family doctor.
Calcitonin (some brand names: Calcimar, Miacalcin) is a hormone that helps prevent further bone loss and reduces the pain that some people have with osteoporosis.
Calcitonin can be taken as a shot or as a nasal spray. Its most common side effect is nausea
Deep vein thrombosis (also called DVT) is a blood clot in a vein deep inside your body. These clots usually occur in your leg veins. While DVT is a fairly common condition, it is also a dangerous one. If the blood clot breaks away and travels through your bloodstream, it could block a blood vessel in your lungs. This blockage (called a pulmonary embolism) can be fatal.
Anticoagulants can cause you to bleed more easily. For example, you might notice that your blood takes longer to clot when you cut yourself. You might also bruise more easily. If you have any unusual or heavy bleeding, call your doctor right away.
Warfarin can cause birth defects. Women who are pregnant shouldn’t take warfarin.
Some other medicines can affect how well an anticoagulant works. If you’re taking an anticoagulant, ask your doctor before you take any new medicine, including over-the-counter medicines or vitamins. Certain foods rich in vitamin K, such as dark green vegetables, can also affect how well an anticoagulant works.
Restless legs syndrome (also called RLS) is a condition in which your legs feel very uncomfortable when you are sitting or lying down. It affects both men and women and can occur at any age, including during childhood, but often worsens with age and becomes a problem for older adults. RLS can make sleeping and traveling difficult and uncomfortable. Some cases of RLS are related to other conditions, such as pregnancy, iron-deficiency anemia or kidney failure. Other cases of RLS have no known cause. RLS may be hereditary, which means it can run in your family.
Treatment for RLS includes medications and lifestyle changes. See the box below for a list of things that you can do at home to help relieve your symptoms.
Medications used to treat Parkinson’s disease can help reduce tremors and twitching in the legs. If your iron levels are low, your doctor may prescribe an iron supplement. Sleep aids, muscle relaxants (called benzodiazepines) and pain medications (called opioids) may also relieve symptoms. In some cases, an anticonvulsant medicine (usually used to stop seizures) can be helpful. For many cases of RLS, a combination of medications is usually needed to best treat the condition. Your doctor may prescribe several trials of medication before finding one that works best for your case of RLS.
Lowering your “bad” cholesterol (also called LDL, or low-density lipoprotein) can reduce your risk of having a heart attack or stroke. A number of lifestyle changes can help you improve your cholesterol level (see the box below). However, if these lifestyle changes don’t help after about 6 months to 1 year, your doctor may suggest medicine to lower your cholesterol.
Even if you take cholesterol-lowering medicine, it’s important to keep up with your lifestyle changes. Eating a healthy diet and being physically active can make your medicine more effective. Your doctor can give you tips on how to make healthy food choices and include physical activity in your daily routine.
Nonsteroidal anti-inflammatory drugs (also called NSAIDs) stop cyclooxygenase enzymes (also called COX enzymes) in your body from working. COX enzymes speed up your body’s production of hormone-like substances called prostaglandins. Prostaglandins cause the feeling of pain by irritating your nerve endings. They are also part of the system that helps your body control its temperature.
By reducing the level of prostaglandins in your body, NSAIDs help relieve pain from conditions like arthritis. They also help reduce inflammation (swelling), lower fevers and prevent blood from clotting.
You have 2 types of COX enzymes in your body: COX-1 and COX-2. Researchers believe that one of the jobs of COX-1 enzymes is to help protect your stomach lining. The COX-2 enzyme doesn’t play a role in protecting your stomach.
Traditional NSAIDs stop both COX-1 and COX- 2 enzymes from doing their jobs. When COX-1 enzymes are blocked, pain and inflammation is reduced, but the protective lining of your stomach is also reduced. This can cause problems such as upset stomach, ulcers and bleeding in your stomach and intestines.
COX-2 inhibitors only stop COX-2 enzymes from working. Since the COX-2 enzyme doesn’t help to protect your stomach, COX-2 inhibitors may be less likely to irritate your stomach or intestines.
If you use 2 or more drugs at the same time, the way your body processes each drug can change. When this happens, the risk of side effects from each drug increases and each drug may not work the way it should. This is called a “drug-drug interaction.” Vitamins and herbal supplements can affect the way your body processes drugs too.
