No Regrets & Update

Have you ever heard yourself or someone else say he/she wished they had been in contact with someone before it was too late?

This past weekend, Solange, my friend and Scrabble-playing partner, who resided here in the mill apartments, passed away. While her death was not totally unexpected because of health issues, it was still a shock. We had spoken a few days earlier to schedule our next game, she told me she was feeling too tired to play. As she often had these days in recent weeks, I told her I would call again in a day or two. She was a fierce Scrabble player who disliked losing and would always ask to play another game. We often split our wins and always shared a treat.

When her son phoned on Saturday, I instinctively knew that the call was not a good one.

Solange was 95 years young, born in Antwerp, Belgium and a Holocaust survivor. She was a registered nurse who later relocated to the US with her late artist husband and they lived in many cities in our home state of NJ. Coincidentally, their last NJ address was close to our last NJ address, although we had never met there. She relocated to NH after her husband's passing to be closer to her son who lived in the state.

Solange became a close friend of both myself and my husband. Patrick. We enjoyed food and conversations through shared dinners at our apartment homes. The most recent was at our home on Easter when she and another resident joined us for dinner. She insisted on bringing a homemade banana tart, which was delicious, even the leftovers.

Private services were held quickly in NJ early this week in keeping with her faith. We were unable to attend; however, I asked her son about holding a celebration of life here at a later date. Her family will be returning to clear out her residence.

This isn't the first time a family member or friend has passed and as sad as it's always been, my goal is to never have regrets about not having called, visited or written. Of course, we all have regrets for many things, but for myself keeping in touch means having a few less.

Thanks to fellow bloggers who asked about the status of my left knee injury, 

Here's an update following an orthopedics consultation and my first physical therapy session. The good news is that the orthopedic review showed the knee structure are intact with a mild degree of arthritis and a mild kneecap dislocation, without any significant tissue damage. Recovery (no pain) could take 6-8 weeks.

My nemesis: Elliptical 

The physical therapy appointment included an evaluation and balance testing and confirmation that my balance could be improved, the lack of which can be attributable to age. For the record, the knee injury wasn't caused by a fall, as I am always careful to avoid hazards as much as possible, particularly snow and ice. Instead, my injury was caused by exercise, specifically the use of an elliptical, stationary equipment in the Clocktower gym. 

As I've learned, repetitive motion on an elliptical can lead to overuse injuries, especially in the knees or hips. Also, the elliptical's motion has been labelled awkward or unnatural, potentially leading to improper form or discomfort. 

If not appropriately positioned using the elliptical, a user could strain their knees — as I did. Also, the low-impact design of this machine often leads to overuse injuries in the knee and hip as users tend not to realize they're doing more than they’re physically able — and that would describe my actions. And, when the orthopedic PA (physician's assistant) shared that she never uses this equipment, I thought, why did I ?

My PT assessment concluded that no brace or walking assistance (cane, walker) are needed. However, I received a set of at-home exercises to perform before the next appointment later this week. Yes, I've been doing them them as this will be the routine for up to 10 weeks

Which do you think results in death more often — hip fracture or cancer?

That's what the PT therapist asked me and, while I had not read any statistics beforehand, I knew that given my age the correct answer would be hip fracture.

While cancer is a leading cause of death at any age, hip fractures can have a higher mortality rate for older adults in the short-term. Being cancer-free may not result in death, but breaking your hip could be fatal. 

Studies have indicated that the one-year mortality rate for older adults with a hip fracture can be over 20% and sometimes worse than those with various types of cancer. Also, the risk of death after a hip fracture can persist for up to 10 years after a fracture.

Why are hip fractures so deadly?

It's due to many factors including immobility-related complications, surgical risks and the overall impact on health and quality of life. One of the most serious risks is the increased likelihood of developing blood clots, leading to pulmonary embolisms or strokes. 

