The body is beautifully designed to constantly change and make adjustments to maintain homeostasis...a healthy place where all systems work together in perfect equilibrium. However, when things are not working as planned, your body is also designed to give you feedback. Sometimes the feedback is benign (like a stomach ache from eating too much), while other times the feedback is important and should not be ignored (like severe lower right-sided abdominal pain that makes you nauseous or vomit). When calling your physician or reporting to the emergency department with a problem, try to be clear and concise (when symptoms began, the degree of pain from 1 to 10, and bring a medication and allergy list with your medical history).

The following list are some of the symptoms that should not be ignored:

Chest Pain:

While chest pain can be from many benign causes such as a pulled muscle from heavy lifting it can also be more serious. A dull ache, sharp stabbing pain, crushing or burning sensation, especially when associated with radiating pain to the neck, jaw and left shoulder can be a sign of a heart attack and should not be ignored. If the symptoms fail to subside after 5 minutes of rest, call 911 or have someone take you to the closest emergency department.

Speech or Vision Loss:

Sudden slurred speech and or blurred vision often associated with weakness in an arm or leg can be a sign of a stroke. These signs can also be associated with intoxication from alcohol or drugs. Call 911 or have someone take you to the closest emergency department.

Severe Abdominal Pain:

Abdominal pain can occur for many non emergency reasons; constipation, gas, overeating, stress or muscle strain. However, if the pain is associated with nausea, fever, bloody stools, difficulty breathing, and vomiting blood, than it may be related to a much more serious problem such as appendicitis. Other causes include: irritable bowel syndrome, gastrointestinal disease, gastritis, or hernia. Consult your physician immediately or get to an emergency department.  

Unexplained Weight Loss:

Losing weight is the most common health and wellness goal. However, when weight loss of 10 or more pounds in 4 to 6 months is not associated with conscious dieting, it may be a sign of a much more serious problem...consult your doctor.

According to the Mayo Clinic, an unexplained drop in weight could be caused by various conditions —including overactive thyroid (hyperthyroidism), diabetes, depression, liver disease, cancer or disorders that interfere with how your body absorbs nutrients (malabsorption disorders).

Persistent or High Fever:

A fever is often a normal response when your body is fighting infection and usually not a cause for alarm. However, persistent fever can signal a hidden infection, which could be anything from a urinary tract infection to tuberculosis. In some cases, cancerous (malignant) conditions, such as lymphomas , cause prolonged or persistent fevers, as can some medications.Call your doctor if your temperature is 103 F (39.4 C) or higher or you've had a fever for more than three days.

Shortness of Breath:

There are many non-serious reasons for shortness of breath such as; very strenuous exercise, extreme temperatures, massive obesity and high altitude all can cause shortness of breath. However, it can also be a sign of a medical problem. If you have unexplained shortness of breath, especially if it comes on suddenly and is severe, seek emergency medical care.

Mayo Clinic lists the following medical causes for breathlessness: chronic obstructive pulmonary disease, bronchitis, asthma, pneumonia, a blood clot in the lung (pulmonary embolism), as well as other heart and lung problems. Difficulty breathing can also occur with a panic attack — a sudden episode of intense anxiety that triggers severe physical reactions when there is no real danger or apparent cause.

Unexplained Changes in Bowel Habits:

Consult your doctor if you notice unusual or unexplained changes in your stool (relative to what is normal for you). Some serious signs are: bloody, black or tarry-colored stools, persistent diarrhea or constipation, and unexplained urges to have a bowel movement.

Changes in bowel habits could signal a bacterial, viral or parasitic infection. Other possible causes include irritable bowel disease and colon cancer.

Confusion or Personality Changes:

Confusion and personality changes could be caused by many problems, including infection, poor nutrition, mental health conditions or medications. However, seek medical attention if you have sudden: poor thinking skills, difficulty focusing, sustaining or shifting attention, or behavior changes.

Unexplained Full Sensation in Your Stomach:

If you notice that you consistently have a sensation of fullness in your stomach, even though you have been eating less than usual, get checked by your doctor. This sensation is called early satiety. Early satiety can be associated with nausea, vomiting, bloating or weight loss. Experts at the Mayo Clinic recommend that you consult with your doctor about the possible causes of early satiety including; gastroesophageal reflux disease, commonly known as GERD, and peptic ulcers. In some cases, a more serious problem, such as pancreatic cancer, could be a factor.

Seeing Flashes of Light:

If you see very bright and sudden flashes of light or bright spots it could be a sign of a serious problem with your eyes. While these symptoms are often associated with severe migraines, it can also be a sign of a more serious eye problem called a detached retina. If so, it requires immediate medical care can help prevent permanent vision loss.

Sources: Mayo Clinic, NIH – National Institute on Aging

 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 GCSOM.

For all of Dr. Mackarey's articles visit: mackareyphysicaltherapy.com

The number one resolution each year is to lose weight. The internet is flooded with endless recommendations for diet and exercise. While not guaranteed, the recommendations below are safe, simple and easily implemented. And, it is a good way to start your day…give it a try!

