Constipation is not a glamorous topic, but it's certainly important, especially in older adults. As anyone who has experienced occasional or even chronic constipation can tell you, it can really put a damper on quality of life and well-being. Constipation can also cause more substantial problems, such as: * Severe abdominal pain, which can lead to emergency room visits * Hemorrhoids, which can bleed or be painful * Increased irritability, agitation, or even aggression, in people with Alzheimer's disease or other forms of dementia * Stress and/or pain that can contribute to delirium (a state of new or worse confusion that often happens when older adults are hospitalized) * Fecal incontinence, which can be caused or worsened by having a hard lump of stool lodged in the lower bowel * Avoidance of needed pain medication, due to fear of constipation Fortunately, it's usually possible to help older adults effectively manage and prevent constipation. This helps maintain well-being and quality of life, and can also improve difficult behaviors related to dementia. The trouble is that constipation is often either overlooked or sub-optimally managed by busy healthcare providers who aren't trained in geriatrics. They are often focused on more "serious" health issues. Also, since many laxatives are available over-the-counter, some providers may assume that people will treat themselves if necessary. Personally, I don't like this hands-off approach to constipation. Although several useful laxatives are indeed available over-the-counter (OTC), I've found that the average person doesn't know enough to correctly choose among them. Also, although in geriatrics we often do end up recommending or prescribing laxatives, it's vital to start by figuring out what is likely to be causing or worsening an older person's constipation. For instance, many medications can make constipation worse, so we usually make an attempt to identify and perhaps deprescribe those. In short, if you're an older adult, or if you're helping an older... What are some side effects of constipation in the elderly? Pick the correct answer from the following options: A. nausea, increased heart rate B. decreased irritability and bleeding C. pain, irritability, bleeding D. not enough information
C

I love going to the spa. Honestly, who doesn't. These days, unfortunately, my spa trips are few and far between. I blame the damn kids for that one! So, as you can imagine, I was pretty damn excited when the in-laws presented me with an Urban Spa voucher for the Urban Indulgence package: one hour hot stone Lomi Lomi massage followed by a Heavenly Spa Facial - two hours on indulgent bliss, for Christmas. I had never had a hot stone massage before so was very much looking forward to this, if nothing else out of curiosity about what is involved. Whenever you see pictures advertising a hot stone massage, the beautiful model always has a bunch of largish stones on her back so I wasn't sure whether it was more an acupressure experience where they left the stones strategically placed on the back to work their magic or whether it was an actual massage. Turns out that it is an actual massage. I requested a firm massage as my back has really been giving me issues. Carrying 15kgs of Crazy Kid or 9kgs of Kiki (or 26kgs of double babies) really isn't too good for the back so it had been causing me problems for a couple of months. My therapist (the lovely Kristy) gave me an expertly firm massage and used a small, smooth hot stone, along with her hands, to perform the massage. It was quite a unique experience as one minute I could sense that she was using her hands to do the massage then then next I'd get a sweep of hotness as the stone was run over me. It really was a delightful sensory experience. As my back was a problem area, Kristy spent 30 minutes just on that then the other 30 minutes was spent on the rest of my body. I could feel myself drifting in and out of consciousness throughout the massage. One really special thing about this massage was that the massage table was heated. Such a small touch, but one that was greatly appreciated (although it was a great contributor to my lack of consciousness!). Why was Fred bored? Pick the correct answer from the following options: A. because John got married B. not enough information C. because the event was lengthy D. because John ate all the cake
C

I was fencing wire at Flat Broke Acres and trying to tighten up the wire a bit. I lost the grip of the fencing wire and the pliers smacked me in the mouth. This is what I hit myself in the mouth with. The curved end glance off my left front central incisor. It hurt some, my lips were lacerated, I scared my wife when I came in to take a look at it in the mirror but the pain to come was far worse. Tooth was intact thank goodness and was a bit wobbly and I said to myself yup, this could be a problem. A month or two later I hit it again when I was putting a portable step fence panel in the bed of the truck and it bounced and split the bridge of my nose and hit the tooth again. did not break or get displaced. Thank goodness I have a particularly thick head. Tooth trauma is a strange thing. It can blow up anywhere up to a year later. So almost 6 months later I was flying to a meeting in Orlando and of course the tooth decided to react to changes in atmospheric pressure just so I could experience the exquisite pain of barodontalgia. Kind of pain that makes you want to pry the top of your head off with a pitchfork because it would take your mind off the pain. Problem was it did not resolve after landing or anytime during the 4 days I was at the meeting. A combo regimen of acetaminophen and ibuprofen manage the pain well enough until I could get home and have it seen to. Pain did not end but the Xray showed no fracture or endodontic lesion. Strange. Then as suddenly as it occurred, the pain ceased. Strange x 2. Snapped another film and there was no pathology. Tooth was vital on pulp testing. So I did nothing more. I chalked it up to it being a karmic reminder about patients and dental pain as I've never had a cavity let alone a dental abscess. It let me feel your pain. What did the narrator likely feel after the tooth pain went away? Pick the correct answer from the following options: A. upset B. relief C. anger D. not enough information
B