Common Misconceptions About Caffeine
Caffeine is Not Addictive
Caffeine can be habit-forming but it is not addictive. The American Journal of Drug and Alcohol Abuse states that caffeine is considered to be a mild stimulant but does not have the qualities of addictive stimulants like cocaine and amphetamines. However, sudden abstinence from caffeine can produce mild withdrawal symptoms such as headache, restlessness and irritability. Therefore, it is recommended to slowly wean off caffeine over a week or two to lessen these symptoms.
The need to eliminate caffeine from your diet is not supported in the literature. In fact, studies show that moderate caffeine use can actually enhance your mood and improve focus and alertness. The American Dietetic Association suggests limiting caffeine intake to 200mg to 300mg (2- 3 cups of coffee) per day.
Caffeine Does Not Necessarily Cause Dehydration
While caffeine is a diuretic, its effects are very mild. However, like all diuretics, it will cause you to urinate more often and therefore, lose fluids. The more fluids you lose, the greater the chance for dehydration, especially if you are at risk due to health issues. Also, long distance runners and athletes performing in conditions of extreme heat must use caution. Minimal to moderate caffeine intake with generous use of water and sports drinks should suffice.
Caffeine Does Not Contribute to Heart Disease
A study conducted at the University of Madrid of more than 126,000 people found that women who drank 2-3 cups of caffeinated coffee per day had a 25% lower risk of heart disease. Also, a 33 year long study of more than 1,000 participants at Johns Hopkins University found that coffee had no significant effect on the risk of hypertension. Moderation seemed to be the key component in these studies. Interestingly, caffeinated colas did increase the risk of hypertension; however, it was believed to be due to the high amounts of sugars and other ingredients in the drink.
However, for many reasons, physicians tell their cardiac patients, especially those with high blood pressure or abnormal heart rhythms, to avoid caffeine. This matter should be discussed in more detail with your physician before using caffeine. Tea, especially black and green, contains a much smaller amount of caffeine than coffee, is often recommended for the health benefits of antioxidants.
Caffeine Does Not Cause Hyperactivity in Children
While studies show that moderate caffeine (40 – 200mg) in children does not make them hyperactive, others demonstrate that a 12 oz can of cola with only 35 mg of caffeine makes them bounce off the walls. It has been concluded that it is the sugar and other ingredients in the soda that makes them hyperactive. In fact, some studies show that small amounts of caffeine can work like Ritalin, and improves focus in children with attention disorders.
Caffeine Does Not Cause Bone Loss
Caffeine has been shown to increase calcium excretion when taken in large amounts. Unless a child drinks caffeinated coffee in place of milk, there is no scientific evidence that bone loss will occur. When caffeine is used in moderation, no evidence of bone loss exists.
Caffeine Does Not Cause Fibrocystic Breast Disease
There is no scientific evidence to support the claim that caffeine causes fibrocystic breast disease or breast cancer. Confusion may lie with the fact that caffeine is associated with increased breast pain during monthly hormonal changes. If so, women are well advised to reduce the intake of caffeine during this time.
Source: www.LifeScript.com
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 associate professor of clinical medicine at The Commonwealth Medical College.
Most of us are all too familiar with someone in our family or workplace that can be described as a hyperactive or high energy person. I am sure members of my family or coworkers in my office are thinking that this statement is a self-description. Consequently, based on doctor’s advice, it is best to limit me to one cup of coffee or pay the price when I become a hyperactive taskmaster. Now, after further research on this topic, I have concluded that it may be that I am just be hyperactive by nature, regardless of my caffeine intake. While many of you may find the following facts hard to believe, and the effects of caffeine may vary for each individual, the facts are still the facts.
Caffeine
Approximately 80% of the world's population consumes caffeine on a daily basis. While research is constantly being done on health benefits and side-effects of caffeine, great controversy and misconception persists. The purpose of this column will be to discuss the “current wisdom” and present the truth about caffeine.
