Tag: older adults

Coping with Old Farthood By Teaching Patience to Others

I get notices from the Iowa legislators about how great it is that I’m getting to be an old fart. An Iowa senator even reminded me: “Check your driver’s license to see if it’s time to renew!”

That’s one of the few things I’m up to “speed” on—see what I did there?

Other things remind me that I’m getting older. I walk slower. I can make several miles by walking out to the mall, walking up and down inside, and walking back. I made 5 miles yesterday.

Here’s the thing; I don’t powerwalk and, for the first time, I made a couple of stops along the way to rest. I’ve never done that before. Part of the reason is that, early this spring I had a bout of painful shin splints and calf cramps which took me a week to recover from. I wrote a very long blog post about that.

This time, before I set out for home, I was sitting inside and watching people outside. The bench I sat on faces the parking lot and a street runs along just outside of it. There’s a crosswalk visible from my bench.

As I gazed out at the parking lot, I saw one blue SUV with the two doors on the driver’s side wide open, making it impossible for anyone to park in the lane next to it. One elderly gentleman wearing a cap sat shotgun and appeared to be napping. A few minutes later, a woman with an unsteady gait made her way out to the car. She moved slowly and a few times I though she might topple over. She didn’t look very old, and she might have been younger than me, but not by much. She got in the back seat behind the napping man. The two side doors remained open.

A few minutes later, an old man with a wheeled walker came out of the mall and started to cross the street. He would push the walker forward a couple of inches at a time and then sort of drag his legs a couple of steps forward. He pushed the walker forward a couple of inches, and shuffled a couple of steps behind it; that’s the way he went. As I watched him, I wondered if I was going to have to hurry out there to help because I thought he might fall any second.

I actually took my eyes off him for a few minutes and when I looked back, I couldn’t see him in the crosswalk anymore. I figured he made it across, but then I noticed that the SUV was still sitting there and both driver’s side doors were still open. I peered around the crosswalk—and he was still scraping along, inching forward a few inches at a time. Drivers would have to either wait or back up and find another route.

He just kept creeping along. I think it took him all of 15 minutes just to get to the SUV, a distance that could have been measured linearly as not much more than 20 yards or so.

I remember wondering where and who the driver was. There were two seats left and I thought “No way is he the driver!” The driver must have still been in the mall somewhere.

As I sat there, the old man inched over to the SUV and finally made it. I almost could have taken a nap during the whole journey, but I’m not quite that old yet.

Then he opened the driver’s side back side door—and shoved his walker in the back seat! There was now only the driver’s seat open, and still no driver in sight.

And finally—the old guy got in the driver’s seat! He pulled up his trousers, started the SUV, backed carefully out of the parking lane and cruised smoothly out of the parking lot and away to who knows where, maybe a dance hall.

After I recovered from incredulity, I walked back home. I sat down to rest once before trying to across the street where, a month ago I had a sudden attack of calf cramps which nearly stopped me in the middle of the crossing. At that time, I had to hobble over to a bench and massage the cramps before heading the rest of the way home.

This time, as cars waited for me to get across, I could feel the cramps starting again but I slowed down instead of trying to trot across. I thought, “They’ll just have to wait.” No cramps this time.

Maybe that’s one of the reasons the state legislators send out cards and certificates to seniors. We help teach patience to others. You’re welcome.

What’s Up with Seasonal Vaccines This Fall?

I just read an interesting article in JAMA on this fall’s Covid-19 vaccine. Most of it is from the FDA meeting in June (Rubin R. This Fall’s COVID-19 Vaccines Will Target Omicron XBB Subvariants, but Who Needs Them Remains to Be Seen. JAMA. Published online July 05, 2023. doi:10.1001/jama.2023.10053).

One expert was quoted, indicating that there will be “…an elaborate discussion” at the CDC ACIP meeting about who should get the new monovalent XBB.1.5 vaccine. I don’t see that the meeting is scheduled yet.

There are some other interesting quotes to pass along:

“Back in March and the first half of April, XBB.1.5 represented more than 80% of circulating SARS-CoV-2 in the US, according to CDC estimates. Its dominance began to slip in late April, and as of late June, XBB.1.5 represented little more than a quarter of circulating SARS-CoV-2 variants. By then, though, XBB.1.5 and 9 other XBB subvariants together accounted for a total of 96% of circulating SARS-CoV-2 in the US. Fortunately, members of the XBB family of subvariants are antigenically similar to each other, so a vaccine against XBB.1.5 should protect against the rest of them as well, the WHO committee noted.”

“By the third quarter of 2022, an estimated 96.4% of approximately 143 000 blood donors in a nationwide, longitudinal cohort had SARS-CoV-2 antibodies from previous infection or vaccination or both, according to an analysis published in June in Morbidity and Mortality Weekly Report.

Or, as Sawyer told JAMA, “[t]he whole US has had this virus in one form or another.”

Because of the high prevalence of SARS-CoV-2 antibodies in the population, Paul Offit, MD, in an interview predicted “a focused recommendation by the CDC” regarding who should receive the XBB.1.5 vaccine.”

“Offit said he expects that the CDC will recommend the new monovalent XBB.1.5 vaccine for groups at the greatest risk for severe disease, reflected in continuing hospitalizations for COVID-19. Those groups likely would include people who are 75 years or older, people with severely compromised immune systems, and pregnant people, Offit said.”

“At least for people 60 years or older, the fall vaccine situation will be more complicated than it was a year earlier, Schaffner noted. That’s because at its regular monthly meeting in June, ACIP voted to recommend that this age group have the option of being vaccinated against respiratory syncytial virus (RSV) after consulting with their physician or pharmacist.”

That would mean that there would be 3 vaccines coming in the fall: RSV, Covid-19, and influenza. Sena and I have been doubtful about why a conversation with a physician would be necessary for the RSV vaccine. We don’t know whether that means you couldn’t get it without a physician’s order. There are also questions about coadministration of the RSV and Covid-19 vaccines.

Because the time is coming soon for seasonal vaccines, we’re hoping the questions will be answered soon.

Four Seasonal Vaccines for Older Adults?

There are a number of seasonal vaccines recommended for older adults in the U.S. They include vaccines for influenza, pneumonia, and the newest one is Respiratory Syncytial Virus (RSV).

I noticed that during the recent FDA meeting to decide on approval of another vaccine for the XBB variant of Covid-19, many experts objected to the use of the word “periodic” in the voting question.

Those objecting to it did so because of the implicit suggestion that Covid-19 is a seasonal virus. Not all experts agree on that. I gather it takes time to determine whether or not an infectious agent should be considered seasonal or not.

If the XBB variant of Covid-19, RSV, pneumonia, and influenza are all considered seasonal, then there are 4 vaccines for which older adults would be eligible.

The consensus among most experts is that you can take both influenza and Covid-19 vaccines at the same time. Most of us older adults also get the pnemococcal vaccine as well.

Will the RSV vaccine be added to the list? Should you get all 4 at the same time? Or should they be spaced out? Should you get the influenza and Covid-19 vaccines together and wait a week or two before getting the RSV and pneumococcal vaccines?

The increase in recommendations for vaccinations could be burdensome for those without health insurance. Vaccine uptake will probably continue to be a challenge.