Certain foods or drinks can also prevent your medicine from working the way it should or make side effects worse. This is called a “drug-food interaction.” For example, if you’re taking a traditional NSAID, drinking alcohol can increase your risk of liver disease or stomach bleeding.
Drug-drug interactions and drug-food interactions can be dangerous. Be certain that your doctor knows all of the over-the-counter and prescription medicines, vitamins and herbal supplements that you are taking. Also, talk to your doctor before you take any new over-the-counter or prescription medicine or use a vitamin or herbal supplement.
It’s important to take medicines exactly as your doctor tells you to. Ask your doctor whether you need to avoid any foods or drinks while using a prescription NSAID.
As many as 1 out of every 3 people who have a heart attack report feeling depressed. Women, people who have been depressed before, and people who feel alone and without social or emotional support are at a higher risk for feeling depressed after a heart attack.
Being depressed can make it harder for you to recover. However, depression can be treated.
People who are depressed have most or all of the above symptoms nearly every day, all day, for 2 or more weeks. One of the symptoms must be depressed mood or loss of interest in daily activities.
If you have some or all of the above symptoms, see your family doctor. Your doctor will ask you questions about your symptoms, your health and your family’s history of health problems.
Many times people feel depressed because they are inactive and aren’t involved in social and recreational activities. You may find that participating in a hobby or recreational activity improves your mood. Interacting more with other people or beginning an exercise program can also help you feel better. Many people who have had a heart attack benefit physically and mentally from a cardiac rehabilitation program. Talk to your doctor about what kinds of activities and exercise programs are right for you.
Hospice is the term for a special program of care for terminally ill (dying) patients and their families. Rather than trying to cure an illness, hospice efforts aim to make the patient comfortable, ease pain and other troublesome symptoms and support the family through a sad and difficult time.
A hospice care program tries to provide the best quality of life for dying patients by providing a holistic approach. That means giving spiritual, mental, emotional and physical comfort to the patients, their families and their other caregivers.
Yes. The services of hospice care programs are provided wherever patients are spending their final days. This includes their own home, a family member’s home, a hospital, a nursing home or a hospice facility.
The members of the hospice team try to help nursing home patients be as free of pain as possible. They also try to help them be at peace with themselves and their illness. At the same time, the hospice team provides support, education and counseling to family members, nursing home staff and other nursing home residents who know the patient.
Bereavement support is help in coping with the loss of a loved one. Grieving is a normal psychological process that nursing home staff members, family members and friends go through when a person they love or take care of passes away.
Normal grief has no timetable or calendar. People experience grief in many different ways. Many people feel anger, loneliness, guilt, confusion and fear after a loved one dies. It helps to be able to talk about these feelings and about the person who has passed away.
Hospice is committed to helping people who are grieving. Hospice staff members and volunteers offer warm professional support to help family members with emotional healing and readjustment. Hospice respects the natural dying process. It provides patients and family members with an opportunity for spiritual growth during this final phase of life.
Yes. Depression is very common among people who have Alzheimer’s disease. In many cases, they become depressed when they realize that their memory and ability to function are getting worse.
Unfortunately, depression may make it even harder for a person who has Alzheimer’s disease to function, to remember things and to enjoy life.
Try to keep a daily routine for your family member who has Alzheimer’s disease. Avoid loud noises and overstimulation. A pleasant environment with familiar faces and mementos helps soothe fear and anxiety. Have a realistic expectation of what your family member can do. Expecting too much can make you both feel frustrated and upset. Let your family member help with simple, enjoyable tasks, such as preparing meals, gardening, doing crafts and sorting photos. Most of all, be positive. Frequent praise for your family member will help him or her feel better–and it will help you as well.
As the caregiver of a person who has Alzheimer’s disease, you must also take care of yourself. If you become too tired and frustrated, you will be less able to help your family member. Ask for help from relatives, friends and local community organizations. Respite care (short-term care that is given to the patient who has Alzheimer’s disease in order to provide relief for the caregiver) may be available from your local senior citizens’ group or a social services agency. Look for caregiver support groups. Other people who are dealing with the same problems may have some good ideas on how you can cope better and on how to make caregiving easier. Adult day care centers may be helpful. They can give your family member a consistent environment and a chance to socialize.
Sometimes when people feel sad, they say they are “depressed.” But depression is more than just feeling sad. It’s a medical illness. Someone who has “major” depression has most or all of the symptoms listed in the box below nearly every day, all day, for 2 weeks or longer. There is also a “minor” form of depression that causes less severe symptoms. Both have the same causes and treatment.
