By Bob Aronson

vitamin b from bagelsThe National Institutes of Health (NIH) says Americans have been taking multivitamin/mineral (MVM) supplements since the early 1940s, when the first such products became available. MVMs are still popular dietary supplements and, according to estimates, more than one-third of all Americans take them. MVMs account for almost one-fifth of all purchases of dietary supplements.

“You have to get your vitamins.”  I’ve heard that phrase since I was a child, but why?  What are Vitamins and are vitamin pills or supplements the same as the vitamins found naturally in what we eat and in sunshine?  Vitamins are not all the same.  There can be a huge difference between those that are naturally contained in our food and the sometimes “smelly” things that come in a bottle from your Pharmacy.

Over the past several years there have been a number of news reports about vitamins. Some experts support their use, some say the supplements are worthless and others say they can actually cause harm.  What’s true?  All of the above!  We’ll try to shed some light on the subject so let’s start with their importance to our health.

Vitamin deficiencies lead to a wide range of problems spanning from anorexia to obesity, organ malfunction, confusion, depression and fatigue.  We need vitamins.  The question that must be answered is; how do you know which ones?  We’ll provide an answer.

Tough question when you consider the fact that the NIH says, “No standard or regulatory definition is available for an MVM supplement—NIH LOGOsuch as what nutrients it must contain and at what levels. Therefore, the term can refer to products of widely varied compositions and characteristics. These products go by various names, including multis, multiples, and MVMs. Manufacturers determine the types and levels of vitamins, minerals, and other ingredients in their MVMs. As a result, many types of MVMs are available in the marketplace.”

It is entirely possible that there are no standards because the vitamin industry is huge and can afford heavy lobbying to ensure that they remain free of government regulation.  The NIH says that sales of all dietary supplements in the United States totaled an estimated $30.0 billion in 2011. This amount included $12.4 billion for all vitamin- and mineral-containing supplements, of which $5.2 billion was for MVMs.  If the government set standards, every single manufacturer would have to reformulate their products to meet them.  Doing so would be costly so there is no wonder that the industry would rather not rock their very profitable boat.

vitaminsWhether your vitamins are hurting you is another story. What people are not aware of is that all vitamins are not created equal, and most are actually synthetic and the synthetic vitamins are rarely like the real thing.

The type of vitamins that benefit us most is murky but there are some.  However, a healthy diet should provide most of the nutrients our bodies need.  Sometimes, though, supplements can help. The problem is, which ones?  How do you know what to buy?

For the most part, medical science has made it clear that most vitamin supplements are either useless or cause harm and we’ll elaborate on those claims shortly.  First, though, you ought to know what’s good for you and what seems to work for some conditions.

This article in Smithsonian.com lists five supplements that can be helpful. http://www.smithsonianmag.com/science-nature/five-vitamins-and-smithsonian.com2supplements-are-actually-worth-taking-180949735/#VsZOfYrBAkvtVYvY.99

Of all the “classic” vitamins—the vital organic compounds discovered between 1913 and 1941 and termed vitamin A, B, C, etc.—vitamin D is by far the most beneficial to take in supplement form. Researchers found that adults who took vitamin D supplements daily lived longer than those who didn’t.

Other research has found that in kids, taking vitamin D supplements can reduce the chance of catching the flu, and that in older adults, it can improve bone health and reduce the incidence of fractures.

Probiotics

A mounting pile of research is showing how crucial the trillions of bacterial cells that live inside us are in regulating our health, and how harmful it can be to suddenly wipe them out with an antibiotic. Thus, it shouldn’t come as a huge surprise that if you do go through a course of antibiotics, taking a probiotic (either a supplement or a food naturally rich in bacteria, such as yogurt) to replace the bacteria colonies in your gut is a good idea.

In 2012, a meta-analysis of 82 randomized controlled trials found that use of probiotics significantly reduced the incidence of diarrhea after a course of antibiotics.

All the same, probiotics aren’t a digestive cure-all: they haven’t been found to be effective in treating irritable bowel syndrome, among other chronic ailments. Like most other supplements that are actually effective, they’re useful in very specific circumstances, but it’s not necessary to continually take them on a daily basis.

Zinc

Vitamin C might not do anything to prevent or treat the common cold, but the other widely-used cold supplement, zinc, is actually worth taking. A mineral that’s involved in many different aspects of your cellular metabolism, zinc appears to interfere with the replication of rhinoviruses, the microbes that cause the common cold.

This has been borne out in a number of studies

Niacin

Also known as vitamin B3, niacin is talked up as a cure for all sorts of conditions (including high cholesterol, Alzheimer’s, diabetes and headaches) but in most of these cases, a prescription-strength dose of niacin has been needed to show a clear result.

At over-the-counter strength, niacin supplements have only been proven to be effective in helping one group of people: those who have heart disease. A 2010 review found that taking the supplement daily reduced the chance of a stroke or heart attack in people with heart disease, thereby reducing their overall risk of death due to a cardiac

​Garlic

Garlic, of course, is a pungent herb. It also turns out to be an effective treatment for high blood pressure when taken as a concentrated supplement.

A 2008 meta-analysis of 11 randomized controlled trials (in which similar groups of participants were given either a garlic supplement or placebo, and the results were compared) found that, on the whole, taking garlic daily reduced blood pressure, with the most significant results coming in adults who had high blood pressure at the start of the trials.

On the other hand, there have also been claims that garlic supplements can prevent cancer, but the evidence is mixed.

Vitamin Supplements are unnecessary and may cause harm.

In December of last year, the Annals of Internal Medicine reported that, “Not only are the pills mostly unnecessary, but they could actually doAnnals of internal medicine logo harm those taking them. We believe that the case is closed—supplementing the diet of well-nourished adults with (most) mineral or vitamin supplements has no clear benefit and might even be harmful.  These vitamins should not be used for chronic disease prevention. Enough is enough.”  http://www.cbsnews.com/news/multivitamin-researchers-say-case-is-closed-supplements-dont-boost-health/

Based on three studies examining multivitamins’ links to cancer prevention, heart health, and cognitive function, the research is a blow to the multi-billion dollar industry that produces them and to the millions of Americans who religiously shell out their dollars for false hope.

The doubts about vitamin supplements are not new.  In his 2013 book Do You Believe in Magic, Dr. Paul Offit pointed to a handful of major studies over the past five years that showed vitamins have made people less healthy. “In 2008, a review of all existing studies involving more than 230,000 people who did or did not receive supplemental antioxidants found that vitamins increased the risk of cancer and heart disease.”

Last year, researchers published new findings from the Women’s Health Initiative, a long-term study of more than 160,000 midlife women. The data showed that multivitamin-takers are no healthier than those who don’t pop the pills, at least when it comes to the big diseases—cancer, heart disease, stroke. “Even women with poor diets weren’t helped by taking a multivitamin,” says study author Marian Neuhouser, PhD, in the cancer prevention program at the Fred Hutchinson Cancer Research Center, in Seattle.

That said, there is one group that probably ought to keep taking a multi-vitamin: women of reproductive age. The supplement is insurance in case of pregnancy. A woman who gets adequate amounts of the B vitamin folate is much less likely to have a baby with a birth defect affecting the spinal cord.

The problem is that many vitamin and mineral supplements are manufactured synthetically. Some estimates place the amount at 90 percent and higher and while they are made to mimic natural vitamins they are not the same. Natural vitamins come directly from plants and animals, they are not produced in a lab and — most synthetic vitamins lack co-factors associated with naturally-occurring vitamins because they have been “isolated.”

Isolated vitamins can’t always be used by the body, and are either stored or excreted. Most synthetic vitamins don’t have the necessary trace minerals either and must use the body’s own mineral reserves which can then cause mineral deficiencies.

Most synthetic supplements contain chemicals that do not occur in nature. The history of the human race is such that our bodies have grown accustomed to consuming the food we grow and gather naturally, from the earth, not food that is synthesized in a lab.

web md logoWeb MD offers this assessment.

What Vitamin and Mineral Supplements Can and Can’t Do

http://www.webmd.com/vitamins-and-supplements/nutrition-vitamins-11/help-vitamin-supplement 

 By Kathleen M. Zelman, MPH, RD, LD

Reviewed By Elizabeth Ward, MS, RD

Experts say there is definitely a place for vitamin or mineral supplements in our diets, but their primary function is to fill in small nutrient gaps.  They are “supplements” intended to add to your diet, not take the place of real food or a healthy meal plan.

 WebMD takes a closer look at what vitamin and mineral supplements can and cannot do for your health.

Food First, Then Supplements

Vitamins and other dietary supplements are not intended to be a food substitute. They cannot replace all of the nutrients and fruits and veggiesbenefits of whole foods. 

 “They can plug nutrition gaps in your diet, but it is short-sighted to think your vitamin or mineral is the ticket to good health — the big power is on the plate, not in a pill,” explains Roberta Anding, MS, RD, a spokesperson for the American Dietetic Association and director of sports nutrition at Texas Children’s Hospital in Houston. 

 It is always better to get your nutrients from food, agrees registered dietitian Karen Ansel.  “Food contains thousands of phytochemicals, fiber, and more that work together to promote good health that cannot be duplicated with a pill or a cocktail of supplements.”

 What Can Vitamin and Mineral Supplements Do for Your Health?

 When the food on the plate falls short and doesn’t include essential nutrients like calcium, potassium, vitamin D, and vitamin B12, some of the nutrients many Americans don’t get enough of, a supplement can help take up the nutritional slack. Vitamin and mineral supplements can help prevent deficiencies that can contribute to chronic conditions.

 Numerous studies have shown the health benefits and effectiveness of supplementing missing nutrients in the diet.  A National Institutes of Health (NIH) study found increased bone density and reduced fractures in postmenopausal women who took calcium and vitamin D.

  Beyond filling in gaps, other studies have demonstrated that supplemental vitamins and minerals can be advantageous. However, the exact benefits are still unclear as researchers continue to unravel the potential health benefits of vitamins and supplements. 

 Web MD offers these tips to guide your vitamin and mineral selection:

  • Think nutritious food first, and then supplement the gaps.  Start by filling your grocery cart with a variety of nourishing, nutrient-rich foods.  Use the federal government’s My Plate nutrition guide to help make sure your meals and snacks include all the parts of a healthy meal.
  •  Take stock of your diet habits. Evaluate what is missing in your diet. Are there entire food groups you avoid? Is iceberg lettuce the only vegetable you eat? If so, learn about the key nutrients in the missing food groups, and choose a supplement to help meet those needs. As an example, it makes sense for anyone who does not or is not able to get the recommended three servings of dairy every day to take a calcium and vitamin D supplement for these shortfall nutrients.
  • When in doubt, a daily multivitamin is a safer bet than a cocktail of individual supplements that can exceed the safe upper limits of the recommended intake for any nutrient.  Choose a multivitamin that provides 100% or less of the Daily Value (DV) as a backup to plug the small nutrient holes in your diet.
  •  Are you a fast food junkie?  If your diet pretty much consists of sweetened and other low-nutrient drinks, fries, and burgers, then supplements are not the answer.  A healthy diet makeover is in order. Consult a registered dietitian.
  •  Respect the limits. Supplements can fill in where your diet leaves off, but they can also build up and potentially cause toxicities if you take more than 100% of the DV.
  •  Most adults and children don’t get enough calcium, vitamin D, or potassium according to the 2010 Dietary Guidelines.  Potassium-rich foods, including fruits, vegetables, dairy, and meat are the best ways to fill in potassium gaps. Choose an individual or a multivitamin supplement that contains these calcium and vitamin D as a safeguard.
  •  The best way to judge any supplement or medication is by reviewing clinical trials. There aren’t a lot of them done on vitamins, vitamin clinical trialbut those that have been conducted are quite revealing.  The NIH concluded that most supplements not only don’t work as intended, they actually make things worse. They examined the efficacy of 13 vitamins and 15 essential minerals as reported in long-term, randomized clinical trials and there were some positive results like:
  • A combination of calcium and vitamin D was shown to increase bone mineral density and reduce fracture risk in postmenopausal women.
  • There was some evidence that selenium reduces risk of certain cancers.
  • Vitamin E maydecrease cardiovascular deaths in women and prostate cancer deaths in male smokers.
  • Vitamin D showed some cardiovascular benefit.

Those few positives are overwhelmed by the negative findings.

  • Trials of niacin (B3), folate, riboflavin (B2), and vitamins B6 and B12 showed no positive effect on chronic disease occurrence in the general population
  • There was no evidence to recommend beta-carotene and some evidence that it may cause harm in smokers.
  • High-dose vitamin E supplementation increased the risk of death from all causes.

