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
Economy Class: The Worst of the Worst
LOL, I have flown a lot of miles, but I have never flown any of these airlines in the ‘Worst of the Worst.” We used to fly RyanAir when we lived in Germany, and if you know to expect nothing, you get what you expect :-). It’s a lot like Jazeera, only without reserved seats and without leather seats. Oh, and people shoving to get on; I guess it was pretty bad, but oh, it was so CHEAP! Awful, but the flights were short, so you just gut it out and get there.
This is from the Frequent Flier Crier:
Economy class is pretty bad, even at its best. And at it’s worst, it’s truly horrendous, a toxic mix of too-tight seats, rancid peanuts, and don’t-bother-me service.
So which airline’s coach class is the worst of the worst? Business Insider Australia set out to answer that question, using data compiled by airline reviewer Skytrax on such measures as seat comfort, inflight entertainment, meals, and inflight service.
Such perennial service underproviders as Spirit and RyanAir made the list, at 18th and 11th worst respectively, but the other contenders for the title of world’s worst airline will be mostly unfamiliar to U.S.-focused travelers.
The envelope, please …
1. Turkmenistan Airlines (rated 30.8 on a 100-points scale)
2. Sudan Airways (rated 33.3)
3. Ukraine International Airlines (rated 36.3)
4. Uzbekistan Airways (rated 37.5s)
5. Air Koryo (rated 39.2)
6. Bulgaria Air (rated 41.8)
7. Rossiya Airlines (rated 42.7)
8. Iceland Express (rated 42.8)
9. Tajik Air (rated 43.3)
10. Syrian Air (rated 44.8)
Regarding Turkmenistan, the report noted that “terrible rankings on Skytrax for in-flight entertainment, seat comfort, service efficiency, staff response to passenger requests, and staff language skills make it the worst airline you can find.”
So next time you’re tempted to dub Spirit or US Airways or Frontier the worst airline ever, find some solace in the fact that the flight could have been worse. Much worse. It could have been Turkmenistan bad.
Sunrise in Seattle: A Quick Trip
Oops!
Sorry! I intended to keep writing, but as it sometimes can, life just got away from me. I took a quick trip to Seattle to see my Mom on Mother’s Day, stayed with my best friend from college, ummm . . . when I count the number of years we have been friends, I am shocked!
Flying out of Pensacola, we flew over Bayou Texar:
I had a great seat, but the lady next to me sounded like she had terminal pneumonia, so I kept my face toward the window. Everything went smoothly, arrived a little early. Two hassles: I had decided for just a short trip I would use a shoulder bag/suitcase, and even though it was light, it gets heavy lugging it from gate to gate. On the good news side, it sure is a lot easier to travel with just cabin baggage, easy on – easy off.
Second, I just hate it that Seattle has relocated all the rental cars to an off-site location. The buses only stop at one end of the terminal or the other so again, there is a lot of lugging, whether it is wheeled or shoulder. You have no control over when the bus will come or when it will leave. It used to be so easy, just dropping the car off and walking directly into the terminal; now I have to calculate extra time for unknowns in the rental return process, oh aarrgh.
Traffic to north Seattle was horrible, even on a Saturday, it was like a normal work day when all the workers are streaming out of the city. On work days, there are windows when traffic is less, but a Saturday! Aarrgh!
It was not raining, or not much. That was a really good thing. Temperatures were lower than Pensacola. That was a good thing. We had a great Mother’s Day brunch, with my sisters and their hubbies, and Mom and I did some shopping. The next day, more errands and catching up on banking and bureaucracies. Those were all good things.
My good friend and I had time to catch up and – as we are wont to do – analyze and strategize. We spent a good amount of time laughing at ourselves and our dilemmas. We laughed at the problems of aging. We laughed at who we thought we would be (who ever thinks they will get old??) and who we have become. Here is what sunrise over Lake Washington looks like from my friend’s house:
Flight home uneventful; arrived in Atlanta a few minutes early and I was out the door in a flash, running running running down one concourse and up the other to see if I could get on the earlier flight to Pensacola which was leaving in MINUTES! “No, no, not possible” the gate clerk said without even looking up; she was already working on two other women, I am guessing flight attendants trying to get back home. I waited a minute, bushed from the long run and lugging the shoulder luggage, then said “I think I will just go find a barbecue” and the gate attendant said “Wait!” and I thought she was going to tell me where to find the best barbecue, because I had like three hours, but no . . . she was printing me out a ticket! I got the last seat, back, back, way back in between two great big United States Marines, but it was a fun 45 minutes and I was home three hours earlier. All that is really good!
