Author: Jeannie Collins Beaudin

Do you, or someone close to you, have problems completing tasks or staying focused at times, but find you’re able to spend long periods doing something that interests you? Do you constantly misplace things or go to another room, only to forget what it was you wanted to do when you got there? Are you oblivious to the passing of time sometimes? If so, you may have ADHD (attention deficit hyperactivity disorder) or its close environmentally-induced cousin, VAST (variable attention stimulus trait).

I mentioned a couple of blogs ago that I’m reading “ADHD 2.0”, written by two psychiatrists, Edward Halloway and John Ratey, who also have ADHD themselves, giving them a unique perspective. It’s fascinating and I’m learning to look at this sometimes-debilitating syndrome quite differently. I thought I’d share some of what I learned… a book review of sorts.

Their first book, “Driven to Distraction” (love the title!) introduced ADHD to the public in 1994—most people hadn’t heard of it or knew little about it—and they’ve been writing to educate us all ever since. Now, 30 years later, almost everyone knows someone who is challenged with ADHD but it’s still not well understood. Has the syndrome become more common or are we just more aware of it? How well do medications for ADHD work and do sufferers need to take them for the rest of their lives to control negative symptoms? Are there other strategies that can help?

What is ADHD?

The syndrome has gone through an evolution in its naming: originally called ADD (attention deficit disorder), it was renamed ADHD (attention deficit hyperactivity disorder) to include the hyperactivity trait shown by some who are diagnosed. Of course, not everyone with ADHD also shows increased activity, particularly girls, so they created categories of ADHD: ADHD predominantly inattentive, ADHD predominantly hyperactive-impulsive (quite rare, according to the authors I am reading) as separate diagnoses from ADHD combined type. Somehow a syndrome name that includes “hyperactive” when the person does not show hyperactivity seems a little off… but there’s more that doesn’t fit the name, as these two doctor/authors describe it.

The CDC (Centers for Disease Control) in the US defines it as the following: “ADHD is one of the most common neurodevelopmental disorders of childhood. It is usually first diagnosed in childhood and often lasts into adulthood. Children with ADHD may have trouble paying attention, controlling impulsive behaviors (may act without thinking about what the result will be), or be overly active.”

“A child with ADHD might daydream a lot, forget or lose things a lot, squirm or fidget, talk too much, make careless mistakes, take unnecessary risks, have a hard time resisting temptation, have trouble taking turns, or have difficulty getting along with others.” All negative traits but, as I learned, there are many positives associated with ADHD too.

How does it affect adults?

Although ADHD information sources often discuss effects in children and don’t mention adults, Drs. Halloway and Ratey emphasize that, in their experience, children do not grow out of the condition—it’s just as much an issue for adults. Those who appear to have done so have merely learned to compensate very well. Some people even manage to create advantage from the traits.

My hubby, for example, was never diagnosed with ADHD but one evening, as we listened to documentary on the syndrome, we looked at each other and said “yeah, you have it!” However, he’s always used tools like leaving himself notes to stay organized and on task, often putting sticky notes on the dash of the car for errands not to be missed. He also likes to start projects right away and finish them as quickly as possible. I remember all my friends being envious of what my “hyperactive husband” was able to accomplish. I would come up with an idea, just musing (We should do Such-and-such…) and the next thing I’d know, it was all done! Having a desire to constantly be active can be put to great advantage in life. Even when a person with ADHD with hyperactivity is sitting still, seemingly relaxed and daydreaming, their mind is active and at work, thinking, planning and making decisions.

Are there treatments when it’s a problem?

ADHD is considered the most treatable disorder in psychiatry… medications are more effective for ADHD than for any other mental health condition. So, if a short attention span has become a problem, especially at school or work, it’s well worth talking to your doctor. Together you can decide if medication is needed, and for how long. But there are also many behaviour and lifestyle changes that can help to manage symptoms in the long term and turn them to advantage, as my hubby did. Many ADHD traits can be beneficial in the workplace, too. Once controlled, whether with medication or non-drug strategies, ADHD can be a driver of creativity and artistic talents that can springboard a person to success. You just need to learn strategies to help you finish the job.

The authors describe ADHD as a way of being, a brain wired in a particular way, rather than a “deficiency”. Instead of a disorder, they describe it as an array of traits associated with a unique kind of mind that can become a distinct advantage when managed with understanding (or an abiding curse, if not). To children they treat, they describe their brain as being like a Ferrari with weak brakes. You just need to learn how to strengthen the brakes on all that horsepower to really go places!

Lots of advantages too…

Besides the obvious variability in attention (those with ADHD can overfocus as well as become distracted when bored) those affected also tend to be quite comfortable with uncertainty. While this can lead to impulsive behaviour, it also can result in diving excitedly into a new business venture that becomes a great success rather than hesitating due to fear of failure, or inventing something imaginative that no-one has thought of before. They need to investigate odd noises, how things work, or what’s in that petri dish to satisfy their strong sense of curiosity. They often feel an abiding need to create something. They tend to be optimistic, seeing limitless possibilities where others only see the limits.