So what’s the bottom line?  Our research indicates that most medical authorities pretty much dismiss the usefulness of most vitamin supplements. Most revealing, though, and also dangerous is the fact that there are no standards for vitamin supplements.  The companies that make them can each have their own formulations and there is no approval process so the consumer may be at great risk.  Buyer beware.  Don’t believe the advertising.  If you are determined to take these supplements, though, google them and look for clinical trials.  If there are none, don’t buy.  If there are, read them carefully.  For the most part the best advice is, save your money because most of us don’t have a clue as to what we are buying.

Bob Aronson of Bob’s Newheart is a 2007 heart transplant recipient, the founder of Facebook’s nearly 4,000 member Organ Transplant
My new hat April 10 2014Initiative (OTI) and the author of most of these donation/transplantation blogs. You may comment in the space provided or email your thoughts to me at bob@baronson.org. And – please spread the word about the immediate need for more organ donors. There is nothing you can do that is of greater importance. If you convince one person to be an organ and tissue donor you may save or positively affect over 60 lives. Some of those lives may be people you know and love.


By Bob Aronson

aching back cartoon

When I was growing up in Chisholm, Minnesota my dad swore that a chiropractor did more for his aching back than anyone else.  Dad was a meat cutter (he despised the term “Butcher” because he butchered nothing) and carried quarters of beef from the truck into his supermarket meat cooler.  Those things are heavy, bulky and very hard to handle and as a result he suffered back problems all his life.  Sometimes he could barely get out of bed he hurt so badly.  When that happened he would call Dr. Cole who, like all doctors then, made house calls.

My mom had an old fashioned, very heavy, super sturdy all wood ironing board set up in the living room and that’s whaironing boardt Doc Cole would use as a treatment bed.  Dad would lie face down on that old ironing board and Doc Cole would begin doing whatever manipulation Chiropractors do.  I don’t remember a time when it didn’t work.  Dad always felt better and was back at work the next day, but the pain always returned.  That’s the sum total of my experience with Chiropractors.  I have never been to see one or been in the care of a Chiropractor nor do I know anyone who has.

Here is the definition of the treatment as provided by the American Chiropractic Association (ACA).   Chiropractic is a health care profession that focuses on disorders of the musculoskeletal system and the nervous system, and the effects of these disorders on general health.  Chiropractic care is used most often to treat neuromusculoskeletal complaints, including but not limited to back pain, neck pain, pain in the joints of the arms or legs, and headaches.

logoDoctors of Chiropractic – often referred to as chiropractors or chiropractic physicians – practice a drug-free, hands-on approach to health care that includes patient examination, diagnosis and treatment. Chiropractors have broad diagnostic skills and are also trained to recommend therapeutic and rehabilitative exercises, as well as to provide nutritional, dietary and lifestyle counseling (there is much more to the definition. You can read it here http://www.acatoday.org/level2_css.cfm?T1ID=13&T2ID=61

There is no shortage of definitions of the practice so “Cherry Picking” a few can be misleading but from what I can find, traditional medical science is becoming more accepting of the practice in recent years, but still seems to stop short of an endorsement.  Here is the definition of Chiropractic according to Medicine Net dot com. http://www.medterms.com/script/main/art.asp?articlekey=2706

Chiropractic: A system of diagnosis and treatment based on the concept that the nervous system coordinates all of the body’s functions, and that disease results from a lack of normal nerve function. Chiropractic employs manipulation and adjustment of body structures, such as the spinal column, so that pressure on nerves coming from the spinal cord due to displacement (subluxation) of a vertebral body may be relieved. Practitioners believe that misalignment and nerve pressure can cause problems not only in the local area, but also at some distance from it. Chiropractic treatment appears to be effective for muscle spasms of the back and neck, tension headaches, and some sorts of leg pain. It may or may not be useful for other ailments.

Not all chiropractors are alike in their practice. The International Chiropractors Association believes that patients should be treated by spinal manipulation alone while the American Chiropractors Association advocate a multidisciplinary approach that combines spinal adjustment with other modalities such as physical therapy, psychological counseling, and dietary measures. For some years the American Medical Association (AMA) opposed chiropractic because of what it termed a “rigid adherence to an irrational, unscientific approach to disease.” However, Congress amended the Medicare Act in 1972 to include benefits for chiropractic services and in 1978 the AMA modified its position on chiropractic.

So, now that we have defined terms the question is, “When should I choose a chiropractor to treat a condition, and which conditions can they successfully treat?”  The answer to that question depends entirely on who you talk to.  Even Chiropractors differ with one another on exactly what conditions they can and can’t treat.

Preston H. Long is a licensed Arizona Chiropractor who practiced for almost 30 years.  Be warned, his assessment of the Preston long book coverChiropractic profession is quite negative.

Long has testified at about 200 trials, performed more than 10,000 chiropractic case evaluations, and served as a consultant to several law enforcement agencies. He is also an associate professor at Bryan University, where he teaches in the master’s program in applied health informatics.  What follows is just a half dozen bullet points from a blog he wrote titled, “20 Things Most Chiropractors Won’t Tell You.”(I Bob Aronson selected only the first six points and edited them for brevity) you can read the entire unedited version here http://edzardernst.com/2013/10/twenty-things-most-chiropractors-wont-tell-you/

Have you ever consulted a chiropractor? Are you thinking about seeing one? Do you care whether your tax and health-care dollars are spent on worthless treatment? If your answer to any of these questions is yes, there are certain things you should know.

 1. Chiropractic theory and practice are not based on the body of knowledge related to health, disease, and health care that has been widely accepted by the scientific community.

Most chiropractors believe that spinal problems, which they call “subluxations,” cause ill health and that fixing them by “adjusting” the spine will promote and restore health. The extent of this belief varies from chiropractor to chiropractor. Some believe that subluxations are the primary cause of ill health; others consider them an underlying cause. Only a small percentage (including me) reject these notions and align their beliefs and practices with those of the science-based medical community. The ramifications and consequences of subluxation theory will be discussed in detail throughout this book.

 2. Many chiropractors promise too much.

The most common forms of treatment administered by chiropractors are spinal manipulation and passive physiotherapy measures such as heat, ultrasound, massage, and electrical muscle stimulation. These modalities can be useful in managing certain problems of muscles and bones, but they have little, if any, use against the vast majority of diseases. But chiropractors who believe that “subluxations” cause ill health claim that spinal adjustments promote general health and enable patients to recover from a wide range of diseases. Some have a hand out that improperly relates “subluxations” to a wide range of ailments that spinal adjustments supposedly can help. Some charts of this type have listed more than 100 diseases and conditions, including allergies, appendicitis, anemia, crossed eyes, deafness, gallbladder problems, hernias, and pneumonia.

3. Our education is vastly inferior to that of medical doctors.

I rarely encountered sick patients in my school clinic. Most of my “patients” were friends, students, and an occasional person who presented to the student clinic for inexpensive chiropractic care. Most had nothing really wrong with them. In order to graduate, chiropractic college students are required to treat a minimum number of people. To reach their number, some resort to paying people (including prostitutes) to visit them at the college’s clinic.

4. Our legitimate scope is actually very narrow.

Appropriate chiropractic treatment is relevant only to a narrow range of ailments, nearly all related to musculoskeletal problems. But some chiropractors assert that they can influence the course of nearly everything. Some even offer adjustments to farm animals and family pets.

 5. Very little of what chiropractors do has been studied.

Although chiropractic has been around since 1895,  little of what we do meets the scientific standard through solid research. Chiropractic apologists try to sound scientific to counter their detractors, but very little research actually supports what chiropractors do.

6. Unless your diagnosis is obvious, it’s best to get diagnosed elsewhere.

During my work as an independent examiner, I have encountered many patients whose chiropractor missed readily apparent diagnoses and rendered inappropriate treatment for long periods of time. Chiropractors lack the depth of training available to medical doctors. For that reason, except for minor injuries, it is usually better to seek medical diagnosis first.

Obviously the previous report is pretty damning but the author’s views are not universally shared.  The problem with finding positive reports about the Chiropractic profession is that there are very few traditional double blind placebo studies.  Double blind studies are the “Gold Standard” in medicine.  Most of the supporting evidence for Chiropractic medicine is of the testimonial variety otherwise known as “Anecdotal” evidence. Often you will see ads that suggest 9 out of 10 who tried something got relief and while that sounds good, it is anecdotal, not double blind and that’s why Chiropractors are suspect in the eyes of the medical profession, even though Medical Doctors will on occasion for specific ailments send their patients to Chiropractors.

Here’s an evaluation of the top ten Chiropractic studies of 2013…it is not positive because, the author says, the studies were not really studies. http://www.sciencebasedmedicine.org/top-10-chiropractic-studies-of-2013/

web md logoThe Medical Profession Does Recognize that Chiropractic Manipulation Can Help.

So, what about the good side of the profession? Where’s the evidence that Chiropractic manipulation of the spine actually has lasting benefits?

I searched for a long time and the best non anecdotal defense I could find for the Chiropractic profession was in Web MD. You can read all of it here, but note that the endorsement is strictly for back pain. http://www.webmd.com/pain-management/guide/chiropractic-pain-relief

Among people seeking back pain relief alternatives, most choose chiropractic treatment. About 22 million Americans visit chiropractors annually. Of these, 7.7 million, or 35%, are seeking relief from back pain from various causes, including accidents, sports injuries, and muscle strains. Other complaints include pain in the neck, arms, and legs, and headaches.

Learn The Truth About Back Pain Causes and Treatments

What Is Chiropractic?                                       ,

Chiropractors use hands-on spinal manipulation and other alternative treatments, the theory being that proper alignment of the body’s musculoskeletal structure, particularly the spine, will enable the body to heal itself without surgery or medication. Manipulation is used to restore mobility to joints restricted by tissue injury caused by a traumatic event, such as falling, or repetitive stress, such as sitting without proper back support.

Chiropractic is primarily used as a pain relief alternative for muscles, joints, bones, and connective tissue, such as cartilage, ligaments, and tendons. It is sometimes used in conjunction with conventional medical treatment.

The initials “DC” identify a chiropractor, whose education typically includes an undergraduate degree plus four years of chiropractic college.

What Does Chiropractic for Back Pain Involve?

A chiropractor first takes a medical history, performs a physical examination, and may use lab tests or diagnostic imaging to determine if treatment is appropriate for your back pain.

The treatment plan may involve one or more manual adjustments in which the doctor manipulates the joints, using a controlled, sudden force to improve range and quality of motion. Many chiropractors also incorporate nutritional counseling and exercise/rehabilitation into the treatment plan. The goals of chiropractic care include the restoration of function and prevention of injury in addition to back pain relief.

What Are the Benefits and Risks of Chiropractic Care?

Spinal manipulation and chiropractic care is generally considered a safe, effective treatment for acute low back pain, the type of sudden injury that results from moving furniture or getting tackled. Acute back pain, which is more common than chronic pain, lasts no more than six weeks and typically gets better on its own.

Research has also shown chiropractic to be helpful in treating neck pain and headaches. In addition, osteoarthritis and fibromyalgia may respond to the moderate pressure used both by chiropractors and practitioners of deep tissue massage.

Studies have not confirmed the effectiveness of prolotherapy or sclerotherapy for pain relief, used by some chiropractors, osteopaths, and medical doctors, to treat chronic back pain, the type of pain that may come on suddenly or gradually and lasts more than three months. The therapy involves injections such as sugar water or anesthetic in hopes of strengthening the ligaments in the back.

People who have osteoporosis, spinal cord compression, or inflammatory arthritis, or who take blood-thinning medications should not undergo spinal manipulation. In addition, patients with a history of cancer should first obtain clearance from their medical doctor before undergoing spinal manipulation.

All treatment is based on an accurate diagnosis of your back pain. The chiropractor should be well informed regarding your medical history, including ongoing medical conditions, current medications, traumatic/surgical history, and lifestyle factors. Although rare, there have been cases in which treatment worsened a herniated or slipped disc, or neck manipulation resulted in stroke or spinal cord injury. To be safe, always inform your primary health care provider whenever you use chiropractic or other pain relief alternatives.

On my OTI Facebook group I asked for individual experiences with chiropractors and got very few, most were positive but general in nature offering few details.

Other Non-Traditional Remedies

There are other non-traditional remedies for back pain that we have not mentioned here.  Below you will find several that were listed in “About dot com. “ For the full list of 15 options click on this link. http://altmedicine.about.com/od/chronicpain/a/back_pain.htm

 Acupuncture

A 2008 study published in Spine found “strong evidence that acupuncture can be a useful supplement to other forms of accupunctureconventional therapy” for low back pain. After analyzing 23 clinical trials with a total of 6,359 patients, the study authors also found “moderate evidence that acupuncture is more effective than no treatment” in relief of back pain. The authors note that more research is needed before acupuncture can be recommended over conventional therapies for back pain.

