What Your Hands May Reveal About Your Health
When you're visiting your doctor's office, does your doctor sometimes look closely at your fingers? A pulmonologist or cardiologist may be looking for signs of clubbing which is defined as a thickening of the flesh under the nails...causing the nail to curve downward, similar to the shape of the round part of an upside-down spoon. Clubbing is an indication of a heart or lung disorder causing chronically low blood oxygen levels.
There are other things your nails may reveal. Horizontal ridges may be another sign of trouble. Horizontal ridges, created when normal growth of the nail is interrupted, can be caused by many factors including, infection, toxins, underlying metabolic diseases or periods of reduced blood oxygen levels. These lines are called Beau's lines. If they are visible only on one nail, a nail infection may be the culprit but if the lines appear on all or most of the nails, you will want to bring it to the attention of your doctor during your next routine visit.
Writer's personal experience with Beau's lines: I am particularly interested in this topic because I had deeply creased thumb nail lines - both hands - for years before my own PH / hypoxic (chronic low blood oxygen levels) was diagnosed in the year 2000. A few months after starting on supplemental oxygen 24/7, my creases disappeared completely. Eight years later, I have had not one hint of Beau's lines.
Of course, my little experience is purely anecdotal and would probably make me look like a lunatic to my doctor's eyes if I mentioned it during a visit. To some doctors, spending time on a patient's nails is probably a little like reading tea leaves, interesting, but hardly hard science. Still, if your nails change in color or texture, it can signal something is going on that needs to be addressed.
For a more detailed discussion on clubbing and Beau's lines, we have listed a few online resources.
MedlinePlus Medical Encyclopedia: Clubbing of the fingers or toes
HealthMad.com - What Causes Ridges in Fingernails and What You Can Do About Them
azTeen Magazine - What Causes Fingernail Ridges?
Depression and Chronic Illness
Whether its called the blues, the blahs, moods, a funk, or anxiety: it is still the same beast – depression. Although common in those with a chronic illness, depression is often under treated, possibly because it carries the stigma of being a weakness. According to the Mayo Clinic, most health professionals today consider depression a chronic illness that requires long-term treatment, much like diabetes or high blood pressure.
Why do individuals with chronic illnesses get depressed? Possibly it is what patients see as the end of their familiar lives. Their life has changed and how they see themselves has changed as well. They often feel like they have no control over the events in their lives. The course of each day can no longer be predicted or controlled.
Common symptoms of depression are:
- Difficulty concentrating, remembering details, and making decisions
- Fatigue and decreased energy
- Feelings of guilt, worthlessness, and/or helplessness
- Feelings of hopelessness and/or pessimism
- Insomnia, early-morning wakefulness, or excessive sleeping
- Irritability, restlessness
- Loss of interest in activities or hobbies once pleasurable, including sex
- Overeating, or appetite loss
- Persistent aches or pains, headaches, cramps, or digestive problems that do not ease even with treatment
- Persistent sad, anxious, or "empty" feelings
- Thoughts of suicide, suicide attempts
Not everyone with depression will have the same symptoms. Also, the severity, frequency, and duration of symptoms will vary depending on the individual and his or her particular type of depression.
If you or someone you love is experiencing depression, no matter how mild, it is important to discuss your feelings and concerns with a medical professional. Depression rarely dissipates on its own.
Sources:
Depression Caused by Chronic Illness - WebMD
Depression (major depression) - MayoClinic.com
Hot Weather Affects Water Retention
If you have an ongoing battle with your water weight, you need to know that you may retain a bit more than usual during spells of high temperatures. Even healthy people may retain some extra water during hot weather. As a PH'er you'll want to stay out of the heat as much as possible, keep your salt intake low and wait out the hot days. Ah boy, the joys of summer!
Humor and Laughter ARE Good For You. Really!
While there are no definitive studies to prove that laughter is good for your health, it sure feels good to let go and really laugh now and then. Yet most of us laugh all too infrequently. Let's face it, when you have a chronic illness that makes you feel draggy much of the time, it's not always easy to see the humor in things.
