Savvy Smarts: How to Pick the Perfect Color for Any Room in Your Home ~

Interior Designer, Kristi Witt, gives her five expert tips for choosing the perfect paint  ~

Selecting paint colors for a room can be a very daunting task, not to mention trying to figure out the perfect color for every room in your house!  According to Kristi Witt, interior designer and owner of Kristi Witt Design, paint is the easiest design change to make for a space and the least expensive. Kristi offers her insight below.

Kristi says, “The best way to begin the process is to give yourself plenty of time to discover what you truly like, how you want to see color brought into your home and the ambiance or mood you wish to create for each room.”

Allowing time for plans, notes and thoughts to incubate is a key ingredient to picking the right color. “Don’t hurry and don’t worry”… If a color isn’t what you thought it would be – from paint chip to sample swatch on the wall – it is perfectly ok to rethink your plan or select a new color that suits you and your room better. Paint stores have small sample jars for the express purpose of narrowing down the right color without having to commit to a gallon.

1. Collect your thoughts:Pour through your favorite home decor catalogs, magazines, online sites and design books, look for inspiration and make a “wish book” for yourself. Once you have several ideas, dog-eared pages or photos of rooms saved which you are really drawn to, hone in on the key elements of these spaces and ask yourself what is the common thread with each one that appeals to you and what are your reasons for liking them.

For example: Do soft creamy neutral tones found in your favorite furniture catalogs resonate with you more or do you appreciate edgy industrial spaces that pay homage to raw building materials and texture? Are you drawn to boho chic with a flair for colors and prints or would you prefer a single bold statement-maker for a room in the form of an accent wall to offset artwork?

2. Inspiration: Take a look in your closet for further inspiration. Do the items you wear have anything in common with the spaces you like? If you’d rather throw out everything in your closet and make a fresh start, why that’s ok, too… just think of a wardrobe you would rather be wearing and imagine how this can relate to the vision you have for your home. Designer fashions in the latest trend, timeless classic pieces, accessories with punchy color, natural textures and shades, tone on tone… all can work for you.

3. Think about Space: When selecting paint for your space, think of what the space is used for. If it is a quiet bedroom or sitting room, your plan may be to afford a feeling of calm and serenity through peaceful tranquil colors such as pale blue, cream, light beige, taupe or soft grey. Bold, vibrant color creates energy, interest and excitement… a wonderful way to go with a focal wall as you enter a room to set a tone. Deep rich colors such as dark red or espresso introduce drama and can feel very much at home whether in the dining room or a powder room. Again, it is all about how you or your guests want to feel in a particular room and what you wish to say about your space, and yourself, through color.

4. Linking: Color plays a role in linking one room to the next and can be used to introduce adjoining spaces in a variety of ways. Consider where your eye will travel as you enter rooms with access and visibility to adjoining spaces: perhaps you’d love to see a sneak peek of bold color in the living room as you enter a front hallway, painted a crisp “art-gallery white”… a delightful way to be playful and dramatic at the same time. A continuation of the same hue throughout may be more your style to keep things harmonious and connected.

5. Another option: When using the same color throughout, tint or shade the color just a bit for a subtle variation. Nuance in color will distinguish each room while still maintaining a sense of order. The function and purpose of a room can also be emphasized with the color selected… much like you might play up your best features by wearing a certain color. If the room opens up to the back garden you might try to highlight the blue sky or green grass using the fairest hints of a similar color on the wall – at night, you will be reminded of your exterior space even when you can’t see it!

Picking colors for your home is a lot like picking your favorite restaurant or comfort food… you might have a hard time deciding! But even if you think you have way too many choices, you are very likely to be able to settle on one (or perhaps half a dozen) if you sat down and tried.

When considering color, ask yourself plenty of questions about what you find interesting, soothing or expressive and realize there are truly no wrong answers.  It often boils down to what “feels right.” What are waiting for? There’s a paint bucket out there with your own name on it!

About Kristi Witt

San Francisco interior designer, Kristi Witt, brings insight, energy and optimism to each project and believes understanding how her clients relate to their space is a main ingredient to good design. She listens carefully and offers options on how to achieve goals, creating comfortable, beautiful spaces that work for them, inspire them and reflect their individual personalities.

Educated in fine art and graphic design, Kristi has always been able to merge her creative talent with a love for helping others. She started out running her own catering and event-planning business in Memphis for 15 years, satisfying clients with beautifully executed parties and delicious menus. In addition to catering, she is also a published singer and songwriter, has operated her own home staging business since 2005 and has experience as a realtor. It is this varied experience that allows her to give clients a unique combination of creativity, practicality and perspective. For more information on Kristi Witt, visit www.kristiwittdesign.com.

Savvy Smarts: Winter Survival ~ Cold Weather Health Tips

The entire nation has been under siege by an onslaught of brutal winter weather, with massive amounts of snow, ice, and frigid temperatures.  As we look ahead to continued severe weather, here are some winter survival tips from Topical BioMedics, Inc., to help you get through it safely and in the best of health.

COLD FACTS

While winter can be a wonderland, offering the outdoor pleasures of skiing, snowboarding, sledding, skating, and hiking—not to mention the chores of shoveling snow, digging out cars, and scraping ice.  As we undertake outdoor activities, we need to be mindful that cold temperatures also challenge our bodies and present serious health hazards.

