Senior Health: Live Question and Answer Session
July 16, 2003

A live question and answer session about senior health was held on Wednesday, July 16, 2003. Thank you to our sponsors and the healthcare professionals at Columbia St. Mary's and Advanced Healthcare! Read the archive now...

Q: Linda of Menomonee Falls - What does a defilbulator do? Does it regulate a galloping heart or does it start a heart that is not beating or both?
A: Moderators - A difibulator "jolts" the heart, which allows the heart's electrical system to have a more effective heart rhythm.


Q: Melinda of Racine - My father recently had a mild stroke, was diagnosed with arrythmia and had a pacemaker put in. His surgeon now wants to do a cardioversion. Are there any risks associated with this? I'm also concerned that he is going to be at risk for another stroke. He's also taking coumadin for blood thinning.
A: Moderators - I am hesitant to give you an answer to this one without knowing more about his medical history. The arrhythmia your father has is most likely atrial fibrillation. That by itself can cause a stroke. When the atrium is fibrillating, quivering, blood can clot within the atria. If it happens to make a stronger stroke, the clot could dislodge, causing a stroke, as well as congestive heart failure (fluid in the lungs.) So, as you can see, there is a risk to not doing anything also. My best suggestion is to talk seriously with your doctor about their recommendations. If it does not sound comfortable to you, I would recommend getting a second opinion from a cardiologist.


Q: Gwen of Milwaukee - I read on the National Cancer Institute Web site that 1 in every 57 women in the U.S. will develop ovarian cancer. This seems so high. Is this accurate?
A: Moderators - I'm not familiar with the actual numbers. The best advice that I can give you is to make sure that you see your physican each year for a gynecological exam.


Q: Debbie of West Allis - My father swore by drinking a glass of rye whiskey each night after dinner. Now everyone is talking about drinking a glass of red wine each night. Is it the alcohol that's important?
A: Moderators - It's not the alcohol that helps, but it is the natural substance that is in a red wine, specifically, a red wine. The rye does not have the same effect, so you would be looking for a red wine.


Q: Harry of New Berlin - I feel silly asking this question, but here we go. My golf game is getting worse and worse and I don't like that. What can I do to keep flexibility and strength, specifically to help my golf game?
A: Moderators - Any exercise that helps you make the natural movements that you would use with golf. I'm sure you know a lot about golf already. Practice makes perfect, but also, just practicing making the movement will help to train your muscles to improve your golf game. Another suggestion, ask the pros.


Q: Jeff of Grafton - I'm really concerned about my dad. He's been diagnosed with diabetes, and he's overweight. He can control his diabetes with diet, but refuses to do so, and relies on his medicine instead. I feel like one of those al-anon people, not knowing what to do. I really like him, and know that when I talk about it, he just shuts me out, but I can't stand watching him this way. What can I do?
A: Moderators - Perhaps your father is not ready yet. Accepting a chronic disease is not easy. Right now he needs your support and your love. Your father is making his choice. He has the option of controlling his diabetes with diet and exercise...OR taking medications. Perhaps at some time in his life he will be ready to start working more on himself, and exercise. One thing that family sometimes does is become the "Diabetes Police." If you are the diabetes police, that makes your father "the criminal." You know how cops and robbers go. The harder the cops try to catch the robbers, the harder they try to not get caught. Ask your father what you can do to help him. Otherwise, let him make his choice. Has he seen a diabetes educator? Many insurance companies pay for diabetes education. The educator will help him learn what to do to take care of himself. Please call your local diabetes program (most hospitals have a program), and ask his Dr. to refer him for diabetes education. There is a clinic right in Grafton that has a diabetes educator. Good luck. And love your father for who he is. He's lucky to have you caring so much about him.


Q: Dan of Whitefish Bay - I'm terrified of retirement. I've had co-worker after co-worker that's gone downhill after they stopped working. Would it be so wrong if I kept working? How about part-time? I don't want my brain to turn to mush.
A: Moderators - Research proves your point. An active mind should not age as quickly. Why do you feel forced to retire? Unless your aging process limits your abilities to perform your job duties, why not continue to enjoy it?

Dr. Isaac Pierre, M.D.


