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Exercise

The benefits of exercise are no longer theoretical. All recent studies concerning exercise and its effect on people conclusively state that exercise will help most people live longer and healthier lives. Whether you are young or old, overweight or underweight, or even if you have a disability, exercise will benefit you.

Most of us at any age wish we were more fit. Becoming older doesn’t mean we have to become weaker and more fragile. Most physical changes of aging are due to inactivity and lifestyles that do not include regular exercise. Becoming and staying physically fit is the most important thing we can do to maintain our ability to continue doing the activities we now enjoy. The more fit one is, the more independent one may remain, as well as being happier and more satisfied with life.

It’s truly never too late to begin a fitness program of regular exercise. In this article I would like to list the beneficial reasons of exercising and also give valid reasons for not putting it off any longer.

Reasons to exercise:

  • Live longer. Those who exercise regularly have been proven to add years to their lives.
  • Help to lose weight. Combined with proper diet one will lose weight.
  • Strengthen your heart. A stronger heart pumps blood more efficiently and doesn’t have to beat as fast.
  • Lift your mood. People who exercise tend to be happier and less depressed.
  • Improve chronic conditions. Exercise has been found to lower blood pressure and to improve diabetes and arthritis.
  • Defend against illness. Exercise can boost the immune system and help fight off illness, especially flu and colds.
  • Improve stamina. Exercise can provide more pep and energy and less fatigue.
  • Improve circulation. Exercise can improve our blood cholesterol and help keep our arteries clear.
  • I say so. Just wanted to see if you’re paying attention. I really do exercise, bicycling and swimming, and I feel so much better for doing so.

Overcoming excuses for not exercising:

  • Not enough time. Wake up earlier. Do several shorter periods of exercise throughout the day. Drive less, walk more.
  • Tried it before didn’t work. Set realistic goals. Pace yourself. Reinforce in your mind the benefits of exercise.
  • I might injure myself by exercising. Start with a beginning exercise group. Pace yourself. Consider working with a trainer.
  • It’s too expensive. Joining a gym or having expensive equipment at home would be nice, but are not necessary. Watch an exercise video at home. Try just plain walking or climbing stairs.
  • I’m not athletic. Most people are not particularly athletic. It is not a prerequisite for routine exercise. Anyone can and should exercise.
  • It’s just too much work. If exercise is just too much to do for your own good, then do it for those who love you. They will have you around longer, and will enjoy your health and happiness.

Sun Protection

Sunscreen

I’d like to make my annual plea for the liberal use of sunscreen to protect all of us — young and old — from the damaging effects of the sun.  Please understand that the “healthy” bronze tan color that many people seek is actually how the skin demonstrates that it has been damaged by the sun.

The sun produces two types of invisible light. One is ultraviolet A (UVA), which is the ray that produces a tan but causes skin damage and aging, (think wrinkles and “old age” skin spots). The other is ultraviolet B (UVB), which causes the uncomfortable sunburn.

Both types can cause skin cancer, especially the deadly melanoma. This year in the U.S. there will be approximately 76,000 new cases of melanoma with some 9,000 deaths. These statistics can be reduced significantly by protecting our skin from the sun.

The damaging rays from the sun are most intense between the hours of 10 AM and 4 PM.

These are my suggestions:

  • Always start the summer season with a new fresh tube of sunscreen; price has nothing to do with performance.
  • Use a sunscreen with an SFP rating of at least 30. Higher than 50 is probably not necessary.
  • A sunscreen should be labeled “broad spectrum” protecting against both UVA and UVB and be water/sweat resistant.
  • Use at least 1 ounce (2 tablespoons) for your entire body, and apply liberally to the face, ears, and neck.
  • Don’t overlook applying to feet, back of neck, and bald spots.
  •  Apply at least 20 minutes before sun exposure and every 2 hours thereafter and more frequently if swimming or sweating profusely.
  • Avoid using sunscreen sprays on children as they can inhale the chemical ingredients. Use the lotion form only.
  • Whenever possible, wear light colored tight knit clothing and brimmed hats while in the sun.
  • Avoid tanning salons where damage — similar to the effects of the sun — can be done to the skin.

A sunscreen that has always been a favorite of mine, and one just recently highly recommended by Consumer Reports Magazine, is a brand called “NO-AD.” This product comes with an SPF of either 30 or 45, and is one of the cheapest sun screen products on the shelves.

Enjoy your outdoor summer activities, but do yourselves and especially your children a favor, and protect your/their skin from both damage and cancer by properly using a good sunscreen product.

heart-stethoscope

Atrial fibrillation is an irregular often rapid heart rate, causing the heart’s two upper chambers to quiver instead of beating regularly. Fortunately, the lower two chambers still work normally and are able to pump the blood out of the heart, although not as efficiently.

It is this inefficient pumping that can cause the frequent symptoms of palpitations, shortness of breath, weakness, and lightheadedness, to name a few.

