Lessons I've learned since breaking my hip in July: the body, the doctors, the remedies and the lessons in who and what to trust
For the last several months, sleep for me has been very difficult to come by. I broke my hip July 24th, the latest in a long string of big surgeries going back to 2018, but seven since summer before last. That's a huge burden of cortisol (stress) and pain medications post op.
On top of that, I've been far less active because of those surgeries. Hard to hike and run one-legged when your hands are also recovering.
There's that. At least it would give your neighbors something to laugh at.
A perfect storm, if you will, for all kinds of issues, from osteopenia in the hips (yep) to the kind of GI tract back up so typical of the elderly.
Can't happen to THIS active girl, right? Wrong. Of course it can, and did. Like I said, you all could tell me I was full of shit before this diagnosis but now there's solid proof, sorry for the pun.
I took a very powerful protein powder (MEND) for two months post-op at the recommendation of my surgeon. It worked as designed- I healed faster than I ever have- but with all the other conditions it also caused me to back up very badly despite my taking psyllium every night.
Since early August I've not had a full night's sleep due to what I thought were kidney/urinary tract issues. I've averaged about three to four hours a night which frankly, is just brutal.
You really do turn into the Wicked Witch, and it really does have terrible side effects on just about every aspect of life. I've been desperate to fix the urinary issues, the sleep issues. The symptoms were escalating rapidly, and I didn't want to end up in the hospital again.
Not asking much really.
Here's some of what I've learned along the way. What was prescribed, what worked, what I found, what worked, and what didn't, and what was damned dangerous.
As you and I age, certain organs can and do slow down, like kidneys. However, all the things I keep going on about like diet and exercise help keep those systems functioning quite well, even as they slowly begin to end us, as is Nature's way.
That said, kidney disease and constipation are NOT normal by products of just aging; they are more often by products of either bad habits or situations we can't quite control like disease, along with bad doctoring or both.
Aging is a factor but it isn't an excuse.
Same with sleep. Poor sleep is not an automatic byproduct of aging, either.
So I've been asking for help, beginning with the VA urologist.
Given my contentious and dysfunctional relationship with the VA urologist who informed me to either take a very bad medication (below) or just "get my chakras checked out"- really now) I did some research on alternative remedies for overactive bladder, irritated bladder, the like. Let's start with those.
Some of them have paid off, albeit you have to wait for results.
To that, for anyone with nocturia or OAB, this: the NIH has reports on the use of pumpkin seed extract and capsaicin, both of which are widely available. I've been using both daily. They have worked, too. Fair warning, they take time, like up to two months. No side effects.
I've also used aloe gel caps, two twice a day, on the advice of a Denver urologist. For the most part, used wisely and not overdone, none of these have deleterious side effects. The good news is that they can often work without our ingesting corporate chemicals (Rx) which can cause all manner of other issues.
It took two Urgent Care stops and one Emergency Room visit for me to find out that what was going on was, in fact, that I was seriously constipated.
Constipation puts pressure on the bladder, causing OAB-like symptoms. Oh, this confusing body. Each time you see a specialist, it's the hammer-and-nail joke; they can't see anything other than the organs/systems for which they are trained. Such specialization has made idiots of otherwise very smart people, with the urologist as a perfect example.
Any quick Google search will show that people with severe constipation may also present with overactive bladder symptoms. If I can find that online, then the VA urologist probably received training on it. But it takes the willingness to do the sleuthing. If they won't, we have to, if for no other reason than to protect ourselves from them.
That particular urologist pushed Oxybutnyn at me for the OAB. Side effect of the pill? Constipation. Not just that. This particular medication is absolutely not indicated for those with the kind of bad backup I had. I also have several other conditions for which this particular pill is contraindicated, all of which are clearly noted in my medical records. And had she asked as part of, well, doctoring.
This is how older/elderly people end up dead or with a colostomy bag for the rest of their lives, tagging Leo Notenboom here for his input about this issue. Our parents weren't brought up to question their doctors.
We must question or we can die.
Lost sleep over time contributes to all manner of illnesses, not the least dementia.
Which leads me to another pothole. A big one. Some of the remedies we take to get more sleep to fend off dementia can actually contribute to dementia.
Here was a perfect lesson in how we create a perfect storm in the body: to help me sleep, one nurse practitioner recommended Tylenol PM. The active ingredient is DIPHENHYDRAMINE HYDROCHLORIDE.