 

Just how does acupuncture work? According totraditional Chinese medicine, pain results from blocked energy along energy pathways of the body, which are unblocked when acupuncture needles are inserted along these invisible pathways. Acupuncture may release natural pain-relieving opioids, send signals to the sympathetic nervous system, and release neurochemicals and hormones.

 See Also: Using Acupuncture to Help Relieve Chronic Pain | Sciatica – Causes, Symptoms, and Natural Treatments | What is Trigger Point Therapy?

Massage Therapy

massage therapyIn a 2009 research review published in Spine, researchers reviewed 13 clinical trials on the use of massage in treatment of back pain. The study authors concluded that massage “might be beneficial for patients with subacute and chronic nonspecific low back pain, especially when combined with exercises and education.” Noting that more research is needed to confirm this conclusion, the authors call for further studies that might help determine whether massage is a cost-effective treatment for low back pain.

Massage therapy may also alleviate anxiety and depression associated with chronic pain. It is the most popular natural therapy for low back pain during pregnancy.

The Alexander Technique

Alexander Technique is a type of therapy that teaches people to improve their posture and eliminate bad habits such as slouching, which can lead to pain, muscle tension, and decreased mobility.

 There is strong scientific support for the effectiveness of Alexander Technique lessons in treatment of chronic back pain, according to a research review published in the International Journal of Clinical Practice in 2012. The review included one well-designed, well-conducted clinical trial demonstrating that Alexander Technique lessons led to significant long-term reductions in back pain and incapacity caused by chronic back pain. These results were broadly supported by a smaller, earlier clinical trial testing the use of Alexander Technique lessons in treatment of chronic back pain.

You can learn Alexander technique in private sessions or group classes. A typical session lasts about 45 minutes. During that time, the instructor notes the way you carry yourself and coaches you with verbal instruction and gentle touch.

Hypnotherapy

Also referred to as “hypnosis,” hypnotherapy is a mind-body technique that involves entering a trance-like state of deep relaxation and concentration. When undergoing hypnotherapy, patients are thought to be more open to suggestion. As such, hypnotherapy is often used to effect change in behaviors thought to contribute to health problems (including chronic pain).

Preliminary research suggests that hypnotherapy may be of some use in treatment of low back pain. For instance, a pilot study published in the International Journal of Clinical and Experimental Hypnosis found that a four-session hypnosis program (combined with a psychological education program) significantly reduced pain intensity and led to improvements in mood among patients with chronic low back pain.

 Balneotherapy

One of the oldest therapies for pain relief, balneotherapy is a form of hydrotherapy that involves bathing in mineral water or warm water.

For a 2006 report published in Rheumatology, investigators analyzed the available research on the use of balneotherapy in treatment of low back pain. Looking at five clinical trial, the report’s authors found “encouraging evidence” suggesting that balneotherapy may be effective for treating patients with low back pain. Noting that supporting data are scarce, the authors call for larger-scale trials on balneotherapy and low back pain.

Dead Sea salts and other sulfur-containing bath salts can be found in spas, health food stores, and online. However, people with heart conditions should not use balneotherapy unless under the supervision of their primary care provider.

Meditation

An ancient mind-body practice, meditation has been found to increase pain tolerance and promote management of chronic pain in a number of small studies. In addition, a number of preliminary studies have focused specifically on the use of meditation in management of low back pain. A 2008 study published in Pain, for example, found that an eight-week meditation program led to an improvement of pain acceptance and physical function in patients with chronic low back pain. The study included 37 older adults, with members meditating an average of 4.3 days a week for an average of 31.6 minutes a day.

 Although it’s not known how meditation might help relieve pain, it’s thought that the practice’s ability to induce physical and mental relaxation may help keep chronic stress from aggravating chronic pain conditions.

One of the most commonly practiced and well-studied forms of meditation is mindfulness meditation.

Tai Chi

Tai chi is an ancient martial art that involves slow, graceful movements and incorporates meditation and deep breathingTai chi. Thought to reduce stress, tai chi has been found to benefit people with chronic pain in a number of small studies.

 Although research on the use of tai chi in treatment of back pain is somewhat limited, there’s some evidence that practicing tai chi may help alleviate back pain to some degree. The available science includes a 2011 study published in Arthritis Care & Research, which found that a 10-week tai chi program reduced pain and improved functioning in people with long-term low back pain symptoms. The study involved 160 adults with chronic low back pain, half of whom participated in 40-minute-long tai chi sessions 18 times over the 10-week period.

 Music Therapy

Music therapy is a low-cost natural therapy that may reduce some of the stress of chronic pain in conjunction with other treatment. Studies find that it may reduce the disability, anxiety, and depression associated with chronic pain.

 A 2005 study published in Annals of Physical and Rehabilitation Medicine evaluated the influence of music therapy in hospitalized patients with chronic back pain. Researchers randomized 65 patients to receive, on alternate months, physical therapy plus four music therapy sessions or physical therapy alone and found that music significantly reduced disability, anxiety, and depression

 Conclusion

It is difficult at best to arrive at a conclusion about the effectiveness of Chiropractic manipulation for two reasons. 1) there are very few real scientific studies and 2) The members of the profession don’t even seem to agree on just when and on which conditions Chiropractors can offer lasting relief.  I can only conclude with this thought.  At one time Chiropractors were ridiculed by the medical profession and not covered by health insurance.  Now, that has changed and the profession seems to be enjoying a degree of legitimacy It has never before had.

If you will take anecdotal evidence as scientific proof then Chiropractors are very effective.  If you prefer to make a decision based on scientific studies…well, the jury may still be out.

The bottom line is quite simple.  If you have been to a Chiropractor and the visit or visits have resulted in relief from what ails you, then keep going.  You are the best judge of what’s right for you.

 

Bob AronsonBob Aronson of Bob’s Newheart is a 2007 heart transplant recipient, the founder of Facebook’s nearly 4,000 member Organ Transplant Initiative (OTI) and the author of most of these donation/transplantation blogs. You may comment in the space provided or email your thoughts to me at bob@baronson.org. And – please spread the word about the immediate need for more organ donors. There is nothing you can do that is of greater importance. If you convince one person to be an organ and tissue donor you may save or positively affect over 60 lives. Some of those lives may be people you know and love.


By Bob Aronson

loneliness cartoonDepression, what is it? Why can’t you just snap out of it? Many people including family and friends who have not experienced depression have great difficulty understanding it much like people who are not addicts can’t understand addiction. In both cases we often hear advice like, “Snap out of it, you’ve got things pretty good. There’s no reason to be depressed.” Or, “You made the choice to start drinking or using drugs so choose to stop.” Oh, if it were that simple.

Here’s a cold slap in the face to bring us into reality. Depression is a mental illness, like the common cold is a physical illness. There has long been a stigma associated with mental illness held over from the days of Insane Asylums and “Crazy” people. That stigma is rapidly disappearing because so many people suffer from depression which is often a chemical imbalance that is quite treatable. Your mental health is every bit as important as your physical health and one can affect the other.

Here are some shocking statistics from the National Institutes of Mental Health (NIMH).

Major Depressive Disorder

  • Major Depressive Disorder is the leading cause of disability in the U.S. for ages 15-44.3
  • Major depressive disorder affects approximately 14.8 million American adults, or about 6.7 percent of the U.S. population age 18 and older in a given year.1, 2
  • While major depressive disorder can develop at any age, the median age at onset is 32.5
  • Major depressive disorder is more prevalent in women than in men

Major or clinical depression is an awful feeling. It is a gnawing at the pit of your stomach, in your gut that makes you feel hopeless, helpless and alone. It is as though someone locked up your ability to reason, your sense of humor and your will to live in a windowless, dark, solitary confinement jail cell from which there is no escape. It is a constant feeling of impending doom combined with a profound sadness and even fear. It can steal your energy, memory, concentration, sex drive, interest in activities you used to love and…it can even destroy your will to live. Depression may not be as common as the common cold but it is much more common than ever before. Nearly 20 percent of Americans suffer from it at one time or another.

Logic says that you should be able to “Will” yourself out of this mood, but will power alone cannot give you tStop being sadhe boost you need to get your life’s engine started again. Mental illness is not unlike physical illness. You cannot use will power to eliminate depression any more than you could use it to stop cancer. No one wants to be depressed, no one,. Think about it. If will power would work as an anti-depressant there would be no depression because again, no one wants to feel like what I described.

Let’s get to the medical description and symptoms as offered by the Mayo Clinic. http://www.mayoclinic.org/diseases-conditions/depression/expert-answers/clinical-depression/faq-20057770

“To be diagnosed with clinical depression, you must have five or more of the following symptoms over a two-week period, most of the day, nearly every day. At least one of the symptoms must be either a depressed mood or a loss of interest or pleasure. Signs and symptoms may include:
• Depressed mood, such as feeling sad, empty or tearful (in children and teens, depressed mood can appear as constant irritability)
• Significantly reduced interest or feeling no pleasure in all or most activities
• Significant weight loss when not dieting, weight gain, or decrease or increase in appetite (in children, failure to gain weight as expected)
• Insomnia or increased desire to sleep
• Either restlessness or slowed behavior that can be observed by others
• Fatigue or loss of energy
• Feelings of worthlessness, or excessive or inappropriate guilt
• Trouble making decisions, or trouble thinking or concentrating
• Recurrent thoughts of death or suicide, or a suicide attempt
Your symptoms must be severe enough to cause noticeable problems in relationships with others or in day-to-day activities, such as work, school or social activities. Symptoms may be based on your own feelings or on the observations of someone else.
Clinical depression can affect people of any age, including children. However, clinical depression symptoms, even if severe, usually improve with psychological counseling, antidepressant medications or a combination of the two.”

The National Institutes of Health (NIH) has this to say about depression.

What causes depression?

Several factors, or a combination of factors, may contribute to depression.
• Genes—people with a family history of depression may be more likely to develop it than those whose families do not have the illness.
• Brain chemistry—people with depression have different brain chemistry than those without the illness.
• Stress—loss of a loved one, a difficult relationship, or any stressful situation may trigger depression.
Depression affects different people in different ways.
• Women experience depression more often than men. Biological, life cycle, and hormonal factors that are unique to women may be linked to women’s higher depression rate. Women with depression typically have symptoms of sadness, worthlessness, and guilt.
• Men with depression are more likely to be very tired, irritable, and sometimes even angry. They may lose interest in work or activities they once enjoyed, and have sleep problems.
• Older adults with depression may have less obvious symptoms, or they may be less likely to admit to feelings of sadness or grief. They also are more likely to have medical conditions like heart disease or stroke, which may cause or contribute to depression. Certain medications also can have side effects that contribute to depression.
• Children with depression may pretend to be sick, refuse to go to school, cling to a parent, or worry that a parent may die. Older children or teens may get into trouble at school and be irritable. Because these signs can also be part of normal mood swings associated with certain childhood stages, it may be difficult to accurately diagnose a young person with depression.

get out of bedOk we’ve defined the malady and we know how clinicians determine if patients have it so the next logical question is, “What can you do about it.” Well, the answer is simple, but it will take a major commitment on your part to make the answer work for you, we can start by identifying some hazards, potholes on the road to good mental health.

Depression: Ten Traps to Avoid

Dr. Stephen Ilardi, author of “The Depression Cure,” has identified several things that can make depression worse. First, know this. Depression is a serious medical condition and should be treated by a doctor or licensed therapist. Having said that, here”s what Dr. Ilardi suggests.

Trap 1: Being a Couch Potato

When you’re feeling down, it’s tempting to hole up in your bed or on the couch. Yet exercise – Even moderate activityclinical depression image like brisk walking – has been shown to be at least as effective against depression as antidepressant medication. It works by boosting the activity of the “feel-good” neurochemicals dopamine and serotonin.
For an “antidepressant dose” of exercise, try at least 40 minutes of brisk walking or other aerobic activity three times a week.

Trap 2: Not Eating “Brain Food”

Omega-3 fats are key building blocks of brain tissue. But the body can’t make omega-3s; they have to come from our diets. Unfortunately, most Americans don’t consume nearly enough Omega-3s, and a deficiency leaves the brain vulnerable to depression. Omega-3s are found in wild game, cold-water fish and other seafood, but the most convenient source is a fish oil supplement. Ask your doctor about taking a daily dose of 1,000 mg of EPA, the most anti-inflammatory form of omega-3.

Trap 3: Avoiding Sunlight

Sunlight exposure is a natural mood booster. It triggers the brain’s production of serotonin, decreasing anxiety and giving a sense of well-being. Sunlight also helps reset the body clock each day, keeping sleep and other biological rhythms in sync.

During the short, cold, cloudy days of winter, an artificial light box can substitute effectively for missing sunlight. In fact, 30 minutes in front of a bright light box each day can help drive away the winter blues.

