Thursday, August 19, 2004
I watched a NOVA program on television...
...Tuesday night about the efforts of cigarette manufacturers to produce a "safer" cigarette. At the beginning of the program was a short profile on exactly what chemicals cigarettes deposit into the body and what the effects of these chemicals are on body chemistry. Although the profile did not specifically mention that anemia could have its cause in smoking, the explanation of what happens to the body, especially in relation to hemoglobin, got me thinking that cigarette smoking may very well have something to do with Mom's anemia.
This morning, I did an initial search involving web documents mentioning both "anemia" and "cigarette". It seems that there appears to be a link between iron deficiency anemia, which is the type my mother has, and cigarette smoking, which doesn't surprise me. Smoking definitely has an effect on hemoglobin production and the ability of existent hemoglobin to distribute oxygen to cells. In order to compensate for the effects of cigarette smoking on hemoglobin production and productivity, the recommended "normal range" of hemoglobin for smokers is supposed to be elevated by a fair number of tenths. Some of the significant links I found which explore the relationship of cigarette smoking to iron deficiency anemia are as follows:
I do not intend to take these suggestions lightly. My intent is to do everything possible to try and nip Mom's anemia in the bud, especially considering the effects of anemia cited in the article connected to the last link above, even though that article considers anemia a risk factor "independent" of cigarette smoking.
Blood was drawn yesterday for a BMP. I was told a CBC was not ordered. This surprised me and I'm it sorry wasn't ordered, as that is the test which analyzes for hemoglobin and hematocrit. I'm going to enter the results of the BMP at the Mom's Tests site later. In review: Her BUN and BUN/Creat Ratio are still high but I confirmed with both her facility doctor and the director of nursing that, considering that Mom's readings tend to run high, I don't need to get excited until she begins to show reading of 35 and above. I'm now thinking that if we are able to bring her hemoglobin back into what would be considered a normal range for her, her BUN and BUN/Creat ratio readings will probably settle down.
I've just made an appointment for her to see her PCP on the afternoon of September 8th. Thus, I'll wait until the week previous to have her standing blood draw taken. At the same time I'll have the raft of tests ordered by her hematologist done. I'm hoping for and expecting very good results although I'm not going to rely on luck. Effort will be involved in raising her health profile by modifying our routines at home, specifically her movement and awake routines, since her dietary routine here is already topnotch. And, of course I'm going to see to it that she does not take up smoking, again. I don't anticipate this to be difficult as I'm thinking she may have almost completely forgotten that she smokes since she is no longer displaying any of her typical habits that surround the smoking of cigarettes.
The more I think about it, the more I realize that allowing certain long term, destructive habits to continue just because a person is, "old, give her/him a break" is akin to giving up on the amazing recuperative powers of the bodies of Ancient Ones, and, for that matter, their spirit. While I believe it's true that it is my mother's amazing spirit and will that have kept her alive and in fairly decent health with protracted problems developing only over the last few years, I also believe that giving into our societal tendency to underestimate the regenerative capabilities of Ancient Ones and the recuperative powers that breaking long standing bad habits can have sells Ancient Ones severely short and may, as well, shorten their lives. At the very least it can seriously lower their quality of life. I have come to believe that a relaxed attitude toward Ancient One status, including our readiness to allow Ancient Ones to have their way even if that way is obviously damaging, shows an unexamined lack of respect toward life in its Ancient Years. Yes, Ancient One status is, in part, about physical decline. But it is also about life. Life always does better when it is aided by healthy habits, regardless of how old one lives to be. While I believe that people should be allowed to (and will, anyway) kill themselves in whatever way they choose and dictate their own health status, I'm coming to consider that when someone begins to falter in their ability to judge what they want and don't want to do to pursue either goal of keeping themselves as healthy and active as possible or pursuing a steady decline out of life, those caring for that person need to take over and make judicious decisions about what the person in question is going to do.
For instance, my mother often talks about wanting to pursue "interesting" activities, but her former routine put her in such a position, health-wise, that she didn't have the energy or the ability to pursue them. So she'd sit in her rocking chair (or lay in her bed) and decide that whatever she had wanted to do wasn't worth doing. I could, I know, allow my mother to come back to the life she was leading with extreme stubbornness prior to this episode of tottering health. It would be no more stressful for her in the short run, despite the fact that having to endure the certain hospital and skilled nursing facility stays that would result is, in the long run, not something she enjoys doing. As well, some of the routines from her skilled nursing facility stay that I intend to continue do, indeed, provoke a certain level of personal stress for her. On Monday when my visit began early but she still wasn't dressed and ready for therapy, I delivered some good humored prods.
She glared at me from her semi-reclined position on the bed and asked defiantly, "Why!?!" as though she expected me to be able to come up with an answer.
"I'm surprised you're continuing to ask that question, Mom," I responded. "Don't you feel better than you've felt in a long time?"
"Well, yes," she begrudged me.
"Don't you have more energy?"
"Maybe. I'm not sure."
"Well," I confirmed for her, "I can see that you do. And part of that is because you've been forced to get out of bed and move around. Wouldn't you agree that the proof is in the pudding?"
"That's what they say," she said.
"Well, I can see from the evidence that 'what they say' certainly applies to your stay here. So I think we just need to go with it and continue to make and eat the pudding you've been served here since you're doing so well on it."
She mumbled and grumbled and shot me dirty looks but when I moved to "whup her up" she rose under her own steam in defiance of my arms wrapped around her. "I can do it myself," she said, as though she was settling an argument in her favor.
"Good. That makes my job a lot easier."
Well, I've got places to go, things to do and people to see to get everything ready for Mom's arrival, tomorrow. I'll check in...
...later.
