mackarey_admin, Author at Mackarey & Mackarey PT

Osteoarthritis, the most common type of arthritis, is often considered to be a normal part of aging. Usually by the age of forty our joints, especially those which are weight bearing (lower spine, hips, knees, ankles, feet) begin to show signs of wear and tear. The cartilage begins to thin, joint surfaces are not as smooth, and fluid which lubricates the joint becomes diluted, dehydrated and less protective. Consequently, these aging joints become stiff, sore, weak, and sometimes swollen. Most people with osteoarthritis report additional pain and stiffness in the winter and early spring due to cold, damp weather and NEPA has plenty of it! The cold, for example, restricts the flow of blood to the joints, leading to more pain and stiffness. While moving to a warmer and less humid climate is one solution, it is not practical for most. But all is not lost because there are other alternatives to protect and keep your joints healthier this winter and early spring.

1.Parafin Bath and Hot Packs:

A paraffin bath is one of the best methods to apply heat to your hands and feet to ease pain and stiffness associated with osteoarthritis. A special heating unit works like a crock pot to melt the wax to liquid form. The hands and/or feet are dipped into the wax several times to create a warm coating around the entire area. A 20 to 30 minute treatment while watching TV or listening to good music will provide pain relief, improve mobility in the joints and bring life back to winter damaged skin. $39.99 to $159.99 (www.bedbathandbeyond.com).

Hot packs, electric and microwavable, offer heat to bring blood flow and lessen joint pain and stiffness. They are great for neck and lower back pain, depending on the shape of the pad. Consider rectangle for lower back and cylinder/round to wrap around neck and joints of arms and legs. SourceMed.com offers an electric pad which creates moist heat for $59.95 and a microwave “bed buddy” (herbal or nonherbal) can be found for $9.99 to $43.95 at TheWarmingStore.

2.Hand and Toe Warmers:

Hand and toe warmers are small packets placed in the gloves or boots of skiers, campers and hikers to keep the hands and feet warm. These throw away warmers can also be used by anyone with cold hands or feet whether you are shoveling snow, attending an outdoor event in the cold or sitting in a cold, drafty room watching TV. (Walmart, Dick’s, Gander Mountain, www.amazon.com)

3.Knee, Ankle, Wrist, Elbow, Wrist Sleeves:

Supportive sleeves for the joints can provide protection and warmth year round, but especially during the cold winter and early spring. Those made with neoprene material offer warmth and compression and can be valuable when participating in activities such as skiing, walking, running, basketball name a few. Additionally, it can be helpful for those having joint pain with daily activities such as grocery shopping or house work. These devices should not be used when sitting for prolonged periods of time or sleeping. There is no scientific evidence that supports the use of cooper or magnets weaved into the sleeves for additional pain relief. (available at most pharmacies and medical equipment stores)

4.Compression Shorts and Shirts:

Similar to neoprene sleeves, compression shorts, pants and shirts can be invaluable to those participating in outdoor activities in cold temps. UnderArmor, Reebok, Nike, and others make these products which can also be worn indoors for those working in cool, drafty environments.

5.Hot Tub:

It seems obvious how and why hot water and massaging water jets can soothe the sore joints and muscles. To ensure additional pain and stress relief, add a candle, soft music and a cocktail!

6.Low Impact Exercise for Legs:

If you suffer from osteoarthritis to the joints of your lower body, you would be well-advised to limit impact activities such as running and basketball. Instead, walk, swim, use the elliptical and bike to protect your joints.

7.Low Impact Exercise for Arms:

As above, if you have arthritis in the joints of the upper body, use low weights, avoid push-ups and dips, which transfer your body weight through the arms.

8.Nonsteroidal Anti-Inflammatory Drugs (NSAIDs):

These over-the-counter, non prescription drugs include aspirin and ibuprofen (Advil, Motrin) which are very effective in the treatment of the pain and inflammation associated with arthritis. However, like all drugs, they are not without their risks so one must consult with their primary care physician and pharmacist before using them. For example, NSAIDs can thin the blood, irritate the stomach and may interact with other medications.

9.Topical Creams: Lidocane, Capsacian

Topical analgesics or pain relievers can be rubbed into or sprayed on the skin over the affected area. Some products are counterirritants using menthol, methylsalicylate and camphor which provide a sensation on the skin other than pain. Salicylate based products can work like aspirin to provide relieve from mild pain and inflammation. Capsaicin based products can also provide temporary relief due to the counter stimulation of warmth and tingling. A few things to keep in mind when using these products: one, discuss it with your physician or pharmacist. Two, topical agents are more effective in superficial joints such as the fingers, toes, wrist, elbow, knee and shoulder than in the deep tissues of the hip, buttocks, or lower back. Three, wash your skin thoroughly ater using these products and before using heat, cold or electric stimulation.

10.Massage:

The therapeutic benefits of massage are well documented. However, like most treatments, it is important to find a qualified professional that meets your needs. Licensed physical therapists, physical therapist assistants and massage therapists are the best choice. Benefits include; relief from pain, headaches, muscle spasm, and stress, improved relaxation, posture, and breathing.

SOURCES: www.apta.org; www.webmd.com

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 The Commonwealth Medical College.

