Ian Coote, MD3
Special Feature “ Health & Exercise Forum” with Geisinger Commonwealth School of Medicine the 3rd Monday of every month!
Guest Columnist: Ian Coote
Ian Coote, MD3 originally from Rogersville, PA is a third-year medical student at Geisinger Commonwealth School of Medicine. Ian majored in Biological Sciences at Ohio Northern University before graduating in 2015. He hopes to pursue a career in emergency medicine upon graduating from GCSOM.
Growing old is one of life’s inevitabilities. While growing old is something we all hope to achieve, as we age our bodies start to wear down. Many people start to have more aches and pains as they grow older which can seriously impact their happiness and overall quality of life. It is important for us to take care of our bodies when we are young and to continue to take care of ourselves as we get older. Knowing how to care for our health and being aware of some the things to watch out for as we age is essential. One of the more common issues that people experience as they age is problems with their bones, specifically osteoporosis.
The human skeletal system is made up of 206 bones. Our bones have several functions including physical support, transferring the forces produced by our muscles to allow us to move around the world, protection of our internal organs, mineral regulation, and serve as the location where our red blood cells are made. Each bone in our body is made up of three basic layers. The outermost layer is known as the periosteum and it is a thin fibrous layer that can be thought of as a sort of “plastic wrap” that serves as the outer layer of bone. This periosteum or “plastic wrap” has several purposes; it contains the blood vessels that supply nutrients to the bone, it contains nerves that allow us to feel, and it serves as the attachment point for muscles and tendons which allows us to move our arms and legs. The next layer of bone is called compact bone. It is made from tightly packed minerals and is very strong, stiff, and dense. The compact bone serves to provide support to our bones and to protect our internal organs. The innermost layer of bone is called cancellous bone. The cancellous bone is made up of the exact same minerals as the compact bone but is much more spongy and arranged in a mesh-like pattern. Cancellous bone serves to provide internal support to bones and is the region in which red blood cell production occurs.
Our bones are constantly undergoing a process of being broken down and rebuilt. This means that old, worn-out bone tissue is being degraded and the minerals that make up the old bone are being recycled and made into new, healthier bone. This process is known as bone remodeling and there are two types of cells that are involved, osteoclasts and osteoblasts. The easiest way to understand how osteoclasts work is to think of them as the bone’s inspection and demolition crew. Osteoclasts search around bone to find weak or damaged bone and then release chemicals that dissolve the weak bone. The minerals or building materials of the bone are then recycled. Osteoblasts are the construction crew of the bones. They are constantly laying down the building material of bone and helping it to mature into strong healthy new bone. This process of bone remodeling is happening constantly and it is very important that there is a healthy balance between the activity of the bone demolition crew and the bone construction crew.
Osteoporosis is essentially an imbalance between the osteoclast “demolition crew”, and the osteoblast “construction crew”. In osteoporosis the demolition crew is working much harder and faster than the construction crew. This produces bone that is thinner, less dense, brittle, and overall weaker than normal healthy bone.
The group of individuals that is at the greatest risk for developing osteoporosis is post-menopausal women. The reason that women who have gone through menopause are at increased risk for osteoporosis has to do with estrogen. Estrogen is a naturally produced chemical in the human body that is mainly produced by the ovaries. Estrogen has a role in maintaining bone health in that it inhibits the activity of the osteoclasts, which are the bone demolition crew. With the osteoclasts inhibited, the osteoblasts, the bone construction crew, are able to build strong healthy bone without being overwhelmed by the destruction that the osteoclasts cause. Women who have gone through menopause have decreased activity within their ovaries and therefore much less estrogen present in their bodies. This lack of estrogen means that the osteoclasts are not as inhibited as they were before the woman went through menopause and therefore the bone demolition crew starts to work faster than the bone construction crew. When this occurs, bones become thin and brittle and are much more likely to fracture.
While postmenopausal women are at the greatest risk for developing osteoporosis, they are not the only population at risk. As we age, our osteoblasts, or bone construction crew, become tired and start to slow down. It is also not unusual for older people to stop eating a well-balanced diet which leads to fewer of the essential components that make up bone to be present in the body. Therefore, it is not surprising to learn that 10 million Americans over the age of 50 have osteoporosis and that 2 million of these are men.
NEXT WEEK: Part 2: Ways to Prevent and Treat Osteoporosis
Read Dr. Mackarey’s Health & Exercise Forum – every Monday. This article is not intended as a substitute for medical treatment. If you have questions related to your medical condition, please contact your family physician. For further inquires related to this topic email: drpmackarey@msn.com
Paul J. Mackarey PT, DHSc, OCS is a Doctor in Health Sciences specializing in orthopaedic and sports physical therapy. Dr. Mackarey is in private practice and is an associate professor of clinical medicine at Geisinger Commonwealth School of Medicine.
Brendan Bormes, MD3
This column is a monthly feature of “Health & Exercise Forum” in association with the students and faculty of Geisinger Commonwealth School of Medicine (formerly The Commonwealth Medical College).
Brendan Bormes, MD3: GCSOM GUEST AUTHOR
Brendan Bormes, MD3 is a third-year medical student at GCSM. A native of Clarks Summit and graduate of Scranton Preparatory School, he majored in biology and music at Bucknell University and received a masters in physiology and biophysics from Georgetown University. His interests after medical school include Anesthesia and Surgery.
