health, physical exercise

Contents Brain and Heart

1. Reducing your risk of stroke and heart attack . . . . 32. Exercising for a healthy heart . . . . . . . . . . . . . . . . 43. Choosing a home blood pressure unit . . . . . . . . . . 54. Staying mentally sharp . . . . . . . . . . . . . . . . . . . . . . 6

Digestive and Urinary Tracts5. Avoiding heartburn . . . . . . . . . . . . . . . . . . . . . . . . 76. Preventing excess gas. . . . . . . . . . . . . . . . . . . . . . . 87. Preventing constipation . . . . . . . . . . . . . . . . . . . . . 98. Do’s and don’ts for diarrhea . . . . . . . . . . . . . . . . 109. Dealing with stress incontinence . . . . . . . . . . . . . 10

Bones and Joints10. Preventing osteoporosis . . . . . . . . . . . . . . . . . . . . 1111. Treating back pain at home . . . . . . . . . . . . . . . . . 1212. Living with arthritis: Assistive devices . . . . . . . . 13

Skin and Hair13. Spotting skin cancer . . . . . . . . . . . . . . . . . . . . . . . 1414. Guarding against dry skin . . . . . . . . . . . . . . . . . . 1515. Controlling dandruff . . . . . . . . . . . . . . . . . . . . . . 15

Eyes and Ears16. Ensuring proper lighting . . . . . . . . . . . . . . . . . . . 1617. Protecting your eyes from the sun . . . . . . . . . . . . 1718. Preventing noise-induced hearing loss . . . . . . . . . 1819. Choosing a hearing aid . . . . . . . . . . . . . . . . . . . . . 18

Nose, Throat and Mouth20. Relieving seasonal allergies . . . . . . . . . . . . . . . . . 1921. Soothing minor sore throat pain . . . . . . . . . . . . . . 2022. Battling bad breath . . . . . . . . . . . . . . . . . . . . . . . . 2123. Choosing toothpaste and mouthwash . . . . . . . . . 22

Legs and Feet24. Controlling painful leg cramps . . . . . . . . . . . . . . 2325. Self-care tips for varicose veins . . . . . . . . . . . . . . 2326. Shopping for shoes . . . . . . . . . . . . . . . . . . . . . . . 2427. Staying ahead of athlete’s foot . . . . . . . . . . . . . . . 25

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28. Preventing and treating corns and calluses . . . . . 2629. Warming up cold hands and feet . . . . . . . . . . . . . 27

Prevention of Common Illnesses30. Do’s and don’ts for avoiding infections . . . . . . . 28 31. Fending off the flu . . . . . . . . . . . . . . . . . . . . . . . . 29

Medications32. Avoiding food and drug interactions . . . . . . . . . . . 30 33. Asking the right questions about

your medications . . . . . . . . . . . . . . . . . . . . . . . . . 31

Doctor-Patient Relationship34. Getting the most from a visit to your doctor . . . . 3235. Following your doctor’s advice . . . . . . . . . . . . . 33

Food and Nutrition36. Choosing disease-fighting foods . . . . . . . . . . . . . 3437. Using healthy cooking methods . . . . . . . . . . . . . 3538. Do’s and don’ts for losing weight . . . . . . . . . . . . . . 3539. Handling food safely . . . . . . . . . . . . . . . . . . . . . . 3640. Keeping foods safe at picnics . . . . . . . . . . . . . . . 37

Dietary Supplements 41. Choosing a multivitamin as you get older . . . . . . 3842. Making informed decisions about

herbal supplements . . . . . . . . . . . . . . . . . . . . . . . 39

Safety and First Aid 43. How to prevent falls . . . . . . . . . . . . . . . . . . . . . . . 4044. Preventing yardwork mishaps . . . . . . . . . . . . . . . 4145. Treating puncture wounds . . . . . . . . . . . . . . . . . . 4246. Do’s and don’ts for minor burns . . . . . . . . . . . . . . 4347. Staying clear of lightning . . . . . . . . . . . . . . . . . . . 4448. Handling a medical emergency at home . . . . . . . 45

Stress Management49. Healthy ways to deal with stress . . . . . . . . . . . . 4650. Getting a good night’s sleep . . . . . . . . . . . . . . . . . 47

BRAIN AND HEART

Reducing your risk of strokeand heart attackOne of the best ways to protect yourself against a stroke orheart attack is by not smoking. Here are other ways:

• Maintain a healthy weightBeing overweight increases your risk of high blood pressure,high cholesterol levels, cardiovascular disease and diabetes —risk factors for a stroke and heart attack. So eat a nutritious dietand aim for 30 to 60 minutes of physical activity on most days.

• Limit fats and cholesterolLimit meat to a total of 6 ounces daily. Choose fat-free orlow-fat dairy products. Limit saturated fats and avoid transfats. Instead of solid fats (butter, margarine, shortening), usemonounsaturated oils (canola, olive and peanut) and polyun-saturated oils (corn, safflower, sesame, sunflower and soy).

• Eat fish that have omega-3sEat fish that have omega-3 fatty acids, such as salmon andtrout. (See “Eat foods high in omega-3s,” page 34.)

• Eat plenty of fruits and vegetablesProduce contains nutrients such as potassium, folate andantioxidants that may protect against stroke and heart attack.Eat at least three servings of fruits and at least four servingsof vegetables daily.

• Use alcohol moderately, if at allToo much alcohol can raise blood pressure. Moderate drink-ing is defined as no more than one drink a day for women andanyone age 65 or older and no more than two drinks a day formen under 65.

• Reduce sodium (salt)Limiting sodium in your diet and making other lifestylechanges can help prevent high blood pressure. If you alreadyhave it, reducing sodium intake further may help lower it.

350 Head-to-Toe Health Tips

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Exercising for a healthy heart If you exercise regularly, you may lower your risk of a heartattack and stroke. If you’re middle-aged or older and haven’tbeen exercising regularly or have a chronic health problem,work with your doctor to develop an exercise program. Tocondition your heart safely:

• Start at a comfortable level of exertion Try walking five to 10 minutes over a short distance indoors.Increase five minutes a session, as tolerated.

• Schedule regular exercise Aim for 30 to 60 minutes a day of low- to moderate-intensityphysical activity.

• Include variety Combine three types of exercise — stretching (flexibility),endurance (aerobic) and strengthening (weight training) —and three levels of intensity — warm-up, workout level andcool-down — in each exercise session.

• Cross-train to reduce your risk of injury Alternate among exercises that emphasize different parts ofthe body, such as swimming, bicycling and walking.

• Don’t overdo it Start slowly and build up gradually, allowing time betweensessions for your body to rest and recover. And forget the say-ing “No pain, no gain.” A little muscle soreness when you dosomething new isn’t unusual, but soreness doesn’t equal pain.If it hurts, stop doing it.

• Increase your physical activityEven routine activities such as gardening, climbing stairs or washing floors can burn calories and help improve yourhealth, although not at the same level as a structured exerciseprogram. Just keep moving: Walk or bike to the store insteadof driving, park farther away at the shopping mall, take thestairs instead of an elevator.

4 Mayo Clinic Health Solutions

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Choosing a home blood pressure unitYou can track your blood pressure by using a home monitorbetween checkups. To choose the best monitor for you, askyour doctor for advice and balance convenience with accuracy:

• Know your optionsAneroid models are inexpensive and easy to transport. Theyinclude a stethoscope. Some have extra-large dials for easierreading, but they aren’t recommended if you have troublehearing or have poor dexterity in your hands. Electronic (digi-tal) models are the most popular and can be expensive, butthey’re easy to use. However, if your heart rhythm is usuallyirregular, an electronic model may give you an inaccuratereading. Wrist monitors are difficult to calibrate, and digitalfinger units aren’t reliable.

• Get a good fitMost monitors have standard-size inflatable arm cuffs. If yourarm is too large or too small for the cuff, buy the right size. A poor fit reduces accuracy. The inflatable portion of the cuffshould wrap around 80 percent or more of your upper arm.

• Consider your abilitiesIs the gauge or digital display large enough to read easily? Doyou hear well through a stethoscope? Can you easily pumpthe inflatable cuff?

• Test before you buyAsk your health care professional or medical supply sales-person to show you how to get the most accurate reading.