In Northeastern Pennsylvania, winter is a fun-filled time for outdoor activities. Many people will be enjoying the outdoors hiking, snow shoe hiking, sledding, down-hill and cross-country skiing, snow-boarding, ice-skating and ice fishing. However, frigid, wind, snow, and sleet can play havoc on your skin. It is critical to be keenly aware of the time spent in the cold no matter what age and to recognize the importance of making skin protection part of your daily regimen throughout the entire year. Dry, red, flaking, itchy and scaly skin can make you crazy and uncomfortable. Furthermore, dry and cracked skin is an opportunity for a variety of bacterial, fungal and viral infections to enter your body.

10 Winter Skin Safety Tips For Outdoor Active Lifestyles

Limit Use of Soap: Excessive use of soap and water in the cold winter months can strip away the skin’s natural oils. Use cleansing creams, gentle skin cleansers or bath lotions with moisturizers instead of harsh soap. Following the use of a good skin product, your shin should feel soft and smooth, not tight or dry. Non detergent fragrance free neutral-pH products are helpful and kind to winter skin. Experiment with several mild soaps such as CetaphilR, AveenoR, NeutrogenaR, BasisR or DoveR until you find the right one for you. Dr. Ted Stampien, MD, a local dermatologist in Clarks Summit, recommends that shower gels should be avoided because they contain alcohol.
Soak Your Skin With Moisturizers: One proven method to prevent dry winter skin even when using regular soap is to moisturize your skin immediately after bathing to trap in water in the surface cells and then gently pat dry. For severe dryness, Dr. Stampien also recommends that you apply a second coating of moisturizing cream after you pad dry for further protection. He notes that creams are more moisturizing than lotions or gels. For extremely dry skin apply baby oil or almond or vitamin E oil to moist skin. Also, if your skin is so dry that it itches, apply 1% hydrocortisone to the area followed by a thick moisturizing cream. Try thicker creams such as Eucerin and Lubriderm and use cosmetics with moisturizers.
Protect Your Skin From the Sun: Many people forget to protect their skin from the sun in the winter. However, when the winter sun is reflected off the snow and ice it can be very strong on an unprotected face, especially the cheeks and lips. While SPF 15 is considered adequate protection, dermatologists recommend a minimum of SPF 30 for most people. Choose a sunscreen with ingredients that block both UVB and UVA rays. Apply lotion liberally to all exposed skin before you go outside. Remember to include the lips, ears, and around eyes. Sunscreens are available in lotion, gel, spray, cream and sticks. Some are made fragrance-free, hypoallergenic, or especially for sensitive skin or children. Dr. Stampien states that patients with sensitive skin or eczema typically tolerate sunscreens that contain zinc and titanium oxide such as Blue LizardR, SolbarR and NeutrogenaR and that these patients should avoid sprays and gels as these products usually contain alcohol which can sting upon application. UVUV-blocking ski goggles or sunglasses with wraparound or large frames protect your eyelids and the sensitive skin around your eyes, common sites for skin cancer and sun-induced aging. Goggles and sunglasses also help reduce the risk of cataracts later in life. However, the sun is a good source of Vitamin D. Recent studies show that people may be developing Vitamin D deficiency due to over protection from the sun. For those concerned about overprotection from both UVA and UVB rays and becoming Vitamin D deficient, Dr. Stampien, suggests using Vitamin D supplements of 600-1000 IU. He feels that this provides adequate levels of Vitamin D to maintain healthy bones and muscles and may lower the risk of certain cancers.
Do Not Soak in The Tub: The longer you soak in water, the more skin oils you lose. Therefore, in the winter it is wise to limit baths and showers to 5 minutes or less and use tepid water. Avoid very hot water. Also, only wash your face once or twice a day in the winter. Cool water wiping without soap is recommended if washing your face more than once per day.
Try to Avoid a Hot Dry House: Keep your house temperature at 68-70 degrees and use a portable humidifier with 40-50% humidity levels in rooms that you spend a lot of time in such as the kitchen, TV and bedroom.
Wear Skin-Friendly Fabrics: Natural fibers such as cotton and silk are skin-friendly. However, DryTech products like those made by Nike and UnderArmor wick sweat away and prevent chaffing when participating in outdoor activities.
Proper Diet Can Protect Your Skin: As with all matters of health and wellness, a diet rich in vegetables, fruits, grains, seeds, and nuts is essential. Additionally, certain foods such as avocados offer niacin, an inflammation-reducing agent which can improve complexion. Yellow and orange produce such as carrots, cantaloupes and apricots are also recommended. Keep in mind that alcohol and caffeine are diuretics that can cause the body and skin to lose fluid and nutrients. Stay hydrated.
Live Healthy: Smoking causes vasoconstriction of the blood vessels which limits blood flow of oxygen and nutrients to the skin and other tissues. Daily exercise to improve circulation and adequate sleep to replenish and recharge you body, contribute to health and wellness.
Avoid Dry Feet: Low humidity and cold temperatures can lead to skin breakdown and cause dry, scaly and uncomfortable feet. Coat your feet generously with lotion and sleep with cotton socks to maintain moisture. Remember, dry and cracked skin can allow bacterial, fungal and viral infections to enter the body.
See A Dermatologist: Skin conditions are often a symptom of a much more serious underlying medical problem. For example, problems with the thyroid, liver, or kidney or cancer can be associated with skin ailments. If problems persist, seek medical attention.