1. Weight Yourself – Step on the scale first thing in the morning for a more accurate reading. After a day of eating and drinking different amounts and types of foods with various activity and exercise levels, will alter the numbers. Inconsistencies can be frustrated.
2. Hydrate – Drinking 1 – 2 glasses of water before breakfast can aid your cause. Water is calorie free and fills you up. It may also stimulate your metabolism to burn more calories.
3. Work Out Early – A moderate duration and intensity of exercise before you eat breakfast can yield better results. Some studies show that fasting workouts rely less on food to burn for energy and more on body fat stores. Also, you are less likely to miss a workout due to other commitments if you do it first thing in the morning.
4. High Protein for Breakfast – Protein will make you feel fuller. So enjoy a Greek yogurt smoothie with fruit and peanut butter or eggs and turkey sausage with whole wheat toast. Moreover, your body will use energy (calories) to breakdown the protein and less likely to store it as fat. Unfortunately, a delicious stack of pancakes will do the opposite…stored as fat.
5. Plan for the Day – by making a meal plan for the day, you can choose to eat less calories and healthy foods. Once the day gets away from you and you’re too hungry to prepare healthy options, it is easy to grab a convenient but unhealthy and high calorie fast food. Pack grapes and apples for snacks at work or school and have dinner prepared the night or weekend before.
6. Spend Time Outdoors – being outdoors is not only healthy for your mental wellbeing, but also your physical health (vitamin D etc). Some studies suggest that people who spend time in the morning sun tend to have a lower BMI, even compared to those who soak up the afternoon sun!
7. Measure it! – Using a measure cup or spoon will allow for more accurate portion control. A half filled bowl of cereal in the morning, may actually be 1-2 cups.
8. Be Mindful – Think before you put food in your mouth. Instead of eating while reading the paper or watching the morning news, eat slowly, chew thoroughly, and taste your food. In between bites, take deep breaths and relax because this ritual can help you eat less and lose weight.
9. Use Small Plates and Glasses – Smaller dinnerware will give the appearance of having a full plate with small portions. Also, standard drinking glasses are very large and when filled with orange juice it is very high in calories, so use a small juice glass.
10. Don’t Make Your Coffee a Dessert – Specialty coffees with excessive sugar, cream, and flavored syrups can add more than 500 calories to your diet, which is 1/4 the entire daily caloric recommendation for women (2000 for women and 2500 for men). Use skim milk and sugar-free flavors or try green tea.
11. Healthy Snacks – prepare and pack healthy snacks for work or travel. Fruit, veggies, low-fat cheese, and fiber rich crackers are some examples. Beware of granola bars high in sugar and calories pretending to be healthy!
12. Limit Time Spent Sitting – Studies show a strong correlation with time spent sitting (commuting to work) and weight gain. Consider using a travel app to shorten commute times and park further from work to encourage walking.
13. Make a List – Those who make a shopping list buy less junk food. So, make a list that includes healthy choices for dinner and snacks and stick to it!
14. Hot Sauce – A recent study suggested that hot and spicy condiments on your foods may help with weight loss. Capsaicinoids, the hot chemical in chili peppers, can reduce body fat, suppress appetite and boost metabolism. So, spice up your breakfast with chili peppers and hot sauce on your omelet.
15. Sleep it Off – getting adequate sleep and controlling excessive stress can have a positive impact on weight control. Those not getting enough sleep tend to be hungry, eat more and exercise less.

Source: WebMD, Mayo Clinic

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 GCSOM.

For all of Dr. Mackarey's articles visit: mackareyphysicaltherapy

AFTER VACCINATION…MAINTAIN A HEALTHY IMMUNE SYSTEM

Every January, people make numerous resolutions related to health and wellness such as eating less and exercising more. As we enter our second new year living (or dying) with the COVID virus, it may be that the best health and wellness resolution is to GET FULLY VACCINATED!

The Omicron variant

The Omicron variant of SARS-CoV-2 is spreading throughout the United States like a wildfire. Consequently, a critically important New Year’s resolution is take action and seek the best protection possible. First and foremost, getting fully vaccinated offers the best protection considering the fact that the efficacy of the vaccination to prevent serious illness, hospitalizations and death is well-documented. Once vaccinated, taking care of your health and wellness is also important. The human body is designed to defend against some (but not all) foreign bodies such as germs, bacteria, and viruses. A healthy immune system may foster a speedier recovery from illness. While you may not be able to improve an otherwise healthy immune system, you can take steps to maintain its health and integrity.

A Healthy Immune System

A healthy immune system protects us by creating a barrier that stops invaders or antigens, from entering the body. When an unwelcome invader slips through the barricade, the immune system responds by producing white blood cells and other chemicals and proteins that attack the foreign substances.

10 TIPS TO MAINTAIN A HEALTHY IMMUNE SYSTEM:

1. GET FULLY VACCINATED!
2. Don’t Smoke – it is obvious why this tip is critically important
3. Eat a Mediterranean Diet – high in fruits and vegetables, fish/seafood, nuts, seeds, legumes, extra virgin olive oil and minimal amounts of red meat and Drink Plenty of Water … and drink alcohol in moderation
4. Maintain a Healthy Body Weight – body mass index (BMI) between 18.5 and 24.9 is healthy. To calculate your BMI: www.nhlbi.nih.gov
5. Get Adequate Sleep – 8 hours is a good goal but if not possible, supplement with a daytime nap
6. Practice Good Hygiene – Avoid infection by washing hands often and thoroughly. Flossing and brushing your teeth is also important.
7. Prepare Foods Properly - clean meat/fish cutting surfaces and cook food thoroughly
8. Limit stress and Be Positive - make time to reflect and meditate and, when possible, avoid people who “suck the oxygen out of the room!” YouTube “Progressive Muscle Relaxation” for easy to use relaxation techniques
9. Be Active – physically and mentally – keep your body and mind moving and when possible spend time outdoors and enjoy the natural beauty of NEPA
10. Exercise – BUT DO NOT OVER EXERCISE! While exercise is an essential part of a healthy immune system, over exercise can weaken your immune system. In fact, many marathoners report a mild fever and flu-like symptoms after running the 26.2 mile race. 

