Anesthesia Linked to Dementia Risk in Seniors
It may not be dementia. It may be a reaction to a medication in the elderly that LOOKS like dementia.
My father was 87, and doing pretty well for a man 87. He still walked on his own, using a walker when he had to, and very rarely, a wheelchair if we were going a long ways. He went into the hospital for a minor surgery. The tube inserted in his hand for the anesthetic became infected. Dad was acting weird, he was having hallucinations, and my sister rightly identified that Dad had a reaction to the diuretic drug Lasix; when they switched him to an alternative, the raving and hallucinations stopped.
He was transferred to a rehabilitation unit, where for two days, they put him back on Lasix. Poor communication between hospital and the rehab facility, plus standardization of drug regimens – they switched him without telling him, or us. Once again, he went loony tunes, and at the same time, his right hand began to swell until it looked like a lobster claw. He kept saying it hurt, and it was big and red, and the rehab people kept saying it would get better.
Dad was rushed to another hospital, one the rehab clinic worked with, and the doctors told us he had a ‘cascade of problems’ and which were the primary three we wanted them to work with?
Get him off the Lasix, first thing, we all agreed, and find a way to have it annotated on any record that he is never to have Lasix. (It did no good; the next hospitalization, back at the first hospital, they gave him Lasix again, which made him crazy and masked all the other symptoms.)
Long story short, there were a cascade of hospital mistakes – not one hospital, two hospitals and the rehab clinic – where miscommunications, inattentions and shortage of trained personnel resulted in a cascade of issues that led to my father’s death later that year. The other lesson learned is that if you go into a hospital, make sure you have a good support system, someone with you who will bravely ask questions, and remind someone if an inappropriate medication is prescribed. You need a family member with you for protection against inattention, mistakes, miscommunications and personnel shortages.
It’s not like there’s anyone to bring a lawsuit against; they were all doing the best they could, but Dad was old. My bet is that he might have lived another couple years, at the very least, had he not gone in for that first non-essential minor surgery. To me, the moral of the story is if you want to live a long life, stay away from hospitals.
Anesthesia Linked to Increased Dementia Risk in Seniors
Exposure to anesthesia has been linked to a 35 percent increase of dementia in patients over age 65, according to a new study.
By Jeffrey Kopman, Everyday Health Staff Writer
FRIDAY, May 31, 2013 — Caregivers and seniors struggling with the dilemmas of elder care have another risk to weigh against potential rewards — senior patients exposed to general anesthesia face an increased risk of dementia, according to research presented at Euroanaesthesia, the annual congress of the European Society of Anaesthesiology (ESA).
Researchers reviewed the medical information of 9,294 French patients over the age of 65. The patients were interviewed several times over a ten year period to determine their cognitive status.
After two years, 33 percent of participants had been exposed to anesthesia. Most of the exposed patients (19 percent overall) were exposed to general anesthesia — a medically induced coma. The rest were exposed to local/locoregional — any technique to relieve pain in the body — anesthesia.
In total, 632 participants developed dementia eight years after the study began. A majority of these patients, 512, were diagnosed with probable or possible Alzheimer’s disease. The remainder had non-Alzheimer’s dementia.
The gap between dementia related to general anesthesia (22 percent) and non-dementia patients (19 percent) was associated with a 35 percent increased risk of developing dementia. This risk was linked to at least one general anesthesia.
“Elderly patients are at an increased risk for complications following anesthesia and surgery,” said Jeffrey H. Silverstein, MD, MS, and vice chair for research at the Department of Anesthesiology at Mount Sinai in New York City. “[They] are particularly prone to postoperative delirium, which is a loss of orientation and attention. Anesthesiologists have been evaluating higher cognitive functions (for example, memory and executive processing) and found that a substantial number have decreases in one or more of these areas after a surgical procedure.”
Researchers hope this study will lead to more awareness for surgeons.
“Recognition of postoperative cognitive dysfunction (POCD) is essential in the perioperative management of elderly patients,” said study author Dr. Francois Sztark, INSERM and University of Bordeaux, France, in a press release. “A long-term follow-up of these patients should be planned.”
Elderly Care: Risk vs. Reward
Senior citizens and their caregivers might be willing to accept an increased risk of dementia if it means getting necessary anesthesia for an important medical procedure. Dementia is a relatively common occurrence in old age: One in three seniors has Alzheimer’s disease or dementia by the time of their death.
But surgery at old age can also carry more severe, and less common, health risks. In fact, simply surviving surgery can be difficult for elderly patients, especially those over the age of 80.