Even though it is not Seattle to Kuwait, I still like to shower after a long flight, I just feel germy! AdventureMan made me a beautiful salad with sauteed Portobello mushrooms on top, oh yummmmm and we delighted to be together again. Woooo HOOOOO, home again 🙂 Sorry to be out of the loop, but when you are one day out, one day back with two days in between, time just swooshes by.
Sunset Dolphin Cruise with Olin Marler in Destin
We did this same cruise with the same house guests two years ago, and . . . we never get tired of it. We don’t do it that often, and it is always fresh and relaxing.
We booked with Olin Marler Charters out of Destin. Fortuitously, we had a Groupon. It was so easy, buy the tickets online, call for a reservation, be at the dock at 5 p.m. for boarding.
Yes, it can be a crowd. Yes, you always have to know where you want to be and head directly there so you will have a good view, although people do wander. Yes, you have to hope that people who take young children aboard will be responsible and watch them like hawks. Other than that, these cruises are fun and easy.
There are other cruises. The others that we saw were all very crowded, people packed like sardines on little barge-like boats. We like a boat with a couple levels and lots of places where you can take photographs without having to crawl over anyone – or having people crawl over us! – to get a photo. This is our second time with Olin Marler, and I expect it will not be our last – it’s just so much fun.
We saw lots of dolphins. Dolphins are not so easy to photograph as they surface and dive, oh aaargh. If you want to see dolphins from our last trip, click on the blue hypertext in the first paragraph.
Also lots of seagulls and lots of sunset 🙂 Great times with special old friends from Germany, our sons have been best of friends for years, too.
This is the boat they took us out on, the yellow one:
Sunset is nearing:
Can’t get a good shot of the dolphins so might as well see if I can get something interesting with the seagulls and sunset:
When the sun actually sets, it gets cold quickly. We had a very warm day, maybe 80 degrees F. and it dropped almost immediately by 30 degrees. Fortunately, we knew this happens and came prepared this time 🙂
Great way to end a day, followed by dinner with the same good friends.
Stranger in a Stranger Land
. . . . And the land I am talking about is utility bills, water and sewage bills to be specific.
This month we got a very low water-related utilities bill. I say this in relative terms, for about a year, we have been paying huge bills, bills which, to my perception, seemed out of proportion with the water we have been using. AdventureMan called the utilities company and they explained that the averages are measured in certain winter months, and then you are charged for that usage.
So this time, I called, because I didn’t understand the explanation. A very patient, very kind customer service representative explained it again to me. They send notices, she explained, saying they are about to monitor the water usage, and your sewage will be charged accordingly. “We can measure how much water you are receiving,” she explained, “but we don’t really know what is going down the pipes as sewage or waste water (laundry, etc) or going into the ground, which is not sewage. So we measure intake during three – four winter months when people are NOT watering, and guesstimate (my word, not hers, this is a sort of paraphrase, even with the quotes) what your sewage rate is.”
It’s still a little vague to me, but just clear enough for me to understand that just when we should have been NOT watering the year before, we installed a large new planted area and watered generously while the plants settled in. We watered generously during the exact time we were to be not watering at all and using water conservatively.
For a year, I have been calling in plumbers and asking them to look for a leak, fixing every kind of water problem I could find, not understanding how we were being charged so much.
We saw a program on 60 minutes, a follow up to the “Lost Boys” segment they did years ago on groups of Sudanese men who came to the US as the Janjaweed marauded through there villages, killing, raping, destroying everything in sight. It showed their disorientation as they learned how things are done here; I feel their pain. I can identify with their confusion. My next monster to tackle is COX cablevision; they keep raising my rates, it is all totally arbitrary, and I want to find an alternative. Our son – and many others – have explained different avenues, but until you actually do it, it seems complicated. I like to understand what I am doing, and I am not ready to just throw up my hands and give up; I insist on understanding! There must be some rationality (except for Cox’s mendacious billing) and we will prevail!
But for now, through no understanding on our part, we did not water during the measuring months this last year, and now have a very reasonable water bill. Ahhhhhhh. Life is sweet.
Mobile Museum of Art
We were so efficient at the Mobile Botanical Garden that we had plenty of time to hit the nearby Mobile Museum of Art. Actually, we loved the whole park area; there is the Botanical Garden, the Museum of Art, also walking paths, a huge water . . . something, it might be a river or a large lake with a dam in it, I don’t know what it is, but it is a large amount of water. There are athletic fields and even some offices, not large office buildings but some smaller outlying kinds of state or county offices. It’s a nice park, it has a nice feeling, a lot going on.
It doesn’t hurt that it is one of the prettiest days of the year, not hot, not humid, and no mosquitos!