They also cannot tolerate boredom. Think of it as lack of stimulation for an active brain. If what’s being discussed is not engaging—whether the concept is not understood or just doesn’t seem important—the ADHD mind just moves on to another subject. My ADHD hubby is always changing topics of conversation suddenly. It’s just that he’s gotten bored with the subject and his mind has moved on. He does keep conversations interesting however…

Those with ADHD also often lack an internal sense of time. It’s like the ADHD mind can enter a state of flow more easily, where one is so focused on the current activity that all else—including the passage of time—is blocked out. Musicians, artists, athletes and others commonly enter a state of flow when performing their art/sport. I described this in an earlier blog (see link below). Those with ADHD generally recognize only 2 times: now and not now, making procrastination a prominent ADHD trait.

I have to admit that some of these characteristics—creativity, tendency to procrastinate, no sense of time, easily slipping into the hyper-focused state of “flow”—suggest I may have a degree of ADHD too, although certainly the “non-hyperactive” version… That was a surprise! But I guess it could explain my enthusiasm to start a business from scratch in the competitive pharmacy world. My hubby’s willingness to do what it takes and do it now, along with my thinking “outside the box” with a compounding specialty, private consultations, radio talks, presentations to groups and other innovative projects made it a success. My pharmacy was actually featured in 5 different Canadian Pharmacy journals over the years!

So, think of ADHD as a collection of contradictory tendencies: a lack of focus combined with an ability to hyper-focus; a lack of direction combined with highly directed business building skills; a tendency to procrastinate combined with an ability to achieve a lot in a short time; impulsive decision-making combined with inventive problem-solving skills; social cluelessness combined with amazing intuition and empathy, and more. The trick is to learn to capitalize on the positive traits while using strategies (and medication if necessary) to manage the negative ones.

So, as the authors of ADHD 2.0 point out, the word “deficit” is a misnomer. It’s just the opposite—people with ADHD have too much focus and attention, just sometimes on the wrong thing. The challenge is to control and direct it so they can take advantage of all the plusses tucked away inside their brain!

Experts tell us that as many as 10% of us are born with these traits, but many are never diagnosed (especially girls who tend to display a dreamy state rather than hyperactivity and disruptive behaviour). It is considered a readily inherited (“highly heritable”) condition and often runs in families. However, certain “brain insults” like lack of oxygen at birth, head injuries, early infections, or exposure to magnetic field non-ionizing radiation (MFR) such as from power lines, leaky kitchen appliances, etc., can also cause ADHD.

Environmentally-induced attention problems

But there are also many people who act as if they have ADHD but do not qualify for a diagnosis. Their ADHD-like symptoms are believed to be caused by the massive increase in stimuli that bombard our brains in the modern world. Writing advice tells authors we need to capture people’s attention within 8 seconds or most will become bored and move onto something else. That’s much less time than writers had in the past to engage readers. Our attention spans have shortened dramatically. In our efforts to keep up with all the information coming at us, many have developed new, sometimes antisocial habits to cope, constantly checking our phones/computers to keep up with the flow of information, trying not to fall behind. I know when my inbox starts to fill up, I feel a pressing need to whiz through the unopened emails before it becomes an overwhelming monster.

There is a name for this now, as proposed by Drs. Halloway and Ratey: VAST (variable attention stimulus trait) and the symptoms are very similar to ADHD. In fact, the doctors say the term could be used to describe those diagnosed with ADHD as well, describing it better. Although we may skim through information, quickly deleting what doesn’t capture our interest, in contrast, we can spend significant time devouring what does catch our attention and piques our curiosity… variable attention, not a deficit of attention… and a different way of thinking: traits, not a disorder.

However, repeated actions often become unconscious habits. Our brains strengthen the thought pathways we use most often, turning them into “ruts” our minds want to follow to save energy. Picking up your phone to check for messages can become a habit you do without thinking, even when socializing with others, whenever there’s a lull in the conversation. Perhaps eventually we’ll all end up with ADHD-like behaviours, variable attention stimulated by the immense amounts of information we process each day. Hopefully, with professional help when necessary, we can manage to take advantage of this alternate way of thinking… and control the downsides.

It starts with being aware of the effects social media can have on us, with its constant stream of attention-grabbing tools, and being aware of when your mind-hopping has become a problem, seeking help when needed. ADHD 2.0 is a worthwhile read, if you’re looking for more information, ideas for non-drug treatment, and a positive point of view of ADHD/VAST. I highly recommend it!

References:

ADHD 2.0–Edward Halloway and John Ratey 2022 Amazon.ca Amazon.com

What is ADHD?—Centers for Disease Control (CDC)

Get into the State of Flow—blog by Jeannie Collins Beaudin

What is VAST? Do you have this unique ADHD brain trait?—VAST Diversity

ADD Needs a Better Name. We Have One—ADDitude Magazine

Photo by Milad Fakurian on Unsplash

#ADHD #VAST

I just read a wonderful article written by a pharmacist-blogger who is leaving her job to move into a new area of pharmacy (link below). Her article wasn’t about her new career, though. She was talking about something kind a client of hers had done for her, and the warm positive emotions this action created for her.

This woman thanked her for her help over her years at the pharmacy and told her she would miss her, while wishing her well in her future adventures. And she made the extra effort to order a little Chakra meditation bracelet with pretty stones for her, as a meaningful gift.

The pharmacist wrote about how she was so very touched that a client would go to the trouble to say thank you for her service, something that she felt was just a regular part of her job.

