October is National Breast Cancer Awareness Month. Due in great part to improved awareness and advances in treatment and early diagnosis, the survival rate continues to improve. The American Cancer Society relies on information from the Surveillance, Epidemiology and End Results (SEER) database to provide survival statistics for different forms of cancer.
While the overall 5-year survival rate for breast cancer is 90% and the 10-year survival rate is 84%, the survival rate for those fortunate to have early detection and treatment is even more encouraging. For example, when breast cancer is determined to be “localized” (no sign that the cancer has spread outside of the breast), the 5-year survival rate improves to 99%! AWARENESS AND EARLY DETECTION ARE CRITICAL!
Maintain Healthy Body Mass Index (BMI) – studies repeatedly show that obesity increases the risk of breast cancer. A healthy BMI for women falls between 18.5 and 24.9. To find out your BMI visit: www.calculator.net
Maintain a Healthy Diet – the Mediterranean Diet emphasizes plant-based foods such as vegetables, beans, whole grain, fruits, nuts and seeds, and plant-based oils, especially olive oil. Avoid sugared drinks, refined carbs and fatty foods and eat fish or chicken instead of red meat.
Limit Alcohol Consumption – While no alcohol consumption may be optimal, up to one drink a day for women is acceptable.
Avoid or Limit Hormone Replacement Therapy – Studies show that menopausal hormone therapy increases the risk of breast cancer. For those who must take hormones to manage menopausal symptoms, limit the time period to less than three years and avoid progesterone.
Consider Estrogen-Blocking Drugs – For women with a family history of breast cancer or those over 60, consulting your physician about the pros and cons of these drugs.
Do Not Smoke – Studies show that smoking increases the risk of breast cancer. Visit: smokefree.gov for help with smoking cessation.
Breast Feed – According to the scientific literature, women who breast feed for at least a year in total have less risk of developing breast cancer. So, breast feed as long as possible.
Participate in Research – What can you do to help? Participate in clinical trials studying new and more effective ways to detect and treat breast cancer. Visit the National Cancer Institute
Limit - Manage Stress - According to a recent long-term study, both men and women have a higher incidence of cancer in those who did not manage chronic stress well. Life is full of potential stress and it cannot be avoided. But, you can learn to handle stress better. Exercise, meditation, and counseling are some options to explore. Try Progressive Muscle Relaxation (PMR) videos.
Exercise – A recent study in the Journal of the American Medical Association from Harvard has found that regular exercise can improve the survival of patients with breast cancer.
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.
For all of Dr. Mackarey's articles visit our Health and Wellness Page!
As more of us become more comfortable living with COVID 19, travel plans have exploded. For 2 ½ years many have put air travel for family vacations on hold and we are eager to get back to air travel. As you may have gathered from my previous columns, travel is one of my passions. My family and I have been fortunate to have visited many spiritual places of natural wonder and beauty that we call our National Parks. Many of the parks are on the west coast and require some preparation to endure the many hours of travel by airplane through different time zones. Moreover, travel to other countries and continents, often requiring 8, 10, 16 or more non-stop hours on a plane can really take a toll on your mind and body and gave new meaning to the term “jet lag.”
According to the Mayo Clinic, jet lag, also known as jet lag disorder, is a sleep disorder that can occur in people who travel through different time zones in a short period of time, such as a flight from New York City to Los Angeles. Obviously, the further the distance traveled and the more time zones entered, the more significant and drastic the symptoms, as found, for example, in those traveling from the United States to Asia.
Sunlight has a direct impact on our internal clock by regulating melatonin, a hormone that regulates sleep and wake cycles in the body. Travel through different time zones can affect the amount and duration of sunlight and therefore, impact the regulation of these cycles. The inability to regulate the cycles results in many symptoms.
Posture exercises are designed to keep your body more upright and prevent rounded shoulders and forward head/neck.
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.