• Learn how to use it properlyAfter you buy a blood pressure monitor, take it with you toyour doctor’s office. In addition to making sure the deviceworks properly, your doctor or nurse can help you learn howto use it.

• Check accuracyEvery six to 12 months, have your home monitor checkedagainst a standardized unit at your doctor’s office, fire department or public health service.


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Staying mentally sharpBoost your memory and develop habits that can help counterage-related memory loss:

• Make associationsFor example, if you’re introduced to Fred who has red hair,link his name to his hair color.

• Choose what to rememberIf you meet several people at once, focus on remembering afew key names.

• Recite, retrieve and reviewRecite key information several times to learn it and retrieve it often. Review information you’ll need, such as pagingthrough your high-school yearbook before your reunion.

• Break it down Break down new information into units. For example, to memo-rize a long-distance phone number, break it down into the areacode, three-digit exchange and four remaining numbers.

• Pay attentionForgetfulness may indicate nothing more than having toomuch on your mind. Slow down and pay full attention to thetask at hand. Reduce distractions.

• Keep track of appointments, tasks and contactsUse appointment books, calendars, to-do lists, address booksor computer software — whatever works for you.

• Develop routinesFor example, put frequently used items such as keys in a designated spot when not using them.

• Create rituals and cues for common tasksFor example, make sure your keys are in hand before lockingyour car doors. Place packages you need to mail near thefront door so that you won’t forget them.

• Consider meditationPreliminary research indicates that meditation increases bloodflow to the area of the brain that’s associated with memory.


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DIGESTIVE AND URINARY TRACTS

Avoiding heartburnHeartburn results from a backup of acid-containing stomachcontents into your esophagus. Here are tips for prevention:

• Eat smaller meals Too much food expands your stomach and puts pressure on a band of muscle (the lower esophageal sphincter) that helpskeep food and acid from backing up into your esophagus.

• Avoid alcohol, fatty foods, chocolate, spearmint and peppermint

These foods can relax your lower esophageal sphincter andpromote upward flow of stomach contents.

• Consider using an antacid or H-2 blockerAntacids such as Maalox, Mylanta, Tums and others help neu-tralize stomach acids temporarily. Over-the-counter histamine(H-2) blockers such as Pepcid AC, Tagamet HB, Zantac 75and others reduce stomach acid production, which may relieveor prevent symptoms when taken before a meal. But overuseof antacids or H-2 blockers can cause side effects.

• Don’t eat before sleepingWait two to three hours after eating before lying down. Thisallows enough time for increased stomach acid produced after a meal to taper off and for the stomach to empty from that meal.

• Stop smokingThe nicotine from cigarettes can relax your lower esophagealsphincter, allowing acid to flow back into your esophagus.

• Lose excess weight Slimming down if you’re overweight helps reduce the pressureyour abdomen puts on your stomach when you’re lying down.

• Wear loose clothesA tight belt or waistband can put pressure on your stomachand push acid into your esophagus, causing discomfort.


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• Elevate the head of your bedRaise the head of your bed four to six inches. This helps keepstomach acid in your stomach, where it belongs.

Preventing excess gas Too much gas typically is caused by the incomplete absorp-tion of certain starches and sugars during digestion. Bacteriain your intestine then ferment the sugars, forming gas. To prevent excess gas:

• Limit gassy foodsThe worst gas-formers are beans and other legumes, wheatand wheat bran, cabbage, onions, Brussels sprouts, sauerkraut,apricots, bananas and prunes. Milk and other dairy productsalso can cause gas if you have reduced amounts of lactase,the enzyme needed to digest lactose, the main sugar in milk.

• Consider taking anti-gas productsBeano, a food enzyme, helps improve the digestion of gas-forming foods. Nonprescription medications such assimethicone (Gas-X, Mylicon) or antacids that also havesimethicone (such as the anti-gas formulations of Maalox or Mylanta), may relieve gas.

• Eat fewer fatty foods Fatty meats, fried foods, cream sauces and gravies tend toincrease gas and bloating. And they can contribute to unwantedweight gain.

• Limit sugar substitutesMany healthy people poorly absorb sorbitol and mannitolcontained in some sugar-free foods, candies and gums. Theamount of sorbitol contained in five sticks of sugar-free gumcan cause gas and diarrhea in some people.

• Consider products for lactose intolerance, if neededIf you have trouble digesting milk sugar (lactose), this maycause gas. Consider buying lactose-reduced or lactose-freeproducts. Or consider products with the lactase enzyme (suchas Dairy Ease or Lactaid), which can help you digest lactose.


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Preventing constipation To help prevent constipation:

• Don’t skip mealsBalanced, regularly scheduled meals promote regular bowelfunction.

• Eat high-fiber foodsEmphasize fresh fruits, vegetables and whole grains at everymeal. Increase fiber even more by adding 2 to 3 tablespoonsof wheat bran to cereals, casseroles and baked goods.

• Drink plenty of fluidsDrink eight or more 8-ounce glasses of liquid daily in theform of water, juice, milk, tea or soup.

• Increase your physical activity Try to get at least 30 minutes of exercise such as walking,biking or swimming on most days of the week.

• Answer the urgeWhen you feel the urge to go, don’t delay. Holding a bowelmovement can foster constipation.

• Be flexible about ‘normal regularity’Don’t fret if you’re not a once-a-day person. Some peoplehave bowel movements several times daily, while others havethem only three times a week.

• Ask your doctor about fiber supplements If you’re having difficulty getting enough fiber in your diet,your doctor may recommend a fiber supplement. Over-the-counter products such as Citrucel and Metamucil promoteregularity similar to the way that fiber in food does. But foodis still the best source of fiber.

• Don’t rely on stimulant laxativesThese include products such as Dulcolax and Senokot, whichwork by irritating the walls of your intestines. Habitual use can make constipation worse. For occasional relief, tryosmotic agents, such as milk of magnesia. Don’t use laxativesregularly without consulting your doctor.


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Do’s and don’ts for diarrhea Diarrhea ordinarily clears up on its own. For a mild case ofdiarrhea, here’s how to manage your discomfort at home:

• Drink certain liquidsTry broth, diluted fruit juices (except prune juice) and bever-ages containing electrolytes, such as Gatorade. Drinks thathave electrolytes help replace the fluids and body chemicalslost during diarrhea.

• Drink enough liquids Drink enough liquids daily so that you urinate about everyfour hours. If you have diarrhea and your urine is dark, youmay be getting dehydrated. This is a clue to drink more fluids.

• Eat low-fiber foods (only when you have diarrhea)As your symptoms improve or your stools become formed,start to eat low-fiber foods, such as soda crackers, toast (whitebread), eggs, rice or chicken. Don’t consume greasy or fattyfoods, milk, or highly seasoned foods for a few days.

• Avoid medicationsShort-term diarrhea doesn’t require antibiotics. And for mostcases, you don’t need an over-the-counter anti-diarrheal product.These may slow the elimination of the infectious agent andactually prolong your diarrhea. Situations vary, though, so askyour doctor about your specific case.

Dealing with stress incontinenceSudden, strong pressure (stress) on your bladder from exercis-ing, coughing, sneezing or heavy lifting can cause inconti-nence. This “leaky bladder,” called stress incontinence, iscommon among women. Treatment varies, depending onseverity. Talk with your doctor about options, such as:

• Kegel exercisesTo do Kegel exercises, imagine that you’re trying to stop yourflow of urine. Squeeze the muscles you’d use and hold for acount of three. Relax for three counts. Repeat. Do these several


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times a day. With a simple physical exam, your doctor canhelp you identify these muscles and learn to do Kegels. Mostwomen will benefit, and the results can be long lasting. If you do Kegels routinely, you’ll likely see improvement withintwo months. If you don’t experience improvement, talk withyour doctor.

• Absorbent pads and adult diapersMost of these products are no bulkier than normal underwearand can be worn under everyday clothing. But don’t resort to using diapers without asking your doctor about all yourtreatment options.

• Other proceduresAsk your doctor about other options, such as injected bulkingagents and other minimally invasive surgical procedures.

BONES AND JOINTS

Preventing osteoporosisTo help prevent osteoporosis, get proper nutrition and regularphysical activity, and avoid smoking and excessive alcoholconsumption.

