QUESTION: I'm a 67-year-old widow in good health. I recently purchased a condominium that offers a communal hot tub in the complex. Is it safe for someone my age?
ANSWER: Soaking safely in a hot tub does not depend on chronological age but on your health. People who have heart or blood-pressure problems, or are diabetic, pregnant or taking medication, should consult their physician.Hot tubs cause the body's blood vessels to dilate, blood circulation to increase and the heart to work more effectively. However, they can get as hot as 104 degrees Fahrenheit, which may adversely affect the heart, temperature-control system and blood pressure.
When blood vessels are dilated, the heart beats faster, similar to the way it works during mild exercise. While it's OK to soak for 10 to 20 minutes, beyond that you may begin to feel nauseated, dizzy and short of breath.
Being submerged for too long in water hotter than the body's temperature makes it difficult for the body to control its internal temperature, because it can't release excess heat. Consequently, one can develop hyperthermia. This risk can be lessened by keeping at least one-half of the body above water, and by entering and leaving a tub gradually to allow the body to adjust to the temperature change.
During a hot soak, blood pressure may go down, and it may drop more when you stand to leave. This can cause fainting, especially if you are prone to low blood pressure.
Avoid alcohol while soaking and for at least 30 minutes before and after. Alcohol, coupled with the circulatory effects of hot water, can increase the risk of dehydration, fainting and heart problems.
One also needs to think about transmission of infections; the water should be chlorinated and continuously circulated.
QUESTION: My 76-year-old brother has been diagnosed with Dupuytren's contracture, the hand ailment for which former President Reagan had surgery this winter. Can you tell me about it?
ANSWER: Dupuytren's contracture is a common condition that tends to be more nuisance than painful. The deforming hand ailment was named for French surgeon Baron Guillaume Dupuytren, who in 1831 concluded that the disorder was an occupational injury. There is no convincing evidence that this is so, although many doctors believe some unknown factor triggers the condition in those predisposed to it.
Dupuytren's contracture stems from a nodule that forms below the crease in the palm nearest the fingers. Other early symptoms may include a burning sensation when grasping a hard object or a feeling similar to a pebble trapped in a shoe. The pain tends to disappear in a few months.
As more scar-like tissue is formed, the nodule hardens, shrinks and may cause puckering of the overlying skin. For most people, the process stops at this point. In others, a band or cord forms, pulling down a finger. The ring finger is affected most often, followed by the little, middle and index fingers. Several fingers may become crooked, but not at the same time, and the damage may not progress at the same rate.
The incidence of Dupuytren's contacture increases with age, and the condition is more common and severe in men. Surgery is the only proven treatment, and the simplest procedure is the one Dupuytren described: Divide the cords or bands of tissue. Rehabilitation therapy is as important as the procedure.
Surgeons generally recommend operations where Dupuytren's contracture seriously interferes with activity. More than one operation is sometimes needed.
QUESTION: My wife and I are in our mid-50s and work full time in demanding jobs. Every year, we plan weeklong excursions to get away from it all. I dread the start of these trips because the frenzied airport departures add to our already hectic lives. Any tips on minimizing pre-travel stress at our age?
ANSWER: Learning to operate at a slower pace may be a considerable adjustment, but it will best serve your physical and mental-health needs. For example, pack in advance and work only one-half day the day prior to departure to help you start off relaxed.
Since the mind drives the whole body, older adults may experience symptoms such as insomnia, gas, diarrhea and constipation before a trip. Breathing slowly from the abdomen may help, and medication can be taken if the problem is severe.
Try to get a good night's sleep before departing and, if you fear flying, mild sedation may be advisable the day of a flight. To ease anxiety about losing luggage, minimize your baggage and use carry-on items when possible.
Arrive at the airport in good time. Securing boarding passes in advance and checking baggage with a porter outside the terminal will allow you to proceed directly to the departure area. Should your plane be delayed, have a book handy.
Regarding your overall trip, don't try to accomplish too much. Leave some free time.
Send questions about growing older to On Aging, P.O. Box 84256, Los Angeles,CA 90073. Questions of general interest will be answered in the column; individual answers cannot be provided.
(C) 1989 Washington Post Writers Group