Medical experts will tell us laughter is worth pursuing. A good laugh or just looking at the funny side of life, can really elevate a mood and there are other benefits as well.
According to the University ofMaryland Medical Center's website, laughter and cultivating a good sense of humor can protect against heart attack. Other studies have shown that humor strengthens the immune system, changes body chemistry and a good hard laugh actually increases the amount of oxygen that reaches the brain.
In thinking about this topic, we decided to ask a few of our PH friends what they do to elevate their mood.
Annonymous writes: "I have a running joke with a friend who loves dark humor as much as I do. We speculate on the worst case scenario when it comes to being terribly disabled. We paint a bleak picture of someone with multiple problems and it's really dark stuff, but it makes us feel "lucky" just to have PH to worry about. And we get so tickled by the absurdness of it all.
I know our brand of humor is not for everyone, but it makes us laugh and I feel such a connection with my friend. We're revealing our fears, but having fun with it at the same time. It works for us."
Irene offers: "Humor is definitely therapeutic, no doubt about that. The movie Airplane does that to me. Also my grandkids make me laugh, usually when they're acting cute, but sometimes when they melt down I find it comical (strange for a grandparent?). Work can make me laugh since I'm lucky enough to work with people who find humor in some of the same things I do. Often times, it's either laugh or cry and I much prefer laughing."
Cheryl writes: "I love the movie Planes, Trains and Automobiles. It makes me laugh and laugh even though I know every scene. My husband looks at me like I'm crazy because I get so worked up, I'm nearly crying. I am not all that easily amused so this movie is a gem to me."
Nancy tells us: "Nothing can make me laugh more than watching animals or children at play. Seeing their complete joy in discovering the world around them always makes me laugh."
Michelle adds: "When I really need a good laugh, I turn to anything written by Larry David. He's a comedic genius. IMHO, no other sit-com has been as well written as either Seinfeld or Curb Your Enthusiasm.
Lewis Black's stand-up comedy show is also very funny. His angry, observational humor is perfectly delivered.
My silly little dogs often make me laugh, too. Especially when they get the "Zoomies" and start running around the house at break-neck speed. That's a kick."
Seek out things that make you smile or laugh and pass them along to others and with us too. You will benefit in ways you cannot imagine. It really is good for your health.
Read more about the health benefits of humor and laughter:
WebMD
University of Maryland Medical Center
DOES YOUR CHICKEN TASTE SALTY?
The USDA allows producers of "All Natural" chickens to inject the birds with a sodium solution. This adds weight which increases the price and adds hidden salt to our diets. If you're trying to avoid salt - and most of us are - you'd better start reading the chicken label too!!!
LEARN MORE HERE:
The Modesto Bee | Nutrition Quiz
Oxygen Anyone?
How Can You Tell If You're Getting Enough?
Know About Blood Saturation
By now, you surely have used the gizmo called the pulse oximeter in your doctor's office. When you take your 6-minute walk, you will be checked periodically to see how much oxygen-rich blood is getting to your fingertips. Also, pulse ox readings are typically taken during routine visits to your cardiologist or pulmonoligist offices.
For PH'ers or anyone with a serious heart or lung issue, it's a good idea to have a pulse oximeter of your own for home use. By having your own pulse ox, you will be able to identify potential problems early. Also, by taking your readings around the house, you may become mindful of the need to slow down the pace. The goal always is to keep your blood sat reading above 90 and the closer it is to 100 the better.
If you are using supplemental oxygen, a pulse ox will help you identify the tasks that require more oxygen and the times when less is called for. It's to your advantage to actively manage the liter flow on your supplemental tank both to maximize the use of your oxygen when you are away from the house and to ensure you receive the right amount at all times. This is why some of us choose to wear a small gas or liquid tank even when we're in our own homes. You cannot actively manage the liter flow of a stationary unit.
Typically insurance companies do not pay for a pulse ox for home use, but there are a number of pulse ox units to be found online (Amazon.com) at all prices. Some are under $100 and my personal experience with a unit costing $79 is that it is dependable and accurate. If you are careful not to drop your pulse ox or get it wet, an inexpensive unit should be a fine choice.
