If you were expecting some inspired words about Noah and The Flood, I am sorry that is not the topic for this time. Psalm 42:1 leads into my thoughts somewhat more directly: “As the deer pants for flowing streams . . . “

In the midst of summer, with heat and humidity creating “heat advisory” status, it is important to pay attention to the amount of water that we drink in any given day. Hydration is important because the body is comprised mostly of water. The proper balance between water and the chemistry of our blood (mainly sodium and potassium) determines how all systems of our bodies function. Adequate hydration is key in regulating body temperature, heart function, blood pressure, removing waste, proper function of nerves and muscles, and in maintaining a healthy metabolism.

If we wait until we feel thirsty before drinking a glass of water, we're already dehydrated. Thirst is not the best indicator of hydration status. It is recommended that a person maintain the habit of being proactive in health maintenance or improvement by beginning each day with 16 ounces of water immediately upon arising. . . and then continuing to drink water throughout the day up to 64 ounces, ideally. The primary benefit is that water helps the body combat heat, aids digestion, aids the effectiveness of prescription drugs, jump-starts kidney and bowel function, and enhances heart, blood vessel, nerve, and muscle function. Think of it this way: WATER is cheap medicine.

Signs and symptoms of dehydration include:

  • loss of appetite
  • fatigue
  • flushed, reddened skin in the face
  • dizziness, light-headedness
  • dark-colored urine
  • dry cough

While water is the prime fluid to support body function, the chemistry of the blood is supported by other foods and beverages that provide sources of sodium and potassium. Think of a tall glass of lemonade, made from fresh-squeezed lemons with a few lemon slices in the glass. Sports drinks, fruit juice, soft drinks also supply some sodium and potassium, but be mindful of the nutritional contents on the labels. Alcoholic and caffeinated beverages are not recommended for optimal hydration because they actually pull more water out of the body than they add to it.

In addition to water and other beverages, foods that supply potassium that is key to the body's health, moreso in hot weather, include bananas, canteloupe, strawberries, potatoes, chard, spinach, and lentils. To make water-drinking more appealing, try adding sliced lemons and limes to a pitcher of water, or a few slices of cucumber, or perhaps whole strawberries and a mint leaf. 


It's epidemic . . .

The incidence of falling in the aging population has risen alarmingly, with increased need for emergency and acute care, and often with significant long-term implications. This does not mean that having a fall is inevitable, but rather it reminds us to be mindful of risks, circumstances, and how these things may apply to one's circumstances.

Why is this of concern to the extent of being called an epidemic? One potential result of a fall is fracture of bone(s). Fractures often require lengthy healing time with limited mobility; limited mobility can result in blood clots, most often in the leg. Clots become of concern because when they break loose, the result may be heart attack or stroke. In addition to immobility from fractures, the healing time often involves limitations in self-care in normal daily living. Another result of falls can be internal bleeding, commonly seen in the brain; a slowly leaking brain injury may cause symptoms some weeks after a fall. A fall that does not cause any of these results may still change strength and flexibility, limit independence, and increase likelihood of recurrent falls.

There are those persons who have fallen, even to the extent of “head over heels” falling down a long flight of stairs, and stated boldly “I am perfectly fine, didn't hurt a thing, I don't need to go to the doctor.” More often than not, that individual will begin feeling aches and pains several days after such a fall; the pain may increase to the extent that a visit to the clinic is in order. . . and it is at that point xrays are finally done, to rule out or to rule in, fractures, even 'hairline' fractures. It is to the person's benefit to visit an MD soon after a fall to make sure nothing is seriously injured. But certainly emergency care is needed if/when there is an obviously-distorted arm or leg, or if one is unable to walk or bear weight. Bones become brittle with age, with the spine being a likely location for injuries from falls, and a spinal exam can be of great significance. Delayed treatment can have permanent consequences.

The causes of falls can be attributed to change in balance making it challenging to walk safely, certain medications may cause instability with walking or general dizziness, visual changes especially a change in accuity of depth perception, and unsafe footwear. It's worth considering alternatives to minimize the risks.

Consider these adaptations that may lessen the chance of falling:

  • Use handrails on all stairs; install handrails if they are not currently in place.
  • Use night lights in bedroom, hallway, bathrooms.
  • Remove all scatter rugs permanently.
  • Wear supportive footwear.
  • Use grab-bars in the bathroom.
  • Be especially cautious getting in and out of bathtub or shower.
  • Keep cellphone within arm's reach at all times; have several extensions in your home if you use a landline.
  • Consider a personal alert alarm system, such as the one advertized as “I've fallen and I can't get up;” some of those systems include GPS technology.It's epidemic . . .



Perhaps you read the article in the Star Tribune of April 23, 2017 by Gail Rosenblum
“Tackling a once taboo topic.” It is the first in a series of three articles addressing end of life issues, with information on how people are approaching this topic in today's information climate. Let me suggest you read this series of articles.

Every major healthcare provider group in Minnesota has encouraged such preparation of documents over the past five or six years. Perhaps you noticed the promotion on Twin Cities Public television around Thanksgiving and Christmas, called “The Convenings.” This program was hosted by Cathy Wurzer, describing how to conduct this sort of discussion with families, as we generally gather (convene) at holiday time. Certain individuals have said “I leave all that up to my doctor, I trust him/her totally.” Except, be mindful that the physician's practice is focused on cure and healing . . . in almost all circumstances. Additional resources for information may be a medical social worker at your healthcare clinic who is equipped to navigate the options for care on your behalf. An attorney and/or a financial advisor may also assist in creating such end of life documents, as well the legal aspects of property and finance. Pastors and parish nurse may also be good resources on how and when to prepare spiritually and physically for the end of life.

There is a broad spectrum of circumstances that may prompt discussions with those closest to you. While many assume this is a topic of conversation for later in life, there are those who have chosen to be proactive at a younger age due to frequent extensive travel in parts of the world with different medical services available. There are those who enjoy sports that present a degree of risk of serious injury who wish to plan for the “what if” circumstances. Motor vehicle accidents can involve much traumatic injury, which is more common in young adults. Morbid? Perhaps so, but consider creating a legal document that clarifies personal wishes. If the person who is injured is a minor, there may be questions of role of custodial and non-custodial parents; for individuals who are single with no next of kin nearby, it is recommended to appoint an agent for end of life decisions; furthermore, if one's next of kin is unable to make decisions, it is recommended that a trusted friend be identified to make legal decisions.

Talking about it does not make it happen. Talking about it does give everyone an opportunity to discuss healthcare options, quality of life, and other things that are important to you. This brings up the question of whether these decisions can be changed over time. Yes, they can. The documents related to end of life decisions are signed and notarized. It is recommended that these documents be amended and changed when either you or your designated agent for medical decisions experiences a new diagnosis or change in status of a chronic condition, if there is a divorce in the family that would impact which family members can speak for you, if an agent should pass away or even move a great distance away, or when there is a significan health or social status change for you or your designated agent.

There is no cost to you for completing these documents that are available from your healthcare clinic or online at www.honoringchoices.org. It is recommended that you provide a copy to your physician to have them included into your medical records. Copies should also be provided for your agent, for your immediate family, and perhaps for your attorney.

Because of the close relationship between Lutheran Church of the Good Shepherd and Fairview Healthcare, there is initial and ongoing training for our parish nurse at Fairview. The information and forms are standardized for all healthcare providers and recommended by the MN Department of Health. There are many other resources to assist in making these decisions; MN Agency on Aging has an extensive roster of information: 800-333-2433. It is recommended that this discussion, and these decisions, be made well in advance of a health crisis. . . .as the title here says “talking about it doesn't make it happen.”