While that most assuredly gave me a good night's sleep for the first time since early August, that also has serious side effects, including the following:
- dry mouth, nose, and throat
- drowsiness
- dizziness
- nausea
- vomiting
- loss of appetite
- constipation
- increased chest congestion
- headache
- muscle weakness
- excitement (especially in children)
- nervousness
Here we go again. So many of these have terrible implications for older folks.
Tylenol PM is an anticholinergic. After I finally had a night's sleep to get me back on my feet again I started researching in earnest. I gave myself three nights to get back on track, then the pills were trashed.
You and I really need to stay on top of these things.
DH is one of those seriously bad drugs for the elderly for all the above reasons, and contributes to misdiagnoses by doctors. Their side effects are misread as indications of either age or other conditions, when they are sometimes if not most of the time, simply side effects.
This is how we end up with polypharmacy. Far sicker and worse off than when we started.
Benadryl's active ingredient is the same, which is why this common, over-the-counter remedy is listed as potentially dangerous along with many other familiar-but-not-safe drug store products.
Why on earth would anyone suggest a drug with constipation as a side effect to someone who has serious constipation?
Modern medicine. Doctors and caregivers who are too rushed, resentful, don't like their patients or who can't be bothered to really doctor. Part of this I have empathy for. Part, I don't. Because when you and I show up in distress, that's because we're sick or can't sleep or whatever, and that's why we're there.
Expecting your patient to show up in their Sunday best and on their best behavior when they are in extremis is ridiculous.
Both the urologist and the nurse practitioner were quick to suggest products which could have killed me off entirely. That's one reason I take my phone to these appointments so that I can look those drugs up online and challenge them before I leave.
My urologist was livid that I questioned her. I'll be filing a complaint with Office of Inspector General. Such doctors are deadly to people who don't have the wherewithal to research.
Finally, one Saga Supporter sent me this, which we might all keep handy before we shop for ourselves or for anyone else past sixty or thereabouts.
The Beers List. This is an evidence-based list of drugs to be used with caution (or not at all) in older patients:
https://agsjournals.onlinelibrary.wiley.com/doi/full/10.1111/jgs.18372
I reviewed this list and the VA had me on a good many of these at different times and in some cases past sixty. If you read the warnings, they are stark and terrifying, especially given how vulnerable we are to bad or mis-diagnoses, lack of oversight and limited followup. I would strongly recommend all of you to scan this list for anything you might be on and consider your options, most especially if the side effects match what you are seeing. Many thanks for this contribution.
Let's get back to good news.
A friend suggested CALM, a magnesium product, which is pleasant and easy to take at night. It appears to work. Calm, which my beloved mentor took for years (and she did her research) also has some very positive side effects as in preventing constipation, among other things, so it's worth considering.
Here are some of ways to get magnesium:
Foods that are high in fiber are generally high in magnesium. Dietary sources of magnesium include legumes, whole grains, vegetables (especially broccoli, squash, and green leafy vegetables), seeds, and nuts (especially almonds). Other sources include dairy products, meats, chocolate, and coffee. Water with a high mineral content, or "hard" water, is also a source of magnesium.
As with all things, too much can have side effects. That said, I suggest that we all be a bit like my food-and-diet compulsive friend Jim Stutsman who researches everything, and is extremely careful about what he and his wife ingest.
I've been sleeping all right, sleep that is still pock-marked with sporadic hallway trips, but not like back in August when it was every half-hour (CHECK YOUR CHAKRAS MY AGING ASS, DOCTOR) all night long.
As for that hallway.
I'm still crashing on the couch, surrounded by all the stuff exported out of the bedroom and bathroom because the water mitigation issue is under investigation for fraud by the contractor. Oh, and my HVAC system up and died in its entirety just as winter is settling in. Thank GOD I got all that wood cut.
With a roaring fire, it's nearly 80 in the living room and about 50 in the bedroom. I'm considering putting a sleeping bag in the hallway. Which is hard, but per Goldilocks, at least the temperature is just right.
Knowing me I'd trip on my sleeping bag and injure myself just trying to relieve myself.
There's that.
Look. I've been complaining to my friends about the lack of adventure. I beg to differ.
Trying to survive poor doctoring is indeed an adventure.
Trying to survive fraudulent contractors is an adventure.
Finding humor in still sleeping on my couch, almost no furniture, my stuff still in boxes and stashed all over the house where I can't find it is an adventure.
If my doctors don't kill me off, this house just might.
What's all that if not an adventure?
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