When core body temperature lowers, it decreases circulation and threatens vital organs.   Staying warm and keeping our body temperature normal takes a lot of energy.  When we get cold, our body protects itself by drawing as much blood as possible to our vulnerable internal organs.  Consequently, our extremities are “sacrificed” as blood is redirected—making our hands and feet take the brunt of the cold.   We’ll also shiver, which is another of the body’s defense mechanisms to keep us from losing more heat.

Although they are not directly exposed, our lungs can be damaged by breathing in frigid air.  In fact, deep inhalation of extremely cold air, over time, may even lead to premature lung aging.  Breathing in cold air may also trigger breathing problems in those already susceptible, such as asthmatics.

Below are some common winter health hazards and conditions that can be prevented with proper preparation.

FROSTBITE

Frostbite is not just a risk during sub-zero temperatures.  The fact is, it can happen when the thermometer reads as “high” as 27 degrees Fahrenheit. It occurs when the skin and the body tissue beneath it freeze, making the skin very cold, and then numb, hard, and pale.  Areas of the body most prone to frostbite are the smaller, exposed areas, such as fingers, toes, nose, and ears.

Frostbite can also occur when you touch something that is frozen, such as ice or metal, as these will also conduct heat away from the body, lower your temperature, and eventually freeze tissue.

The first stage of frostbite, called frostnip, doesn’t cause permanent damage.  But as frostbite progresses, it affects deeper layers of the skin.  In severe cases, affected areas turn black and hard as the tissue dies.

Because of numbness, you may not even realize you have frostbite unless someone points it out to you.  Symptoms include:

·        A slightly painful, prickly or itchy sensation

·        Red, white, pale of grayish-yellow skin

·        Hard or waxy-looking skin

·        A cold or burning feeling

·        Numbness

·        Clumsiness due to joint and muscle stiffness

·        Blistering (which can occur 24 to 48 hours after rewarming of the skin)

TREATING FROST BITE

If you suspect someone has frostbite—especially a child—call the doctor or 911 immediately, then take these steps:

·        Bring the person indoors to a warm place (do not try to thaw frostbite outside as warming and then re-exposing frozen parts to cold can cause permanent damage)

·        Remove wet clothing

·        Be gentle—do not vigorously rub frostbitten parts

·        Thaw frostbitten parts in warm (never hot) water; do not use dry heat (such as a fireplace or heating pad)

·        To help promote circulation, gently rub in Topricin Pain Relief and Healing Cream, which stimulates blood flow to the affected area

·        When frostbitten part has been warmed and treated with Topricin, loosely wrap to keep warm

HYPOTHERMIA

Hypothermia takes place when your body loses heat faster than it can produce it, causing a dangerously low body temperature.  Normal body temperature is about 98.6 degrees Fahrenheit.   Hypothermia occurs as your body temperatures goes below 95 degrees Fahrenheit.

When your body temperature drops, your heart, nervous system, and other vital organs cannot function properly.  If untreated, hypothermia may lead to heart failure, respiratory failure, and possibly even death.

The most common causes of hypothermia are exposure to cold weather or immersion in cold water.  Even if the outside temperature isn’t below freezing, a high wind chill factor may put you at risk. Because water rapidly draws heat out of the body, body heat is lost much faster in cold water than in cold air.

The elderly and the very young are especially vulnerable to hypothermia, and even inadequate indoor heating can put them at risk.

SYMPTOMS OF HYPOTHERMIA:

Besides shivering, signs of hypothermia include:

·        Clumsiness or lack of coordination; stumbling

·        Slurred speech or mumbling

·        Confusion or difficulty thinking

·        Drowsiness or very low energy

·        Weak pulse and shallow breathing

·        Progressive loss of awareness and loss of consciousness

Because symptoms come on gradually and cause confused thinking, a person with hypothermia may not even be aware they are in danger.

If you suspect someone has hypothermia, call 911 or your local emergency number immediately.  If possible, bring him/her inside, remove wet clothing, and cover him/her with layers of blankets.

COLD COMFORT TIPS

Whether you’re fighting the elements and shoveling the driveway, or heading out to the ski slopes, here are some tips for staying warm and healthy.

·        Keep yourself hydrated.  You may be surprised to know that your body uses more water in winter than in the summer, so you need to consume more fluids.  That’s because it takes a lot of energy to keep warm, and the heat generated to maintain a stable temperature uses up moisture.  Drink plenty of water (or water mixed with 50% fruit juice).  Avoid coffee and non-herbal tea as caffeine is dehydrating, and ditto with carbonated beverages like soda.  Hot beverages may seem more soothing, but you’re better off with warm or tepid drinks because you’ll be more likely to consume more of them during the day.

·        Your skin needs more hydration in the winter, too.  Always have a pot of water the top of a burning woodstove to replace lost moisture, and invest in a humidifier because dry heat also draws water out of the air.  You skin will thank you!

·          Dress in layers for thermal protection.  You can peel them off as you exercise and your body heats up.  You’ll want to keep dry, too—especially your feet–since wetness intensifies the damage cold weather does to your body.

·        Because you lose most of the heat through the top of your head, wear a hat.  (Think of your body like a chimney, with heat rising.)

