Ellie Cannon: Is strolling good for mother when she falls loads?

Mother is 75 years previous, very small and weak, usually falls. However she appears obsessive about strolling in all places to train, which she thinks will make her stronger. I’m afraid the extra she walks, the extra seemingly she’s going to fall. Am I proper or is train good for her?

Train, particularly strolling, is helpful for a 75-year-old. It strengthens bones and muscle groups, and has different advantages reminiscent of stopping coronary heart illness and serving to to cease feeling lonely.

However falls are a major problem, significantly for the aged and frail—and the reason for 1000’s of hospitalizations and even deaths every year.

So it is a basic case of evaluating dangers and advantages.

The GP ought to be capable to refer anybody who falls usually to a falls clinic. There, the analysis will take a look at all doable causes — reminiscent of medicine negative effects or coronary heart issues — and provide you with methods for mitigation, together with safer methods of exercising than strolling.

The Royal Osteoporosis Society (theros.org.uk) has wonderful reality sheets and movies on workout routines to assist keep steadiness and energy. On the location’s residence web page, click on the “Data and Assist” tab after which choose “Train and bodily exercise for osteoarthritis” from the drop-down menu. Scroll down till you see the “Sustaining Regular” subheading, then click on on the hyperlink beneath and you’ll be in the precise place. Age UK additionally provides train lessons in some areas.

Fitted, supportive sneakers and insoles can even assist, in addition to ensuring you get your eyes checked usually. Inside the house, unfastened rugs, muddle, and dim lighting must be averted.

My physician instructed me final yr that I ought to come off citalopram, the antidepressant I’ve been taking for years, as a result of they don’t work on individuals over 65. Mirtazapine was placed on me and I used to be left feeling very anxious and depressed once more. I learn in your column not too long ago a few 72-year-old who was instructed by his physician to take citalopram. Was my physician fallacious?

Citalopram is a part of a household of antidepressants known as selective serotonin reuptake inhibitors, or SSRIs. It’s one among eight generally prescribed for quite a lot of situations, together with melancholy, nervousness, obsessive-compulsive dysfunction, consuming problems, and ache situations. Some are particular – eg escitalopram for nervousness.

The observe of various GPs can fluctuate in line with their expertise, however normally all of us comply with steerage from both the Nationwide Institute for Well being and Care Excellence (NICE) or specialist psychiatry information reminiscent of Maudsley’s tips for prescribing.

Geriatric psychiatry is a specialty in itself, as the best way psychological well being issues manifest modifications with age. Different issues come into play, reminiscent of reminiscence loss. If a affected person is taking a number of medicines, we should be cautious that they don’t work together – and for these causes we frequently use decrease doses of antidepressants within the aged.

Sertraline, citalopram, and escitalopram are acknowledged in geriatric psychiatry because the SSRIs that must be used. Your medicine could have been discontinued for different causes, reminiscent of doable negative effects, bleeding from the intestines, glaucoma or coronary heart illness.

If somebody is taking anti-inflammatories regularly or the blood thinner warfarin, for instance, we’d advise towards taking an SSRI due to the bleeding dangers of taking them collectively. Mirtazapine can be an excellent different.

Switching antidepressants isn’t simple for the affected person as a result of it could trigger negative effects whereas the brand new medicine is settling in, though after some time these issues reduce once more. Nonetheless, this should even be evaluated as a part of the method.

For the previous 2 months my urine has been smelling unhealthy and searching moderately darkish. It’s much like once I had a urinary tract an infection, however I don’t have a burning sensation or ache once I go to the bathroom. I’ve elevated my fluid consumption and switched to decaf however nothing has modified. I take heartburn drugs omeprazole and naproxen for my sore knees. Are you able to assist?

A chronic change of urine must be achieved by a GP. The most effective place to start out is by asking should you can depart a pattern for testing and having a cellphone session with the outcomes. Urinary issues are an vital cause for going to the GP for individuals of all ages.

The most typical change in urine odor because of an infection happens, particularly in ladies.

This can be accompanied by burning, ache, and a frequent urge to urinate usually in small quantities. However the signs could be milder as soon as the odor modifications or cloudiness.

A chronic change of urine must be achieved by a GP. The most effective place to start out is by asking should you can depart a pattern for testing and having a cellphone session with the outcomes

This may be recognized with a urine dipstick take a look at and urine tradition in a lab, which takes about two days to finish.

A change in urine is important to examine for the presence of blood. This may be seen within the dipstick take a look at as properly. Though all of us acknowledge a visual quantity of blood within the urine, small quantities can even happen and never be so apparent. It could seem darkish moderately than pink. Blood within the urine could be extra generally from an an infection or kidney stones, however it will also be an indication of bladder most cancers or critical kidney issues.

Naproxen is a non-steroidal anti-inflammatory drug, or NSAID, used to focus on joint ache or swelling, and in the long run can be identified to pose a threat for kidney issues.

Much less generally, modifications within the odor and shade of urine will also be an indication of sort 2 diabetes or liver issues.

This “gentle” covid continues to be a risk

There’s loads of Covid going round in the intervening time and final week, I caught it! I used to be intrigued as a result of my virus appeared to comply with the identical sample I had seen in pals not too long ago – it felt like a traditional chilly, it lasted two days. I had a light cough which unusually disappeared as soon as my take a look at turned constructive. Everybody I’ve spoken to who’s had Covid previously month or so appears to have had the identical expertise, with not one of the previous warning indicators like a excessive temperature or a change in style or odor.

This will point out that, after three years, Covid-19 is a really totally different virus than the one we began with. Having stated that, people who find themselves extraordinarily in danger, reminiscent of leukemia sufferers or individuals awaiting transplants, ought to nonetheless watch out.

It’s estimated that 1 in 25 individuals at present has the virus, so there’s an affordable probability any of us will catch it.

The “superpower” in Paris is nothing to be envied

Actuality TV star Paris Hilton took to the interview circuit final week to advertise her memoir and discuss rising up with ADHD – consideration deficit hyperactivity dysfunction.

I do know there are those that suppose ADHD doesn’t exist, however I’m not one among them.

Signs embody inattentiveness and impulsivity, and might have a major influence on sufferers’ time in school and work and their relationships. Prognosis and remedy, each in childhood and as an grownup, could be a big profit.

The 42-year-old actual property heiress, who was recognized with the situation as a baby, takes medicine and now considers it her “superpower”. I’m all for that form of constructive method.

However I cringe once I hear individuals say “I’ve just a little ADHD” or that they’ve self-diagnosed utilizing an internet questionnaire, after they’ve by no means seen a physician. It’s a critical situation and it’s important to not underestimate it.

Actuality TV star Paris Hilton took to the interview circuit final week to advertise her memoir and discuss rising up with ADHD – Consideration Deficit Hyperactivity Dysfunction