Medicines used to treat depression are called antidepressants. They correct the chemical imbalance in your brain that causes depression. These medicines usually work very well, but they may have some side effects. The side effects typically decrease with time. Antidepressants can start to work right away, but it may take 6 to 8 weeks before you see the full benefit. Don’t stop taking the medicine without checking with your doctor first.
Dementia is a brain disorder that makes it hard for people to remember, learn and communicate. These changes eventually make it hard for people who have dementia to care for themselves. Dementia may also cause changes in mood and personality. Early on, lapses in memory and clear thinking may bother the person with dementia. Later, disruptive behavior and other problems can create a burden for caregivers and other family members.
Dementia is caused by the damage of brain cells. A head injury, stroke, brain tumor or disease (such as Alzheimer’s disease) can damage brain cells and lead to dementia.
The agitation can have many causes. A sudden change in surroundings or frustrating situations can cause people who have dementia to become agitated. For example, getting dressed or giving the wrong answer to a question may cause frustration. Being challenged about the confusion or inability to do things caused by the dementia may also make the person agitated. As a result, the person may cry, become irritable, or try to hurt others in some way.
If the hallucinations are not making your loved one scared or anxious, you don’t need to do anything. It’s better not to confront people about their hallucinations. Arguing may just upset a person who has dementia. If the hallucinations are scary to your loved one, you can try to distract the person by involving him or her in a pleasant activity.
Sometimes very simple things can help with this problem. It is all right for your loved one to wander in a safe place, such as in a fenced yard. By providing a safe place, you may avoid confrontation. If this doesn’t work, remind your loved one not to go out a certain door by placing a stop sign on it or putting a piece of furniture in front of it. A ribbon tied across a door can serve as a similar reminder. Hiding the doorknob by placing a strip of cloth over it may also be helpful.
An alarm system will alert you that your loved one is trying to leave a certain area. Your alarm system may just be a few empty cans tied to a string on the doorknob. You might have to place special locks on the doors, but be aware that such locks might be dangerous if a house fire occurs. Don’t use this method if your loved one will be left home alone. Make sure your loved one wears a medical bracelet, in case he or she does wander away from home.
Dementia is a problem in the brain that makes it hard for a person to remember, learn and communicate. After a while, this makes it hard for the person to take care of himself or herself.
Dementia may also change a person’s mood and personality. At first, memory loss and trouble thinking clearly may bother the person who has dementia. Later, disruptive behavior and other problems may start. The person who has dementia may not be aware of these problems.
If your family member has some of the signs of dementia, try to get him or her to go see a doctor. You may want to go along and talk with the doctor before your relative sees him or her. Then you can tell the doctor about the way your relative is acting without embarrassing your relative.
Grief is a normal, healthy response to loss. One of the greatest losses that can occur is the death of someone you love. Other losses include the loss of your health or the health of someone you care about, or the end of an important relationship, such as a marriage. Healing from a loss involves coming to terms with the loss and the meaning of the loss in your life.
In the first hours or days after the loss, you may feel shocked, numb and confused. You may not remember what people have said to you. You may think and act as though the loss hasn’t occurred. This is called denial.
As the shock wears off, reality will slowly break through. You’ll begin to realize that the loss has happened. It’s normal to feel abandoned and angry. You may direct your anger toward God, religion, doctors and nurses, the one who has died or other loved ones, or even yourself.
You may start to feel better in small ways. For example, you may find it’s a little easier to get up in the morning, or you may have small bursts of energy. This is the time when you’ll begin to reorganize your life around your loss or without your loved one.
You’ll probably start to feel better in 6 to 8 weeks. The whole process can last anywhere from 6 months to 4 years.
If you feel like you’re having trouble at any point, ask for help. People who can help include friends, family, clergy, a counselor or therapist, support groups and your family doctor.
Be sure to talk with your family doctor if you have a lot of trouble eating, sleeping or concentrating for more than the first couple of weeks. These can be signs of depression. Your family doctor can help you with depression so you can start to feel better.
No. Pathologists perform autopsies in a way that doesn’t interfere with burial or cremation. Once the autopsy is completed, the hospital tells the funeral home. An autopsy won’t delay funeral services.