SOURCES: www.lifescript.com; Mayo Clinic; WebMD

CONTRIBUTING AUTHORS: Ted Stampien, MD, is a dermatologist in Clarks Summit, PA
EVERY MONDAY – Read Dr. Paul J. Mackarey “Health & Exercise Forum” in the Scranton Times-Tribune.

Dr. Meghan Haggerty

Guest Columnist: Meghan Haggerty, MD

Dr. Haggerty is a native of NEPA (Scott Township) and received her BS from The University of Scranton and her MD from Drexel University College of Medicine. She completed her residency in Radiation Oncology at Syracuse University New York (SUNY) Upstate. Currently, she practices at Northeast Radiation Oncology Center (NROC) and is a Clinical Assistant Professor of Medicine at TCMC. She resides in Scranton with her husband Daniel and sons, Daniel and James.

Although many causes of cancer are not modifiable, such as age or genetics, lifestyle factors have been linked to a variety of malignancies. It is estimated that about one half of all cancers can be prevented. Here are some suggestions to help decrease your chances of a cancer diagnosis.

Quit smoking - Tobacco use is the most preventable cause of cancer. It accounts for 30 percent of all cancer related deaths in the United States and adult smokers lose an average of 13 years of life due to this addiction. Smoking accounts for 90% of all lung cancers, and has also been implicated as a causative factor for cancers of the mouth, throat, esophagus, pancreas, liver, stomach, cervix, kidney, colon, and bladder. In addition, health complications from smoking frequently interfere with a patient’s ability to receive optimal medical treatment for their cancer. For example, surgery offers patients with very early stage lung cancer the best chance of cure, but may be too high risk for a patient with severely compromised lung function.
Maintain a healthy weight - Certain forms of cancer occur with increased frequency in obese men and women. Excess weight also increases the likelihood of dying from cancer. One well understood way in which obesity causes cancer is seen in the case of uterine cancer. Fat cells throughout the body produce estrogen. In obese women, excessive amounts of estrogen lead to overgrowth of the inner lining of the uterus and increase the chances of developing cancer there. In fact, obesity is thought to cause at least 50% of all uterine cancers. Physical activity contributes to healthy weight and also is associated with a decreased risk for many types of cancer. Healthy adults should engage in moderate to vigorous exercise 150 minutes per week. Adults with limited exercise capacity due to other health problems should stay as physically active as their condition allows. Even modest increases in exercise are associated with health benefits that reach far beyond cancer prevention.
Eat a well balanced diet – The link between certain types of food and cancer risk has been extensively studied but for the most part, remains largely unconfirmed. Some of the most consistent findings in published literature include the following:
1. Processed and red meats slightly increase the risk of colorectal cancer. -A high intake of tomatoes decreases your prostate cancer risk.
2. Calcium and vitamin D reduce the risk of colorectal cancer, but excessive amounts of calcium may increase your risk of prostate cancer. (Calcium recommendation to confer colorectal cancer protection without significantly increasing prostate cancer risk – 700mg/day)
3. Folate decreases your risk of colon and breast cancer, especially in women who drink alcohol.
4. The amount that each of the above listed items is thought to contribute to the development or prevention of cancer is, if anything, small. Therefore, it is unnecessary that you avoid/overindulge in any one specific type of food. Try to eat a well balanced diet and always keep in mind that excess calories from any source leads to weight gain, which as stated above, increases the risk of multiple cancers.
Limit sun exposure and avoid tanning beds - Skin cancer is the most commonly diagnosed cancer, with over one million cases reported annually. Melanoma accounts for about 5% of all skin cancer diagnoses but accounts for 75% of all skin cancer related deaths. The primary cause of skin cancer is exposure from the sun. The risk of cancer increases with cumulative sun exposure but what is most dangerous is intense exposures that result in blistering burns, especially in childhood. Tanning beds should be completely avoided, as exposure yields a large increase in your risk of melanoma. So limit the time you spend in the sun, especially between the hours of 10 AM and 3 PM. Use sun screen and wear protective clothing.
Avoid cancer causing viruses – It is well established that certain viruses have the potential to cause cancer. Examples include human papillomavirus (HPV), hepatitis B virus(HBV), hepatitis C virus(HCV), and human immunodeficiency virus (HIV). Vaccines are now available to prevent HPV and HBV infections. Transmission of other cancer causing viruses such as Hepatitis C and HIV is primarily thorough infected blood and body fluids. Prevention can be accomplished with the practice of safe sex, avoidance of needle sharing, and continued screening of blood and organ donors.
Prevention strategies, such as those listed above, focus on modifying environmental and lifestyle risk factors that promote cancer. Implementation of these modifications will result in a decreased number of cancer diagnoses and deaths. Another way to decrease cancer incidence and mortality is through screening programs. Screening detects abnormalities before they are clinically apparent, allowing for intervention either before cancer develops or at an early stage, when treatment is most effective. In an upcoming column, we will review screening recommendations for common types of cancer.

Visit your physician regularly and listen to your body.

EVERY MONDAY – Read Dr. Paul J. Mackarey “Health & Exercise Forum” in the Scranton Times-Tribune.