Hey, my oxygen tubing must be kinked!!!!!
How can you tell if oxygen is flowing through your nasal cannula? Lick your lips and hold the nose piece close to but not touching your damp lips. You will feel the air flow on your lips. This sounds silly, but when you're half asleep and you wake up feeling short of breath and the cannula is firmly in place, you'll want to confirm that the gas is indeed flowing. It's not as easy to feel the flow on dry skin.
Places to Go, Things to Do You May Not Have Considered
If you want to go to some local attractions or programs but don't want to go alone, consider checking into day trips and classes that are commonly sponsored by local senior centers, rec centers and churches. Many centers and churches offer short classes, shopping trips and day trips to local attractions like parks, theatrical and musical events, museums, etc. The trips are usually free or available for a modest fee. They also arrange transportation from the sponsor's location.
Signing up for a trip is a good way to meet people in your own community who have similar interests. The trips usually require advance registration and often have a list for alternates if a cancellation is necessary.
Contact your local senior center (numbers are usually listed under city government in the phone book) about future trips. Or check with nearby churches and rec centers for programs they offer.
Spring is right around the corner so if you're fighting the cold weather blahs, it might be a good time to plan something to look forward to and soon!
WHY YOU SHOULD DISCUSS SLEEP APNEA WITH YOUR PH DOCTOR
Sleep apnea (cessation of breathing during sleep) is somewhat common and can run the gamut from mild to severe. If you snore loudly, do not feel rested upon awakening, awaken often during the night, OR need frequent naps you may have severe sleep apnea. But even if you have minor symptoms, the condition can contribute to your PH load so you will want to cover the topic with your doctor. Some physicians feel it should be included in a PH workup, but it is often overlooked. Testing typically requires an overnight stay at a special clinic; charges are usually covered by insurance companies. If you are found to have sleep apnea, you will most likely be fitted with a non-invasive ventilator (either cpap or bipap) for home use. If you have not been tested for apnea and you either have symptoms or think it may be a contributor to your PH problems, you'll want to broach the subject during your next PH checkup.
SURVIVING IN COLD TEMPS
Cold temperatures are nothing to be taken lightly, especially for individuals with a chronic respiratory disease like pulmonary hypertension. Pulmonary hypertension patients are often taking blood-thinners. Those patients should take special precautions in cold weather because they are more susceptible to frostbite and hypothermia. It is important to note that hypothermia (low body temperature) can occur indoors and sometimes, even in the middle of summer.
On emaxhealth.com, Dr. Paul Oh, medical director of Cardiac Rehabilitation Programs at Toronto Rehabilitation Institute says, "Heart-related deaths increase by about 20 percent in winter months. There is approximately a one percent increase in death due to heart disease for every one Centigrade drop in temperature. The number of deaths due to cardiovascular disease peaks within one to three days following a cold snap. Because cold weather causes an immediate increase in blood pressure and increased heart rate."
To decrease the risk of cold exposure: - Wear layered clothing. Wear a cap to prevent rapid heat loss, even indoors if necessary.
- Try to heat at least one room to 70 F.
- Put an extra blanket on the bed or wear a cap or socks while sleeping.
- Carry extra clothing, blankets and high-energy snacks (nuts, candy bars, cereal) in the car. Keep the gas tank near full to prevent icing in the gas line. Avoid traveling alone, and if stranded, never leave the vehicle and attempt to go for help. Use a cell phone to summon help.
- Listen to weather forecasts and dress appropriately when going outside. Pay close attention to wind-chill factor and avoid going outdoors in extreme weather.
- Avoid alcoholic beverages: they cause the blood vessels to dilate and the body to lose warmth.
- Wear a mask or scarf around the mouth and nose in extreme cold or windy weather. The scarf will warm the inhaled air.
- Try to get a warm, lightweight coat (down is ideal) for winter.
