When it comes to drunkenness, caffeine does not help

February 17, 2011 by  
Filed under ADDICTION

A strong cup of black coffee is not an antidote to alcohol intoxication. Neither are 2 cups. Or even three. Of a caffeine-rich energy drink for that matter.

Caffeine is known as a stimulant that can keep you awake and boost performance. The popular use of caffeinated energy drinks among young people during exams week attest to this.

However, the notion that caffeine is an effective antidote to the sedating effect of alcohol is completely wrong.

The appearance of caffeinated alcoholic beverages (CAB) in the market is causing concerns among health experts. Several manufacturers recalled their CAB products following FDA warnings last year but the practice of mixing caffeine with alcohol has not abated. It is as easy as simply mixing their own cocktail.

According to researcher Dr. Jonathan Howland of the Department of Community Health Sciences and Department of Emergency Medicine, Boston University:

“Although several manufacturers of caffeinated beer have withdrawn their products from the market, there is no sign that young people have decreased the practice of combining alcohol and energy drinks. Critically, CABs may increase alcohol-related risks in a number of different domains, but have been subject to very little systematic research.”

Risky behavior has been attributed to this dangerous mixture including intoxicated driving (either as driver or passenger), committing and being a victim of sexual assault and having an alcohol related injury or accident.

In order to clarify once and for all the belief that caffeine blunts the effect of alcohol, thus allowing one to drink and drive, the researchers tested 129 people ages 21 to 30 drink alcohol with or without caffeine. After 30 minutes, they were tested on a driving simulator. The results showed that all drinkers were not fit enough to drive – regardless whether they had taken caffeine or not. The take home message, according to Dr. Howland, is:

“If you’re intoxicated – whether you have caffeine or not – you shouldn’t be driving. Your performance really falls apart.”

Let us hope we can get the message across!
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The health hazards of phoning while driving

June 16, 2010 by  
Filed under HEALTHCARE

We all know we are not supposed to be doing it – handheld phoning and driving at the same time. Yet we do it all the time. On the Swiss highway, there is big sign from the police: “If you keep on phoning, we’ll have to get to know you better.” Yet, people are getting caught all the time. There are many reasons why we shouldn’t phone and drive. You might think you know it all but let’s have a look again.

Talking hinders driving

We are aware that driving takes a lot of concentration. One split second of inattentiveness and distraction can be fatal. There are many things that can distract us during a drive – the radio, the kids at the backseat, the landscape, even the navigation system. However, the phone is the worst of them all. A large number of traffic accidents are attributed to phone use. Studies have shown that phoning while driving is just as bad as driving under the influence of alcohol. Dr. Amy Ship of Harvard Medical School and Beth Israel Deaconess Medical Center in Boston:

“Although there are many possible distractions for drivers, more than 275 million Americans own cell phones, and 81 per cent of them talk on those phones while driving.”

Driving hinders talking

It is not only your driving that is affected by the phoning-driving combination. Your communication skills are affected as well. A recent report in Family Science Review shows that relationships to those near and dear can suffer through distracted phone calls while driving. Such phone calls are characterized by abruptness, delayed responses, and sometimes even missing important details of the conversation. Thus, half-heard phone calls lead to a lot of misunderstanding that can affect relationships.

I used to answer my phone and yell to my husband “I can’t talk, I’m driving”, and disconnect. However, I realized this is all very unnecessary, not to mention stupid. Nowadays, I simply let the phone ring in my handbag or even put it to mute. The message: talking hinders driving but driving hinders talking, too.

It’s not only about the talking

Now, smart phones are not only for talking. It’s for texting, surfing, emailing, tweeting, and what else. These activities are even more distracting than simply talking. You need your hands as well as your eyes to do these.

PREVENTIVE MEASURES

Use hands-free devices

Health authorities recommend the use of hands-free devices while driving. This may reduce but not completely get rid of distraction while driving. Definitely the distraction of talking can be improved by hands-free devices. But not the texting, etc.

Legislations

In many countries, phoning while driving is a traffic violation that can lead to hefty fines. In North America, all Canadian provinces except New Brunswick and Alberta as well as 41 American states have legislations in place. But these laws, like most traffic legislations, are not taken seriously.

Doctors should warn their patients.

People sometimes could take advice more easily from their doctors than from the law enforcers or their loved ones. If a doctor can talk to a patient about the hazards of smoking and alcohol, he or she can also talk about the hazards of phoning while driving. Primary care clinicians should therefore discuss this issue with their patients. This is according to a commentary by Dr. Ship in the recent issue of the New England Journal of Medicine.