The 25th Steamtown Marathon is one month away! While the serious heat waves of summer may be behind us, any prolonged endurance activity in minimal to moderate heat can be dangerous if not prepared. Adequate hydration is critically important, not only to those training for a marathon but also for other outdoor endurance activities such as cycling, hiking, long distance power walking, etc
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.
The risk of dehydration is not limited to endurance athletes and outdoor enthusiasts. 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.
Is water adequate to prevent dehydration? Will a sports drink improve my performance? While some answers to these questions apply generally to all, others vary according to the temperature, humidity, length of time and intensity of the activity and condition of the athlete.
Proper hydration is essential for the comfort and safety of the recreational and serious athlete. Hydration is critical to maintain cardiovascular function, body temperature and muscle performance. As temperature, humidity, intensity, and duration of exercise increase, so too does the importance of proper hydration. Excessive sweating can lead to a loss of blood volume which requires the heart to work much harder to circulate you blood through your body.
Dehydration is a major cause of fatigue, loss of coordination, and muscle cramping leading to poor performance. Pre-hydration, (drinking before exercise) is the first step in preventing dehydration. Marathon runners, other long-distance runners, and cyclists often prehydrate1-2 days before a big event. Rehydration, (drinking during or after exercise) is the second step in preventing dehydration. While athletes may be more vulnerable to dehydration, all persons engaging in exercise would benefit from increased performance, delayed muscle fatigue and pain by maintaining adequate hydration. Proper pre-hydration would include drinking 12-16 ounces of water 1-2 hours before exercise. Athletes with other health issues should consult their family physician before engaging in long distance endurance sports.
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.
There are many reasons why losing weight, the number one health goal in America, is the most elusive. Not the least of these reasons is the psychology of eating…because in the land of plenty, we eat mindlessly! Consider the facts; first, we blamed it on the fact that the food was unhealthy…but when we chemically modify the food such as removing or altering the fat or sugar and removing the calories, it failed to reduce our weight. In fact, it has been discovered that “fake sugar,” even thought it does not have calories, can still increase blood glucose levels. Next, we decided fat cells were the enemy but we failed to control our weight when we removed fat cells from our body through liposuction. Then, we decided the problem was our digestive system so we placed bands or staples in the stomach or by-passed the small intestine. While these efforts helped many in the short run, long term, without a change in behavior, it failed as a long-term solution. Many medical professionals have concluded that the problems people have with weight are not exclusively due to the food, fat cells, stomach or intestines, but rather, THE MIND!
Mindful eating, also referred to as intuitive eating, is based on Buddhist teachings in which focus is placed on the experience of eating, AND ENJOYING, our food. The concept was presented in a feature column in The New York Times written by Jeff Gordinier based on his time spent in a Buddhist monastery. He discovered that mindful eating practitioners ate in silence and chew small pieces of food very slowly and deliberately to experience its taste, texture and smell. It requires full attention to the experience of eating and drinking on the body and mind. It is often referred to as “the opposite of diets” because with mindful eating there is not right or wrong way to eat but rather varying degrees of awareness about WHAT WE EAT AND WHY. Furthermore, the goal of this exercise is to teach our mind and body to connect and communicate while eating so one can learn important cues such as: what are my hunger signals? What does my stomach feel like when it is half, three-fourths and completely full?
One study of 1,400 mindful eaters found that they enjoyed lower body weights, greater sense of well-being and suffered from fewer eating disorders. However, many feel the concept, while valuable, is very difficult to put in practice in the busy American family. Research shows that, even when not perfectly relaxed, the simple act of the family meal can have a powerful impact on mindfulness, health and wellness.
In a country that thrives on a fast pace with over-book schedules, families struggle to balance work and school and after school sports and activities. Consequently, fast food, eat-and-go habits have become the norm. According to some studies, most find it difficult find time to sit and relax for a family meal even once a week. Additionally, when families do pull off a family meal, it is often overwrought with school drama, sibling rivalry, and parental discipline about school, homework or social activities, making the situation stressful. Despite the family conflict, studies strongly support the health values of the family meal.