Pressure sores are areas of injured skin and tissue. They are usually caused by sitting or lying in one position for too long. This puts pressure on certain areas of the body. The pressure can reduce the blood supply to the skin and the tissues under the skin. When a change in position doesn’t occur often enough and the blood supply gets too low, a sore may form. Pressure sores are also called bedsores, pressure ulcers and decubitus ulcers.
Anyone who sits or lies in one position for a long time might get pressure sores. You are more likely to get pressure sores if you use a wheelchair or spend most of your time in bed. However, even people who are able to walk can get pressure sores when they must stay in bed because of an illness or injury. Some chronic diseases, such as diabetes and hardening of the arteries, make it hard for pressure sores to heal because of a poor blood supply to the area.
Don’t lie on pressure sores. Use foam pads or pillows to take pressure off the sore. Special mattresses, mattress covers, foam wedges or seat cushions can help support you in bed or in a chair to reduce or relieve pressure. Try to avoid resting directly on your hip bone when you’re lying on your side. Use pillows under one side so that your weight rests on the fleshy part of your buttock instead of on your hip bone. Also, use pillows to keep your knees and ankles apart. When lying on your back, place a pillow under your lower calves to lift your ankles slightly off the bed. Change your position at least every 2 hours.
When sitting in a chair or wheelchair, sit upright and straight. An upright, straight position will allow you to move more easily and help prevent new sores. If you cannot move by yourself, have your caregiver shift your position at least every hour, or more often if possible.
Hospice care: Talk with your loved one about hospice care and advanced directives. Hospice care focuses on providing people whose illness can’t be cured or controlled with treatment with the most dignified, pain-free existence possible in their last stage of life. Advance directives are instructions on what kind of care your loved one wishes to receive when he or she becomes unable to make medical decisions.
Financial and legal issues: You and your loved one may wish to have an accountant or lawyer help you sort through financial and legal issues. You can review things such as your loved one’s insurance policy, finances and his or her will.
Funeral arrangements: Perhaps the most difficult part of this process is planning your loved one’s funeral. Talk with your loved one about his or her preferences (for example, burial vs. cremation) in relation to your budget. Ask your loved one how he or she wants the service to be conducted. For example, you may want to discuss things such as what hymns or readings to include in the ceremony and whom your loved one wants to have as his or her pallbearers. Don’t feel that any detail is too small to discuss. When selecting a funeral provider, be sure to compare prices, services and payment options. It will be easier to do this sooner rather than later.
CPR may be done when a person stops breathing or the heart stops beating (like when a person has a heart attack). When it’s possible that the person may get better, CPR is important.
However, when a patient has an advanced life-threatening illness (such as cancer) and is dying, CPR may not be the option to choose. It’s important for the patient, family members and doctor to talk about this issue before the need arises.
Pressing on the chest can cause a sore chest, broken ribs or a collapsed lung. Patients with breathing tubes usually need medicine to keep them comfortable. Most patients who survive will need to be on a breathing machine in the intensive care unit to help them breathe for a while.
Few patients (less than 10 percent) in the hospital who have had CPR survive and are able to function the way they used to. Many patients live for a short time after CPR, but still die in the hospital. CPR may also prolong the dying process.
Patients who have more than one illness usually don’t survive after CPR. Almost no one with advanced cancer survives CPR and lives long enough to leave the hospital. Of the few patients who do, many get weaker or have brain damage. Some patients may need to live on a breathing machine for the rest of their lives.
Artificial hydration is a way to replace fluids that have been lost through vomiting, sweating or diarrhea. It may be necessary when a person is too sick to drink enough water or eat enough food.
There are two ways to replace fluids in someone who needs them. The first way is to put the fluid right into a vein. This is called intravenous (IV) fluid replacement. The other way is to put the fluid under the skin. This is called hypodermoclysis, or subcutaneous fluid replacement.
With IV fluid replacement, doctors and nurses need to watch the person very closely in a hospital. But a family member or other caregiver can do hypodermoclysis at home after a doctor or nurse shows him or her how to do it.
A bag of fluid is connected to a plastic tube and to a long needle. The needle is put under the skin and taped in place, usually on the chest, abdomen or thighs.
A “drip chamber,” or small window, in the tube shows how fast the fluid is dripping. The speed of the drip can be controlled by using a roller clamp. A nurse or doctor should replace the needle every 4 to 7 days so the flesh around the needle does not become infected.