Caffeine is completely absorbed within 30 to 45 minutes of ingestion and its effects linger for about three hours. Eventually it is excreted and there is no accumulation in the body. Caffeine has been shown to affect mood, stamina, the blood vessels in the brain, as well as stomach and intestinal activity. However, for most people, when used in moderation (200 to 300mg or 2-3 cups), caffeine use is perfectly safe and may offer some health benefits.
Sources of Caffeine
Caffeine is a natural substance found in certain leaves, seeds, and fruits of over 60 plants worldwide. In our culture, the most common sources in our diet are coffee, tea leaves, cocoa beans, cola, and energy drinks. Caffeine can also be produced synthetically and added to food, beverages, supplements, and medications. Consumption of 130 to 300 mg of caffeine per day is considered minimal to moderate. Amounts exceeding 500 mg are moderate to heavy and more than 1000 mg/day is excessive. The average daily caffeine consumption among Americans is about 280 mg/day and 20% to 30% consume more than 600 mg/day. Caffeine contents in some of the more popular forms are:
NEXT MONDAY – Read Dr. Paul J. Mackarey “Health & Exercise Forum” in the Scranton Times-Tribune: Common Misconceptions About Caffeine.
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.
What medical problem does a carpenter, typist, truck driver, jackhammer operator, violinist, pianist and court stenographer have in common? Carpal tunnel syndrome! Over the past 10-15 years, carpal tunnel syndrome has moved to the forefront in medicine and has become water cooler conversation. So what is carpal tunnel syndrome and how is it treated?
Carpal tunnel syndrome (CTS) is a nerve disorder caused by compression of the median nerve at the wrist. The median nerve is one of three main nerves that provide sensation to the hand. This nerve specifically supplies sensation to the thumb, index, middle, and half of the ring finger. In CTS, compression on the median nerve occurs as it travels through a narrow passage in the wrist called the carpal tunnel. The carpal tunnel is formed by eight bones in the wrist (the floor of the tunnel) and the transverse carpal ligament, a strong ligament traveling across the roof of the tunnel. Within the tunnel there are nine tendons, which are a bit smaller than a pencil. These tendons share this space with the median nerve. In the case where there is swelling on the structures in the carpal tunnel, a person can experience pins and needles, numbness, and aching in the hand.
Common causes of CTS include:
Risk factors for CTS include:
Some common symptoms include:
To be properly diagnosed, a physician will discuss your symptoms and medical history, and examine strength and sensation. A nerve conduction study, electromyography (EMG), and x-ray may be ordered to provide information regarding sensation in the median nerve distribution and confirm compression at the carpal tunnel.
Treatment focuses on the causes. Therefore treatment suggestions may include activity modification and postural changes during activities. Other suggestions may include frequent rest periods, elevation, and exercises or stretching. Wrist splints are effective in relieving compression at the carpal tunnel and are typically recommended for night wear. Appropriate fit of the splint is vital. Occupational therapists or certified hand therapists can check the fit of pre-fabricated splints or can fabricate a custom splint. The above mentioned treatments all focus on decreasing inflammation and compression on the median nerve.
Your physician may order pain relievers or anti-inflammatory medication. A cortisone injection into the carpal tunnel may also be recommended to assist with decreasing inflammation near the carpal tunnel.
A referral to an occupational therapist or certified hand therapist may be made. A therapist can provide information regarding the diagnosis, appropriate treatment, and symptom reduction. They can make recommendations to introduce into daily activities to allow appropriate positioning of the upper extremities. A therapist will also instruct individuals on helpful stretching exercises or fabricate a wrist splint. Other treatments include ultrasound, iontophoresis, and massage. The focus of therapy is to introduce changes and interventions that reduce inflammation at the carpal tunnel to assist with symptom relief.
Surgery, referred to as a carpal tunnel release, may be indicated if symptoms are significant and impair functional activity performance.
To reduce your chances of getting CTS:
Guest Contributor: Nancy N. Naughton, OT, MS, CHT is a certified hand therapist at Professional Orthopedics in Scranton, PA.