THE IMPORTANCE OF GOOD DENTAL HYGIENE
Good dental hygiene is important in maintaining overall health. Untreated gum disease and poor oral hygiene habits can lead to serious heart disease. The theory is that bacteria from the mouth gets into the blood stream through tiny cuts making it possible for the bacteria to irritate the blood vessel walls and sometimes collect around heart valves. The worse the gum disease, the more dangerous the bacteria being released. The simple act of chewing, brushing and flossing can cause the release of some bacteria, but if the mouth is in a healthy state, bacteria won't be present in large quantities.
Don't neglect your oral hygiene. As a person with a serious chronic illness that taxes the heart, you certainly do not need to challenge your system further. See your dentist regularly and make sure he'she knows your diagnosis. You'll also want to discuss your use of blood thinners when applicable, and also your need to avoid pain medication that restrict blood vessels.
SURVIVING HOLIDAY SHOPPING
The holidays can be stressful and for a person with a chronic illness like pulmonary hypertension, it is far too easy to overdo. It is extremely important that PH patients take precautions before plunging into the holiday shopping frenzy. We hope the tips that follow help to make your holiday season a great success while maintaining your health.
- Shopping online is the way to go and this year, nearly everyone is offering online discounts and free shipping. It's easy and safe
- It's never too late to check on the availability of a handicap plackard for your vehicle in your state. And if you have one, don't be afraid to use it. If you have PH and qualify for a plackard, you don't have to explain yourself to anyone.
- If a store offers the use of an electric cart, use it. Don't be shy, these carts are for people like us. Using the cart will conserve energy and provide a seat during the potential and inevitable long wait at the check-out.
- If you have portable oxygen on hand, take it along. Dealing with crowds and long lines taxes the body, so use that oxygen.
- There are some great, light-weight, three-legged camp chairs out there so if you're going shopping with a friend and you do not have a scooter, ask your friend to carry the little chair for you. If you're stuck in a long shopping queue, you will find it very useful.
- If a store does not have scooters, take a cart at the front door of the store even though you have only a few purchases planned. The cart can be used for support when you walk or stand. Besides holding your purchases, the cart can be used to carry your oxygen.
- Try to shop when the stores are less crowded. Early to mid-morning (Monday through Thursday) may be the best time to avoid large crowds. Usually the shelves will be better stocked then, too.
- While it's fun to check out new stores, you'll save a lot of energy if you shop at the tried and true where you know the layout well.
- Whether you bag your own groceries or someone does it for you, make sure all preishible items are bagged seperately. If you're tuckered out when you return home, you can leave the other items in the bags to be shelved later.
- Ask those bagging your goods to keep the bags a little on the light side. They will be much easier to carry in the house.
- As about help in carrying your bags to the car. Also in some areas of the country, you'll find customer pick-up windows. If enough people ask for these kinds of services, the store may consider adding such a service in the future.
- Invest in a foldable shopping cart to help transport bags from the vehicle into the house.
- If you have a great deal of difficulty going out to shop, perhaps a friend, neighbor or relative would be willing to do it for you. Some senior service agencies and churches will provide these kinds of services on a volunteer-basis. Check in your area for availability of these services.
- Call ahead for prescription refills and use pharmacies with drive-up windows whenever possible. Use mail-order and online pharmacies: many are reliable and dependable. Your insurance company may offer discounts through a specific mail-order pharmacy.
- Shopping for clothing can be an exhausting experience even for those in the best of health. Know your measurements, write them down on a file card and carry it with you. Keep a small fabric measuring tape with you to check items like slacks and skirts. This can help avoid tiring trips to the dressing rooms. Know the stores return policy if the item does not fit when you get it home. Keeping measurements of family members will be helpful for holiday shopping.
In summary, if you pace yourself this holiday season by planning carefully and taking time outs to rest and rejuvinate, we think you'll enjoy plenty of holiday cheer.
THE IMPORTANCE OF WEIGHT MANAGEMENT
Are You Keeping Track of Your Weight? It's important to monitor your weight closely as excess fluid build-up can be gradual, dangerous and go unnoticed. Extra water causes the heart to work harder which is something no PH'er needs. While it's normal to gain two to three pounds in the course of a day, your weight first thing in the morning before you eat anything and after your Lasix has taken effect, should be consistent from day to day.
