Opa Goes to the Dominican Republic

La Romana, Dominican Republic in October 2014. A picture says a thousand words.

Opa Turns 86!

We began celebrating Opa's birthday at 4:00 p.m. on August 13th.

As Opa'd requested, there were rouladen and spaetzle, followed by cake and coffee. But what Opa seemed to enjoy the most, besides the presents, were the Elder Flower Martinis that we had before dinner.

Since Opa had eaten more than usual earlier that day, I didn't expect the martinis to have the effect that they did. Oops! And I worried that Opa might not make it to dinner, but I underestimated his stamina.

Opa was in great spirits for the entire day, laughing, joking and celebrating as one does when it's someone's birthday. Whose birthday it was, Opa wasn't sure. But it didn't matter to him in the least.

There was only one little glitch and that was when I decided to ask our tipsy Opa how he felt about turning 86.

It was just a momentary glitch. Memory loss was a definite advantage for Opa who quickly recovered from the shock and continued celebrating until midnight when his "63rd" birthday officially came to an end.

Happy 86th birthday, Opa, our dear father, grandfather, uncle and friend! Sto Lat!

Health Problems Resolved

So the health problems that Opa experienced after the cystoscopy (which I wrote about here) appear to be resolved! Although it took a couple of weeks, the Urotonic Tea seems to have worked. Opa is symptom free and back in good form! 

Table

I wake up this morning to find that Opa has set the table during the night. There are four place settings perfectly arranged.

 

There is also a candy in a wrapper on one of the plates, a funnel in one of the three juice glasses, a ceramic bowl and two stacked glass bowls, a straw trivet, and four shot glasses (!). 

It reminds me of this poem --

Table

A man filled with the gladness of living

Put his keys on the table,

Put flowers in a copper bowl there.

He put his eggs and milk on the table.

He put there the light that came in through the window,

Sounds of a bicycle, sound of a spinning wheel.

The softness of bread and weather he put there.

On the table the man put

Things that happened in his mind.

What he wanted to do in life,

He put that there.

Those he loved, those he didn't love,

The man put them on the table too.

Three times three make nine:

The man put nine on the table.

He was next to the window next to the sky;

He reached out and placed on the table endlessness.

So many days he had wanted to drink a beer!

He put on the table the pouring of that beer.

He placed there his sleep and his wakefulness;

His hunger and his fullness he placed there.

Now that's what I call a table!

It didn't complain at all about the load.

It wobbled once or twice, then stood firm.

The man kept piling things on.
 

 ~ by Turkish poet, Edip Cansever

Update on Opa's Health

Opa has had some difficulties since his cystoscopy which was done a couple of months ago as part of his annual physical checkup. The results were good -- no signs of bladder cancer -- but he experienced some complications.

Since finishing the course of antibiotics, the incontinence has improved significantly, but there is still blood in the urine. Plus there are side-effects from the antibiotics: diarrhea, fatigue and poor appetite. Opa's not even interested in his all-time-favourite beverage, milk!

I called the clinic a couple of days ago, thinking that maybe the antibiotics didn't clear the urinary tract infection. I was told that no bacteria grew in the urine culture. This was surprising since the urinalysis revealed white blood cells which usually indicates a UTI. This was also troubling since now the most likely cause of Opa's symptoms is injury to the urethra or bladder from the cystoscopy.

Before returning to the urologist, who is likely to recommend some invasive treatment, we've decided to go the alternative medicine route.

A holistic health care professional recommended Urotonic Medicinal Tea to help soothe and heal the  urinary tract and Ultimate Flora Critical Care to restore proper digestive function and boost the immune system. Opa's iron levels tend to be on the low end of normal since he rarely eats meat, and are probably even lower now that he's had this bleeding problem for so long, so we've also added Floradix.

We were told that improvement of urinary symptoms is generally experienced in about three days with the Urotonic Tea. It's Day 2 now, so we'll see how it goes. Keeping fingers crossed!

How a Girl Can Get a Boy's Attention

"Opa, what's the best way for a girl to let a boy know that she likes him?"

"Oh, that's easy. First she should find out where he is and go there. Then she should make a few rounds so that he can see her. Very soon he will think, "Oh, there is that beautiful girl! I must ask her to go to the dance with me!"