Maintain a Healthy Immune System

To maintain a healthy immune system, physical activity is one of the most important factors in improving a lifestyle in a positive way. A minimum of 30 minutes of physical activity, 5 days per week can greatly contribute to longevity. Most experts agree that moderation is important. If you overindulge in exercise you will be at greater risk for musculoskeletal injuries and may weaken your immune system. This is especially true for those who are newcomers. The goal is to gradually work into a fitness program and maintain it for life. 

Researchers have found that the benefits of regular physical activity are numerous. Some of the more important benefits are:

• 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/Maintains Immune System
• Improves Pain Threshold

Sources: WebMD;

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

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 orthopedic and sports physical therapy. Dr. Mackarey is in private practice and is an associate professor of clinical medicine at GCSOM.

For all of Dr. Mackarey's articles, visit: mackareyphysicaltherapy.com/forum

Special Feature “ Health & Exercise Forum” with GCSOM: Steven Scheinman, MD, GCSOM President and Dean

Steven Scheinman, MD, Geisinger Commonwealth School of Medicine President and Dean, retired at the end of 2021, leaving behind a legacy that will continue in perpetuity. It is often said that success can be measured by the degree to which one makes the world a better place. By that measure, my friend and mentor, Dr. Steven Scheinman, is a very successful man! His numerous contributions to our community will have a long-lasting positive impact, not only on health and wellness, but also on the spirit and pride of its humble citizens.

Dr. Scheinman has demonstrated many of the attributes associated with great leaders and philosophers; openness, with a curiosity and tolerance for diverse cultural and intellectual experiences; conscientiousness, with a gift for dutifulness, diligence, and orderliness; and extraversion, with a tendency to experience positive emotions and being active and sociable.  

A summary of some his most impactful accomplishments:

In 2010, the Robert Graham Center, a think tank focused on primary care, analyzed the physician shortage in Pennsylvania. The researchers concluded, “Pressures from a growing, aging, increasingly insured population call on Pennsylvania to address current and growing demand for primary care providers to adequately meet health care needs. Policymakers in Pennsylvania should consider strategies to bolster the primary care pipeline . . .”

Northeastern Pennsylvania was certainly not immune to the problem. In fact, our need for increased access to primary care, which includes mental and behavioral health, reached a boiling point in September of 2012 when our community was shocked by a tragic rash of teen suicides.

That same year, Dr. Steve Scheinman arrived in Scranton to assume leadership of what was then The Commonwealth Medical College (TCMC). Our community was justifiably proud of the school…almost singlehandedly and completely single-mindedly, the people of northeastern Pennsylvania built the school without a major hospital or university partner – something no other community has done. Its purpose, of course, was not just to be a point of pride. It was to ensure the health and wellbeing of our entire region.

When Dr. Scheinman took the reins, TCMC intended to re-populate the region’s physician workforce but had few ways beyond admissions policies favorable to local students to incentivize its talented young graduates to remain. Dr. Scheinman took the school’s mission as his own and went to work. He guided our medical school to full accreditation – with six commendations, including one for community engagement. He convened a consortium of mental and behavioral health providers, patients and caregivers and founded the Behavioral Health Initiative (BHI), which has gone on to help found the Autism Collaborative and create opportunities for additional graduate medical education in psychiatry in our region.

Undeniably, however, Dr. Scheinman’s most important achievement was in presiding over TCMC’s integration with Geisinger. Geisinger was the perfect partner for this community’s medical college. Both the school and the system are focused on the health of the people in our region. Both focus on serving community and solving the problems that affect our overall wellbeing. Importantly, integration with Geisinger secured the future of medical education in northeastern Pennsylvania. The crowning achievement, however, of becoming Geisinger Commonwealth School of Medicine (GCSOM) is its turbocharged ability to meet the founding goal of the school – to create a physician pipeline right here in our neighborhoods. Together with leaders from Geisinger, in 2018 Dr. Scheinman announced the launch of the Abigail Geisinger Scholars Program.

Dr. Scheinman tells me that area students have always expressed to him a deep desire to come home – and since 2016 more than 30 have done so -- but financial considerations too often derail these plans. Thanks to the Abigail Geisinger Scholars Program, financial considerations are now an incentive, not an obstacle. And because GCSOM maintains admissions policies that favor local students, a great number of Abigail Geisinger Scholars grew up right here in northeastern Pennsylvania.

The program offers tuition-free medical education to GCSOM students in exchange for a promise to return to our region and work as a Geisinger physician. Today, up to 45 students per class are enrolled in the program and are dedicated to specializing in family medicine, internal medicine, medicine/pediatrics, and psychiatry – all areas of primary care devoted to keeping people healthy and out of the hospital. In 2021, the first five students in the program graduated from GCSOM and are now in residency training. In the coming years, we will see hundreds added to that number with each and every one ultimately “coming home.”

All of this happened under the leadership of Dr. Steve Scheinman, who earlier this year announced his retirement. On Jan. 3, Dr. Julie Byerley will succeed Dr. Scheinman as the third president and dean of Geisinger Commonwealth School of Medicine. As he leaves us to enjoy a well-deserved retirement, I think the entire community owes him a sincere thank you not only for securing the future of our school, but also for helping our community realize the vision of what having our own medical school would mean --  a guaranteed pipeline of excellently trained physicians to care for us. His legacy will be the wonderful young GCSOM graduates practicing in our region. Here are a few who are already doing so:

· Pat Connors, MD, who practices internal medicine with Prime Med in Scranton.