Sometimes, recovery can be long and challenging and can also lead to less independence. Other potential health risks include pneumonia, heart failure or blood clots, any one of which can increase the risk of death. Female patients tended to have better post-fracture survival than men, but had a significantly higher risk for getting a fracture. Unfortunately, people over age 85 had the worst odds for survival.

It's important to note that statistics for hip fracture deaths do not apply are not a one-fits-all scenario. It's not just age that's a factor, but gender, pre-existing conditions like cardiac disease, dementia and chronic respiratory issues, plus the timeliness and quality of surgical treatment — all can impact mortality rates. While a 1-year mortality of about 21 to 22% has been cited in online sources for surgically-repaired hip fractures, this is only an average.

Just to be clear — Hip replacement does not result in as many deaths as hip fractures. While this surgery does have certain risks, it's usually much lower than the mortality rate associated with hip fractures, especially in the initial months after the fracture. Several people I know, including fellow bloggers, had successful operations and recovery from hip fractures.

Exercises to improve my balance

Balance decline in adults of (ahem) a certain age isn't uncommon, so I'm not alone. Lack of balance can lead to increased risk of falls and possible fractures. Aging brings a loss of muscle mass and strength, especially in the legs and core, making it harder to maintain balance. While I've been fortunate not to have a serious fall, not taking chances is my goal. 

The balance and strengthening exercise I've been assigned to do at home do not require specialized equipment. All that's needed is a chair and who doesn't have that equipment at home and resistance band provided by the PT therapist, but which can also be bought online. Since I'm not planning to become a statistic anytime soon, these are being done on a daily basis. 

Fall detection (not fall protection) is why I wear an Apple watch  as I often go walking alone. This device will automatically call emergency services if someone becomes immobile after a hard fall and send a message with the location to emergency contacts. Apple is not the only fitness tracker with fall detention, brands by Samsung, Garmin and Goggle also have this important feature.

If anyone is interested in more information, The National Institute on Aging website has helpful information here Older Adults and Balance Problems. 

Going Slowly This Week

Internet source

That's what I've been doing this week, usually sitting down with my left leg elevated as much as possible.

What happened? Thanks for asking, but of course, I would have shared anyway.

The truth is that I'm not exactly sure but hoping that it is a possible muscle issue in that leg. This is the first time that I've experienced anything like this, so I have no thoughts on how. While there's no pain, an area to the side of my left knee is sensitive (tender) when pressed in one area.

The cause? Yet to be determined and, later today, I have an appointment with our medical professional, a nurse practitioner. After phoning for an appointment this week, the triage nurse recommended using an ice pack for 20 minutes on and 20 minutes off and also to take ibuprofen.

Like myself, maybe you have been curious about this 20 on and 20 off regimen. If you are already knowledgeable, than read no further.

Why 20 minutes?

Applying ice for 20 minutes can reduce inflammation and pain by constricting blood vessels. It's important to allow at least 20-30 minutes between icings as longer is not necessarily better but can be detrimental. 

Too Much of a Good Thing ?

When it comes to icing an injury thinking that longer icing could be better is counterproductive and even harmful as it can lead to what's called reactive vasodilation. If you're not familiar with those words, me too. It refers to the widening of blood vessels, which can reverse the benefits of icing causing possible tissue damage or ice burns. Also, too much cold can restrict blood flow, potentially slowing down the healing process. 

What caused my discomfort?

Treadmills at Clocktower Place

I've used that term because I really am not sure what caused this knee issue.  It's possible that my over-attention fanaticism in making a daily step count was the cause, however unlikely that seems to me. 

Most days, it wasn't about completing 10,000 steps, more like 12-13,000 steps. More than half the steps were usually done using the treadmill or elliptical in the mill building's health club when the weather has been nasty. The in-house gym here is convenient on days when driving to a gym would be an excuse not to go; it takes under 4 minutes to walk there. And, as we live downtown, excursions to the library, post office and other places are always walked.