• Eat calcium-rich foodsDairy products such as milk, yogurt and cheese are the richestsources of calcium. Fat-free and low-fat products, calcium-fortified orange juice and cereals, fish with edible bones, andcertain vegetables (such as rhubarb, soybeans and spinach) aregood sources. Healthy adults ages 19 to 50 need at least 1,000milligrams (mg) of calcium a day from all sources. Olderadults need 1,200 mg a day.

• Consider a calcium supplementCalcium carbonate is the least expensive and most commonlyused calcium supplement, and it’s better absorbed when takenwith meals. Calcium citrate is more easily absorbed butrequires more pills to reach the recommended amount.Calcium phosphate is the least likely to cause constipation.


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• Get enough vitamin DIf you’re not taking a multivitamin, consider a calcium supplement that also has vitamin D, and milk that’s fortified with Vitamin D. Vitamin D is essential for enhancing theamount of calcium that ultimately reaches your bones. In addi-tion, the body can produce vitamin D from exposure to sunlight.Ten to 15 minutes of exposure two to three times a week helps.

• Exercise regularlyRegular physical activity and exercise help slow bone loss and improve balance, coordination and muscle strength.

• Avoid smoking and excessive drinking of alcohol Smoking increases the rate of bone loss. Regularly drinkingmore than moderate levels of alcohol can hasten bone lossand reduce ability to absorb calcium.

Treating back pain at homeBack pain usually resolves within two to three weeks by tak-ing the simple self-care measures noted below. But contactyour doctor immediately if your back pain is the result of afall or blow to your back, it causes weakness or numbness inone or both legs, or it causes new bladder or bowel problems.

• Apply cold, then heatApply ice four times a day — but no longer than 20 minutesat a time. Put ice in a plastic bag, then wrap the bag in a clothor towel to keep a thin barrier between it and your skin. Afteracute pain subsides, usually within the first two days, try aheating pad (low setting), heat lamp, warm compress or take a warm bath. Limit each heat application to 20 minutes. Toavoid burns, don’t fall asleep while using a heat source.Consider setting a timer to turn off the heat source or toawaken you if you do happen to fall asleep.

• Use over-the-counter medications if neededAcetaminophen may help control pain. Nonsteroidal anti-inflammatory drugs, such as ibuprofen, also can reduceinflammation. Read labels and use the recommended dosesunless your doctor advises otherwise. Check with your doctorif you’re taking other medications.


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• Combine rest with gentle movementGet plenty of rest, but avoid prolonged bed rest. Staying inbed more than two days may slow your recovery. Moderatemovement keeps your muscles strong and flexible. Avoidheavy lifting, pushing or pulling.

Living with arthritis: Assistive devices If you have arthritis, assistive devices may allow you to bemore independent with daily tasks. Consider these options:

• Hand aidsLook for aids that provide a wide-diameter grip. Many pens,for example, have thin shafts that force you to grasp themwith a tightly closed fist. A foam or plastic sleeve that slidesover the pen can correct this problem.

• Grooming and personal hygieneIf you have limited range of motion, use long-handled brushesand combs. Consider bathing aids such as long-handled spongesand brushes, bath benches and grab bars. Use an electric tooth-brush, a Radius toothbrush or one with a foam handle. Usemirrors with foam rubber handles for an easier grasp.

• Getting dressedBuy a shoehorn with an extension handle and use a stockingaid to help pull on hosiery. Look for tools that grip buttonsand zippers. Sew elasticized Velcro tabs onto shirt cuffs. Selectwraparound skirts or stretch trousers if limited range ofmotion makes dressing a challenge. Try clip-on neckties.

• In the kitchenPut everything that you use often within easy reach. Store fre-quently used cookware and utensils in cabinets at hip-to-shoul-der height. Consider a single-lever faucet so it’s less taxing onyour finger joints. Use an electric can opener and electric knife.

• Cleaning your homeUse a long-handled mop, dustpan and broom. Keep cleaningsupplies on each floor and store supplies within easy reach.Avoid unnecessary bending or stooping.


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SKIN AND HAIR

Spotting skin cancerLearn to recognize the signs and symptoms of the three typesof skin cancer. Even melanoma, the deadliest form, can usuallybe successfully treated if caught early. And remember, nomatter what your age, minimizing your exposure to ultraviolet(UV) light will help reduce your risk of skin cancer and premature aging.

• MelanomaAlthough melanoma can occur in normal skin, it often developsin a pre-existing mole or other dark spot. Examine your molesand look for these ABCDs:

Asymmetry. One half of the mole doesn’t match theother half.

Border irregularity. The edges are often ragged, notched,blurred or irregular, and the pigment may spread into thesurrounding skin.

Color. The mole may have shades of black, brown andtan, or areas of white, gray, red, pink or blue.

Diameter. Melanomas are typically larger than a pencileraser, although early melanomas may be smaller.

Also look for changes in the surface of a mole, scaliness,oozing, bleeding, or the appearance of a bump, spread ofpigment from the border into the surrounding skin, itchiness,tenderness, or pain.

• Basal cell carcinoma (BCC) This may appear as a small, raised, smooth, shiny or pearlybump that’s whitish to pink in color. Over time, it may crust,ulcerate and bleed. BCC is slow growing and rarely invadesinternal organs, but it can spread to nearby tissues if leftuntreated.

• Squamous cell carcinoma (SCC)Most often this type of skin cancer appears as a raised, scaly,crusty or wart-like bump, ranging in size from a pea to achestnut. SCC can spread internally if left untreated.


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Guarding against dry skinWith age, oil glands become less active. Your skin is less ableto replenish the oils and fluids removed by soap and water. Toguard against the drying effects of bathing, try these tips:

• Limit frequencyBathing once a day or every other day is sufficient for mostpeople.

• Limit time and temperatureUse warm (not hot) water for a maximum of 15 minutes.

• Select soaps carefullyChoose superfatted, nonsudsing soaps that clean without remov-ing natural oil. This includes brands such as Basis, Purposeand others. Soap substitutes in bar, gel and liquid forms are lessdrying than are deodorant and antibacterial soaps.

• Limit use of soapLimit use of soap to your face, underarms, genital areas,hands and feet. Using clear water on the other areas of yourbody cleans adequately most of the time.

• Pat dry, don’t rubWhen toweling dry, pat your skin gently. Or brush your skinrapidly with the palms of your hands.

• Seal in moistureWhile still damp, lubricate your skin with an oil or cream,especially on your legs, arms, back and sides. A heavy mois-turizer (water-in-oil formula) is longer lasting than a lightcream that contains more water than oil (oil-in-water formula).

Controlling dandruffTry these suggestions to control common dandruff:

• Shampoo regularlyStart with a mild, nonmedicated shampoo. Gently massageyour scalp to loosen flakes. Rinse thoroughly.

• Use medicated shampoo for stubborn casesLook for those containing pyrithione zinc, salicylic acid, coal tar or selenium sulfide in brands such as Denorex, Head &


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Shoulders, Neutrogena T/Gel, Selsun Blue or Tegrin. For bestresults, use a dandruff shampoo each time you shampoo.

• Use tar-based shampoos carefullyThese shampoos are strong dandruff deterrents, but they canleave a brownish stain on light-colored or gray hair. They canalso make your scalp more sensitive to the sun. Check thelabel for ingredients.

• Treat your hair gentlyDandruff shampoos can be harsh on your hair and scalp. Usea conditioner regularly. For mild cases of dandruff, alternatedandruff shampoo with your regular shampoo.

• See a dermatologistIf dandruff persists or if your scalp becomes irritated orseverely itchy, you may need a prescription shampoo. Anantifungal cream called ketoconazole (Nizoral) often worksagainst dandruff and is available as a shampoo.

EYES AND EARS

Ensuring proper lightingIncrease overall lighting in your home to compensate for yourneed for more light as you get older. Make sure rooms haveuniform lighting from several sources.

• Position lights appropriatelyConcentrate light on close work by using adjustable goose-neck lamps and lights underneath kitchen cabinets. The fineryour task, the more light you need. Position lights for readingto shine from over your shoulder. Use lampshades that com-pletely shield the bulb so that light is directed up and down,not into your eyes.

• Turn down glareReplace glaring ceiling fixtures with wall or floor lamps thatdirect light upward. Choose matte surfaces instead of shinytabletops and highly polished floors that reflect light into youreyes. Select a nonglossy, off-white paint for walls. This type ofsurface maximizes light in a room without creating glare.