·        Wear good quality socks—and even sock liners–and water proof footwear to keep feet warm and dry as wetness accelerates any “deep freeze” effects.

·        Don’t forget your face, ears, and eyes.  UV protection is important, and good polarized sunglasses will prevent “snow blinding” as the sun glares off snow.  Use goggles to prevent wind chill.  Because the nose and ears are easily frostbitten, and cold air breathed into lungs is harmful, wear a facemask if you expect to be outside for any length of time or when the temperature drops below 21 degrees Fahrenheit, wear a scarf at all times (which can be wrapped around mouth and nose if necessary).  Ear muffs are helpful, and there are a number of low-profile styles that wrap around the back of the head and so can be comfortably worn under hats.

·        Think mittens, not gloves.  When the temperature hits 32degrees Fahrenheit or below, your fingers can actually get frost bitten when you wear gloves because fingers are separated and can’t keep each other warm.  There are also some new designs that feature “fingerless” gloves, plus a mitten panel to pull over when need be.

·        Be sure to stretch and warm up before any outdoor activity, as cold muscles are more easily injured.  Then afterwards stretch and cool down.

·        When shoveling snow, choose a smaller, lighter shovel and use your knees to lift instead of your back.  Pace yourself, and lift light loads, to prevent strain and injury. Never let your breathing get heavy and labored, and don’t let your heart race—stop and rest whenever you feel your body is getting stressed.

·         When walking in deep snow on unknown terrain, take a walking stick to avoid losing your footing in case there’s a sudden drop or unseen obstacle.  Bring a thermos of fluids so you’ll stay hydrated, and a flashlight in case you fall over and need to attract attention.  Of course, the “buddy system” is always the best.

·        Before and after outdoor activity apply Topricin.   When applied beforehand, it helps maintain vibrant micro capillary blood flow in your extremities and helps maintain a more constant blood flow.  Applied afterwards, it stimulates maximum blood flow to chilled extremities, helping to get them warm more quickly.  It also eases the aches and pains of exertion by helping the body to heal the damage that’s causing the pain.

Lou Paradise, president and chief of research of Topical BioMedics, Inc., makers of Topricin, says, “It’s been a particularly rough winter all over the country, so it’s important for everyone to be aware there are ways to protect their body and enjoy the season without incident or injury.”

Founded in 1994 and headquartered in Rhinebeck, NY, Topical BioMedics, Inc., is the research and development leader in topical regulated natural biomedicines for pain relief.    The company’s flagship product, Topricin Pain Relief and Healing Cream, was introduced in 1994 and in spring of 2009 was awarded a patent for the treatment of pain associated with fibromyalgia.

All Topricin are FDA-regulated over-the-counter medicines.  Doctors and pharmacists can find out more about Topricin in the 2010 edition of the Physicians’ Desk Reference (PDR).   The Topical BioMedics’ family of products includes Topricin original, Topricin Foot Therapy, and Topricin Junior for children, which was awarded a Parent Tested/Parent Approved (PTPA™) Seal of Approval in November 2010.

For additional information, visit www.topricin.com.

Savvy Smarts: What is Anti-Aging Medicine?

By Frank Comstock, M.D. ~

Anti-aging medicine is a program of optimal diet, nutraceuticals, exercise, bioidentical hormone therapy, and stress management directed at optimizing health and slowing, even reversing, the aging process.

Anti-aging medicine is all about wellness. We supply the body with what it needs to rebuild, repair and regenerate. We utilize healthy diet, nutritional supplementation, exercise, hormone replacement therapy and stress reduction to restore health and vitality.

Anti-aging medicine is much more than “preventive medicine,” it is a proactive, preventive health care program. In contrast to traditional medicine, which focuses on disease care, the focus of anti-aging medicine is on health care. We focus on lifestyle interventions that restore energy, improve health, and slow the aging process. In anti-aging medicine we are able to decrease dosages and even eliminate medications in many patients.

Our healthy diet focuses on blood sugar and insulin control. Patients eat a balanced diet to support metabolism and promote fat burning. We avoid processed foods that sabotage our health and well being. We choose food groups that are a premium fuel to run the body. This optimal diet is the foundation to healthy aging and vitality.

In anti-aging medicine we utilize nutritional supplements to support cell function and balance oxidative stress to dramatically decrease the risk of degenerative diseases. Supplements work synergistically with our diet to improve overall health and body weight.

Our exercise programs focus on shorter duration resistance training, as well as interval training to build muscle, burn fat, and support optimal bone density. With this approach patients spend less time exercising yet obtain maximal results from their exercise program.

Hormone replacement therapy is a pivotal part of anti-aging. As we age many of our vital hormone levels decline leading to weight gain, low energy, muscle loss and decrease in immune function. We use bio-identical hormone therapy to bring the hormone levels into a healthier range with restoration of energy and metabolism. Patients notice tremendous benefits when their hormones are in balance.

Stress reduction is a powerful modality to improve health. All of our anti-aging programs lower stress burden on our bodies. In addition, we utilize simple yet effective stress reduction techniques to improve our health in many areas.

All components of anti-aging medicine work synergistically to allow us to regain health and vitality. By decreasing our reliance on medications for chronic conditions, we attain true health reform.