A recent study from Columbia University that received national attention found that children who participated in a family meal regularly were less likely to have problems with drugs or alcohol and more likely to excel in school. Moreover, those children eating with their families at least 5 times per week benefited most. Other studies have found that the there is a significantly lower incidence of teens who smoke, use alcohol, have sex at a young age, fight, get suspended from school or commit suicide among those who have meals with their family on a regular basis.
| Mindless Eating | Mindful Eating |
| 1. Eating past full and ignoring body signals | 1. Listening to your body and stopping when full |
| 2. Eating when emotions tell us to eat | 2. Eating when our bodies tell us eat |
| 3. Eating alone, at random times and places | 3. Eating with others, set times and places |
| 4. Eating emotionally comfort foods | 4. Eating nutritious and healthy foods |
| 5. Eating and multitasking | 5. When eating, just eat |
| 6. Considering a meal an end product | 6. Considering where food comes from |
– by Christopher Willard PsyD
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
Read all of Dr. Mackarey's Articles at: https://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.
Covid-19 has certainly redefined the workplace as many employees continue to work from home. Prolonged hours sitting at a workstation that may not be optimal has also changed the way we define workplace health and safety. It may be more important than ever to pay close attention to designing an ergonomic workstation, changing position, and stretching regularly to prevent injury.
Since 1894 Labor Day has been designated as the national holiday that pays tribute to the contributions and achievements of American workers. Research supports the notion that healthier employees are happier and more productive. When employers encourage healthy behavior and safety at work, they benefit in many ways. For example, in addition to improving job satisfaction and productivity, healthy employees save money by using less sick time, worker’s compensation benefits and health benefits. For example, according to the Centers for Disease Control and Prevention, approximately 75 percent of employers” health care costs are related to chronic medical problems such as obesity, diabetes, high blood pressure, and high cholesterol. Deconditioned, overweight employees are more likely to suffer from these preventable conditions and are at greater risk for injury. Employers, please consider using this holiday as an opportunity to start a health promotion program at your workplace…have a health fair, offer healthy snacks, encourage walking, smoking cessation, exercising at lunch, and offer fitness club stipends.
Lower back pain, one of the costliest illnesses to employers, is one example of a problem which can be prevented with a good health and safety program. It is widely accepted in the medical community that the best treatment for lower back pain (LBP) is prevention. Keeping fit, (flexible and strong), practicing good posture, and using proper body mechanics are essential in the prevention of LBP. At our clinic, significant time and effort is spent emphasizing the importance of these concepts to our patients, employees, and the businesses we work with through industrial medicine programs. A comprehensive approach can produce significant reductions in LBP injuries through an onsite safety program which promotes education, wellness, body mechanics, lifting techniques, postural and stretching exercises and ergonomics.
Visit your doctor regularly and listen to your body.
NEXT MONDAY – Read Dr. Paul J. Mackarey “Health & Exercise Forum!”
This article is not intended as a substitute for medical treatment. If you have questions related to your medical condition, please contact your family physician. For further inquires related to this topic email: drpmackarey@msn.com
Paul J. Mackarey PT, DHSc, OCS is a Doctor in Health Sciences specializing in orthopaedic and sports physical therapy. Dr. Mackarey is in private practice and is an associate professor of clinical medicine at GCSOM.
For all of Dr. Mackarey's articles visit: mackareyphysicaltherapy.com
This is the third of three columns dedicated to healthcare for college students. Please find these “10 Tips to Keep Yourself Healthy in College” helpful. However, no discussion regarding the health and wellness of college students would be complete and thorough without addressing what health care and university experts consider the two most dangerous behaviors on college campuses across the nation: binge drinking and unprotected sexual activity. While it is not my intent to offend the religious and moral values of any reader, it is my purpose to provoke direct and meaningful conversation between parents, religious leaders and students. To prevent serious health problems in college, parents must share their experience and discuss their values regarding sexual activity and alcohol consumption with children before they leave home to live independently in college. If you are unable to have a direct conversation about these issues, consider doing what several readers have done; mail a copy of this column to your child!