"Is that how Oma got your attention?"

"Oh, yes!"

Breakfast for Michael the Cat

Now that Opa has finished his course of antibiotics, he is definitely feeling better. It shows, not only in his mood but also in his creativity. He's back to preparing interesting meals, not only for himself and me but also for Michael the Cat.

This morning, Michael was treated to a bowl of dry, uncoooked, soup noodles with a side of crumbled chicken bouillon cubes.

I thought this was pretty clever since, unlike the other cat meals that Opa has lovingly prepared (like sandwiches, cheese wedges, pudding, bananas, mango juice, cereal, milk, and bowls of sugar), the ingredients of this one were closer to those of commercial cat food.

But as usual, Michael would have none of it. The expression on his face this morning was like "Seriously?"

Unlike Opa, Michael knows exactly where his cat food is. It's in the kitchen, steps from his food and water bowls. He'll even show you if you forget.   

He probably showed Opa, too, but his efforts were obviously ignored.  

Opa Makes Lunch

So Opa surprised me today by making lunch: a delicious relish sandwich for me and an equally delicious butter (no, that's not cheese) sandwich for himself. Yum!

New Hiding Spot

So I'm cleaning out the fridge today when, behind the crisper drawer, I find a plastic sandwich bag filled with three small, elastic-tied bundles.

The bundles had a weight to them. What could they be? I am both afraid and curious to find out. 



Ha! Mystery solved!



Opa being normal...

On Father's Day, Opa was in great spirits. He was also a little tipsy. So he gleefully went along with my niece when she suggested he play a little dress up. 

 

 

When she asked Opa if he had any advice for her, he said, "Yes, you should always be normal!"

 

Of course, we laughed because Opa wasn't exactly following his own advice that evening. But then he added, "By normal, I mean always be yourself. Never try to be someone you are not."

Sage advice as usual, Opa.

Nothing that a little fishing can't cure...

Opa Gets Cranky

 

Opa has had some cranky days as of late. And no wonder. Since his yearly physical, which included a cystoscopy that was done a couple of months ago, it has been one thing after another. First he had a nasty fall that resulted in 8 stitches, a CT scan and a 10 hour overnight wait in the ER.

A couple of weeks later, Opa woke up one morning with Bell's Palsy. We knew that it wasn't a stroke because he was unable to move the eyebrow on the affected side of his face (stroke victims are able) and had no weakness in his arms or legs. But it was still quite distressing, for me anyway.

 

The effects of Bell’s Palsy are bad enough, but the dementia created a huge challenge. Opa could not remember why his eye was dry. All he knew was that he wanted to rub it. So he did. Every two minutes. His eye was a mess in no time, red and irritated, with the lower lid hanging lower and lower. Solution: preservative-free eye drops, ointment, and an eye-patch.

As usual, Opa was quite calm about the situation. But I was not. I hovered over him like a mother hen, putting in eye drops every couple of hours, making sure he kept his eye-patch on, applying the ointment at night. How annoying this must have been for him! At first, he didn’t show it. But after a week of this, he told me in no uncertain terms that he would no longer wear the patch and would take care of his own eye, thank you very much. So what could I do except to take a deep breath and hope for the best?

 

As it turned out, the symptoms improved dramatically each day, without any interference from me and despite Opa's frequent eye rubbing. I was quite amazed that, a week later, Opa’s recovery from Bell's Palsy was complete!

.
Opa has also been challenged with intermittent bouts of incontinence, an unexpected adverse side-effect of the cystoscopy, which we were told should resolve in time. I bought him Tena protective guards which also had an unwanted side-effect, though it took me a few days to realize it. Several times I was greeted in the morning by soaked mats in the bathroom and standing water in the basement below. The toilet wasn’t plugged so what was going on? I finally clued. Opa must have been quite persistent during the nights when he tried, with eventual success, to flush the offending guards down the toilet! So, needless to say, the guards were scrapped, and we persevere instead with frequent changes of clothing and bedding, never straying too far from a bathroom. When blood appeared in Opa’s urine today, we went to a walk-in clinic. Poor Opa. Turns out he has a bladder infection.

 

Keeping fingers crossed that there will be no more setbacks and that Opa will be back in good form in a few days.