Frank Comstock, M.D. is board-certified in emergency medicine and anti-aging medicine. For the past ten years, he has practiced anti-aging medicine at Lifestyle Spectrum in Tucson, Arizona. His practice centers on individual consultations with patients for bio-identical hormone replacement therapy, supplementation programs, and healthy diet and exercise programs.

For further information or to purchase the book, please visit www.lifestlyespectrum.com, www.authorhouse.com and www.amazon.com

Savvy Smarts: Deriving the Most Benefit from Your Next Medical Appointment

By Linda Garvin, RN, MSN, Patient Advocate ~

As a Register Nurse with 30 year’s plus experience, I still witness numerous patients arriving at their physician’s office totally unprepared for their medical visits. With limited time available to spend with your physician, it is important that you are as prepared and organized as possible prior to your medical appointment. Here are some tips from a nurse health advocate and educator on preparing for your next medical appointment:

§  Prior to Your Next Appointment: Write down and prioritize your questions, with your most important questions at the top of your list. This will be a lot easier than memorizing your questions and will help prevent you from forgetting something significant you want to discuss with your physician.  You will find it helpful to bring along the following items with your list of questions: A pen and paper to write notes, your insurance card, cash or a credit card for co-payments, address and telephone number of physician’s office and glasses if needed.

§  Medical History:  Bring along any significant health information pertaining to the following:  family history, known allergies, major illnesses, surgeries, hospitalizations or any abnormal test results.

§  Recent Diagnosis: If you have recently been diagnosed with an acute or chronic health problem educate yourself about the health condition. Your research may assist you in not only understanding what information may be provided to you by your physician, but will help in coming up with specific questions to ask your doctor.

§  Symtomology: If you are experiencing any unusual symptoms or feel different after taking a medication or treatment, document this information. Your documentation should include when your symptoms began, the frequency and what improves or worsens your symptoms.

§  Medications: Bring a list of all medications you are currently taking including prescription, over-the-counter, vitamins and herbal supplements. Your medication information should include the dosage, frequency and reason you are taking each medication.  To decrease to costs of your medications, ask your physician if you can safely substitute less expensive generic medications for brand name medicines that you are taking.  If your doctor prescribes new medications, ask him/her if they can give you samples.

§  Bring Someone Along: Consider bringing a close friend or relative that can accompany you while your physician is speaking with you during the entire exam. This person could take notes for you while you are communicating with your physician, avoiding the possibility of you becoming distracted.

§  Resources: If you need additional information and resources about your health condition, request this information from your physician or someone from the office staff. Ask about community resources [support groups, lectures], medical equipment and specialists. If your condition is chronic, you may want to go on the web to see who has written articles on your medical condition.

§  Timeliness: If it is your first visit to this physician’s office, give yourself enough time to find the office and for parking. This will help you to be on time and more relaxed for the appointment.

§  Be Honest: Probably the most important piece of information I can give is to be honest with your physician. If you have been having unusual symptoms, like blood in you urine or stool, do not hide this information from your physician. Your symptoms may be early signs of a disease process that can be treated and managed before it becomes life threatening.

Linda Winkler Garvin, R.N., M.S.N., of Alameda, California, is a Health Advocate, Consultant & Educator in the Bay Area and Director of Health Management Associates.   As nurse educator & former insurance consultant, Linda can help you identify critical health questions & assist with decision making-PLUS -advocate on your behalf, so you can control and manage your health needs and costs.  Linda also has expertise in chronic pain management & in elder care planning.  She is the author of several articles on Pain Management, Healthy Lifestyles, & Nutrition. Learn more at www.healthmanagerbayarea.com or e-mail at garvin_linda@yahoo.com.

Savvy Smarts: Domestic Violence and Financial Dependency: A Look at an Abuser’s Main Source of Power

By Nancy Salamone ~

It’s clear that many people don’t understand why women who have left abusive relationships often return. Many people place blame on the victim for returning by suggesting that the victim even likes or thrives on the abuse. The attitude is; if they didn’t like being abused they would leave and not return, right?

But the reasons why women return to abusive relationships are extremely complex and have less to do with the content of the woman’s character and more to do with the effects of abuse.  It’s widely known that an abused woman may leave her abuser seven to eight times before she leaves permanently.

Eighty-five percent of women who leave an abusive relationship return.  According to the National Coalition Against Domestic Violence a significant proportion of women who return to the relationship attribute their inability to deal with their finances as a major contributing factor, which is often enhanced by the fact that the abuser often has all of the economic and social standing and complete control over the family finances.

These women’s options are further limited by the fact that many who leave often face one or more additional barriers including having at least one dependent child, not being employed outside of the home, possessing no property that is solely theirs, and lacking access to cash or bank and credit accounts. For these reasons it is very likely that many of these women would experience a decline in living standards and security of life for themselves and their children if they were to leave their partner.

As a result of all of these combined factors, many survivors of domestic violence who summon the courage to leave the abusive relationship eventually return for financial reasons.

In most cases women arrive at shelters with few more resources other than the clothes they are wearing. Some are burdened with debt—in many cases their partners. Still others tumble into debt after they have left the abusive relationship because they overspend on impulse or budget poorly. Very few of them are yet to have addressed the emotional and psychological issues that have dictated their poor financial choices. Rarely is a battered woman accustomed to managing her own money.