Trap 4: Not Getting Enough Vitamin D

Most people know vitamin D is needed to build strong bones. But it’s also essential for brain health. Unfortunately, more than 80 percent of Americans are vitamin D deficient. From March through October, midday sunlight exposure stimulates vitamin D production in the skin – experts advise five to 15 minutes of daily exposure (without sunscreen). For the rest of the year, ask your doctor about taking a vitamin D supplement.

Trap 5: Having Poor Sleep Habits

sleepChronic sleep deprivation is a major trigger of clinical depression, and many Americans fail to get the recommended seven to eight hours a night. How can you get better sleep?

Use the bed only for sleep and sex – not for watching TV, reading, or using a laptop. Turn in for bed and get up at the same time each day. Avoid caffeine and other stimulants after midday. Finally, turn off all overhead lights

Trap 6: Avoiding Friends and Family

When life becomes stressful, people often cut themselves off from others. That’s exactly the wrong thing to do, as research has shown that contact with supportive friends and family members can dramatically cut the risk of depression. Proximity to those who care about us actually changes our brain chemistry, slamming the brakes on the brain’s runaway stress circuits.

Trap 7: Mulling Things Over

When we’re depressed or anxious, we’re prone to dwelling at length on negative thoughts – rehashing themes of rejection, loss, failure, and threat, often for hours on end. Such rumination on negative thoughts is a major trigger for depression – and taking steps to avoid rumination has proven to be highly effective against depression.

How can you avoid rumination? Redirect attention away from your thoughts and toward interaction with others, or shift your focus to an absorbing activity. Alternatively, spend 10 minutes writing down the troubling thoughts, as a prelude to walking away from them.

Trap 8: Running with the Wrong Crowd

Scientists have discovered that moods are highly contagious: we “catch” them from the people around us, the result of specialized mirror neurons in the brain. If you’re feeling blue, spending time with upbeat, optimistic people might help you “light up” your brain’s positive emotion circuits.

Trap 9: Eating Sugar and Simple Carbs

Researchers now know that a depressed brain is an inflamed brain. And what we eat largely determines simple carbsour level of inflammation. Sugar and simple carbs are highly inflammatory: they’re best consumed sparingly, if at all.

In contrast, colorful fruits and veggies are chockablock with natural antioxidants. Eating them can protect the body’s omega-3s, providing yet another nice antidepressant boost.

Trap 10: Failing to Get Help

Depression can be a life-threatening illness, and it’s not one you should try to “tough out” or battle on your own. People experiencing depression can benefit from the guidance of a trained behavior therapist to help them put into action depression-fighting strategies like exercise, sunlight exposure, omega-3 supplementation, anti-ruminative activity, enhanced social connection, and healthy sleep habits.

So you think you’ve avoided all the traps, but you are still depressed, now what? According to the National Alliance on Mental Illness (NAMI) here are the options. (http://www.nami.org/Content/NavigationMenu/Mental_Illnesses/Depression/Depression_Treatment,_Services_and_Supports.htm)

Treating Major Depression

pillsAlthough depression can be a devastating illness, it often responds to treatment. The key is to get a specific evaluation and a treatment plan. Today, there are a variety of treatment options available for depression. There are three well-established types of treatment: medications, psychotherapy and electroconvulsive therapy (ECT). A new treatment called transcranial magnetic stimulation (rTMS), has recently been cleared by the FDA for individuals who have not done well on one trial of an antidepressant. For some people who have a seasonal component to their depression, light therapy may be useful. In addition, many people like to manage their illness through alternative therapies or holistic approaches, such as acupuncture, meditation, and nutrition. These treatments may be used alone or in combination. However, depression does not always respond to medication. Treatment resistant depression (TRD) may require a more extensive treatment regimen involving a combination of therapies.

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Bob Aronson of Bob’s Newheart is a 2007 heart transplant recipient, the founder of Facebook’s nearly 4,000 mmagic kindom in backgroundember Organ Transplant Initiative (OTI) and the author of most of these donation/transplantation blogs. You may comment in the space provided or email your thoughts to me at bob@baronson.org. And – please spread the word about the immediate need for more organ donors. There is nothing you can do that is of greater importance. If you convince one person to be an organ and tissue donor you may save or positively affect over 60 lives. Some of those lives may be people you know and love.


By Bob Aronson

If you have cataracts, even the beginnings of cataracts, you could experience the same sudden and painful glaucoma attack I did.  Recently on my Facebook group, Organ Transplant Initiative (OTI) I wrote about my experience with Acute Closed Angle Glaucoma.  It started headache imagewith a little headache and by the time I got to the ER had foolishly endured 16 hours of searing hot, constant, ever increasing pain.  I knew I had early stage cataracts but never associated that condition with the pain I was experiencing.

Since that episode I have learned that transplant recipients or anyone taking corticosteroids (Cortisone, Hydrocortisone and Prednisone) may have a greater risk of contracting Glaucoma, more on that in coming paragraphs.

We rarely hear about Glaucoma  and when we do we get the impression that it develops slowly and only affects old people.  I have spent a good share of my lifetime working with the medical profession and have had the beginnings of cataracts for a while and still did not know that Glaucoma could attack suddenly, with intense pain and be caused by a cataract.

Before I go into any detail about what you can do should the same thing happen to you, let me first explain the two eye afflictions.  They are very different diseases and both can lead to blindness if not treated.  Here’s the simple answer.  A cataract is an opaque (you can’t see through) area on the lens. It’s kind of like one of those windows that lets light in but you can’t see through it.  Research indicates that about 90% of people have some cataract activity by age 65, but many get it earlier.  Regular eye exams will reveal it, even if it is just getting started.  The surgery for cataracts is pretty simple and very effective because the medical team will replace the lens.  There is a marked and significant improvement  in vision.

Glaucoma is totally different.  It is a complicated group of eye diseases which affect the optic nerve and can lead to progressive, irreversible vision loss.  It is the second leading cause of blindness caused by fluid accumulation that increases pressure inside the eyeball.

There are two main types of glaucoma, 1) open angle and 2) closed angle glaucoma. I won’t go into the medical details here., just some quick definitions.  If you would like more information just Google Glaucoma.

1) Closed Angle Glaucoma (acute angle-closure glaucoma). This is the condition that affected me.  It can come on suddenly closed angle glaucoma(and it did) and the patient commonly experiences pain and rapid vision loss. Fortunately, the symptoms of pain and discomfort make the sufferer seek medical help, resulting in prompt treatment which usually prevents any permanent damage from occurring.  In my case I waited too long and was lucky they were able to save my left eye.

 

 

2) open angle glaucomaPrimary Open Angle Glaucoma (chronic glaucoma) – progresses very slowly. The patient may not feel any symptoms; even slight loss of vision may go unnoticed. In this type of glaucoma, many people don’t get medical help until some permanent damage has already occurred.

 

 

Here are some of the signs and symptoms of closed angle glaucoma

  • Eye pain, usually severe (It came on suddenly and kept getting worse.  Like a red hot poker in the eye.  It finally becomes unbearable pain).
  •  Blurred vision(in started out blurred and by the time I got to the ER I had no vision in the eye)
  • Eye pain is often accompanied by nausea, and sometimes vomiting (the symptoms were not unlike the worst hangover you’ve ever had.  Or…if you don’t drink, like the worst case of stomach flu you’ve ever had).
  • Lights appear to have extra halo-like glows around them
  • Red eyes
  • Sudden, unexpected vision problems, especially when lighting is poor

Signs and symptoms of primary open-angle glaucoma

Peripheral vision is gradually lost. This nearly always affects both eyes.

  • In advanced stages, the patient has tunnel vision

Rrisk factors are linked to glaucoma?

  • Advanced age – people over 60 years have a higher risk of developing glaucoma. For African-Americans, the risk rises at a much younger age.
  • Ethnic background is a risk factor as well.  For example,  East Asians, because of their shallower anterior chamber depth, have a higher risk of developing glaucoma compared to Caucasians. The risk for those of Inuit origin is considerably greater still. Studies show that African-Americans are three to four times more likely to develop glaucoma than whites.  Also…it appears as though Glaucoma favors women over men.  Studies indicate that women are three times as likely to develop glaucoma as men.  There are other risk factors as well and included among them is the use of corticosteroids.
  • Patients who take Corticosteroids like cortisone, hydrocortisone and prednisone for long periods of time have a raised risk of developing several different conditions, including glaucoma. The risk is even greater with eyedrops containing corticosteroids.

Now that you have some background lets talk about the disease.  I get frequent headaches, I always have and aspirin has always worked for me.  When this attack hit me, I took some aspirin, it did nothing.  Then I remembered telling a physician about my headaches and he suggested that maybe they were mini-migraines but we did not pursue the topic even though his suggestion stuck with me.

As the headache worsened I thought about the mini migraines and my wife Robin went to the pharmacy to get some over the counter migraine medicine.  It had no effect and the headache kept getting worse.  Then we called my primary care doc, told him I was having a migraine and he called in a prescription.  I was to take it every four hours, which I did but the headache got worse.  Several times during this ordeal Robin asked me if I wanted to go to the ER to which I responded negatively.  Finally after 16 hours of worsening pain, loss of vision and vomiting I gave in.  It was 4 AM when I awakened Robin to tell her I could no longer tolerate the pain so she drove me to the Mayo Clinic Emergency Department in Jacksonville.

Upon entering the ER I was asked to describe my symptoms which I did but also said I was experiencing a migraine headache.  The Doctor listened but immediately looked at my eyes and expressed some doubt about my self-diagnosis.  She ordered morphine for pain a CT scan of my head and called for an ophthalmologist, who arrived within minutes and conducted a more thorough exam of my eyes which included testing for pressure on the eyeball.  He quickly arrived at the conclusions that I was suffering from  acute closed angle glaucoma.  Subsequent research tells me that medical people are concerned about eye pressures that are over 23-25.  Mine was 60.  I had waited far too long to come to the ER.  The eye specialist continually put drops in the eye until the pressure was down to a safer level at which time I was hurried into a laser surgery room where they zapped the eye to create a tiny hole that would release more pressure.  It took only a few minutes.  The headache was gone, my stomach was back to normal and I was high on morphine for two days.

I’m writing this so that others don’t make the same mistake. Headaches can be serious, and when you combine a bad headache with vision loss and vomiting the Emergency Room is where you should be headed.  I got lucky….my vision was not lost.  A few days after this incident I went back to Mayo and they did the laser surgery on the other eye.

In about six weeks I will return to the clinic and have the cataracts repaired and that, I hope, will be the end of this vision episode.

There are some steps you can take to prevent this condition.  Here’s what the Mayo Clinic Says.  http://www.mayoclinic.org/diseases-conditions/glaucoma/basics/definition/con-20024042

  • iglaucoma preventionGet regular eye care. Regular comprehensive eye exams can help detect glaucoma in its early stages before irreversible damage occurs. As a general rule, have comprehensive eye exams every three to five years after age 40 and every year after age 60. You may need more frequent screening if you have glaucoma risk factors. Ask your doctor to recommend the right screening schedule for you.
  • Treat elevated eye pressure. Glaucoma eyedrops can significantly reduce the risk that elevated eye pressure will progress to glaucoma. To be effective, these drops must be taken regularly even if you have no symptoms.
  • Eat a healthy diet. While eating a healthy diet won’t prevent glaucoma, it can improve your physical and mental health. It can also help you maintain a healthy weight and control your blood pressure.
  • Wear eye protection. Serious eye injuries can lead to glaucoma. Wear eye protection when you use power tools or play high-speed racket sports on enclosed courts. Also wear hats and sunglasses if you spend time outside.

Don’t make the same mistake I did.  Don’t  self-diagnose, don’t delay.  When a condition has the potential to destroy your vision you must get immediate medical attention.


Bob Aronson of Bob’s Newheart is a 2007 heart transplant recipient, the founder of Facebook’s nearly 4,000 member OrganMy new hat April 10 2014Transplant Initiative (OTI) and the author of most of these donation/transplantation blogs. You may comment in the space provided or email your thoughts to me at bob@baronson.org. And – please spread the word about the immediate need for more organ donors. There is nothing you can do that is of greater importance. If you convince one person to be an organ and tissue donor you may save or positively affect over 60 lives. Some of those lives may be people you know and love.


By Bob Aronson

You are what you eatAs I did the research for this blog, I “Cherry Picked” information from a great many sources.  I am not a medical professional, but made every effort to ensure that the information I used came from experts.  I have identified sources where possible. 

This is a blog, it is made up of a good many opinions.  You should not make decisions about your health based on this or any other posting or even your own research. Only a highly skilled, educated and experienced physician can do that.  Blogs like this can only offer you general information.  As you read this remember that no two people are exactly alike.  What works for one person may cause serious damage to another even though they share similar characteristics.  Your health is too important to be left to chance.  It should be managed by a qualified physician who can focus on your specific condition, examine you, call for appropriate tests, diagnose and then develop a treatment program to meet your unique needs.