· Rachel Brutico Gianotti, MD, a Geisinger pediatrician, and her husband, Vince Gianotti, MD, an emergency medicine doctor in Wilkes-Barre.

· Matthew Mullen, MD, a Geisinger cardiac surgeon in Scranton.

· Angela DiBileo Kalinowski, MD, a family medicine doctor with Prime Med in Clarks Summit.

Thank you, Dr. Scheinman!

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 orthopedic and sports physical therapy. Dr. Mackarey is in private practice and is an associate professor of clinical medicine at GCSOM.

Read all of Dr. Mackarey's articles at: mackareyphysicaltherapy.com/forum

While the Christmas spirit is still strongly present and the New Year just days away, I thought it would be appropriate to reprint a column from Christmas 2006. The forward to the column was written by Father Scott Pilarz, President of the University of Scranton who passed away on March 10, 2021 from complications related to amyotrophic lateral sclerosis (ALS) at age 61. As always, he offered sage advice and reflection for a healthy mind, body and spirit…thank you Father Pilarz for your many contributions to our community!

To my loyal readers this holiday…that the spirit of this holy season would be with you for 30 seconds each day for the rest of your life. The love, faith and hope of this season are so powerful that it could transform our lives if we somehow find a way to reflect upon it daily. I believe that it is the foundation for a healthy mind, body and spirit. This is proven in the fact that those of faith live longer and happier lives. All major religions promote physical and spiritual health, wellness and respect for life. In 2006, I asked Rev. Scott R. Pilarz, S.J., President of the University of Scranton to offer some words of reflection on how this holy season relates to a healthy mind, body and spirit:

“On the surface of things, it seems counterintuitive to write a column on health and fitness during the week before Christmas.  For many, this can prove to be the unhealthiest time of year.  People find themselves too busy to exercise and simultaneously confronted with too many opportunities for eating and drinking.  Certainly an abundance of culinary temptation is especially the case on a university campus, where just about every department and division hosts a party.  The cold weather can also be a hindrance to outdoor activity.  It’s too tempting to stay inside and, specifically, on the couch in front of a fire, making resolutions to exercise after the New Year.

This is, however, also the season for renewing our spirits and remembering what’s most important in our lives.  As a result, we might consider the importance of regular exercise as an ingredient not only to physical health, but to spiritual health, as well.  The connection between these aspects of our lives has been stressed by a variety of spiritual traditions over the centuries.

The Jesuit tradition, with which I am most familiar, has long given exercise a place in its schools and educational philosophy.  Jesuit schoolmasters knew that they wanted to form “the whole person” and not simply the minds of their students.  Since the first plan of studies, or Ratio Studiorum, was published in the sixteenth century, Jesuit educators recognized the importance of encouraging their students to work their bodies as well as their souls and minds.  It was understood that exercise promoted balance and concentration needed for study and prayer.  The Spiritual Exercises, which are the living legacy of the Jesuit’s founder, St. Ignatius Loyola, are rigorous.  They depend on divine assistance as well as the focus and strength of a person at prayer.  St. Ignatius started his career as a soldier, and he never lost his appreciation for the kind of discipline that exercise fosters. 

Early Jesuits also had a healthy appreciation for the value of friendly competition.  This long-standing tradition may help explain the success centuries later of Jesuit college athletic teams, including The University of Scranton Royals.  It also accounts for the fact that the University still requires students to enroll in physical education courses and is home to a Department of Exercise Science and Sport.

Here’s hoping that readers will mine their own spiritual traditions during this sacred season and discover again the way in which exercise can be of benefit to “the whole person.” Remember, physical activity is one of the most important factors in improving a lifestyle in a positive way. But, it does not have to be complicated. A minimum of 30 minutes of physical activity, 3-5 days per week will many positive effects on your body.

Some simple suggestions for beginning an exercise program are:

• Get your physicians approval
• Consult with a physical therapist to set up a program for your needs
• AEROBIC EXERCISE:
• Buy good running sneakers – not walking shoes
• Plan to exercise 3-5 times per week for 30-35 minutes
• Walk for aerobic fitness
• Begin 5-10 minutes and add 1-2 minutes each session
• Walk in a mall if it is too hot or too cold
• WEIGHT TRAINING:
• Use light dumbbells, sandbag weights and elastic resistance bands 3-5 pounds to start, add 1 pound once 25 reps becomes easy
• Begin with 5-10 repetitions and add 1-2 reps each session. Continue until 25 reps becomes easy, then increase weight by 1 pound for 15-20 reps
• Alternate weight training days with walking days
• 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 an 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
• BE RELIGIOUS! Be religious about exercise BUT don’t get too compulsive!

Read Dr. Mackarey’s Health & Exercise Forum – Next 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 GCSOM.

For all of Dr. Mackarey's articles visit: mackareyphysicaltherapy.com

Dry Tech Exercise Clothing

Dry Tech is the best thing that has happened to exercise apparel since “jogging suit” was donned by all the “cool dudes” in the 70’s and 80’s . It is has great style and even better function. The specially made material is light weight and breathable and wicks moisture from the skin to the outer layers. Therefore, it will not get heavy with sweat which can weigh you down and cause friction with your skin which can lead to chaffing and blisters. The following exercise apparel is now available in Dry Tech:

• Short sleeve tee with a matching long sleeve shirt
• Shorts and compression under shorts
• Colorful socks; NOTE: Shoes are a very important aspect to safe and comfortable exercise but are unique for running and other specific sports (tennis, basketball). Sneakers may be too difficult to buy for someone else.

