Q: My aunt, 67, has always been very active with tennis and golf, but two years ago she fell and broke her hip. The docs say she's healed, but she's just not the same person. She walks with a cane and has aged a lot. Is there anything I can do for her? - Anna K., Eugene, Oregon
A: Yes, you can help her improve her quality of life. If she hasn't done physical therapy, make sure her orthopedic surgeon gets her set up for it. But even if she's had PT, it sometimes takes two or three rounds to recover fully. Scar tissue and compensating for discomfort can throw off balance and stride. At her age, unless there are complications, such as osteoporosis or a chronic disease, with some hard work she should be able to bounce back and participate in activities she enjoys without many restrictions.
Unfortunately, your aunt's fall and resulting break is not unusual. The Centers for Disease Control and Prevention estimates that 3 million older people are treated annually in emergency departments for injuries from a fall. The number of fatalities from falls has skyrocketed to more than 25,000 annually.
Another increasing hazard: Falls after a hospitalization for any cause. These days Medicare doesn't reimburse for medical costs associated with a fall in a hospital. As a result, hospitals keep patients bed-bound, and that increases the risk of falling once they head home! Fortunately, there's a lot your aunt and others can do to improve muscle strength, balance and mobility:
- As we mentioned, get her back in PT.
- Arrange for in-home support from an organization such as a visiting nurse service. They can make sure her house is fall-proof by removing easy-to-trip-over throw rugs; suggesting the addition of grab bars in the bathroom and railings on stairways; and adding brighter lights around the house. They can also supervise in-home exercise.
- Suggest she talk with a therapist or counselor who can help her feel more determined and optimistic about doing the work it takes to become physically stronger.
Q: My 16-year-old niece was diagnosed with Type 2 diabetes. Her endocrinologist is telling her to exercise and lose weight before they start her on metformin, but I think she needs more aggressive therapy to dodge complications as she gets older. Am I right? - Emily M., Columbus, Ohio
A: Developing Type 2 diabetes at that young age can result in devastating premature complications. An ongoing clinical trial called Treatment Options for Type 2 Diabetes in Adolescents and Youth (TODAY) has shown that Type 2 diabetes is more aggressive in kids than adults and that complication rates increase steadily over the years. In fact, serious diabetes-related disorders, such as heart attack and other cardiovascular problems, kidney disease, retinopathy and pregnancy complications can occur in as little as seven and a half years after diagnosis. So, yes, she and her doctor should tackle the diabetes aggressively, using both lifestyle changes (nutrition and physical activity) and medication, in order to avoid big trouble by the time she's in her mid-20s.
When you talk with her about this, remember a couple of things. First, no one wants to be overweight or obese. And, second, she's not alone. Thanks to the availability of calorie-laden fast food and an increasingly sedentary lifestyle, between a quarter and a third of U.S. children and teens are now overweight. Then, let her and her parents know that the smart approach is to combine lifestyle changes in diet and exercise with medication (metformin is approved for kids 10 and older).
Also, suggest that they ask the doc for a referral to a certified diabetes educator. A CDE provides a comprehensive plan for battling diabetes, including nutritional information, an exercise plan and emotional support. You can find one in your niece's area by going to the National Certification Board for Diabetes Educators website at ncbde.org and typing in her ZIP code. Start now, and she'll be healthier and happier tomorrow.
Distributed by King Features Syndicate, Inc.
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