While the numbers vary depending on procedure, researchers have found that mortality risk tied to elective major surgeries increases with age. The risk more than doubles for patients over 80 compared to patients ages 65 to 69.
But other surgery complications are even more common in seniors.
“The major risk for elderly patients following surgery is pneumonia,” said Dr. Silverstein. “Cardiac complications are next most common.”
However, Dr. Silverstein still feels that if surgery is deemed necessary, patients should not fear the risks.
“In theory, only necessary surgery is done,” he said. “Knowing how [patients] reacted to anesthesia and surgery in the past may give them some idea of their postoperative course.”
Last Updated: 05/31/2013
It’s Why We’re Here: Lunch at Taco Rock
There is a graciousness in Pensacola that reminds me of life in the Middle East, although the local Pensacolians would be astounded to be compared with the Middle East. If you look closely, though, you can see the similarities.
There is politeness and civility toward others, even strangers. When workmen are in your home, you offer them ice water, or iced tea, and you ask about their families before they start work. It seems to us that when we call for help, we get the same service people coming to our house; I don’t think it is an accident.
People chat a little before they get down to business. I think many a Pensacolian would feel comfortable in the souks, sitting and drinking a little tea before they start to discuss the appropriate price level for the bauble they are considering. They ask about a person’s health, and they ask about your family. They take meals to those who are suffering or recovering.
People spend time with family. Families go to church together, families have meals together, families share child rearing. Multi-generations live near one another. People who went to school together more than fifty years ago form their own kind of family, sharing deeply, attending the funerals of one another’s kin. Funerals are well attended. Very Arab, if only they knew.
There are pockets in the United States where you find groups of Arab nationals; Pensacola has these groups, even a discreet mosque or two. There are stores selling international supplies, including zaat’r and sumak and harissa, chana dal, bulger, wuhammara . . . and restaurants billing themselves as ‘Mediterannean’ whose food would be recognizable to those in the Levant and the Gulf.
There is almost always a breeze off the Gulf to fight the heat and humidity and mosquitoes, and, by the grace of God, there is air conditioning and ice water coming out of the refrigerators. Life is sweet.
Life is all the sweeter because we can get together with our son and his family on the spur of the moment, and end up at a great family place like Taco Rock, where our little grandson can get down when he gets restless, and where there is plenty of time for us to chat, discuss Django Unchained, discuss new developments in entertainment technology, discuss upcoming vacations and arrangements – there is that great luxury of time together, and tasty food at reasonable prices. LOL, this is the Pensacola equivalent of a Michelin Red R, good local cuisine at reasonable prices. Hmmmm, Mexican is probably not qualified as good local food at reasonable prices, but close enough . . .
He is such a delight, our little grandson, who calls the coming baby “that little girl,” as in “when that little girl comes, I’m going to teach her how to float on her back!”
This week, there is another parade! Pensacola must be the parade capital of the world; so many parades! We’ll pick up our grandson, stand on the corner and wave our arms until they throw us some beads. Great fun and good exercise. 🙂
This post is really a great excuse to post some new photos of our grandson 🙂
Making Idols
A confluence of events happened at a period in my life when I was paying attention, and those things coming together have influenced me enormously. The first was participation in a bible study conducted in a branch of Christianity not my own, whose dogma is occasionally repellant and repugnant to me, but whose study of the chapter in the bible is thorough. The second was my move back to the Islamic world, and my choice to study Arabic at the Qatar Center for the Presentation of Islam.
In both cases, what I learned is that we have more in common than we have differences. I also learned that if we focus on the differences, it can be devastating.
Both groups know the Bible. My Moslem sisters knew the bible better than I did, and when discussing such issues as covering hair and wearing abaya, could quote me verses from my own book which re-inforced their argument. It was mortifying – and edifying.
My Baptist friends also surprise me. For every one who rails against gay marriage or ordination of women, there was another who would laugh and quote scripture saying “did you notice the same penalty for a woman who cuts her hair? or wears pants in public?” I learned a lot about my own religion, my own beliefs, and the goodness of others by my interactions with both these groups.
One of the differences in the Moslem world was that many houses I went into (I was honored to be invited into their homes) were very plain. The furniture might be basic or elaborate, but often, the walls were bare. Maybe there might be a calligraphy with a Quranic verse on the wall – that was it. No paintings, especially no human figures – no idols, no images.