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.
For all of Dr. Mackarey's articles visit our Health Care Forum!
This is the second of three columns dedicated to healthcare for college students. As part of the preparation, think about a first aid kit, health care history, and insurance file. For parents without other children at home, once you finish with these preparations and your child departs for college away from home, plan to take dance, art history and conversational Italian classes to occupy your time without children. Resist the temptation to be a helicopter parent…life goes on!
Remember, in living a large community and sharing close quarters makes the development and spread of disease a natural progression. College life can be very unhealthy for many reasons: lack of sleep, poor eating habits, poor hygiene and stress.
Last week we discussed common illnesses among college students, how to manage and when to seek professional help. Below you will find a list of symptoms that should never be ignored. The college health services department should be contacted if you have any of the following symptoms:
Get a small/medium plastic storage box and use it to keep all of the following health care items together in one place.
NEXT MONDAY – Read Dr. Paul J. Mackarey “Health & Exercise Forum!” Next Week: “Health Tips for College Students – Part III”
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: www.mackareyphysicaltherapy.com/forum
It is hard to believe it is that time of year when parents and students are preparing to return to school. Many will leave home for the first time as college freshmen. Over the past month I have received several requests for a copy of my three part series of columns on health tips for college students. In view of this, I thought other parents preparing to send a child off to college this fall might also find this information valuable.
To fully appreciate the importance of this topic, one must keep in mind that living in a large community and sharing close quarters is the first ingredient in the development and spread of disease. College life can be very unhealthy for many reasons. Lack of sleep, poor eating habits and stress add spice to the recipe for disease. Lastly, poor hygiene added to the equation, will really get the Petri dish cooking up some nasty germs.
These are caused by viruses. While both are similar flu symptoms are typically more severe.
Cold Symptoms: coughing, sneezing, watery eyes, mild fevers
Flu Symptoms: high fever (above 102 degrees), body aches, dry cough, upset stomach or vomiting
Covid-19 Symptoms: can appear 2-14 days after exposure and can vary from mild to severe; fever, chills, cough, shortness of breath, fatigue, muscle or body aches, headache, loss of taste or smell, sore throat, congestion or runny nose, nausea or vomiting, diarrhea
Cold & Flu Treatment: rest, plenty of fluids, and treat symptoms. Consult your physician or college health services for the best medicines to control your symptoms. Caution should be used when taking excessive flu meds containing aspirin because an increase in complications (Reye Syndrome) are associated with the flu in college students.
Covid-19 Treatment: get tested and isolate if positive. Contact the college health services to discuss isolation and treatment protocols. If you have mild to moderate symptoms an antiviral may be recommended. Otherwise, over-the-counter nonsteroidal anti-inflammatory drugs may be adequate with rest and fluids
Prevention: While it is not possible to prevent getting a cold or flu, you can take precautions, such as washing your hands and getting a flu shot. Get full vaccinated for Covid-19. And, depending on school protocols and infection rates, MASK UP!
Symptoms: very sore throat, pain in the ears or sinuses, persistent fever
Treatment: These symptoms require a visit to the college health services department. You may need to take antibiotics. If so, take as directed and take all of them or you may have a relapse.
Prevention: Avoid close contact with infected people – no kissing, sharing drinks or eating utensils. Wash your hands, get plenty of rest.
Meningitis is a common form of this disease that can infect the brain, spinal cord and/or blood
Symptoms: high fever, stiff neck, severe headache, a flat, pink or purple rash, nausea and vomiting, as well as sensitivity to light
Treatment: Immediate medical treatment is required. This disease is serious it can be fatal or cause permanent brain damage.
Prevention: It is strongly recommended that all teens, especially incoming freshman college students, receive a vaccine to prevent the infection of most, but not all, strains of bacteria that cause this disease.
Mono is caused by a virus and is also known as the “kissing disease.” It is very common among college students.
Symptoms: fever, sore throat, headache, swollen lymph nodes (glands) in the neck, extreme fatigue.
