Kim Regnier

2 Of the Toughest Decisions

We are in what is considered the “sandwich” time of our life or middle aged. Exploring life after 50 we have several things that arise, on our calendars, and things that we should or need to pay attention.

mother, daughter, together-1327186.jpg — Taking care of elderly parent.

This is the time of life that our parent get more phone calls regarding health issues. They say that we need to check things out further. Possibly a bad medical report. Being prepared for that next step is very important. Preparing yourself for the 2 options that are likely to happen: 1) everything’s fine. 2) we need to review and continue to investigate the results of testing. We have to be prepared both for ourselves, or our loved one’s decision. The decision that no treatment is wanted. On the other hand, they may choose to do everything possible.

Are the results good or bad

Our loved one needs to understand that they have options. They get to make the decision, do we move forward and investigate further, or let it be. While as the children of our parents, we prefer to be selfish. We would like to push and go as far as medical science will allow. We have to also remember that they have rights. They have the right to say no thank you. They also, have the right to take any treatments options available, and fight as hard as they can, for whatever the outcome might be. We are very blessed these days that medical science has allowed us to find so many treatment options.

biology, research, laboratory-316571.jpg — What, Which medical treatment to do!

Looking back, I remember working ICU that day. The day that the 90+ year old lady was my patient. She had a stroke a few days previous. Her prognoses was poor at best. There was much discussion about organ donations. According to HRSA at https://www.organdonor.gov “there’s no age limit to donation or to signing up.” Speaking with the family about what they want to be done. Most family members wanted us to do everything we could. We should do full CPR. I remember thinking what would the patient have wanted. She is the one lying in the bed, sick, neuro deficits. Why did she not write this down or tell someone? Realizing that not everyone is comfortable with making these decisions, I still wondered. When she did CODE, every effort was made to revive the patient. Our efforts were not met with success. Or, were they, is that what she wanted? The family was opening to organ donation and that process was started.

question, question mark, response-1015308.jpg — What would she want? Everything or Nothing?

Recently, my father-in-law passed. He had planned his funeral; last revision was 2012. So, 9 years before he became ill. He had a living will, he gave a copy to all 3 of his children. He had chosen songs, bible verses, and who was to sing, and preform the service. This made the decisions, when he passed, easier on his family. In no way, were the decisions easy, but there was the knowledge of his wishes to base it on.

workspace, desktop, coffee-3524009.jpg — Plan, review and plan again. Write it down!

Take time to talk about these things with your loved one. Ask what they prefer, resuscitation or not. What specifics do they want during funeral services? While this is a really tough process, most of our parents have been thinking and know what they want. Many times, they do not tell us, as they do not wish to upset us.

Luke 12:35 “Be dressed in readiness, and keep your lamps lit.”

Cancer, that 6 letter word NO ONE wants to hear.

The 5 goals to help control cancer.

April is national cancer control month. According, to medical news today, the 5 goals of the program of national cancer control month:

Cancer prevention
Early detection
Improving treatments
Increasing survival rates
Improving quality of life

Learn more by visiting the ACS the national cancer the national foundation for cancer research have also created a free cancer prevention kit.

cancer, newspaper, word — The word no one wants to hear!

Have you ever heard those words? Those words of we need to check this out; or we need to recheck; or we have found… These are words that none of us are ready for or happy to hear. I work in health care, I have to give these talks to patients. I monitor and do several follow up tests for things that are questionable. One of the worst conversations that you can have with the patient, is any conversation that starts with the above.

It’s very hard as a medical provider to tell a patient that there is a concerning nodule, that there’s some lab result that is not quite right. Saying it, being empathetic, and knowing they are scared and worried. Always, trying to make sure that you give good information. Giving the information that is clear and in terms they can understand. Along, with being very conscious of getting them their results as soon as possible. Has to be high on any providers list.

laboratory, medical, medicine — Ask How long it will take to get results.

Please as a patient also be proactive, if you haven’t heard results in 48 to 72 hours after you have finished with a test, call your provider. Leave a message if you need. Let them know that you wish to know the results. There are occasions, where it takes longer to get results back, but your provider should let you know this time period. They should tell you “we should know something in a week” or “we should know something in 2 weeks”. Again, if you have not heard. Call your provider and ask for the results.