In my house, I am surrounded by images, photos, paintings, weavings – they give me joy, but I do not worship them. They are not idols, they are merely art or family – things that make me smile. I distinguish between idols and gods. Yesterday’s reading from Deuteronomy sticks with me, however, and I can hear my sweet teachers at QCPI saying to me “But doesn’t it say in Deuteronomy 4 that you are to have no idols?”
Deuteronomy 4:25-31
25 When you have had children and children’s children, and become complacent in the land, if you act corruptly by making an idol in the form of anything, thus doing what is evil in the sight of the Lord your God, and provoking him to anger, 26I call heaven and earth to witness against you today that you will soon utterly perish from the land that you are crossing the Jordan to occupy; you will not live long on it, but will be utterly destroyed.
27The Lord will scatter you among the peoples; only a few of you will be left among the nations where the Lord will lead you. 28There you will serve other gods made by human hands, objects of wood and stone that neither see, nor hear, nor eat, nor smell. 29From there you will seek the Lord your God, and you will find him if you search after him with all your heart and soul. 30In your distress, when all these things have happened to you in time to come, you will return to the Lord your God and heed him. 31Because the Lord your God is a merciful God, he will neither abandon you nor destroy you; he will not forget the covenant with your ancestors that he swore to them.
The Lord Laughs at the Wicked
When I start to fret about those in high places who oppress the poor and the workers, whose lives are so far from worrying about a roof over their head and food to eat that they will pass still laws further oppressing the poor and homeless, I take consolation in this psalm.
The Pensacola City Council is passing a draconian measure against the homeless. I’ve been so proud of Pensacola, and the citizen response to the homeless, the beds Pensacola provides, the meals the citizens, through a variety of church and social agencies, hand out. Their response is humane, and compassionate.
The homeless are attracted by the moderate climate; they are here in droves. They panhandle at the intersections, they approach you at downtown attractions. They often have dogs. For the most part, they greet people cheerfully or respectfully, and they aren’t aggressive.
They are, in truth, a kind of plague on Pensacola, but as a traveler, I have brushed my teeth in many a restroom, changed my clothes, even had to rise out a coffee stained outfit before my next flight once – these are things for which the homeless will be charged with an offense against the law. If I were without a place for the night, I might look for a safe public restroom in which to sleep, especially if I had a child with me, as so many women did when I worked with homeless women.
I understand the problem.
But I also understand the desperation of those who have little, and that very little – a public restroom, a safe place to sleep outdoors – are being taken away from them by this statute. It’s heartless, and if there is truly an accounting at the end of our lives, and an afterlife, I fear for those who put additional burdens on the poorest of the poor.
Psalm 37
Of David.
1 Do not fret because of the wicked;
do not be envious of wrongdoers,
2 for they will soon fade like the grass,
and wither like the green herb.
3 Trust in the Lord, and do good;
so you will live in the land, and enjoy security.
4 Take delight in the Lord,
and he will give you the desires of your heart.
5 Commit your way to the Lord;
trust in him, and he will act.
6 He will make your vindication shine like the light,
and the justice of your cause like the noonday.
7 Be still before the Lord, and wait patiently for him;
do not fret over those who prosper in their way,
over those who carry out evil devices.
8 Refrain from anger, and forsake wrath.
Do not fret—it leads only to evil.
9 For the wicked shall be cut off,
but those who wait for the Lord shall inherit the land.
10 Yet a little while, and the wicked will be no more;
though you look diligently for their place, they will not be there.
11 But the meek shall inherit the land,
and delight in abundant prosperity.
12 The wicked plot against the righteous,
and gnash their teeth at them;
13 but the Lord laughs at the wicked,
for he sees that their day is coming.
14 The wicked draw the sword and bend their bows
to bring down the poor and needy,
to kill those who walk uprightly;
15 their sword shall enter their own heart,
and their bows shall be broken.
16 Better is a little that the righteous person has
than the abundance of many wicked.
17 For the arms of the wicked shall be broken,
but the Lord upholds the righteous.
18 The Lord knows the days of the blameless,
and their heritage will abide for ever;
19 they are not put to shame in evil times,
in the days of famine they have abundance.
20 But the wicked perish,
and the enemies of the Lord are like the glory of the pastures;
they vanish—like smoke they vanish away.
21 The wicked borrow, and do not pay back,
but the righteous are generous and keep giving;
22 for those blessed by the Lord shall inherit the land,
but those cursed by him shall be cut off.
23 Our steps* are made firm by the Lord,
when he delights in our* way;
24 though we stumble,* we* shall not fall headlong,
for the Lord holds us* by the hand.
25 I have been young, and now am old,
yet I have not seen the righteous forsaken
or their children begging bread.