Your doctor will decide how fast the fluid should drip. Your doctor will show you how to control the drip and tell you when to check it at home. You can ask your doctor for help if you have questions or problems.
If a patient isn’t able to swallow because of a medical problem, he or she can be given fluids and nutrition in ways other than by mouth. This is referred to as artificial hydration and nutrition. This is sometimes done when someone is recovering from a temporary problem. It may also be done when someone has an advanced, life-threatening illness and is dying.
There’s always a risk when someone is fed through a tube. Liquid might enter the lungs. This can cause coughing and pneumonia. Feeding tubes may feel uncomfortable. They can become plugged up, causing pain, nausea and vomiting. Feeding tubes may also cause infections. Sometimes, patients may need to be physically restrained or sedated to keep them from pulling out the feeding tube.
An advance directive tells your doctor what kind of care you would like to have if you become unable to make medical decisions (if you are in a coma, for example). If you are admitted to the hospital, the hospital staff will probably talk to you about advance directives.
A good advance directive describes the kind of treatment you would want depending on how sick you are. For example, the directives would describe what kind of care you want if you have an illness that you are unlikely to recover from, or if you are permanently unconscious. Advance directives usually tell your doctor that you don’t want certain kinds of treatment. However, they can also say that you want a certain treatment no matter how ill you are.
Advance directives can take many forms. Laws about advance directives are different in each state. You should be aware of the laws in your state.
A durable power of attorney (DPA) for health care is another kind of advance directive. A DPA states whom you have chosen to make health care decisions for you. It becomes active any time you are unconscious or unable to make medical decisions. A DPA is generally more useful than a living will. But a DPA may not be a good choice if you don’t have another person you trust to make these decisions for you.
Living wills and DPAs are legal in most states. Even if they aren’t officially recognized by the law in your state, they can still guide your loved ones and doctor if you are unable to make decisions about your medical care. Ask your doctor, lawyer or state representative about the law in your state.
By creating an advance directive, you are making your preferences about medical care known before you’re faced with a serious injury or illness. This will spare your loved ones the stress of making decisions about your care while you are sick. Any person 18 years of age or older can prepare an advance directive.
People who are seriously or terminally ill are more likely to have an advance directive. For example, someone with terminal cancer might write that she does not want to be put on a respirator if she stops breathing. This action can reduce her suffering, increase her peace of mind and increase her control over her death. However, even if you are in good health, you might want to consider writing an advance directive. An accident or serious illness can happen suddenly, and if you already have a signed advance directive, your wishes are more likely to be followed.
You may change or cancel your advance directive at any time, as long as you are considered of sound mind to do so. Being of sound mind means that you are still able to think rationally and communicate your wishes in a clear manner. Again, your changes must be made, signed and notarized according to the laws in your state. Make sure that your doctor and any family members who knew about your directives are also aware that you have changed them.
If you do not have time to put your changes in writing, you can make them known while you are in the hospital. Tell your doctor and any family or friends present exactly what you want to happen. Usually, wishes that are made in person will be followed in place of the ones made earlier in writing. Be sure your instructions are clearly understood by everyone you have told.
Medicines can help you feel better. But if medicines are taken incorrectly, they can actually make you feel worse. To use prescription medicines and medicines you can buy “over-the-counter” (without a prescription) correctly, follow the guidelines below.
Make your medicine part of your daily routine by taking it at the same time (or times) every day, such as when you wake up or with meals. Keep the medicine bottle(s) in a place you see often, such as on the kitchen counter. (Make sure that medicines are in childproof containers and kept out of the reach of children.)
Talk to your doctor about things to avoid while you are taking a prescription medicine. Some foods can cause side effects, such as stomach upset, if you are taking medicine. Drinking alcohol is generally not a good idea while you are taking medicine. Some medicines cause reactions such as sun sensitivity (getting a sunburn or sun rash), so you may have to limit your outdoor activities or protect your skin from the sun.
If you are taking an over-the-counter medicine, read the label to see what to avoid while you are taking it. Follow the instructions just as you would with a prescription medicine. If you have questions, ask your doctor or pharmacist.
Just like foods, some medicines come in both brand names and generics. Generic medicines are generally cheaper. Ask your doctor or pharmacist if a generic form of your prescription medicine will work for you.
