Monday, June 27, 2022

Medication and High Blood Pressure - What You Need to Know

About 75% of people over the age of 60 have high blood pressure, and this increases their risk of having a heart attack or stroke.  If you are one of those people, and you have been trying without success to lower your blood pressure by eating healthy and getting exercise, you may be surprised to discover that the real problem could be some of the medications you are taking, including over-the-counter drugs.  

How can you find out which drugs are most likely to cause your blood pressure problems?  Is there a way to reduce your risk?

Over-the-Counter Medications which Raise Blood Pressure

Two common NSAIDS which can raise your blood pressure, especially when taken in high doses or for a long time, are Ibuprofen and Naproxen.  In addition, they can also reduce the effectiveness of the medications your doctor might prescribe to help you lower your blood pressure.  

Other medications which raise blood pressure are things you might pick up at your local grocery store or pharmacy, including cold and cough medicines, decongestants and certain antacids which are high in sodium. Carefully read the labels to see if any over-the-counter medication you are taking should not be used by someone with high blood pressure.

You should also avoid weight-loss stimulants, as well as some herbal remedies and dietary supplements.

If you take any of these over-the-counter medications, your doctor may not be aware of it.  Make sure he knows exactly what you are taking, how much of it, and for how long.  Make a list of everything you take, including over-the-counter medications, and bring it with you to your doctor appointments. Your physician may be able to help you find a safer option. 

Prescription Drugs Which Can Raise Blood Pressure

If you are struggling with high blood pressure and cannot understand why it is so hard for you to control it, you might also ask your pharmacist or doctor to go through your list of prescription medications with you and see if one of them could be causing your problem.

Antidepressants, including fluoxetine, monoamine oxidase inhibitors, and tricyclic antidepressants, are one category of drugs which could raise your blood pressure.  Even if you successfully took one of these antidepressants for years, you may have to change to a different one as you age and develop new health problems.

Another category of drugs which raise blood pressure are the oral steroids which are often prescribed to treat conditions such as gout, lupus, rheumatoid arthritis and other types of inflammation. 

If you have an autoimmune disease or cancer, your doctor might prescribe immunosuppressants, central nervous system stimulants, or other drugs to treat your condition. These drugs can also increase your blood pressure.

How to Protect Yourself from Dangerous Medication Combinations

If you have high blood pressure and other indications that you are developing heart problems, you may want to try reading the highly rated book shown here: "Prevent and Reverse Heart Disease."  (Ad)  It could help you learn how to counteract some of the health issues you have been experiencing, and get you back on the road to feeling better.

In addition, discuss your health treatments with your physician. Obviously, if you are taking a life-saving drug to help you deal with depression, cancer or some other serious illness, that may be more important than a minor increase in blood pressure. However, if your blood pressure becomes seriously high, you may want to talk to your doctor about potential alternatives.

Do not forget that your pharmacist is also a valuable resource. Try to fill all prescriptions at one pharmacy.  Their computer system will automatically alert the pharmacist if you are prescribed a drug which might be inappropriate for you.  Most pharmacists are also willing to spend time discussing your prescriptions with you and may be able to recommend alternatives that your doctor does not know about. If you are regularly taking an over-the-counter medication, or trying to find something to take for a cough, cold or allergies, your pharmacist may be able to make recommendations which will not raise your blood pressure.

Knowledge is power. We all need to be aware of how the things we put in our bodies can affect us, and be willing to take advantage of all the resources available to us.  

Source of facts: AARP Bulletin, October 2021

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Friday, June 17, 2022

Train Your Working Memory to Improve Cognitive Function

UCI Memory Lab Brain Training Helped Me.
In the summer of 2018, I took a brain class from a local community college, which started me on a journey to protect my cognitive ability, to the extent possible.  I was in my late 60s at the time.  During that class, a guest speaker from the University of California - Irvine MIND Program asked us to sign up for their C2C registry, which stands for "Consent to Contact."  They use this registry to find people who are willing to participate in a variety of studies to help them test different programs which might improve the memory of people as they age. I was excited to join their program!  If you have a research university near you, you might be able to enroll in a similar opportunity.

APT Webstudy

The first program UCI directed me to try has been the APT Webstudy, which is available to anyone, anywhere for free over the internet.  You can try it, too.  Since 2019, I have logged on, as instructed, every three months and used their online program to test myself to see if there has been any changes in my working memory.  Working memory could also be thought of as your very short-term memory, or your ability to keep track of things going on right now.

