Monday, December 9, 2013

What do shingles look like?

This is a photo of Mom last year when she got shingles on her face and head. This is after 2 days of what the nursing home called a "rash" and it got much worse.  The nursing home sent her to the doctor thinking she needed antibiotics but he immediately noticed that there were specific linear boundaries to it and diagnosed shingles.  When someone has shingles on the head, s/he may get pus-filled blisters that ooze, like canker sores on ones lip but they are in a broader area within a specific boundary.  Don't touch the ooze!! It's grose but it's full of the shingles virus and you could contract or spread it.

In mom's case it's like someone drew a perfectly level line starting just under her nose and around to her left ear then on to the back of her head. From that point the line went over the very middle of her head and down her nose.  Think of a ball and the same lines; it's like 1/4 of the ball was covered in sores.  

She had shingles years ago and they were in a very specific strip from the middle of her back around her waist to the left and across the front of her body.  Shingles infects the nerve endings in the skin and the patterns are very specific and linear - it's very geometric.  In men shingles often forms on the left chest, back and shoulder.  The pain is quite severe and often the initial fear is a heart attack but it's on the surface not a deep pain so that's how you can tell the difference.

I would also note Mom's eye and the eyebrow. This area was swollen and painful overall.  Her eyes are blue and usually clear but the infected eye turned right turquoise and the white part got yellowish.   She had many sores in her eye brow and into her hair line.

A year later, I notice that her forehead is still red and blotchy and the hair in the infected area is thinner.  She's 93 so part of it could be her age but I can't help wonder if the sores helped increase the thinning.

Shingles on my head, shingles on the head, shingles on the face, how can i tell if i have shingles? How can i tell if mom has shingles? how can i tell if dad has shingles?

Monday, November 4, 2013

So it's time to take away the car but should grandpa keep his guns too?

Caring for elderly parents often means worrying about the right time for them to stop driving but because I live in the US of A and we have the right to bare arms - it's irresponsible NOT to consider if and when to remove guns from an elderly family member.  It is especially important if he or she is suffering from dementia, becoming paranoid or has violent potential.

Keeping a parent from driving seems minor compared to the possible firestorm that might result from telling grandpa that he can't be trusted with his hunting rifle any longer.   I realized this today after reading about an 88 year old man who shot a police officer in the head after the officer responded to a fire at the elderly man's home.  News reports indicate a history of threats to shoot neighbors and a short-lived restraining order filed by a girl friend.  This makes me wonder if he had dementia which caused his outbursts to become worse over time.

Last year  I read about another instance where an elderly man shot two of his children at his home.  One died and the other was seriously injured.  The man was later diagnosed with dementia and news reports indicated that police had been at the home before.   I wonder why his children did not remove guns from the home if he was showing signs of dementia and growing paranoid.  It seems like the first thing we should do but, like the car, the situation poses all kinds of emotional questions about their judgement, independence and rights.

We want to show our parents respect and empathy but something has to change.  It's MORE important to remove firearms than a vehicle, though either might be used to cause harm.  I would hope that police and families could work together to act when an elder demonstrates that he or she may no longer be trusted with guns.  Families need to watch for the first sign that something is wrong and then take action.  Unfortunately, given our right to own guns, I suspect there is no one to call for help unless the elderly person actually does something to actually harm somebody.  It's a shame there is not more that police can do to remove fire arms from someone with alzheimers or any other type of dementia.  I am all for forced removal of guns and ammunition as well as a federal blacklist of individual that are diagnosed with dementia, paranoia due to age related decline or anything other condition that could result in violent behavior.  Though I have great compassion for these folks, at some point in the progression of their disease there is no reasoning with some violent elders. Thus, there is no reason they should retain their right to own guns - their right to bare arms must be removed for the safely of those around them. The right to a safe environment by the many far out weights the right of one who's judgement and comprehension are gone. 

Tuesday, May 7, 2013

Best powder for old feet

I stopped using foot powder with talc on my mom's feet; it seems to leave mom's feet looking worse!  The best stuff is GoldBond medicated baby powder; iIt contains corn starch, kaolin clay and zinc oxide.  It seems much finer than powders with talc and I believe the bits of talc have sharp edges that cause greater irritation.  The clay in the baby powder may also be more absorbent.   SO - to prevent sores and keep feet dry - powder WITHOUT talc.

For more advise on the best care for elderly feet see my other posts:

What is the best powder to keep feet dry?  Old feet have special needs.  How do I keep mom's feet dry?

Sunday, February 10, 2013

Clothing options for dowagers hump

The past year or two finding tops to fit over my mom's severe dowagers hump is impossible so I alter off-the-rack tops to fit her.   I use an old method that my grandma taught me when she made or altered clothes. She used patterns that she knew were too big to make the garment then she'd have the "wearer" put it on inside out and pinch darts or seams where needed to get a better fit specific to "that" body. 

So - now I buy tops for Mom that are too large, put them on her inside out and just start pinching fabric to make darts around the neck and upper body until the garment appears to fit better.  Then I take it off and stitch up the darts.    Often the altered top ends up being much shorter in back and longer in front so start with long garments to end up with something that has enough fabric to cover the back and still be long enough to come down beyond the waist.