I’ve experienced this too…

I think I related strongly to the article because, as I read it, I thought of the little binder I keep in a desk drawer with thank you notes tucked inside and I knew just what she was talking about. I had received these from pharmacy clients over the years who wanted to tell me they appreciated what I had done for them with something more than just spoken words. Occasionally, usually while looking for something else in my desk, I come across the binder and flip through the notes. But today, I experienced that same warm feeling just thinking about them, knowing they were there. I wonder whether the people who sent the cards and notes realize how meaningful they are to me…

More recently, I’ve been receiving similar gratification from you, my readers. I want to tell you that these comments are really appreciated and make writing more worthwhile for me. Blogging satisfies a child-like desire I have to help others, sharing information that might help solve a health problem or, better yet, prevent one. But it’s hard to know (other than through the dreaded “unsubscribes”!) whether I’m achieving or missing this goal.

Aiming for that “connection”

So, I really do want you to know that I love the 2-way conversation that a blog can be. I often guess that, if I find a topic interesting, you will too but I’m sure I miss the mark sometimes. Often, I see information on a topic that I know little about, and that inspires me to learn about it (keeps the brain in shape, you know!) Sometimes my interest comes from a conversation I’ve had with someone, a long-time personal interest, or, once in a while, I get a great question or info request from a reader. I research the idea and then I share what I’ve learned with all of you.

For example, right now, I’m reading a book on ADHD (Attention Deficit Hyperactivity Disorder). It caught my eye because one of my children was diagnosed with this many years ago. The authors, who are both physicians and have ADHD themselves, explain that this condition is often misunderstood. Many people think of it as a disorder that only affects children, but adults have it too. They insist that it is really a set of traits, not a “disorder”. Yes, some of these traits can create difficulties for the person but others can give them definite advantages.

They say having ADHD is like driving a Ferrari that has very weak brakes… you just need to learn to control the ride and be able to stop or change lanes when you need to! And they offer the latest research-based ideas to do just that. Of course, sometimes you need these brakes for your fast moving thoughts, not for your muscles. ADHD doesn’t always involve hyperactivity, even though it’s in the name. So, stay tuned for a little summary of what I’m learning about ADHD, its symptoms, its advantages, and new treatments, in an upcoming blog…

All about communication

It helps me stay on track when readers let me know what they’re interested in. Sometimes I will research then write an entire blog to answer the question or request for information, and sometimes I’ll combine a few related questions that have shorter answers, so these responses will appear later. Occasionally, I have written a private reply.

However, I try to save all questions and suggestions until I’ve responded, even if it takes a while to find the best reader-friendly way to explain the topic (health questions can be technical). And of course, I always ensure the questioner’s privacy is maintained! You know: “names have been changed to protect the innocent”, as they say on the crime shows and, here, I try to change or just not mention anything else that could possibly identify a reader.

So, thank you to all those who have taken a moment to say they enjoyed an article or shared a potential topic for a future one! As it did for the pharmacist-blogger I follow, it really makes a difference to me and my energy and enthusiasm to continue…

But I want to leave you with the most important thought…

Kind words, compliments, and expressions of appreciation can really change someone’s life for the better. And it doesn’t need to be a formal note or gift. Acknowledge your appreciation of that grocery clerk who helped you find an item with more than a cursory thank you—say it like you really mean it—or pay a compliment to someone you don’t even know. It takes so little time and energy, but can make such a difference in their day. Too often, especially when working with the public, the only time customers will speak to an employee is to complain! I still remember the toll booth worker years ago in Orlando, who told us so very sincerely to just have a great day! You could tell he really meant it and this person I will never meet again has stuck in my memory for years…

And don’t forget your family and co-workers. I expect they could use a morale boost in their day too. Be that person who makes others feel better about themselves.

One last thing…

Please do take a moment to send me an email with that burning health question you always wanted to ask…. I’ll bet there are many others who are wondering the same thing and I’ll know I’m talking about topics that matter to you!

Now you just have a really great day…

This is the link to the blog I read, if you’re interested in reading it…

Impact? — Drug Opinions, Cynthia Leung https://drugopinions.wordpress.com/2022/04/30/impact/

What is monkeypox?

Monkeypox is a viral infection, native to Africa, that has recently been attracting some attention in the news. Like COVID, it’s a zoonotic virus—it usually occurs through contact between animals and humans. It is found in rodents and primates, and was first identified in 1958 in lab monkeys, hence the name.

About 9,000 cases are reported in Africa each year, but experts say many more cases are probably missed due to poor reporting systems. Previously, cases that occurred outside Africa were associated with travel there. This outbreak is attracting attention as there appears to be human to human spread, a new behaviour for this virus.

Why is it in the news?

Monkeypox causes skin rashes, fever, chills, swollen lymph nodes, headaches, body aches, and exhaustion in people who are infected, symptoms like smallpox but milder. It is newsworthy because recently this virus has begun spreading between humans and to several other countries outside Africa, including Canada and the US. It’s been noted to pass from one person to another during close skin contact (for example during sex, although it’s not considered a sexually transmitted disease). It can also spread through air droplets, body fluids, and virus-contaminated objects.

Young children and people who have weakened immune systems tend to have more severe symptoms from monkeypox. Three to 6% (or 3 to 6 out of 100 people who catch it) will die. This compares to a 30% death rate from smallpox (or 30 out of 100). The World Health Organization (WHO) is watching this development closely, of course, as they do with all new contagious diseases. After the past 2 years of pandemic, we all know how viruses can mutate when they jump to a different species.