The program consists of doing a self-report on my memory, and then playing four games on the screen to test myself.  The tests consist of looking at a series of playing cards and trying to remember whether I have seen that card earlier in the test.  

The APT Web Study takes me about 20 minutes every three months, which means the time commitment is minimal. So far, my scores have remained remarkably stable, going up and down by only a small amount over the past three years. That is ideal.  The program describes itself as an Alzheimer's Prevention Trial for people over the age of 50.  I don't know that it will prevent Alzheimer's Disease, but it will provide you important clues to watch and discuss with your doctor if your scores begin to change.  If you want to try it out and track your memory yourself, you can find the free program at:  

I have found it very reassuring to be able to test myself every few months and confirm that my working memory continues to operate normally. However, this test does not seem to do anything to improve my memory, as far as I can tell.  It is possible, however, that it is slightly training my working memory, which is a benefit in itself.

Next I Tried tDCS Brain Stimulation

In May of 2022, I also agreed to participate in a more active type of brain training involving the use of tDCS electrical stimulation on my brain, while I simultaneously completed a series of memory activities under the supervision of researchers. This study took place at the UCI Working Memory and Plasticity Lab under the direction of Dr. Susanne Jaeggi, with the help of a number of research assistants.  According to their brochure, they "have developed an intervention on cognitive training and successful aging.  The aim of the intervention is to optimize opportunities for cognitive health and wellbeing in older adults."  Anything that could help me achieve more successful aging sounds like a good program to me!

Over the past decade the researchers at the UCI Memory lab have "developed computerized interventions to improve learning and memory in diverse populations ... focused on working memory."  

They have used their interventions to train several hundred children, young adults, and older adults (like me!).  They have also found that just a couple of weeks of training improved working memory for at least several months, with the hope that the benefits will last much longer.   According to their research "the more you train, the more you improve."  

What Happened During the tDCS Experiment?

The first session began with a series of sixteen words which I was shown briefly. Then I was asked to recall as many as possible.  Afterwards, I was hooked up to the tDCS device, with two electrodes strapped to my head.  The letters stand for Transcranial Direct Current Stimulation. It is described as "a non-invasive, painless brain stimulation treatment that uses direct electrical currents to stimulate specific parts of the brain. A constant, low intensity current is passed through two electrodes placed over the head which modulate neuronal activity."  It has been used for several years as a treatment for depression and now they are doing research to see if it can also improve working memory.  Early research indicates that it may be effective. The idea of trying it sounded exciting to me, and also a little scary.  

While wearing this equipment, I used an iPad to perform a number of memory tests, which were in addition to the word memory test which I had been given at the start of the session.  The computer tests consisted of being shown an object, animal, plant or number and then recalling whether it was the same as the item I had watched scroll by briefly on the computer screen one back, then two back, and eventually three back.  

In other words, I might be shown a lemon, then an orange, then an apple, then a lemon, then a pear, then an apple, and so on.  When I got to the second lemon, I had seen it before "three back," so I clicked on it.  I had to keep on my toes, because I had also seen the apple three back, and I had to click on it.  I confess that at times I got confused about when I had seen an object before. Was it two back, three back, or four back?  However, I plunged ahead and tried my best.

After the tDCS electrodes were removed about 30 minutes later, I was asked to recall the words that I had been asked to remember at the beginning of the session!

Following the brain activities, I was taken to another building where they performed an MRI to see how my brain looked on the first day of the training program.

That was the end of the first session.

For sessions two through six, which took place the following week, I did all the same things, except I did not repeat the MRI that week.  At the beginning of each session I was shown a group of 16 new words, and asked to repeat them from memory.  Then, I was asked to recall all the words I could from earlier in the week. By Friday, I was being asked to recall as many of the 80 words I had been asked to memorize as possible! 

After the word recall, I spent about an hour each day in the lab with the tDCS electrodes strapped to my head, while performing a variety of memory matching tests, striving to improve how far back I could remember the items each time.

The following week, I attended session seven, which was a repeat of session one, including the MRI.  The researchers plan to compare the two MRIs to see if my brain underwent any physical changes as the result of the training.  

During the second MRI, I was given a device with two buttons on it. I was shown a series of words and asked to punch either the "yes" or "no" button to confirm whether or not the word I was shown briefly on a screen was a word I had been asked to memorize during the preceding week. I did this while the MRI machine was making its loud, metallic sounds.  It was very challenging and I know I made a few mistakes during the session.