Kidney disease is disabling and killing us and no one seems to be paying attention.   To get yours I am going to start this post with some startling, even shocking facts.

  • Chronic kidney disease can lead to kidney failure, heart attack, stroke and death. In factkidney graphic, kidney disease is the nation’s ninth leading cause of death
  • 26 million Americans have kidney disease (many of whom don’t yet know it) and an additional 76 million are at high risk of developing it.
  • Of the 122,000 people on the national organ transplant waiting list about 100,000 are waiting for kidneys and there are not enough to go around.
  • Nearly a half million Americans are getting dialysis and the number is growing rapidly.
  • Diabetics are in the greatest danger of developing kidney disease and The American Diabetes Association says 25.8 million of us have it, that’s 8.3 percent of the U.S. population. Of these, 7 million do not know they are diabetic.
  • And – a final startling fact.  Kidney disease kills 100 thousand Americans a year, that’s more than prostate and breast cancer combined, but kidney disease gets nowhere near the publicity or concern of those two malignancies.

 

Got your attention?  Ok…there’s a lot more to come but first let’s define the topic. – just exactly what do kidneys do and what is kidney disease?  Here’s what the National Kidney Foundation says:

The kidneys are bean-shaped organs, each about the size of a fist. They are located just below the rib cage, one on each side of the spine. The kidneys are sophisticated reprocessing machines. Every day, a person’s kidneys filter about 120 to 150 quarts of blood to produce about 1 to 2 quarts of waste products and extra fluid. The wastes and extra fluid become urine, which flows to the bladder through tubes called ureters. The bladder stores urine until releasing it through urination.”

 So what is kidney disease?  The Mayo Clinic offers this explanation:

Chronic kidney disease, also called chronic kidney failure, describes the gradual loss of kidney function. Your kidneys filter wastes and excess fluids from your blood, which are then excreted in your urine. When chronic kidney disease reaches an advanced stage, dangerous levels of fluid, electrolytes and wastes can build up in your body.

In the early stages of chronic kidney disease, you may have few signs or symptoms. Chronic kidney disease may not become apparent until your kidney function is significantly impaired.

Treatment for chronic kidney disease focuses on slowing the progression of the kidney damage, usually by controlling the underlying cause. Chronic kidney disease can progress to end-stage kidney failure, which is fatal without artificial filtering (dialysis) or a kidney transplant.”

Causes of Kidney Disease

What causes Kidney disease?  First let’s define terms.  There’s ESRD (End Stage Renal Disease or Kidney failure), where the organs just quit working and there is CKD (Chronic Kidney Disease) which can lead to kidney failure.  The causes could be many but the most common are diabetesDiabetes and High blood pressure.  There are concerns, too, that some environmental factors may also contribute to both CKD and ESRD.  Sri Lanka, for example, has banned Monsanto Corporation’s “Roundup” herbicide on the grounds that it causes both kidney maladies.  Monsanto says its studies offer convincing evidence that the charges are not true.

What to do about it

Much is known about who faces the greatest risks of developing chronic kidney disease and how it can be prevented, detected in its early stages, and treated to slow or halt its progression. But unless people at risk are tested, they are unlikely to know they have kidney disease; it produces no symptoms until it is quite advanced.

Even when it is not fatal, the cost of treating end-stage kidney disease through dialysis or a kidney transplant is astronomical, more than fivefold what Medicare pays annually for the average patient over age 65. The charges do not include the inestimable costs to quality of life among patients with advanced kidney disease.

Much is known about who faces the greatest risks of developing chronic kidney disease and how it can be prevented, detected in its early stages, and treated to slow or halt its progression. But unless people at risk are tested, they are unlikely to know they have kidney disease; it produces no symptoms until it is quite advanced.  And…it appears as though it is quite common that many physicians overlook simple tests that could save lives.  For example, high blood pressure, is a leading cause of kidney failure yet many physicians don’t check to see how well vital organs are functioning.  Patients, then, have to be their own advocates and insist on tests to see what effect diabetes and/or high blood pressure are affecting their organs. For some reason kidney disease often is not on the medical radar, and in as many as three-fourths of patients with risk factors for poor kidney function, physicians fail to use a simple, inexpensive test to check for urinary protein.  So, our message to you is simple…make sure your doctor checks the amount of protein in your urine at least once a year.

A study published in April online in The American Journal of Kidney Disease demonstrated how common lifestyle factors can harm the kidneys. Researchers led by Dr. Alex Chang of Johns Hopkins University followed more than 2,300 young adults for 15 years. ParticipantJohns Hopkinss were more likely to develop kidney disease if they smoked, were obese or had diets high in red and processed meats, sugar-sweetened drinks and sodium, but low in fruit, legumes, nuts, whole grains and low-fat dairy.

Only 1 percent of participants with no lifestyle-related risk factors developed protein in their urine, an early indicator of kidney damage, while 13 percent of those with three unhealthy factors developed the condition, known medically as proteinuria. Obesity alone doubled a person’s risk of developing kidney disease; an unhealthy diet raised the risk even when weight and other lifestyle factors were taken into account.

Overall, the risk was highest among African-Americans; those with diabetes, high blood pressure or a family history of kidney disease; and those who consumed more soft drinks, red meat and fast food.

Dr. Beth Piraino, president of the National Kidney Foundation, said, “We need to shift the focus from managing chronic kidney disease to preventing it in the first place.”  And one of the ways to prevent kidney disease is to live healthier.  I know, no one wants to hear those words, “Live Healthier.”  Ok, I won’t use them again, but if you eat right and get the right kind and amount of exercise you can avoid kidney problems.  Want some good recipes and ideas for weight control?  Try this link  http://www.kidney.org/patients/kidneykitchen/FriendlyCooking.cfm

You are at greater risk of having kidney disease if others in your family have it or had it, genetic factors are important, but in addition you should know that African-Americans, Hispanic Americans, Asian-Americans and American Indians are more likely than white Americans to develop kidney disease.  I have been unable to find out why.  One Doctor said that prevention is the key and that it is not very complicated.  “I wouldn’t have to work so hard if they didn’t smoke, reduced their salt intake, ate more fresh fruits and vegetables, and increased their physical activity. These are things people can do for themselves. They involve no medication.”

Physicians also urge patients with any risk factor for kidney disease to be screened annually with inexpensive urine and blood tests. That includes seniors 65 and above, for whom the cost is covered by Medicare. Free testing is also provided by the National Kidney Foundation for people with diabetes.

The urine test can pick up abnormal levels of protein, which is supposed to stay in the body, compared with the amount of creatinine, a waste product that should be excreted. The blood tUrine testest, called an eGFR (for estimated glomerular filtration rate), measures how much blood the kidneys filter each minute, indicating how effectively they are functioning.

If it is determined that you have kidney disease you should be referred to a nephrologist.  If you are not referred, ask for a referral.  The Nephrologist will work closely with your family physician to help control the disease.

There are two medications commonly used to treat high blood pressure that often halt or delay the progression of kidney disease in people with diabetes: ACE inhibitors and ARB’s (angiotensin receptor blockers). Careful control of blood sugar levels also protects the kidneys from further damage.

As I conducted the research for this blog I found that one of the most comprehensive websites for factual, understandable information about Kidney Disease is India’s “The Health Site.” It also contains a good deal of advertising and other questionable material, but its information on the kidneys and kidney disease is backed up by solid research.  What follows is some of it.  http://www.thehealthsite.com/

12 Possible Kidney Disease Symptoms

Even an unhealthy lifestyle with a high calorie diet, certain medicines. lots of soft drinks and sugar consumption can also cause kidney damage. Here is a list of twelve symptoms which could indicate something is wrong with your kidney:

  1. Changes in your urinary function: The first symptom of kidney disease is changes in the amount and frequency of your urination. There may be an increase or decrease in amount and/or its frequency, especially at night. It may also look more dark coloured. You may feel the urge to urinate but are unable to do so when you get to the restroom.
  2. Difficulty or pain during voiding: Sometimes you have difficulty or feel pressure or pain while voiding. Urinary tract infections may cause symptoms such as pain or burning during urination. When these infections spread to the kidneys they may cause fever and pain in your back.
  3. Blood in the urine: This is a symptom of kidney disease which is a definite cause for concern. There may be other reasons, but it is advisable to visit your doctor in case you notice it.
  4. Swelling: Kidneys remove wastes and extra fluid from the body. When they are unable to do so, this extra fluid will build up causing swelling in your hands, feet, ankles and/or your face. Read more about swelling in the feet.
  5. Extreme fatigue and generalised weakness: Your kidneys produce a hormone called erythropoietin which helps make red blood cells that carry oxygen. In kidney disease lower levels of erythropoietin causes decreased red blood cells in your body resulting in anaemia.  There is decreased oxygen delivery to cells causing generalised weakness and extreme fatigue. Read more about the reasons for fatigue.
  6. Dizziness & Inability to concentrate: Anaemia associated with kidney disease also depletes your brain of oxygen which may cause dizziness, trouble with concentration, etc.
  7. Feeling cold all the time: If you have kidney disease you may feel cold even when in a warm surrounding due to anaemia. Pyelonephritis (kidney infection) may cause fever with chills.
  8. Skin rashes and itching: Kidney failure causes waste build-up in your blood. This can causes severe itching and skin rashes.
  9. Ammonia breath and metallic taste: Kidney failure increases level of urea in the blood (uraemia). This urea is broken down to ammonia in the saliva causing urine-like bad breath called ammonia breath. It is also usually associated with an unpleasant metallic taste (dysgeusia) in the mouth.

10. Nausea and vomiting: The build-up of waste products in your blood in kidney disease can also cause nausea and vomiting. Read 13 causes for nausea.

11. Shortness of breath: Kidney disease causes fluid to build up in the lungs. And also, anaemia, a common side-effect of kidney disease, starves your body of oxygen. You may have trouble catching your breath due to these factors.

12. Pain in the back or sides: Some cases of kidney disease may cause pain. You may feel a severe cramping pain that spreads from the lower back into the groin if there is a kidney stone in the ureter. Pain may also be related to polycystic kidney disease, an inherited kidney disorder, which causes many fluid-filled cysts in the kidneys. Interstitial cystitis, a chronic inflammation of the bladder wall, causes chronic pain and discomfort.

It is important to identify kidney disease early because in most cases the damage in the kidneys can’t be undone. To reduce your chances of getting severe kidney problems, see your doctor when you observe one or more of the above symptoms. If caught early, kidney disease can be treated very effectively.

http://www.thehealthsite.com/diseases-conditions/12-symptoms-of-kidney-disease-you-shoulnt-ignore-world-kidney-day-special/

Kidney Disease Prevention

Ten Steps you can take

 Our kidneys are designed such that their filtration capacity naturally declines after the age of 30-40 years. With every decade after your 30s, your kidney function is going to reduce by 10%. But, if you’re going to increase the load on your kidneys right from the beginning, your risk of developing kidney disease later in life will definitely be higher. To be on the safe side, follow these few tips and take good care of your kidneys to prevent the risk of developing kidney problems.

1. Manage diabetes, high blood pressure and heart disease: In most of the cases, kidney disease is a secondary illness that results from a primary disease or condition such as diabetes, heart diseases or high blood pressure. Therefore, controlling sugar levels, cholesterol and blood pressure by following a healthy diet, exercise regimen and medication guidelines is essential to keep kidney disease at bay.

2. Reduce the intake of salt: Salt increases the amount of sodium in diet. It not only increases blood pressure but also triggers the formation of kidney stones. Here are a few tips to actually cut down your salt intake.

3. Drink lots of water every day:  Water keeps you hydrated and helps the kidneys to remove all the toxins from your body. It helps the body to maintain blood volume and concentration. It also helps in digestion and controls the body temperature. At least 8-10 glasses of water a day is a must.

4. Don’t resist the urge to urinate: Filtration of blood is a key function that your kidneys perform. When the process of filtration is done, extra amount of wastes and water is stored in the urinary bladder that needs to be excreted. Although your bladder can only hold a lot of urine, the urge to urinate is felt when the bladder is filled with 120-150 ml of urine.

So, if start ignoring the urge to go to the restroom, the urinary bladder stretches more than its capacity. This affects the filtration process of the kidney.

5. Eat right:  Nearly all processes taking place inside your body are affected by what you choose to eat and how you eat. If you eat more unhealthy, junk and fast food, then your organs have to face the consequences, including the kidneys. Here’s more information on the relation between unhealthy diet and kidney damage.

You should include right foods in your diet. Especially foods that can strengthen your kidneys like fish, asparagus, cereals, garlic and parsley. Fruits like watermelon, oranges and lemons are also good for kidney health. 

6. Drink healthy beverages: Including fresh juices is another way of drinking more fluids and keeping your kidneys healthy. Juices help the digestive system to extract more water and flush out wastes from the body. Avoid drinking coffee and tea. They contain caffeine which reduces the amount of fluids in the body. So, the kidneys have to work harder to get rid of them.