It's also possible to walk the apt hallways in the apartment building, the third or main floor is  an estimated 1/4 mile, end-to-end. Some residents walk it several times rather than using the gym facilities, which require a monthly $25 fee. 

Equipment in the Health Club facility at Clocktower Place

There are actually three equipment rooms/gyms in the health club here, as well as a pool, whirlpool, showers, changing rooms and sauna. It's unusual for a former mill building, not many area apartments offer have similar facilities.

Where did the 10,000 step-a-day standard originate ?

Couldn't locate an English version

I mentioned a 10,000 step routine, which most likely many of you know about. It's become the default for many walkers, myself included.

Did you know that its creation was partly due to the 1964 Tokyo Olympics? These games brought renewed focus on physical activity and healthy living. A Japanese research team led by Dr Yoshiro Hatano, professor at the Kyushu University of Health and Welfare, began to worry about the rise in obesity in Japan.

Enter the Yamasa company in Tokyo, Japan (internationally known as Yamax) which in 1965 created a pedometer called Manpo-kei which translates to the 10,000 steps meter believed to be the amount of physical activity sufficient to decrease the risk of coronary heart disease. 

The company used the slogan Let's walk 10,000 steps a day! as part of a marketing campaign. It soon became the mantra of Japanese walking clubs and Manpo-kei was the minimum they were expected to walk. In time, this concept spread to health conscious walkers worldwide. Essentially, the 10,000-step goal was based on marketing. Despite its start, the 10,000-step goal was adopted globally as people around the world adopted it as a fitness target. 

Is walking 10,000 steps a day helpful ?

The Manpo-kei concept is not a set requirement. Many recent studies including by Harvard Health have shown that even fewer steps can provide health benefits. Some studies have suggested that regularly walking just  4,000 to 6,000 steps a day can result in improved health. It's more important to set a target which meets individual needs for a person to commit to staying motivated for the long run. 

Currently, activity trackers, also known as fitness trackers on wearable technology and cell phones are the modern equivalent of pedometers. Most do far more than count steps. Activity trackers can determine how far you've traveled and the type of movement such as jogging or swimming.

Pedometers go way back

Early pedometer sketch by da Vinci

Surprisingly (to me) Leonardo da Vinci who has been credited with so many things is also credited with inventing the first mechanical step counter in the 15th century. It was worn at the waist, with a long lever arm tied to the thigh. When the thigh moved back and forth in walking, the gears rotated, activating gears to count the distance. 

Da Vinci envisioned this device as a tool for military purposes, specifically to track the distance covered by soldiers and aid in laying out encampments. While this pedometer design was never realized in his time, it represented an early conceptualization of a device that later evolved into the modern pedometer which still serve the same purpose of tracking steps and distance

In the 1700s, Thomas Jefferson commissioned a step counter made by one of the top Parisian watch-makers. Worn in a vest pocket, it had a lever arm which was tied to a string that passed through a hole in the bottom of the vest pocket. The other end of the string was tied to a strap below the knee, walking caused it to pull on a lever arm attached to gears. Back then, there were big issues than closing activity rings, so Jefferson wasn't posting his daily activity anywhere. Proof is difficult to obtain as Jefferson didn't apply for patents on any of his inventions and I couldn't locate an online image.

Abraham-Louis Perrelet

In 1777, Abraham-Louis Perrelet, a Swiss-born horologist (watchmaker) invented a self- winding mechanism for pocket watches that used an oscillating weight inside the watch that moved up-and-down during walking. 

Then, in 1780, he invented a self-contained pedometer that also used a spring-suspended lever arm to measure steps and distance while walking. His invention it was based on the mechanism he created to power a self-winding watch.

The Japanese model came many years later, Perrelet is widely credited with inventing the first working pedometer.

While 10,000 steps a day originated as an arbitrary number for marketing purposes, there's significant evidence that walking affects both physical and mental well being. 