Q: David of Brookfield - I read the answer about sleeping too little. I've got the opposite problem: I sleep all the time. I sleep about 12 hours per night and just can't seem to make it through the afternoon without an hour long nap. I'm otherwise quite happy. Do I have a problem?
A: Moderators - That depends. Have you always slept more than the average person. Most of us would get and ideal amount of sleep in around 8 hours. Do you sleep soundly and awake refreshed? Usually a person who is sleeping 12 hours per night would not need to take a daytime nap. Sometimes we sleep more when we are depressed about something. There are other conditions that do not allow us to sleep soundly. One example is sleep apnea, where the body wakes itself up constantly throught the night. This means excessive daytime sleepiness. It seems from your short note that you are quite happy with your life, making depression less likely. I would want you to discuss this in person with your primary care physician. This doctor could ask these questions in person to determine if this is just you or related to another condition.

Dr. Isaac Pierre, M.D.

Q: dj of milw - i sometimes feel like i have a hard time walking. it's hard to explain but it seems like my hip slips a bit in the joint and for awhile it's laborous to walk. is this something i should be concerned about? as i get "over the hill" will this happen more frequently?
A: Moderators - I would be concerned enough to make an appointment with your primary care provider. While I can not make a diagnosis over the computer, you are recognzing that your hip joint is behaving something normally. Often, as part of the aging process, our joints age as well. A simple physician exam, plus or minus an x-ray, may determine a diagnosis and then a treatment plan. You do not want your hip determining your lifestyle. Walking should not be laborious.

Dr. Isaac Pierre, M.D.

Q: AJ of Green Bay - I love the site. It is a great resource and very helpful. Will you have more chats in the future? Incorporating video or audio would make this even better. Now my question; I am quickly approaching 70 and my PSA has increased from a low 2.7 to over 4 in the past few years. Should I be worried? Is this normal? Should I consult a physician?
A: Moderators - Thank you for your interest. There are additional chats planned. I do not have specifics for you. Please be on the lookout. The PSA (Prostate Specific Antigen) is a tool used but is not the ideal, "end-all be-all" tool for diagnosing prostate cancer. It should not be used as a substitute, but as an adjunct, to a clinical exam, along with other medical tools. I would recommend discussing these findings with your individual physician. Your numbers may represent the normal aging process but this can not be decided based on this laboratory value alone.


Q: Jodee of - As I get older I don't want to be a burden on my family. What should I look for when researching Senior Communities?
A: Moderators - You should look for a place that will meet your needs; fellow residents with whom you relate, a physical environment in which you will feel comfortable, a setting that is close to your family, friends and medical doctors. I think that your anticipated comfort and happiness should be foremost. I would examine very closely the services received for the cost expected. I would ask your physician as well as other friends that are investigating similar living situations. Good Luck!

Dr. Isaac Pierre, M.D.

Q: Sammy of Milwaukee - What do you feel about the Atkins diet for seniors? Is it better or worse now that I'm over 65?
A: Moderators - This diet utilizes minimal amounts of carbohydrates to force your body into a type of starvation. Studies have shown that this may help lose weight in the short term but has no real long term benefits for weight loss and/or health. I do think that it is important to be aware of the amounts, and the types, of each food group that you eat but do not believe that the Atkins diet is a real solution for proper health. As Americans, we probably eat too much of everything-including carbohydrates, but I would not recommend the Atkins diet to a patient of any age.

Dr. Isaac Pierre, M.D.

Q: Martha of Port Washington - For the past 2 years, approximately every 3 months, I develop a boil about the dimensionof a dime, on my upper right buttock. It always appears at about the same spot. What, if anything can I do to stop the recurrance & why do I continue to get it? I am 60 yrs of age, and on unemployment at this time, and I have no medical coverage, so I cannot afford to get medical treatment for this problem. What can I do to get help with this? Thank you.
A: Moderators - From your description, it sounds like this is a recurrent cyst. This most likely confers no great risk to your person, but does pose a small risk of local infection. The ideal treatment would be to have a doctor remove the cyst in an office setting because otherwise it may become exacerbated as you are experiencing with it coming and going. There is a clinic for the medically uninsured on Saturday mornings at Columbia St. Mary's clinic, the Family Health Center, located at 1121 E. North Avenue. For more information, you should call 267-6500 and ask to speak with Ann Marie Jones.

Dr. Isaac Pierre, M.D.