Be Proactive, If you have not heard……Call your provider to get results.

There are many screening tools and test out there. Many that look for cancers to try to control cancers. Control I mean try to catch them early, so that we can do as much as possible to keep them from metastasizing or spreading to other parts of the body. Please see my blog on health care screenings for MEN and Women.

We have made great strides in treating cancers but more importantly we’ve made great strides in early detection, over the last several years. We have noticed that in doing more screenings, we have had more false, positives than in the past. However, even with more false positives, we are catching more true positives, therefore treating earlier. Having more success in treating.

We also have made great strides in quality of life and more days. As time goes on the screenings and treatments continue to advance. Getting the word out and continuing to do our part is very important. I recommend getting your screenings. Be proactive. Live your best life!! Please share my blog with your friends. Sign up for our emails so you know when a new post comes out, and/or join us on our Facebook page.

This is not to be used as medical advice but to be used as knowledge to help you in your family or those you share with in your health care journey.

Obstructive Sleep Apnea

Better sleep equals better health.

Do you snore? Does your spouse/significant other say that you stop breathing in the night? Do you not feel rested in the morning? Do you wake yourself snorting or gasping for air? If you answered yes to any of these questions, consider talking to your healthcare provider about a sleep study.

What is OSA? Obstructive Sleep Apnea is a condition where the back of the airway collapses when you sleep. Most people who do notice issues, feel it when lying on their backs. They do not tend to notice when lying on sides or stomach. When this happens, it makes it harder for you to breathe, so your subconscious, causes an arousal. Not enough for you to wake completely, just enough that you start breathing, again. When this happens several times a night, you can see why you don’t feel rested. You do not get enough restful sleep. Also, called REM sleep.

Who are at higher risk for OSA?

Men

folks with neck size over 17inches

overweight individuals especially if large abdomen

Narrowed airway

Smokers

Family history of OSA

Chronic nasal congestion

High Blood Pressure

Diabetes

and more…….

There is test that can be done to see if you have sleep apnea. Some providers will start with an overnight pulse ox. This is a machine that you wear on your finger while sleeping one night. This will monitor your oxygen levels in your blood while sleeping. If this shows that you most likely have some spells where you stop breathing in the night(by evidence of low oxygen in the blood), a formal sleep study may be ordered.

Sleep studies are often done one two separate appointments. Night one, to see if you stop breathing, in the night. If you do, how many times and how severe is your sleep apnea. The second night, to put you on a cpap and see what settings you need. There are many types of mask they will find what works best for you. Do not fright, if you do not like it later you can try another type of mask.

Things that you can do to help if you have symptoms:

Call your doctor to make an appointment to discuss your symptoms.

Try sleeping on your side or stomach

Avoid alcohol-it can make it worse

Lose weight if you are overweight

Untreated OSA, meaning that you have it and not using a CPAP can worsen health conditions such as high blood pressure, high blood sugars, cause heart arrhythmias, and so on. So, if you snore, if you spouse notices you stop breathing in the night, talk to your healthcare provider to see if you need further testing. This information is for your information only. It is not intended to be medical advise. If you have questions please contact your primary care provider.

Mammogram

Self breast exams monthly and mammograms yearly are important steps to healthier you.

“Ok, go in here, put on the gown with the front open. When you are done come out and we will get started.” You may or may not have heard these words. If you have you know you are about to have a mammogram.

mammography, bless you, mammogram machine — Mammogram machine.

Mammograms in the beginning were general purpose x rays with no compression, in the 1960’s. We have progressed to now having digital mammograms. See Advances in Breast Imaging for a great history of mammography.

According to UpToDate, 2020, Breast cancer is the second most common cause of cancer death in women. This is why early detection is so important. I recently had a post on self breast exams. You should do your self breast exam once a month. Mammograms are the next thing to complete. It is a yearly exam that we have all heard the horror stories about. Being a women is hard work. But I would not have it any other way!

