By Richard P. Holm, MD
 
Women’s health can be directly tied to the burden of household responsibilities. In a 2016 study, researchers found that women are more often the primary parent of children, the one who determines family healthcare decisions, the caregiver for the elderly parents on both sides and the one that does more of the cooking and dishes, cleaning, laundry and grocery shopping. Other studies have found that doing dishes alone was particularly burdensome.
 
The U.S. Bureau of Labor says our society is getting somewhat better in sharing the household work, but a difference still remains. For example, in 2003, men participated in food preparation and clean-up on average of 35 percent of his days, and in 2015 it was 43 percent. Nice to see an eight percent improvement but the women’s share in 2015 was still 70 percent. In 2015, women participated in cleaning housework 50 percent of her days while it was 22 percent for men. Lawn and garden work was the only chore accomplished more by men than women.
 
How much does this happen because the man is often the primary earner? In another study done at Indiana University in 2016, they studied household work in families where the woman’s income was larger than the man’s. They found that household burdens seemed not to align with income but rather with the traditional roles of masculinity and femininity. They also found that in same-sex couples, gender identity still directs roles. We haven’t reached equality of the sexes at work and we haven’t reached equality at home, either.
 
This is important because of the possible negative effect it may have on family relationships. There are studies to show that each person in a household has expectations and responsibilities, whether it be the alpha mom, the alpha dad, the children or even the grandparents. If the woman (or the man) expects the other to pitch in but ends up stuck with all the chores, she or he may be disappointed, embittered, angry and feeling abused. If those hard feelings are not resolved and are covered up, then depression may be the result. 
 
When one member of the family is hurting, everyone feels the pain. Research data from Myrna Weissman PhD, a professor of psychiatry, shows that mental illness and depression spreads within a household. Strong emotional sharing occurs there, and when emotional pain of one person in the family is treated and improves, everyone gets better.
 
Simply helping with the dishes might be an enormous step toward making a happier home.
 
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By Richard P. Holm, MD
 
Washington Irving once said, “There is a sacredness in tears. They are not the mark of weakness, but of power. They speak more eloquently than ten thousand tongues. They are the messengers of overwhelming grief, of deep contrition, and of unspeakable love.”
 
Normal human tears are a biological wonder composed of a watery portion for providing the cornea hydration and nutrition; a mucous lubrication component for making a tear slimy; and a third thin outer layer of oil for slowing evaporation. Put together you have the astonishing, life-sustaining, curative, slippery and slow-to-evaporate human tear. Vision is completely dependent on tears because the cornea, for purposes of transparency, is designed without blood vessels and is kept alive only by the nutrition it receives from tears.
 
“Dry eye,” is a condition related to issues involving the eye surface, including the loss of the effectiveness of tear film. Symptoms include pain, itching, burning, redness and mucous around the eye with fluctuating vision that interferes with recreation, reading and even driving. Paradoxically, watery eyes usually indicate a dry and inflamed eye with reactive, poor-quality tears.
 
The most common causes for dry eye are side effects from many medications. These include decongestants, antihistamines and meds used for acne, fluid excess, blood pressure or bladder spasm. Environmental causes include extensive reading, eye surgery, excessive computer use, contact-lenses, low humidity, wind or fans blowing on the face and a diet without enough oil or certain minerals and vitamins. Primary medical causes for dry eyes include immunologic conditions like diabetes, rheumatoid arthritis, lupus, scleroderma, low thyroid, Sjogren’s syndrome, vitamin A deficiency and just plain aging. Dry eye affects twice as many women as men, and in the U.S. alone, we spend $3.8 billion in health care dollars for this condition, with societal costs estimated at $55 billion a year.
 
For treatment, we focus on situations causing symptoms and then find ways to avoid those situations. We can include in our diet enough fish, flaxseed or flaxseed oil, liver, carrots, broccoli and walnuts. Protective eyewear can help. Doctors treat some cases with surgery by plugging the tear ducts that drain tears away. Eye drops that reduce inflammation can help. Artificial tears are often prescribed, but as helpful as tears from a dropper may be, they are never as good as the real deal.
 
Nothing will ever compare to the value and the sacredness of a human tear.
 