I love it that not all the art is inside the building. There is statuary outside, along the walking path, and this huge made-from-found-objects butterfly at the entrance. It is wonderful. As you enter the museum, looking through miles of glass out through trees at the water, you immediately think “what a place for an event!” thinking wedding, reception, small chamber group performance, etc. Truly beautiful spaces; I would show you but they have a really strict policy about photographing inside the building, so I didn’t.
They have some surprising pieces, surprisingly good for a small museum. They have some very odd pieces, par for the course in a small museum. They have an amazing art glass collection, beautifully displayed in a room with gorgeous natural light that allows each piece to shine. They had an exquisite visiting exhibit based on a Vietnamese classic, with intricate, ethereal pieces.
Too much to take in on one visit! I think our favorite piece in the exhibit were some gorgeous silvery angel wings on a wall near the gallery entrance on the top floor. When you get closer to the exhibit, you see it really, REALLY is silvery – it is silver spoons! The bowls of the spoons form the outer part of the feathers, hundreds of spoons, and the base of the spoon the lower part. It is whimsical and surprising, and made me whoop a little (trying to be respectful in a museum 🙂 ) with delight. We are eager to go back and to take our little grandson, as he gains in ability to focus his attention 🙂
Driving Directions From I-65
From I-65, take the Springhill Avenue Exit (Exit 5) and head west on Springhill Avenue. Go approximately 1 1/2 miles and turn left on John D. New Street (traffic signal). Take an immediate right onto Museum Drive. The Museum is the first building on the right.
Native Cafe at Pensacola Beach
Just when we think we know all the restaurants in town, Urban Spoon comes up with a Pensacola restaurant we didn’t even know existed. It’s getting a big buzz, too, listed as one of the most talked about restaurants in Pensacola. Hoping it is too early for the Spring Break crowd, we head for the Native Cafe after early church. OOps!Too late! And it’s not the spring breakers, at least I don’t think so, these look like locals.
We wait for maybe thirty minutes on one of the sweetest Sundays of the year, not too hot, not too cold, a tiny bit breezy – perfect beach day, and we don’t mind at all sitting outside, waiting for a table or booth.
Once we’re in, we can see why people like it. It’s not so original as Andy’s Flour Power in Panama City Beach, but they have original art on the walls, a funky decor, and a LOT of customers.
We see a lot of huge breakfasts being delivered. The Crab Cake Benedict seems to be a big hit, all the platters look huge. People are digging right in and look happy. Service is quick and efficient.
AdventureMan has been dying for some Biscuits and Gravy. His favorite place for biscuits and gravy, Adonna’s, in downtown Pensacola on Palafox, no longer serves biscuits and gravy. He says these are pretty good!
The little Alaska girl who lives inside me wanted crab cakes, but not all the bread and sauce that comes with the Crab Cake Benedict, so I asked, and was able to order the appetizer Crab Cakes, which was perfect. It came with Remoulade Sauce – yummm.
LOL, you can see, as usual, I forgot to take a photo before I started eating. There were three complete crab cakes; just be glad I remembered when I did!
The food was good, but we probably won’t go back until October or so, when the tourist season dies down. The Native Cafe has been FOUND! Too many people, too long a waiting line. We have the luxury of being able to go when no one else is around except those of us who live here. (You can live here thirty or forty years and you are still not a local; local is people who grew up and went to school in Pensacola 🙂 )
Mobile Botanical Garden Plant Sale: Plantasia
AdventureMan and I had one of the sweetest days of the year – nice cool sunny morning, heading into a warm afternoon as we got up early to head over to the Mobile Botanical Gardens Annual Plant Sale.
They do a GREAT job. Starting with publicity, ads in the Pensacola News Journal and information sent out to all the regional gardening clubs and extension centers raising the level of awareness and creating a buzz. Everyone wants to go.
You get there, and parking is well organized and handy to the sales area. Signage is great – ENTER HERE! EXIT ONLY! PERRENIALS! ROSES! SHADE PLANTS! TREES! And great signs telling you how each plant is color coded and you know immediately what the price is:
Lots and lots of healthy looking plants. We knew what we wanted and found it quickly, except for the ones that were already sold out. Check-out was friendly – and fast. There was an exit strategy; people with large purchases could leave plants, drive into a pick up zone and have them loaded up. It was an amazingly efficient and well-run operation. Perfect weather, great selection of healthy plants, well-organized and efficient – it doesn’t get much better.
Well done, Mobile.
Return to Five Sisters in Pensacola on a Rainy Saturday
It was another endlessly rainy Saturday when my husband asked where I would like to go for lunch.
I knew immediately where I wanted to go. I love Five Sisters almost any day, but especially on a rainy Saturday. I like it that they have live music on Sundays, and sometimes on Thursday nights, but I really like it that there is no music on a rainy, dreary Saturday, so we can talk and hear each other. 🙂
Five Sisters is packed – it often is – with people seeking the same thing, a warm, cheery place filled with great smells and great cooking.