This is where The Business of Me plays such a vital role as it takes a disparate group of women of varying socio-economic backgrounds and different life experiences who come together at a domestic violence shelter with one thing in common; their need to get out and stay out of an abusive relationship.
The Business of Me teaches survivor’s real-world, practical and easy to use personal financial management skills which they can use in their daily lives.

The program helps these women overcome their fear of managing their personal finances by teaching them specific real-world, money management techniques in an innovative way that promotes deep self-reflection and active management of financial futures. It also guides participants in creating and maintaining a budget to achieve success with their goals and addresses debt and how to handle it, insurance, documentation, savings, and charitable giving. Finally, the program teaches survivors how to talk to children about money.

While teaching financial self sufficiency skills (which are as important in our daily lives as knowing how to use a knife and a fork) the program guides the women to focus on their futures and to be continually seeking new opportunities for themselves. The program provides a support mechanism to help them develop their goals and the means to accomplish them.

In short, “The Business of Me” is designed to reduce the number of women who return to domestic violence relationships and revictimization. 

The outlook isn’t good. The results of a national study done of high school students are appalling. According to Jumpstart.org the average score on a 31 question test yielded an average correct score of only 48.3%. Put simply, a majority of seniors will leave high school financially illiterate.  

We are experiencing difficult economic times. Corporations are reducing retirement savings contributions and fewer and fewer employers are offering any type of retirement savings plan at all. At the same time advances in medical science make it likely that we’ll live longer lives. In times like these financial literacy is essential if we are to live independent lives.

Being financially literate and knowing how to manage your finances gives you the confidence you need to make your own decisions about where you want your life to go. 

With knowledge comes confidence; with confidence comes an “I can do it” and an “I want to do it” attitude. With the power that this knowledge brings you want to control your own life and you want to make your own decisions. 

By accepting this responsibility you no longer have to live in fear, because you’ve planned and you’ll know exactly when and how you’ll meet your financial obligations, and you’ll see progress towards the future that you’ve chosen for yourself. 

This responsibility is not a burden; it’s a beautiful thing because you’ll never again allow yourself to be controlled by someone else. No one will be able to step on you financially ever again.

Nancy Salamone is author of Victory Over Violence: Nancy’s Story and the Business of Me. For more information or to purchase the book, please visit www.nancysstory.com, www.amazon.com

Savvy Smarts: Treat Me, Not My Age ~ A Doctor’s Guide to Getting the Best Care

By Mark Lachs, MD ~

Over my 25-year medical career, the route by which people are admitted to the hospital for an overnight stay has subtly evolved in ways that most patients (and even many doctors) may not realize. Specifically, the proportion of patients who walk (or wheel) themselves through the hospital’s front door at their doctor’s recommendation and are whisked directly to a bed upstairs has declined precipitously. Conversely, the percentage of patients who are admitted to the hospital via the emergency room has increased just as dramatically.

There are several reasons for these trends. First, when you’re sick, you want and often need to address the problem as quickly as possible. If you can’t find your regular doc to figure out how sick you are or what to do, the ER is the only reasonable alternative. There are very few incentives (in fact, there are a ton of disincentives) for your primary care doc to say, “Sure, bypass the ER and come on over right now.” There’s operational risk to his practice (he has patients scheduled every fifteen minutes for the next eight hours; treating you could result in the cancellation of many appointments), economic risk (tending to patients with complicated situations doesn’t get him much more income than the five common colds you’ve just displaced), and legal risk (he’s the guy who diverted you from the ER — what if you have a heart attack on the way to his office?). Why would any primary care doc want to ruin his day with potential ulcers like this?

Another force driving this trend: Insurers simply won’t pay for many of the elective tests and evaluations that “semisick” people used to get as part of a hospitalization; they believe that these can be done on an outpatient basis. Gone, for example, are the days when you could be admitted to the hospital for a leisurely evaluation of weight loss, wherein your doc brought you in for a few days of scans, X-rays, and blood tests. In my opinion, this is a mixed blessing; you already know about the many ways older people run into difficulty in the hospital and why most geriatricians will tell you to avoid going if you can. On the other hand, sometimes the complicated series of tests and consultant opinions I need to evaluate a spot on a chest X-ray, intermittent belly pain, or some other new symptom can be logistically overwhelming even to young patients with good mobility and access to transportation. I often find myself wishing I could bring my older patients into the hospital for less than twenty-four hours just so the four or five tests they need could be done efficiently and without taxing their bodies, memories, and travel budgets. On a positive note, a trip to the hospital is unnecessary for many of the things we used to do there (such as a simple hernia repair), which can now be handled in outpatient surgery centers or even some physicians’ offices. That’s a good thing.

So now more than ever, if you need to be admitted to the hospital, there is a high likelihood that it will be through the emergency room. Unless you’re having a major scheduled surgery, it is increasingly difficult for your physician to call ahead to reserve a bed for you, as if it were a table for two in a restaurant. And anyway, if you’ve been to the ER recently, you know it’s more like the department of motor vehicles or the supermarket deli counter than a fancy restaurant — you’ll probably be “taking a number” and waiting. (And what’s worse, you can’t tip the maître d’ to cut the line; it’s going to take a sucking chest wound to get immediate service.)