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​Prairie Doc® Perspectives - Week of February 10, 2019

By Richard P. Holm, MD
 
A beautiful 90-year-old woman came into the emergency room after another fall. The last year had been tough for her as she had developed diastolic heart failure. Her weakness and breathlessness were helped some by diuretics, but she was troubled by extreme variations in blood pressure, high one moment and dangerously low the next. Also, she had a calcified and somewhat tight aortic valve and was on a blood thinner for atrial fibrillation.
 
Heart disease in the elderly includes a wide variety of conditions. The following is a partial list:

• Aging coronary arteries with blockage and subsequent heart attack can be challenging to diagnose because older people don’t always have symptoms to allow intervention.
• Calcification of heart valves, especially the aortic valve, can occur with age when tightening of the valve causes progressive failure of the heart’s capacity to push past that obstruction and do its work.
• Heart pump weakness involves both the systolic squeeze (which pushes blood flow out of the heart through arteries) and diastolic relaxation (which allows blood flow, from veins, back into the heart). Heart weakness can result from either one or both, as aging heart muscle in the elderly becomes replaced by scar tissue. Extreme variation in blood pressure, high one moment and dangerously low the next can be a sign of diastolic heart problems.
• The “broken heart syndrome,” can be a reversible systolic heart weakness caused by severe and prolonged sorrow.
• Overactive blood clotting can develop in the elderly causing dangerous blood clots to the coronary arteries, the brain or anywhere. Experts say that up to 80 percent of all deaths in nursing homes result from blood clots.
• Falling can cause bleeding and fracture. Falling is often the result of heart disease in general and can happen when the blood pressure drops just after standing. Falls can also occur due to neurological conditions, just plain inactivity or TOO MANY MEDICINES. If you get light headed when standing, tell your doctor, and ask her or him to consider you might be on too many medicines.

 
The risk of falling was simply too high to continue my 90-year-old patient on blood thinners. I stopped them and backed off a little on the diuretic which could have been worsening her blood pressure drops and causing the falls. The age-old ethic came to mind: “First of all, do no harm.” Balancing the advantages and harms of medicines in the elderly requires careful consideration, and sometime less is best.
 
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By Richard P. Holm, MD
 
The phone rang, and I answered it because the call was from a nearby community. No big surprise that the caller was obviously not from anywhere near, and the caller was asking for a donation for some organization in which I had no interest. I said, in a kindly tone, “No thank you,” and hung up. They will never end the call. YOU MUST HANG UP.
 
Financial abuse by telephone or internet has been called “the crime of the 21st century.” People of all ages are at risk, but scammers commonly target the elderly. Those of us past 65 are more often home to answer the phone, are apt to stay on the line longer and are less likely to report a crime. Making all of this worse, telemarketing crime is challenging to prosecute and, therefore, inviting to criminals.
 
There are plenty of bad guys out there. The National Council on Aging has written a compendium of common fraudulent traps that can result from telephone calls or internet messages. Here are some:

• Callers may pose as Medicare representative to obtain your personal numbers for the purpose of billing Medicare for bogus services. Remember, U.S. Government agencies will NEVER initiate a call.
• Because of outrageous prices for drugs, people are lured to purchase less expensive prescriptions from internet and out-of-country pharmacies. Beware that doses of drugs may be different than desired, and sometimes unsafe substances are added.
• Callers may be selling false or dangerous anti-aging products and claim reduced wrinkles or bags under eyes. Don’t trust them. Talk to your doctor.
• Con-artists may promise to split a large sum of money with you, provided you first agree to send a “good faith” donation to help cover shipping costs. Don’t believe it.
• “Hi Grandma, do you know who this is?” Never give out the name of a family member on an unsolicited call. They usually ask you for money for a fake emergency or rescue. Always check by calling family first.
• Especially after a major disaster, callers ask for “rescue money” to help those harmed which, of course, goes to the scammers, not those in need.
• Fake investment plans are everywhere. Strangers calling or emailing you with a great investment opportunity, should not be trusted, especially if it sounds too good to be true.

 
Take home message: Don’t respond to calls or emails from strangers selling or pushing you into something. Don’t donate to causes that you didn’t initiate. Beware of scammers. In a kindly tone, say, “No thank you,” and JUST HANG UP.
 
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