Volume 2, Issue 6 |
September 26, 2005 |
Eva's heart starting racing. She didn't know if she could take another breath. Her hands were trembling. She felt tensed. Sweat pearled on her forehead. Eva is not racing. She isn't a star in the latest action movie either. And she is not watching an horror movie. But she feels she is in it! Eva is home alone, seating in the living room of her suburban home. All is calm and quiet. Nothing is stirring. Eva is in the high-risk elderly population: a less formally educated woman who doesn't have a close family to care for her. She has chronic physical problems and Harry, her husband of 42 years died not even 7 months ago. Eva has some of the symptoms of a condition that affects millions of Americans: General Anxiety Disorder. She hasn't really been diagnosed yet because "separating a medical condition from physical symptoms of an anxiety disorder is more complicated in the older adults" according to the Anxiety Disorders Association of America (www.adaa.org). People, like Eva, who may have anxiety are usually uneasy, more apprehensive and worried about what may happen. It becomes a disorder when it interferes with normal functioning. It can cause headaches, digestive tract disturbances, fatigue, weight gain, or greater irritability.
A generalized anxiety disorder is characterized by motor tension (restlessness, muscle tension, and being easily fatigued), autonomic hyperactivity (shortness of breath, heart palpitations, sweating, and dizziness), or vigilance in scanning (feeling keyed-up and on-edge irritability and having exaggerated startle responses).
Benzodiazapines may be useful in patients with anxious symptoms and when used with antipsychotic medications may be synergistic in effect. However caution should be used in selecting benzodiazapines in older adults. They are contraindicated in people with sleep apnea, a common condition with a prevalence of approximately 30% in those over age 65 (Ancoli-Israel et al., 1991). The benzodiazepines selected by most geriatric specialists are lorazapam (Ativan) or oxazapam (Serax). Other benzodiazapines have pharmacokenetic profiles generally less well suited to older adults. Benzodiazapines in older adults with cognitive disorders may exhibit paradoxical reactions or stimulation and agitation rather than tranquilization.
It is important to educate patients about their diet too. More vitamins, like C, B or E found in fruits (berries) and vegetables (beans, peas), along with whole grains, potatoes, yams, raw nuts and seeds can be important. Refined sugar and refined flour products, along with food additives like aspartame, monosodium glutamate, nitrates and nitrite should be avoided. Alcohol and coffee consumed in very small quantity, if at all (Jesse Lynn Hanley, M.D., 2003).
| Ingredients | |
| Tomatoes (big enough to be stuffed and not too ripe) | |
| Green peppers | |
| 2 cloves of garlic | |
| 2 Tablespoons of uncooked rice | |
| Italian sausages (mild or hot, as you like) - 2 per green peppers | |
| Salt and pepper to taste | |
| Bratwurst sausages - 2 per tomatoes | |
| 1 onion |
Fall is the traditional beginning of the greatest season for the most number of birds. To attract the widest variety, landscape your property with plants that offer cover and natural foods for them, as well as make your yard look more beautiful. Provide a source of water as well.
First, take an inventory of your feeders. Ideally you want to place feeders in areas that offer nearby cover for the birds and permit you to watch the bird activity from your favorite inside chair. Having some dense cover, shrubs, or trees close by will help protect birds from predators - essentially the neighbors' cat! Feeder selection should match the foods you offer. For example, tubular feeders attract goldfinches and pine siskin. Tube feeders for sunflower seeds attract house finches and chickadees. Black oil sunflower
seeds, perhaps the best all-around seed, also can be served from Hopper feeders for cardinals and other small birds.
Flat feeding trays positioned close to the ground accommodate doves, sparrows and other ground feeding birds that generally like mixed seed. These trays should have a lip to prevent seeds from falling off. An optional cover is helpful to prevent rain and snow from fouling the seeds. The bottom of the tray can be wood or fine mesh screen, which permits better drainage.
With appropriate backyard habitat and the proper combination of seed and feeders, you should be able to attract a good assortment of birds. Your immediate surroundings, whether urban brick, woodlot or creek, will affect your success, but having neighbors who feed birds will help.
Providing food for the birds is easier than you think. Like us, birds have their favorite kinds of food. Chickadees and finches, for example, like sunflower seeds. Steller's jays and blue jays prefer peanuts. White Proso millet is the preferred food of sparrows and mourning doves. The favorite food of pine siskin and some kinds of finches is the Nyjer seed. Black oil sunflower seed is our favorite seed to feed in the winter because of its high oil content. Northern flickers prefer suet cakes.
Put out some peanuts in the shell, some tree nuts, or raisins for special treats and watch the birds learn to come for them within minutes.
October |
November |
December |
| 10/1 - Littleton - Friend's Craft Fair at Ketring Park | 11/5 - Denver - Veterans’ Day Parade | 12/10 - Highlands Ranch - Breakfast with Santa |
| 10/2 - Denver - Komen Race for the Cure | 11/5 - Englewood - Holiday Bazaar | 12/11 - Denver - Jingle Bell 5K Run/Walk |
| 10/15 & 16 - Highlands Ranch - Fall Craft Show | 11/8 - Election Day | 12/13 - Highlands Ranch - House Decorating Contest |
| 10/23 - Girl Scouts Mile High Council 5K and 1K Walk/Run | 11/11 - Veterans Day | 12/21 - Winter begins |
| 10/22 - Denver - America's Walk for Diabetes | 11/16 - Englewood - Puppet Show | 12/25 - Christmas |
| 10/30 - Daylight Saving Time Ends | 11/24 - Thanksgiving | 12/26 - Hanukkah |
| 10/31 - Halloween | 11/24 - Denver - Turkey Trot 4 miles Run/Walk | 12/31 - Denver - New Year's Eve Fireworks |
Again this year we will be distributing calendars to everybody on our list! Make sure you pick one up starting November 7. We will mail one to all physicians we have worked with this year and also to all patients we have taken care of this year.
Like previous years, we are planning to make gift baskets for our less fortunate and lonely patients. To help us raise the funds for them, we are planning to make a Holidays Cookbook. We will sale them for $5 each.
We are asking you to give one of your best Holiday Recipes for our cookbook by November 14. We need 20 original recipes!
Cookbooks will be for sale on November 21, 22 and 23.