It’s that time of year…the nights come early and last long. The sun is barely rising when you leave for work, and it’s setting by the time you get home. In the fall and winter, especially this far north, many people start to feel the gloom of their surroundings creep into their psyche...Is this normal, or a sign of something more serious?
Seasonal affective disorder, or SAD, is at the far end of a spectrum of seasonal mood changes. The mildest of these, “seasonality”, is a normal response to cyclical changes in weather and light exposure. However, when symptoms like depressed mood, lack of motivation, or a shift to more vegetative daily habits become severe and debilitating, SAD may be the cause. In fact, one study found that SAD affects up to 10% of primary-care patients, and that those with a previous diagnosis of depression are even more at risk. Fortunately, though, there are well established therapies that can help those afflicted with SAD to get through the dark winter months. The American Psychiatric Association defines SAD as a subtype of either Major Depressive Disorder or Bipolar Disorder, depending on the symptoms. It can consist of episodes that onset during either fall/winter or spring/summer, or have symptoms characteristic of either “major depressive” or “manic” episodes. The vast majority of those with SAD, however, experience a persistent overall depressed mood during the shorter days of fall and winter.
If enough of these symptoms are present for a long enough time and onset in a seasonal pattern, that can mean Seasonal Affective Disorder. Most people with the disorder find themselves sleeping more and eating more (especially carbs), and report that their symptoms can even resolve with relocation to a sunnier environment. Along the spectrum of disease is a less severe form called “subsyndromal” SAD, which can still be effectively treated. Periods of SAD tend to resolve with the coming of spring, but they can be immensely distressing and always deserve medical intervention. No one knows exactly why Seasonal Affective Disorder happens, but it appears to be associated with decreased exposure to natural light during the fall and winter months. One possible explanation is the “phase-shift” hypothesis. It states that your body’s circadian rhythms, which are regulated by hormones and the brain, become out-of-step with environmental sleep/wake cues as the days shorten. In other words, the light levels around you and your body’s internal clock are telling you two different things about when to sleep. This disruption of circadian rhythms, or “phase-delay”, likely contributes to the symptoms of SAD, although precisely how it induces changes in mood remains unclear. Another hypothesis for the mechanism underlying SAD involves abnormalities in the activity of serotonin, a neurotransmitter in the brain. Normally, serotonin regulates mood and attention. However, studies have found that people with SAD clear serotonin out of their brains faster, giving the hormone less of a chance to provide a boost in mood.
Current medical treatment of SAD targets the changes in both circadian rhythms and serotonin metabolism. This can be accomplished with light therapy, antidepressant medications or a combination of both.
Visit your doctor regularly and listen to your body.
NEXT MONDAY – Read Dr. Paul J. Mackarey “Health & Exercise Forum!”
This article is not intended as a substitute for medical treatment. If you have questions related to your medical condition, please contact your family physician. For further inquires related to this topic email: drpmackarey@msn.com
Paul J. Mackarey PT, DHSc, OCS is a Doctor in Health Sciences specializing in orthopaedic and sports physical therapy. Dr. Mackarey is in private practice and is an associate professor of clinical medicine at Geisinger Commonwealth School of Medicine (formerly The Commowealth Medical College).
NEW TREATMENT FOR PARKINSON’S DISEASE
AUGMENTED REALITY: Part 2 of 2
BILL CONNELL, SPT3
Bill is a 3rd year doctor of physical therapy student at The University of Scranton and works as a student PT aide at Mackarey Physical Therapy. He is a graduate of Scranton Prep and plans to practice orthopedic and sports PT in California. He and his classmates at completed a graduate research project on the use of augmented reality for Parkinson’s disease and will present it at The American Physical Therapy Association National Combined Section Meeting in New Orleans in February 2018.
Last week in this column, we discussed a disease that affects more than 1 million people in the United States, Parkinson’s disease. This neurodegenerative disease affects the way our brain produces and uses dopamine and therefore, it affects the way people living with the disease are able to move. The hallmark signs: a resting tremor, slowness of movement, muscle rigidity, and gait and balance disturbances can all be treated through medication, rehab therapy, or in severe cases, surgical intervention. Managing these symptoms is important an important part of maintaining a high quality of life and independence in daily activities. The problem with these treatments is that they can be time consuming, expensive, and not as effective after continued use. Luckily, recent research has proven that exercise and an active lifestyle can help our brains use available dopamine more efficiently.
One of the biggest barriers to an active lifestyle for people with Parkinson’s disease is problems with balance and walking. These problems include a slow, shuffling gait and difficulty with turning or changing from one surface to another, like stepping from a hardwood floor onto a carpet. Freezing of gait can also occur, where their movement is involuntarily halted, another major fall risk. All of these symptoms are more likely to occur in environments that are crowded and unfamiliar which can lead to a more sedentary or homebound lifestyle. While medications do help manage these problems for a time, they are characterized by having on and off periods throughout the day meaning they work for a few hours, and then the symptoms return for a few hours. As previously mentioned, an active lifestyle is vital to improve quality of life and so there has to be a better way to address this problem moving forward.
A group of my fellow classmates from the University of Scranton and I, conducted a systematic review of literature to find out how people with Parkinson’s could walk more safely in their environment by using augmented reality visual cues. Past research has suggested the use of audio or visual cues for training gait in therapy sessions, but until recently, these methods were difficult to translate safely to community ambulation. It is now theorized that, by using a visual cue, the person is able to use a different part of their brain to control walking, one that bypasses the basal ganglia, or the part of the brain most affected by Parkinson’s. Using this new technology could change the way people with Parkinson’s move.