“The U.S. Preventive Services Task Force found that spending three minutes discussing the risk of tobacco use with a patient increases the likelihood of that patient quitting smoking. The same might be true for cell phone use.”

Driving restrictions for patients with ICDs

June 30, 2009 by  
Filed under HEART AND STROKE

icdICD stands for implantable cardioverter defibrillator. This is a device implanted in patients suffering from heart problems such as coronary artery disease or dilated cardiomyopathy. An ICD is a battery-operated implant that detects and responds abnormal rhythms of the heart or arrhythmias. Once an arrhythmia is detected, the device applies an electrical jolt to restore the heart rhythm back to normal. Over the years, ICDs have saved thousands of lives.

Recently, the European Society of Cardiology (ESC), in conjunction with other European health organizations that included European Heart Rhythm Association (EHRA), and the European Association of Cardiovascular Prevention and Rehabilitation (EACPR) issued a consensus statement that outlined restrictions on driving of motor vehicles by patients with ICDs. ESC made the announcement at the Europace 2009 sessions. The consensus statement was published in the EHRA journal Europace June 13, 2009 online issue.

The restrictions made a distinction between the types of vehicles as well as the type of drivers. Stricter regulations apply to driving trucks, buses and other large professional vehicles compare to small personal vehicles. There are also regulations that apply to patients who spend long periods of time behind the wheel as part of their jobs or professional life.

So what does an ICD actually does to the patient that may cause problems when driving a vehicle?

According to the UK-based Arrhythmia Alliance, most modern ICDs work n 3 ways:

It is feared that at the moment when the ICD applies the electric shock, the patient sitting behind the wheel might lose control of the vehicle he is driving.

According to Dr Johan Vijgen, chairperson of the task force that developed the recommendations

“Driving restrictions vary across different countries in Europe. We hope the document may serve as an instrument for European and national regulatory authorities to formulate uniform driving regulations.”

The restrictions aim to protect the patients as well as other drivers of vehicles.

ICDs had some bad publicity last year mainly due to some product recalls as well as study results that indicated some people have implanted ICDs which they don’t and would never need. The latest restrictions on driving by ICD patients wouldn’t make this device any more popular.

 

Photo credit: commons.wikimedia.org/wiki/Image:ICD.jpg

Driving under the influence of … stress

April 7, 2009 by  
Filed under STRESS

drivingWe are not supposed to drive when we are under the influence of alcohol or certain drugs. But what about driving while under stress? You may think that stress and driving actually go together in one package. Tell that to the people driving to and from work everyday during rush hour. Tell that to the person standing still in a gridlock. Tell that to the mom who has to shuttle her little kids to and from school, to football practice, and so on.

But sometimes major events can drastically increase stress and anxiety levels that will in turn have adverse effects on performing daily routines, including driving. With serious consequences.

One of the most traumatic and stressful experience that Americans have had in recent years is the September 11 terrorist attacks. The incident had such long lasting effects on people’s psyche that researchers are just discovering now, 8 years later.

Psychologist Alexander J. Rothman and his colleagues at the University of Minnesota analyzed records obtained from the US Department of Transportation to see if there was any relation between geographic location and the rate of fatal traffic accidents that occurred in the three months immediately following the September 11 terrorist attacks… The authors found that there was an increase in the rate of traffic fatalities in the three months following the 9/11 attacks, but only in the Northeast, the region closest to the terrorist attacks on the World Trade Center. A follow-up analysis showed that there was a significant increase in the rate of traffic fatalities in the months following September 11 in the state of New York. This pattern of findings is consistent with the premise that stress-related reductions in the quality of driving led to a spike in the rate of fatal traffic accidents.

The findings of the study indicate that living close to the location of a highly traumatic event leads to increased psychological stress. In turn, psychological stress can impair a person’s driving ability, an impairment that can lead to serious, even fatal traffic accidents. There is therefore a need to re-examine what we know about stress and driving. In addition, psychologists will be able to anticipate behavioural patterns in response to traumatic experiences. The results of the study have been published in Psychological Science, a journal of the Association for Psychological Science.

I cannot drive effectively when I am under stress, even it is not necessarily due to a major traumatic experience. The stress of work and family responsibilities can sometimes be too much. That is why I prefer to take the public transport. Less stress, less damage to the environment.