If you’re already suffering from kidney problems, you should avoid juices made from vegetables such as spinach and beets. These foods are rich in oxalic acid and they help in the formation of kidney stones. But you can definitely have coconut water.

7. Avoid alcohol and smoking: Excess intake of alcohol can disturb the electrolyte balance of the body and hormonal control that influences the kidney function. Smoking is not directly related to kidney problems but it reduces kidney function significantly. It also has an adverse effect on heart health which can further worsen kidney problems.

8. Exercise daily: Researchers believe that obesity is closely linked to kidney related problems. Being overweight doubles the chances of developing kidney problems. Exercising, eating healthy and controlling portion size can surely help you to lose extra weight and enhance kidney health. Besides, you will always feel fresh and active. Here’s more about how obesity and kidney disease are linked.

9. Avoid self-medication: All the medicines you take have to pass through the kidney for filtration. Increased dosage or taking medicines that you are not aware of can increase the toxin load on your kidneys. That’s why you should always follow dosage recommendations and avoid self-medication. Read more about how drugs affect the kidneys. 

10. Think before you take supplements and herbal medicine: If you’re on vitamin supplements or if you’re taking some herbal supplements, you should reconsider your dosage requirement. Excessive amount of vitamins and certain plant extracts are linked to kidney damage. You should talk to your doctor about the risk of kidney disease before taking them.

Dialysis and Transplantation

By Ed Bryant

(I could find no additional information about Mr. Bryant other than the following website.  His information, though, is sound).

https://nfb.org/images/nfb/publications/vod/vow0006.htm

Dialysis

Dialysis is not an “artificial kidney.” A person undergoing hemodialysis must be hooked up to a machine three times a week, three to four hours per session. A normal vein cannot tolerate the 16–gauge needles that must be inserted into the arm during hemodialysis, so the doctor must surgically connect a vein in the wrist with an artery, forming a bulging fistula that will better accommodate the large needles needed for treatment.dialysis

Like the kidney, a hemodialysis machine is a filter. Where it uses tubes and chemicals, the kidney uses millions of microscopic blood vessels, fine enough to pass urine while retaining suspended proteins. Long–term high blood glucose can significantly damage the kidney’s filters, leading to scarring, blockage, and diminished renal function. Diabetes is the leading cause of kidney disease. Long–term diabetics often have cardiovascular and blood pressure problems, and the added strain of hemodialysis, with its rise in blood pressure straining eyes and heart function, can be too much for some. The diabetic dialysis patient spends, on the average, 33% more time in the hospital than does the non–diabetic dialysis patient, according to 1999 USRDS figures.

Some patients choose CAPD (continuous ambulatory peritoneal dialysis) or its variant, CCPD (continuous cycling peritoneal dialysis), both of which can be carried out at home, without an assistant. Unlike hemodialysis, which uses a big machine to remove toxic impurities from the blood, peritoneal dialysis works inside the body, making use of the peritoneal membrane to retain a reservoir of dialysis solution, which is exchanged for fresh solution, via catheter, every four to eight hours. CAPD is carried out by the patient, who simply exchanges spent for fresh solution, every four to eight hours, at home, at work, or while travelling. CCPD, its variant, makes use of an automated cycler, which performs the exchanges while the patient is asleep. Although more complicated and machine–dependent, it does allow daytime freedom from exchanges, and may be the appropriate choice for some. Though the risk of infections is heightened (as it is with any permanent catheterization), these two processes have advantages, one being that insulin can be added to the dialysis solution, freeing the patient from the need to inject, and giving good blood sugar control.

Transplantation

Kidney transplantation is a logical alternative for many. It substantially improves a patient’s kidney transplantquality of life. Although the transplant recipient must be on anti–rejection/ immunosuppressive therapy for life, with the inherent risk from otherwise nuisance infections, a transplant frees the patient from the many hours spent on hemodialysis procedures each week, or from the periodic “exchanges” and open catheter of CAPD, allowing a nearly normal lifestyle. For those ESRD patients who can handle the stresses of transplant surgery, the resulting gains in physical well–being add up to real improvement in quality of life and overall longevity.

“Fifty percent of all kidney transplantations taking place today are into diabetics,” states Giacomo Basadonna, MD, PhD, a transplant surgeon at Yale University School of Medicine, in New Haven, Connecticut. He reports that success rates are identical with kidney transplants performed on non–diabetic ESRD patients. “Today,” he advises, “average kidney survival, from a living donor, is greater than 15 years.”

One of the areas where we are seeing rapid improvement is immunosuppressive medication. The traditional mix of immunosuppressants: cyclosporine, prednisone, imuran, is giving way to more targeted medications that may have fewer side effects. Cellcept, by Roche/Syntex, and Rapamycin (Rapamune), by Wyeth/Ayerst, have been approved by the FDA, and others are being tested. The risk of organ rejection is always present, but each new development increases the chances of success.

I and others knowledgeable in kidney transplantation advise you to pick the best transplant center possible. Once you have read their statistics, ask your prospective center the following questions. If they don’t answer to your satisfaction, you should consider going to another center.

1. Do you have an information packet for prospective donors and recipients?

2. Can you put me in touch with someone who has had a transplant at your center?

3. What is your “graft survival” (success) rate?

4. Who will my transplant surgeon be? If a fellow or resident, will he/she be supervised by a practicing transplant surgeon?

5. How long have your current surgeons been doing kidney transplants? How many have they done? That your center has 35 years experience with kidney transplants is of little consequence if my surgeon has only done ten in his or her career.

6. What is the average post–operative stay in your hospital?

7. When I come for my transplant, or come back for follow–ups, will there be any affordable housing for me and/or my family? (Ronald McDonald House, or other lodging with discount rates…) or will I get stuck in a luxury hotel for $125 a night?

8. How often will I need to come back to the center for follow–ups? Can my nephrologist do the blood tests and send you the results?

9. Can you recommend a nephrologist in my area?

10. Do you have a toll–free number to call for after–transplant information?

11. What is your policy on people with insufficient health insurance? Will you work with an uninsured patient? What will it cost?

12. Are you prepared to satisfy my doubts? Will you show me the documents that answer my questions? Will you guarantee the price quoted?

Conclusion

Kidney disease can be manageable if caught early and treated appropriately.  The information contained in this blog should allow you to make good decisions that can provide you with the quality of life you seek and deserve.  For more information about kidney disease and treatment here are some additional sources.

  • The National Institute of Diabetes and Digestive and Kidney Diseases (NIDDK)

http://tinyurl.com/qfna7f2

 

 

 

 


My new hat April 10 2014Bob Aronson of Bob’s Newheart is a 2007 heart transplant recipient,
 the founder of Facebook’s nearly 4,000 member Organ Transplant Initiative (OTI) and the author of most of these donation/transplantation blogs. You may comment in the space provided or email your thoughts to me at bob@baronson.org. And – please spread the word about the immediate need for more organ donors. There is nothing you can do that is of greater importance. If you convince one person to be an organ and tissue donor you may save or positively affect over 60 lives. Some of those lives may be people you know and love.


 By Bob Aronson

insomnia imageNormally I hope my blogs are interesting enough to keep people engaged and awake while reading them.  In this case if you get sleepy, go with it because chances are that if you are reading this you are an insomniac.

I can fall asleep at the drop of a hat.  I wake up shortly after it has fallen.  Insomnia or the inability to sleep normally is a terrible malady and one which affects millions of people, especially transplant patients both pre and post surgery.  Often insomnia is the result of the drugs we take – but not always.

It’s always good to start with a definition of terms.  Exactly what is insomnia?  Well, I’m going to offer a couple of sources.  First the National Sleep foundation says there are at least five ways to describe insomnia: http://tinyurl.com/n8mjwsu

  1. Acute insomnia is a brief episode of difficulty sleeping usually caused by a life event, such as a stressful change in a person’s job, insomnia math cartoonreceiving bad news, or travel. Often acute insomnia resolves without any treatment.
  2. Chronic insomnia is a long-term pattern of difficulty sleeping. It is usually considered chronic if a person has trouble falling asleep or staying asleep at least three nights per week for three months or longer. Some people with chronic insomnia have a long-standing history of difficulty sleeping. Chronic insomnia has many causes.
  3. Comorbid insomnia is insomnia that occurs with another condition. Psychiatric symptoms — such as anxiety and depression — are known to be associated with changes in sleep. Certain medical conditions can either cause insomnia or make a person uncomfortable at night (as in the case of arthritis or back pain, which may make it hard to sleep.
  4. Onset insomnia is difficulty falling asleep at the beginning of the night.
  5. Maintenance insomnia is the inability to stay asleep. People with maintenance insomnia wake up during the night and have difficulty returning to sleep.

The American Academy of Sleep Medicine elaborates even more.  They say there are the following kinds of insomnia. http://tinyurl.com/lus3682

  1. General insomnia

A classification of sleep disorders in which a person has trouble falling asleep, staying asleep, or waking up too early. These disorders may also be defined by an overall poor quality of sleep.

  1. Adjustment insomnia

internet cartoonThis disorder, also called acute insomnia or short-term insomnia, disturbs your sleep and usually stems from stress. The sleep problem ends when the source of stress is gone or when you adapt to the stress. The stress does not always come from a negative experience. Something positive can make you too excited to sleep well.

  1. Behavioral insomnia of childhood

This condition occurs when children don’t go to bed on time unless a parent or guardian enforces a bedtime. If the children are made to go to bed at a specified time, then they tend to fall asleep at a normal hour. If they are not given strict bedtimes, then they may linger awake for hours at night.

  1. Idiopathic insomnia

Idiopathic insomnia is a lifelong sleep disorder that starts during infancy or childhood and continues into adulthood. This insomnia cannot be explained by other causes. It is not a result of any of the following other sleep disorders.

  • Medical problems
  • Psychiatric disorders
  • Stressful events
  • Medication use
  • Other behaviors

It may result from an imbalance in your body, such as an overactive awakening system       and/or an underactive sleep system, but the true cause of this disorder is still unclear.

  1. Insomnia due to a drug or substance

This type of insomnia is directly related to the use of any of the following substances:

  • Medication
  • Caffeine
  • Alcohol
  • A food item

Your sleep is disrupted by your use of the substance. This type of sleep problem may also   occur when you stop using a substance

  1. Insomnia due to a medical condition. 

This insomnia is caused by a mental health disorder. The insomnia is a symptom of the   disorder. The course and severity of insomnia are directly linked to that of the mental health disorder, but the insomnia is a separate focus of treatment. This insomnia is a disorder only if it is severe enough to require separate treatment.

  1. Insomnia nonorganic, unspecified. 

This type of insomnia suggests that known substances and other physical causes of  the insomnia have been ruled out. This means that the cause of insomnia is most likely due to an underlying mental health disorder, psychological factor, or sleep disruptive behaviors.

The name may also be used on a temporary basis while further evaluation and testing are completed. It is the name used when a person with insomnia does not meet the criteria for another type of insomnia.

  1. Insomnia organic, unspecified. 

This type of insomnia is caused by a medical disorder, physical condition, or substance exposure. But the specific cause remains unclear. Further testing is required to discover the exact cause. The name may be used on a temporary basis while further evaluation and testing are completed.

  1.  Paradoxical insomnia is a complaint of severe insomnia. It occurs without objective evidence of any sleep disturbance. Daytime effects vary in severity, but they tend to be far less severe than one would expect given the expressed sleep complaints.People with this disorder often report little or no sleep for one or more nights. They also describe having an intense awareness of the external environment or internal processes consistent with being awake. This awareness suggests a state of hyperarousal. A key feature is an overestimation of the time it takes them to fall asleep. They also underestimate their total sleep time.10.
  2. Psychophysiological insomnia.

This insomnia is associated with excessive worrying, specifically focused on not being able to sleep. The insomnia may begin suddenly following an event or develop slowly over many years.

People with this sleep disorder worry too much about their insomnia and about being tired the next day. As a result, they learn to become tense and anxious as bedtime approaches. They may have racing thoughts that all relate to insomnia and trying to fall asleep. As they worry about falling asleep, they become more and more tense, which makes it less likely that they will be able to fall asleep.

While all transplant patients may suffer from some form of insomnia,
Kidney transplant patientresearch clearly indicates that those who have kidney transplants are much more likely to have sleep problems.  This eye opening  article will give you some insight and solutions as well. “The Kidney Transplant Side Effect That No One Tells Chronic Kidney Disease Patients About

December 07, 2013 Kidney Buzz http://tinyurl.com/m5bmhky

 And, there’s a lot more about kidney disease and sleep which can cause major health complications and even increase the risk of death.