“Augmented” reality is a computer generated projection into a person’s real environment. This differs from “virtual” reality which uses a computer generated environment. An example of augmented reality you may have seen before is on Snapchat where computer generated objects like crowns or dog ears are added to regular pictures. Our research team specifically focused on the use of augmented reality visual cues to improve the speed, length of each stride, and the cadence during ambulation. It was found that these visual cues are produced from various devices including a cane or walker with a laser attachment that projects a line onto the ground in front of the user when the base of the cane comes into contact with the floor. Another option used to augment reality is a pair of glasses or goggles that shows a cue across the lens that appears to be projected into the environment, cuing the user to step. The cues varied from horizontal lines, to vertical lines that flow with the user’s movement and, in with more advanced technology; a checkerboard pattern is projected over the walking surface to facilitate normal gait.
We found 8 studies that tested these measures in the past 10 years and after analyzing their results, we found statistically significant gains in all measures, including some studies that showed less in freezing of gait. These are promising results, but more high quality studies will be needed in order to determine if these devices will consistently produce the same results over time, find which cues work best, and additional benefits to their use. Practical application simply requires the use of walkers and canes with laser projections. They are readily available and are relatively inexpensive. The glasses, however, are not as easy to obtain. Much of the available research utilized glasses that aren’t available at retail, however, there has been research done with both Google Glasses and Epson Moviero BT Smartglasses. As technological advances continue, there is great promise that augmented reality glasses become more available and less expensive. Until then, obtaining and appropriately programming the glasses will be difficult for most, unless they are involved in clinical trials.
In February, my colleagues and I will present our research at the American Physical Therapy Association’s National Combined Sections Meeting in New Orleans, LA. If you are interested about learning more about this topic or other research being done by the University of Scranton PT Department visit:
Visit your doctor regularly and listen to your body.
NEXT MONDAY – Read Dr. Paul J. Mackarey “Health & Exercise Forum!”
This article is not intended as a substitute for medical treatment. If you have questions related to your medical condition, please contact your family physician. For further inquires related to this topic email: drpmackarey@msn.com
Paul J. Mackarey PT, DHSc, OCS is a Doctor in Health Sciences specializing in orthopaedic and sports physical therapy. Dr. Mackarey is in private practice and is an associate professor of clinical medicine at Geisinger Commonwealth School of Medicine.
This column is a monthly feature of “Health & Exercise Forum”
NEW TREATMENT FOR PARKINSON’S DISEASE –AUGMENTED REALITY Part 1 of 2
Guest Columnist: BILL CONNELL, SPT3
Bill is a 3rd year doctor of physical therapy student at The University of Scranton and works as a student PT aide at Mackarey Physical Therapy. He is a graduate of Scranton Prep and plans to practice orthopedic and sports PT in California. He and his classmates at completed a graduate research project on the use of augmented reality for Parkinson’s disease and will present it at The American Physical Therapy Association National Combined Sections Meeting in New Orleans in February 2018.
William Connell, SPT3
There are currently around one million people living in America with Parkinson’s disease (PD). That makes it the second most common, age related, neurodegenerative disease behind Alzheimer’s disease. The disease affects structures deep within the brain and changes its ability to produce and use dopamine, a neurotransmitter with many functions, including the ability to control certain aspects of movement. PD most commonly affects males and those above the age of 60, and to date there is no cure. The hallmark signs include a resting tremor, slowness of movement, rigidity or unyielding muscle tightness, and problems with balance and walking. Research suggests there may be some genetic and environmental causes for Parkinson’s but for the majority of cases, the cause is impossible to determine. While that may sound bleak, the good news is that the ongoing research for living with and treating Parkinson’s has shown encouraging results.
Parkinson’s disease has seen a surge research thanks to major foundations and prominent spokespeople like Michael J. Fox and Muhammed Ali. This recent research has provided an incredible wealth of knowledge. There are a wide variety of primary treatment options available that vary on an individual basis. These include medications, surgical interventions, and physical and/or occupational therapy. These options do work at easing symptoms, but the medications and surgical interventions can have negative side effects and therapy sessions can become expensive over the course of the disease. Luckily, research has found something to help those with Parkinson’s disease become more efficient at using their decreasing levels of dopamine, EXERCISE.
Research has proved that exercise can alleviate many of the symptoms that people with Parkinson’s live with including all of the hallmark signs, anxiety, depression, sleeplessness, and therefore improves quality of life. This research has led to the formation of many exercise groups that lead people with Parkinson’s through workouts using boxing, dancing, cycling or circuit training. These programs have made a huge impact for those who participate as they provide a social and supportive environment to do exercises people may not have ever thought they would do.
These treatments help, however they can’t be used at all times. They address many symptoms, but walking remains a problem for many people with Parkinson’s, especially in crowded or unfamiliar environments. People with Parkinson’s will typically walk with slow, uneven, shuffling steps and is often associated with a “freezing” of gait. Freezing gait occurs when walking is suddenly interrupted and the body is unable to progress with the movement. These abnormal characteristics of gait increase the risk of fall and therefore many people with Parkinson’s become more sedentary due to feeling unsafe while walking in the community. Recent technological advances may have given medical professionals a new, safe way to both train and assist people with Parkinson’s disease for community ambulation. This technology is called augmented reality. As more research about Parkinson’s disease emerges it has become evident that an active lifestyle can increase quality of life for people living with the disease. Using technology to make this lifestyle more safe and realistic may turn out to be the key to moving forward with Parkinson’s.