Q: Tracy of Oak Creek - My husband and I have found that our sexual drive has diminshed with our age, what do you suggest to bring this healthy, and fun, part back into our lives?
A: Moderators - This is a common concern as we age. First of all, I would talk to your doctor about this concern. There are certain hormone deficincies that can play a part decreased libido. Erectile dysfunction in men and postmenopausal changes in the vaginal tissue can make intercourse difficult. There are good treatments for many of these problems. Making time for the two of you to focus on each other and specifically your sex life also helps.

Karina Peterson MD

Q: Betsy of Germantown - My son talks about how much cardiovascular exercise he does: 3 times a week for at least 20 minutes. I'm 68 now. How concerned should I be about doing cardiovascular exercise?
A: Moderators - You should be very concerned about cardiovascular exercise! It is very important for your heart, lungs and joints and bones to continue to exercise especially as you age. I would check with your doctor before you start an exercise program. A good program to start with is walking for 20 - 30 minutes for 3 - 5 days a weak.


Q: Frank of Middleton - I've always had problems with the sun and burn easily. In the last few years it has gotten worse and worse. Is this just something I need to deal with with more sunscreen, or can I take something?
A: Moderators - There is no medication to take to decrease your skins sensitivity to the sun. As you age your skin changes as you are noticing, it is important to use plenty of sunscreen. At least SPF 15. You should make sure to ask your doctor to take a close look at your skin atleast once a year. If you have any new moles, changing moles, nonhealing skin lesions or scaling lesions you should have these examined. If you are on any medications you should also make sure that these are not increasing your skins sensitivity to the sun.

Karina Peterson MD

Q: Chris of Waukesha - What can I do now, as a 32 year old male, to make sure that I don't have back problems later. I know all the obvious stuff, bend your knees, etc. What else can I do?
A: Moderators - In general, staying active and exercise is the best way to prevent back problems in the future. Extra weight is very hard on the back. Watch your weight. Weak abdominal muscles also increase your chance of back problems. Swimming is a very safe exercise for the back, it is low impact but also a good exercise for the back muscles.


Q: Debra Gatzke of Waukesha - My Father has osteoarthritis and has had several joint replacements. At this point he would like to avoid any additional surgery. We are interested in medical management. What type of physican is the most educated regarding benefical pain medications? Is there a web site he can visit to learn additional pain relief strategies?
A: Moderators - Most family practice and internists are well trained in the use of pain medications. If your father's pain is not being well controlled the next step would be to see a pain specialist, usually these are anesthesiologists. Often, they can help patients find a pain medication plan that will control the pain. Once that has happened you can return to your regular doctor for refills on these medications. Most hospital systems in the Milwaukee area have a pain clinic. I would refer your father back to his own physician.


Q: TT of MIlwaukee - What medication are available to slow down the effects of alzheimer's disease? Who qualify for the medication? What are other alternatives to these medications? What can one do to slow down the process? What should one do to be prepared if he/she knows that he/she gets it? How can family members and loved ones prepare for the hard time ahead?
A: Moderators - There are several medications to help with Alzheimers disease. They will not reverse the memory loss that has already occured but will help slow down the progression of the disease. Your doctor will determine if you qualify for the medications. They should make sure that there are not any other medical causes for the memory loss, including high blood pressure, blockages of the arteries to the brain. Each medication has different side effects and dosing schedules and along with your doctor you can decide which one is best for you. Other alternatives to medication are environmental: regular schedules, keeping notes, pill boxes.

Karina Peterson MD

Q: Waled of Milwaukee - I have a friend who got diabetes. He is in his 30's . His wife is asking if that will affect pregnancy. Will they be able to have children? Does that affect sex too?
A: Moderators - Diabetes should not affect the wife's pregnancy. If diabetes is not well controlled, over time it can affect the arteries and nerves in the body, including the heart, kidney and genital organs. This can lead to problems with erectile dysfunction. If diabetes is controlled, along with good blood pressure control and cholesterol control you can significantly reduce you risk for early problems with erectile dysfuntion along with heart disease and kidney disease.