Mammograms are an x ray technique that allows the radiologist to see, if any areas look like they need further evaluation. They will compare your exam from year to year. If there is an area of concern they will do further testing. Normally that includes spot compression mammogram. This is looking at a specific area more closely. I had this call one time, and man was that enough. I went for my routine exam. The following day they called to say I needed another view. When I got there, they had me get into a gown. The technician looked and found the spot of concern on my mammogram. Marked my breast and took the x ray. She then sent the picture to the radiologist and he cleared me. I was one of the blessed ones.

It is best to get your mammogram at the same place each year. The radiologist can compare your exams easier. These comparisons could mean the difference between having to repeat an exam or not. My compression exam was the first time I had a mammogram at that hospital. They did not have any previous exams to compare. Had they had them, chances are I would not have needed the second images.

While there are reported cases of false positives, those are less with the advances in technology. Digital mammograms are the most recent which gives a clearer picture. When a spot is found the next step as mentioned about is compression views. Then the decision is made to move to either ultrasound or biopsy. Those topics are for another day.

When it is your turn to go into the room, put on that gown, open to the front. Know that all the hassle is worth it. Not only to save the tata’s but to save your life. Early detection is a key to treatment. I challenge you to share with a friend the information you have learned about the importance of self breast exams and mammograms. Share my post with them.

Depression

Many folks suffer from Depression. Especially now with all the social distancing. Get them help!

We hear the word depression a lot. Just saying the word can make you feel down, low, gloomy, hopeless. Most people are able to say the word and feel or get a visual of what depression looks like. STOP!!! That is not even close, for those who deal with it daily. It is described as a black cloud hanging over one’s head. The motivation to get up and do something, is just not there. Sleeping 12-18 hours a day. Not being able to get to sleep, laying in bed for hours. They say “my mind will not shut off”. A sense of doom, always waiting for the other shoe to drop. A heaviness on them. So many ways that it is described.

According to DSM 5 : Depression is diagnosed when an individual experiences five or more symptoms during the same 2-week period and one should either be a depressed mood and or loss of interest or pleasure.

*Depressed mood most of the day, nearly every day.

*Markedly diminished interest or pleasure in all, or almost all, activates most of the day, nearly every day.

*Significant weight loss when not dieting or weight gain, or decrease or increase in appetite nearly every day.

*A slowing down of thought and a reduction of physical movement (observable by others, not merely subjective feelings of restlessness or being slowed down).

*Fatigue or loss of energy nearly every day.

*Feelings of worthlessness or excessive or inappropriate guilt nearly every day.

*Diminished ability to think or concentrate, or indecisiveness, nearly every day.

*Recurrent thoughts of death, recurrent suicidal ideation without a specific plan, or a suicide attempt or a specific plan for committing suicide.

If you or someone you know has these symptoms, what are you to do? There are numerous websites that you can take online quizzes that will give you a score. My go to is https://www.mdcalc.com/phq-9-patient-health-questionnaire-9. This site allows you to answer the questions on the PHQ9. It will give you a score. You can also make an appointment with your primary care provider. They can talk with you, discussing symptoms and what if any treatment is needed. I will discuss some general treatment options.

Walking is a simple way to get in daily exercise. Try to be better today than yesterday.

Exercise: I know we all have an excuse to not exercise. It is too hot, too cold, uphill both ways, I have kids…..you get the idea. The cold hard facts are you have to make it a priority. You do not have to have any equipment; you do not need to join a gym. You need to get out of your chair and do something. Heck if you can’t get out of your chair, you can still do some type of exercise. Exercise releases endorphins and endorphins make us happier. While you may still need to consider other treatment options, exercise can be added to any of them. There is a program called silver sneakers, here is a blog post with 4 simple chair exercises. You can add others as you are able.

mental health, mental, health — Evidenced based therapies help you put the pieces back together.

Therapy: many folks with depression can do evidenced based therapy by a licensed therapist. These therapies are normally a scheduled sequence of visits. You and the therapist discuss things you can do to help with symptoms. You will normally have homework from these sessions. Most folks who choose therapy do GREAT! It is a commitment in your health. These tools unlike medication work even after you are finished with the therapy protocol. You will learn many tools that you can look back on years from now.

jar, pills, medicine — Please do not take anyone else’s medications. Only take medications that are prescribed to you from your healthcare provider.