But as a geriatrician I can help you here. I’ve spent thousands of hours in emergency departments — as an ER physician myself, as a geriatrician ministering to my patients there, as a family member hovering nervously over a loved one, and even as a patient from time to time.

Here, then, are my rules on how to emerge from the emergency room unscathed.
1) Avoid it if you can. Call your doctor with your symptoms for the best assessment of whether you really need to go. A good doc can sometimes offer appropriate treatment without the need for the ER.

2) Don’t dawdle in calling your doctor if you’re on the fence. If you’re experiencing symptoms that you think you can “tough out” and soon discover they aren’t improving, your doc needs to hear about it ASAP.

3) Sometimes you just have to go. Trying to bypass the ER to go right to a hospital bed is appealing, but if there are no doctors on the floor or if it lacks the right resource, you might not get the care you need.

4) Ask your physician to call ahead. In making such an overture, your physician not only can provide useful info to expedite decisions about the care you need, but also let the ER doc know that you are part of a system of care, and that your journey through the ER is being monitored.

5) Squeaky wheels get the grease. Patients and families who advocate for themselves get better care, so long as that advocacy is not obnoxious.

6) Understand the game plan. At every juncture during your ER stay, ask the physician for a brief update on how the latest information changes the list of diagnostic possibilities and what the next step is.
The above is an adapted excerpt from the book Treat Me, Not My Age: A Doctor’s Guide to Getting the Best Care as You or a Loved One Gets Older by Mark Lachs, MD. The above excerpt is a digitally scanned reproduction of text from print. Although this excerpt has been proofread, occasional errors may appear due to the scanning process. Please refer to the finished book for accuracy.

Copyright © 2010 Mark Lachs, MD, author of Treat Me, Not My Age: A Doctor’s Guide to Getting the Best Care as You or a Loved One Gets Older

Author Bio
Dr. Mark Lachs, author of Treat Me, Not My Age: A Doctor’s Guide to Getting the Best Care as You or a Loved One Gets Older, is a physician, scientist, and gerontologist at Weill Cornell Medical College in New York City. His research has been published in the New England Journal of Medicine and the Journal of the American Medical Association, and he has appeared on The Today Show, NPR’s All Things Considered, and in many other national and local media outlets. His numerous honors and awards include a National Institute on Aging Academic Leadership Award and a Paul Beeson Physician Faculty Scholarship (the country’s preeminent career award in aging). He and his wife, Susan, a nurse practitioner, have three children and live in Connecticut.

For more information please visit treatmenotmyage.com.

Savvy Smarts: 5 Things Your Doctor Isn’t Telling You About CPR

By Viki Kind, MA ~

CPR or cardiopulmonary resuscitation used to be very simple to understand. Cardio stands for heart, pulmonary stands for lungs and resuscitation means to revive from death. When a patient died, someone would push on the person’s chest to try to restart the heart while giving mouth-to-mouth resuscitation to help the person breathe. Over time, CPR has become more complex as healthcare professionals have discovered advanced ways to try to bring the person back to life. The patient may now be given medications, his heart may be electrically shocked with paddles placed on the chest, and he may be placed on a ventilator to help him breathe. What seemed like an easy question, “Does the person want CPR?” has turned into a more complicated decision.

What do you need to know to make a good decision?

1.  Make sure you really understand what really happens during CPR.
In the past, doctors only used CPR on patients who were having a heart attack and might benefit from receiving CPR.  Now we use it for everyone, including those in a terminal state, whether it will work or not.  When I ask people, “What is CPR?” they say it is when someone pushes on their chest or shocks them with paddles.  Most people do not realize they will be put on a breathing machine which they may have to stay on for the rest of their lives.

Tip:  Ask your doctor to describe exactly what will be done to you during CPR.

2.  CPR doesn’t work like you see on television.
I’ve asked many groups of healthcare professionals, “How many of you would like to die by CPR?” No one ever, ever raises a hand. What is it that they know that they’re not telling us? They know that the chance of CPR working is minimal, sometimes even 0 percent.   On shows like ER, CPR brings the patient back to life about 75 percent of the time (Diem, Lantos and Tulsky 1996), when in real life it only works, at best, 17 percent of the time for those who are healthy (Peberdy, et al. 2003). In situations where someone is seriously ill and in the intensive care unit, the chance of success may be as low as zero percent.

Tip:  Ask your doctor about the “real” chance of CPR bringing you back to life.

3.  CPR isn’t going to make you better and it might make you much worse.

When the healthcare team is pushing on the person’s chest, there is a chance of broken ribs or a collapsed lung.  In addition, the longer the patient isn’t able to breathe, the greater the chance for brain damage.

Television misleads you by letting you think a person will be healthy enough to go home about 67 percent of the time (Diem, Lantos and Tulsky 1996). In reality, if CPR is able to bring the patient back to life, the chance of this person going home with good brain function is about 7 percent (Kaldjian, et al. 2009). For others, they may survive CPR but they won’t be able to leave the hospital.

Tip:  Ask your doctor about what kind of life you might have after CPR.

4.  Think about the kind of death you are choosing.

With CPR, you might not have the opportunity for a peaceful and profound death experience. When you picture the last minutes of your loved one’s life, do you see strangers straddling the patient on a bed, pushing on the patient’s chest, while the family waits outside in the waiting room? Or do you see a time with family and friends gathered around the bedside, with words of love being expressed, music being played or prayers being said?