Atrial fibrillation is the most common heart arrhythmia. It is found in over 6 million Americans and accounts for some 90,000 deaths annually. It occurs in about 1-percent of individuals in their 60s, and increases to 12-percent for adults who are in their 80s. Some 30-percent of people with atrial fibrillation are unaware of their condition.

Atrial fibrillation can be brought on by increasing age, prior coexisting heart disease, high blood pressure, thyroid disease, and drinking alcohol. It can come and go, or it can be chronic and permanent. It is usually not life threatening, but it is a serious condition and needs to be treated.

There are two main goals in the treatment of atrial fibrillation. First is to attempt to control the rhythm, that is, get the rhythm back to the normal beating pattern. If a normal rhythm cannot be obtained, then the second goal is to control the heart rate. Ideally one would want to have the rate 80 beats per minute or below. Both of these goals can be accomplished with medication.

If one is very symptomatic or has relatively new onset atrial fibrillation, the heart can be electrically treated with a small electrical shock while under brief anesthesia. This treatment however, is rarely a permanent solution.

One of the main problems with atrial fibrillation is the chance of having a stroke. Blood clots can form in the quivering upper chambers. If a clot breaks loose it can go to the brain, causing a stoke.

This can be prevented by taking a blood thinning medication. Another complication is heart failure due to a weakening of the heart muscle.

There is a new advanced procedure called ablation. In this case a catheter is inserted in a large blood vessel in the groin and threaded up into the heart. Through highly technical computerized imaging, the trigger area for the fibrillation in the upper chamber is identified and lightly burned with high frequency radio waves. This destroys the area where the abnormal impulses of atrial fibrillation are generated. The success rate for this procedure is around 70-percent initially, and up to 90-percent if a second procedure is necessary.

Many people with atrial fibrillation are living relatively normal lives today when properly managed. It is a condition not to be feared, but to be monitored closely and treated appropriately by your doctor.

Blood pressure measuring studio shot

Normal blood pressure is 120/80. The upper number is called the systolic blood pressure and measures the pressure in your blood vessels when the heart beats. The lower number is called diastolic and measures the pressure in your blood vessels between beats when the heart relaxes.

The higher the number, the greater the pressure your heart needs to pump the blood. High blood pressure for most adults is defined as 140/90 or higher, and as new guidelines have suggested for those over 60 years of age, 150/90 or higher.

The most common type of high blood pressure is called primary hypertension and has no known cause. The less common type is called secondary hypertension — which is usually caused by something such as kidney abnormalities, congenital heart defects, certain medications, and recreational drugs.

Blood pressure should be checked in children during their well child exams, beginning at age three, and every one to two years thereafter. If one has a family history of hypertension and especially as one gets older, blood pressure should be checked more often.

Many local pharmacies offer on-site blood pressure machines for your convenience; however, it is preferable for the sake of accuracy and consistency to have your healthcare provider check your blood pressure.

Some people suffer from “white coat hypertension,” which is a falsely elevated blood pressure in the doctor’s office brought on by anxiety. These people — and others who so desire — can measure their blood pressure at home with the use of a blood pressure monitor, which can be purchased from most pharmacies.

When checking your blood pressure at home, remain seated with legs uncrossed for several minutes and avoid caffeine, alcohol, and exercise for at least 30 minutes prior to taking your blood pressure.

Some people with high blood pressure have no symptoms while others may have headaches, dizziness, or nosebleeds.

Risk factors for high blood pressure include increasing age, family history, and race. Women are more likely to develop hypertension after menopause.

Complications of high blood pressure include heart attack, heart failure, stroke, and kidney and eye disease. When treated timely and properly, these complications occur much less frequently.

Life style changes can help to control and prevent high blood pressure — here’s what you can do:

– Eat healthy foods such as fruits, vegetables, whole grains and less saturated fat.

– Lose weight if you are overweight.

– Limit salt intake.

– Limit alcohol. If you drink, do so in moderation.

– Don’t smoke.

– Participate in regular physical activity.

– Manage stress.

Controlling your blood pressure will go a long way to insure a longer and healthier life.

Kids

I’d like to talk about several common activities involving our children, how to ensure safety and to avoid unnecessary injury.

Playground injuries, mostly from falls, account for over 200,000 emergency room visits per year. The highest risk group is five to nine years of age. Young children need close adult supervision.

Make sure that underneath the equipment there is an adequate shock-absorbing material, such as chipped wood or any type of rubber product. Also, one needs to inspect the equipment to ensure that it is in good repair.

Bicycling (300,000 emergency visits a year) and skateboarding (30,000 visits) are the leading cause of head injury accidents in children. Proper safety for these activities includes adult supervision of younger children, routine bicycle maintenance, and mandatory use of head-protective helmets. These helmets must be proper to the activity and they must fit appropriately, but most importantly they must be worn!

Swimming accidents leading to drowning, and are the second leading cause of injury death among children 14 years and younger. All pools must be adequately fenced in and have properly functioning gates. Injury can be avoided by not running around the pool, not jumping onto floating objects, and proper use of a diving board. Again, adult supervision is paramount in preventing swim-related activities.