The UCI Memory Lab plans to do a follow-up set of memory tests, plus an additional MRI, in three months to see if my memory and my brain have maintained their training. I certainly hope I continue to benefit from this training. I have noticed that it seems slightly easier for me to remember names and events since my seven sessions at the memory lab. Is it real improvement or am I just imagining it?  It is hard to know for sure.

Meanwhile, I may try some memory games to continue exercising my brain, even though I will not have the tDCS machine to use while practicing the memory games.  One highly ranked workbook I found was the "Memory Activity Book:  100+ Brain Exercises to Supercharge Your Memory."  (Ad) It is certainly worth a try while I attempt to retain as much of my enhanced memory as possible.  Anyone could use this book, or a similar one, to train their own memory.  UCI emphasizes that we all must "use it or lose it" when it comes to keeping our brains active.

I was also surprised to learn that it is possible to purchase your own tDCS device and, in fact, you can look here at a: wide variety of tDCS devices in various price ranges (Ad) and see if one of them could help give your own memory a boost.  I do not know if one is any better than the others, so you may want to read the reviews and discuss it with your private physician.  

The tDCS device I used at UCI did not have any negative side effects on me. I did not experience pain or any type of sensation, either during or after the procedure. However, your experience could be different.  They did question me frequently about whether it gave me a headache, made my scalp itch, cause any rashes, and things like that.  My conclusion from their questions is that some people do have negative side effects.

Brain Classes and Personal Behavior 

In addition to the studies mentioned above, I have continued to take brain classes and attend programs held by various researchers from the University of California at Irvine.   Here are the basics of the personal behaviors you can adopt in order to protect your brain health and retain your memory as long as possible:

Cognitive Engagement or challenging yourself mentally is an important key to brain health.  This means learning new skills, reading books, playing a musical instrument and things like that.

Social Engagement or spending quality time with family and friends, including making new friends, is beneficial to cognition.  The best "brain game" you can play is to be deeply engaged in an interesting conversation with other people.

Diet and Nutrition, or specifically adhering to a "heart healthy" diet such as the Mediterranean diet, is linked to overall brain health and longevity.  One of the most highly recommended diets for brain health is called the "Mind Diet" (Ad) and it is worthwhile to pick up a copy of the cookbook so you can follow their diet plan more closely.  

Physical Activity, including any type of exercise, can produce "beneficial changes to brain structure and cognitive function.  This means that physical activity can actually change the structure of your brain, and it can be virtually any activity you enjoy ... walking, swimming, dancing, gardening, etc.

Sleep is crucial for brain health.  In fact, every session I had with the tDCS machine started with questions about how I slept the night before.  

If you want to age well and maintain a strong working memory and your cognitive ability well into your retirement years, you may want to to take brain classes in your area, participate in any brain training they offer, and adopt the personal behaviors recommended above.  These actions could make a huge difference in the quality of your life in the future. 

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Tuesday, June 7, 2022

Mandatory Evacuations - What to Take With You


With wildfires, tornadoes, hurricanes, and floods expected to increase in frequency and intensity in the coming decades, millions of people in the U.S. and around the world are likely to face a mandatory evacuation at least once in their lifetimes. In the best case scenario, you might have plenty of time to prepare, such as when a hurricane is predicted to hit your area in a few days.  On the other hand, a mandatory evacuation could happen without warning and you may have only a few minutes to get out.  The warning could even come with a phone call in the middle of the night, when you are groggy and not thinking clearly.  

Whether you have plenty of time to prepare, or you need to leave in a hurry, everyone should have a plan and a list of everything they need to have with them during an evacuation.  One thing you could do is print this article and post it in a prominent place in your home, where you can quickly review it and use it as a checklist when you need to leave in hurry.  Just add your own notes in the margin about where to find things.

If You Have 15 Minutes or Less to Evacuate

Obviously, if a wildfire is roaring up the hillside towards your home in the middle of the night, you may have to rush out the door in your pajamas, jump in your car, and take off, leaving everything behind. Your life is more important than anything in your home.  

However, in most cases, people have at least a a few minutes of warning that they need to evacuate.  In that situation, below are the most important things you need to make sure you have with you.  Clip out this list and put it in several convenient places in your home, such as in the drawer of your nightstand, on the door of your refrigerator, or some other safe place where it will be easy to find. In an emergency, it is easy to get rattled and forget something obvious, such as your wallet or cell phone.  Having a list will help you stay focused on the most important things you need to do. 

Your family - Try to be sure that everyone is accounted for and in the car with you before you worry about anything else.  