Michael the Cat

"Bananas? Really?"

The Red Wine Experiment

In Opa’s family, there is a high risk of cardiovascular disease. Opa himself has cardiovascular disease and had life-saving bypass surgery almost 20 years ago.  At 85, he has outlived all of his 10 siblings many of whom did not survive beyond middle age.

After the bypass surgery, Opa was prescribed the beta-blocker Sotalol to control blood pressure and the statin Lipitor to control cholesterol. Although he took these medications faithfully for more than 15 years, both his blood pressure and LDL cholesterol levels remained high. Opa was also diagnosed with non-alcoholic fatty liver disease (NAFLD) which was attributed to his diet. Four years ago, Opa decided that the side-effects of Lipitor, particularly muscle pain and fatigue, were no longer tolerable. And, against his doctor's advice, he stopped using all prescribed medications.  

Opa hardly eats any meat, but he does love cheese, cream, milk and butter. So when he discontinued the meds, I suggested that we start drinking red wine with rich meals to help lower cholesterol (and also because I happen to like red wine). He agreed even though he didn't particularly like wine and almost never drank alcohol.

Like many others, I have known for a long time that moderate drinking of red wine and other alcoholic beverages is associated with a reduced risk of heart disease. But I didn’t know how much cardio protection wine offers until today.

According to the British Medical Journal, 30 grams of alcohol a day may cause an estimated reduction of 24.7% in risk of coronary heart disease ("standard" drinks of a 5 oz glass of wine, a 12 oz can of beer, and a 1.5 oz shot of hard liquor each contain about 14 grams of alcohol).

Findings published in the American Heart Association journal showed that “drinking 1 to 2 drinks per day, 3 to 4 days per week decreased the risk of having a heart attack by as much as 32%... and was found to be associated with an approximately 20% reduction in the risk for ischemic stroke and may even be beneficial in preventing subsequent strokes.”

In regard to mortality by all causes, the American Heart Association published a 2010 review showing that moderate alcohol consumption reduces the risk of mortality by all causes by 20%. (It should go without saying, but I'll mention anyway that high levels of alcohol consumption show the opposite effect.)

But what about statins?

Statins also reduce mortality. According to a recent Cochrane review, statins reduce risk of mortality by all causes by 0.76%. Across studies, for every group of 100 patients who did not take statins, 5.17 died within a few years, and for every group of 100 patients who took statins, 4.41 died within a few years. This positive effect, although small, is greater than the findings yielded in the previous Cochrane review which showed a 0.07% reduction in mortality. Also noteworthy is that some 15% - 20% of patients using statins experience side effects; muscle aches, fatigue, liver toxicity, and memory loss are among the most recognized to date.

And beta-blockers?

 

The Journal of the American Medical Association (Jama) released a media statement in October of 2012 with this headline: Beta-Blocker Use Not Associated with Lower Risk of Cardiovascular Events. Although beta-blockers have been the standard treatment for coronary artery disease, the 2012 review showed that “beta-blocker use was not associated with a lower event rate of cardiovascular events at 44-month follow-up, even among patients with prior history of MI [myocardial infarction]. Further research is warranted to identify subgroups that benefit from beta-blocker therapy and the optimal duration of beta-blocker therapy.”

So did Opa make the right decision when he switched to wine?

Beta blockers have not been shown to have any long term cardioprotective effects. Statins have been shown to reduce the rate of mortality by nearly 1% but also have unpleasant (and sometimes dangerous) side-effects. And two drinks of red wine (or other alcoholic beverage) a few times a week have been shown to reduce the risk of mortality by 20%, the risk of heart attack by 32%, and the risk of stroke by 20%. Plus side-effects are generally pleasant. So, based on the research, it's safe to say yes, Opa made the right decision. It'a slso safe to say that he made the right decision based on the results of his check-up.

As I think I mentioned in a previous post, Opa recently returned to his doctor for a complete physical (read: he finally said yes after numerous suggestions over the past few years). Results were as follows:

· blood pressure 120/80 (normal)

· LDL cholesterol 2.1 (considered to be in the ideal range for people at risk of heart disease)

· liver function normal (confirmed by blood tests and ultrasound)

Opa’s doctor was amazed (as was I!) and wondered what might account for these results. He smiled when I suggested that it might be the red wine. His advice to Opa? “While I can’t prescribe red wine, I suggest that you just keep doing what you’re doing.”