A group of my fellow classmates from the University of Scranton and I, conducted a systematic review of literature to find out how people with Parkinson’s could walk more safely in their environment by using augmented reality visual cues. Past research has suggested the use of audio or visual cues for training gait in therapy sessions, but until recently, these methods were difficult to translate safely to community ambulation. It is now theorized that, by using a visual cue, the person is able to use a different part of their brain to control walking, one that bypasses the basal ganglia, or the part of the brain most affected by Parkinson’s. Using this new technology could change the way people with Parkinson’s move.
Next week in this column, we’ll discuss augmented reality technology and how it works.
To find more information about Parkinson’s Disease visit: https://www.michaeljfox.org/ or http://www.parkinson.org/.
To see more of this research project, and others like it from the University of Scranton Physical Therapy Department, visit: http://www.scranton.edu/academics/pcps/physicaltherapy/pt-research.shtml.
Visit your doctor regularly and listen to your body.
NEXT MONDAY – Read Dr. Paul J. Mackarey “Health & Exercise Forum!” PD – NEW TREATMENT Part 2
This article is not intended as a substitute for medical treatment. If you have questions related to your medical condition, please contact your family physician. For further inquires related to this topic email: drpmackarey@msn.com
Paul J. Mackarey PT, DHSc, OCS is a Doctor in Health Sciences specializing in orthopaedic and sports physical therapy. Dr. Mackarey is in private practice and is an associate professor of clinical medicine at Geisinger Commonwealth School of Medicine.
Guest Columnist: Paul Mackarey, Jr. DPT
According to the Centers for Disease Control and Prevention (CDC), the 2017/18 flu season has been exceptional. Normally, elderly adults have the largest number of flu related hospitalizations while young children are second. This year, however, baby boomers between 50 and 64 years of age are the second most vulnerable. And, as of January 27, 37 pediatric flu related deaths have been reported. At the risk of creating an overreaction and promoting “germaphobic” behavior, if there is one time of year that diligent hygiene has merit, it is now…during flu season.
Contracting the cold or flu can make you feel run-down and under the weather for weeks. Unfortunately, your daily activities and responsibilities cannot take a sick day. The common cold and flu is most prevalent during late fall, winter and early spring. According to flufacts.com, “The influenza virus, more commonly known as the flu, is defined as a contagious respiratory infection that infects the nose, throat, and lungs. Each year approximately five to 20 percent of the population in America contracts the flu and related deaths caused by the flu virus average at 23,600.” Thankfully, there are several easy and effective preventive measures that can reduce the probability of contracting the cold and flu. These preventive measures are designed to help keep your immune system strong and healthy. A healthy immune system fights against pathogens, such as the cold and flu virus. This article will focus on the ten best ways to prevent the flu and cold this season.
The vaccine produces antibodies that protect against the cold and flu virus within two weeks after vaccination. There are currently two different types of vaccines; an “intramuscular shot,” meaning it is injected into the muscle and a nasal-spray vaccination is available for people two to 29 years of age. The traditional intramuscular vaccine has been used for decades and has been approved for use in people six months of age and older. Recently, two new intramuscular vaccines are available. A hi-dose vaccine was designed for people 65 years and older and a vaccine designed for people 18 to 64 years of age is also available. NOTE: FOR THE 2017/18 FLU SEASON: The CDC does NOT recommend the nasal spray flu vaccine. Flu vaccines have been updated to better match current viruses.
The most common way to spread the cold and flu virus is by direct contact. The virus can live on surfaces for hours and even days eagerly waiting to get picked up by the next individual.
Germs attach onto your hands and can be passed onto other public surfaces. The most effective ways to cover a sneeze are to use a tissue or your sleeve.
Exercising regularly causes an increase in your heart rate. Therefore, the heart can pump more oxygen rich blood throughout the body. Increased blood flow to the body has been proven to increase the body’s immune system and help to prevent illness.
Eating nutrient rich foods is the best way to keep your immune system strong. Phytochemicals are natural immune boosting chemicals found in plants, fruits and vegetables, specifically, dark green, red, and yellow vegetables and fruits. Yogurt is also an effective way to prevent illness. Studies have shown that eating low fat yogurt regularly can reduce susceptibility to colds by 25 percent. Research also suggests that the natural bacteria found in yogurt stimulates and strengthens the immune system.
Staying hydrated is important. Water flushes your system by filtering out poisons as it replenishes your body. Dehydrated individuals feel tired and unfocused. A healthy adult requires eight 8-ounce glasses of fluid a day. The easiest way to determine if you are dehydrated is by the color of your urine. If it is dark yellow your body may require fluids.
Doctors recommend a full eight hours of sleep a night. The demands of your busy life sometimes make that difficult. However, during the cold and flu season, it is particularly important. If you are not well rested, your body becomes tired and “run-down,” leading to a weakened immune system and leaves you more susceptible to illness.
Statistics show that smokers are at a higher risk of contracting more frequent and severe cold and flu symptoms. This is because the toxic chemicals in smoke are seen as pathogens or foreign contaminants in the body. As a result, your immune system is working overtime. Also, smoking is proven to paralyze cilia that line your nose and lungs. The cilia, or delicate hairs, are designed to remove cold and flu viruses out of your nasal passageway before they can infect the body. Smoking a single cigarette can paralyze the cilia for up to 40 minutes.