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
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.
NEPA has one of the highest cancer rates in the country, particularly thyroid cancer! The purpose of this column on thyroid cancer is to raise the level of awareness for early detection and successful treatment for this disease.
The thyroid gland is a butterfly shaped structure located in the front of your neck. It is responsible for secreting hormones that control the way your body uses energy to work at maximum function.
Thyroid cancer, while not common, has shown a dramatic increase in the United States with nearly 22, 500 cases diagnosed in 2011. According to Mark Frattalli, MD, one reason for the escalation in diagnosed cases of thyroid cancer is the advent of more accurate and sensitive diagnostic tests. However, environmental exposures are also believed to have a significant impact.
Women are three times more likely than men to get thyroid cancer. However, when a nodule is discovered in the thyroid of a male, it is more likely to be malignant (cancerous) than in females. More importantly, the good news is that only 10% of all thyroid nodules are malignant. The most common malignancies have an excellent prognosis, as less than 7% of all cases lead to death.
A diagnosis of a thyroid nodule usually begins by the discovery of a lump on the gland on physical exam by your physician. The second most common method of diagnosing a thyroid nodule occurs by chance when ultrasound is performed to another area of the head or neck. Diagnostic ultrasound is also used to confirm or locate the nodule and once diagnosed, treatment options are discussed. Based on the ultrasound test, your physician may recommend a needle biopsy to rule out a malignancy (cancer) and to determine the need for surgery. Surgical options involve the removal of half or all of the thyroid gland. Your surgeon may refer you to a radiation oncologist (radiologist with a specialty in cancer) to consider radioactive iodine (RAI). The RAI pill is ingested and, by taking up iodine, it will destroy remaining thyroid tissue in your body. Chemotherapy is sometimes recommended for the most aggressive tumor types.
Once treatment is concluded, close follow-up is required. Patients usually must take a thyroid hormone to replace the loss of thyroid function from the gland removal and to suppress the thyroid-stimulating hormone (TSH) which is secreted in the pituitary gland to reduce the risk of reoccurring cancer. Follow-up also includes blood level monitoring for TSH and thyroglobulin and a thyroid scan can be performed if necessary.
The surgical decision is complicated and requires a thorough discussion with your surgeon to determine the best choice for the individual patient. For those concerned about the cosmetics of a surgical scar in the front of the neck, surgeons utilize microinvasive methods with small incisions. While robotic thyroid surgery eliminates the neck incision because it goes through the armpit, extended surgical times and higher complication rates make it less attractive for most surgeons and patients.
In summary, thyroid cancer is not common and, like all cancers early detection is critical. Visit your physician regularly for physical exams. Moreover, the good news is that only 10% of all thyroid nodules are malignant and the most common malignancies have an excellent prognosis.
Medical Expert/Contributor: Mark Fratalli, MD – Head and Neck Surgeon at Delta Medix; Chairman of Head and Neck Surgery at Regional Hospital; Surgery Education Director at The Commonwealth Medical College – Scranton, PA.
Visit your doctor regularly and listen to your body. Keep moving, eat healthy foods, and exercise regularly
NEXT MONDAY – Read Dr. Paul J. Mackarey “Health & Exercise Forum” 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 and is an associate professor of clinical medicine at The Commonwealth Medical College.
A Question from a Reader: I am 56 years old and with each passing year I find myself identifying more closely with my senior patients in ways I never imagined. I notice an occasional stiff back and noisy knees in the morning, require frequent visits to the restroom on long trips (especially if I am drinking plenty of fluids to stay hydrated), and more recently a reasonable fear of shingles. I have seen a number of patients over the years with shingles outbreaks and some have been very painful and serious. Shingles is a painful rash caused by the chickenpox virus that remains dormant in your body years after having the pox. Often, when older or with an immune system in a weaken state, the virus resurfaces and causes the painful rash. But, sometimes it is more complicated and can cause a host of other problems such as hearing or visual impairment or inflammation of the nerves. In fact, one of my patients suffered from foot drop from a shingles outbreak affecting the nerve root in his lower back which weakened the muscles of the ankle. However, there is good news! You may have read advertisements in magazines or seen commercials on television regarding ZostavaxR, the vaccine for shingles manufactured by Merck & Co. I just got my prescription!