Exercise Mat

An exercise mat is helpful if you decide to exercise at home. Also, if you participate in yoga or Pilates classes, a mat is required equipment.

Hand Held Dumbbells and Sandbag Leg Weights

These are essential for those interested in home exercise. For the average beginner, 3-5-8-10 pound (two of each) weights will be adequate.  Dumbbells are good for shrugs, biceps, and triceps, bent over rows and lats, and lunges. Incremented and stackable dumbbells are also available by Bowflex SelecTech 552 (5-52 pounds for $299). and NordicTrack $189. Sandbags, which can be purchased as graduated weights from 1 to 5 pounds, are good for leg extensions, hamstring curls, hip hikes and hip abduction.  

Resistance Bands

These cheap and versatile bands are also essential for a home program. The bands come in different colors to represent the amount of resistance with yellow being the easiest and black the most difficult. They can be used for upper and lower body. For specific band exercises visit a previous column in “Health & Exercise Forum” at The Times Tribune or www.mackareyphysicaltherapy.com

Aerobic Equipment

• Bike – Plus: upright or recumbent bikes are an effective and affordable method of aerobic exercise. It is very useful for those suffering from lower back, hip, knee or ankle/foot pain because it can be performed with partial weight bearing. Minus: must be able to bend your knees at least 110/115 degrees.  
• Treadmill – Plus: great for those who love to walk or run and need and indoor alternative in inclimate weather. Minus: large and expensive
• Elliptical – Plus: a good alternative to the pounding of running. Minus: expensive, large, and require full weight bearing. 

Fitness Club Membership

• Location is important for convenience. The type of gym, such as, cross fit, exercise machines vs. traditional free weights, must be considered. Equipment and other services such as personal trainers, swimming pool, sauna, hot tubs, Pilates, and yoga classes are also important to some.
• If the person you want to gift already belongs to a gym, consider purchasing a gift certificate for massage, Pilates, yoga, spin class or aquatic exercises at their gym (which usually costs extra) or another studio.

Personal Trainer Gift Certificate or Home Virtual Trainers

This can be an opportunity for someone to either get the proper advice from a professional to begin a fitness program or to revamp and tune up an old stale program. Word of mouth is a good way to find a reputable certified trainer.

Peloton – ($1,495 bike, $2,495 treadmill); Mirror Exercise – ($995); FightCamp – ($1,219.)

Electronic Fitness Monitors or Wearable Tech Monitor

These devices use GPS technology to help the user track their activity to get more out of their exercise routines. They monitor activity, heart rate, distance, location, calories, and more. Some examples are:

• Pedometers – clips on a belt – best for tracking steps - tracks steps taken by walkers and runners and translates it to miles. Some also translate calories expended. Suggestions: “Perfect Fitness” or Timex” $5-$25.

• Activity Trackers – worn as wrist band – best for tracking general fitness, calories and sleep patterns 24/7. It can be connected wireless to your cell phone. Suggestions: “Fitbit” $119 to $149. Garmin Vivoactive 3  $159.

• Running Watches – are worn as a wrist watch – best for timing workouts and counting laps - a rugged, waterproof watch to be worn while running to track laps, splits, countdown, intervals and training logs. However, it does not track distance, speed or heart rate. Suggestions: Timex Ironman $38.97. Garmin Forerunner 45S $129.

• Heart Rate Monitors – worn as a chest-strap or wrist strap – monitors your heart rate in real time.  Suggestions: Garmin Vivofit 4 $62.; Polar H10  $89.95

• WHOOP – this next generation fitness and health monitoring is smaller and faster with new biometric tracking, including skin temperature, blood oxygen, and more. Whoop.com $30/month.

Weight Loss and Activity Monitoring Apps

Note: Basic Apps are free and more advanced versions are under $10.

• Weight Loss – Suggestions: “Lose It”; “My Diet Coach” - helps you keep a journal, calculates calories for free. The App gives calorie credits if you exercise and provides ongoing feedback to help you stay on track to attain your optimal weight.

• Activity Monitor – Suggestions: “Endomodo”; “Human” – uses GPS to track your every step when you go for a hike, run, fitness walk, touring walk at Disney, or bike ride on trails, ski cross country or downhill. It will calculate distance, speed, location, total time and total calories.

Nutritional Counselor Gift Certificate

Sometimes you need professional help to get started and stay focused. Just as with a personal trainer, a qualified and licensed nutritional counselor will assist you in establishing a safe and effective program to meet your nutritional and dietary goals. Again, ask around to see who has a good reputation or who may be a good fit for the recipient of your gift.

These gifts can be purchased at most local sporting goods stores or on-line.

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 GCSOM.

For all of Dr. Mackarey's articles visit: mackareyphysicaltherapy.com/forum

Holiday shopping is stressful to your body as well as your wallet. Driving from store to store, getting in and out of the car, bundled in a sweater and winter coat, the expert shopper carries package after package from the store, to the car, over and over again. Six, eight, or ten hours later, the shopper arrives home exhausted, only to realize that 15, or 20 packages must be carried from the car into the house. This dilemma is compounded by the fact that the rain turned to sleet, and the sleet to snow. Travel by car and foot are treacherous. You are slipping and sliding all the way from the car to the house while carrying multiple packages of various sizes and shapes. The shopping bags get wet and tear, forcing you to tilt your body as you carry the packages. Of course, no one is home to help you unload the car and you make the trip several times alone. You get into the house exhausted and crash onto the couch. You fall asleep slouched and slumped in an overstuffed pillow chair. Hours later you wake up with a stiff neck and lower back pain. You wonder what happened to your neck and back. Consider the following:

• Lack of sleep and stress – can cause your muscles to tighten up and spasm.
  • Try to get a good night sleep before a day of shopping
  • Lessen the stress by preparing a shopping list, organizing a sequence to visit stores in a logical order
  • Try not to “do it all” in one shopping day.
  • Delegate…get some help from family members.