Here are some tips that help ensure each is a success:
  1. practice with really cheap or used clothes, just TRY IT and you'll get the hang of it.
  2. try knit fabrics first, zig-zag the end of fabric before hemming, 
  3. when hemming, it's likely you'll have to sew across the bias (across the weave) since the fabric will fall at an angle from the back due to the rounded hump.  This takes some practice so give yourself a couple of inches of fabric BELOW where the hem will be to help with "smoothing" the hemline. 
  4. try some additional seems along the sides  - think princess seams - to help remove extra "bulk" around the middle.  don't be afraid to stitch it up and cut off the fabric after a few fittings to ensure it's a good fit. , if you get something large enough to fit over the back area, it's likely to be too big around the middle which will cause extra folds and unwanted bulk, the seams will help remove the bulk.
  5. don't use tops with "shirt-type" collars, they are too hard to alter. 
  6. be prepared to re-hem the garment and cut off a lot in the front. 
  7. be sure to measure and pin the hem when the top is ON your elder, this ensures it's long enough and even.  
  8. use safety pins to keep the darts instead of straight pins; this prevents getting poked.
Good luck!

Here are links to other sources for information on sewing or fashions for clothing with dowagers hump:
Louisiana arthritis clinic
Rusty Bobbin blog
Threads magazine article on dowagers hump  (one of my fave magazines by the way)
Silverts for special needs or "adaptive" clothing

clothing for dowagers hum, clothes to  cover dowagers hump

One of my posts makes me saddest...recurring sores and cancer

One post on this blog is, by far, the most popular and reading the numbers about it makes me sad.  Titled "CAUTION  - recurring sores may be skin cancer", this post gets more and more hits everyday and that's what makes me sad. The posts come from all over globe, about half from the USA but many others in Europe, India, and former USSR block countries.  If people are concerned enough to research sores or pimples that won't heal, it means they have reason to worry for themselves or likely someone they love.

If you're one of those readers, know that I hope and pray for YOU, for anyone, that dermatology care (skin doctor) is affordable and easy for you to find.  I worry about the  un-insured, who won't visit  a doctor because they can't pay for it. Or people who ask a regular family doctor who will not take it seriously.  I know of two cases where the patient's regular doctor would not make a referral to a dermatologist or the dermatologist got it wrong.  One other, my nephew, didn't take it seriously and was uninsured.  My husband asked for a biopsy only to stop my nagging and it turned out to be cancer.  His physician never looked at his skin and only referred  him for a biopsy because he wanted to help my husband get off his case.

The bullets below describe these cases.  I will add that - none have passed away even though they got treatment more than 3 years ago.  I hope that offers some comfort to know that many of these skin cancers, if caught soon enough, are can be treated and are not fatal. 

Here are the  cases and their symptoms.
  • My husband, age 49 at the time:
    location: side of his nose, middle of his nostril
    appearance:  erupted as a pimple then healed up for about 3 months then erupted again, when not "a pimple" it was red and looked like a tiny cluster of capillaries or small blood vessels.
    prognosis: very good; it was caught  very, very early so they just cut out a small portion of his nostril, there is a small divot there now but it's hardly visible. If he gets too tan, it remains white but he should not be out in the sun anyway.   It's been 3 years now and it looks better and smoother all the time.  While the incision was healing he kept it covered with a band aid when he went out in the sun so that the healing skin would  not darken permanently.
  • My nephew, age 28 at the time:
    location: side of his nose, middle of his nostril
    appearance:  erupted as a pimple then healed up, when not "a pimple" it was red and looked like a tiny cluster of capillaries. The cluster grew as time went on.  After a year he attempted to treat it with some kind of "black salve".  This seemed to burn the skin and made it look horrible but did nothing to help it heal. If anything, it made things worse because it delayed his surgery and the cancer grew bigger.
    prognosis: pretty good because he was young.  It was caught  early enough that surgery was possible but they had to remove his entire nostril and replace it with a flap of skin from his forehead.  He was in a lot of pain during the three weeks it took for the flap to graft onto his nose.  He had a 4 inch incision running up his forehead and the flap had to remain attached near his eye brow so that it got blood supply as it "grew" into his nostril. After a month he had another short procedure to sever the flap and close everything up.  It's been 6 years now and his scars look better and smoother all the time.  He avoids the sun at all costs but as a teen and young adult, he regularly got terrible sunburn during the summer.  He's convinced that this is the main cause of his cancer. I must note that 1 year after this surgery, he felt a small tingling under his eye and it turned out to be cancer as well. He caught it early so it was easily cutting out and there is little scaring.
  • My friend, age 60 at the time: two types of cancer
    location: cheeks and bridge of nose
    appearance:  scaly patches on cheeks and a very smooth patch of pale skin on the nose. She was treated for psoriasis on her cheeks for at least 5 years before going to a new dermatologist who did immediate biopsies and found cancer.  The dermatologist noticed the patch on her nose had no visible pores so ordered a biopsy of it as well, it was also cancer.
    prognosis:  very good, subsequent check ups reveal no return of either cancer. Both were slow growing types of cancers. She believes that if she had not gone to a new dermatologist she might have a very bad prognosis. She will tell anyone - follow your hunches, be an advocate for yourself and get pushy with your doctor or find another if you feel it's necessary.  Even psoriasis should respond to treatment after a while. She was embarrassed that she waited 5 years to seek a second option.
  • My friend's mother, age 82 at the time
    location:  top of the bridge of her nose and down the side, the region where eye glasses would rest against her skin.
    :  red blistered patch of skin that would seem to heal a bit then get worse again.  She had very fair skin and was sensitive to perfumes and dyes. Her general practice doctor told her and her daughters it was irritation from glasses or sunglasses, even though he was told over and over she didn't wear glasses, not even reading glasses.  One visit to a new doctor and he sent her to a dermatologist without question, he was immediately quite concerned about it.  We believe that the original doctor didn't care because she was elderly, beginning to demonstrate age-related forgetfulness and her only insurance was medicare. 
    prognosis:  good because it was a slow growing cancer, subsequent check ups reveal no return of the cancer. 
 Recurring pimple on nose, recurring sore on nose. sore that won't go away, sore that will not go away, pimple that will not go awayreoccurring lesion on nose,