If you're holding onto water, there are two things you can do: limit your fluid intake and severely limit salt in your diet.
If you gulp down a 32 ounce soda, you'll have added two pounds of water to your weight in the blink of an eye. A healthy person might be able to handle copious amounts of fluid during a day, but not a PH'er. PH'ers should spread out their fluids consumption and stay hydrated,
but not overdo it. Too little fluid intake can also cause the body
to hold onto fluid so you'll want to discuss the right amount for you with your doctor.
Excess salt intake is another big problem. Did you know that 1 tsp of salt containns 2,000 mg of sodium? It is recommended that PH'ers and also others with heart disease, limit their intake to 2,000 mg. per day. And foods need not taste salty to be salty so take care in choosing the foods you eat.
In summary, get yourself a good scale and weigh yourself every morning. Be sure to report any sudden changes to your doctor.
CONTINGENCY PLANNING AND YOUR DME
If you use an oxygen concentrator and/or a cpap or bipap machine, you'll want to have some contingency plans for possible power outtages.
To get started, read what the folks at COPD International have to say:
COPD International
CONSIDER ALTITUDE IN MAKING YOUR TRAVEL PLANS
Thinking About a Trip to the Mountains? Reconsider.
People who have lung disease may find they feel "healthier" on high pressure days. These people might also feel less well in the mountains or flights on commercial airplanes where the air pressure is low. This is because air has weight and higher pressure helps air enter the lungs more easily. Conversly, at elevations where the air is "thinner" the body has to work a little harder to breathe. Healthy people might not notice the extra load, but a PH patient probably will.
Pioneering scientists discovered atmospheric pressure (also known as barometric or air pressure)in the 17th century, and determined a startling new fact-that air actually has weight. Evangelista Torricelli, one of the first to discover atmospheric pressure, once said, "We live submerged at the bottom of an ocean of the element air." The Earth's gravitational field is pulling on air, and this pull, or "pressure" of air, is called atmospheric pressure.
At elevation even healthy people can have problems. At extreme altitudes, mountain climbers who get altitude sickness are experiencing pulmonary hypertension. If the climber is otherwise healthy and descends to a safer altitude to acclimate, the PH will most likely correct itself. For people with PH, choosing a destination at a higher altitude is asking for trouble.
So, if you are yearning to visit that mountain retreat, you'd better talk to your doctor before you finalize your plans. He/she may prescribe supplemental oxygen temporarily for your trip or advise you to pick a spot at sea level for your vacation.
For information on barometric or air pressure, visit:
Nova Online
CARING FOR CARE-GIVERS
As important they are to their children, friends, spouses, or family members, caregivers need help, too. The following link lists the resources that are available to provide that help. Links show how to find help providing care, government benefits, legal matters, and end-of-life issues, long-distance caregiving, and resources for caregiver support.
For specific links on this topic go to:
Caregivers' Resources - Official information and services from the U.S. government
HOT TUBS AND PH
Does That Hot Tub Look Inviting? Forget it.
People with heart conditions including patients with PH, should avoid extreme heat including hot tubs. Why? In higher temperatures, we sweat to get rid of heat. During that process, blood is sent to the skin where temperatures are cooler, which opens up the blood vessels. In turn, the heart rate rises and blood pressure drops. That combination can be dangerous for anyone with weakened cardiovascular systems.
EXERCISE AND PH
Just hearing the word "exercise" can fill a pulmonary hypertension patient with dread, but many recent studies revealed that some form of regular exercise might be beneficial. Frequently pulmonary hypertension patients avoid exercise because they do not have the strength, energy, or endurance to walk or do other strenuous activity, but it may be possible to get exercise from the comfort of a chair with little exertion.
Chair exercises are slow movements, such as rolling the shoulders or stretching the hands above the head while seated. These activities are safer for patients who might become dizzy doing the same technique while standing. The exercises sound simple, but don't underestimate their physical and mental benefits.
It is advisable, however, for PH patients to consult with their physician before attempting ANY new routine, and chair exercises are no different. Please note the precautions section on the following sites.