AdventureMan ordered the grilled shrimp platter:
And I ordered the Blackened Fish on Cheese Grits (sorry, it is a little blurry, I must have been shaking with hunger . . . )
I never get tired of Five Sisters.
Seafood Platter Deli AKA Gulf Coast Seafood Deli on 9 Mile Road
“We’re going to drive ‘all the way’ out there,” AdventureMan tells me and we laugh, because ‘all the way’ is such a relative term. When we lived in Kuwait and in Qatar, we would drive a minimum 30 minutes to get to a restaurant, any restaurant, not only because of distances but also because of traffic, horrendous traffic, in the evenings. While the Seafood Platter Deli is 13 miles away, it takes us less than 20 minutes to get there. Welcome to Pensacola 🙂
This is a very unusual restaurant. It is so old-timey Gulf Seacoast, and at the same time, I thought as we entered “My Moslem friends would love this!”
Many of my Moslem friends think Americans are unbelievers. They think we don’t talk about God. They don’t know we pray – sometimes without ceasing. Just as I was astounded as I learned things about Islam and Moslem culture living in the Middle East, they were also astounded learning things about us, like that we take care of our families. Think about it – most of what many people in the world know about Americans comes from the impact of cable TV. They watch American TV and they think they understand American culture. Horrifying thought, isn’t it?
So how amazing is it to walk into a restaurant where, as you stand at the counter to order, and you look at the big menu on the wall, there is a stand, with a bible on it. And there is paper, and a pencil, and a sign saying “Prayer requests.” I don’t know about your restaurant experiences, but this is unique in my experience – in America. In the Middle East, there are all kinds of restaurants with Qu’ranic verses on the walls, and the sounds of religious services piped into the restaurant. People talk about God all the time. It’s a whole different world; and my Moslem friends would feel right at home in the Seafood Platter Deli.
Of course, in Saudi Arabia, we would rush to buy our pre-sunset felafels, and then sit and munch, listening to all the souk grates coming down as shops closed for the Mahgrib prayer. Everything closed, five times a day, in Saudi Arabia, for prayer.
At the Gulf Coast Seafood Deli / Seafood Platter Deli (I don’t know what the real name is, and both names appear when you Google it) there are scriptures on the wall. When you sit down, the little basket holding condiments tells you to “count your blessings.”
The interior dining room (as opposed to the deli section, and the counter where you order food when you come in) is wall-to-wall sea mural, family friendly, Fish and sea life everywhere. There are also families who pray when their meal is delivered to the table, before they eat. The wait-staff is patient, and personal. You get the impression they truly want you to have a good experience at this restaurant.
We were hungry. We are mildly disgruntled to see piping hot food delivered to tables around us who arrived after we did, but not very. Even though we are hungry, we know that our ordering our food grilled or blackened slows things up in the kitchen, where the majority of the meals are fried. It is really really hard for people like us to watch other customers thoroughly enjoying their fried shrimp, fried catfish, fried grouper, fried scallops, etc. They look SO delicious. Every now and then, maybe once every couple months, we slip up and eat something deep fried, just because yes, yes, it tastes so good, and we know it is like the WORST thing for us. What a pity that deliciousness can be so lethal.
Ah! There it is! Our meals! We tuck right in and then I remember “Oh no! I haven’t taken any pictures!” AdventureMan is used to this, and bless his heart, he stops eating so I can shoot what is left of his grilled scallops, so tasty and delicious, so fresh!
I had so much salmon on my platter that I had salmon and steamed vegetables for dinner, too! The salmon was copious, lightly blackened, seared on the outside, moist on the inside, just the way I love it. It was some of the best salmon I have had in Pensacola (not exactly salmon country, but that little Alaska girl still lives in my heart and I can’t resist salmon when I see it on the menu.)
There’s another thing we loved about the Seafood Platter Deli – remember Dembo’s Smokehouse? We love restaurants that honor their heritage, and the Seafood Platter Deli has this wonderful wall:
Last, but not least, the food was so good, and so plentiful, that we couldn’t eat it all and ended up taking some home. We also took home some dessert, one dessert, $1.99 for a goodly portion of Vanilla Wafer pudding, that old-fashioned kind, maybe Banana pudding. It was so GOOD, we wish we’d gotten two. 🙂
Gulf Coast Seafood Deli / Seafood Platter Deli
Address: 2250 W Nine Mile Rd, Pensacola, FL 32534
Phone:(850) 969-3299
We love this place, and look forward to driving ‘all the way out there’ for more fabulous Gulf seafood.
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