Shingles, also called Herpes Zoster, is a painful skin rash that often blisters. It is caused by the same virus that causes chickenpox, the Varicella Zoster virus. When a person has chickenpox, the virus remains in their body throughout life. As a result, years after the outbreak of the pox, shingles can occur, especially at times when the body is in a weakened state. While rare, this scenario can also occur for those having the chickenpox vaccine.
While shingles signs and symptoms vary, the hallmark sign is a painful rash, which is commonly found on one side of the face/head or shoulder/trunk and lasts between 2 and 4 weeks. In some cases, the pain can be fairly significant and often develops along with a tingling sensation 1 to 5 days before the rash. Other symptoms include, but are not limited to; headache, fever, chills and upset stomach. In very rare cases, a shingles infection can lead to more serious problems such as; infection of the brain (encephalitis), infection of the lung (pneumonia), hearing and visual impairment and death. In 20% of the cases, shingles can lead to a very painful inflammation of nerves called post-herpetic neuralgia that lasts long after the rash has cleared.
How common is Shingles?
More than one million people get shingles each year in the USA.
Who is most vulnerable?
Among those who have had chickenpox, people who are 50 years old and older are the most vulnerable. Among this group, those who have a poor immune system or a weakened physical state due to other health issues such as cancer, chemotherapy, and long term steroid use are most vulnerable.
Is there a way to prevent shingles?
In 2006, a vaccine to reduce the risk of shingles was licensed. Studies found a 50% reduction in shingles among those who were vaccinated. For those who were vaccinated and still had shingles, it was found to reduce the intensity of pain as compared to unvaccinated people.
Additionally, when possible, shingles can be prevented by maintaining a strong immune system through maintaining a well-balanced, healthy lifestyle including a healthy diet and daily exercise.
Who should get the Shingles vaccine?
While it is presently recommended for those 60 years of age and older, those over 50 are also eligible.
Who should not get the Shingles vaccine?
Those under 50 years of age
Those who have ever had a life-threatening allergic reaction to gelatin or the antibiotic neomycin
Those with a weakened immune system due to: AIDS or other immune system diseases, prolonged use of steroids, cancer treatments such as radiation or chemotherapy, cancer involving the bone marrow or lymphatic system such as leukemia or lymphoma
Those who are pregnant or might be pregnant
Those with moderate acute illness with a temperature of 101 degrees Fahrenheit or higher
What are the risk factors for the Shingles vaccine?
As with any medicine, severe allergic reactions can occur, however, no serious problems have been reported with the shingles vaccine to date.
Mild problems such as redness, soreness, swelling, or itching at the injection site can occur in 1 of 3 people.
Headaches can occur in 1 of 70 people
In summary, shingles affects more than a million people per year in the USA. The painful rash and the possibility for more serious complications associated with shingles makes the shingles vaccine a viable option for those over 50. To learn if you would benefit from the vaccination, discuss this matter further with your physician.
Sources: US National Library of Medicine – National Institutes of Health; Centers for Disease Control
Medical Reviewer: Gregory Cali, DO, Pulmonologist, Dunmore, PA
Read “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 an Associate Professor of Clinical Medicine at The Commonwealth Medical College.