Since the virus responds to the smallpox vaccine, these vaccinations are recommended for contacts of those who are sick, especially if they are at higher risk of complications. Those who are infected are being recommended to isolate until more is known about the virus and how it spreads. The incubation period is 5 to 21 days, and recovery takes 2 to 4 weeks.

Interesting stuff about smallpox…

What is also interesting to me, is that this newly spreading “pox” has fostered some discussion of the history of its viral cousin, smallpox. That virus was around for thousands of years before it was declared eradicated in 1980.

The first vaccine ever developed was for smallpox and it’s a medical success story. Although it took 20 years for success, eventually international governments committed to the vaccine program, providing proper funding and donations to less wealthy countries, plus reporting of cases. It’s estimated that more than 300 million people worldwide died with smallpox. Those who survived often had disfiguring scars on large areas of the body, including the face, and were sometimes left with blindness.

Smallpox killed 30 to 50% of Europeans who contracted it, but was even more devastating to some other populations. I knew that colonists accidentally introduced the smallpox virus (and others) to native peoples in the Americas, where it decimated the indigenous population. However, I didn’t realize that British soldiers intentionally spread it to native villages as a form of biological warfare in 1863-64, distributing infected blankets and other items, which resulted in the annihilation of entire villages.

Seeing the system “at work”…

The last case of smallpox was reported in 1977 and children are no longer given the smallpox vaccination. This has added to the concern around monkeypox, as young people would have less potential immunity, should this virus develop more infectious abilities, and those of us vaccinated as children may have waning immunity after so many years. It certainly is interesting to see the world monitoring system at work detecting and tracking contagions that could possibly become our next pandemic!

This is an example of infectious disease monitoring doing what it is supposed to do—identifying potential infectious diseases, warning us to be careful, and alerting medical workers so they will recognize the infection quickly. It’s what was missed with COVID-19 where large numbers were sick and dying before the world was aware it had started, and by then it was too late to contain it. Although the monkeypox virus seems to be much less infectious than SARS-CoV-2, at least we all know what we need to do to better protect ourselves, thanks to public education programs in the past 2 years.

So, don’t throw away those masks yet… they’re still a useful part of protecting ourselves, and each other, that we may need again in the future! But take comfort in knowing the system is working when you hear these reports in the news…

References:

What to Know About Monkeypox and the Latest Cases—Medical News Today

EXPLAINER: What is monkeypox and where is it spreading?–Canadian Healthcare Network

“Mandala Sun”, by Jeannie Collins Beaudin

I love it when I see research that shows us how we can prevent a disease—especially an all-too-common one like diabetes. I just read this week that vitamin D is now thought to help decrease the chance that a person with pre-diabetes will progress to full diabetes. We’re always better off when we prevent illness, rather than have to treat it after it develops, so I thought I’d tell you about it!

So, this study is good news! People with diabetes are at higher risk of many conditions, like cardiovascular disease (heart disease and stroke), kidney disease, vision loss, foot problems (diabetes is the greatest cause of amputations in adults), and more. It’s not a disease you want to develop. Being diagnosed with pre-diabetes is a time to pay attention and make some real changes in your lifestyle.

Diabetes is a lifestyle disease

Diabetes is closely related to our lifestyle… your food choices, how much you exercise, heavy alcohol use, and carrying extra pounds increase your risk, along with factors you can’t control, like your family history, having had temporary diabetes during pregnancy, and just getting older. Smoking, excessive uncontrolled stress, poor sleep, and uncontrolled blood pressure can worsen potential complications if you do progress to full diabetes.

The study I read found that taking a daily vitamin D supplement of 1000 units or more reduced the chance of developing full Type 2 diabetes (the type that most commonly begins in adulthood, although increasingly it’s being seen in teenagers, sadly). Although Vitamin D didn’t appear to make a difference for those with average risk of diabetes, or those who were obese, it could be a good strategy to ask your doctor about if you’ve been told you are “insulin resistant” (meaning you need more insulin to handle the sugars in your diet), or that you have “pre-diabetes”.

The researchers couldn’t say for sure why vitamin D supplements didn’t make a difference in those who were very overweight but I have a theory that comes from my many years of studying hormones (vitamin D is considered a hormone, by the way). Like all hormones, vitamin D is fat-soluble so the body will store it in fatty tissues. Our vitamin D supplements are actually made from fish liver oils, because fish store their vitamin D in fats in the liver too. So, those with more fatty tissue will store away more of the vitamin D they ingest, leaving less to have an effect on the body. Remember, this is just my theory, yet to be demonstrated in research, but it holds true for other hormones. I don’t know about you, but I always like to understand the reason something happens…

Of course, vitamin D supplementation is just an additional strategy you can consider for a healthier future. A diagnosis of pre-diabetes is a signal to improve your diet (seeing a dietician can help) and to get more exercise (even a 30 minute walk every day can make a difference). Change is difficult, but remember that one small change each week can make a difference to your future. The good news is that pre-diabetes can be reversed in many people with just lifestyle changes… and now we know vitamin D can help too.