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• Use natural light wiselyDesign skylights with light wells that provide reflected light,not direct sunlight. On windows, install blinds that allow youto direct light upward to reflect off the ceiling. This offersuniform illumination and minimizes glare.

Protecting your eyes from the sunChoose sunglasses that:

• Provide maximum protection from UV lightLong-term exposure to ultraviolet (UV) light increases yourchance of cataracts. The greater the blockage of UV light, thelower your risk of damage. Choose lenses that block 99 percentto 100 percent of ultraviolet A (UVA) and ultraviolet B (UVB)light. Check the label.

• Reduce glareChoose sunglasses that are dark enough to reduce glare —light that bounces off smooth surfaces such as pavement,water, sand and snow — but not so dark that it’s hard to readtraffic signals. Polarized lenses decrease glare, but make surethey also provide maximum UV light protection.

• Fit close to your faceTo minimize UV light that can enter from the sides, buywraparound sunglasses.

• Meet your needsSunglasses that meet the above criteria don’t need to beexpensive. If you wear glasses for vision problems, ask youreye doctor about transition lenses that protect your eyes bydarkening automatically when you’re out in the sun. However,it takes time for the lenses to darken and lighten in differentlighting conditions, so make sure these types of lenses meetyour needs.


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Preventing noise-induced hearing lossRepeated exposure to loud noise and even a one-time exposureto loud noise can damage the delicate, sound-sensitive haircells in your inner ear. This type of hearing loss is irreversiblebut preventable. To protect your hearing:

• Lower the volume on your TV and stereo Choose personal stereos with an automatic volume limiter.

• Turn down the volume on headphonesBy directing sound into your ear, headphones can producelevels loud enough to damage your hearing. Hold your headsetan arm’s length away. If you can hear the sound, the volumeis probably too high.

• Muffle the soundNoise can be damaging if you have to raise your voice to beheard by someone an arm’s length away. Wear earplugs orearmuffs when you’re around noisy tools, equipment orfirearms. Use commercially made devices that meet federalstandards. Make sure the protectors fit snugly. Don’t use cotton earplugs. They’re ineffective and can become lodged in your ear canal.

• Have your hearing testedIf you’re frequently around loud noise, have your hearingchecked annually. A hearing test can detect mild hearing lossbefore the damage is obvious or disabling.

Choosing a hearing aidYou can greatly increase your satisfaction with a hearing aidby following these suggestions:

• Learn about the choicesHearing aids come in many styles and sizes — from smallones that fit completely in the ear canal to larger ones that fitin or behind the ear. The components can be analog or digital.The disposable “one-size fits-all” hearing aids can’t comfort-ably fit everyone, so discuss all options with your audiologist.


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• List your prioritiesWhen people buy hearing aids, they typically face a trade-offamong three factors — cost, performance and size. If yourank those factors, it’ll help you and your audiologist make aselection.

• Find out what meets your needsMake sure you understand why a specific type of hearing aidis recommended and how it will meet your needs. Don’t

symptom relief. Oral decongestants or anti-allergy nasalsprays may help. Avoid decongestant nasal sprays becausethey can worsen nasal congestion. Ask your doctor for advice.

• Pinpoint the offenderIf medications aren’t effective, a skin test may help identifythe substance you’re allergic to (allergen). Tiny amounts ofsuspected allergens are introduced into the skin by multiplepricks, scratches or injections. Be sure a doctor who special-izes in allergic diseases does the test.

• Consider allergy shotsIf you have a severe, recurrent allergy, or if allergy medica-tions aren’t working, allergy shots may help to desensitizeyour system. Begin them at least six months before your allergy season starts.

Soothing minor sore throat painTo help relieve a sore throat, try the tips below. However,see your doctor if you’re exposed to strep or have any of these signs or symptoms: fever, nausea, vomiting, swollenneck glands, difficulty breathing or swallowing, tonsils withpus, or severe pain that doesn’t improve in a few days.

• Drink lots of liquidsBeing well-hydrated helps keep mucus thin and easy to clear.

• Gargle with warm salt waterMix about a teaspoon of salt with a glass of warm water tosoothe and help clear your throat of mucus.

• Suck on lozenges or hard candy, or chew sugar-free gum

These products stimulate secretion of saliva, which bathes andcleanses your throat.

• Consider taking pain relieversOver-the-counter analgesics such as acetaminophen oribuprofen may temporarily help relieve sore throat pain.


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• Rest your voiceIf your sore throat involves an inflamed larynx, talking a lotmay lead to more irritation and temporary loss of your voice.

• Humidify the airAdding moisture to the air prevents drying of mucous membranes and the resulting irritation.

• Avoid air pollutantsDon’t smoke. Avoid smoke-filled rooms and fumes fromhousehold cleaners or paint.

Battling bad breathOccasional bad breath is usually due to bacteria, certain foodsor a dry mouth. When bad breath doesn’t respond to self-care,ask your dentist to check for gum disease or poor-fitting dentalwork or see your doctor for a possible medical cause. To fightbad breath:

• Brush and floss after you eatGood dental hygiene is the best way to prevent odor.

• Brush your tongueGiving your tongue, including the back of your tongue, a goodbrushing removes dead cells, bacteria and food debris. Somepeople may benefit from using a tongue scraper, available atmany pharmacies.

• Chew sugar-free gumThe action stimulates flow of saliva to prevent dry mouth andto wash away food particles and bacteria.

• Rinse your mouth with waterPeriodically swish your mouth with water to help keep it clean.

• Don’t smokeSmoking dries out your mouth and causes its own unpleasantmouth odor.

• Cut down on odor-causing foods and beveragesThe most likely offenders are garlic, onions, fish, milk, eggs,legumes, cabbage, broccoli, Brussels sprouts, coffee and alcohol.


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• Carry mouthwash or breath mintsNot all mouthwashes fight bacteria, but they disguise badbreath. The strong oils in peppermint, spearmint and winter-green also cover up odor.

Choosing toothpaste andmouthwashUse toothpaste that has fluoride, the best defense againstdecay. Here’s an analysis of some of the claims made bytoothpaste and mouth-rinsing products:

• Plaque controlSome products claim to remove plaque or kill bacteria thatcan cause plaque. But all toothpastes remove some plaque ifyou brush and floss well.

• Tartar controlAnti-tartar pastes can help prevent a buildup of tartar, but notoothpaste can remove tartar — that takes a professionalcleaning. In addition, an anti-tartar paste may increase yourteeth’s sensitivity to cold.

• Desensitizing pastesThese products contain chemicals that block pain perceptionin your teeth. Sensitive teeth may be a sign, however, of aproblem that needs treatment, not cover up.

• Baking soda pastesBaking soda is a mild abrasive and stain remover, but whenwet it loses some of its stain-removing power.

• Extra whitenersSome of these toothpastes contain strong abrasives that maybe harsh on delicate gum tissue.

• MouthwashesIf certified by the American Dental Association as plaque fight-ers, these products can complement dental care by protectingsurfaces you may have missed when brushing and flossing.


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LEGS AND FEET

Controlling painful leg crampsSeveral factors, including dehydration, use of diuretics oroveruse of your muscles, can trigger leg cramps. They usuallyoccur during rest or sleep. Your doctor may prescribe quinineor a muscle relaxant if you have frequent leg cramps.

To prevent leg cramps:

• Stretch dailyAt least three times a day, including before bedtime, stretchyour calves and feet. Stand two to three feet from a wall,placing your hands on the wall. Keep your heels on the floor.Lean toward the wall and bend one knee. Hold for 15 to 30seconds. Straighten your leg. Repeat with the other knee.Stretch each leg at least three times.

• Drink plenty of liquids dailyFluids help your muscles contract and relax.

To relieve leg cramps:

• Stretch and massageStraighten your leg and point your toes upward while yougently rub the cramp to help the muscle relax.

• Stand upFor a calf cramp, put your weight on the cramped leg and slight-ly bend your knee. For a thigh cramp, keep both legs straightand lean forward at the waist. Use a chair to steady yourself.

• Apply cold or heatUse a cold pack to relax tense muscles. Use a warm towel orheating pad later if you have pain and tenderness.