The CPR decision is about more than medicine.  It frames the dying experience for the patient and the loved ones.  I would encourage people to balance the chance of CPR working and bringing the person back in a good condition with the desire for a good, peaceful and dignified death.  This is why healthcare professionals wouldn’t want to die by CPR; there is nothing peaceful or dignified about this type of death.

Tip:  Ask your doctor if your loved ones could be in the room with you during CPR so they could say their goodbyes.

5.  The decision about CPR is only one part of a good end-of-life plan.
It is important to put the act of CPR into the context of this person’s life.  The following questions are just as important as, “Do you want CPR?”

Where would the person want to die?
Whom would the person want to be with as he or she dies?
What would bring peace and comfort during the dying process?
For many people, CPR just prolongs the dying process, is this okay?

I am not saying that people shouldn’t choose to attempt CPR; I just want patients and their loved ones to have the facts about CPR.  Talk to your doctor and take the time to make wise and informed decisions for yourself and for those in your care.

References:
Diem, S. J., J. D. Lantos, and J. A. Tulsky. 1996. Cardiopulmonary resuscitationcon television: Miracles and misinformation. New England Journal of Medicine 334 (24): 1578–82.

Kaldjian, L.C., Z.D. Erekson, T.H. Haberle, et al. 2009. Code status discussion and goals of care among hospitalized adults. Journal of Medical Ethics 35 (6): 338–42.

Peberdy, M.A., W. Kaye, J.P. Ornato, et al. 2003. Cardiopulmonary resuscitation of adults in the hospital: A report of 14,720 cardiac arrests from the National Registry of Cardiopulmonary Resuscitation. Resuscitation 58 (3): 297–308.

About Viki Kind, MA:
Viki Kind is a clinical bioethicist, medical educator and hospice volunteer.  Her book The Caregiver’s Path to Compassionate Decision Making: Making Choices For Those Who Can’t, guides families and healthcare professionals through the difficult process of making decisions for those who have lost capacity. She lectures across the United States teaching healthcare professionals to have integrity, compassion and to improve end-of-life care through better communication. Patients, families and healthcare professionals have come to rely on Viki’s practical approach to dealing with challenging healthcare dilemmas.

Savvy Smarts: Spinach on Our Walls ~ His Silent Tantrums

By: Rhonda Ricardo ~

“She’s not the woman I fell in love with anymore,” men told me while collecting stories for Cherries Over Quicksand.  Men described how they fall in love with the “whole package”, including her dreams and goals.  They said they have learned that some women are just too giving to consider her goals before his goals.  These men said they should have spoken up about her taking time to follow her own goals and should have helped out at more at home, for both their sakes (and the family’s sake) and most importantly for the sake of their steamy lifelong romance.  Men supporting her dreams while she supports his; another step toward decades of romance, what a way to live!

Do you ever get the sense that he is constantly testing you?  After three years, Joanne’s man, Richard, started telling her that he was not hungry just before dinner was to be served.  Nightly, Joanne continued to cook their full dinner and arranged it beautifully but he hardly ever joined her at the table.  She said it was not as though he needed to lose weight, but more as if he was looking for something to complain about.

When he did join her, he would grumble that he was too full while acting like a slug unable to reach the front door even if a championship quarterback was there to give him the game ball.  Later, he developed a new symptom.  He started to complain that taking a shower was just too much work and would fall into bed smelling like a sack of cow pies, even on a weekend when he’d only watched television all day.

Joanne finally decided to try to get down to the truth.

“Is something wrong?” Joanne asked her husband many times.  He would always answer, “Nope.”  Then she would hear him having a great time talking and joking about sports with his buddies on the phone.  He definitely did not seem depressed, she was stumped.

She said it was like he had left her mentally, but was physically still in the house.  Joanne was especially sad because she remembered how they both used to look forward to dinnertime to sit, share about their jobs, and laugh together.  She did not know why he had become so cranky.  She grew tired of wishing for the past.

Joanne finally started eating the foods she enjoyed; those that helped her keep her hot figure.  Then, she just sashayed her hot self in a direction toward making her life’s dreams come true.  She had much more time to devote to her own goals, now that she was not grocery shopping and planning meals.

Joanne started the party equipment rental business she had always wanted to develop and grew exceedingly happy with her new routine.  She was surprised to find that he was actually impressed by her take charge actions.  She witnessed his insulting attitude transform into adoring eyes that appreciated every minute she could spare.

Richard takes her to dinner now, more than when they first dated and they drink up each other’s words like the syllables taste better than the wine.  If she suggests a new restaurant he makes the reservation and loves every minute of being seen with his hot woman.

He now buys food on his way home and fills the refrigerator before Joanne gets home, with the hope that she will prepare dinner for him.

Joanne said, “I can’t believe the change in him.”  Now he lights up when she serves the same meals he used to whine about, as long as she dines with him.  Of course, she is busy pursuing her own goals now, so sometimes he must fend for himself.  She knows, for example, that he enjoys his hotdogs while watching a game on television when she’s not home, so he’s not hurting.