Summer or Winter…the weather changes can cause joint pain! It is not just a cold weather problem…
“Everybody talks about the weather, but nobody does anything about it,” said Mark Twain. Just ask 93% of the arthritis sufferers who believe that the weather affects their pain level. History tells us that Benjamin Franklin, Leonardo da Vinci, and Christopher Columbus also felt this way about the weather. In my clinical practice of orthopedic and sports physical therapy, an informal survey found that 95 out of 100 patients (95%) with arthritis reported increased pain with weather changes. While most people report that the coldness and dampness seem to irritate their joints, they also report more pain with weather changes in the summer. There is a reasonable explanation…
Joints in the body have a lining called synovium that secretes a lubricating fluid called synovial fluid. In joints with arthritis, there is an overproduction of synovial fluid. In theory, when the barometric pressure changes, so to will the pressure inside your joints, especially if it is already overfull with extra fluid from arthritis. This added pressure stimulates the nerve endings in the joint to produce inflammation and pain.
Despite this overwhelming response from patients, scientific studies vary in their support of this claim. According to the Mayo Clinic, in 1961, a famous arthritis doctor (rheumatologist), built a climate chamber and discovered that when high humidity was combined with low barometric pressure, patients reported increased joint pain and stiffness. A recent study found that changes in barometric pressure and cooler temperatures are associated with joint pain. However, other studies have found increased joint pain with high barometric pressure in both warm and cold weather while another study found pain with low pressure.
What does this mean? It means that patients with arthritis consistently report pain with weather changes but science has not found an accurate method to consistently support these claims. Some of these inconsistencies may be attributed to the fact that there are differences in sensitivity among individuals. For example, some patients have symptoms before the weather changes, while others notice symptoms during or after the weather changes. Still yet, some report more pain in colder conditions while others notice more pain in warmer weather. It appears that changes in the weather, such as a high to a low or warm dry to cold damp and vice versa is the culprit when it comes to irritating arthritis in a joint.
If I have arthritis, should you move to Arizona? Yes and no! Yes, the warm and dry climate of Arizona will probably make you feel better overall. However, it will not cure the degenerative changes in your joints and you may still have pain when CHANGES in the weather occur. This is proven to be true by the fact that there are many very busy rheumatologists in Arizona!
In conclusion, it is safe to say that there is some evidence to support the claim that most patients with arthritis have increased symptoms of joint pain and stiffness with CHANGES in the weather:
Therefore, each patient must be individually evaluated by their physician to determine the extent of their arthritis and its relationship to the changes in the weather. While the cause of their increased symptoms with changes in the weather may not be completely understood, each patient must determine the adjustments in their lifestyle and/or medications according to the particular weather patterns that affect their problem most.
Visit your doctor regularly and listen to your body.
NEXT MONDAY – Read Dr. Paul J. Mackarey “Health & Exercise Forum!” 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 and is an associate professor of clinical medicine at The Commonwealth Medical College.
PREVENTION OF DEHYDRATION IN THE ELDERLY
Part 3 of 3 on Dehydration in the Elderly
Because of the possibility of the life-threatening, and at best life-altering, consequences of dehydration, prevention is best defense against dehydration. We must take a proactive approach to ensure and/or encourage adequate fluid intake. Consider some of the following practical tips to promote optimal hydration.
Review your medications and note if any have the potential to reduce your body fluid levels or alter your electrolyte balance. Diuretics, hypnotics, and laxatives are some examples of medications that have the potential to contribute to dehydration. Avoid beverages that contain caffeine or alcohol since both have dehydrating properties. Keep a check on your urine. As a general guide to hydration, urine should be plentiful, pale in color, and odorless. Dark, scanty, and strong-smelling urine may be the signal of dehydration.
Remember that simply breathing in and out uses more than a pint of water a day. On an average day, try to drink about two liters of water. You will need to hydrate more of you are experiencing vomiting, diarrhea, or an infection that causes fever. If you are exercising, drink slowly and frequently, especially in hot weather.
Some elderly individuals fear frequent nightly urination. To prevent this occurrence, begin your fluid consumption early and not later then 6 o’clock at night. Eliminate the need to “think” about drinking more fluids. Carry a water bottle around with you or at least keep a glass filled with your favorite, healthy beverage within your reach or at least within your view! Having fluids nearby and easily accessible will help to remind you to drink!