26 They are ever giving liberally and lending,
and their children become a blessing.
27 Depart from evil, and do good;
so you shall abide for ever.
28 For the Lord loves justice;
he will not forsake his faithful ones.
The righteous shall be kept safe for ever,
but the children of the wicked shall be cut off.
29 The righteous shall inherit the land,
and live in it for ever.
30 The mouths of the righteous utter wisdom,
and their tongues speak justice.
31 The law of their God is in their hearts;
their steps do not slip.
32 The wicked watch for the righteous,
and seek to kill them.
33 The Lord will not abandon them to their power,
or let them be condemned when they are brought to trial.
34 Wait for the Lord, and keep to his way,
and he will exalt you to inherit the land;
you will look on the destruction of the wicked.
35 I have seen the wicked oppressing,
and towering like a cedar of Lebanon.*
36 Again I* passed by, and they were no more;
though I sought them, they could not be found.
37 Mark the blameless, and behold the upright,
for there is posterity for the peaceable.
38 But transgressors shall be altogether destroyed;
the posterity of the wicked shall be cut off.
39 The salvation of the righteous is from the Lord;
he is their refuge in the time of trouble.
40 The Lord helps them and rescues them;
he rescues them from the wicked, and saves them,
because they take refuge in him.
“We Must Meet One Another Doing Good”
Woooo HOOOOO! I like this new Pope Francis! He takes on religious dogma and shatters all assumptions. Yes, Jesus died for us ALL! Even us non-Catholics? Even atheists? Yes, says Pope Francis, emphatically yes. “Do good and we will find a meeting point.”
Pope Francis rocked some religious and atheist minds today when he declared that everyone was redeemed through Jesus, including atheists.
During his homily at Wednesday Mass in Rome, Francis emphasized the importance of “doing good” as a principle that unites all humanity, and a “culture of encounter” to support peace.
Using scripture from the Gospel of Mark, Francis explained how upset Jesus’ disciples were that someone outside their group was doing good, according to a report from Vatican Radio.
“They complain,” the Pope said in his homily, because they say, “If he is not one of us, he cannot do good. If he is not of our party, he cannot do good.” And Jesus corrects them: “Do not hinder him, he says, let him do good.” The disciples, Pope Francis explains, “were a little intolerant,” closed off by the idea of possessing the truth, convinced that “those who do not have the truth, cannot do good.” “This was wrong . . . Jesus broadens the horizon.” Pope Francis said, “The root of this possibility of doing good – that we all have – is in creation”
Pope Francis went further in his sermon to say:
“The Lord created us in His image and likeness, and we are the image of the Lord, and He does good and all of us have this commandment at heart: do good and do not do evil. All of us. ‘But, Father, this is not Catholic! He cannot do good.’ Yes, he can… “The Lord has redeemed all of us, all of us, with the Blood of Christ: all of us, not just Catholics. Everyone! ‘Father, the atheists?’ Even the atheists. Everyone!”.. We must meet one another doing good. ‘But I don’t believe, Father, I am an atheist!’ But do good: we will meet one another there.”
Responding to the leader of the Roman Catholic church’s homily, Father James Martin, S.J. wrote in an email to The Huffington Post:
“Pope Francis is saying, more clearly than ever before, that Christ offered himself as a sacrifice for everyone. That’s always been a Christian belief. You can find St. Paul saying in the First Letter to Timothy that Jesus gave himself as a “ransom for all.” But rarely do you hear it said by Catholics so forcefully, and with such evident joy. And in this era of religious controversies, it’s a timely reminder that God cannot be confined to our narrow categories.”
Of course, not all Christians believe that those who don’t believe will be redeemed, and the Pope’s words may spark memories of the deep divisions from the Protestant reformation over the belief in redemption through grace versus redemption through works.
The pope’s comment has also struck a chord on Reddit, where it is the second most-shared piece.
More from Reuters:
Atheists should be seen as good people if they do good, Pope Francis said on Wednesday in his latest urging that people of all religions – or no religion – work together.
The leader of the world’s 1.2 billion Roman Catholics made his comments in the homily of his morning Mass in his residence, a daily event where he speaks without prepared comments.
He told the story of a Catholic who asked a priest if even atheists had been redeemed by Jesus.
“Even them, everyone,” the pope answered, according to Vatican Radio. “We all have the duty to do good,” he said.
“Just do good and we’ll find a meeting point,” the pope said in a hypothetical conversation in which someone told a priest: “But I don’t believe. I’m an atheist.”