Some good tips and actual chair exercises can be found on the following sites:
COPD International
North Dakota State University -- Donna Terbizan, PhD, Professor, Health, Nutrition and Exercise Sciences; Julie Garden-Robinson, PhD, LRD, Food and Nutrition Specialist, NDSU Extension Service
San Diego Eldercare Directory
University of Georgia - 34-page manual of chair exercises as a PDF file
EAT WELL ON A BUDGET
Don't spend your money on overpriced and oversalted prepared foods. If you're on a budget and have been told to watch your salt intake, your best bet is to make it yourself. It's not that hard to do.
My mother was a "cooking by scratch" enthusiast so some of the products I find in the supermarket are surprising and irksome. Although I did not have much interest in what my mother was concocting as a child, I did notice she did not buy many prepared things. Perhaps it was because there were so few on the shelves back in the 50's and 60's, but even later in life, she continued to cook from scratch.
When I look at what is sold in markets these days, it's amazing to me how much "convenience" foods cost and if you stop to think for more than a nanosecond about it, you will realize how dearly you pay for them compared to the raw materials they are made from especially when with a little bit of knowledge, you can make the same or better with relative ease.
In the case of Pasta Sauce, you're really getting robbed. Pasta sauce is nothing more than tomato sauce with some spices thrown in. You can buy an 8-pack of 15 ounce cans of organic tomato sauce at Costco for about #3.50. That is $.43/can. If you open up one of those cans, put it in a sauce pan, throw in some garlic, basil and chopped onion along with anything else that appeals to you and simmer it for ten minutes, you have pasta sauce. Pasta sauce can set you back $3.50 or more at the market so I think you see the point.
My other pet peeves? Here are just a few: Salad dressings, rice and pasta mixes, shake and bake, packaged croutons. Below you'll find a few words about each..
Salad Dressing - start with vinegar and oil and add spices and spices to flavor.
Rice Mixes - plain old rice or pasta is a lot cheaper and you can flavor it with anything you like. To your rice, add dried cranberries, unsweetened coconut, dried fruit or chopped nuts, some chicken broth in the cooking liquid. Be creative.
Shake and Bake - Duh, how about bread crumbs and herbs? That's all it is and your homemade mix won't have all the salt and other stabilizers they add to the commercial offering.
Packaged Croutons - This is how bread bakeries use old bread. Make your own by cutting old bread into squares, coating them with a little olive oil and garlic powder and popping them into the oven.
If you're on a budget, there are ways to eat well and spend your money wisely.
TRAVEL WITH OXYGEN
Travel with oxygen and other medical devices is a stressful event in the modern world, but it is possible and manageable. It helps to be as informed as possible on the restrictions and regulations.
The Transportation Security Administration (TSA) has a wealth of information on their website:
TSA
Also check out their page on "Hidden Disabilities" where oxygen equipment and implanted medical devices are explained:
TSA - Hidden Disabilities
Tired of the hassles and expense of traveling with oxygen by air? Alternatives are available for oxygen users taking a short trip. Consider the bus or train. Amtrak and Greyhound allow individuals to take their own oxygen systems on board (portable concentrators or tanks). No extra fees are charged.
Greyhound also does not allow smoking on their buses and there are designated smoking areas in the depots that can be easily avoided. Find more information here:
Breathin' Easy
INTERACTIONS WITH DRUGS
Grapefruit has been shown to affect the metabolism of many medications, increasing the risk of toxicity and adverse events. If you include grapefruit in your diet or plan to add it, discuss this with your physician.
For a more detailed discussion on this topic go to:
The Center for Food-Drug Interaction
Back to the Tips Index Page
This site has been constructed by your friends and neighbors in the PH community. The material on this web site has been prepared and is copyrighted by PH Central, Inc. The material is for informational purposes only and does not constitute medical, financial, theological or legal advice. The material does not necessarily reflect the opinions of PH Central, Inc, and is not guaranteed to be correct, complete, or up to date. This information is not intended to substitute for obtaining medical advice from a doctor, legal advice from an attorney, or financial advice from a financial planner. No person should act or rely on any information on this site, or linked to this site, without seeking the advice of the appropriate profession to which the information applies.
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