Over-the-counter (OTC) medicines also come in generics. Compare the lists of ingredients. If the generic has the same ingredients as the brand name, you may want to consider using it. But be careful: The generic may contain different amounts of certain medicines. Ask your doctor or pharmacist if you have questions about which medicine to choose.
Any medicine needs time to work. When you are given a prescription, ask your doctor how long it should take for the medicine to make you feel better. It might take time to find the correct medicine for you and the correct amount of it. Call your doctor if you have concerns about what you’re taking or if you don’t feel better after taking your medicine as prescribed.
If you’re trying to treat yourself with an over-the-counter medicine and it doesn’t seem to be working, call your doctor. Your sickness can get much worse if you wait too long to get treated by your doctor.
A drug-food interaction happens when the food you eat affects the ingredients in a medicine you are taking so the medicine cannot work the way it should.
Drug-food interactions can happen with both prescription and over-the-counter medicines, including antacids, vitamins and iron pills.
A drug-food interaction happens when the food you eat or drink affects the ingredients in a medicine you are taking so the medicine can’t work the way it should.
Drug-food interactions can happen with both prescription and over-the-counter medicines, including antacids, vitamins and iron pills.
Only some medicines interact with grapefruit. Examples include medicines for:
Medicines can treat or prevent illness and disease. However, sometimes medicines can cause problems. These problems are called adverse drug reactions. You should know what to do if you think that you or someone you take care of is having an adverse drug reaction.
No. Even medicines that don’t need a prescription (called over-the-counter medicines) can interact with each other or with prescription drugs and cause problems. Supplements, herbal products in teas or tablets, or vitamins may also cause adverse reactions when taken with certain drugs. Be sure to tell your doctor and pharmacist if you’re using any of these products.
Some types of food may also cause adverse drug reactions. For example, grapefruit and grapefruit juice, as well as alcohol and caffeine, may affect how drugs work. Every time your doctor prescribes a new drug, ask about possible interactions with any foods or beverages.
Acetaminophen and NSAIDs relieve pain caused by muscle aches and stiffness, and reduce fever. NSAIDs can also reduce inflammation (redness and swelling).
OTC pain relievers can be helpful in treating many types of pain, such as pain from arthritis, earaches, back pain, and pain after surgery. They can also treat pain from the flu (influenza) or a cold, sinusitis, strep throat or a sore throat. Children who may have the flu or chickenpox should not take aspirin because they are at higher risk to develop a condition called Reye’s Syndrome.
Acetaminophen can be a good choice for relieving headaches and other common aches and pains. It can be used safely by most people on a long-term basis for arthritis and other chronic painful conditions if pain is improved. Make sure you tell your doctor about any OTC medications you take regularly.
Ibuprofen is helpful for menstrual cramps and pain from inflammation (such as muscle sprains). If ibuprofen doesn’t work for you, naproxen and ketoprofen may be options.
Side effects from OTC pain relievers aren’t common for healthy adults who only use pain relievers once in a while. However, side effects can be a concern for people who use pain relievers often or who have health problems. If you have health problems or use pain relievers often, talk to your doctor.
Acetaminophen can be used safely by most people. It can cause liver damage in people who take very high doses or who already have abnormal liver function . To reduce your risk of liver problems, never take more than the recommended dose of acetaminophen. For adults and children older than 12, this means a maximum of 8 extra-strength or 12 regular-strength pills a day.
With long-term use, NSAIDs can cause gastrointestinal (GI) problems. These problems range from upset stomach to ulcers to GI bleeding. For minor stomach upset, eating some food or drinking some milk before you take an NSAID may help. Your risk of GI problems from NSAIDs goes up the higher the dose you take and the longer you take them. Drinking alcohol may increase this risk. Acetaminophen is much less likely than NSAIDs to cause GI problems.
NSAIDs may also make high blood pressure worse. If NSAIDs are used regularly for many years, they can also hurt your kidneys. Your doctor can check for this problem with a blood test.
If you have questions about the side effects of OTC pain relievers, talk to your doctor.
A hip fracture is a break in the bones of your hip (near the top of your leg). It can happen at any age, although it is more common is people 65 and older. As you get older, the inside of your bones becomes porous from a loss of calcium. This is called losing bone mass. Over time, this weakens the bones and makes them more likely to break. Hip fractures are more common in women, because they have less bone mass to start with and lose bone mass more quickly than men.