Heavy alcohol consumption negatively affects the body and its immune system in several ways. Heavy drinkers are more prone to cold and flu illnesses because alcohol suppresses the immune system and significantly dehydrates the body.
It is important to relax and “unwind” at the end of a busy day. Relaxing lowers cortizol levels in the blood. Cortizol is a hormone released into the body’s blood stream when a person is feeling stressed or pressured. Over time, this hormone weakens the immune system. Relaxing causes interleukins, the main components of your immune system that fights against the cold and flu virus, to increase in your bloodstream. It is recommended that one makes time for at least 30 minutes of relaxation each day.
(webMD)
…make a special effort to clean these areas frequently
1. CELLPHONE – it is with us at ALL times; kitchen, bedroom, bathroom, office car. Bacteria loves its warm dirty surface and has been found to be 10 times dirtier than a toilet seat as E.coli, a harmful and potentially deadly bacterium has been found on it. Wash your hands often and swipe the surface with antibacterial swipes frequently.
2. TV REMOTE CONTROL – stuck between the dark and warm pillows and sofa cushions, bacteria flourish on the surface of this device which has been touched by every family member and their runny-nosed friends.
3. COMPUTER KEYBOARD – like the phone and remote, it is the most touched and dirty places in your daily routine. Wash hands and swipe surface.
4. DISH SPONGE – considered the dirtiest item in your home or office. Ring it out after each use, soak in bleach, clean in dishwasher and replace often.
5. TOOTH BRUSH HOLDER – the germs from your mouth drip from the brush onto the holder two or three times a day. Overtime, a buildup of germs becomes overwhelming and dangerous as those with illnesses share the holder with others. Dry the brush after each use and clean the holder often. During an illness, do not share the holder and start a new toothbrush after an illness.
6. MONEY - as much as we love the feel of money in our hands, studies show that the average dollar bill has 3,000 bacteria. Wash your hands after handling money.
7. OFFICE KITCHEN – not everyone in your office practices good hygiene. The sink, sponge, towels, cups, silverware, and dishes in your office area potential Petri dishes. While it is good to use reusable products, take care to clean them carefully and use wash, dry, bleach, and replace.
8. LAUNDRY – some studies show that dangerous viruses found in undergarments are able to survive the spin cycle and dryer. For those items, hot water, bleach, and long hot drying cycles are recommended.
9. PURSES/BRIEFCASES – money, food, tissues, and hundreds of hands. It goes wherever you go…bathroom, countertop, bank, and office. Clean and empty regularly.
10. ATM – countless strangers touch the ATM keypad in a public area where dirty money is handled regularly. Use antibacterial swipes and wash hands.
Sources: www.flufacts.com; www.webmd.com; www.lifescript.com; www.cdc.gov
Guest Contributor: Paul Mackarey, Jr. DPT, is a Doctor of Physical Therapy.
Read Dr. Paul J. Mackarey “Health & Exercise Forum!” Every Monday in The Scranton Times-Tribune.
This article is not intended as a substitute for medical treatment. If you have questions related to your medical condition, please contact your family physician. For further inquires related to this topic email: drpmackarey@msn.com
Paul J. Mackarey PT, DHSc, OCS is a Doctor in Health Sciences specializing in orthopaedic and sports physical therapy. Dr. Mackarey is in private practice in downtown Scranton, PA and is an associate clinical professor of clinical medicine at GCSOM.
TRY A NEW APPROACH TO WEIGHT LOSS IN 2018…MINDFUL EATING! Part 2 of 2
Mindful eating, also referred to as intuitive eating, is based on Buddhist teachings which focus on the experience of eating, AND ENJOYING, our food. The concept was presented in a feature column in The New York Times written by Jeff Gordinier, based on his time spent in a Buddhist monastery. He discovered that mindful eating practitioners eat in silence and chewed small pieces of food very slowly and deliberately to experience its taste, texture and smell.
One study of 1,400 mindful eaters found that they enjoyed lower body weights, greater sense of well-being and suffered from fewer eating disorders. However, many feel the concept, while valuable, is very difficult to put in practice in the busy American family. Fortunately, research shows that the simple act of the family meal can have a powerful impact on mindfulness, health and wellness, even if it isn’t a picture-perfect meal.
In a country that thrives on a fast pace with over-booked schedules, families struggle to balance work and school and after school sports and activities. Consequently, fast food, eat-and-go habits have become the norm. According to some studies, most find it difficult to sit and relax for a family meal even once a week. And often, when families do pull off a family meal, it is often overwrought with school drama, sibling rivalry, and parental discipline about school, homework or social activities, making the situation stressful. Even so, despite the family conflict, studies strongly support the health values of the family meal.
A recent study from Columbia University that received national attention found that children who participated in a family meal regularly were less likely to have problems with drugs or alcohol and more likely to excel in school. Moreover, those children eating with their families at least 5 times per week benefited most. Other studies have found that there is a significantly lower incidence of teens who smoke, use alcohol, have sex at a young age, fight, get suspended from school or commit suicide among those who have meals with their family on a regular basis
EVERY MONDAY – Read Dr. Paul J. Mackarey “Health & Exercise Forum!”