“I’ll tell you a secret,” whispered Joanne.  “Because I never expected him to ever want to eat with me again, I was actually starting to crave more time for myself but this is so much better, especially because he never skips his nightly shower now!”

By following her dreams and loving her man their romance flourished; it gives hope to those of us who find spinach on our walls.

About the author:

Rhonda Ricardo is the author of Cherries Over Quicksand, freelance columnist for The Californian/North County Times, engaged to racecar driver Robert Broguiere and the mother of three adult children.  Rhonda has been invited to join Welcome Home Troops by Founder/Executive Director Sue Rebar to entertain incoming troops facing the rising military divorce rates, and share her devotion to helping build strong families through her humorous relationship-saving stories.

Savvy Smarts: Back-to-School Means Mom Finds Time to Read

By: Hannah Shaner ~

Hey, Mom, now that the kids are back in school all day, why not make a fall/winter reading list for yourself or a new book club? Here are some reader favorites:

1.      Stan’s Leap by Tom Duerig
The makers of TV’s Lost should have read Stan’s Leap and filmed the show on Henderson Island, a real place in the South Pacific that’s 5,000 km from anything else. If stranded there, one might never be rescued. Tom Duerig’s story explores what happens when people must learn to live together without modern tools and amenities, and with little hope of ever seeing friends and family again. Clashes arise between faith and science, older and younger generations, unfamiliar cultures and levels of selfishness. But did the world really forget them for 20 years?

2.      The Drawing Lesson by Mary E. Martin
How far will a desperate artist go to push a rival genius into a creative abyss from which he may never return? Through this battle of opposing wills and philosophies, Mary E. Martin shares one man’s personal struggle with the unintended consequences of his past, the dark side of his psyche and his future. Reviewer Simon Barrett says, “The art world may seem a strange choice as a setting, but The Drawing Lesson works in a wonderful way.”

3.      Reunion in Carmel by Tim Comstock
Unbridled terror visits an idyllic vacation town in Reunion in Carmel, the new mystery novel from Tim Comstock. Police officer Will Kempton moves his family to a California tourist town after 14 years as a hardened New Jersey detective. But when a string of gruesome murders rattles the quiet town and comes too near his own children, Kempton must draw on skills he thought he’d left behind to track down the killer. As he unravels clues and battles rigid local politics, Kempton wonders if his past may have come back to haunt him. ac

4.      Ashes by Audrey Peyton
The radio suddenly arrests Kit’s attention: The world is slowly being reduced to ashes. In the next 100 days, almost all human, plant and animal life disappears from Earth. Who could commit such evil? And how? Answers come too soon for three survivors when greed and brutality disrupt the fragile peace they’ve established for themselves. Inspired by her childhood during the London bombings of World War II, Audrey Peyton’s Ashes will grip you until the stunning end.

5.      Insignificant Moments by Jeremy Asher
For 27-year old Jaye Logan, life has been full of neglected opportunities and missed chances: unadventurous career, only one serious girlfriend. On the day he decides to climb a mountain and seek something better in life, something better finds him—in the form of a beautiful young woman he rescues. In typical Jaye fashion, he lets this girl of his dreams slip through his fingers. Reeling from disappointment, he sends a simple yet heartfelt e-mail about the key to life winging into the ether.

Author Jeremy Asher’s inspirational novel Insignificant Moments follows Jaye and his e-mail as they begin affecting the world. The book speaks to the profound impact a single moment can have on our lives and in our hearts.

6.      Cooking with Healthy Girl by Mandy Potter
What goes better with reading than a snack, or a shared dish at book club? Mandy Potter got started on her quest to find healthier ways to cook the food she loves when she struggled to lose weight following the birth of twins. Dieting didn’t work, and she couldn’t find many of the ingredients so-called “healthy” cookbooks called for. She researched ways to make the dishes she’d grown up with taste the same, yet have fewer calories, and less fat, sugar and cholesterol. Cooking with Healthy Girl contains 239 pages of recipes, everyday staples, and a complete four-week menu.

All these books are available at Amazon.com and BarnesandNoble.com and The Savvy Gal Store

Happy reading!

Stan’s Leap
By Tom Duerig
Published by iUniverse
ISBN 9780595508488
Softcover 6×9
Retail price $21.95

http://www.stansleap.com

The Drawing Lesson
By Mary E. Martin
Published by iUniverse
ISBN 9781450229364
Softcover, 6×9
Retail price $19.95

http://www.thedrawinglesson.wordpress.com

Reunion in Carmel
By Tim Comstock
Published by AuthorHouse
ISBN 9781452014104
Softcover 6 x 9
Retail price $18

http://www.reunionincarmel.com

Ashes
By Audrey Peyton
Published by AuthorHouse
Published by iUniverse
ISBN 9781450014397
Softcover, 6 x 9
Retail price $19.99

http://www.audreypeyton.com

Insignificant Moments
By Jeremy Asher
Published by iUniverse
ISBN 9781450231787
Softcover, 6 x 9 $18.95
Available at www.amazon.com and www.barnesandnoble.com

Cooking with Healthy Girl: Everyday Recipes Made Healthy
By Mandy Potter
Published by AuthorHouse
ISBN: 9781449073428
Photos by Miesner Photography
Softcover, 8.5 x 8.5
Retail price $29.99

http://www.cookingwithhealthygirl.com