WOW features fall prevention and preventative care

The Woman of Wellness (WOW) program on July 2 featured two talks - one on fall prevention and one on preventative care. The event, hosted by the Fallbrook Healthcare District at Fallbrook Library, drew a small crowd of about 50 women to hear from two staff members from Rancho Family Medical Group.

Anna Julien, D.O. gave the featured presentation, "Ring around the rosie... let's not fall down!" including risk factors, consequences and fall prevention. Most falls happen in and around the home, most likely in the bathroom or kitchen with slick floors, throw rugs, and clutter being potential causes.

Other causes include weak muscles, vision or balance problems and dizziness. She said, "One-third of Americans 65 or older fall each year; every 14 seconds, an elderly person falls and every 27 minutes, an older person dies from a fall."

A fall impacts people's lives as the fear of falling again tends to limit their activities and social life. The physical outcome of falls includes 20 to 30 percent moderate to severe cuts, broken bones and head trauma, which is responsible for half of the fatal falls. Bones that are typically broken in falls include the wrist, hips, and spine. Julien said that 95 percent of broken hips are the result of falls.

She then reviewed the prevention of falls in six easy steps. First, she recommended finding a good balance and exercise program to work on building balance, strength and flexibility. Tai Chi classes are good for this and are offered at the Fallbrook Community Center. She said Otago, an exercise program developed in New Zealand, is also a good option; videos of it can be downloaded online.

The second step is to talk to one's doctor to assess one's risk for falls. Risks include reactions to and interactions of medications. She encouraged the elderly to be honest with their doctors in talking about any falls they have already had.

The third step is to review medications with a pharmacist. Taking four or more medications increases one's risk for falls. Julien said that it is important to take medications only as prescribed and to tell the pharmacist about all medicines, including over the counter ones, vitamins and herbal supplements, that one is taking.

Fourth, have regular vision and hearing tests. These should be done yearly as healthy eyes help prevent falls and inner ear problems affect one's balance and increase the risk for falls.

The fifth step to prevent falls is keeping one's home a safe place. This involves removing clutter, making a clear path through rooms, making sure lights are working, having any needed repairs to floorboards or handrails done, using non-slip mats in the shower or tub, and having grab bars installed in the bathroom.

The sixth step is to talk to family members to get help with moving furniture, changing light bulbs and making needed home repairs. Julien gave other advice including "getting up slowly after sitting or lying down for awhile, wear shoes in and out of the house, maintain a healthy weight and enjoy healthy foods." She added that underweight women are more likely to break a bone if they fall.

She also recommended the use of walking aids like walkers to keep moving. "Use it or lose it!" she said regarding mobility. Alarm devices to alert others when one falls are also a good idea she said.

Brenda Robinson, P.A., then reviewed information on the latest preventative care checklist for women. Among the new regulations is having a pap smear every five years after a normal one, instead of every two or three years. Because vitamin D is important in preventing osteoporosis and breaks from falls, annual lab screenings now include checking vitamin D levels.

She reminded everyone that oral hygiene is related to systemic diseases so biannual dental exams are important. Robinson also emphasized having a thorough skin exam once a year and for those who have had skin cancer already, twice a year.

"Insurance coverage determines what [tests] and how often to have them," she said. Another new recommendation is a screening for hepatitis C for people born between 1945 and 1965. Also, most screening tests are not recommended for people 75 or older unless there are risk factors present; this information sparked a lot of remarks from the ladies present. Robinson said she would still order tests if her patient wanted or needed them.

Regarding vaccines, the one for shingles is given one time only, at age 60, but pneumonia vaccines are not good for life as people have been told in the past. There are now two different ones which have to be given in a specific sequence, so a doctor should be consulted about them.

While answering questions, Robinson explained the difference between a sigmoidoscopy and a colonoscopy. The first one only examines the lower colon and needs to be done every five years while the latter goes farther up the colon and is repeated every 10 years. She also explained that estrogen is stored in fat cells which is why petite women have a harder time with menopause.

An individual's need for testing and screening is based on her own risk factors (age, family history, past medical history and social history) so she should consult her own doctor for a full preventative care program.

Next month's WOW program, on personal safety, will take place August 6.