Karina Peterson MD

Q: Linda of Menomonee Falls, Wisconsin - What exactly do defibulator paddles do for the heart? Do they start a heart that is not beating or do they regulate a galloping heart beat? Or can they do both?
A: Moderators - Defibrilator paddles can do both. They are used to try and start a heart that has stopped beating. Paddles can also be used to convert an irregular heart beat into a regular heart beat. Often cardiologists will try to use medications to regulate a heart beat. We are now seeing the addition of automatic defibrillators to many public arenas, the patches are placed on the patient and will read the heart beat and decide if a shock is needed.

Karina Peterson MD

Q: Desiree of Milwaukee - What is best way to go about encouraging older adults to start eating properly to maintain the heatlth that they have?
A: Moderators - I find that education is typically the best and most effective intervention. Even this can be difficult, however. The culture in which one first learns about diet and nutrition can be the biggest hurdle. Sometimes, it takes a life-altering event (such as a heart attack) to encourage one to change his or her nutrition patterns. Often elderly adults learn from friends who have "learned the hard way." Dietician consultations are available at most clinics and should be taken advantage of.


Q: Matt of Greenfield - How much noproxen sodium can I take before it starts to pose a health risk? The labelled suggests not more than 220mg per 8 hours, but I'd like to do a lot more for my pain.
A: Moderators - Under a physician's supervision, the dose can be increased to a dose of 500 mg every 12 hours, barring any medication interactions or other health problems.


Q: Heather Gergen of Pewaukee - My grandmother had her right hip replaced a few years ago. She has three sisters and others have had problems with their right hip. Now my mother gets pain in her right hip and I am very sensitive in my hip. Is there a genentic predisposition to hip problems down to even a specific side and is there any thing I can do now to avoid problems in the future? Exercises? Calcium pills? What specifically?
A: Moderators - The nature of the hip problem is important to distinguish. A physician should try to determine the diagnosis before any specific treatment can be decided upon. That being said, some forms of joint disease are indeed hereditary. EVERYONE should exercise to some extent. Being overweight or obese predisposes one toward joint disease, as does a sedentary lifestyle. If you are a woman or are otherwise prone to osteoporosis, a calcium supplement with vitamin D is a great idea. Women should get at least 1500 mg of calcium in their diets through food or supplementation.


Q: Calvin of Milwaukee - Can you recommend ways to help keep seniors active after retirement?
A: Moderators - Establishing sustainable and enjoyable habits is key. Barring any serious health conditions, exercise time can actually INCREASE upon retirement. Walking programs are excellent low-impact forms of exercise. Many community programs exist to encourage retired adults to remain active (water aerobics, golf, competitive sports, etc.) at every level of difficulty. But don't forget mental activity! Book clubs and intellectual groups (bird-watching, astronomy, volunteering, mentorships) are very popular as well.


Q: Pat of Oconomowoc - I have osteoporosis and am currently taking a calcium supplement (Citracal +D), drinking 3 glasses of milk per day, walking on my treadmill, and taking Fosamax (70 mg/week). I've had one retest bone scan which showed some improvement. Is it possible to "get over" the osteoporosis and have healthy bones?
A: Moderators - It really depends upon your age and the severity of your bone loss at the time of diagnosis. If your bone loss is minimal, it is indeed possible to reverse the process to the point where you are equal to people your own age. If your loss is severe, slowing your bone loss to prevent a fracture may be a more reasonable goal.


Q: Lee of Milwaukee - I recently had a bone density scan done and my score was -3.2. What does this mean and what course of treatment might I expect my doctor to prescribe?
A: Moderators - The 3.2 to which you refer needs to be clarified. Is it your "t-score" or your "z-score" and do you mean +3.2 or -3.2? The t-score compares your bone density to that of young/healthy adults. The z-score compares you to an age-matched population. If your t-score is -3.2, it would mean that you have severe bone loss and should be treated with medications to prevent bone loss and reduce your risk of a fracture.


Q: Bill S of New Berlin - Is the old saying" If it hurts when you do that,then don't do that"good medical advice?
A: Moderators - Not typically. Unexplained pain should be explored and a reason for it should be found. Excessive pain has been found to be correlated with depression and several other problems.


Q: Dennis Jenders of Milwaukee, WI - Does cracking your knuckles, or other joints, cause Arthritis?
A: Moderators - Of course, this is something that our parents always warned us about. However, there is no medical edvidence to suggest that "knuckle-cracking" causes arthritis. That being said, cracking one's knuckles isn't exactly good for the joints either.