Your pets
- If possible, put your pets in a small, portable pet kennel (Ad). They come in a variety of shapes and sizes. It will make it easier to control your animals, especially if they become afraid or excited about what is happening.  Put your pets in the car as soon as you can, so they do not panic and disappear.  However, do not delay your evacuation by spending a lot of time looking for them.  If they hide and cannot be found, you may have to leave them behind.  In the event of a fire, let the firefighters know about any missing pets and they will try their best to rescue them.

Your purse and wallet - If you have your wallet and/or purse with you, it means you will probably have your driver's license, some cash, your bank debit card, and credit cards.  This will enable you to rent a hotel room, or purchase food and other items you may need while you are evacuated. 

Your medications - If you are taking any life saving medications, grab a bag and just sweep them into it.  Do not take the time to sort through them.  Just take everything you think you might need.  Once you get to an evacuation center, they can help you replace any medications which you may have missed.

Important documents
- Ideally, everyone should have a small portable lockbox or fireproof home safe (Ad) that contains your important documents, all in one place.  These documents should include your passports, birth certificates, social security cards and copies of insurance policies, including policies on your home and automobiles. If you store all these papers in one convenient lockbox or safe, it will be easy to grab all the documents you would otherwise not have time to locate.  Later, it will save you time if you do not have to replace your important documents.   You may also want to keep copies of your important documents in a notebook, which you can grab as you rush out the door, even if you have very little time. My husband and I have a notebook which contains copies of our wills, trust, Advanced Directives, I.D.'s, insurance policies, marriage certificates, birth certificates, and other important information we might need in an emergency.

Small electronics - Because most of us have a great deal of important information stored on our phones, tablets, and laptop computers, you want to try to grab these things, along with their chargers, before you take off.  It will make it easier for you to find contact phone numbers of your friends and family, and enable you to let others know you are OK. 

If the items above are the only things you have time to grab, at least you will be leaving with your most essential items.  Hopefully, however, you will have enough evacuation time to toss a few more items in your car.  

IMPORTANT:  If you are fleeing a wildfire, do not spend more than 5 minutes gathering as much as you can before you leave.  Fires can move quickly and you may have less time to get to safety than you think you do.

If You Have an Hour or More to Evacuate

If you have a little extra time to evacuate, you still need to hurry.  This would include situations such as when a fire is in your general area, but has not reached your neighborhood; or when a hurricane has taken an unexpected turn towards you, but is still a few hours away; or when you live in a flood prone area with a major storm headed your way.  In these situations, you might have an extra 30 to 60 minutes to evacuate, or even a little more time, but you still should not linger too long. If you are fortunate enough to have this extra time, what additional items should you take with you?

Make sure you have everything listed above - Do not let yourself get distracted by things you want to take, until you are sure you have loaded everything you need to take. First, double-check that you have everyone in your family, and, if possible, your pets, wallets, medications, small electronics and important documents.  

Secure Your Preschoolers in the car - Strap your youngest children into their car seats, and pack up a few things for them.  Make sure they have a favorite stuffed animal they can cling to.  Things could be very crazy for the next few days, and having their favorite toy will bring them some comfort when they do not understand what is happening.  Make sure you also have diapers, formula, or any other essentials which could be hard to find for a few days.

Let Your School Age Children Grab What they Want -  Give children who are old enough a suitcase or even a couple of trash bags.  Tell them to put some clothing and their toothbrushes in one bag, and a few of their favorite toys in the other.  This could reduce their stress in two ways.  First, you are giving them a task which will distract them from what is happening.  Second, if your home is destroyed, at least your children will have been able to bring a few of their favorite things with them.  Most other things can eventually be replaced. 

Fill a suitcase or a couple of shopping bags with your valuables - Since you have a little extra time, put your jewelry box, small family heirlooms, photo albums, artwork, sterling silver, and similar items in a few shopping bags and put them deep in interior of your car's trunk. These are things you will not need to get out when you stop at a hotel or an evacuation center.  However, it will give you peace of mind to know that they are safely locked in your car.

Fill a suitcase with an armload of clothing - Ideally, you should have a change of clothing, underwear, toiletries and similar items for everyone in your family.  However, this is not the time to pack carefully.  Just grab a few things and stuff them in a suitcase.  You just need enough clothing to last a few days.  If your home is totally lost, local charities or your private insurance will help you replace some of your clothing.