Part 2 of 2

Last week this column discussed “The Top Ten Tips for Better Sleep.” One tip, relaxation, visualization and breathing techniques has great value as a natural sleep aid and warrants further discussion. Dozens of scientific studies have proven that relaxation is an effective treatment for insomnia. Relaxation techniques practiced during the day can counter daily stress responses and reduce the likelihood that stress hormones will be elevated at night. Since relaxation techniques elicit a brain-wave pattern similar to Stage I sleep, the transition state between waking and sleeping, they make it easier to eventually move into deeper sleep stages. When practiced at bedtime or after a nighttime awakening, relaxation techniques help turn off negative sleep thoughts, quiet the mind, and relax the body.

Relaxation Techniques

The key to relaxation is becoming aware of tension and its corresponding state, relaxation, in each of the body’s muscles. Once aware of the difference, you can learn to relax muscles one at a time until gradually your whole body is ready to drift into a restful sleep. Lying down or sitting comfortably, begin with the muscles in your feet. Contract the muscles with gentle force for three to five seconds and then relax. Don’t stop breathing while you tense the muscles. Repeat a few times and continue upwards to your calves, thighs, buttocks, and abdomen. Then, move onto your fingers, arms, neck, and face. Repeat this exercise two more times for a total of about forty-five minutes of relaxation time. Each time, you begin by tensing the muscles, holding the tension 5 – 10 seconds, and then relaxing.

Directing your attention from everyday problems by using a mental focusing device can help promote relaxation. You can choose a word or phrase that has special meaning to you, for example, sunset and repeat it, silently or out loud, until you feel relaxed. You can also choose a visual image of an enjoyable, relaxing place for example, walking on the beach. While you are in your favorite, peaceful place, imagine what you may be seeing, hearing, feeling, and smelling. When using your mental focusing device, let relaxation happen at its own pace. If distracting thoughts occur, disregard them and return your attention to your mental focusing device.

Deep Breathing

Diaphragmatic breathing can also promote relaxation using deep breathing techniques because it uses less effort and energy to breathe. When relaxed or sleeping, we breathe with the abdomen. When we feel stressed, our breathing pattern changes to short, shallow, irregular chest breaths, or we hold our breath. This type of breathing is not effective and further stresses the body. Since waste products were not removed during exhalation, they build up in the bloodstream and we feel more anxious. Practice the following steps to learn diaphragmatic breathing:

Lying on your back or sitting comfortably, place one hand on your upper chest and the other just below your rib cage.
Breathe in slowly through your nose so that your stomach moves out against your hand. The hand on your chest should remain as still as possible.
Tighten your stomach muscles, letting them fall inwards as you exhale through pursed lips.

Diaphragmatic Breathing Exercises

Breathing exercises that utilize diaphragmatic breathing can calm our bodies and promote sleep. The following are two examples of breathing exercises that are recommended to bring on drowsiness and reduce insomnia:

Lie on your back or side, eyes closed, and begin with a few very deep inhalations, filling your lungs as much as possible. Exhale fully, drawing your abdomen in to expel as much air as possible. Repeat this three times and at the end of the third exhalation hold your breath as long as you can. Repeat this procedure two or three times or until you feel drowsy.
Exhale completely through your mouth. Inhale through your nose to a count of four. Hold your breath for a count of seven. Exhale slowly through your mouth for a count of eight. Repeat this cycle three times.

People who practice relaxation techniques fall back to sleep faster, sleep longer, have a better quality of sleep, and are more rested in the morning. Gradually they develop a greater sense of control over their mind and sleep. Although relaxation by itself is not a cure for insomnia, it has a significant positive effect on sleep for most insomniacs, especially when used in combination with the other tips discussed in last week’s column, which outlined 10 tips for better sleep.

Contributor: Janet Caputo, PT, DPT, OCS, clinic director at Mackarey & Mackarey Physical Therapy Consultants, LLC. Scranton, PA

PART I OF II

It has been long known that sleep has a significant impact on health. In fact, sleep is third only to diet and exercise when it comes to health and wellness.

Recent studies funded by the National Institute of Health (NIH) have found important information on sleep that may lead to new approaches to improve how students learn and older people retain memories.

Researchers at the University of California, Berkeley, have discovered that getting a good sleep BEFORE you learn PREPARES the brain for initial formation of memories, while getting a good sleep AFTER you learn helps one SAVE and CEMENT the new information solidly into the architecture of the brain. Moreover, in this pre and post sleep model, one is less likely to forget new material. Furthermore, it was determined that if you haven’t slept well, your ability to learn new material may be compromised by up to 40% for young students and more so as we age.

Unfortunately, the research also shows that sleep patterns change as we age and so too does deep memory, which begins to decline as we leave our 30’s. Those over 60 have a 70% loss of deep sleep compared to young adults 18 to 25 and this has been found to correlate to memory loss, especially of new material.

It is recommended that people discuss their sleep problems with their family physician because many medical conditions such as sleep apnea, narcolepsy, restless leg syndrome and others may contribute to sleep disorders.

The “24/7” society offers 24 hour cable, internet, email, and work shifts. According to the National Sleep Foundation, 20% of all Americans report less than 6 hours of sleep per night. Sleep deprivation contributes to poor work performance, athletic performance, motor vehicle accidents, relationship problems, mood swings, anger and depression. It is also associated with increased risk of heart disease, diabetes and obesity. However, all is not lost. Current wisdom offers the following suggestions to improve your chances for a good night’s sleep.