The Sunshine Vitamin

You may remember from my earlier blog, Is Your Body Dying for Vitamin D?, that vitamin D is called the sunshine vitamin. Our bodies make vitamin D when our skin is exposed to sunshine, as much as 10,000 to 20,000 units in 30 minutes of sun. A session of 5 to 30 minutes 2 or 3 times a week, depending on weather conditions and skin type, is considered enough to supply a person with sufficient vitamin D during the summer. So, with summer coming up, at least here in the northern hemisphere, we just need to get outside for a short while before putting on sunscreen, which could block exposure to the vitamin producing rays of the sun.

During the winter months, depending on how close you live to the equator, it may be a good idea to supplement. Here in Canada, they recommend taking a vitamin D supplement from October until April, as the sun’s rays are not strong enough to help us produce enough of our own (plus we usually have lots of layers of clothing on when outside to keep warm, blocking the sun from reaching the skin!!).

Having enough vitamin D also helps the immune system to function, making it a factor in preventing and recovering from infections (including COVID-19), as well as reducing inflammation, aiding absorption of calcium from our diet (and thereby helping to reduce risk of osteoporosis), and reducing how much we feel chronic pain.

So, for all these reasons, get outside and enjoy those sunny days, and mark your calendar with a reminder to start an inexpensive vitamin D supplement this fall, available at any pharmacy!

References and More Reading:

Preventing type 2 diabetes with the “sunshine” vitamin?—McMaster Optimal Aging Portal

Vitamin D supplementation of 1000 IU or more per day may reduce the risk of type 2 diabetes in patients with prediabetes—McMaster Evidence Summary

Could Sunshine Be Good for You?—Jeannie Beaudin’s Blog

Sunshine, Viatmin D, and COVID-19…What’s the Connection?—Jeannie Beaudin’s Blog

Hola! I’m back after a wonderful 3 months in Costa del Sol, Spain this winter. I’m over the jetlag and busy setting up an apartment for our daughter, who is moving back home for a while as she searches for an affordable house to buy—a hard task these days, at least in Canada! I’ve been reading that multi-generational living arrangements are becoming more popular these days, and I can understand why. We’re enjoying having her here, sharing cooking, conversation, and ideas for what we’ll do next!

But I want to tell you about an interesting aspect of our winter in Spain…

This year, we travelled there with my sister and her husband who has problems with his memory. There are various ways memory loss can occur, and his doctors determined his is a vascular dementia, where decreased blood circulation to parts of the brain cause damage to memory centers. His Mom had received the same diagnosis years ago.

As a pharmacist, I learned about memory loss and how the symptoms often progress as time passes. But too many of us know about dementia firsthand, having experienced various types of dementias in family and friends, with Alzheimer’s Disease being the most common type. Before the trip, we had spent lots of evenings with my sister and her husband, sharing dinners and socializing. We noticed he could remember new information only briefly, while he could easily talk about the sports he played when he was a young man.

However, spending significant time with him every day for 3 months was still an eye-opener to the life my sister has been sharing with him for the past few years. Several times, my hubby voiced concerns about whether he could live with a dementia patient every day… all day long. I suppose we all do our best, for as long as we can manage it, and we marveled at my sister’s coping abilities and positive outlook.

There are many difficulties that can arise for someone with damaged short-term memory, especially when travelling—like worsening of symptoms from travel fatigue, confusion from changes in daily routine, disorientation from a change in surroundings, unfamiliar foods, decision-making over what to order in restaurants and, for travel companions, fear of them just getting lost in another country.

Here’s just an example…

I learned that, despite the need to explain things multiple times, showing respect for the person with dementia is very important. We all need and deserve respect, a basic human right. So, even after the 20th time he asked whether the mountain we could see from our balcony was Lutes Mountain, a landmark near his home, we needed to explain calmly that Lutes Mountain was in Canada, while we were in sunny Spain! Patience and politeness are necessary virtues when caring for a person with dementia. They don’t understand why you would be angry or impatient, with no memory of conversations that might have taken place just minutes before. Caring for a person with dementia is an exercise in controlling one’s emotions.

But his questions inspired us to find out the actual name of the mountain (part of the range of Andalusian Mountains). There was no point in expressing frustration that he’d already asked the same question, because we knew he remembered neither the question nor its answer. The funny thing was that none of us could remember the name of that mountain either, though we looked it up several times! The exercise created a little empathy in all of us.

The mountain is called Calamorro, by the way (I just had to look it up yet again!!). On a clear day, you can see from Gibraltar to Granada from its summit. In previous years, we’d taken the “teleferica” (cable car) we could see from our apartment balcony up the mountain, then climbed steps carved into the rock to the viewing platform at the summit. We did that excursion 3 years ago when we were all there together. The photo above was taken from the viewing platform at the top, looking toward Fuengirola in the distance.

Support for caregivers

Spending every day with someone with dementia is no small feat, although it does have its rewards. The emotional toll of controlling your feelings, not just anger and frustration, but also the sadness of gradually losing someone you love, are coupled with extra responsibilities, as the affected person gradually loses the ability to do their share of tasks in the household and requires more assistance. But keeping any disabled person in their home is a goal worth pursuing and is an achievement one can be proud of. My sisters and I had done this for our mom, who passionately did not want to go into a nursing home, keeping her in her apartment until she passed away at age 91. It’s something we can feel good about.