• Driving Long Distances or Getting in and out of the car multiple times
  • Prolonged sitting and driving, especially with poor posture is very stressful to the neck and back
  • Getting in and out of the car, twisting and turning multiple times, especially with bulky clothing, is very stressful to the neck and back
  • Use a lumbar roll when sitting in the car
  • Sit up straight and adjust seat closer to steering wheel and limit reaching with arms and slouching
  • Use the headrest for your neck on the highway
  • Get out and stretch backwards to extend your neck and back every 45-60 minutes in the car

• Carrying packages
  • Make a few extra trips to the car to drop off packages before they accumulate
  • Multiple packages of different sizes and shapes, especially with torn bags or without handles make your neck and back vulnerable
  • Bending over to browse through or paying for items, especially while holding your purse or other packages, makes your neck and back strain
  • Bending over and twisting to put items in the car and trunk makes you vulnerable to back pain
  • Use good quality shopping bags and a cart when possible
  • Put down items when browsing or paying
  • Do stretching exercises bending you neck backwards, extending your lower back and pinch your shoulder blades together 10 times every 30 minutes of shopping
  • Use a lightweight purse when shopping or use a wallet and leave the purse at home

• Slipping and twisting
  • Twisting and slipping while carrying packages can twist and strain your back or neck
  • Be extra careful in bad weather by wearing good shoes with a nonskid sole
  • Switch sides, alternating from right to left when you carry your packages and your purse

• Resting or sleeping in a slouched position
  • Falling asleep on too many pillows or with your neck twisted is very bad for your neck and your lower back in a hammock position is very bad for your lower back
  • Make sure to lie down flat, with one pillow for your neck and maybe one under your knees
  • If you sit, use a lumbar roll in the small of your lower back

• Poor Footwear
  • Heels and most dress shoes may look good but don’t cut it for shopping support
  • Wear comfortable shoes with good support like you wear to walk at Disney

• Pamper Yourself: After all your hard work, in the spirit of the spirit of the holidays, treat yourself to some great relaxation with the aid of:
  • A Full Body Massage
  • A Foot Massage
  • A Pedicure
  • A Whirlpool Bath
  • Some Wine and Cheese

Other Tips:

Plan Ahead: It is very stressful on your spirit, wallet and back to do all of your shopping in the three weeks available after Thanksgiving. Even though we dislike “rushing” past Thanksgiving to the next holiday, try to begin holiday shopping in before 

Use the Internet: Supporting local businesses is important. However, Internet shopping can save you lots of wear and tear. Sometimes, you can even get a gift wrapped.

Gift Certificates: While gift certificates may be impersonal, they are easy, convenient and can also be purchased over the internet.

Perform Stretching Exercises: Chin Tucks, Shoulder Blade Pinch, Back Extension. Stretch intermittently throughout the shopping day…try the three exercises below, gently, slowly, hold 3 seconds and relax, repeat 5 times.

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

For all of Dr. Mackarey's Articles visit: mackareyphysicaltherapy.com/forum

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.

The time has come again …transitioning from that sun-kissed summer skin to that sense of itchy dryness which takes over during the frigid NEPA winters. For some reason, our skin never seems to feel as good in the winter as is does during the warm summer months. Perhaps when prompted by a healthy dose of vitamin D from the sun, some of us take better care of our skin during the summer months and take extra precaution with sunscreen and moisturizers to maintain its natural glow. Some of us hardly alter our skin care routine and daily habits with the change of seasons and just find our skin to feel healthier in the summer rather than in the winter. Whichever your individual case may be, I have 10 tips that will have your skin looking good and feeling good all winter long.

