Willow Glen, California Since1955
Seniors
 (Photograph by George Sakkestad) In case of emergency, it's important to act promptly. Providing accurate medical info is crucial for seniors Just in Case: Looking over the EKG machine in the Good Samaritan Hospitalemergency room are Barry Arata (left) and Stefan Donbay. Oftenseniors wait too long to get to ER after the onset symptons. Don't wait for severe, crushing chest pain before calling forhelp, advises the American Heart Association (AHA). Warning signsmay be less dramatic, such as a feeling of uncomfortablepressure, squeezing, fullness or pain in the center of the chest. (By Rita Baum) "It was the best of times, it was the worst of times ... " So wroteCharles Dickens in the opening chapter of his classic story ATale of Two Cities. Since 1859, when the novel was firstpublished, those memorable words have been applied to manysituations. They certainly ring true for people who face a suddenand traumatic medical emergency, often during the best time oftheir lives; a time when the golden years of freedom andrelaxation are unexpectedly turned around by an episode thatnecessitates an ambulance ride that thrusts them into a hospitalemergency room. Approximately 40 percent of patients admitted to the GoodSamaritan Hospital emergency room in San Jose are age 65 orolder, and are there most often due to a stroke, heart attack orfall. "Getting to an emergency room promptly and obtaining accuratemedical information can be the keys to preventing permanentdisability," says Steven Matarelli, R.N., Ph. D., associate chiefnursing officer at the hospital. But many older people delay calling 911 at the onset of symptoms,taking a wait-and-see attitude. Some believe their symptoms arenot serious and will go away. Even if they do seek help,approximately 30 percent of these patients can't give an accurateaccounting of their diagnosis, medical history andmedications - perhaps due to the stressfulness of the situation,says Matarelli. These delays can adversely affect treatment. Whentreatment is started immediately, doctors can stop a stroke orheart attack quickly. Stroke is the number-three killer in America, but with newclot-busting drugs, victims have a better chance of survival anda good recovery, especially if treatment is obtained within threehours after the symptoms begin. During a stroke, blood flow tothe brain is interrupted, causing brain cells in the affectedarea to die from lack of oxygen. Doctors must quickly restoreblood flow to minimize the damage, and every minute counts. But not everyone makes it to the hospital in time. Denial anddelay cause 25 percent of stroke sufferers to die beforeobtaining help. Almost one-third of strokes occur in people underage 65, and they too have a poor record for seeking immediateassistance. Eighty five percent of strokes are ischemic, caused by clots ornarrowed arteries. The other 15 percent are hemorrhagic,occurring when a blood vessel ruptures, causing bleeding into thebrain. Stroke symptoms include trouble walking, a sudden loss ofstrength, numbness in one or more parts of the face or body,difficulty speaking or slurring of words, dizziness, loss ofbalance, blurry vision, tingling in the face, or intenseheadache. If any of these symptoms occur, don't waste timecalling for emergency medical assistance, advises the AmericanStroke Association. To reduce the risk of stroke, experts advisepatients to lower their blood pressure, stop smoking and heavydrinking, take off excess weight, keep blood sugar under control,limit sodium intake, increase vegetable consumption, exercisedaily, stay on medication, and see a doctor regularly. A heart attack occurs when the heart muscle is injured becausethe arteries supplying blood and oxygen to the heart becomeblocked with plaque or fatty substances, and a blood clot forms.The first hour of the attack can be the killer, warn experts atthe Mayo Clinic, but more than half of Americans wait two hoursor longer before seeking treatment, and about half of them diebefore reaching the hospital. According to Dr. Ronald Rossen at the Heart Associates ofNorthern California, located in Los Gatos, if clot-busting drugsare given in time or if balloon angioplasty is performed to openblocked arteries, the chances of survival are dramaticallyimproved. Don't wait for severe, crushing chest pain before calling forhelp, advises the American Heart Association (AHA). Warning signsmay be less dramatic, such as a feeling of uncomfortablepressure, squeezing, fullness or pain in the center of the chest.Other signs include shortness of breath with or before chestpain; discomfort in one or both arms, the back, neck, jaw orstomach; breaking out in a cold sweat; nausea; andlight-headedness. If any of these symptoms occur, don't wait morethan five minutes before calling 911. Automatic external defibrillators (AED) - portable devices thatdeliver a small electrical shock to restore normal heart rhythmduring a sudden cardiac arrest - are standard equipment inambulances and are becoming common in many police and firedepartments, public buildings and recreation facilities. During a heart attack, time is of the essence - with each passingminute, more tissue is deprived of oxygen. The recommendationsfor reducing the risk of heart attack are similar to those foravoiding a stroke: reduce cholesterol level and high bloodpressure; maintain a healthy diet and reasonable weight; avoidsmoking; exercise; take recommended medications and see a doctorregularly. After heart attack or stroke, falls are the most common episodesthat necessitate emergency treatment in older individuals, withthe highest rate among people age 85 or older. For seniors, fallsare the leading cause of death from injury in the home and theprimary cause of accidental deaths. More than 90 percent of hip fractures are associated with falls.When falls occur at home, there may be a delay in gettingemergency care if the elder lives alone and can't get up to callfor help. Many older people who live alone subscribe to anemergency response system that can be activated by pressing abutton on a small pendant or wristband that is worn 24 hours aday. Falls can be avoided by addressing household hazards such as poorlighting at doorways and stairs, loose rugs and electric cords,obstacles in paths and papers on the floor and slippery surfaces.Strategically placed grab bars and handrails can also be helpfulin preventing falls. Taking four or more prescription medications may lead todizziness due to drug interactions. Check with the doctor orpharmacist to learn the side effects of all drugs. Shoes shouldfit well and have nonskid soles. A daily walk or other exercisehelps maintain good balance and equilibrium. When in unfamiliarsurroundings, be alert to hazards. Older people who have fallen are advised to undergo a thoroughmedical evaluation. Falls associated with instability can bemarkers of poor health and declining function and a sign of anacute illness or exacerbation of a chronic disease. Be prepared for emergencies by keeping important medicalinformation near the telephone at home and in a wallet when awayfrom home. When calling 911, one should give an address and thenearest main street, make a simple statement about the nature ofthe problem, list the symptoms and give a brief medical history.Once contact has been made, stay on the phone for instructions. In a future column, I will review a variety of free orinexpensive accessible service and equipment options that make iteasy to get lifesaving help fast. New technologies make itpossible to call for and get help in minutes in almost anysituation. But don't wait for an emergency - investigate new,unremarkable symptoms by making an appointment with a doctorright away. Early detection and treatment of a health problem mayhelp keep the ambulance away. Rita Baum is a Los Gatos resident. She has a masters's degree ingerontology and has worked in the field of aging for more than 20years. |
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