The Alzheimer’s Society suggests it’s a matter of balance between the quality of life for the caregiver and that of the affected person. The caregiver needs to respect and satisfy their own needs while considering the preferences and emotions of the person they are caring for and understanding what those are for them, especially as communication becomes more difficult. It’s always desirable to keep the person in their home with familiar surroundings as long as possible, but that is contingent on the caregiver’s continuing ability to give adequate care and cope with their situation.

Support can make a significant difference to the wellbeing of those living with someone with dementia and their ability to continue in this role. This support can come from friends and family members, from professional support workers, or through information from organizations dedicated to educating caregivers both about dementias and how to deal with them on a daily basis.

I think it also helps for caregivers to educate friends and family, not only about what to expect, but about what their needs are and how to best satisfy them. Those of us on the sidelines are often willing to help but don’t really know what is best to do. Communication is key, as always, and asking what support is needed and offering to help is important.

Points to remember

People with dementia are individuals and need to be treated with respect, dignity and compassion, while maintaining their privacy and safety. It’s important to consult the person about their likes, dislikes, and opinions, but they may need assistance in completing the action that has been decided upon.

I noticed on our trip that, although a decision about what to order was made ahead of time when eating in a restaurant, in the confusion and stress of ordering it was easier for him to just order what everyone else was having, resulting in a meal that wasn’t what he wanted. Knowing when to help to ensure needs and desires are met, while continuing the person’s independence, can be a balancing act for caregivers.

Experts recommend focusing on abilities even though they will change over time, rather than losses, as much as possible. Sometimes this means finding new activities and hobbies, keeping in mind that new skills would be difficult to learn. My sister tells me that her hubby is enjoying gardening this spring, something that he used to do out of necessity but wasn’t previously a major interest. I’ll want to share some of my tomato seedlings with him!

Meanwhile, I’ll need to remind myself to check in with my sister more often to see what I can do to make her life easier, less stressful, and more fun…

Additional reading:

Quality of Life–Alzheimer’s Society

We know now that COVID is here for the long haul. Moving toward our “new normal” is a gradual process that we need to do carefully. Normal life includes vacations and many of us crave travel, but how can we do this safely? Just like at home, we can stay safer if we know what to do and stick to pandemic safety rules.

My hubby and I (both retired) love to spend winter in Spain and, after much consideration, we decided to go this winter. We made it here safely … even did a rapid test 3 days after arrival just to be sure we didn’t catch the virus during the trip (probably the riskiest part of travelling). So, what’s it like to travel during a pandemic that’s winding down? What are we doing differently to stay safe?

I think the most important factor is to remember that there are still lots of opportunities to catch the virus, especially with the newest variation, Omicron, being so contagious. We do things differently at home to prevent infection, and it’s no different when travelling. We still need to do everything we can to reduce our risk. And our vacation expectations need to be a little different…

Be vaccinated (it’s required!)

First, I wouldn’t consider travelling if I wasn’t fully vaccinated, with a booster. The last thing you’d want is to end up in hospital, especially in a foreign country. But being fully vaccinated drastically reduces the chance you’ll need medical services and, knowing this, many countries (including Spain) require proof of vaccination before you come. I think the most complicated part of getting here was filling out the online form to get the required “QR” code for entry into Spain. We printed ours and loaded them onto our phones, as they can be requested at any time, and there are fines for not being able to produce your QR code!

We also checked into hospitalization insurance, just in case. It turns out we’re triple protected: Spain (and many European countries) have automatic insurance coverage for tourists, we have our private insurance, and our provincial Medicare also reimburses medical services at their usual rate.

Know the conditions at your destination

As well as checking international COVID maps and information, we also monitored a local Facebook group for expats living in the area we are staying in. It was great to be able to ask questions about conditions and rules and see photos of the streets and venues. As well, we communicated with people from Canada who had visited Costa del Sol recently to get their impression of daily life here during the pandemic. From this we could see that it was not much different than at home. In fact, the rules are stricter, and compliance appears to be higher here.

Case levels are similar to those in Canada and hospital bed availability is better than the situation at home when we left, where lockdowns were being introduced because of the high demands on hospitals due to COVID infections. Still, we knew it would not be like our usual stays here. We need to behave differently, just like we do at home, to protect ourselves.

Wear a mask that fits properly

Masking is an important part of safe travel, but they’re like condoms… they only work if you put them on and ensure they don’t leak! 😊 Buy the best quality mask you can—we have N95s for higher risk situations, like planes and shopping—and medical masks for strolls on the Paseo Maritimo and walks in the neighbourhood. I tie the ear loops of my medical masks close to the mask and tuck in the sides to improve the fit, as suggested by the CDC, as they’re too loose to seal properly on my smaller face. I also staple the sides to keep them tucked in and brought a small stapler with me for this purpose.

Masks really do make a difference in the transmission of infection (as medical personnel have known for generations!) and both the quality and the fit of the mask are important. The mask isn’t working as a filter if you’re breathing through gaps in the sides.

To improve fit and comfort with ear loop masks, consider using a device to pull the loops toward the back of your head. This does 2 things: it pulls the mask more snugly to the face (reducing leaks), and it relieves pressure on your ears (which, as any nurse will tell you, can get sore after a few hours). This device can be a commercially made strip of plastic with hooks, or a headband or strip of fabric with buttons sewed on. I’ve even seen some cute, crocheted ones made by creative people. My hubby just took a loop from a used mask, tied the ends to the ear loops of the mask he was wearing, and pulled it behind his head (note photo above). Worked great!