This article is not intended as a substitute for medical treatment. If you have questions related to your medical condition, please contact your family physician. For further inquires related to this topic email: drpmackarey@msn.com
Paul J. Mackarey PT, DHSc, OCS is a Doctor in Health Sciences specializing in orthopaedic and sports physical therapy. Dr. Mackarey is in private practice and is an associate professor of clinical medicine at Geisinger Commonwealth School of Medicine.
TRY A NEW APPROACH TO WEIGHT LOSS IN 2018…MINDFUL EATING! (Part 1 of 2)
There are many reasons why losing weight, the number one resolution for the New Year, is the most elusive goal of all. Not the least of these is the psychology of eating . In the land of plenty, we eat mindlessly! Consider the facts. First, we blamed the food, thinking it was bad. But, when we chemically modify the food to remove or alter the fat or sugar and remove the calories, it fails to reduce our weight. In fact, it has been discovered that “fake sugar,” even though it does not have calories, can still increase blood glucose levels. Next, we decided that fat cells were the enemy, but when we removed fat cells from our body through liposuction, we failed to control weight gain. Then, we decided the problem was our digestive systems, so we placed bands or staples in the stomach or by-passed the small intestine. While these efforts helped many in the short run, long term, it failed as a long-term solution without a change in behavior. Many medical professionals have concluded that the problems people have with weight are not exclusively due to the food, fat cells, stomach or intestines, but rather, THE MIND!
Mindful eating, also referred to as intuitive eating, is based on Buddhist teachings which focus on the experience of eating, AND ENJOYING, our food. The concept was presented in a feature column in The New York Times written by Jeff Gordinier, based on his time spent in a Buddhist monastery. He learned that mindful eating practitioners eat in silence and chewed small pieces of food very slowly and deliberately to experience its taste, texture and smell. He discovered that it requires full attention to the experience of eating and drinking on the body and mind. It is often referred to as “the opposite of diets” because with mindful eating there is no right or wrong way to eat, but rather varying degrees of awareness about WHAT WE EAT AND WHY. The goal of this exercise is to teach our mind and body to connect and communicate while eating so one can learn important cues such as: what are my hunger signals? What does my stomach feel like when it is half, three-fourths and completely full?
One study of 1,400 mindful eaters found that they enjoyed lower body weights, greater sense of well-being and suffered from fewer eating disorders. However, many feel the concept, while valuable, is very difficult to put in practice in the busy American family. Fortunately, research shows that the simple act of the family meal can have a powerful impact on mindfulness, health and wellness, even if it isn’t a picture-perfect meal.
In a country that thrives on a fast pace with over-booked schedules, families struggle to balance work and school and after school sports and activities. Consequently, fast food, eat-and-go habits have become the norm. According to some studies, most find it difficult to sit and relax for a family meal even once a week. And often, when families do pull off a family meal, it is often overwrought with school drama, sibling rivalry, and parental discipline about school, homework or social activities, making the situation stressful. Even so, despite the family conflict, studies strongly support the health values of the family meal.
A recent study from Columbia University that received national attention found that children who participated in a family meal regularly were less likely to have problems with drugs or alcohol and more likely to excel in school. Moreover, those children eating with their families at least 5 times per week benefited most. Other studies have found that there is a significantly lower incidence of teens who smoke, use alcohol, have sex at a young age, fight, get suspended from school or commit suicide among those who have meals with their family on a regular basis.
Mindless Eating Vs. Mindful Eating
EVERY MONDAY – Read Dr. Paul J. Mackarey “Health & Exercise Forum!”
This article is not intended as a substitute for medical treatment. If you have questions related to your medical condition, please contact your family physician. For further inquires related to this topic email: drpmackarey@msn.com
Paul J. Mackarey PT, DHSc, OCS is a Doctor in Health Sciences specializing in orthopaedic and sports physical therapy. Dr. Mackarey is in private practice and is an associate professor of clinical medicine at Geisinger Commonwealth School of Medicine.
Hypertension: Part 2According to the Centers of Disease Control (CDC), Hypertension (HTN), also known as high blood pressure (HBP), affects one in three adults (67 million people) in the USA. Unfortunately, only one-half of those with high blood pressure control the problem and, as a result, are at great risk for heart disease and stroke.
Blood pressure numbers represent the force against the walls of your arteries. Normal blood pressure (BP) is defined as a systolic pressure (the top number) of 120 mm Hg and a diastolic pressure (the bottom number) of 80 mm Hg (120/80). The Joint National Committee on Prevention, Detection, Evaluation, and Treatment of High Blood Pressure has classified blood pressure as follows:
*(National Institutes of Health, Medline Plus)
For most people with HBP, there are no obvious symptoms. HBP is usually detected at a health fair or a routine visit with a physician. However, over time, HBP can cause problems with the heart and kidneys. Sometimes, a more serious condition can develop from very high blood pressure called malignant hypertension. Symptoms include; severe headache, nausea and vomiting, confusion, vision changes and nosebleeds. Notify your physician immediately if you develop these symptoms.
Almost everyone has had their blood pressure checked with a standard or automatic blood pressure cuff. Sometimes, when a problem is detected, a home blood pressure unit is recommended to track BP throughout the day.
According to a recent long-term study, both men and women without a history of coronary artery disease or high blood pressure suffered from both diseases when they did not manage stress well. Those who allowed stress to upset them, (short fused and easily frustrated) had significant increases in cholesterol and blood pressure when compared with those who were more even-tempered and easygoing under stress.
