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Washington is the eighth-healthiest state in the U.S. for older adults for the second consecutive year, according to the latest America’s Health Rankings Senior Reportfrom United Health Foundation.

The 2023 report gives Washington the best ranking among states in the Pacific Northwest. Oregon is 12th,Idaho is 18th, and Montana is 23rd.

The five states considered the healthiest are, in order, Utah, New Hampshire, Colorado, Minnesota, and Vermont. 

Washington’s top-10 position is attributed to a low prevalence of seniors with multiple chronic conditions and a low poverty rate. The report lists a few areas for improvement by the Evergreen State, however, especially in mental health. Washington ranks 45th in the nation for seniors with depression, 38th for drug-related deaths among seniors, and 35th for states with high rates of suicide among seniors.

Notable changes for adults 65 and older in recent years in Washington include: 

  • Volunteerism decreased from 36 percent to 25 percent.
  • Access to high-speed Internet increased from 78 percent to 88 percent of households.

For all states, rankings are based on four determinants that directly influence health outcomes: Behaviors, community and environment, policy, and clinical care. Washington scored five out of five “stars” in social and economic factors, clinical care, and behaviors.

The full report is online at americashealthrankings.org.

Source: United Healthcare

srmedia by — August 15, 2023 in Health & Fitness

By Daniel Sackman

Talking about prostate health is a day in the life of a urologist. But as a specialist who treats conditions involving the male reproductive system and urinary tract, I know this conversation is far from routine for most men. That’s why I welcome opportunities to focus on issues around men’s health.

Today I’ll discuss a common clinical diagnosis — especially for men over 50 — known as benign prostatic hyperplasia, or BPH. Simply put, BPH means an enlarged prostate, a condition generally considered to be a regular part of male aging.

But what does “normal aging” really mean in terms of how men experience BPH signs or symptoms? My answer may seem vague. But every patient is different, and an enlarged prostate can cause a range of symptoms, from mildly bothersome to severely uncomfortable. Plus, you have to factor in the hereditary aspect of prostate health; if your parent or sibling has BPH, you are four times more likely to develop it yourself.

What to expect when you’re experiencing BPH.

The prostate is a small gland that sits between the bladder and the penis. Urine leaves the bladder and flows through the center of the prostate by way of the urethra. As the prostate tissue gets larger, it presses up against the urethra. As the urethra tube narrows, men may experience one or more of the following:

  • A weak or slow urine stream.
  • Difficulty in starting to urinate, or a stream that stops and starts.
  • Nocturia, or frequent voiding at night.
  • A feeling of urgency or increase in frequency.

Of course, these symptoms can also be caused by other medical conditions. To rule out other diseases, a urologist will need to do a physical exam and further testing to confirm a BPH diagnosis.

What are the treatment options for BPH?

Fortunately, men have plenty of options, especially as the prostate often continues to grow as men age. For some men who only experience mild or occasional symptoms, the best course of action may be only observation and monitoring. More bothersome or advanced symptoms can be treated with medication or surgery, as well as newer, non-invasive procedures.

BPH medications: Drugs known as alpha-blockers, such as Flomax, typically work by relaxing the muscles around the urethra. This leaves the urethra channel wider for a more normal urine flow. Another class of drugs is 5-alpha-reductase inhibitors like Proscar, which decreases the prostate’s size by as much as 25 percent. I always counsel my patients that, just like taking any medication, there can be potential side-effects to these drugs, such as changes in blood pressure and possible sexual side-effects.

Surgery for BPH: The most common BPH surgery is called a transurethral resection of the prostate, or TURP. To reduce the pressure on the urethra from the prostate enlargement, I surgically remove part of the prostate. Some men who opt for the TURP procedure can experience reoccurring urinary tract infections or even (although rare) erectile dysfunction.

Effective, non-invasive techniques: Two popular options are performed right in the office and don’t require general anesthesia. As the name suggests, the Urolift procedure lifts the prostate away from the urethra to open the channel for a better urine flow. The Rezum technique uses high-pressure steam to decrease prostate tissue enough to open the urethra. Patients usually see an improvement in symptoms within just a few weeks. Another positive outcome of these non-invasive procedures is that the effects can be beneficial for at least five years and safely be repeated if necessary.

Dr. Daniel Sackman is a MultiCare Health System urologist. This article was originally published by MultiCare in 2020 and updated in 2022.

srmedia by — August 3, 2023 in Health & Fitness
Is yoga for you:?

Older adults have an increased burden of chronic disease, disability, and frailty. Frailty affects up to 50 percent of adults 80 and older, and its prevention and management are high-priority areas in public health and clinical practice. Yoga may be a prevention and management strategy and is already used to improve balance and mobility in older adults. 