1. Sunscreen: Bet you thought this was strictly a summer necessity. Nope! The sun’s UVB rays, or the type of rays that damage our skin without proper protection, remain strong even through the winter months. Add some snow and ice into the mix, which reflects up to 90% of the sun’s UVB rays, and we get a double dose of harmful rays. This only increases our risk of skin damage, and even cancer. Try using a broad-spectrum sunscreen with an SPF of 30 or higher on the face, ears, and hands during the winter.
2. Moisturize: Moisturizers keep water from escaping from our skin. Hence, it may be beneficial to apply moisturizer a few minutes after taking a shower, as the cream helps to seal in the hydration gained from the shower.
3. Ditch the hot showers: Long, hot showers can wipe away some of our skin’s natural oils and moisture. Cutting down our time in the shower, as well as using warm or lukewarm water can help to reduce excess skin dryness or eczema flare ups. Patting dry instead of rubbing dry is also important for preventing further skin irritation.
4. Turn down the heat: The first thing that we usually do on a cold winter day is to turn up the thermostat to take the chill out of the air. Well, you may want to think twice before you do this as heat within our homes tends to be dehydrating to the skin. Consider keeping your household temps at a comfortable 68-70 degrees with an ideal humidity of about 50% to minimize dryness.
5. Use a humidifier: Adding moisture to the dry winter air can help to maintain skin hydration and to decrease overall dryness and flakiness. A good place to put it would be in your bedroom, as a large portion of your day is spent there.
6. Light and soft clothing: Heavy wool sweaters and thick thermal wear can be itchy and irritating when directly placed on the skin. Thick clothing typically isn’t as breathable or comfortable as cotton or other light fabrics. Stick to light and airy layers to avoid any irritation and build heavier clothing on top.
7. Hydrate: Water, water, and more water! Studies show that good hydration can improve blood flow to the skin, which increases skin cell growth, as well as improves dryness and overall complexion. A simple rule of thumb for appropriate water intake is to divide your body weight by 2, and to drink that amount in ounces daily.
8. Exercise: Getting some level of activity in each day increases our heart rate and gets our blood pumping much more efficiently. With increased blood flow, our skin benefits by gaining more oxygen, growing new cells, and producing more collagen to improve elasticity and smoothness.
9. Non-irritating Soaps and Cleansers: Soaps and face washes that contain fragrances or exfoliating properties tend to have more chemicals, and thus more irritating factors for the skin. Minimize scented products, especially for the face, as much as possible to prevent excess redness and drying throughout the winter.
10. Don’t miss the lips: Dry and cracked lips are never fun to deal with, and cold air only seems to make it worse. In addition, avoid picking, licking, or biting the lips to prevent further cracks and irritation. Consider using daily Vaseline or other lip balms and ointments, especially overnight, to keep the lips hydrated and smooth.

For more information, refer to the American Academy of Dermatology or www.aad.org.

www.washingtonpost.com/health/winter-seriously-dries-out-your-skin-cold-air-and-heating-systems-are-to-blame

www.aad.org/public/everyday-care/skin-care-basics/dry/heal-dry-chapped-lips

www.everydayhealth.com/skin-and-beauty/top-tips-for-healthy-winter-skin.aspx

Mia Woloszyn, MD3 Mia Woloszyn is a native of Madison Twp, PA. She graduated from Scranton Preparatory School in 2015 and attained of Bachelor of Science in Biology from the University of Scranton in 2019. She is currently a 3^rd year medical student at Geisinger Commonwealth School of Medicine. Her clinical interests include Dermatology, Primary Care, and Preventative Medicine.

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

For all of Dr. Mackarey's Articles visit: mackareyphysicaltherapy.com/forum/

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 past Saturday was the first day of regular firearms deer season. It is considered to be a holiday in the state of Pennsylvania as approximately, 750,000 hunters from age 12 to seniors (including myself) will hike through the woods in search of a whitetail.

I am a whitetail, turkey, small game hunter, and an avid outdoors enthusiast with great passion for mountain biking, kayaking, whitewater rafting, hiking and mountain climbing in our state and national parks. After an extended period of time away from hunting (in the off season), I am eager to be back in the woods. When possible, I try to make time to shed hunt and scout in preparation for the upcoming season. While I am active during the summer, I am not necessarily in “hunting shape” and certainly not acclimated to cold, wet and windy conditions. With this in mind, I offer health and safety tips for hunters based on the knowledge of experts in the field and my expertise as a health care provider. Good luck and be safe!

Common Health Problems for Hunters:

• Chest Pain/Shortness of Breath – overweight and deconditioned people must be very careful when overexerting themselves in the woods while hunting. This is especially true for those with a history of heart disease. Make sure you take your medication and drink plenty of fluids 24 hours before and while hunting. Eat a good breakfast with a balance of protein and carbohydrates. A bagel with peanut butter is a good quick start. Pack healthy snacks and water to sustain you.
• Knee Pain- in the front of the knee or knee cap is common with hunting. This can happen from excessive hiking on uneven or hilly terrain in the woods, especially if there is weakness in the leg muscles. When walking down hills try this simple trick to keep your knees safe. Slightly bend at the knees and bring your buttock back so your knees stay over (or slightly behind) your toes to reduce stress on the joint.
• Neck, Lower or Middle Back Pain- can be caused by prolonged hiking with a heavy load or prolonged sitting in a tree stand in slouched positions, especially if one has tight hamstrings. Field dressing and carrying the deer out of the woods is also very stressful on the back. Take multiple breaks and stretch backwards, (the opposite direction of bending over to drag the deer). Also, consider where you want to position your hunt, avoid large hills that you may have to drag the deer up on the way out.
• Shoulder Pain- can occur from recoil of a gun shot or the overhead activity of climbing a tree.
• Hamstring Pain- can occur if the muscle is tight or weak. Prolonged walking, bending over and large steps over fallen trees can contribute to this problem. When free walking in the woods, look for the path of least resistance.
• Ilio-Tibial Band Pain- when walking on the side of a hill there is a difference in the length of the legs. Overtime, this can lead to pain on the outside of the hip and leg.
• Foot Numbness or Pain- can occur from prolonged squatting or poor fitting shoes/boots. However, lower back pain can also be associated with these symptoms.
• Hand Numbness or Pain- can be caused by repeated recoil of the gun on the shoulder. Also, this may be associated with prolonged pressure of a shoulder strap or leaning on something under the arm.