Exercise combats HBP and maintains a healthy body weight. The key to success when it comes to improving your life with exercise is to develop a regular, consistent program. A good program must include aerobic exercise (walking, jogging, biking) for 30 minutes (or 15 minutes twice a day) 4-5 days per week and mild/moderated weight training 2- 3 times per week.
In conclusion, while HBP is a potentially serious medical condition, for most it is a controllable and preventable problem. Lifestyle changes such as diet, exercise and stress reduction have been found to be most effective.
SOURCES: Centers For Disease Control (CDC); American Heart Association (AHA), University of Pittsburgh Medical Center (UPMC), National Institutes of Health (NIH), Medline Plus, Zee News
Visit your doctor regularly and listen to your body.
NEXT MONDAY – Read Dr. Paul J. Mackarey “Health & Exercise Forum!”
This article is not intended as a substitute for medical treatment. If you have questions related to your medical condition, please contact your family physician. For further inquires related to this topic email: drpmackarey@msn.com
Paul J. Mackarey PT, DHSc, OCS is a Doctor in Health Sciences specializing in orthopaedic and sports physical therapy. Dr. Mackarey is in private practice and is an associate professor of clinical medicine at Geisinger Commonwealth School of Medicine.
This column is a monthly feature of “Health & Exercise Forum” in association with the students and faculty of Geisinger Commonwealth School of Medicine (formerly The Commonwealth Medical College).
Guest Authors: Michael Ambrose and Christian Bohan
3rd Year Medical Students at Geisinger Commonwealth School of Medicine (GCSOM) collaborated on this column.
Michael Ambrose, MD3, is from Coopersburg PA and attended college at the University of Scranton and is now a 3rd year medical student at GCSOM. His future interests include Emergency Medicine and cardiology.
Christian Bohan, MD3, grew up in Danville, PA prior to pursuing a degree in Neuroscience at the University of Pittsburgh. He is currently interested in neurosurgery and continues to enjoy learning about the different fields of medicine. In his free time, Christian can be found pursuing his interests of travelling and photography.
75 million people in the United States have been diagnosed with hypertension and hypertensive related diseases are the leading cause of death. Hypertension, otherwise known as high blood pressure, is defined as a constant elevation of blood pressure as opposed to a quick response to a stressful situation. A “normal” reading is 120/80 but can also be higher or lower based on an individual person’s body. A systolic pressure (top number) over 140 and a diastolic pressure (bottom number) over 90 is considered stage 1 hypertension. Usually, blood pressures below 140s/90s do not need to be treated medically, if you are less than 60 years old.
The purpose of this article is to bring awareness to the severe consequences associated with hypertension and the importance of regular checkups, early diagnosis, and treatment.
Perhaps the most obvious organ affected by hypertension is the heart but how exactly is it affected? There are two main diseases associated with the heart: coronary artery disease and congestive heart failure. Coronary artery disease is the narrowing of the vessels that supply the heart itself with blood. This can be caused by hypertension through turbulent blood flow which causes cholesterol to stick to the surface of the blood vessels. If one of these cholesterol plaques ruptures, it can cause a blockage in one of the coronary arteries, which would cause a heart attack. This is different from congestive heart failure, which is essentially the inability of the heart to pump enough blood to meet the energetic demands of the body (the heart gets tired). With increased blood pressure, the heart has to work harder to pump the same amount of blood through the system. Eventually the heart won’t be able to keep up, which will result in symptoms of fatigue and shortness of breath which gets worse with slight exercise such as walking up stairs.
Although not as obvious as the heart, the brain is also an organ that is severely impacted by hypertension. Although more blood to the brain may sound like a good thing, there are severe consequences involving the vessels. A stroke is caused when a part of the brain does not receive enough blood flow for a period of time. This can be caused by a blockage in an artery which prevents blood from getting to the tissue or it can be caused by a bleeding vessel which reroutes the blood away from the tissue that needs it. The first consequence is called an ischemic stroke, which means that part of the brain loses blood flow due to a blood clot causing an obstruction in the artery. This is associated with hypertension because turbulent flow is associated with clot formation. The second consequence is called a hemorrhagic stroke which occurs when the smaller arteries rupture (from increased pressure) causing bleeding within the brain. In both cases the result is the same: blood doesn’t reach its target and brain cells die.
The kidneys are another organ that can be affected by high blood pressure. This may not be obvious until you understand that the function of the kidney is to filter all of the blood in the body. In order to filter the blood effectively, the kidneys have a lot of tiny blood vessels that can be damaged from too much pressure. Over time, when high blood pressure is not kept in check these arteries can narrow, weaken or harden. When this occurs, the kidneys lose their ability to filter blood, leaving toxic substances in the body. What makes this even worse is that the kidney is also responsible for regulating blood pressure which can potentially make the hypertension worse.
High blood pressure also has adverse effects on the eyes. The eyes have small blood vessels and for the reasons we mentioned earlier, these vessels can be damaged with high blood flow. When the eye does not receive enough blood flow, the cells die causing blindness.
While this seems intimidating, there are steps you can take to decrease your blood pressure and lower your chances of developing these diseases. Perhaps the most important is regular monitoring of your blood pressure. You can do this by having regular checkups with your doctor, getting it checked at local pharmacies and there are even devices available for use in your own home. If you notice that your pressure is high, be sure to let your doctor know so you can come up with a plan to lower it. First and possibly the most important step in lowering blood pressure is diet and exercise. A low salt and low fat diet can help lower and keep it down at a manageable level. Aerobic exercise for 30 mins a day for at least 4-5 days a week is recommended to keep your heart healthy which further helps with maintaining a good blood pressure. Other steps you can take include limiting use of tobacco products and alcohol. If these methods aren’t adequate to lower your blood pressure, talk to your doctor about including medication into your care plan.