Francis’s reaching out to atheists and people who belong to no religion is a marked contrast to the attitude of former Pope Benedict, who sometimes left non-Catholics feeling that he saw them as second-class believers.
Island Kitchen in Pensacola
“I think this is what MaMa might fix for us if we lived in Jamaica,” I said to AdventureMan as our meals were delivered at the Island Kitchen. We’ve passed Island Kitchen a hundred times, and many of those times AdventureMan has said one of these days he’d like to give it a try. This was the day.
There were other Islanders eating there – one eating oxtail and another eating goat curry. It looks like a lively place on the weekends, when expats come to eat food from home and listen to Island music.
I ordered the Jamaican Tea; it was delicious. I thought it was ginger, but the server said no, it was an herbal tea.
We ordered at the counter – so many options, and a set of choices unlike any other restaurant in Pensacola. Our orders were the special-of-the-day, AdventureMan ordered the Chicken With Brown Sauce and I ordered the Chicken Curry.
It was down-home chow. It was food like Grandmama would serve, if Grandmama were Caribbean. There are other options – Oxtail. Goat Curry. Beef Pasties. Everything looked well prepared, wholesome, and copious.
Still hoping for an Ethiopian restaurant in Pensacola . . . 🙂
Rovaer Norway: The Best Wedding Proposal Ever
The groom-to-be was able to rope the entire village into participating in his proposal to his girlfriend. He knocks her socks off – no matter what the highs and lows of the marriage to come, she will never forget this proposal:
Hilarious Abercrombie & Fitch Homeless Campaign
Scour your closets, donate your Abercrombie & Fitch clothing to the homeless 🙂
Bloggers Create Freedom Friday in Oppressed Eritrea
I heard whispers of this on National Public Radio, and found this write up on The International Business Times website. The message is simple – in a country where even a glance can be interpreted as treason, express your non-support of the government by STAYING AT HOME ON FRIDAY, the day Ethiopians usually go out and visit with friends, gather together and mingle. Ghandi would smile; this is civil expression at it’s most civil 🙂
Let the empty streets speak for you. LOL @ a tyrant making staying at home a crime against the government!
Eritrean bloggers outside of Ethiopia started it, smuggling an old Eritrean phone book out of the country and making calls to acquaintances – and strangers – in Eritrea. People didn’t even have to respond. they could just listen . . . then they developed a robo-call to help them enlarge the number they could reach.
Eritrea is considered one of the continent’s most opaque countries. National elections have not been held in the Horn of Africa country since it gained independence in 1993. Torture, arbitrary detention and severe restrictions on freedom of expression remain routine.
President Isaias Afwerki does not tolerate any independent media, the internet is strictly controlled and Reporters without Borders recently named it 179th out of 179 countries for freedom of expression.
It is illegal to criticise the government, prompting the Eritrean diaspora to set up a campaign to reverse the Arab-style call to take to the streets every Friday by emptying the streets in protest.
“We made phone calls from diaspora to Eritrea,” Meron Estefanos toldIBTimes UK. “We have a phone catalogue and called random numbers every Friday, telling them to stay at home and think about problems in our country.”
The phone calls “give them [Eritreans within the country] an opportunity to protest without risking too much”, according to Freedom Friday’s coordinator in the UK Selam Kidane.
The activists turned to a computerised auto-dialer called robocall to spread hundreds of thousands of taped messages to Eritrean phones. “It is time to restore our liberty and dignity” messages were sent automatically.
In another message, the mother of renowned political prisoner Aster Yohannes recalls the fate of her daughter, who was arrested in 2003 and has disappeared.
After two years, the movement is finally gaining momentum inside the country.
“Now they trust us inside the country, we have our team in Eritrea that puts out posters and leaflets late at night,” Estefanos said.
“The plan now that we have their trust is asking them to go out and demonstrate.”
About 1,500 Eritreans leave their country every month, according to the United Nations, paying up to 30,000 euros ($39,500) each to seek a new life free of grinding poverty and repression.
Earlier this year, Amnesty International put the spotlight on Eritrean asylum-seekers who are kidnapped from Sudanese refugee camps by the local Rashaida tribe, sold to Bedouin criminals in Egypt’s Sinai peninsula and severely abused while they are held for ransom.
One thousand refugees are held captive in the Sinai, according to reports. About 7,000 people in total may have been tortured and 4,000 may have died as a result of the people-trafficking in humans from 2009 to October 2012, according to recent data. A total of 3,000 people disappeared from 2007-11.





