Take Time To Chill Out: At the end of a busy day make sure you take time to chill out. Give your eyes and mind an opportunity to wind down and rest. No computer use for 1-2 hours before bedtime! You may think harmless surfing the net or checking your email won’t get you wound up. However, the computer light triggers a receptor in the brain that affects your body rhythms and your sleep-wake cycle.
Sleep in the Bedroom – No Work: Research shows that people with sleep disorders sleep better in a sleep test room than in their own bedrooms. Upon further review, most of these people have turned their bedrooms into everything other than a bedroom. The room often is a place for snacking, television, a computer, and home office. Sleep experts suggest limiting bedroom use for sex and sleep. Limit the distractions that stimulate the brain. Keep the room quiet, dark, cool and cozy. Also, consider keeping pets out of the bedroom if they distract you or if you have asthma or allergies.
Shut Out The Worries at Bedtime: Research suggests that 30% of Americans lose sleep over economic problems at least 3 nights a week and 12% every night. Try to distract your brain from your problems with music, a good book or audio book. Consider keeping a pen and pad on your bed stand to allow you to write important reminders that come to mind as your try to sleep.
Avoid Alcohol: While an alcoholic beverage may help you fall asleep, once you metabolize it and the sedative wears off in 3-4 hours, you may wake up more alert. Instead, try a cup of warm milk or decaffeinated chamomile tea. Warm liquid makes you drowsy by a sudden increase in core temperature which drops quickly to cool the body. A cool body sleeps better.
Keep The Bedroom Cool: A warm bedroom with too many blankets can make you restless. Research shows that higher core-body temps are associated with insomnia. Keep the room at 60-65 degrees to help the brain cool the body and shut it down.
Eat Dinner Earlier: Eating a late meal too close to bedtime makes the body work too hard digesting the food when it should be relaxing. Eat at least 2-3 hours before bed. At the same time, eat a light snack because hunger can also wake you up. Remember, cheese, turkey and other proteins have sleep inducing amino acids.
Limit Caffeine: While coffee and other caffeine drinks may give you a lift in the morning, drinking it later in the day can contribute to insomnia. Limit yourself to 2 cups of caffeinated drinks in the morning and avoid coffee, tea, and other soft drinks containing caffeine such as Red Bull, Jolt and Java after lunch.
Stick to Your Bedtime: Going to bed at different times every night is like traveling through different time zones… it upsets your biological clock. Try to create a consistent biorhythm and biological clock by setting a routine sleep and wake-up time.
Reset: If you can’t fall asleep after tossing and turning for 30-45 minutes, get out of bed and do something else. Read, listen to soft music, or meditate to reset your internal clock. Then, return to bed and try again. Also, turn your alarm clock around so you are not tempted to look at it every 10 minutes. Consider performing relaxation techniques that involve visualization and deep breathing techniques.
Exercise: A consistent daily exercise routine can help relieve stress, establish consistent biorhythms, relax muscles and promote sleep. 45-60 minutes of aerobic exercise by walking, biking, running, or swimming combined with a light-weight, high repetition weight training program can be very valuable. However, do not exercise too close to bedtime as it may over stimulate the brain and contribute to insomnia.

SOURCES: Stephanie Schorow, Lifescript; National Sleep Foundation; National Institute of Health

When computer technology was first applied to medicine, many were concerned that it would negatively impact the quality of patient-physician communication. While some may feel that technology has led to more distant interaction, others feel that it has contributed to more informed, involved and empowered patients.

In a recent report released by the Joint Commission, it was determined that poor patient-clinician communication is responsible for approximately 70 percent of serious adverse health outcomes in hospitals. It may be fair to assume that this problem also occurs in outpatient and in home health services. Therefore, any opportunity to improve patient-clinician communications, including mobile apps, must be considered. The most effective apps should allow patients to securely list medical history and medications, as well as, quickly search for and access physicians, hospitals, clinics, first aid, and other health information. Other important features allow patients to be empowered through safe self management with texting, voice mail, and video communications. For those with chronic illnesses, some patient engagement apps will allow for direct communication between patients, health care navigators and other members of the health care team. Many physician groups and hospitals offer mobile apps for patient – physician communications with privacy protections.

Some tools improve engagement between physician and patient while others focus on research, tracking and logging to improve health and wellness. The suggestions below are considered to be some of the best for patients according to leaders in technological applications in medicine:

My Medical App – is a comprehensive medical record-keeping which works as a digital file cabinet. It securely organizes and saves appointments, medical records, lab results, medications and other essential medical data.
iTriage – Health, Doctor, Symptoms, and Healthcare Search: allows patients access to an endless amount of health information right in their pockets. This app allows them to check their symptoms and easily locate a physician or hospital in the event of an emergency.
Diabetes App – Blood Sugar Control, Glucose Tracker, and Carb Counter: This app assists patients with diabetes who often struggle to monitor their condition at home. This app provides a food database for patients to track their consumption and allows physicians to monitor any fluctuations. A free app is available for trial.
iCookbook Diabetic – Recipes, nutritional information and health articles for people with diabetes: a great app, created by dietary professionals, to provide healthy alternatives for cooking healthy. It provides various tools for meal planning and grocery shopping for the diabetic.
Lose it - App for Weight-loss is an invaluable tool to promote weight control by helping to track meals, exercise, calories, and nutrition. It uses a built-in barcode scanner and menus from popular restaurants.
Blood Pressure Monitor – Family Lite: A useful app for patients on the go to monitor their blood pressure and weight. It also provides lifetime data visualization and statistics with displays for medication correlations.
HeartWise Blood Pressure Tracker – This app makes it easy to monitor blood pressure at home. This easy-to-use application is helpful for recording blood pressure, resting heart rate, and weight. It also allows patients to import their existing records.
Pocket First Aid & CPR – In addition to general first aid instructions, this app also shares the American Heart Association’s guidelines on CPR. It offers high-quality videos and illustrations to assist those in need.
Tummy Trends – Constipation and Irritable Bowel Tracker: This app allows patients to track their IBS symptoms, exercise habits, water and fiber intake and stress levels. Also, an interactive graph allows them to share the findings with their physician.
iCalcRisk– Cardiac Risk Tracker: Calculates cardiac risk to promote healthier choices. Physicians can use the visualizations to assess the patient’s ability to manage their cholesterol, blood pressure, and lowering their risk of heart attack.

SOURCES: HealthCareNews; ModernMedicine Network;

Dr. Jonathan Goldner

Research shows, those who prepare in advance for their physician visits, have more satisfaction than those who just show up for their appointment. Moreover, for patients seeing multiple physicians, such as specialists, communication can be poor and your participation in the process can be invaluable.

Make a Checklist:
1. Before your visit, write out a detailed checklist of health issues, concerns and questions. This is especially important if you are seeing more than one physician specialists since your last visit and have had a change in health or prescribed medication.
2. Example: when visiting your family physician for the first time in several months you notice that you have seen two specialists in between. First, you saw a cardiologist for high blood pressure and were put on a blood pressure medication and a blood thinner. Second, you went to an orthopedist for knee pain from osteoarthritis and were prescribed an anti-inflammatory drug for pain and inflammation. With proper preparation such as keeping a hand-written or electronic file medical log or journal, sharing this information with your family physician may be critical. The anti-inflammatory drug may not be safe when taken with the blood thinner and if communication between three physicians did not take place, it is important for you to assist in the process.
3. List any changes in your body (weight loss), medications (daily aspirin prescribed by cardiac specialist) or daily function (unable to walk 1 block without shortness of breath) since your last visit.
Medication List: Type of medication, date prescribed, who prescribed it, and dosage. Be sure to include over-the-counter drugs such as aspirin, multivitamins and herbals.
Symptom List: Make a list of symptoms that you want to tell your physician. For example, weight loss, weakness or loss of voice, or difficulty sleeping can be important changes to tell your physician.
Be Honest:
1. It is important that your physician has complete and accurate information. For example, if you are having anxiety and you are drinking alcohol regularly, it can have serious implications if an anti-anxiety medication is prescribed.
2. Don’t be embarrassed…chances are you are not the only one. For example, if you are using a drug prescribed by another physician for erectile dysfunction, it is important for you to share this with your family physician as it may impact the use of other treatments or drugs and may be related to new symptoms or problems you are experiencing.
Keep a Medical Journal: A medical journal can be kept in a written log or electronic file. It should be chronological and include dates of medical visits, including specialists, tests, medications, vaccinations, etc. After each visit with a medical professional, enter the information before your forget the details. Also, include health insurance and supplemental insurance information in the journal.
Bring a Family Member or Friend
1. A friend or family member can serve as your eyes and ears to remember to ask questions and follow orders that you might forget. They can take notes and organize papers and instructions.
2. If you do not speak English fluently, bring a family member, friend or interpreter to assist you. If you do not have an interpreter, you can usually prearrange for one in advance with your doctor’s office.
Bring Your Glasses and Hearing Aid: If you require glasses and a hearing aid, be sure to wear them for your visit. It will help insure better communication with your doctor.

Remember, your health is too important to rely on memory for accuracy…so be a proactive participant. With technology, it has never been easier to keep a medical journal to improve accuracy and communication. There are several “Apps” such as “mymedicalapp.com” that allow you to do this on your phone, tablet or lap-top computer and offer privacy code features.

SOURCES: www.webmd.com; National Institutes of Health – National Institute on Aging “A Guide for Older People - Talking With Your Doctor”

Today's article was written by Jonathan A. Goldner, DO, FCCP, FCCM. Dr. Goldner has been practicing medicine with Pocono Internal Medicine Specialists at Pocono Medical Center since he completed his residency in 1987. He was the Chief of Staff from 2007-2011 before he transitioned in to his current position of Chief Medical Executive for Medicine and Chronic Disease. Board certified in internal medicine, critical care medicine and geriatrics, he has been the hospital’s Director of Critical Care since 1991. Dr. Goldner is a clinical assistant professor of medicine at both The Commonwealth Medical College and Penn State College of Medicine. He was honored as Pocono Medical Center’s first Physician of the Year in 2006 and has been involved with helping to develop many of the hospital’s new programs over the past 27 years. As a humanitarian, Dr. Goldner just completed his ninth medical mission to Guatemala and volunteers as a medical officer with the federal New Jersey-1 Disaster Medical Assistance Team.