Plan and provide “opportunities to drink”. Individuals typically consume more fluids in a social setting. I witnessed this first-hand. My mother, who was recently hospitalized, constantly complained about how bad the coffee tasted. One day after lunch, my mom, her roommate, and I were having a nice conversation. As our social visit jumped from one topic to another, I noticed that my mother was taking an occasional sip from her coffee cup. Not long thereafter her cup was empty! Another idea is to have a “taste-test”. Gather a group of friends at your home and have fun guessing the flavor of various juices or soft drinks. Invite some companions to meet at a local restaurant for an afternoon “tea” (or other preferred healthy beverage). One last suggestion is to schedule a happy hour before your evening meal and serve liquid appetizers (e.g. tomato juice, orange juice, V-8 juice) or non-alcoholic drinks such as a virgin Bloody Mary.
We must admit that we are all human and tend to judge a book by its cover. With that in mind, do not overlook the appearance of the beverage you offer! Fluids with appealing colors (e.g. pink lemonade) served in attractive bottles, glasses, or stemware are more alluring to the senses and more likely to be sampled. Use a blender to mix cocktail combinations: kiwi-strawberry, vanilla and root beer soda, ginger ale and cranberry juice, and orange and pineapple juice. Garnishing a simple glass of water with a wedge of lemon or a frozen strawberry may be the stimulus that some people need to take their first taste. Adding sprigs of fresh mint or lemon verbena can make a fresh-tasting drink with an appetizing aroma.
In addition to appearance, texture is an important factor to consider when encouraging fluid consumption. Create frozen liquids such as lemon ice, popsicles, gelatin desserts, Italian ices, and snow cones. These delicious drink ideas not only provide healthy hydration but also are a treat to eat.
Fluid substances are not the only way to prevent dehydration. Many types of solid foods contain a substantial amount of water. If an individual has difficulty swallowing liquids or is on a fluid-restricted diet, it may be possible to maintain adequate hydration by increasing the amount of moisture consumed in foods. Fruits and vegetables are great examples because they contain 80% to 90% water.
Knowledge of the symptoms of and the prevention of dehydration can reduce unnecessary hospitalizations and maximize health and well-being for the elderly individual.
Visit your doctor regularly and listen to your body.
Keep moving, eat healthy foods, exercise regularly, and live long and well!
CONTRIBUTOR: Janet M. Caputo, PT, DPT, OCS – is an associate and clinic director at Mackarey Physical Therapy where she specializes in outpatient orthopedic and neurologic rehab.
NEXT MONDAY – Read Dr. Paul J. Mackarey “Health & Exercise Forum” 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 and is an associate professor of clinical medicine at The Commonwealth Medical College.
BENEFITS OF ADEQUATE HYDRATION IN THE ELDERLY
Part 2 of 3 on Dehydration in the Elderly
Water is needed to regulate body temperature, carry nutrients, remove toxins and waste materials, and provide the medium in which all cellular chemical reactions take place. Fluid balance is vital for body functions. A significant decrease in the total amount of body fluids leads to dehydration. Fluid loss also contributes and complicates many health issues. If you are elderly or care for the elderly, understand that this may be one problem that you can often control. It is important for you to understand the many conditions complicated by dehydration.
Good hydration prevents the development of the following ailments:
Visit your doctor regularly and listen to your body.
Keep moving, eat healthy foods, exercise regularly, and live long and well!
CONTRIBUTOR: Janet M. Caputo, PT, DPT, OCS – is an associate and clinic director at Mackarey Physical Therapy in Scranton, PA, where she specializes in outpatient orthopedic and neurologic rehab.
NEXT MONDAY – Read Dr. Paul J. Mackarey “Health & Exercise Forum” in the Scranton Times-Tribune. Next Week, read Part 3 of 3: “Prevention of Dehydration”
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.
Summer heat is here and the risk of dehydration continues for one specific group, the elderly. Age, diet, illness and medications are some of the many reasons why elders suffer from dehydration not only in the summer heat, but year round.