Plan your food and drinks

But, of course, you can’t eat with a mask on, so planning for safer eating is a helpful strategy when travelling. We packed a lunch to eat in an isolated part of the airport rather than eating in one of the restaurants to reduce our risk. I even brought a few straws so I could drink on the plane by tucking it under my mask instead of completely removing it. I can’t say how helpful this strategy is, but I wanted to try everything I could.

On the transatlantic flight, they recommended eating quickly, in less than 15 minutes if possible, and I expect this advice came from studies that found exposures of less than 15 minutes resulted in lower rates of infection. They also suspended service of coffee and alcoholic drinks that are slower to consume and would have greatly increased the time passengers had their masks off. As well, planes were loaded from back to front to decrease contact between people. First Class now gives you the privilege of boarding last without having to pass by other passengers!

But on shorter flights I’d suggest eating and hydrating before you board and keeping a mask on the entire time.

Modify your activities

Lastly, we are being careful about where we go and what we do. Just like at home in Canada, we mostly eat at home. We haven’t used public transit or eaten inside a restaurant yet and may avoid these the entire time we’re here. When eating out, we choose a restaurant with outdoor seating (not possible back home in Canada this time of year!) and well-spaced tables. And, of course, there’s always “take away”, as they call it here, if you don’t feel like cooking, and lots of prepared foods are available to make cooking easier at home, not to mention the wonderful fresh fruits and veggies. There are many small apartments available here, reasonably priced even for shorter vacations, making it easier to cook at your home-away-from-home.

We decided that the purpose of our trip was to be outdoors, enjoying the sunshine and warm temperatures, and walking more than we would at home. Like many European destinations, we can walk to do all our errands—this is one of the things we love about coming here! We go home in better physical (and mental!) condition than when we arrived because of all the walking we do in the (almost always sunny) Costa del Sol. This will not be a sight-seeing trip… We’ll save that for another time!

Especially with short vacations, sticking to outdoor activities, enjoying the weather, and getting some exercise where you can stay distanced from others can still be a great break while making sure you’ll be able to make your scheduled return home. Of course, you can’t travel if you’ve caught the virus and even a mild infection can mean rescheduling flights, especially on a short trip. So, you’d want to use extra caution, for example, avoiding indoor public buildings, at least for the last 2 weeks before your return… which is likely the entire time on a shorter vacation.

Whether you vacation near your home or travel to another continent, your choices make a difference in your risk of getting a COVID infection that could ruin your holiday. Of course, I’m not advocating for everyone to hop on a plane next week but, if you do decide to travel, plan ahead and adjust your expectations for holiday activities. With vaccination, preparation and choosing your activities carefully, it’s possible now to have a safe, enjoyable vacation that’s good for your mental and physical health!

#SafeTravelWithCOVID #COVIDvacation

Well, we’re doing it… we’re flying to Spain next week. Or, perhaps I should say, we have tickets paid for and accommodations booked there. We won’t know until the last minute whether our flight is cancelled/postponed (our airline is cancelling a lot of flights!) Such is life during COVID. Are we brave or stupid? Maybe a little of both…

But I suppose we’re no different than the Olympic athletes who are planning to head to Beijing in February. We’ve weighed the pros and cons, and taken every precaution we can think of. On the down side, we are seeing in the news that many flights are being cancelled due to passengers changing their minds plus lack of staff (that aren’t sick or burned out) to fly the planes… not to mention the weather. Makes me wonder whether our 3-month winter in Spain may be cancelled at the last minute. But one consolation is that the wave should have passed by the time we’re due to head back. We certainly wouldn’t have considered going for a short stint of a week or two.

Why would we consider travelling during a pandemic?

The answer is, our trip was planned last spring when COVID was looking quite settled and it was paid for in November, just after I knew I was recovering from a 6-month-long painful condition but before the Omicron variant was identified. Although we are allowed one change for free, we don’t want to postpone our departure as some have done, since we want to have the option to come back early if we need to, for whatever reason. Of course, after we booked our tickets, the airlines added unlimited changes at no cost to entice travellers… too late for us.

So, our suitcases are packed, we’ve gotten our Euros, and everything is arranged. Our family thinks we’re crazy, heading off to spend 3 months on another continent during the 5th wave of the COVID pandemic. But things aren’t sounding any better here, with dire predictions for the next 4 to 6 weeks that the worst is yet to come.

Spain, in comparison, is believed to have hit its peak of the Omicron wave, and the area we’re staying in, Andalusia, has the lowest case counts in the country. Still, we’ll need to be careful.

Taking all precautions

So, we’ve taken every precaution we can think of to stay safe. We have N95 masks (recommended by the CDC and other authorities as the safest to use), we’ve checked the conditions at our destination repeatedly (including reports from people who have visited there recently), and we got our 3rd boosters before Christmas.

We’ve even been taking vitamin D (reported to be anti-inflammatory and essential for a well-functioning immune system) even though it hasn’t been proven to prevent COVID or reduce symptoms. Of course, we always take 2000iu every winter anyway, living in Canada where there’s not enough sunshine to make our own vitamin D in the snowy season, so that was a no-brainer.