A review of 33 randomized controlled trials (RCTs) by researchers found that yoga improved gait speed (how fast one walks a specified distance) and lower extremity strength in inactive older people. However, yoga didn’t seem to offer a benefit for frailty over activities like exercise or tai chi. The review is published in Annals of Internal Medicine. 

In findings that add to a growing role of yoga in healthy aging, researchers from Brigham and Women’s Hospital and Harvard Medical School reviewed 33 RCTs of 2,384 participants 65 years or older to evaluate the effect of yoga-based interventions on frailty. There was moderate evidence that yoga improved gait speed and lower body strength and endurance. The benefits for balance and handgrip strength were less certain. The researchers said clinicians may consider recommending Iyengar-based styles of yoga that can be customized for older adults.

srmedia by — March 30, 2023 in Health & Fitness

By Shelly Gordon

Like the estimated 160,000 men diagnosed with prostate cancer every year in the U.S., each man must make decisions about what kind of treatment to pursue—and every single one of them wants to avoid the dreadful side-effects of incontinence, erectile dysfunction, and penile shrinkage that can and often do accompany standard prostate cancer treatments, including radical surgery and radiation. Most importantly, they want to maintain their quality of life and continue pursuing activities that bring them joy.

In evaluating their treatment options, men with localized prostate cancer are eligible for active surveillance, or “watchful waiting,” which is commonly offered to lower-risk prostate cancer patients. But many men aren’t a fan of that approach because of the uncertainty of living with a diagnosis of cancer.

Men with localized cancer who are fortunate to live in areas of the U.S. with hospitals that offer robotic focal HIFU find they are good candidates for this non-invasive outpatient procedure. HIFU (high-intensity focused ultrasound) uses concentrated sound waves to destroy the diseased tissue in the prostate. Urologists use ultrasound imagery to guide a probe during the procedure to spare healthy tissue. In addition, if the cancer, it can be retreated with HIFU or other traditional options like surgery or radiation.

Some men have shared their experience with robotic focal HIFU. William Whitlow is one of them.  

“I’m 58, African American, and born and raised in Brooklyn, N.Y. I’m trained as a social worker and for 20-plus years, I worked for the Office of Child and Family Services.

“Had I not been getting my PSA checked since I was 40, I wouldn’t have caught my prostate cancer early enough and my quality of life could have suffered, or worse. Unfortunately, my dad didn’t go to the doctor until his prostate cancer spread to his lymph nodes. He died of the disease in 2001 at age 56.  My uncle also died of prostate cancer. I heeded the advice of my doctor to get tested early and often. That’s why I was able to catch my prostate cancer at stage 1. Because the cancer was detected early, it was easily treatable.

“Before I got the diagnosis, my doctor said my PSA levels were high and he sent me for an MRI, which showed a suspicious shadow. My doctor referred me to a surgeon who does robotic surgery at Maimonides Medical Center.  But I decided it was too invasive, and I was warned of the side-effects of urinary incontinence and erectile dysfunction. I went to see Dr. David Silver, chief of urology at Maimonides, and that’s where I learned about robotic focal HIFU. He said HIFU is ideal for patients whose prostate cancer is still confined to a small part of the prostate like mine was.  He explained that there’s no incision with HIFU and he only destroys the diseased portion of the prostate, sparing surrounding nerves, which means incontinence and impotence are less likely to occur. HIFU is done quickly, in approximately two to three hours, and in a single session at an outpatient surgery center. I chose that option and was able to go home the same day.

“So not only were urinary incontinence and sexual impotence low-risk, I also liked that HIFU was an outpatient procedure. It was the best choice for me. After I returned home, the drugs wore off, and while there was a bit of discomfort, as I had to wear a catheter for a few days, I was able to heal quickly and returned to work after five days. Now I’m back to normal.”

Thousands of men diagnosed with prostate cancer have two things in common: They are determined to beat the cancer and hold on to their quality of life in the process. Most importantly, men have to ask their urologists if they qualify for robotic focal HIFU. It’s a good chance they do, as between 2015 and 2019, 71 percent of prostate cancer cases were diagnosed at a localized stage, meaning the cancer hadn’t spread outside the prostate.

The coverage for a hospital performing a robotic focal HIFU procedure on a Medicare patient is increasing. More than 90 percent cover the current reimbursement level effective Jan. 1, 2023. Both are very positive for prostate cancer patients who can benefit from this therapy,

Shelly Gordon is the founder of G2 Communications. She has worked with medical specialists and medical device manufacturers on articles about medical conditions and treatments.

srmedia by — March 16, 2023 in Health & Fitness