Next to oxygen, water is the nutrient most needed for life. A person can live without food for a month, but most can survive only three to four days without water. Even though proper hydration is essential for health, water gets overlooked as one of the six basic nutrients. Dehydration occurs when the amount of water taken into the body is less than the amount that is being lost. Dehydration can happen very rapidly (i.e. in less than eight hours); the consequences can be life threatening and the symptoms can be alarmingly swift.
In the body, water is needed to regulate body temperature, carry nutrients, remove toxins and waste materials, and provide the medium in which all cellular chemical reactions take place. Fluid balance is vital for body functions. A significant decrease in the total amount of body fluids leads to dehydration. Fluids can be lost through the urine, skin, or lungs. Along with fluids, essential electrolytes, such as sodium and potassium, are also perilously depleted in a dehydrated individual.
Dehydration is the most common fluid and electrolyte disorder of frail elders, both in long term care facilities and in the community! Elders aged 85 to 99 years are six times more likely to be hospitalized for dehydration than those aged 65 to 69 years. More than 18% of those hospitalized for dehydration will die within 30 days, and associated mortality increases with age. Men appear to dehydrate more often than women and dehydration is often masked by other conditions.
Elderly individuals are at heightened risk for dehydration for several reasons. Compared to younger individuals, their regulatory system (i.e. kidneys and hormones) does not work as well and their bodies have lower water contents. The elderly often have a depressed thirst drive due to a decrease in a particular hormone. They do not feel thirsty when they are dehydrated. This is especially true in hot, humid weather, when they have a fever, are taking medications, or have vomiting or diarrhea. They have decreased taste, smell, and appetite which contribute to the muted perception of thirst. Because of dementia, depression, visual deficits, or motor impairments, elderly persons may have difficulty getting fluids for themselves. Many elderly individuals limit their fluid intake in the belief that they will prevent incontinence and decrease the number of trips to the bathroom. The medications that they are taking (e.g. diuretics, laxatives, hypnotics) contribute to dehydration.
Elders may suffer headaches, fainting, disorientation, nausea, a seizure, a stroke, or a heart attack as a result of dehydration. The minimum daily requirement to avoid dehydration is between 1,500 (6.34 cups) and 2,000 ml of fluid intake per day. Six to eight good-sized glasses of water a day should provide this amount. Better hydration improves well-being and medications work more effectively when an individual is properly hydrated.
Those who care for the elderly whether at home or in a health care facility need to be alert to the following symptoms:
Plain old tap water is a good way to replenish fluid loss. Some energy drinks not only have excess and unneeded calories but also contain sugar that slows down the rate at which water can be absorbed form the stomach. Consuming alcoholic and caffeinated beverages actually has an opposite, diuretic effect!
Visit your doctor regularly and listen to your body.
Keep moving, eat healthy foods, exercise regularly, and live long and well!
CONTRIBUTOR: Janet M. Caputo, PT, DPT, OCS – is an associate and clinic director at Mackarey Physical Therapy where she specializes in outpatient orthopedic and neurologic rehab.
NEXT MONDAY – Read Dr. Paul J. Mackarey “Health & Exercise Forum" in the Scranton Times-Tribune. Next week: Part 2 of 3 “The Benefits of Good Hydration”
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.
Part 2 of 2
(Read Part 1 of this article if you missed it last week.)
A bad marriage, an unhealthy relationship, a cruel boss, and a troubled economy are all potential causes of stress because they can produce feelings of anger and depression. There are physical, mental, emotional, and behavioral signs associated with stress:
What are some defense mechanisms that we can use to reduce emotional stress?
Contributor: Janet Caputo, DPT, PT, OCS, is a physical therapist specializing in the management of orthopedic and sports injuries with a special interest in vestibular rehab and falls prevention at Mackarey Physical Therapy in downtown Scranton. NEXT MONDAY – Read Dr. Paul J. Mackarey “Health & Exercise Forum!” 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.comPaul 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.