Photo credit: stock.xchng

The Fine Art of Distraction

April 16, 2008 by  
Filed under ALZHEIMER'S

This post discusses unusual behaviors caused by Alzheimer’s disease and how to respond

My mom was up, dressed and ready to go to church.  On the surface, that seems like a good thing.  However, it was Tuesday morning!  But she was determined to go.  She had her purse in hand, coat over her arm and “no” was not an option.

I tried explaining that it was Tuesday and that we had already gone to church on the weekend.  I tried to show her the calendar, that didn’t work either.  Finally, in desperation, I firmly looked at her and said, “Mom, I am NOT taking you to church. It’s Tuesday!”  She looked at me, didn’t say a word and proceeded towards the front door.  By this time, my throat was aching, my head was throbbing and my eyes were burning.  I wasn’t fighting the tears because of my lack of understanding; I was fighting them because this moment in time helped me to understand how sick she really was.  I was in the heat of the battle against Alzhiemer’s disease and I was losing.  As she pushed past me in the hallway, determined to go to church, it hit me that I didn’t know her and she didn’t know me.  We had been close my whole life and now, our relationship was reduced to an argument about attending church on Tuesday morning.  I had to think fast.  She was heading for the door and I didn’t want to physically restrain her. 

She walked to the end of the hallway, to the front door, turned and headed up the stairs to get the baby who was crying.  Now, that presented another set of problems, but at least she was distracted from her original plan of going to church.

So, how DO you handle these episodes? What DO you do when grandma wants to take her clothes off in the mall or grandpa insists that the little boy in the grocery store is HIS son? Or, Lord forbid, uncle goes for the car keys.  My mother provided at least one answer.  DISTRACTION.

Although logic almost never works, something more important than the original idea almost always works.  Church was important, but a crying baby was more important.  The interesting thing though is it doesn’t have to be important to you, just to them at the time.  Here are some of my favorite distractions.

Laundry-I used to take wash cloths and towels out of the closet, put them in a laundry basket and give them to my mom to fold.  For some reason, laundry was important.

Snacks-My mom was a small woman, but she liked to eat.  Usually the offer of some bread and butter (she loved bread), a slice of her favorite dessert, or a cup of postum (coffee substitute) or herbal tea would be enough to get her mind going in another direction.

Dishes-They probably won’t get done the way that you would do it, but if it works, then you can clean them properly later.

Walk-Unfortunately, this was the first of many incidents.  There were times that I’d say, okay, let’s go (wherever she wanted to go) and we’d go outside and walk the neighborhood till she got tired and forgot where we were supposed to be going.

Drive-A long drive works wonders and I have taken many of them.  The ride will calm both of you.

Conversation-Talk about anything that may be a distraction, weather, an old movie, the children, politics.  Just try to get another thought process going.

If you are away from home and can’t use laundry or dishes try these tips:

  • Have someone ring your cell phone and tell grandpa it’s for him
  • Try singing an old favorite song and getting your loved one engaged. You might look odd, but not as odd as standing next to a naked grandma in the mall.
  • If you are in the mall or grocery store, offer a snack or bottle of water or juice. It may be just enough distraction to get you outside and into the car. 

Most of all, YOU have to remain calm and keep your wits.  Remember, the disease will work in your favor because often, once you distract dad, he may go on to some other strange behavior, but he won’t remember the initial one.

This is not a comprehensive list.  Please share your suggestions and thoughts. 

You Know it is Time To Stop Driving When

March 11, 2008 by  
Filed under ALZHEIMER'S

You’ve been thinking about it, but you are not sure if it’s really time to take the car keys from your loved one who has Alzheimer’s disease.  Below is a list to help you make the decision, but in the meantime keep these thoughts in mind.

Alzheimer’s is not just “getting old” and losing memory.   So the, “to drive or not to drive” issues are more complicated than driving too slowly, or getting a little turned around in terms of directions. 

Those with Alzheimer’s lose some visuospatial ability.  In English that means that they have difficulty perceiving and understanding the space between objects in their field of vision.  So, the car that is just ahead of them may appear to be way down the road.  And the man jogging across the the street two blocks ahead, may seem as if he is running out in front of the car.

Another issue is judgment and the ability to prioritize and respond to events in an appropriate manner.  So, that Uncle Bill may carefully give way to an ambulance with no lights or sirens, but may not respond at all to the stopped car in front of him.

So,  here goes, “You know its time to stop driving when…….”

10.   Dad, usually a careful and safe driver, has received several tickets or warnings in a short and recent period of time.