In 1971, trampoline injuries led to the NCAA eliminating the trampoline from sports competitions. I’m sure it’s also why we don’t see this event in the Olympics.

Trampoline injuries cause 80,000 emergency visits per year, for children age five and younger. If you own a trampoline, do not allow a smaller child to be on a trampoline with a larger child, as the smaller one is 14 times more likely to be injured.

In fact, one should follow the manufacturer’s recommendations and not allow more than one person on a trampoline at a time. Safety netting around the trampoline is essential to protect a child but is not foolproof to prevent injuries.

As with all the above activities, adult supervision is mandatory.

BaseballInjury

A common question that I am asked in my urgent care practice is when to apply either hot or cold packs to treat injuries and pain.

Acute injuries are usually manifested by pain, swelling, and tenderness, whereas chronic injuries are usually manifested by lingering pain from an acute injury or from overuse of muscles and ligaments from too much exercise or heavy work.

Our necks, backs, shoulders, and knees are common sources of ongoing pain. Chronic pain may come and go, whereas acute pain from a recent injury is usually constant.

Ice is used to treat an acute injury because it helps to slow blood flow to the injured area, thus helping to reduce swelling and inflammation. Ice can be applied by using ice in a plastic bag, gel packs (from a pharmacy) or even from using a bag of frozen peas. In general, cold therapy can be discontinued when swelling is gone after an injury.

Heat treatment may begin several days after the injury. It works by opening up blood vessels, which helps by increasing blood flow to the injured tissue, thus easing the pain. The word heat is defined as very warm to comfortably hot, but not too hot. Heat can be applied by using a hot water bottle, a heating pad, a gel pack or a hot soak in the tub.

Be very careful using heat if you have diabetes or poor circulation as you may cause burns to the skin.

The use of products to apply to the skin overlying a painful body part such as “Deep Heat” or “Mentholatum” work by causing the skin to feel cool and then warm. These feelings on the skin distract you from feeling the aches and pains deeper in the tissue. This may be helpful for more minor aches and pains.

Both hot and cold compresses should be wrapped in a thin towel so that you neither burn nor freeze the skin.

Be aware that you may burn your skin if you fall asleep on a heating pad. Hot or cold packs should be used for 15 to 20 minutes at a time. For ice treatments, I recommend repeating every half-hour to hour if convenient, and for heat, every two to four hours.

In summary:

– Use a cold pack as soon as possible for immediate injuries such as sprains of the ankle, wrist, knee, back or any other injured joint or body part. Cold treatment can usually be stopped 48 hours after the injury or until swelling is gone.

– Use a hot pack for a painful injury that lasts longer than several days, for recurrent pain from previous injuries, or as a warm up of painful areas prior to exercising.

Allergies

The media has recently warned of an unusually bad allergy season causing miserable symptoms to countless people.

Seasonal allergies are commonly referred to as allergic rhinitis — also known as “hay fever” — if the nose is mostly affected, and allergic conjunctivitis if the eyes are involved.

 Allergic rhinitis affects up to 40 percent of children and 10 to 30 percent of adults in the United States. It is referred to as “seasonal” if symptoms occur at particular times of the year or “perennial” if it occurs year-round.

Common symptoms of seasonal allergies include sneezing, itchy eyes, nasal congestion, headache, and fatigue. These symptoms can have a tremendous negative impact on the quality of life and on productivity.

American workers lose an estimated six million work days yearly to this disorder, as well as incurring costs of several billion dollars in medical care.

Seasonal allergies usually occur from spring to early fall, and are due to pollens from trees, grass and weeds. Perennial allergies, occurring throughout most of the year, are caused by indoor factors such as dust mites, animal dander, and mold.

Nasal stuffiness from allergic rhinitis can cause swelling and obstruction of the sinuses which can lead to a sinus infection.

There is a strong association between allergic rhinitis and asthma. Up to 50 percent of patients with asthma have allergic rhinitis. Sleep disorders in adults and a high proportion of ear infections in children are also associated with allergic rhinitis.

Treatment for people who think they have allergic rhinitis can begin with an over-the-counter antihistamine such as Benadryl or Chlortrimeton.

However, they are often associated with the bothersome side effect of drowsiness. They should be avoided in children below 2 years of age and in the elderly.

Newer oral antihistamines such as Claritin, Allegra, and Zyrtec, are now available without a prescription and cause significantly fewer side effects and are more conveniently dosed at once or twice a day. Steroid nasal sprays such as Nasacort and Flonase are very effective and are now sold over the counter.

Seasonal allergies can also affect the eyes causing redness, tearing, itching, and swelling of the lids.

This can be treated with cold compresses and with one of the newer oral antihistamines mentioned above. It would also be worth trying over-the-counter allergy eye drops such as Zaditor, Alaway or Naphcon A.

The above mentioned over-the-counter medications for allergy symptoms can be purchased for under $30 at your local pharmacy. If these treatments aren’t working sufficiently, see your doctor who can help you decide what treatment is best for your symptoms.

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