Self-care tips for varicose veinsIf you have varicose veins, try to improve circulation:

• Wear compression stockingsWearing compression stockings is often the first approach to try before other treatments. These stockings are sold at most


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pharmacies and medical supply stores. Using a tape measure,you or your pharmacist can measure your legs to ensure you getthe right size and fit according to the size chart on the package.

• WalkWalking is a great way to get the blood circulating in your legs.Ask your doctor about an appropriate activity level for you.

• Elevate your legsWhen sitting or lying down, elevate your legs above the levelof your heart. Do this 10 to 15 minutes three or four times daily.

• Don’t sit or stand for long periodsChange your position frequently. During long car trips, stop to take a brief walk every couple of hours. On flights, walkthrough the cabin about once every hour. Don’t sit with yourlegs crossed. Remember to wear your compression stockingswhen traveling.

• Watch what your wearPanty-leg girdles can restrict circulation. Avoid high heels.

• Control your weightBeing overweight puts extra pressure on your veins.

Shopping for shoesFor healthier and more comfortable feet, try these tips:

• Don’t buy shoes with pointed toes or high heelsPointed shoes cramp your toes and can lead to foot problemssuch as ingrown nails, calluses, corns or bunions. High heelscan cause back problems by forcing you to lean back tocompensate for the forward tilt of your heel.

• Select laced shoesLaced shoes generally offer more room and adjustable sup-port. Get ample room for your toes. Athletic shoes are ideal.Other good selections are strapped sandals and soft, roomypumps with cushioned insoles for women.

• Wear shoes made of soft leatherGood choices include calfskin or suede. Vinyl and rubberencourage perspiration, which can irritate your skin.


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• Shop for shoes in the early afternoonFeet swell as the day goes on. If you buy shoes in the morn-ing, they may feel too tight later on. Getting fitted at the endof the day may give you a fit that’s too roomy in the morning.

• Have your feet measuredShoe size can change as you age or put on weight. Your archestend to relax with age, and you may need larger, wider shoes.

• Stretch your shoesTo perfect your fit and relieve pressure points, consider havinga shoe shop stretch your shoes at any spot that rubs.

Staying ahead of athlete’s footThe fungus that causes this itchy rash thrives in the warm,dark, wet environment between your toes. The key is keepingyour feet dry.

• Select well-ventilated shoesWear sandals, leather shoes or athletic styles with ventilationholes that allow feet to breathe. Avoid shoes made of syntheticmaterials, such as vinyl or rubber.

• Alternate shoesDon’t wear the same pair every day. Change wet shoes imme-diately. Don’t store out-of-season styles in plastic.

• Protect your feet in high-risk areasWear waterproof sandals or shoes around public pools, showersand locker rooms.

• Wear acrylic socksWhen wearing closed-toe shoes, wear socks made of syntheticfibers such as acrylic or polypropylene that wick away mois-ture. Cotton socks tend to absorb moisture from your feet.

• Change damp socksIf your feet sweat, change your socks twice a day.

• Use antifungal medicationsFor recurring infections, use an antifungal medication such as clotrimazole (Lotrimin AF), terbinafine (Lamisil-AT) or


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miconazole (Micatin, Zeasorb-AF). If an infection lasts longerthan four weeks, see your doctor.

Preventing and treating cornsand calluses

• Wear comfortable shoesWear shoes that don’t cramp your toes. Consider soft, leathershoes or open-toed sandals. Soft insoles cushion your feet.

• Adjust your walking styleAn improper gait, such as walking on the sides of your feet,can produce calluses and corns. If you tend to wear down one side of the heel of your shoes, you may be shifting yourweight unevenly as you walk. Ask your primary care doctoror podiatrist if a shoe insert (orthotic) could help distributeyour weight more evenly.

• Safeguard your skin Pharmacies and medical supply stores have a variety of products such as tufts of lamb’s wool, moleskin pads and toecoverings to protect your skin.

• Try home treatmentGently rub thickened skin with a towel or pumice stone afterbathing. Don’t try to remove all of the toughened skin at once— this process may take a week or longer. Don’t trim a cornor callus, especially if you have diabetes or circulation problems — you might introduce an infection. If you havediabetes or circulation problems, avoid over-the-counter footcare products that have salicylic acid.

• Get professional helpIf a corn or callus becomes ulcerated or sore, see your doctor.Don’t delay, especially if you have diabetes or circulationproblems — a simple problem can quickly turn into aserious one.


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Warming up cold hands and feetIf your hands and feet always seem to be cold, try these simple measures to keep warm:

• Wear warm clothesThis will keep your whole body warm and help maintain circu-lation to your hands and feet. Layer clothing for indoor as wellas outdoor wear. Try wearing a long-sleeved, silk camisole orshirt under a blouse or sweater, topped by a wool jacket for in-door dress. Use warmth-conserving fabrics such as silk, wool ordown, or synthetic fabrics such as polypropylene or Thinsulate.

• ExerciseDuring activity, small, surface blood vessels dilate and morewarm blood flows to your hands and feet. The effect can lastfor several hours.

• Avoid nicotine and limit caffeineBoth are vasoconstrictors that narrow blood vessels andreduce blood flow to small, surface vessels.

• Avoid certain medications Certain migraine medications with ergot derivatives and betablockers such as propranolol act as vasoconstrictors and maycause cold hands and feet. If you suspect that a medicationmight be causing such symptoms, talk with your doctor, butdon’t make changes to your medication regimen without yourdoctor’s advice.

• Reduce stressTense, high-strung people seem more likely to have coldhands. Chronic stress and anxiety can cause your nervous system to continually pump out adrenaline. This hormonealso acts as a vasoconstrictor.


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PREVENTION OF COMMON ILLNESSES

Do’s and don’ts for avoiding infections Follow these tips to help lower your risk of infections:

• Do practice good hygiene Wash your hands before handling food, after using the bath-room and after handling pets. Wash your hands often whenyou have a cold.

• Don’t share eating or drinking utensils That’s a good way to spread infections.

• Do cook certain foods thoroughly — especially hamburger — to kill bacteria

Don’t eat raw or undercooked meat or poultry, raw seafood orraw eggs. Don’t drink or cook with unpasteurized milk.

• Don’t drink water that’s likely contaminated That includes, for example, water from streams or lakes nearcampsites or hiking trails.

• Don’t put your fingers in your mouth or eyes Doing so transmits germs.

• Do avoid contact with ticks and rodentsStay away from these and other disease carriers.

• Do keep up to date with vaccinations They can protect you from life-threatening infectious diseases.

• Do recognize signs of generalized infectionsSigns and symptoms include, for example, fever, sweats andchills. For skin infections, look for redness and warmth.

• Don’t delay contacting your doctor if you’re sick Many serious infections are treatable in the early stages.

• Don’t expect an antibiotic each time you’re sick Antibiotics don’t help with some common infections, and over-use encourages the growth of drug-resistant microorganisms.


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Fending off the fluTo help prevent any illness, eat healthy foods, get enough sleep,exercise regularly and wash your hands often. A flu (influenza)shot is recommended for anyone who wants to reduce the risk of flu, but especially for the high-risk groups below.

• Who needs a flu shot?The Centers for Disease Control and Prevention recommendsannual flu shots for the groups below.1. People at high risk of complications from the flu, including:

• Children age 6 months until their 5th birthday• Children 5 years of age or older and adults with a chronic

condition (such as asthma, diabetes or heart disease)• Pregnant women• Adults age 50 and older• Residents of nursing homes and other long-term care

facilities2. People who live with or care for those at high risk of

complications from the flu, including:• Caregivers and household contacts of anyone at high risk• Household contacts and out-of-home caregivers of children

under 6 months old (these children are too young to getthe flu shot)

• Health care workers

• Who should avoid flu shots?Flu shots are safe for almost everyone. However, if you’ve had a serious reaction to a dose of flu vaccine, or are allergic toeggs, or have history of Guillain-Barré syndrome, ask yourdoctor for advice.

• What’s the best time for a flu shot?Flu shots need updating every year because the virus strainschange frequently. It’s best to get your flu shot in October or November for protection in the peak of the flu season(December through March).

• What are the side effects?Some people may have a minor reaction, such as soreness at the injection site, mild muscle aches or a slight fever for a couple of days afterward.