This morning, I did an initial search involving web documents mentioning both "anemia" and "cigarette". It seems that there appears to be a link between iron deficiency anemia, which is the type my mother has, and cigarette smoking, which doesn't surprise me. Smoking definitely has an effect on hemoglobin production and the ability of existent hemoglobin to distribute oxygen to cells. In order to compensate for the effects of cigarette smoking on hemoglobin production and productivity, the recommended "normal range" of hemoglobin for smokers is supposed to be elevated by a fair number of tenths. Some of the significant links I found which explore the relationship of cigarette smoking to iron deficiency anemia are as follows:
- Anemia - Heart Canada
"Conversely, tea, coffee, and cigarette smoking reduce iron absorption." - MoonDragon's Health & Wellness: Cadmium Toxicity
Cites cadmium toxicity, of which the cadmium filters into the body from cigarette smoking, as a cause of iron deficiency anemia. - McVitamins
A tract on smoking which heavily implicates cigarette smoking in "severe anemia". - Anemia is risk factor for physical decline in older adults
"The researchers also adjusted for other factors that might affect the results, such as age, sex, cigarette smoking and blood pressure, and found that anemia is an independent risk factor."
I do not intend to take these suggestions lightly. My intent is to do everything possible to try and nip Mom's anemia in the bud, especially considering the effects of anemia cited in the article connected to the last link above, even though that article considers anemia a risk factor "independent" of cigarette smoking.
Blood was drawn yesterday for a BMP. I was told a CBC was not ordered. This surprised me and I'm it sorry wasn't ordered, as that is the test which analyzes for hemoglobin and hematocrit. I'm going to enter the results of the BMP at the Mom's Tests site later. In review: Her BUN and BUN/Creat Ratio are still high but I confirmed with both her facility doctor and the director of nursing that, considering that Mom's readings tend to run high, I don't need to get excited until she begins to show reading of 35 and above. I'm now thinking that if we are able to bring her hemoglobin back into what would be considered a normal range for her, her BUN and BUN/Creat ratio readings will probably settle down.
I've just made an appointment for her to see her PCP on the afternoon of September 8th. Thus, I'll wait until the week previous to have her standing blood draw taken. At the same time I'll have the raft of tests ordered by her hematologist done. I'm hoping for and expecting very good results although I'm not going to rely on luck. Effort will be involved in raising her health profile by modifying our routines at home, specifically her movement and awake routines, since her dietary routine here is already topnotch. And, of course I'm going to see to it that she does not take up smoking, again. I don't anticipate this to be difficult as I'm thinking she may have almost completely forgotten that she smokes since she is no longer displaying any of her typical habits that surround the smoking of cigarettes.
The more I think about it, the more I realize that allowing certain long term, destructive habits to continue just because a person is, "old, give her/him a break" is akin to giving up on the amazing recuperative powers of the bodies of Ancient Ones, and, for that matter, their spirit. While I believe it's true that it is my mother's amazing spirit and will that have kept her alive and in fairly decent health with protracted problems developing only over the last few years, I also believe that giving into our societal tendency to underestimate the regenerative capabilities of Ancient Ones and the recuperative powers that breaking long standing bad habits can have sells Ancient Ones severely short and may, as well, shorten their lives. At the very least it can seriously lower their quality of life. I have come to believe that a relaxed attitude toward Ancient One status, including our readiness to allow Ancient Ones to have their way even if that way is obviously damaging, shows an unexamined lack of respect toward life in its Ancient Years. Yes, Ancient One status is, in part, about physical decline. But it is also about life. Life always does better when it is aided by healthy habits, regardless of how old one lives to be. While I believe that people should be allowed to (and will, anyway) kill themselves in whatever way they choose and dictate their own health status, I'm coming to consider that when someone begins to falter in their ability to judge what they want and don't want to do to pursue either goal of keeping themselves as healthy and active as possible or pursuing a steady decline out of life, those caring for that person need to take over and make judicious decisions about what the person in question is going to do.
For instance, my mother often talks about wanting to pursue "interesting" activities, but her former routine put her in such a position, health-wise, that she didn't have the energy or the ability to pursue them. So she'd sit in her rocking chair (or lay in her bed) and decide that whatever she had wanted to do wasn't worth doing. I could, I know, allow my mother to come back to the life she was leading with extreme stubbornness prior to this episode of tottering health. It would be no more stressful for her in the short run, despite the fact that having to endure the certain hospital and skilled nursing facility stays that would result is, in the long run, not something she enjoys doing. As well, some of the routines from her skilled nursing facility stay that I intend to continue do, indeed, provoke a certain level of personal stress for her. On Monday when my visit began early but she still wasn't dressed and ready for therapy, I delivered some good humored prods.
She glared at me from her semi-reclined position on the bed and asked defiantly, "Why!?!" as though she expected me to be able to come up with an answer.
"I'm surprised you're continuing to ask that question, Mom," I responded. "Don't you feel better than you've felt in a long time?"
"Well, yes," she begrudged me.
"Don't you have more energy?"
"Maybe. I'm not sure."
"Well," I confirmed for her, "I can see that you do. And part of that is because you've been forced to get out of bed and move around. Wouldn't you agree that the proof is in the pudding?"
"That's what they say," she said.
"Well, I can see from the evidence that 'what they say' certainly applies to your stay here. So I think we just need to go with it and continue to make and eat the pudding you've been served here since you're doing so well on it."
She mumbled and grumbled and shot me dirty looks but when I moved to "whup her up" she rose under her own steam in defiance of my arms wrapped around her. "I can do it myself," she said, as though she was settling an argument in her favor.
"Good. That makes my job a lot easier."
Well, I've got places to go, things to do and people to see to get everything ready for Mom's arrival, tomorrow. I'll check in...
...later.