Of course, the number of steps walked daily can vary depending on age, fitness level and overall health. A research review found that the risk of death was lowest in people who walked 6,000 to 8,000 steps a day if they were over the age of 60 and 8,000 to 10,000 steps a day if they were under age 60. Research published in the Journal of the American Medical Association (JAMA) indicated that women who averaged 4,400 steps per day had a 41% lower mortality rate than sedentary women. 

Certainly, everyone is different in their goals. The important thing is that people can get better at walking and even faster and just starting is what really matters.

Just don't overdue it, like me. Until my medical evaluation and diagnosis is completed, my walking is on pause, hopefully not for too long, update to follow.

Medically Speaking

My blog posts usually are confined to posts about road adventures, family, occasional recipes, and a lot of funny sights, avoiding hot topics like politics, religion, current events.

Since we returned home from our recent travels abroad, there's been a fair amount of catching up to do — unpacking, household chores and some purging and drop-offs to local thrift stores.

That said, some of the most important things we've been doing involve healthcare.

Most fellow bloggers reading this post will already much about topics mentioned here, so there won't be a lot of medical info. Much more extensive information is available online. 

Also, the purpose of this post is not to persuade anyone to participate in any of the procedures or vaccinations mentioned herein. 

Those decisions are strictly your own, as they should be. Everyone should do what he/she feels most comfortable with for their own well being.

These medical procedures are what we've done in the past couple of weeks.

Screening mammogram: As any female can attest, this procedure can be uncomfortable 😟, but at least brief. After telling myself I was done with it since reaching age 74 this year, I reversed that decision. Many sources recommend screening mammograms every other year from ages 40 to 74. New guidelines do not include recommendations for women after age 74, as there is limited data on whether mammograms save lives in that age group. 

My re-thinking that previous decision was the result of losing two female friends, Linda and April, within the past four months. Both had been previously diagnosed with breast cancer, which returned and was especially aggressive for both. 

Prostate Exam: This is the male equivalent of an uncomfortable procedure (no details here). Grenville went for an exam this week. The American Cancer Society recommends men start cancer screenings at age 50. Screening is generally not recommended in men over 75 as potential benefits are outweighed by the risks in this population.

2023 is the first fall and winter virus season where vaccines are available for 3 viruses deemed responsible for most hospitalizations – COVID-19, RSV, flu.

RSV Vaccine: Respiratory syncytial virus (RSV) is a common respiratory virus that can cause mild, cold-like symptoms. While most people recover in a week or two, RSV can be serious especially for infants and older adults, more likely to develop severe symptoms that need hospitalization. 

There's no maximum age for getting an RSV vaccination. The Center for Disease Control (CDC) recommends adults 60 and older can receive a single dose of the vaccine. This will provide protection against RSV disease in adults 60 years and older for at least two winter seasons, when RSV normally circulates.

Updated Covid: Here we go again. The CDC recommends everyone 6 months and older get an updated COVID-19 vaccine to protect against potentially serious outbreaks this fall and winter. Updated vaccines from Pfizer-BioNTech and Moderna are available now in many retail pharmacies. In most cases there is no charge.

Returning from our recent trip abroad, several group members posted on a messaging app that they'd been infected with COVID symptoms, some more severe than others. Since we're traveling out of the country (again) in a few weeks having as much protection as possible is never a bad thing.

Flu Shot:  All persons aged 6 months of age and older, with rare exception, are recommended to get the annual influenza (flu) vaccination every season appropriate for their age and health status. September and October are the recommended best times for most to get vaccinated. More information can be found online at the CDC and other websites.

This week, I completed the RSV and COVID vaccinations and will get the flu shot within a couple of weeks. We have Medicare and supplemental medical insurance. There was no cost for any of these procedures or/vaccinations.

As stated earlier, every medical decision is a personal one to make yourself or with input from your medical professional. Personally, we hope that everyone stays healthy and takes advantage of all preventative measures available. (Our screening results were thankfully negative. The vaccines may produce soreness at the injection site, usually upper arm.)