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MEDICATIONS

Avoiding food and drug interactionsWhen taking a prescription or nonprescription medication:

• Read the label and all printed information Nonprescription products print information on the package.Prescription drugs generally come with information factsheets and may have warning stickers on the container.

• Don’t mix medications into food unless advisedAcid or minerals in certain foods can alter some drug ingredients. Breaking apart pills can destroy special coatingsthat protect your stomach or the medication, or that create thetime-release mechanism of some drugs (which allows slow,uniform absorption).

• Don’t mix medicine into hot beveragesHeat can destroy or alter drug ingredients.

• Don’t consume grapefruit or grapefruit juice with medications

A substance found in grapefruit and its juice can alter theeffects of several drugs, sometimes causing a buildup ofmedication, which could become toxic. One example is atorvastatin (Lipitor), which is used for high cholesterol.

• Avoid alcoholAlcohol can increase or reduce a drug’s effects or increaseside effects.

• Don’t take a vitamin and mineral supplement or antacids at the same time as your medication unless your doctor approves

Some nutrients can bind with drug ingredients, reducing theirabsorption and limiting their effectiveness.

• Tell your doctor if you’re taking herbal supplements

Many herbal supplements have known interactions with medications, and others haven’t been thoroughly tested for


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interactions. While you’re on medications, check with yourdoctor or pharmacist before adding herbal supplements.

• Take medication as recommendedSome drugs are better absorbed with food to reduce the riskof stomach irritation or upset. Other drugs may be betterabsorbed when taken with a full glass of water an hour or two before meals. Follow your doctor’s or pharmacist’sinstructions.

Asking the right questionsabout your medicationsWhether you’re taking a prescription drug or one you buyover-the-counter, don’t hesitate to ask your doctor or pharma-cist questions. Keep a list of the medications and doses readily available in your purse or wallet.

• What’s the name of the medication?Learn both the generic and brand names.

• Why are you taking it?It’s critical that you understand the purpose of the medication.Knowing why your doctor has recommended a particularmedication will increase the chances that you take the med-ication appropriately and receive the intended benefit.

• What effect can you expect?How will the drug make you feel? How soon can you expectresults? Some drugs take days or weeks to have an effect.

• How much, when and how long should you take it?Make sure the directions make sense. “Four times daily”could mean with each meal and at bedtime or every six hours,including the middle of the night.

• Are there restrictions?Some foods can interfere with the effectiveness of a drug.Alcohol also can interfere and cause certain side effects. Inaddition, some drugs can make you sensitive to sunlight.


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• What are the side effects?What are common side effects? Which side effects may goaway with time? Which side effects should prompt you tocontact your doctor?

• What do you do if you miss a dose?Do you take it as soon as you remember or wait until the nextdose is due?

• Are there alternatives?Do other drugs or treatments cost less or have fewer sideeffects? Will a generic drug provide the same benefit?

DOCTOR-PATIENT RELATIONSHIP

Getting the most from a visitto your doctorMake the best use of a short time that you have for yourappointment.

• Arrive on timePromptness helps ensure an unhurried visit.

• Know your own and your family’s medical historyYour previous medical conditions and those of blood-relatedfamily members are important. Be prepared to discuss them indetail with your doctor.

• Bring someone along if you feel comfortableAn extra set of ears can help. Someone else may help think of additional questions or help you understand instructions.

• Bring a list of concernsOnce you’re in the doctor’s office, it’s easy to forget healthissues you want to discuss. A list will jog your memory, butkeep it brief. Include only issues of primary concern.


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• Bring your medicationsShow your doctor all your medications in their original bottles so your doctor can see the dosage and types of drugs.

• Answer questions accurately and completelyYour doctor needs facts on which to base an accurate diagnosisand treatment plan.

• Speak upIf you have questions or doubts about your diagnosis or treat-ment, express them. For example, your doctor should explainthe benefits of a medication, its possible side effects and howlong it will take to work. Don’t leave until your questions areaddressed and resolved.

Following your doctor’s adviceTo get 100 percent benefit, make sure you understand and canuse your doctor’s advice when you get home.

• Ask for written instructionsHave your doctor list the main points as you discuss them. Orrequest brochures or other published information.

• Know your prescriptionAsk why this drug is best. Find out what you can expect fromit, including side effects and how to take it correctly.

• Expect explanationsBe sure you know why a test is ordered, what it will involve,what the risks are, and how and when you’ll learn results.

• Repeat what you hearThis process allows your doctor to identify any instructionsthat aren’t clear.

• Solve problems togetherIf you don’t think it’s realistic to follow your doctor’s recom-mendations, speak up. For example, financial restraints mightkeep you from buying a certain medication. If you tell yourdoctor, he or she may know of a less expensive generic medication that will work just as well.


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FOOD AND NUTRITION

Choosing disease-fightingfoodsResearch indicates that eating certain foods can help loweryour risk of several diseases.

• Eat at least four servings of vegetables a dayVegetables are loaded with vitamins and minerals, contain fiber,have no cholesterol, and are low in fat and calories. They’re agreat source of phytochemicals, substances that appear to helpreduce the risk of chronic diseases such as heart disease, cancerand diabetes. Eat a variety to get all the health benefits.

• Eat at least three servings of fruits a dayFruits are filled with vitamins, minerals, antioxidants and fiber.Except for a few, such as avocado and coconut, they’re virtuallyfree of fat. Fruits are a major source of flavonoids, substancesthat may help lower the risk of cardiovascular disease and cancer. Choose a variety of fruits to get the most health benefits.

• Eat foods high in omega-3sEating at least two servings (about 3 ounces each) a week offish that are rich in omega-3 fatty acids — such as salmon, trout,tuna, herring and sardines — can help reduce your risk of heartdisease. Instead of frying, bake or grill the fish. Note: The Foodand Drug Administration (FDA) advises pregnant women,nursing mothers and children to avoid king mackerel, shark,swordfish and tilefish (golden bass or golden snapper), which are higher in mercury. Tuna steak and albacore tuna generallyhave more mercury than canned light tuna. Plant sources ofomega-3s include canola oil, flaxseed (ground and oil),soybeans and walnuts (whole and oil).

• Choose whole-grain foodsEating whole grains may lower your risk of cardiovasculardisease, type 2 diabetes and cancer. In addition to the morefamiliar whole-grain breads and cereals, add variety to yourdiet with hulled barley, brown rice, buckwheat, bulgur, millet,quinoa, whole-wheat pasta and wild rice.


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Using healthy cooking methodsSeveral easy cooking methods can result in healthier eating.

• Invest in nonstick cookwareInstead of pouring oil in a pan when you cook, use nonstickcookware. One tablespoon of vegetable oil has 120 calories and14 grams of fat. Or use vegetable cooking sprays. A one-secondspray has negligible calories and less than 1 gram of fat.

• Hold the oil Sauté vegetables such as onions, mushrooms or celery in a small amount of wine, broth, water, soy sauce orWorcestershire sauce.

• Think flavor, not fatKeep a supply of onions, fresh garlic, ginger root, Dijon mus-tard, fresh lemons and limes, flavored vinegars, sherry or otherwines, cornstarch (to thicken sauces), and plain fat-free yogurt.

• Try different cooking methodsMicrowave or steam vegetables. Then dress them up with flavored vinegars, herbs and spices. Cook fish in parchmentpaper or foil to seal in flavors and juices.

• Modify recipesIn most recipes, you can reduce sugar, salt and fat by one-thirdto one-half without sacrificing taste.

• Minimize meatBuy lean cuts of meat. Decrease the amount of meat incasseroles and stews by one-third and add more vegetables,rice or pasta. Or replace meat with beans.

Do’s and don’ts for losing weight• Don’t skip mealsDuring the day when you’re active, your body needs maxi-mum calories and nutrients. Missed meals may result in anunhealthy diet and may increase your risk of obesity. Eatingmeals, including a healthy snack, at fairly regular times mayreduce impulse snacking, meal size and calorie intake.


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• Limit meat consumption Meat is a major source of fat — keep portions under 6 ouncesdaily. Eat more servings of vegetables, fruits and whole grains.

• Don’t starve yourselfIf you’re on a diet that’s too strict, eventually you’ll go backto eating regular food. Unless you’ve learned how to eat avariety of healthy foods and still lose weight, you won’tachieve long-term weight control.