Medications: There are many medications that can help with depression. Each class works in a different way. Actually, each medication within a class can work a little differently. Medications work well for about 33%, work somewhat about 33% and do not work for 33%. There is always a chance of developing side effects when taking any medication. Your primary care provider or mental health provider will discuss these with you. Medications can be a life changing option for some people.

Depression is a real thing; it affects approximately 7% of American’s each year according to National Institute of Mental Health www.nimh.nih.gov/health/statistics/major-depression.shtml. With the highest percentage seen in ages 18-25 at 13.1 percent.

Found on Nat’l Institute for Mental Health site above.

One of our biggest issues that happen for many people with depression is feeling they would be better off dead. National suicide rates in the US in 2017 were 47173 individuals. Suicide was the second leading cause of death ages 10 and 34 and the fourth among individuals between ages 35 and 54. According to www.nimh.nih.gov/health/statistics/suicide.shtml .

If you or someone you know is needing help, call the national suicide hotline.

1-800-273-8255

Depression is a serious mental health disease. Many do not wish to be treated. However, for those who seek treatment, can find what works best for them. If you or someone you know, has symptoms of depression, please make an appointment with your primary care provider or mental health provider to discuss. Please do not try to deal with it on your own.

If you have found things that work for you, or have a success story please comment below. Share this post if you know someone it might help.

This is not medical advice. This is informational purposes only and does NOT constitute a visit with your health care provider. You need to make an appointment with your healthcare provider for treatment.

Independence Day!!

What is Independence Day? “On July 2nd, 1776, the Continental Congress voted in favor of independence, and two days later delegates from the 13 colonies adopted the Declaration of Independence, a historic document drafted by Thomas Jefferson.”(https://www.history.com/topics/holidays/july-4th). However did not become a federal holiday until 1941.

Celebrations are a hallmark of Independence day. Most every town has a parade. Campgrounds are booked full. Lakes are full with swimmers, floaters, boats, ski’s, tubers. Down every street you can smell the grilling happening. Families and friends all having a day to be together to celebrate our freedom.

This July 4th will be like no other. We will most like celebrate in small groups. We will either talk from 6ft apart or we will wear mask. When we go shopping for party supplies, we will be wearing mask. However, I feel the most important thing is to celebrate. We live in a great country! We are able to conform and have our free will. We can have small groups, we can still cook out, go to the lake, go to the park. Get out and enjoy the great outdoors. Many of us will have fireworks both during the day and at night. Our night will be bright with beautiful fireworks.

Don’t let having to use personal distance, wearing a mask, or having to be more cautious this year, damper your celebrations. Keep in mind all the precautions. These are not there to damper your fun, but to help you stay healthy and keep your loved ones healthy. So far, covid 19 has affected the elderly the most. However, with crazy beach parties we are finding it is spiking in the young adult population. Please take precautions while celebrating our great country.

Happy 4th of July!

We still need to be washing our hands!

Reminder to wash your hands. We are getting back to somewhat normal life. Please keep the habit of washing your hands.

Several months ago when Covid 19 was just starting in the US, we were all washing our hands. We were counting to 20, or singing the ABCs, or happy birthday (hopefully in our heads). We were using hand sanitizer and disinfecting wipes. We were being clean. Are you still doing these things or have you given away back to old habits.

It seems that Covid 19 is still rising in some areas. Is this because we are testing more? Is this because we are getting back to business as usual? Is this because we are not wearing mask in public? Is this because we are not washing our hands as much? Whatever the cause or combination of the causes, we are only able to control what we do. Here is my last post on hand washing and which is still relevant today.

Have you ever wished there was a big sign outside the restroom that flashed “DID NOT WASH HANDS”? Most of us think of hand washing after using the restroom. However, do you wash them correctly? Most people do not! I have read up to 95% of people, wash their hands incorrectly. What is proper technique? Here is a video to watch.

Unfortunately, it takes a major health scare, like coronavirus, to encourage us to WASH OUR HANDS. Since we were little, we have heard wash your hands. All through elementary school, middle school, high school we were told to wash our hands. We taught our children the same thing. So now let’s get to the reason behind washing our hands.