9.     You make lame excuses like, my puppy needs to practice her driving skills or the goldfish has swimming lessons, to keep your loved one from driving even short distances.

8.    There are unexplained scratches and dents on the car, garage doors, and mailbox.  And “vandals” have been showing up at night driving into the flower bed near the street or driveway.

7.     Uncle Bill perfectly straddles the yellow line in the middle  of the road.

6.     There is a hole or indentation on the floor where you or other passengers continually use the passenger side brakes.

5.     Grandma stops completely and waits a long time in order to merge with traffic or get onto a highway entrance/exit ramp.

4.     When you ride with Aunt Gertrude, you don’t see very much because your hands are covering your eyes.

3.    Mom sails through the red light and swears at the person who (had the green light) because he blew the horn.

2.     Dad drives 60 mph hour through the park and 25 mph on the highway.

1.     And the number one reason you KNOW its time to take the keys is if you have laughed AND related to one or more of the items in this list.

Hopefully, you smiled as you read the list.  It’s important to keep a sense of humor about these difficult issues.  However, safety is no laughing matter.  So, if you can relate to the above, then its time to get serious about taking those keys.

So, check out the joke below and smile.

 A guy is driving home from a round of golf.  His wife calls him and she is frantic.  “Honey, be very careful, I just heard the news and there is a crazy guy driving down the wrong side of the freeway.”  He replies.  “Honey, it’s much worse than that, there are HUNDREDS of people driving on the wrong side of the freeway.”

So, are you thinking of taking the keys? Have you already taken them? Do you have a funny or not so funny driving experience?  Let’s talk about it!

Friends Don’t Let Friends Drive With Alzheimer’s

March 10, 2008 by  
Filed under ALZHEIMER'S

It’s not their fault, but people with Alzheimer’s should not be driving.  I know that is not a popular position, and there are probably a few situations when the disease is still in the early stages, that driving might be okay.  But the question is this, why take the risk?

You see, it’s rare that doctors stumble upon Alzheimer’s Disease as they are doing a routine check up or testing for some other ailment.  So, when patients are diagnosed, it’s because they have already exhibited symtoms that have caused them or someone close to them a level of concern.  Whether it’s getting lost, a lapse in judgement, confusion or extreme forgetfullness, all of these are reasons to take the car keys and make other arrangements.

THAT is much easier said than done.   Driving represents independence and freedom.  It is one of the first “grown up” things we get to do as teenagers.  It is saddening, to say the least, when you have to take the keys away.  But look at it this way, either you take (or pry) the keys away or there might be a serious, even fatal accident.  Research shows that, “Three out of ten people diagnosed with Alzheimer’s disease had been involved in a serious car accident in the previous few months.” (The Alzheimer’s Sourcebook for Caregivers, Frena Gray-Davidson)

It’s difficult for the caregiver, too.  As you want to allow and encourage as much independence as possible.  You are proud that granny is 75 and still driving, but you have observed enough and perhaps used your passenger side brakes enough to know that its time for granny to stop driving.

First of all, it may help to talk about giving up the keys BEFORE it actually happens, that way there are no surprises. Maybe you could even come up with a timeframe or some parameters for when its time to give up driving.  We’ll look at some specifics regarding giving up the wheel in another post. In the meantime though, keep the lines of communication open.

Make a plan.  What is going to happen once granny gives up her keys?  Who is going to take her to the grocery store? How will she keep her Doctor’s appointments?  Who will get her to the Thursday night card game, etc.  It’s very important that the schedule is interrupted as little as possible.  Enlist family and friends to chip in and make sure she isn’t stuck and in need of a ride.  Consider other options, many cities offer free or very inexpensive transportation for seniors.

Ultimately, you may need help.  If granny won’t voluntarily give up the keys,  you might have to enlist the help of her doctor who can send a letter to the state licensing bureau.  If the doctor indicates that your grandmother has been diagnosed with Alzheimer’s and should not be driving, they should take the proper measures

In the end, its up to you as the caregiver to take the lead and make sure that you, your loved one and other drivers are as safe as possible.  Your family and loved one have to be able to trust you to make the hard decisions as well as the easier ones.

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NOTE: The contents in this blog are for informational purposes only, and should not be construed as medical advice, diagnosis, treatment or a substitute for professional care. Always seek the advice of your physician or other qualified health professional before making changes to any existing treatment or program. Some of the information presented in this blog may already be out of date.