At the risk of sounding trite, I truly believe that each year, month, week, day, and minute is a gift, not to be taken for granted. And that is why we resolve at this time each year to make a concerted effort to improve ourselves; mentally, physically and spiritually, so that we may live a longer and healthier life, in order to spend more time with the friends and family we love.

Not surprisingly, getting physically fit and losing weight are the top resolutions to begin each New Year. According to the University of Pittsburgh Medical Center, 10 million Americans choose to join one of the 45,000 health clubs and hope to get fit and healthy for life. Unfortunately, if starting an exercise program is the hard part, than sticking to it is the hardest part.

Once the initial excitement and enthusiasm wears off, so too does the discipline and determination necessary to overcome the many distractions in our lives to make exercise a priority for life. Diane Klein, PhD polled long-term exercisers (those exercising at least 3 times per week for more than 13 years) what motivated them to “stick with the program.” The answers are in order of importance. Please note that “appearance” was NOT at the top of the list.

10 Motivators to Stick to an Exercise Program

Fitness
Feelings of well-being
Pep and energy
Enjoyment of the exercise
Making exercise a priority
Sleeping better
Feeling alert
Being relaxed
Weight management
Appearance

10 Tips to Stick to an Exercise Program

Add variety to your program – stick to your basic program to meet your goals but add variety to stick to your program. On off days walk in the woods, play tennis, ride a bike, and swim. One day do upper body and the next lower body.
Find an exercise buddy – no one wants to let their buddy down so the likelihood of compliance is much greater when you have someone depending on you. Make sure it is a good match…someone with positive energy!
Make exercise a priority – friends and family must understand that this is important to you. It is a non-negotiable part of your day, like taking a vitamin or brushing your teeth.
Exercise first thing in the morning – For many people it is best to exercise before all of the demands of the day come into play
Exercise on the way home from work – For others, it is best to exercise after they fulfill their other obligations but before they get home, eat and settle in. Some days it will vary.
Exercise even when you are tired – keep in mind that you will be energized after you exercise.
Keep a log of your exercise – writing down the dates, times, speed, distance, reps and sets can help you monitor your progress.
Look for signs of progress – the scale is only one sign of progress. Make note of how your clothes fit, how much energy you have, the pep in your step and the improvement in your exercise log.
Walk – incorporate walking into your daily routine. Walk to the store, walk the dog, walk when you play golf and take the stairs.
Reward yourself – this is an individual preference but try to avoid a food overdose. For example, buy a new dress when you lose 10 pounds, go away for the weekend for the next 10 pounds. Do whatever works for you.

Lastly, if nothing else motivates you to continue your exercise routine, remember that researchers have found that the benefits of regular physical activity are numerous:

Loss or Maintained Body Weight
Reduces LDL /Raises HDL Cholesterol
Improves Circulation and Blood Pressure
Reduces Risk of Heart Disease
Prevents Bone Loss
Reduces Stress/Muscle Tension
Lowers Risk of Depression
Improves Sleep Pattern
Improves Strength and Flexibility
Improves Balance/Reduces Risk of Falls
Improves Immune System
Improves Pain Threshold

Source: WebMD

Visit your doctor regularly and listen to your body. Keep moving, eat healthy foods, exercise regularly, and live long and well!

NEXT MONDAY – Read Dr. Paul J. Mackarey “Health & Exercise Forum” in the Scranton Times-Tribune.

HAPPY AND HEALTHY NEW YEAR 2017! NEW YEAR’S RESOLUTION: GET A “RUNNER’S HIGH” ON LIFE!

The number one New Year’s Resolution in the United States is to lose weight. A close second is to gain control over one’s life. One of the best ways to lose weight is thought diet and exercise. It can also be a very effective method to begin taking control of one’s life. This is especially true for those suffering from stress, anxiety and depression. This year make your New Year’s Resolution to “Get a Runner’s High on Life!”

Specifically, aerobic exercise (exercise that increases your heart rate for 30 minutes or more) such as walking, biking, running, swimming, hiking, elliptical & stepper machines to name a few, is the secret to “runner’s high.” This exercise euphoria is not limited to runners alone, but all who engage in aerobic exercise are more likely to experience high energy, positive attitude, and mental wellness – not to mention burn calories.

Physical activity, specifically aerobic exercise, while well known for its importance to one’s physical well being has also been scientifically proven valuable for preventing and easing stress, anxiety and depression. Studies have found improvement in mental health for groups that engaged in aerobic running, jogging or walking programs, 30-45 minutes 3-5 days per week for 10-12 weeks when compared to a control group and a group in counseling.