Recommended Reading: Sleep Disorders are common in Individuals with Kidney Disease on Dialysis

A study published in Biomedcentral Nephrology Journal found that the most frequent sleep problem among people with a Kidney Transplant was difficulty staying asleep (49.4%), followed by problems falling asleep (32.1%). 62.9% of transplant patients had to wake up to urinate which was the most common sleep disturbance, and caused 27% of transplant recipients to have reduced daytime functionality.

Recommended Reading: Chronic Kidney Disease Patients Do Not Have To Suffer Sleep Loss

Another study first reported by Science Nordic and later published in the Journal of Sleep Research, further confirms that insomnia is linked with a wide range of health problems including higher risk for anxiety, depression, fibromyalgia (chronic widespread pain), whiplash, rheumatoid arthritis, arthrosis

(an age-related cartilage degeneration condition), severe headache, asthma, heart attack and osteoporosis. Researchers also found a less strong association between insomnia and obesity, hypertension and stroke.

Recommended Reading: The Natural Way For Chronic Kidney Disease Patients To Get A Good Night’s Sleep

 

Solutions….How to Get Some Sleep

“Ok,” you say, “That’s good, now what do I do about it?  How can I get a good  night’s sleep?”  And…that’s the $64 or $64,000 or $64,000,000 question depending on the era in which you grew up.  There are a lot of answers to that question and none of them work for everyone.   So let’s start with some advice from the National Institutes for Health NIH) http://tinyurl.com/mo6v483

How Is Insomnia Treated?

http://tinyurl.com/lyvl5or

Lifestyle changes often can help relieve acute (short-term) insomnia. These changes might make it easier to fall asleep and stay asleep.

Several medicines also can help relieve insomnia and re-establish a regular sleep schedule. However, if your insomnia is the symptom or side effect of another problem, it’s important to treat the underlying cause (if possible).

Lifestyle Changes

If you have insomnia, avoid substances that make it worse, such as:

  • booze and smokesCaffeine, tobacco, and other stimulants. The effects of these substances can last as long as 8 hours.
  • Certain over-the-counter and prescription medicines that can disrupt sleep (for example, some cold and allergy medicines). Talk with your doctor about which medicines won’t disrupt your sleep.
  • Alcohol. An alcoholic drink before bedtime might make it easier for you to fall asleep. However, alcohol triggers sleep that tends to be lighter than normal. This makes it more likely that you will wake up during the night.

Try to adopt bedtime habits that make it easier to fall asleep and stay asleep. Follow a routine that helps you wind down and relax before bed. For example, read a book, listen to soothing music, or take a hot bath.

Try to schedule your daily exercise at least 5 to 6 hours before going to bed. Don’t eat heavy meals or drink a lot before bedtime.

Make your bedroom sleep-friendly. Avoid bright lighting while winding down. Try to limit possible distractions, such as a TV, computer, or pet. Make sure the temperature of your bedroom is cool and comfortable. Your bedroom also should be dark and quiet.

Go to sleep around the same time each night and wake up around the same time each morning, even on weekends. If you can, avoid night shifts, alternating schedules, or other things that may disrupt your sleep schedule.

Cognitive-Behavioral Therapy

CBT for insomnia targets the thoughts and actions that can disrupt sleep. This therapy encourages good sleep habits and uses several methods to relieve sleep anxiety.

For example, relaxation techniques and biofeedback are used to reduce anxiety. These strategies help you better control your breathing, heart rate, muscles, and mood.

CBT also aims to replace sleep anxiety with more positive thinking that links being in bed with being asleep. This method also teaches you what to do if you’re unable to fall asleep within a reasonable time.

biofeedbackCBT also may involve talking with a therapist one-on-one or in group sessions to help you consider your thoughts and feelings about sleep. This method may encourage you to describe thoughts racing through your mind in terms of how they look, feel, and sound. The goal is for your mind to settle down and stop racing.

CBT also focuses on limiting the time you spend in bed while awake. This method involves setting a sleep schedule. At first, you will limit your total time in bed to the typical short length of time you’re usually asleep.

This schedule might make you even more tired because some of the allotted time in bed will be taken up by problems falling asleep. However, the resulting tiredness is intended to help you get to sleep more quickly. Over time, the length of time spent in bed is increased until you get a full night of sleep.

For success with CBT, you may need to see a therapist who is skilled in this approach weekly over 2 to 3 months. CBT works as well as prescription medicine for many people who have chronic insomnia. It also may provide better long-term relief than medicine alone.

For people who have insomnia and major depressive disorder, CBT combined with antidepression medicines has shown promise in relieving both conditions.

Prescription Medicines

Many prescription medicines are used to treat insomnia. Some are meant for short-term use, while others are meant for longer use.  There are so many drugs that can be prescribed we are not even going to attempt to list them.  Just know that your primary care physician or, better yet, your sleep specialist has a huge armory of drugs from which to draw, but they’ll want a “history” from you before they even begin to suggest remedies..  And…remember, those remedies may not be medicinal.

medsTalk to your doctor about the benefits and side effects of insomnia medicines. For example, insomnia medicines can help you fall asleep, but you may feel groggy in the morning after taking them.

Rare side effects of these medicines include sleep eating, sleep walking, or driving while asleep. If you have side effects from an insomnia medicine, or if it doesn’t work well, tell your doctor. He or she might prescribe a different medicine.  Also, if you are either pre or post transplant, tell the physician who’s treating you for sleep.  Some medications may not mix well with those you are taking for your condition.   And…as a precaution, never take any medication before you personally check with your transplant team.

Some insomnia medicines can be habit forming. Ask your doctor about the benefits and risks of insomnia medicines.

Over-the-Counter Products

Some over-the-counter (OTC) products claim to treat insomnia. These products include melatonin, L-tryptophan supplements, and valerian teas or extracts.

The Food and Drug Administration doesn’t regulate “natural” otc drugsproducts and some food supplements. Thus, the dose and purity of these substances can vary. How well these products work and how safe they are isn’t well understood.

Some OTC products that contain antihistamines are sold as sleep aids. Although these products might make you sleepy, talk to your doctor before taking them.

Antihistamines pose risks for some people. Also, these products may not offer the best treatment for your insomnia. Your doctor can advise you whether these products will benefit you.

At the risk of sounding overly cautious you should take the same precautions with Over the Counter Drugs as you would with prescriptions.  Talk to your transplant team before you take anything.

Other quick tips

At night.

  • Use the bed and bedroom for sleep and sex only
  • Establish a regular bedtime routine and a regular sleep-wake schedule
  • Do not eat or drink too much close to bedtime
  • Create a sleep-promoting environment that is dark, cool and comfortable
  • Avoid disturbing noises – consider a bedside fan or white-noise machine to block out disturbing sounds

During the day:

  • Consume less or no caffeine, particularly late in the day
  • Avoid alcohol and nicotine, especially close to bedtime
  • Exercise, but not within three hours before bedtime
  • Avoid naps, particularly in the late afternoon or evening
  • Keep a sleep diary to identify your sleep habits and patterns that you can share with your doctor
  • The prevalence of insomnia is higher among older people and women. Women suffer loss of sleep in connection with menstruation, pregnancy, and menopause. Rates of insomnia increase as a function of age but most often the sleep disturbance is attributable to some other medical condition.
  • Some medications can lead to insomnia, including those taken for:

o   colds and allergies

o   high blood pressure

o   heart disease

o   thyroid disease

o   birth control

o   asthma

o   pain medications

o   depression (especially SSRI antidepressants)

  • Some common sleep disorders such as restless legs syndrome and sleep apnea can also lead to insomnia.
  • Sleep is as essential as diet and exercise. Inadequate sleep can result in fatigue, depression, concentration problems, illness and injury.

nih logoNational Institutes of Health- (NIH) supported research is shedding light on how sleep and lack of sleep affect the human body. The NIH and its partners will continue to work together to advance sleep research. Read the full fact sheet…

Insomnia Clinical Trials  Clinical trials are research studies that explore whether a medical strategy, treatment, or device is safe and effective for humans. To find clinical trials that are currently underway for Insomnia, visitwww.clinicaltrials.gov.

PLEASE SHARE THIS BLOG ANYWHERE YOU THINK IT WILL HELP SOMEONE.  ATTRIBUTION APPRECIATED  –PERMISSION NOT REQUIRED. 

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Bob Aronson of Bob’s Newheart is a 2007 heart transplant recipient, GIF shot bob by TVthe founder of Facebook’s nearly 4,000 member Organ Transplant Initiative (OTI) and the author of most of these donation/transplantation blogs. You may comment in the space provided or email your thoughts to me at bob@baronson.org. And – please spread the word about the immediate need for more organ donors. There is nothing you can do that is of greater importance. If you convince one person to be an organ and tissue donor you may save or positively affect over 60 lives. Some of those lives may be people you know and love.


By Bob Aronson

“Working people have a lot of bad habits, but the worst of these is work.” 

Clarence Darrow

Preparation for old age should begin not later than one’s teens.  A life which is empty of purpose until 65 will not suddenly become filled on retirement.

Dwight L. Moody

Retirement: It’s nice to get out of the rat race, but you have to learn to get along with less cheese.

Gene Perret

 pot gardenHow many times have you heard about “Uncle Joe” who retired from his 50 year long career to a recliner chair and died an unhappy man?   That story is all too common and totally unnecessary.  Take  it from this 75 year old retired guy who is busier and happier than at any other time of my life.

At some point all of us retire from our chosen profession or trade and you should know early on that retirement from a job does not mean retirement from life.  Frankly, retirement should mean new opportunities and exciting new experiences that serve to restore your old enthusiasm for life.  Retirement is not a sentence it is a destination and you can write your own ticket.

Often retirement is not by choice but by necessity.  In my case the need for a heart transplant made it a necessity, but so what?  While everyone knows they will retire few are ready for it.  Retirement is a drastic change in lifestyle, one in which you have to change some major habits and behaviors and learn new ones.

Prior to retirement I was a communications consultant who traveled a great deal. I absolutely loved mrunning through airportsy work.  I trained and coached executives, was a frequent keynote speaker at conventions and wrote extensively about communication.  My days started at 5 AM and often didn’t end until midnight.  I had a closet full of suits, ties and freshly pressed shirts and rarely wore anything else, there wasn’t time.

When I retired all of that came to a sudden and screeching halt and the shock was as intense as if I had been shot head first from a cannon into a brick wall target.  I was used to getting up and meeting with the captains of industry, but now in retirement I got up to Captain Crunch and an empty day.  I knew for a very long time, 12 years to be exact, that this day would come.  I had been told I would need a heart transplant and would get weaker and weaker until I got one.  The prediction came true in 2006.  Reluctantly I retired and late that year we moved from Eagan, Minnesota (a twin cities suburb) to Jacksonville, Florida because the Mayo clinic there had a great record of obtaining transplantable organs.

My first rescue from boredom came two months after I got a new heart from the very people who had saved my life, the Mayo Clinic.  One of my Mayo friends called to ask if I would like to write a blog (this one, Bob’s Newheart) and start a Facebook group with a focus on organ donation and transplantation (Organ Transplant Initiative).  This required some learning because I knew nothing about social media or blogging.  Both were in their infancy.  I dove headfirst into cyberspace and found it fascinating and fun because it called upon many of my old skills.

Manother booth shoty second rescuer was my wife Robin.  She ran two businesses out of our home one of them was
designing and making anodized aluminum jewelry.  She sold her colorful creations at art shows all over the south, and southeastern U.S.  In order to do that she not only needed a tent but the furnishings, too.  Items like display cases, necks for necklaces, pedestals, pictures and frames, and other items used to display her work are necessities and can be expensive.  She knew I had an interest in woodwork so she asked if I’d like to build some of those things.

“Oh fun,” was my first thought, but I had few tools.  Slowly and with great deliberation I built a woodworking shop and began to build what she needed to furnish her booth.  It became a never ending job because as styles and tastes changed so did the need for new and different furnishings.

That takes me to today.  This blog, Bob’s Newheart, is my 222nd since November 3, 2007 and the Facebook group, Organ Transplant Initiative (OTI) now has nearly 4,000 members.  I have branched out in the woodworking department as well and have built a number of items for gifts for friends and family.  When I am not at my keyboard I am In my shop and have found that I am at least as busy now as I was when working and even happier.

So I got lucky, I stumbled into avocations that interested me and kept me busy to the point where I don’t miss the job from which I retired at all.  Now…what should you do?  How do you keep your mind and body active and engaged and avoid all the fears every spouse or partner has about retirement?  How do you avoid becoming a couch potato,couch potato 2 the stereotypical old person who sits in front of the TV all day eating unhealthy food and feeling sorry for him (her) self?  It’s really pretty easy and I can sum it up in one word –planning, but you have to do it now!  Check out this link. “http://health.howstuffworks.com/wellness/aging/retirement/10-tips-for-adjusting-to-retirement.htm

Whether you retire through necessity or choice you will retire and, as I said earlier, it can be a major shock to the system. Going from working a full-time job to having nowhere specific that you “have” to be each day may sound wonderful but it doesn’t always work out that way.  Some retired people feel bored and unproductive and when that happens, the days can seem endlessly long and empty. It doesn’t have to be that way.