Q: Jessepcmott7@aol.com of Cedarburg, WI - my doctor just told me after a routine blood sample that my glucose was at 122. he said that 126 was considered diabetic. is that level of 122 something that is permanent? also is the reading type 2 diabetes? Thank you
A: Moderators - A reading of 122, in and of itself, does not qualify you as a diabetic (Type 2 or otherwise). However, was your level checked after you had been fasting? To further answer your question, our blood sugar levels are never permanent. They change routinely in relation to our dietary intake, exercise level, etc.


Q: Judith of Sherwood - Each night after retiring to bed, my left leg, only between my knee and left hip, aches so bad. It keeps me awake, and if I try to get on my side to alieve it, it is even painful to roll back. The only thing thus far that has helped is putting a pillow under both knees, which provides some relief or getting up. If I could sleep standing up, it would be great! What can I do, or what is going on?
A: Moderators - It seems that you may have a form of arthritis in your hip or nerve compression in your lower spine that is aggravated by your position. A physician's examination would better shed light on the exact nature of your symptoms. Over-the-counter pain medicines such as Tylenol may be of benefit.


Q: Gail of Oconomowoc - I have been quite depressed for several years(since menopause started). It is not something that is with me everyday, but there does seem to be a cycle. When it is bad, I feel that I can't do anything, nothing is right, I would like to stay in my house and not see anyone, I don't even like to answer the phone. I just can't even think straight. My emotions are reading to boil over. How much of this is inherited, if it is. I just do not know what to do.
A: Moderators - Yes, what you are describing to me sounds like depression. Whether or not it is inherited, it is abnormal for someone to suffer from it. Depression is treatable. Both medications and therapy in the form of couseling by psychiatrists, can significantly improve one's quality of life. Please seek medical care immediately. I sounds like this is a significant issue that your are struggling with, and you don't need to alone.

Stephanie L. Garrett MD

Q: Louise of Racine - What kind of exercise do you recommend for people in their late sixties?
A: Moderators - Exercise is for everyone, really, at any age. However the type and intensity of exercise really should be determined by your specific goals. Everyone should have as their goal, prevention of heart disease. So any moderate exercise, walking is great, that is done for a total of 30 minutes each day (does not have to be all at once) has shown benefit to ward off heart disease. Now if your goal is flexibility, activities like yoga are wonderful. (Be careful to start easy!). For strength and healthy bones, weight training is excellent. Walking itself is a great weightbearing exercise, but you don't have to be young to lift weights. I would however seek the advice of a personal trainer, or a senior exercise class.

Stephanie L. Garrett MD

Q: Loretta of Madison - Do seniors tend to sleep more or less as they get older? It seems to me that I need less sleep.
A: Moderators - What a great question! Well the topic of sleep in the elderly is a little complicated. Overall, as seniors age they may require less sleep. However sometimes the issue isn't total sleep but the kind of sleep. Seniors tend to experience less deep sleep or REM sleep (the sleep where you experience very intense dreams). Seniors may also have altered latency, or time to sleep. Now if you are functioning well on your less sleep, I would be less concerned than if you were experiencing daytime sleepiness on your decreased amount of sleep. Also make sure that your mood is good as early morning awakening sometimes can be an indication of early depression. In any case, discuss this issue with your primary physician.

Stephanie L. Garrett MD

Q: mary pittner of beloit wisconsin - i was diagnosed with fibromyalgia 4 years ago.I have struggled a great deal trying to work.Our family needs the extra income.But working is really taking a toll on me.I have seen 2 so called specialist,they say they have done all they can,they suggest i try other types of employment.Like we all have multiple talents.How can i get more support for the disability from my doctors.Or who would you recommend in this field
A: Moderators - Fibromyalgia is a very complex disease, and very challenging for both persons with the disease and the doctors who care for them. You mentioned a diagnosis 4 years ago, you did not mention if you have undergone any therapy. Some effective therapies for treating fibromyalgia include antidepressants, biofeedback, and reduction of stress. The doctors who specialize in treating this disease can included internists but also include rheumatologists. If you feel you don't have enough support for what you are experiencing, there is nothing wrong with looking for a physician who you feel hears your concerns and can support. The goal is both therapy and life style changes that will reduce the stress you are under.

Stephanie L. Garrett MD