Preparing Your Body for Hunting

• Prevention is the best management of most musculoskeletal and safety problems associated with hunting. First, one can prevent many of the above problems through proper fitting of equipment, clothing and shoes/boots.
• Fitness - Be sure to maintain a fairly good fitness level in order to hunt safely. Begin an exercise and walking program 2-3 months before hunting season. If you are a beginner, start slowly. Warm up and slowly walk for 10 to 15 minutes and build up over time. Slowly add hills to your walking program.
• Clothing - Wear your hunting clothing, such as boots to break them in while walking for exercise. Drytech clothing instead of cotton can keep you warm and wick moisture away from the body.
• Move & Stretch - As hunters, we sit in our stand or blind and stay still for long periods of time in cold temperatures. This results in a cold and stiff body. When leaving your setup, give you body time to wake up before you start hiking out. Bend the knees or perform small squats repeatedly to get blood and warmth back into the legs. Stretch your spine backwards (the opposite of sitting) to prepare your spine for your heavy pack and do some heel raises for the ankles.
• Strength Exercises - Work on the strength and flexibility of the quadriceps, calf and gluteal muscles. Instead of using the elevator, climb stairs throughout the day to work these muscles. Be careful not to progress too quickly because a drastic change from inactivity to over activity in a short period of time can create problems.
• Be Aware - Know your limitations and adapt to them. Injuries most commonly occur when we overestimate what our body can do or choose to push through pain. Listen to your body, if you have pain, stop and modify your activity. In addition, scout areas that are more easily accessibly in the woods that will still attract deer. This will lead to less stress on your body and when successful, you have an easier drag!
• Use technology to your advantage. Using hunting apps and maps such as HuntWise, OnX or HuntStand, can help give you an idea of the terrain you will be exposed to prior to entering the woods. It will be easier to map out a less strenuous approach into the woods and minimize the load you place on your body.
• Remember, hunting should be fun! Pain from poorly fitted and improperly maintained equipment and clothing can be avoided with good planning. Moreover, injury and death from inactivity and poor fitness is also preventable. 

Sources: www.pgc.state.pa.us

Guest Author: Paul Mackarey, Jr. PT, DPT is clinic director and partner at Mackarey & Mackarey Physical Therapy Consultants, Scranton and Clarks Summit, PA.

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

Get all of Dr. Mackarey's articles at: mackareyphysicaltherapy.com/forum/

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.

The “first Thanksgiving” was in 1621 between the Pilgrims of Plymouth Colony and the Wampanoag tribe in present day Massachusetts to celebrate the harvest and other blessings of the previous year. In 1789, President George Washington, at the request of Congress, proclaimed Thursday, November 26, as a day of national thanksgiving. In 1863, Abraham Lincoln proclaimed the national holiday of Thanksgiving to be the last Thursday of November.

Americans and Canadians continue to celebrate this holiday as a time for family and friends to gather, feast, and reflect upon their many blessings. Like most, I am very grateful for the simple things; family, good friends, food, shelter, and health. This year, I am also thankful for the dedicated scientists who developed the COVID 19 vaccination so we can safely enjoy Thanksgiving with my family. It turns out that being grateful is, not only reflective and cleansing, …it is also good for your health!

Grateful people are more likely to behave in a prosocial manner, even when it is not reciprocated. A study by the University of Kentucky found those ranking higher on gratitude scales were less likely to retaliate against others, even when others were less kind. Emmons and McCullough conducted one of the most detailed studies on thankfulness. They monitored the happiness of a group of people after they performed the following exercise:

There are many things in our lives, both large and small, that we might be grateful about. Think back over the past week and write down on the lines below up to five things in your life that you are grateful or thankful for.” The study showed that people who are encouraged to think of things they’re grateful for are approximately 10% happier than those who are not.

7 Proven Health Benefits of Being Grateful     

1. Being Grateful is Contagious! Studies show that something as simple as saying “thank you” to a stranger holding a door open for you or sending a co-worker a thank you note for helping you with a project makes them more likely to continue the relationship. Showing gratitude can improve your life by fostering solid friendships.
2. Being Grateful Improves Physical Health Research has found that those who are grateful experience fewer aches and pains and tend to report that they feel healthier than most people. Moreover, grateful people are more likely to be health conscious and live healthier lifestyles.
3. Being Grateful Improves Psychological Health Multiple studies have demonstrated that gratitude reduces many negative emotions. Grateful people have less anger, envy, resentment, frustration or regret. Gratitude increases happiness and reduces depression.
4. Being Grateful Fosters Empathy and Reduces Aggression Participants in a study by the University of Kentucky found that those who scored higher on gratitude scales were less likely to retaliate against others and were more sensitive and empathetic when compared to low gratitude scorers.
5. Being Grateful Promotes Better Sleep A study published in Applied Psychology, found that 15 minutes of writing down a gratitude list before bed led to better and longer sleep.
6. Being Grateful Improves Self-Esteem When studying athletes, it was determined that those who scored high on gratitude scales demonstrated improved self-esteem which led to optimal performance. Conversely, those athletes who were not grateful and resented contemporaries making more money, for example, had lower self-esteem and negative performance outcomes.
7. Being Grateful Improves Mental Strength Research has repeatedly shown that gratitude not only reduces stress, but also improves one’s ability to overcome trauma. For example, Vietnam veterans who scored higher on gratitude scales experienced lower incidences of post-traumatic stress disorder. Recognizing all you have to be thankful for, even during the worst times of your life, fosters resilience.

Conclusion:

Amy Morin, psychotherapist, mental health trainer and bestselling author offers this advice: “Developing an “attitude of gratitude” is one of the simplest ways to improve your satisfaction with life. We all have the ability and opportunity to cultivate gratitude. Simply take a few moments to focus on all that you have, rather than complain about all the things you think you deserve.” So…be grateful and have a happy Thanksgiving!

Source: NIH, Forbes, Amy Morin “13 Things Mentally Strong People Don’t Do.”

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!”

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.