Handwashing with soap and water for at least 20 seconds is a way to scrub germs off of your hands. You should wash your hands:

Before and after eating
After using the restroom
Before and after cooking (especially raw meat)
After changing a baby diaper
After petting animals
When visibly soiled
Visiting elderly family either at their home or the hospital
Any other time you think to wash your hands.
Pretty much after any activity.

Hand washing is the most effective form of staying healthy. It helps prevent spreading infections such as diarrheal illnesses and respiratory illness. There have been many studies about hand washing and found that most people do not take the time to wash hands properly. Most give the reason “I don’t have time to spend 20 secs washing my hands”. Especially caregivers who go from one patient to another. This prompted the invention of hand sanitizers as they can be used in place of soap and water, during most situations. Hand sanitizers are hanging on the walls in most public areas. You wave your hand, and a palm full of sanitizer is released. You then can rub hands together until it is dried. Read the recommendations, as most say that you should still use soap and water every so many times of using sanitizer.

The coronavirus is among us and most likely a large percentage of us will get exposed. The best practices to help stop the spread is social isolation and hand washing. The CDC has this information about hand washing in PDF forms, PDF handouts you can print to use at home and office to help with education and remind others to wash hands.

I found a great article from the Minnesota Department of Health about what type of soap to use, plain or antibacterial, liquid or bar, and when should you use hand sanitizer. These are a little different from what the CDC states in the above video, but both offer great information.

Thanks for taking time to read or reread about hand washing. I challenge you to WASH THOSE HANDS FOR AT LEAST 20 SECONDS with soap and water. In all the scenarios listed above and any other time you think of it. Let’s stay clean! Whether Covid, flu or any other illness, clean hands are a main habit of defense.

Daddy, Dad, Father

Daddy, Dad, Father, Grandfather only a few of the name’s men acquire when they become dads. Today is Father’s Day. The day we buy the men in our lives a little something extra. Normally it is a cute gift the kids have made. Then as they age comes the coupon book of chores, the kids are willing to do for dad, over the next few weeks. As adults we tend to be a little more creative and get our father’s something, we feel they need. This is not always what they feel they need.

Father and Son working on a project — Father and son working on a project!

Father’s Day began in 1910 and to be celebrated on the third Sunday of June. Sonora Smart Dodd founded Father’s Day in America. According to Wikipedia in catholic Europe it dates back to 1508. A bill was introduced in congress in 1913 to recognize this day in the US. In 1916 President Wilson tried to get it recognized as a federal holiday, but congress resisted. There was fear it would be commercialized. There were several attempts, but a bill was not signed into law, until 1972, by president Nixon.

Proverbs 23:24 “the father of a righteous child has great joy; a man who fathers a wise son rejoices in him”

Every year on the 3^rd Sunday of June we celebrate our Father’s. We celebrate in our own ways. We know that we are blessed to have father’s in our lives. These men help support our families. They teach us how to fish, hunt or build a camp fire. They mow the yard, fix the fence and some work inside the house too. Whatever you father does, whatever he teaches you, cherish those moments. Our father’s are here to teach, love and comfort us, often they are not here long. Even the ones who are here a hundred years or more we miss when they are gone.

Proverbs 23:22 “listen to your father, who gave you life, and do not despise your mother when she is old.”

Today, I hope you are celebrating your Daddy, Dad, Father. Today let them know that today is their day. Give them that tie, coupon book, or just a great big hug. If they are miles away, give them a call or text. They will cherish these moments.

Bipolar, What????

Mental health is misunderstood by many people. General information about bipolar.

Bipolar is a mental health condition that affects 2.8 million Americans, per Dr. Legg’s artical. It is normally diagnosed when people are in their early 20’s, but can be diagnosed in children. There are different types, but I will be general in this post. Bipolar is treated based on the type you have. The NIMH(National Institute of Mental Health has a great overview of the three types. You will need to be evaluated by a medical professional for diagnoses. This is an overview for informational purposes only. It is not and should not be considered medical advise. You should always see your healthcare professional with your health concerns.

Bipolar is a mood disorder that can have episodes of mania, a hyper sense of security. It can also have very deep depressive symptoms. “It is characterized by a distinct period of abnormally and persistently elevated, expansive, or irritable moods. Increased activity or energy lasting at least one week and , present most of the day nearly every day.” (Uptodate).