In conclusion, hypertension has a lot of widespread consequences but with diligent care, it can be easily
Visit your doctor regularly and listen to your body.
NEXT MONDAY – Read Dr. Paul J. Mackarey “Health & Exercise Forum!” Part 2 “Hypertension”
This article is not intended as a substitute for medical treatment. If you have questions related to your medical condition, please contact your family physician. For further inquires related to this topic email: drpmackarey@msn.com
Paul J. Mackarey PT, DHSc, OCS is a Doctor in Health Sciences specializing in orthopaedic and sports physical therapy. Dr. Mackarey is in private practice and is an associate professor of clinical medicine at Geisinger Commonwealth School of Medicine (formerly The Commonwealth Medical College).
New Year’s Resolutions For 2018… Keep it Simple & Healthy!
New Year’s Resolutions are very predictable. While most are health oriented, I purport that to be truly healthy, one must have a healthy mind, body and spirit And, to have a healthy mind, body and spirit, one must be open-minded and balanced. Interestingly, the ten most popular resolutions listed below all have an impact on a healthy life.
Polls repeatedly show that one of the most consistent resolutions for the New Year is to make more time to spend with family and friends. Moreover, research shows that the comfort and camaraderie of these people whom we love is important to our health and well-being.
The benefits of regular exercise is no longer anecdotal, it is factual. Daily exercise, even in small doses, has been associated with more health benefits than anything else known to man. Studies clearly demonstrate that it reduces cholesterol and coronary artery disease and the risk of some cancers. Also, it increases longevity, helps achieve and maintain weight loss, enhances mood, lowers blood pressure, and even improves arthritis. In short, exercise keeps you healthy and makes you look and feel better. If done properly, there is no down side. So, make this year the year to do it!
Recent studies report that more than 66 percent of adult Americans are considered overweight or obese. As a result, weight loss is one of the most popular New Year's resolutions. However, adhering to a weight loss program is not easy. It requires many things, including, setting reasonable goals and staying focused. Often, professional help is required. While this may be one of the most difficult goals to attain, the ultimate reward and value is well worth the effort.
Second only to losing weight, this resolution, while extremely difficult, is another life-saving goal that must be attempted. Studies report that smokers try and fail four times on average before they are successful. SO, KEEP TRYING! Get help. Talk to your physician about using over-the-counter or prescription nicotine replacement therapy and proven quit-smoking aids. Consider smoking cessation classes, support groups and hotlines in addition to the meds. This is one goal that is worth the effort.
Due in great part to our hectic and stressful work and family demands, the United States is home to millions of people requiring the use of mood elevators and antidepressants. As a result, it is important to learn what really makes you happy in order to FIND YOUR SMILE. It requires the balance of a healthy mind, body and spirit. It might be a walk in the snow, taking dance classes or a trip to the spa. One hint, it is often something simple and inexpensive. Try spending more time with people who make you smile!
While many people use the New Year as an incentive to finally stop drinking, most are unable to adhere to such a rigid goal. Studies show that moderate drinking can offer many health benefits such as lowering cholesterol and coronary artery disease. However, “moderate” is defined as one or two 8 ounce drinks per day and red wine is preferred. However, many heavy drinkers would do well to taper off to a moderate level. For those with a problem and have decided that you want to stop drinking, there is a world of help and support available such as Alcoholics Anonymous. There are also a number of treatment-based programs, as well as support groups for families of alcoholics.
This is one tip that few consider being health related. However, serious stress from financial problems affects millions of Americans every day. This cumulative stress can be very harmful to your health and can be lessened by initiating a plan. Get professional help and learn how to downsize and reevaluate your real needs. Less toys with less stress can lead to a longer life!
There may be no one thing more important to gaining a new perspective on life that to have learned something new. It could be as drastic as returning to school to prepare for a career change or as simple as learning to play bridge. Have you vowed to make this year the year to learn something new? Take a course at local college or read a new book. Visit the Everhart Museum, one of the many libraries in the Lackawanna County Library System, The Scranton Cultural Center and other places of learning and culture. It will enrich your life and make you a more interesting person. Most local colleges and universities offer distance and adult education programs.
Service to others is service to you! There may not be anything more gratifying than providing a service to others in need. Volunteerism makes you a better and healthier person. It fits into any schedule. Donate clothes, time or resources. Locally, we have many charitable causes in need of help: Be a “friend of the poor,” or serve lunch at St. Frances Soup Kitchen.
The goal of organization, like the goal of financial order, has similar health implications because it eliminates tremendous stress. There are many books and websites that offer suggestions on how to organize just about anything in your life. For this reason, I love my iPhone – there’s an App for that!
SOURCE: A. Powell, About.com Guide
NEXT MONDAY – Read Dr. Paul J. Mackarey “Health & Exercise Forum!” This article is not intended as a substitute for medical treatment. If you have questions related to your medical condition, please contact your family physician. For further inquires related to this topic email: drpmackarey@msn.com Paul J. Mackarey PT, DHSc, OCS is a Doctor in Health Sciences specializing in orthopaedic and sports physical therapy. Dr. Mackarey is in private practice and is an associate professor of clinical medicine at GCSOM.
