Living Older, Living Better!
Archived-Featured Tips
by Katrina Gwinn, MD
Living Older Living Better Photo by Carl Gwinn
Tip of the Summer-2008

Avoid Laxative Abuse!

Constipation is more than just a minor irritation.  It can make a person miserable.  Because of this,
laxatives are widely used as over the counter treatments.  However, not all are safe.  

(Just because something is sold in a Drug Store over the counter, that does not mean it is ok for
you!)

From Best to Worst Choices:

  • Those that are bulk forming, such as those containing psyllium (including Metamucil,
    Citrucel) are generally safe to use every day.  
  • Stool softeners can be safe in the short term (including Colace, Surfak, Senekot) but
    should not be used for more than a few days in a row.
  • Prescribed treatments such as synthetic sugars that are not absorbed (Lactulose,
    Sorbitol) are safe but need to be given under your doctor's supervision, as they
    need to be dosed appropriately for you.
  • Mineral oil can be safe as a temporary measure, but for people who have trouble
    swallowing, or those with lung problems or Parkinson's, it can go into the lungs and lead to
    pneumonia.  It can also decrease the absorption of some vitamins.
  • Salt water or tap water enemas are safe as very temporary measures.  However,
    these should not be used regularly or more than rarely, for emergencies, as they can cause
    the bowel to become weaker over time, and even lead to a loss of muscle tone in the gut.  
    Also, some enemas contain additional ingredients such as magnesium (see below) which in
    themselves can have dangers.
  • Magnesium containing laxatives including Milk of Magnesia and even some enemas like
    Fleets enemas can lead to dependence (see below) and also, taking too much of
    Magnesium containing medications can cause delerium (trouble thinking, confusion).  
    How much is too much? For some people, especially those who are older, even the
    recommended over the counter dosage is enough to lead to confusion and trouble thinking.  
    The Magnesium in enemas is absorbed, so be sure to check the package before using
    one!
  • Those that cause an explosive stool are stimulants, and are not recommended.  Their
    use can lead to dependence and addiction (addiction meaning, you cannot have a bowel
    movement without them and you may find yourself relying on larger and larger doses).  Worst
    of all, this can lead to damage of the bowels themselves, leading to weaker bowels and worse
    problems with constipation and even impaction, where stools do not move at all!

The solution to Constipation is PREVENTION with a regular habit of "trying to go"
at the same time every day, drinking plenty of fluid, getting exercise, and eating
fiber!

Tip for February 2008

Make the Most of Your Doctor Visit:
Bring a List, and a Friend, to the Doctor with You!

The most important aspect of the Doctor-Patient interaction is clear
communication.  However, much information is not always heard.  This is
particularly true if the information is of an emotional content, which medical
discussions often are.  We all have things that we plan to discuss with the doctor,
prior to the appointment, which we can easily forget when we are in the doctor's
office.  In order to avoid this:
  • Bring a list of what you want to discuss to the doctor with you to make sure
    the most important things are discussed.
  • Bring a friend or partner with you.  Two sets of ears are better than one, and
    your friend may help you with questions, too.

More information can be found on this site, under "
Manage Health-Managing your
Healthcare Team".

Tip for January 2008

Which Exercise is the Perfect Exercise?

There is no such thing as the perfect exercise for all people.  An exercise must be
tailored to your interests, as well as your abilities or disabilities. A few that others
have found helpful for the reasons cited include:
  • Swimming: good if you suffer from joint pain.  Water aerobics are also
    recommended.
  • Walking: good because it doesn't require any special equipment (other than
    good shoes).
  • Exercising in a class (or with a buddy): helps you exercise regularly because
    you feel peer pressure to attend.

The best exercise for you? The one you will do REGULARLY.

Tip for December 2007

Exercise Your Brain by Exercising Your Body!

Our minds need a diverse set of experiences in order to stay healthy--this include
exercise.   A recent study of people over 65 showed that those who exercised
regularly were less likely to suffer from memory problems than those who didn’t
exercise.  Exercise can also improve your mood.  The current recommendation is
to have a minimum of moderate intensity activity 30 minutes a day, most days of
the week.  And if you feel pain, stop.  Pain is a warning that something is wrong,
and it should never be ignored.  If you have a health condition, check with your
doctor before beginning any exercise program.  Don’t be intimidated by these
recommendations: start low and go slow.  Remember the tortoise and the hare:
that fable applies aptly to how exercise should be approached.

Tip for November, 2007

Grapefruit-Not always a Great Fruit!
Grapefruit contain specific proteins (some furanocumarins and flavanoids), not
found in other citrus fruit, that can interact with a number of medications.  The
juice, as well as the fruit, contain this particular protein, so both can have a risk of
interaction.  These include warfarin (aka coumadin, a type of blood thinner), some
chemotherapeutic agents, Lipitor (a cholesterol lowering drug), other cholesterol
lowering medications, cialis, viagra, and allegra, to name a few.  Some of these
interactions can lead to dangerously high levels of the medication, or, a severe
side effect.  Check with your doctor or pharmacist if you like to eat grapefruit, or
drink grapefruit juice and are also on medication!

A news article about it on the CBS news website, can be found at
http://www.
cbsnews.com/stories/2005/01/20/health/webmd/main668105.shtml.