EXERCISE FOR PHYSICAL HEALTH

Loss or Maintained Body Weight
Reduces LDL /Raises HDL Cholesterol
Improves Circulation and Blood Pressure
Reduces Risk of Heart Disease
Prevents Bone Loss
Reduces Stress/Muscle Tension
Lowers Risk of Depression
Improves Sleep Pattern
Improves Strength and Flexibility
Improves Balance/Reduces Risk of Falls
Improves Immune System
Improves Pain Threshold

EXERCISE FOR MENTAL HEALTH

Helps a person gain control over their lives
Increases self-esteem
Diverts attention away from worry, concern or guilt
Improves mood – with visible signs of improvement in physique & body weight
Increases sense of pleasure and satisfaction
Anger management – release pent-up frustration, anger and hostility
Increase in brain serotonin (natural mood elevator chemical in brain)
Increase in beta-endorphins (natural mood, stress & pain control chemical in brain)
Improvement in natural sleep patterns

HOW TO BEGIN EXERCISE TO GET THE “RUNNER’S HIGH” ON LIFE

Consult your primary care physician. Be sure that your symptoms are not related to other health problems. Also, if you are using antidepressant or other medications discuss the impact it may have on your exercise program with your physician.
Recognize and fight stress, anxiety and depression symptoms that are contrary to or prohibit physical activity such as: fatigue, lack of energy, slow motor skills.
Work hard to recognize and overcome these symptoms to begin an exercise program. An aerobic exercise routine should eventually lessen these symptoms.
Be realistic. Expect that aerobic exercise will take time to have a noticeable benefit. Do not get overly ambitious and set yourself up for failure.
Begin with an aerobic exercise program that is practical and destined to succeed. For example: inactive and deconditioned people should begin walking 5 minutes per day, 3-5 days per week for 1 week. Then, add 3-5 minutes each week until you attain 30-45 minutes per walk 3-5 times per week. Younger and fitter people can begin to walk for 15 minutes and continue until they attain 45-60 minutes per walk, 3-5 times per week. Remember, what seems impossible today will be easier and routine in 3-4 weeks so JUST DO IT !
Find a pleasurable environment: a beautiful park (Nay Aug), a scenic lake (Lake Scranton), quiet countryside (rural farmlands of Dalton). Use a mall in inclement weather.
Find a friendly, uplifting group or individual to walk, talk and exercise with. This may be more appropriate for people feeling isolated or withdrawn. Others may enjoy the peace and quiet of exercising and meditating alone.
Be specific and compliant! Make a serious commitment. Keep a journal or exercise log. Mark a calendar. 30-45 minutes, 3-5 days per week – NO EXCUSES! Get and exercise buddy you can count on and help keep you compliant!
Make it fun! Mix it up. Walk 3 days, swim or bike 1-2 days, some days alone, some days with a buddy.
BE RELIGIOUS! Be religious about exercise BUT don’t get too compulsive!

Read Dr. Mackarey’s 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

According to American Association of Retired Persons (AARP), seniors are considered those 50 years old and older. I will never forget how humbled I felt when I received my application to join AARP two years ago. With this in mind, this year I offer healthy holiday resolution for seniors.

Overindulgence during the holidays causes many seniors make New Year's resolutions related to diet and exercise. But, this year, I propose that you incorporate healthy habits during the holiday season, and you may find that your resolutions are not as hard to keep.

Exercise every day. Every evening, get out of the house for a walk to view the Christmas lights. Dress for the weather, walk with a companion, and take along a flashlight to illuminate your path. Use caution to avoid falls on slippery sidewalks.
Combine shopping and walking. In inclement weather, combine holiday shopping with your exercise. Indoor malls are great places to walk. Inquire with the mall management about walking clubs. Plan to shop early or late to avoid crowds. If you are planning on shopping in a particular store, park at the opposite end of the mall -- even if time is short, you will still get some exercise.
Remember to take your medications. Routines are disrupted during the holidays and you may forget important medications. Make a special reminder to take your medications or order re-fills. If you are traveling, be sure to take enough medications with you in case of delays and have a copy of your prescriptions in case of loss. Be sure to bring a phone number for your doctor along with your health insurance cards, in case of emergency. Carry your medications in your carry-on luggage if you are flying.
Eat your vegetables and salad first. Beginning your meal with healthy vegetables and salads will fill you up and reduce the temptation to over-indulge on high-fat, high-calorie foods. Taste your holiday favorites in small amounts to satisfy your palate.
Be aware of drug interactions. According to Dr. Amy Anderson, internal medicine physician on the medical staff at Baylor University Medical Center," says holiday spices like cloves, thyme and sage can interfere by as much as 50 percent with the body's natural ability to utilize common drugs." Talk with your doctor or pharmacist about your medications and find out if there are any foods you should avoid while taking them.
Know your food ingredients. If you have food allergies, ask about ingredients before you indulge. Be especially careful of home-baked goods if you have an allergy to tree nuts or peanuts. Those ingredients can be deadly if you are affected by these types of allergies.
Practice allergy-free decorating. If you suffer from allergic rhinitis, holiday decorations stored in the attic and basement can build up a coating of dust and mold that can trigger allergies. Some people may also need to rethink Christmas tradition and substitute an artificial tree.
Get a flu shot. The holiday season includes plenty of kissing and hand shaking. Getting a yearly flu shot and frequent hand washing are your best defense for avoiding the flu. If you are sick with a cold or flu, limit contact with others until you are well so you don’t infect others.
Get a good night's sleep. Holiday preparations and helping Santa means less sleep. Do your best to get to sleep 6-7 hours every night and avoid heavy foods and alcoholic beverages before bedtime. If you need to recharge, take a nap during the day.

NEXT MONDAY – Read Dr. Paul J. Mackarey “Health & Exercise Forum” in the Scranton Times-Tribune.

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 assistant professor of clinical medicine at The Commonwealth Medical College.