• Exercise regularlyAny exercise burns calories. To promote weight loss from bodyfat, exercise at a moderate intensity for at least 30 to 60 minuteson most days of the week. Walking is a good form of exercise.

• Drink waterDrinking water with your meal can help fill you up. Drinkingwater also slows the pace of your eating — and people whoeat fast tend to overeat.

• Weigh wiselyDaily weighing can be a helpful tool for some people who aretrying to lose weight or prevent weight gain. But daily shifts inbody water can show up as pounds on your scale. So keep thisin mind and pay greater attention to trends in your weight.

Handling food safelyThink about safe handling of food from the time you shop tothe time you eat.

• When shoppingDon’t buy food in cans or jars with dented or bulging lids.Refrigerate perishable items as soon as possible after purchase. Put fresh fruits and vegetables in bags ratherthan directly in the shopping cart to prevent contact withadditional germs or with drippings from other foods.

• When preparing foodWash your hands with soap and water. Rinse produce thorough-ly before and after peeling. Wash knives and cutting surfacesafter handling raw meat and before preparing other foods to beeaten raw. Launder dishcloths and kitchen towels frequently.


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• When cookingCook all ground meat, hamburger or roast beef thoroughly.Meat, especially if grilled, is likely to brown before it’s completely cooked, so use a meat thermometer to ensure thatmeat is heated to at least 160 F at its thickest point. Avoidundercooked eggs with runny yolks.

• When storing foodAlways check expiration dates. Use or freeze fresh meats withinthree to five days after purchase. Use or freeze fresh poultry,fish and ground meat within one to two days after purchase.Refrigerate or freeze leftovers within two hours of serving.

• When eating outOrder red meat prepared medium or well-done. Ask thatseafood be thoroughly cooked.

Keeping foods safe at picnicsUse these tips to ensure safe eating at your picnics:

• Use an insulated coolerPut ice or a frozen gel pack on top, with foods to be keptcoldest on the bottom.

• Pack right from the refrigeratorKeep food cold or frozen to the touch before putting it in yourcooler or cold vacuum bottle, such as a thermos.

• Wrap all foods separately in plasticDon’t place foods directly on ice that’s not of drinking-waterquality. Keep raw meat, poultry or fish well wrapped so thatdrippings don’t contaminate other foods.

• Don’t put your cooler in a hot trunkTransport your cooler inside your car — not the trunk. Keepit in the shade at your picnic or campsite, and keep the lid on.

• Keep food and utensils covered until serving timeFlies, other insects and household pets can carry salmonellabacteria.

• Keep hot foods hotUse a vacuum bottle or insulated dish for serving.


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• Clean your handsTake along alcohol-based hand sanitizer and disposable handtowels to use before and after working with food.

• Remember the 2-hour ruleReturn leftovers to your cooler as quickly as possible. Twohours is the maximum time food should be left unrefrigerat-ed — one hour if the temperature is 85 F or higher. If your icehas melted or the gel pack is only cool, discard perishableleftovers.

DIETARY SUPPLEMENTS

Choosing a multivitamin as you get olderBecause diets of older adults are often short in more than onevitamin and mineral, a multiple vitamin-mineral pill takenonce a day may make more sense than single-nutrient pills.For quality, look for USP (U.S. Pharmacopeia) on the label.

• Don’t take megadosesLook for a supplement that contains a wide variety of vita-mins and minerals in the appropriate amounts, usually nomore than 100 percent of the Daily Value (DV). Check thecontents to make sure you’re not getting too much of anynutrient, which can be harmful. Talk with your doctor or pharmacist if you have questions.

• Check the iron contentSome studies suggest that excess iron can raise the risk ofheart disease and colon cancer for women beyond menopauseand for men of any age. For these people, it’s probably wiseto use a pill with little or no iron — 8 milligrams (mg) or less.

• Get enough calcium People over 50 need 1,200 mg of calcium a day, but typical-ly consume only 700 to 800 mg a day. A multivitamin canonly include about 200 mg of calcium because a largeramount would make the pill too big to swallow. See“Consider a calcium supplement,” p. 11.


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• Get enough vitamin D This helps the body absorb calcium and is essential to main-tain proper bone strength. Because many older adults don’tget regular exposure to sunlight and have trouble absorbingvitamin D, taking a multivitamin with 400 to 600 internation-al units (IU) will probably help improve bone health.

• Look for vitamin B-12 (cobalamin) Adequate levels of this vitamin may reduce your risk of anemia, cardiovascular disease and stroke. Older adults often don’t absorb this vitamin well. A multivitamin withat least 2 micrograms (mcg) may help.

Making informed decisionsabout herbal supplementsBecause of the limited regulation of herbal supplements in theUnited States, be cautious about using any herb. Read reportson clinical studies about safety and effectiveness, and tellyour doctor if you’re using herbal products.

Avoid using these herbs:

• Borage, coltsfoot and comfrey Toxic chemicals called pyrrolizidine alkaloids contained inthese herbs may cause liver disease, lung problems and possi-bly even cancer, especially with long-term use.

• ChaparralSome cases of liver disease have been linked to the use of thisherb. It’s touted as a cure for cancer and as a substance thatslows aging, “cleanses” the blood and helps treat skin prob-lems, but no evidence supports these claims.

• Ephedra (ma-huang) and some substitutesThis popular herb, once found in several weight-loss products,contains ephedrine, which can stimulate your heart and nervoussystem to dangerous levels, causing a heart attack, seizure,stroke or sudden death. In 2004, the FDA banned the sale ofephedra. In addition, the FDA states that some ephedra substi-tutes, such as bitter orange (Citrus aurantium), may presentserious health risks.


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• GermaniumEvidence doesn’t support claims that this herb promotes goodhealth, fights AIDS, cancer and other illnesses, or helps treatheavy metal (mercury) toxicity. However, there have beennumerous reports of kidney failure, nerve damage and evensome deaths linked to this herb.

• KavaAlso called kava kava, this herb is used for anxiety and insom-nia. Reports of severe liver damage linked to its use have causedseveral European countries to pull it off the market. The FDAhas issued warnings but not banned sales. Until more is known,don’t take kava or products that contain it. If you’ve been usingit, ask your doctor if you need tests to check your liver function.

• Yohimbe Yohimbe can cause serious side effects, including tremors,anxiety, high blood pressure and rapid heart rate.

Exercise caution if using these herbs and many others:

• Feverfew, garlic, ginger and ginkgo Taken in high doses or combined with other blood thinners,such as warfarin (Coumadin), aspirin or other nonsteroidalanti-inflammatory drugs (NSAIDs), each of these herbs couldincrease the risk of bleeding problems.

• St. John’s wortUsed for mild to moderate depression, St. John’s wort canalter the effects of many common prescription drugs, such aswarfarin, heart drugs or seizure medications.

SAFETY AND FIRST AID

How to prevent fallsMany older adults who are hospitalized for a fall never regaintheir former level of independence. Losing your independence— it’s one of the biggest fears you may have about aging.Falling is one of the most common causes. Use this checklistto take a fall-prevention inventory of your home:


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• All roomsKeep electrical cords and furniture out of walking paths.Fasten carpets to the floor with tape or tacks. Don’t usethrow rugs.

• StairwaysMake sure that stairways are well lighted with sturdyhandrails. Carpet runners should not be loose. If you have avision problem, apply bright tape to the first and last steps.

• BathroomsInstall grab handles and nonskid mats inside and just outsideyour shower and tub and near the toilet. Shower chairs andbath benches minimize the risk of falling.

• KitchensDon’t use difficult-to-reach shelves. Never stand on a chair.Use nonskid floor wax and wipe up spills immediately.

• BedroomsPut a light switch by the door and by your bed so you don’thave to walk across the room to turn on a light. Plug nightlights into electrical outlets in bedrooms, halls and bathrooms.

Preventing yardwork mishapsFollow these easy steps:

• Save your backChoose tools with handles long enough to allow you to workwithout bending over. Don’t lift oversized packages of fertilizeror sod. Use a wheelbarrow or just buy smaller packages.

• Wear sunscreenAvoid sunburn by using sunscreen with a minimum sun protection factor (SPF) of 15.

• Skip the scentsPerfume, scented hair spray or lotion attracts stinging insects.