Do a Last Minute Walk-Thru of Your Home - If you have the time, grab a trash bag and your cell phone camera.  Use your cellphone to make a video and quickly document everything you are leaving behind.  It will help with your insurance claims. Meanwhile, fill the trash bag with any last minute things which you would like to bring with you. Suggestions include favorite framed photos, the family Bible, mementos of trips, or a favorite painting still hanging on your wall. Grab anything you can quickly stuff into the bag.  You will cherish these things if you eventually have to replace your home.

Take All Your Cars With You - Although it may seem more convenient to have your whole family in one car, if there is more than one driver in the family, have them each drive one of the cars out of the evacuation area.  You do not want to lose one of your cars, if you can avoid it.  In addition, the extra car will give you more space to take things with you.  If your home is destroyed and you need to stay in temporary housing for a while, it will also be more convenient if everyone has their car with them. 

Below is a list from FEMA which you may also want to print out. It includes some of the additional items you may want to bring with you when you evacuate, if you have time.  It includes items you may want to have if you are uncertain about the conditions where you will be staying after an evacuation.  Below it you will find more emergency evacuation information.

How to "Prepare" to Evacuate

About 20 years ago, there were a number of fires burning in our part of California.   Although our home was not in immediate danger, we were told to "Prepare to Evacuate."  This gave us plenty of time to fill our cars with all the things mentioned in the lists above, as well as do a better job packing a suitcase to take with us.  Fortunately, in that case, the fires did not come close enough to our home to necessitate an evacuation, although many other Southern California homes were destroyed.  By feeling prepared to evacuate, however, I was more comfortable knowing that everything portable that I valued was safely locked in my car, and we could have dropped everything and evacuated with a moment's notice.  

How to Pre-Plan for an Evacuation

Do you live in an area where evacuations are common?  Perhaps you live in an area which gets hit by a hurricane every few years, or occasionally floods.  You might live near a national forest that is prone to wildfires.  If this describes your situation, you may want to pre-plan for a potential evacuation. Here are some of the steps you can take long before you get an evacuation notice:

Fill a back-pack or "get away bag" for each member of the family
- This get-away bag (Ad) should contain a couple of changes of clothes, underwear, a jacket, an old pair of tennis shoes, and basic toiletries such as toothpaste and a toothbrush. Be sure to include a small supply of essential medications. If you have growing children, you should repack the bags at least once a year.

Pack an extra bag with copies of important documents - Make copies of your birth certificates, social security cards, driver's licenses, insurance papers, and other important documents.  Put them in your bag, along with a list of important phone numbers you may need to know in an emergency. You may want to include a small amount of cash, in case local ATM machines are out-of-order during an evacuation.  Keep your original documents in a small fireproof home safe (Ad), and keep an extra set of the safe keys in your get-away bag.  In case you have to evacuate in a hurry, and you have time, you can add your safe, lockbox and small electronics to this backpack and take off quickly.  If you are unable to take the safe with you, there is a good chance it will survive some types of disasters and you can find it after the emergency has passed.

Having get-away bags will also be convenient if you and your family leave your home each morning for school and work.  In an emergency you would not be able to return home to get important belongings. In that event, you can keep the get-away bags in your car.   If there is an emergency evacuation in your neighborhood, you can simply pick up your family members at their jobs or school and go to the evacuation center or a hotel. In a crisis, you would know that you have some basic necessities for each member of the family, as well as copies of important documents. It is likely that if you were away from home during the day, you would also have your cell phones and, possibly, other small electronics with you. It would not be an ideal situation, but it would be better than being caught by surprise without anything you might need.   

After An Evacuation - What Happens?

Fortunately, most of the time you will all be able to return home safely after the emergency is over, and everything will be exactly as you left it.  You can return your belongings to their rightful places, stow away your get-away bags, and relax. You might even decide to update your get-away bags before stowing them away in the trunk of your car. 

However, if your home is no longer habitable after a disaster, you will be glad you were so well-prepared for evacuation.  You will be able to start over and still have at least some of your favorite belongings with you.  If you have either homeowner's insurance or renter's insurance, many of your lost items will be replaced. 

After most major emergencies, FEMA, state agencies, the Red Cross, and local charities will help you fill out the paperwork to file claims, apply for loans, and get other types of assistance.  These organizations may also be able to help you obtain temporary housing and a few items of furniture and clothing.  Despite this generous assistance, you and your family will feel much better if you also have been able to bring some of your own belongings with you. 

While not everything you own can be replaced, it is important to remember is that you were able to save your family. Anything else you save beyond that will just make it easier for you to recover from a disaster.  The most important thing is that you are able to move on with the people you love and cherish.

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