 

I didn't mention it to the doctor, but I can't help but think that, in Opa's case, the dementia might also be a cardio protective factor. Or maybe not the dementia per se but its meditation-like, "living in the present" effects, coupled perhaps with our calm, low-stress home environment. 

 

Studies consistently show the health benefits of meditation. Most striking is a 2009 study from the Medical College of Wisconsin in Milwaukee presented to the American Heart Association. Findings from the 9-year study showed that participants with coronary heart disease who practiced meditation had 47% lower rates of heart attack, stroke, and mortality by all causes compared to nonmeditating controls.

 

Although Opa would never have been interested in meditation or concepts like "living in the present" in younger days, I don't think this research would surprise him today. In fact, if you ask him what the secret to good health is, he will invariably respond with this:

 

He might also want to add: "And maybe drink a little red wine."

Early Morning Ultrasound

Opa and I are not morning people. So, needless to say, I wasn’t thrilled when Opa’s ultrasound was booked for 7:30 am. I was even less thrilled when I learned that the test required an 8 hour fast. Opa is a round-the-clock grazer and he is also very persistent, especially when it comes to quenching his thirst.

Opa drinks 3 quarts of milk a day, and only turns to water when no other drinkable liquids are available. (I recently found a bottle of Tamari on his nightstand.) So I am thinking that it will be quite a challenge to keep Opa on this 8 hour fast. I decide to discuss it with him.

“You know, Dad, you have a checkup appointment tomorrow morning at the hospital and you’re not allowed to have anything to eat or drink after midnight.”

“No problem!” he says confidently.

“Yes, but I was wondering if it might not be a good idea to put a note on the fridge to remind you just in case?”

“The note is a good idea,” he says. “But I don’t think you should put it on the fridge.”

“Where should I put it then?”

“On my finger,” he says with a grin. “If you tied a note to my finger I would notice it right away.”

I laugh. “But what if you rip it off in your sleep?”

“Hm... Yes, yes, I would probably do that. You could tie a note to the handle of the fridge. I would notice that right away too.”

“Thanks, Dad. Great idea.”
 

At midnight, I have the note ready. And I tie the fridge and cupboard door handles securely together with string.

 

 

I also take some extra precautions: wine and cognac are removed from the cold cellar, and scissors and knives are removed from the kitchen and stored in my room for the night.

When I get up rhis morning at 5:30, the note has been moved to the kitchen table, but everything else is intact. At 6:00 am, I wake up Opa. He springs to life and seems quite happy.

“Where are we going?” he asks with a smile of anticipation as I get his shaving stuff ready. But when he hears my answer, his mood fizzles. “To the hospital for a checkup? At this hour? It’s still dark!”

“I know, Dad. It’s really early. I tried to get a different time for you, but...”

“No, I am not going.” He turns and walks away. “I go back to bed.”

 I know from experience that you don’t try to oppose Opa (or me) first thing in the morning. I also know that today I have an advantage: Opa’s 8 hour fast.  

“Before you go, Dad, I was hoping to treat you for a big breakfast after the appointment. Bacon and eggs, pancakes with syrup, orange juice, coffee... or whatever else you’d like. What do you think?”

He turns and glares at me. Then his eyebrows slowly unfurl and I know I’ve got him. Within seconds he is a happy again and lets me shave him (note to self: research electric razors). The rest of the day goes without a hitch... well, except for the clearly audible commentaries about his fellow patients in the waiting room (“Why is that bald man who just came in not wearing a hat? Is he not freezing?” “Look at that woman in the corner! Vow, is she big!”). But I am used to this now.

Breakfast was delicious. We're off to see his family doctor soon for the results of other tests. Maybe afterwards we'll go out for fish and chips.

Sweet Potato Disposal

So we’re cutting sweet potato fries and Opa walks by and snags one.

“It’s raw, Dad. I don’t think you’ll like it.”

“Oh, no, I like it”, he says as he takes a bite and continues walking through the kitchen.

Later, I water the plants in the sunroom and see this: