For Your Health

Created by Judy Gardner, R.N., Parish Nurse

I trust in Your power and grace that sustain and restore me. Loving Father, touch me now with

Your healing hands, for I believe that Your will is for me to be well in mind, body, soul, and spirit.

-St. Padre Pio

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Gluteal Tendinopathy – August 2025

by Mary N. Neal, Retired Occupational Therapist and Speech Language Pathologist

August 2025

As we age, we lose muscle mass. This is usually more pronounced in women due to the loss of estrogen after menopause. It’s very important that we continue to be as active as possible and exercise, even “hitting the gym” to stay as strong as possible and in turn to stay as independent and safe as possible (e.g. fall prevention).

One muscle loss that is often cited is gluteal tendinopathy. This refers specifically to the deterioration of the gluteal muscles and the tendons that connect them to the bones of the pelvic area. What people often call “glutes” (or your buttocks) are three muscles, the gluteus maximus, gluteus medius, and gluteus minimus. They are important in mobility and stability of the pelvic and core area, and so in movement and balance. Not only that, but when weakness in these muscles develops, known as gluteal tendinopathy, it usually causes significant lateral hip pain. This pain can radiate down the outer thigh to the knees and can be especially bad not only during activities but at night, especially if you sleep on your side.

Unlike injuries caused by accident or inflammation, rest is not the answer since the cause is muscle loss. As always, it’s best to work with your doctor and a physical therapist to design an appropriate exercise program to strengthen the glutes, also looking at posture, gait and balance. Adjusting sleep position can also help. As a side sleeper, simply putting a pillow between my legs to provide better alignment gave me the best night’s sleep I’d had in many months!

As we age many health issues will come up. This is one that can be painfully debilitating, but one we can do a lot to improve and make a big difference in our comfort and mobility.

Submitted by:

Mary Neal, retired occupational therapist and speech-language pathologist.

Photo by Anupam Mahapatra on Unsplash

Dementia

by Joseph Flynn, PharmD

July 2025

Dementia – July 2025

A recent headline regarding the use of a common allergy medication and an increased risk for dementia caught my attention. With dementia being such a silent and unpredictable disease, I believe sharing any new evidence and recommendations for prevention is worthwhile. Antihistamines, particularly older “first-generation” such as diphenhydramine (aka; Benadryl) and chlorpheniramine (Chlor-Trimeton), are widely used for allergic conditions but are known to have significant anticholinergic properties. There is increasing concern regarding their potential association with cognitive impairment and the risk of developing dementia, especially in older adults.

Multiple large-scale observational studies have demonstrated that cumulative use of strong anticholinergic medications, including first-generation antihistamines, is associated with an increased risk of incident dementia and Alzheimer’s disease. In a study of adults aged 65 and older, higher cumulative exposure to anticholinergics was linked to a dose-dependent increase in dementia risk, with first-generation antihistamines among the most implicated drug classes. The risk appears to be related to both the dose and duration of exposure, with long-term use conferring the greatest risk.

International analysis of adverse event reporting databases has also identified a signal for increased reporting of dementia events with both first- and second-generation antihistamines, with a stronger association for first-generation agents. Notably, the risk is most pronounced in individuals aged 65 and older, and in those with additional comorbidities (i.e. cardiovascular disease, diabetes, smoking, and depression).

Short-term cognitive impairment, particularly deficits in attention and information processing, is consistently induced by first-generation antihistamines, and these effects may be reversible upon discontinuation. However, the possibility of sustained or irreversible cognitive decline with chronic use, especially in older adults, is supported by epidemiological data.

This risk appears to be particularly relevant for older adults, as age-related changes in blood- brain barrier permeability and cholinergic neurotransmission may increase susceptibility to adverse cognitive effects. Second-generation antihistamines (i.e. loratadine, cetirizine, or fexofenadine), which have minimal anticholinergic activity and limited blood-brain barrier penetration, are preferred when antihistamine therapy is necessary. Risk-benefit assessment and regular medication review are essential in older adults to minimize anticholinergic burden and potential cognitive harm.

As I frequently encounter patients using Benadryl (diphenhdyramine) or Tylenol PM (acetaminophen and diphenhydramine) for sleep help, it is important to know the risks of this behavior so informed decision making can be done.

Together we can be a healthier community.

Joseph Flynn, PharmD

Photo by Steven HWG on Unsplash

Neurodivergence

by James Gregory Neal, M.D.

June 2025

Neurodivergence – June 2025

Neurodivergence is an updated term for what has been described in the past as autism, autism spectrum, and other conditions. This is to try and avoid some of the stigma of the prior terms, which have come to be considered negative, and this does leave us to consider again what is “normal”? There is speculation that Neurodivergence is increasing. There are many thoughts about what is involved, and certainly there is a lot of political power in the idea that this may be caused by vaccines, which has been mostly debunked by the rigorous evaluations of vaccines.

Social processing and academic achievement differences are hard to correlate to specific causes, although there are advances in brain assessment and imaging that give us more clues in these concerns. In my opinion, little consideration is given to the idea that increases in neurodivergence may be due to more widespread recognition of the symptoms and more focus on assessment and diagnoses, even though the symptoms are varied, and onsets are not specific. Clinicians and researchers in these areas have believed that industrial pollutants may be correlated with these developmental differences. Clearly the social disconnects that are frequent hallmarks of neurodivergence are the most disturbing for family, schools, and caregivers and cannot yet be specifically linked to causation such as pollutants. Genetics may also be a cause.

My observations of many patients in my career suggest that there is a wide spread of incidence, types, and approaches to helping people cope with something that may not be what they were expecting for themselves and in their children and young adults. Divergence means to be different from others, and often in unpredictable ways. Isn’t that a major part of being an individual? Isn’t acceptance of others, tolerance of differences, finding the best of others, and focusing on how we treat others what Christ has offered to us in his teachings?

For your health.

James Neal, MD

Photo by Caleb Woods on Unsplash