Treatment: If a sore throat or flu symptoms do not resolve in 7- 10 days, see your doctor for a blood test called the “monospot.” While there is nonspecific treatment, plenty of rest and a healthy diet are essential. Medication to control symptoms can also be used.
Prevention: Plenty of rest, healthy diet, good hygiene
These are very common in healthy, active college students and are rarely serious.
Symptoms: Bruises: a bump or bruise can cause the skin to turn purple, brown or red in color. Strains: are injuries to muscles or tendons from overuse or sudden overstretching. Sprains: are injuries to the ligaments which connect the bones. It can be caused by a twist or fall or awkward sudden movement.
Treatment: RICE: Rest, Ice, Compression, Elevation
If the pain or swelling is not improved in 1-2 days, or if you cannot bear weight on the extremity, visit the college health services dept.
Prevention: While it is important to be physically active, one must do so intelligently:
NEXT MONDAY – Read Dr. Paul J. Mackarey “Health & Exercise Forum!” Next Week: “Health Tips for College Students – Part II”
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 articles visit: www.mackareyphysicaltherapy.com/forum
It is two months away from the 25th Steamtown Marathon. This column is dedicated to those dedicated runners preparing for the big day, Sunday, October 9, 2022.
Congratulations and thank you to Bill King, founder and race director, and his band of brothers, for their tireless efforts organizing and sustaining a great race that instills pride for all people of NEPA. It has inspired many people, including me, to transfer the discipline and determination required to complete a marathon by overcoming challenges one mile at a time.
Now, a little marathon history: In 490 B.C. Phedippides, ran 25 miles from Marathon to Athens to deliver an important military message and died immediately. Ironically, the first marathon of the modern Olympic Games in 1896 in Athens was won by Spiridon Louis, a humble Greek peasant, who stopped along the way for a glass of wine and told the owner of the tavern that he would win the race. He was determined to pace himself properly, as he knew the dusty, hilly path better than anyone in the field. He was greeted with jubilation and become a hero and legend.
Visit your doctor regularly and listen to your body.
NEXT MONDAY – Read Dr. Paul J. Mackarey “Health & Exercise Forum!”
This article is not intended as a substitute for medical treatment. If you have questions related to your medical condition, please contact your family physician. For further inquires related to this topic email: drpmackarey@msn.com
For all of Dr. Mackarey's articles visit: www.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 GCSOM.
It is August and summer is rapidly passing! So, get outdoors and have fun in the sun. However, please be mindful of how your body reacts to high humidity and heat and take appropriate precautions. Athletes are particularly vulnerable this time of year due to daytime practice sessions. (August 8, 2022, first day of acclimatization and August 15, 2022, first day of practice for fall sports according to PIAA), Keep in mind, you don’t have to be running a marathon or playing football in full uniform to suffer from heat stroke.
Heat stroke, one of the most serious heat-related illnesses, is the result of long term exposure to the sun to the point which a person cannot sweat enough to lower the body temperature. The elderly and infants are most susceptible and it can be fatal if not managed properly and immediately. Believe it or not, the exact cause of heatstroke is unclear. Prevention is the best treatment because it can strike suddenly and without warning. It can also occur in non athletes at outdoor concerts, outdoor carnivals, or backyard activities.
Some “old school” folks think that wearing extra clothing and “breaking a good sweat” is an optimal goal for exercise. However, it may be potentially very dangerous in hot and humid conditions. When exercising in hot weather, the body is under additional stress. As the activity and the hot air increases your core temperature your body will to deliver more blood to your skin to cool it down. In doing so, your heart rate is increased and less blood is available for your muscles, which leads to cramping and other more serious problems. In humid conditions, problems are magnified as sweat cannot be evaporated from the skin to assist in cooling the body.
The American Academy of Pediatrics and The American College of Sports Medicine has the following recommendations which are appropriate for both the competitive athlete and weekend warrior:
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: www.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 in downtown Scranton and is an associate professor of clinical medicine Geisinger Commonwealth School of Medicine.