Options for Action

Teaching

senior citizen teacherHave you considered teaching?  Even if that wasn’t your profession, it’s still something that you can do when you retire.  Teaching others what you’ve learned in the years spent in your chosen trade or profession can be very rewarding and some colleges and technical schools like to employ people with real-world experience.  You will also find that some companies employ speakers to share their knowledge and often those engagements result in contracts for more speeches or even training sessions.

 Speaking and/or Training

Speaking and training could be a paying gig, or you could do it simply for the joy of helping others.  One organization that might be of help is SCORE, the Service Corps of Retired Executives. SCORE bills itself as “counselors to America’s small business.”   Volunteers with the organization mentor small business owners, provide counseling, create and lead workshops, and write articles.

Move to an exotic location

I have a friend and former boss, Rick Lewis, who retired big time.  He moved to Cotacachi, Ecuador.
He sold almost all his earthly possessions and took with him only what he could carry, which wasn’t muc13654641373_736dfa7d31_nh.  He lives in the shadow of some beautiful mountains.  He walks everywhere, has lost a some extra pounds, buys food at open air markets at wonderfully low prices, has a much healthier diet, writes blogs about his experience and started a company that will help South American women be more independent.  He travels extensively and is enjoying life to the fullest and  while he has access to all the modern conveniences he uses few other than his computer and cell phone.

Go Back to School

I am convinced that to really enjoy your retirement years you must keep your brain actively engaged and what better for that than the learning environment.  Taking classes ins something that interests you can keep your mind razor sharp but even more importantly it could give you the opportunity to learn more about a lifelong passion, or the start of aSenior studentnother career.  Maybe you wanted to play a musical instrument or learn woodwork or how to write a book…the possibilities are endless.

Best of all…you can go to school again at little or no cost.  There are grants and scholarships available y for senior citizens to attend college but often you don’t even need them.  Some colleges, universities and trade schools provide tuition waivers or discounts for seniors.

And…you can always audit a class, if you have no interest in getting a degree.   Auditing simply means that you attend and participate in the classes, but don’t take exams or receive a grade or credit for taking the class.  Check with the college or university of your choice.  You likely will find several Audit opportunities.

Hobbies

ow about a hobby? Yeah, I know everyone who counsels retirees says the same thing, “Get a hobby,” but it is good advice.  When I was a kid I used to play the harmonica.  At age 70 I took it up again.  Robin is already an accomplished musician and we often practice together.  Better yet, we are now involved in a once a week local jam session and my hobby has morphed into ownership of 15 harmonicas.

If you are at a loss as to what kind of hobby suits you, don’t give up. Keep looking.  Hobby and craft stores conduct free or inexpensive classes in knitting, scrapbooking, leatherwork, jewelry making and more.  You’ll also fin
harmonica collectiond that places like Home Depot and Lowes have classes in carpentry and other woodwork skills along with instruction on gardening.  Stores that sell kitchenware often have cooking classes.  There’s no end to what you can learn, but you have to look.  . Maybe you don’t want to learn how to do anything, but you’re interested in starting a collection. Whether you want to collect autographs or antique dolls, there are plenty of online groups and forums dedicated to your new hobby. Some of them meet in person or even hold conventions. No matter what your interest, you can find others out there with whom to discuss it.

Ok..you don’t want to take classes, free or not,  you just want a hobby that’s fun.  How about starting a collection?  As a youngster I always carried a pocket knife, they can come in very handy for a whole lot of reasons.  I remember, too, seeing a movie starring Allan Ladd called, “The Iron Mistress.”  It was about Jim Bowie of frontier and Alamo fame and how he developed the Bowie Knife.  Ever since then I wanted one of them.  At age 72 I started a knife collection (you can get some very nice knives at a very low cost through Amazon and other internet sites).  Today I have seven fixed blade knives (variations on the Bowie theme) and ten folding pocket knives.

Volunteer

aliensThen there is Volunteering.    God knows we need volunteers in almost any pursuit.  The University of Michigan conducted a study of retirees who were active volunteers and found that 40 percent were more likely to be alive at the end of the study than people who did not volunteer. [Wheeler]. If that isnt’ reason to consider volunteering for something I don’t know what is and — it keeps you moving and engaged.

Other volunteer opportunities include, helping out at local schools, animal shelters, museums and churches.  And…the area in which you can likely land a volunteer job right way…HealthCare.  Hospitals and nursing homes always need volunteers and you could be in on the ground floor of making a significant contribution  in those two areas alone.

I know, too, that there are organizations that specifically recruit senior citizens, such as Senior Corps where the Foster Grandparents program matches exceptional children with adults ages 60 and older who mentor them and help them with reading and schoolwork.  Talk about a rewarding experience…that one alone could give your ego a much needed boost.

Travel

If you like to travel and see the country consider an RV, the come in a wide variety of shapes and sizes from trailers to bus2012 traceres and in every price range.  We own a 30 foot travel trailer so when we go to art shows (we do about 20 a year) we bring our home and our dogs with us.  Of course that means you have to do some serious research into how you want to use your RV.  This can be a major purchase and it pays to take your time and thoroughly investigate every angle.  We love our RV and are old hands at it now and can highly recommend it if you like to travel, meet new people and live, “on the road.”

Become an employee again

Yep…that’s another term for work.  Maybe you need it so keep the door open to returning to the world of the retired but employed ranks.  It doesn’t have to be a full time job and it doesn’t have to be as a Wal Mart Greeter, although there is nothing wrong with that.  I have a 75 year old friend who works part time at a Menards store.  Menards is a Home Depot type story in the Midwest and they employ a good many senior citizens as do many companies. Here are some ideas on what you could do:

  • Hire out as a consultant on based on the expertise you gained while employed
  • Do research in your field for colleges and universities
  • Check city, county, state and federal government listings for openings that might appeal to you
  • Maybe you only want money for special occasions if so try seasonal work.  Companies are always seeking help during holiday seasons.
  • Entertainment venues like ball parks and theaters may need ushers to lead patrons to their seats
  • Customer service reps.  You could get a job answering the phone, working in sales or returns or even store security.
  • If you are handy with tools and can fix things around your home perhaps you can hire out as a handyman or woman on specific projects.
  • Tutor a student.  The money may not be great but there is some to be made tutoring both college and high school students.
  • Make things at home and sell them on line through Craigs list or by opening your own website.
  • Home care.  If you have some medical or therapy credentials you might quality to help care for either an adult or a child in their home
  • If you have bookkeeping or accounting skills many a small business could use you and chances are you could work from home.
  • Clerical work. If you can type and if you are computer literate you might get a part or full time job doing just that.

Essential skills.  

computerIt’s the 21st century and almost any job you take on is going to require computer literacy.  If you don’t know how to type it would be to your advantage to take a typing class and to learn basic word processing and even PowerPoint.

There is virtually no job anywhere today that is not going to require some computer skills so if volunteering or becoming employed again is an option you want to consider then by all means brush up on your computer and typing skills.

Mental and Physical Health

So far we’ve talked about what you can do to keep from being bored and to feel as though you have some value.  What’s missing from this blog, though, is how you take care of your health.  That issue beings with a word few like — Exercise.

No matter what the state of your health you must find ways to be active and to exercise.  Health expenses can be not only a huge financial burden, they can destroy your quality of life.  There are two kinds of exercise I recommend. One is mental and the other is physical.   You should read, research and write as often as possible and social media offers incredible opportunity to do all of that. Even games of solitaire or crossword puzzles can keep you mentally engaged and fit.

When it comes to physical exercise it is important to do what you can when you can.  A brisk walk every
day can do wonders for you and if that sounds boring, try Mall walking where at least you will see other people and iPeople walkingnteresting displays in stores and in the hallways.  If you play golf or tennis all the better, but any kind of activity that will exercise your muscles and elevate your heartbeat and respiration is good for you.

Remember above all else that you have great value.  Your years of service have given you invaluable experience from which others can learn.  Studies indicate that the years beyond midlife are one of life’s most creative, innovative and entrepreneurial periods for many and that us older people can be incredibly creative when given the opportunity. Check out this link for more information.

http://www.usatoday.com/story/money/personalfinance/2013/10/22/preparing-mentally-retirement/2885187/

When I was working I believed I had a mission and a purpose for being and that feeling was reinforced daily by clients who continued to hire me for my advice.  My fear was that upon retirement I would no longer have a purpose and that I would become irrelevant.  Well, that’s possible if you only think of yourself in terms of what you used to do, but what if you change the paradigm?  For example, I am no longer a communication consultant. I am an advocate for organ donation and transplantation and that has become my new relevancy, my new purpose and my new identity.  More and more there are people who know me for my new purpose and know nothing about what I used to be and do.  That’s an old life and frankly, I don’t miss it at all.

Relationships
Finally, the most important consideration of all, your relationship with your spouse or significant other.  Many of us who have worked outside the home for an entire lifetime are a pain in the butt when we are home all the time.  Our life partners aren’t used to it either and both have to make a concerted effort to work on strengthening this new retured couplerelationship.  In my case Robin has her business and I do what I can to help her, but otherwise am pretty much involved in my own activities.  We enjoy each other a great deal and often plan outings or dates when we can spend time together talking about and doing things unrelated to business or hobbies.

Retirement can be very rewarding, if you plan for it, but if you view retirement as the end of life you will be in for a miserable time because it can be the beginning and it should be.  It’s all in your attitude.  You can choose to quit or you can choose to explore new frontiers.  I am not a quitter and I’ll be most of you aren’t either and if that’s the case…get out and find those new frontiers.

Last Resorts

And….if all else fails try some of these:

  • Make a bucket list and start doing all the things on it
  • Make bird houses
  • Become a master gardener
  • Become an expert Starcraft player
  • Sail, backpack, walk[1] or cycle around the world[2]
  • Enter ham radio competitions (contact every state, etc.)
  • Read trashy novels
  • Have a lot of sex while your body is still in full working order
  • Fix up cars or motorcycles
  • Build a boat
  • Build a log cabin
  • Research your family tree
  • Watch birds
  • Amateur astronomy
  • Finally get adequate sleep
  • Become as healthy as possible
  • Save the world
  • Rebuild civilization from scratch
  • Live very well without money for a year
  • Go to the top of a high building and throw away $100.000
  • Burn $100.000 on a public place
  • Spend the last day in the job speaking all the truth to clients

You can find more here http://earlyretirementextreme.com/wiki/index.php?title=Long_list_of_things_to_do_when_you_retire

I always try to practice what I preach so let me recap where I am today at age 75 after a career that I absolutely loved.  My life has changed completely and I love every minute of it.  I am not only not bored, I don’t have time to be bored.  I am having too much fun doing the following:

  1. I took up the harmonica after a 60 year hiatus from it.  Now I own 15 of them and once a week my the Fig Newtonswife and I play in an old time music jam session.  Robin plays several instruments and often we spend an evening playing together.
  2. Woodwork. I’ve always loved working with wood but never had time.  Now I make fixtures and furnishings for Robin’s Art show booth.  I make jewelry boxes for friends and family, front with keyboard and buttonsand recently completed making a CD storage unit that looks like an accordion.
  3. Social media.  As you know I started and run Facebook’s nearly 4,000 member Organ Transplant Initiative group (OTI) and recently wrote my 223rd blog on Bob’s Newheart for WordPress.
  4. I am in the process of writing two books.  One is just a look at life from my earliest memories until now .  So far I have written about 145 pages, and that only got me to when I was 23 years old.  There’s a lot more to write.  The other book is fiction, it is about the first Hispanic President of the United States and the challenges he faces.  It’s part SCI FI, part  James Bond type action and heavy on political intrigue.
  5. I do the grocery shopping, some cooking a little housework and very little sitting.
  6. We travel the country going to art shows in which Robin sells he Jewelry creations.

I think you can tell, by that list that at age 75 I am a very busy guy.  Rarely do I sit still for long.  I absolutely refuse to be bored.  I think I lead a rather exciting life and I’m enjoying every moment of it.  You can do the same.  Retirement can be like being born again because it is what you make it.

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My new hat April 10 2014Bob Aronson of Bob’s Newheart is a 2007 heart transplant recipient, the founder of Facebook’s nearly 4,000 member Organ Transplant Initiative (OTI) and the author of most of these donation/transplantation blogs. You may comment in the space provided or email your thoughts to me at bob@baronson.org. And – please spread the word about the immediate need for more organ donors. There is nothing you can do that is of greater importance. If you convince one person to be an organ and tissue donor you may save or positively affect over 60 lives. Some of those lives may be people you know and love.