Archive for April, 2014

“Slow Medicine,” and Living Wills for the Well

April 17, 2014

Dennis McCulloch, Chief Geriatrician at Kendal-At-Hanover, has written a kind and sensitive book, My Mother, Your Mother: Embracing “Slow Medicine,” The Compassionate Approach to Caring for Your Aging Loved Ones. The book offers a reliable road map and guide for children with aging parents.

People over seventy may find the book a bit creepy as it outlines the stages of decline in store for all of us. Wherever you find yourself on the spectrum, now is the time to see that your living will is documented and ready to be accessed whenever needed.

What I like about the book is the way McCullough draws on over 30 years of experience in which he helped his clients “postpone as long as possible any decline of function that might require institutionalization.”

The debate over end-of-life care weaves in and out of the news and recent book releases, no doubt spurred on by the struggle over the cost for health care. The time to draw up a living will is when we are well, thinking clearly, and before we have trouble making decisions. It can always be updated, but it does need to be put in place.

Those of us who value quality of life over simply existing in a deteriorating state, have likely had to watch a loved one depart after having their life unnecessarily prolonged in a state they never would have chosen for themselves. However, each one of us has the authority to decide how our end-of-life care will be administered, if we put our wishes in place when we are well.

My mother did not choose to make a living will, despite encouragement from us, her children, to do so. She was sure we were out for her money, despite the fact that we had been urging her for years to travel and consider us her insurance if her money ran out. She ended up living her last several years literally physically deteriorating to a shell while continually being “saved” by antibiotics. None of us dared make the choice for her to do otherwise.

Not wanting my children or myself to ever have to be in that agonizing position, I drew up my living will in my 50s. Each of them has a copy, as do health care providers I see. It is a relief to me, and I hope to them, that should I be unable to make decisions: do not resuscitate, no antibiotics, no ventilators, no tube feedings, etc. are all in place. I found a good and reasonable lawyer to draw it up so that I could be sure everything was covered, including appointment of my Health Care Proxy and Power of Attorney designees.

McCullough also suggests that designated contact persons and your physician agree to advocate for your wishes should you ever need emergency services, since hospitals sometimes ignore these legal papers and insist on life-prolonging services, against a patient’s wishes.

Here it is spring, or at least the bulbs are trying to poke their way out of the snow and brighten things up for us. Spring is a time when we think about new life, fresh starts, and increased physical energy to be turning over new leaves. It’s a good time to put all of life in perspective so we don’t have to worry about it later. This is a vital part of keeping each other well and enjoying life.


Beware HQ Tricks to Scam NH with the Northern Pass

April 5, 2014

Hydro Quebec’s (HQ) continuing theme to delude NH citizens into accepting the Northern Pass (NP) came in the form of NP spokesperson, Lauren Collins’s 4/2/14 article in the Boston Globe talking about 1200 jobs for construction. NP clearly figures that if repeated enough times, NH people will believe their scam. Now hear this: translated, the Northern Pass project also means 1200 unemployed on completion of the project in addition to the tourism people the project will put out of work.

Tricks are what Hydro Quebec specializes in. They evidently make much more money that way. In an earlier column, I spelled out the deal HQ tricked Newfound/Labrador’s (NL) former Premier Smallwood into signing. HQ’s trick was for NL to sell power to HQ at 0.2 cents/kwh. That is two-tenths of a cent per kwh, which HQ then sells for 7 cents/kwh. So HQ has made lots of money to buy NH property, alienate neighbors, illegally survey areas, and keep NH citizens riled up. For four years, NH citizens have spent enormous amounts of time and money in their efforts to protect NH’s safe future by urging the NH legislature to require HQ to bury the lines and pay the rent money to the State of NH.

HQ’s Transmission Division was willing to bury 110 miles of line to protect Australia’s environment, and HQ proved that undergounding not only saved Australia’s environment, it reduced outages by 80 percent. So, why all this hoopla for overhead lines in NH? Check out the minutes of the HQ sponsored, 2004 Federal Energy Regulatory Commission (FERC) conference in Hartford, CT. Minutes are on the FERC website.

Impacts of the project on electrical system reliability mean that by HQ’s own analysis, we can expect 80% higher maintenance costs on above ground lines than buried lines. We need to be concerned about future long terms costs, not about providing a few jobs for a few years, and then paying through the nose like Newfound/Labrador. HQ has already destroyed their once beautiful province. To assuage their guilt, they have assured Quebec citizens that Quebec will always have cheap energy, but guess who they plan to hoodwink into paying for that energy? Guess whose land they plan to destroy next? HQ has already bought up huge parcels of NH land and Canada owns every NH dam in the CT River. Is anyone watching?

Keeping each other well includes caring for our environment and all we share it with. We are all part of a larger community of living, breathing life. Even children who have read Dr. Seuss’s Lorax know that. As adults, we have a responsibility to let our governor and legislators know we are not fooled by this disreputable corporation called Hydro Quebec. Hopefully, MA will stand with us in our quest. They too risk high costs for electricity.


Snow, COPD, and the Benefits of Exercise

April 5, 2014

I was surprised to hear a college student say, “I don’t mind the cold but I don’t like snow!” Having been born in a giant snowstorm that tied up Boston for several days, snow has the opposite effect on me. Snow makes me feel safe and protected, gives me a sense of wonder. As kids, we spent every daylight hour we weren’t in school outside building forts, igloos, sledding, or just eating the snow and checking our mittens for unusual formations of snowflakes.

Snow continues to be an important part of winter for me. Having joined the ranks of those with COPD (Chronic Obstructive Lung Disease), getting out in the snow and pumping up my lungs as much as possible tops the list of healthy exercises. The only difference now is that I have to be sure I intentionally exhale fully. If I make my exhalation twice as long as my inhalation, I squeeze my lungs out like a sponge ready to take in a big new breath. With COPD, when people continually take short breaths, their lungs get more sluggish than ever and the last thing we want is rigid, stuck, air bags.

So here’s food for thought if you or a friend are dealing with COPD. The 2:1 breath can be practiced whether sitting in a chair, walking up stairs, running, hiking or just about any activity. You can simply count the time it takes to fully exhale and then inhale to half that amount of time or you can count your paces.

Here in New Hampshire, we have a beautiful natural environment with a variety of free, built in attributes for exercise. Most of us live on or next to some sort of hill. Since we’ve been inundated with snow this year, woods trails have all been smoothed out with 2-3 feet or more of snow. With microspikes, most popular trails and roadways, especially when icy, are safely doable.

It can be a scarey shock to find that when hiking with a group, all of a sudden, you’re winded when you talk while hiking uphill, or when you can’t keep up with the group. As Sam Levenson would say, “So don’t talk on the uphill.” You’re probably not the only one gasping for breath. If necessary, find a group that hikes at a more comfortable pace but keep on hiking! Use ‘em or lose ‘em applies to lungs as well as to muscles.

It helps to find a friend or friends to exercise with both for incentive and companionship. One of the ways we can keep each other well is to get out and enjoy this snow while it lasts. This week, the group I hiked with did the Sugarloafs off the Zealand road. It was a bit steep going up but we had exhilarating luge runs coming down. All that’s needed is a big black trash bag wrapped around your tush and a great hooting “Whoo!” Ah, snow.