New COVID treatments to use at home…

As you may know, I’m constantly reading medical news, being a retired pharmacist. I’ve been watching reports of a common antidepressant, called Fluvoxamine, being useful to reduce inflammation from SARS-CoV-2, the virus that causes COVID. And just last week, the highly rated British medical journal, the Lancet, published results of a study that found the drug reduced the risk of hospitalization of patients at risk of severe outcomes by about 30%, and up to 60% if taken for a full 10 days.

I’m healthy (or at least I’m getting back to my normal healthy self, now that I’ve recovered from the minor surgery that I waited months for because of COVID). Getting to a place that’s warm and sunny (and not icy!) will help me recover my usual strength and stamina. But we’re both over that magical age of 65 and my hubby is a heart patient, generally considered to be at higher risk I think he might be a candidate for Fluvoxamine preventive treatment, should he contract the virus. And they say we all will, vaccinated or not… vaccination just means you’re much less likely to end up in hospital or die from it.

So, here’s the deal (as one famous person likes to put it…) A 10-day course of Fluvoxamine 100mg twice daily is an inexpensive treatment that can make a difference in the outcome of a COVID infection for those considered at high risk of the severe version, if started within the first 7 days of symptoms. It won’t work as well as the far more expensive anti-viral treatments that are available or coming soon, especially if you’re already very ill, but it’s just one more thing that we can do now to help reduce hospitalizations. As a side benefit, since it’s also an antidepressant, I suppose it could help with what I call “COVIDosis”… that blah feeling that this pandemic has left so many of us with. Included in the side effects list, however, you’ll see drowsiness (or, strangely, sometimes insomnia), stomach upset (reduced by taking with food), or sexual problems (but who wants sex when they’re sick anyway?)

Another alternative to prevent lung inflammation is to use an inhaler for asthma, called Pulmicort, twice a day for 14 days. This treatment has fewer side effects while still targeting the lung inflammation that can make it hard to breath. The main side effect is an increased chance of getting a fungal mouth/throat infection called thrush. This can be countered by rinsing the mouth with water then spitting, or by brushing your teeth after using it.

This week, the government announced that our province is on the list of those at or very near hospital capacity and that we all should avoid being in contact with others as much as possible. Reluctantly they announced a 2-week lockdown here in New Brunswick. We all need to do everything we can to slow the spread of the virus to a pace that our heath care system can handle. Shortages in hospital staff have even resulted in less staff at our local clinic, so it makes sense to be making good use of these medications when it’s indicated to reduce the chance of needing acute medical care.

But sadly, it seems to be taking time for the word to get out about these treatments. This is very common in the medical system. Although research and distribution of new knowledge about SARS-CoV-2 infection is advancing more quickly than normal due to the severity of the disease, it always takes time for results of a published study to become policy.

Ontario is the first Canadian province to have added Fluvoxamine to its official list of options for treating COVID. I’m wondering how long it will take NB officials to do the same. Fortunately, Pulmicort is already recommended for COVID treatment (according to our local doctors’ office), and our local Nurse Practitioner was willing to prescribe it for my hubby and I to take with us, just in case.

Hospitalization is very expensive. The drugs they use in hospital to treat severe COVID are also very expensive. Ten days of Fluvoxamine 100mg twice daily or a Pulmicort inhaler is dirt cheap by comparison.

So, if you are diagnosed with COVID and have underlying health problems, like diabetes, heart disease or a poorly functioning immune system (for example, due to cancer treatment or medication you are taking) ask your doctor about taking Fluvoxamine or using a Pulmicort inhaler when you are first diagnosed. They both need to be started early (within a week of diagnosis) for best effectiveness.

Heck, if you’re over 65 like me, you’re already in a higher risk category. That’s why I asked for a course of treatment to take with me to Spain!

Weigh the pros and cons

So, I’m not trying to encourage others to travel right now but, if you’re going to (or have to) travel, I wanted you to know about some of the extra precautions you can take in addition to masks, distancing, hygiene, and reducing contact with others, whether you’re at home or elsewhere.

For us, I know we’ll have a healthier lifestyle in Spain, being able to walk outside in the sunshine and we’ll have lots of fresh fruits and veggies available. If we do go to a restaurant, we will be eating outdoors. How could you go wrong eating the Mediterranean Diet in the Mediterranean? Of course, we’ll have to resist stopping into those wonderful panaderías with their fresh-baked goodies… at least some of the time!)

View from my home today…

Snow and a raging wind have kept us mostly inside here for the past several days. I could have sworn there were planes circling over our house all night last night–such a strong, loud wind. A storm surge has also meant I’d be better off with skates if I wanted to walk to the beach in front of my home… We’re feeling lucky that we haven’t lost our power! It’s enough to start anyone thinking about “getting out of Dodge” to a place where it’s easier to spend more time outdoors, right?

Anyway, wherever you are, stay safe! Like everyone else, we’re trying to learn to live as safely as possible with this disease that they’re saying will be with us for a while longer…

References:

COVID-osis – Midlife Health Blog, Jeannie Collins Beaudin

Common asthma drug cuts COVID-19 hospitalization risk, recovery time – Oxford study — Reuters

Effect of early treatment with fluvoxamine on risk of emergency care and hospitalisation among patients with COVID-19: the TOGETHER randomised, platform clinical trial – The Lancet

#COVIDtreatment #FluvoxamineForCOVID #PulmicortForCOVID