• Wear light-colored, well-fitting clothesBright colors attract insects, too. And loose clothes allowinsects access to your skin.


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• Choose sensible shoesWear closed-toe, sturdy, nonskid shoes to prevent injuriesfrom lawn mowers.

• Turn off the lawn mower motorThen unclog, adjust or fix the equipment. Before refueling,allow the motor to cool for several minutes. Don’t smoke.

• Handle chemicals carefullyBefore spraying bug or weed killers, wait for calm weather.Wind can blow chemicals back toward you and irritate yourskin. Wear protective goggles, gloves, full-length pants and a long-sleeved shirt.

Treating puncture woundsA puncture wound — for example, from stepping on a nail —usually doesn’t result in excessive bleeding. The wound mayseem to close almost instantly, but it may still be dangerousbecause of the risk of infection. If the puncture is deep,contaminated, or the result of an animal or human bite, seekmedical attention right away. Remember these tips:

• Apply gentle pressure if there’s bleedingPress down on the wound using a clean soft cloth. If thewound was deep enough to draw blood, especially if it spurtsor continues to flow after several minutes of pressure — seekmedical attention immediately.

• Clean the woundRinse the wound under running water to help remove debrisand bacteria. Don’t use soap — it can irritate the wound. Ifdirt or debris remains in the wound after washing, use tweez-ers cleaned with alcohol to remove the particles. If you can’tremove all the debris, see your doctor. To clean the areaaround the wound, use soap and a washcloth.

• Apply an antibioticAfter cleaning the wound, apply a thin layer of an antibioticcream or ointment such as Neosporin or Polysporin to helpkeep the surface moist. These products discourage infection.If a rash appears, stop using the product.


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• Cover the woundBandages can help keep the wound clean and keep harmful bacteria out. Change the dressing at least daily or whenever it becomes wet or dirty. If you’re allergic to adhesive, useadhesive-free dressings or sterile gauze and hypoallergenicpaper tape.

• Watch for signs of infectionSee your doctor if the wound doesn’t heal or if you noticeredness, drainage, warmth or swelling.

• Keep tetanus booster shots up to dateAdults generally need tetanus boosters every 10 years. If you have a deep or dirty cut or wound, and you haven’t had a tetanus shot within five years, your doctor may recommend a booster.

Do’s and don’ts for minor burnsRemember these tips:

• Do cool the burnHold the burned area under cold running water for about 15 to20 minutes. If impractical, immerse the burn in cold water orcover it with cold compresses.

• Don’t put ice directly on the burnPutting ice directly on a burn can cause frostbite and furtherdamage your skin.

• Do consider a lotion and pain relieversOnce a burn is completely cooled, apply a lotion or moisturizerto soothe the area and prevent dryness. For sunburn, try 1 per-cent hydrocortisone cream or an anesthetic cream. An over-the-counter pain reliever, such as aspirin, ibuprofen (Advil, MotrinIB, others), naproxen (Aleve, others) or acetaminophen (Tylenol,others) may help.

• Don’t use butterPutting butter on burned skin holds heat in the tissue and maycause more damage. Applying butter increases your chance of infection.


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• Do bandage a burnCover the burn with a sterile gauze bandage. Wrap loosely toavoid putting too much pressure on the burn. Bandagingkeeps air off the burn and reduces pain.

• Don’t break blistersHowever, if the area is tender, snip a tiny hole in the blisterwith a small scissors that has been sterilized in alcohol. If theblister is broken, wash the area with mild antibacterial soap andwater, then apply an antibiotic ointment and a gauze bandage.

Staying clear of lightningIn the United States, hundreds of people are injured or killedby lightning each year. To protect yourself:

• Stay inside your home or an enclosed buildingKeep away from doors, windows and anything that conductselectricity.

• Use the 30-30 rule if you’re caught outsideIf your view of the storm isn’t obstructed and you see light-ning, count how long it takes until you hear thunder. If it’s30 seconds or less, seek a safer location right away. If youcan’t see the lightning but you hear thunder, go to a saferlocation.

• Avoid trees or tall isolated structures They’re lightning targets. Avoid small, open picnic pavilionsand rain shelters. If you’re in an open area, drop anythingyou’re carrying, get away from other people, and crouchdown as low as possible.

• Seek safety in a carClose the windows. Cars with plastic or fiberglass roofs andsides won’t protect you. Get off bicycles and motorcycles.

• Don’t touch metal objects Drop metal items, such as golf clubs, tools or tennis rackets,which conduct lightning.

• Don’t mix water with lightningGet out of and away from water — it conducts electricity.


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Don’t wash your hands, and don’t do the dishes or the laundry.Get out of the shower or tub.

• Turn it off and hang it upDon’t use electrical appliances or talk on the phone. Light-ning can follow electrical wires and phone lines into your home.

Handling a medical emergencyat homeKeep the numbers of emergency services, such as your doctor,fire department and police, next to your phone. If your area isserved by 911, call that number first.

• Stay calmSpeak slowly and clearly when describing the incident.

• Be exact about your locationGive your name, phone number, address, apartment number, cityor town, and directions, including landmarks or cross streets.

• Describe the type of help you needIs it medical, police or fire assistance?

• Give details about the victim’s conditionIs the person bleeding severely? Choking? Unconscious? Howlong ago did the incident occur?

• Describe first aid If someone else is present and giving first aid, what kind is it?Cardiopulmonary resuscitation (CPR) or other emergency care?

• Describe the victim’s locationIs he or she in the upstairs bedroom? Downstairs on the bath-room floor?

• Listen carefullyThen write down instructions. Ask the dispatcher to repeat theinformation.

• Don’t hang up too soonWait until the dispatcher tells you to hang up.

• Make sure your house number is clearly visibleIf it’s dark, turn a light on outdoors to show your house number.


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STRESS MANAGEMENT

Healthy ways to deal with stress Take common clues to stress — headaches, indigestion, sleep-lessness and sweaty palms — seriously. Learn to managestress using these techniques:

• Change the factors you canYou may not be able to walk away from a stressful job orhome situation, but you can develop new responses to defuseanger or conflict. You can also learn to manage your time better with stress-lowering techniques — from delegatinghousehold responsibilities to just saying no.

• Exercise regularlyThe natural decrease in adrenaline production after exercisemay counteract the stress response. People who are physicallyfit handle stress better.

• RelaxLearning techniques such as guided imagery, meditation,muscle relaxation and relaxed breathing can help you relax.Your goal is to lower your heart rate and blood pressure whilereducing muscle tension. You can also focus on hobbies oractivities you find calming, such as reading, listening to musicor playing with your pet.

• Find a friendFrom dealing with cancer to coping with a troubled relation-ship, social support can help reduce stress and prolong life.

• Recognize when you need helpIf stress is keeping you from work or recreation, talk withyour doctor or a specialist in behavioral medicine. Behavioraltherapy is one approach that can help you gain control overyour symptoms.


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Getting a good night’s sleep Sleep deprivation can lead to forgetfulness and problems inconcentration. To sleep better, consider these suggestions:

• Limit time in bed Spending too much time in bed usually disrupts sleep in themiddle of the night.

• Don’t try too hard to sleep Read or watch TV until you become drowsy, and then go to your bedroom to fall asleep naturally. Try to maintain aregular time for going to bed and for getting up.

• Hide the clock A visible readout of how long you’ve been unable to sleepmay worry you needlessly.

• Avoid or limit caffeine, smoking and alcohol Caffeine is a stimulant. Nicotine also can interfere with sleep.And although alcohol is a depressant and may help you dozeoff, it can disrupt restful sleep.

• Exercise and stay active Regular physical activity and exercise contribute to a restfulsleep. Aim for 30 minutes or more of exercise on most days. Avoid exercising too close to your bedtime so it doesn’tinterfere with your sleep.

• Watch what you eat before you sleepA light snack may help you relax before sleeping, but avoidheavy meals and foods that could cause heartburn. Drink lessliquid before bedtime so that you won’t have to go to thebathroom as often.

• Avoid or limit napsDaytime naps can make it harder to fall asleep at night. If youreally need a nap, limit it to 30 minutes or less.

• Check your medications Ask your doctor if any of your medications — both prescrip-tion and nonprescription — may contribute to insomnia.


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