Bipolar disrupts mood, energy, activity, sleep, cognition, and behavior. Many with bipolar struggle to maintain what we would consider a normal life. They have trouble with keeping a job and with interpersonal relationships.

There are many potential symptoms which include inflated self-esteem, decreased need for sleep, but not feeling tired, more pressure to talk or being more talkative than normal. Flights of ideas, being easily distracted. The opposite is being down, depressed, unable to get up in the morning. They can have symptoms in between the sudden ups or downs. While the ups and downs can hit quickly, they normally do not leave as quickly. These swings are normally around a week or longer.

Bipolar type symptoms can be from other substances and or medical conditions. They can include substances such as alcohol, illegal drugs, psychiatric treatments, and some general medical treatments. Neurological, endocrine, and infectious disease conditions can also cause symptoms similar to bipolar. Before making the diagnosis, it is important to rule out any of these causes. Therefore, blood is drawn and urine checked. Once these are found to be normal, the provider may consider a diagnoses of bipolar.

The good news is that there is help for folks who have bipolar. There have been several newer medications to help with the symptoms. The issues with side effects are a little better with the newer drugs. Some of the older medications had stricter guidelines for blood testing and monitoring. They also had higher incidences of intolerance.

Do you or someone you know have bipolar? What are some of the things you do to help with symptoms? Do you take a medication that has done wonders for you? Please comment below if you have information you would like to share!

This is not medical advice nor will any of the comments below be considered medical advice. This is for information purposes only. This is not treatment or to be considered treatment for you or your family. If you feel you have some of these symptoms, see your primary care provider to have further evaluation for your specific needs. Thanks

Fight for life, do your self breast exam!

Learning about self breast exams. They can save your life.

Ladies and gentlemen, do you do monthly self-breast exams? Yes, the guys have it easier. Early detection is a big key to beating breast cancer. A while back I had a post about preventive healthcare for men ,and for women. Today we will talk breast self-exams.

According to Cancer.org last revised Jan 2020 “The American Cancer Society’s estimates for breast cancer in the United States for 2020 are:

About 276,480 new cases of invasive breast cancer will be diagnosed in women.

About 48,530 new cases of carcinoma in situ (CIS) will be diagnosed (CIS is non-invasive and is the earliest form of breast cancer).

About 42,170 women will die from breast cancer.”

Men also can have breast cancer and Cancer.org has information about breast cancer in Men. According to cancer.net “An estimated 2,620 men in the United States will be diagnosed with breast cancer.”

The basics,if you do a self-exam every month, you will learn the feel of your breast. You will notice, if something, just does not feel right. If this happens make an appointment with your primary care provider, to discuss further evaluation. According to National Breast Cancer Foundation, Inc. “Forty percent of diagnosed breast cancers are detected by women who feel a lump, so establishing a regular breast self-exam is very important.” National Breast Cancer Foundation, Inc offers The free resource, 3 Steps to Early Detection. They also offer information on how to do you self breast exam. Breastcancer.org has great information on self breast exams and what to do if you find something that concerns you.

There are many ways to remind yourself. Set an appointment on your phone calendar, for the same date each month. A sticker on your wall calendar(printable here). Always, do it the second Sunday, or if female after your menses. You get the idea, just figure out what will remind you and do your self exam. You could be saving your own life.

Here are some great tools for learning to do your exams. You should start doing these exams around age 20, according to most experts. Clinical exams are completed when you have yearly well women exams. These guidelines change with time, however, there is no cost and no harm in doing your self exam so consider doing them.

Now for the how to do a self breast exam. There are many sites that have handouts (some of the links, listed above also, have them). There are you tube videos(like the one below) you can watch. It is a matter of remembering to do them and being consistent with doing them. Our local TV network runs a campaign called “buddy check 3” you sign up with a friend to remind each other to do their self exam on the 3rd day of the month.

Breast cancer kills both women and men every year. To increase your chances complete your self exam monthly. Do you have a story to share? Did you find something concerning during your self exam? Do you and a buddy remind each other? Feel free to share in comments below.

This is not medical advise, this is for informational purposes only. This is not a substitute for seeing your primary care provider. If you have concerns make an appointment with your primary care provider to address them.