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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 3rd 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:

Preparing Your Body for Hunting

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.

Dance Like Nobody’s Watching!

“Dance like nobody’s watching!” This is one of my favorite quotes from Mitch Albom’s book, Tuesdays With Mori, because it represents interesting facts about human behavior. One, of course, is the ability to be comfortable in your own skin. The other, maybe less obvious benefit, is that challenging your balance through dancing, even if it’s not pretty, is very effective in maintaining or improving quality of life for those with challenges in gait and balance, as found in Parkinson’s disease (PD). In fact, “Dance for PDR”, a new and popular treatment for PD, has recently been validated in the scientific literature as a valuable treatment tool for those with PD. 

The Research

Research published in the Journal of Neural Transmission, shows that dancing is shown to help people with PD improve their ability to walk and enhances their quality of life. The program was applicable to those at various stages of PD, including those using walkers. Moreover, the results found that, in addition to physical improvements, participants also had psychological and social benefits through camaraderie, joy of movement and less isolation.

Participants, none of whom had never engaged in a dance class before, performed a structured dance program for 16 sessions over 8 weeks. Each class was 75 minutes long with seated warm-up activities 50% of the time.  Results showed: 10% improvement in overall movement, 26% improvement in walking and 18% improvement in tremor.

What is Parkinson's Disease?

Parkinson’s disease is a chronic, degenerative disease that leads to slowness of movement, balance disorders, tremors, and difficulty walking. PD results from the loss of dopamine-producing nerve cells in the brain. Dopamine is critical to stimulate the nerves of the muscular system in the body. PD affects approximately 1.5 million people in the USA with 60,000 new cases each year according to the National Parkinson Foundation. Most people know someone affected by PD.  PD typically affects those over 65 years of age and only 15% are under 50.

While there is no current cure for PD, exercise is well documented to relieve some of its symptoms. Specifically, exercise can help keep muscles strong, joints mobile, and tissues flexible. Exercise will not stop PD from progressing but it will improve balance, enhance walking ability, reduce muscle weakness, and minimize joint stiffness. In 2007, a study published in the Journal of Neuroscience revealed that exercise may benefit individuals with PD because exercise encourages the remaining dopamine cells to work harder to produce more dopamine. Also, the researchers discovered that exercise decreases the rate at which dopamine is removed from the brain.  

Exercise and DANCE!

Exercise to improve strength, balance, and flexibility can be performed independently at home or supervised at a rehab or exercise facility. Supervised exercise can include physical therapy, recreational therapy, water therapy, yoga, and Tai Chi. Physical therapy can improve walking ability, enhance balance, reduce fatigue, increase strength, promote flexibility and minimize pain. Physical therapy uses movement techniques and strategies as well as various pieces of equipment to enhance an individual’s level of independence and improve his quality of life. PT can also incorporate leisure activities (e.g. golfing and ballroom dancing) to reduce the symptoms and associated limitations of PD. Tai Chi, a total mind and body workout, is a series of individual dance-like movements linked together in a continuous flowing sequence. Particular benefits for people with PD include reduced stress, increased energy, improved concentration and focus, better circulation and muscle tone, and significant improvements in balance.

Just Dance!

According to Dance for PDR, their program offers internationally-acclaimed dance classes for people with Parkinson’s disease in Brooklyn, New York and, through a network of partners and associates, in more than 120 other communities and 16 countries. In Dance for PD classes, participants are empowered to explore movement and music in ways that are refreshing, enjoyable, stimulating and creative. For more information visit: www.danceforpd.org

So, if you like to dance, “keep on dancing!” If you don’t dance and notice some changes in balance and coordination, or if you have PD…it’s a good time to start!  “Dance like nobody’s watching!”

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 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: https://mackareyphysicaltherapy.com

Part I of II

What is Parkinson's Disease (PD)

Parkinson’s disease (PD) is a chronic, degenerative disease that leads to slowness of movement, balance disorders, tremors, and difficulty walking. PD results from the loss of dopamine-producing nerve cells in the brain. Dopamine is critical to stimulate the nerves of the muscular system in the body. PD affects approximately 1.5 million people in the USA with 60,000 new cases each year according to the National Parkinson Foundation. Most people know someone affected by PD.  PD typically affects those over 65 years of age and only 15% are under 50. However, actor, Michael J. Fox brought national attention to the disease in 1991 when he was only 30 years old. Juvenile Parkinson’s, those diagnosed under the age of 40, is rare and only represents 7% of all those with PD.

Is There a Cure?

While there is no current cure for PD, exercise can relieve some of its symptoms. Although PD affects an individual’s ability to move, exercise can help keep muscles strong, joints mobile, and tissues flexible. Exercise will not stop PD from progressing but it will improve balance, enhance walking ability, reduce muscle weakness, and minimize joint stiffness. In 2007, a study published in the Journal of Neuroscience revealed that exercise will benefit individuals with PD because exercise encourages the remaining dopamine cells to work harder to produce more dopamine. Also, the researchers discovered that exercise decreases the rate at which dopamine is removed from the brain.  

How do we Treat PD?

Depending on the stage of the disease and the level of assistance required, exercise to improve strength, balance, flexibility and ambulation for those with PD, can be performed independently at home or supervised at a rehab or fitness facility. Supervised exercise can include physical therapy, recreational therapy, water therapy, yoga, and Tai Chi… AND DANCE! Physical therapy can improve walking ability, enhance balance, reduce fatigue, increase strength, promote flexibility and minimize pain. Physical therapy uses movement techniques and strategies as well as various pieces of equipment to enhance an individual’s level of independence and improve his quality of life. Recreational therapy incorporates leisure activities (e.g. golfing and ballroom dancing) to reduce the symptoms and associated limitations of PD. Recreational therapy adapts these activities to meet the specific needs of the person with PD. The modified activities are taught by professionals who have significant knowledge and experience in this area. Water therapy is especially helpful to people with PD because the water provides enough buoyancy to lessen the amount of balance required to perform essential exercises. The cushioning effect of the water allows for freedom of movement while providing the appropriate level of resistance necessary to achieve the desired results. Using a combination of physical and mental exercises, yoga promotes flexibility, reduces stress levels, and increases stamina and strength in individuals with PD. Tai Chi, a total mind and body workout, and is a series of individual dance-like movements linked together in a continuous flowing sequence. Particular benefits for people with PD include reduced stress, increased energy, improved concentration and focus, better circulation and muscle tone, and significant improvements in balance.

Exercising With PD

If you choose the convenience of a home exercise program, consult your physician or physical therapist for recommendations regarding: (1) the types of exercise best suited for you and those which you should avoid, (2) the intensity of the workout, (3) the duration of your workout, and (4) any physical limitations you may have.

The type of exercise that works best for you depends on your symptoms, fitness level, and overall health.  Your exercise program should address not only strength but also flexibility and endurance and should include all body parts: face, mouth, neck, torso, arms, legs, hands, and feet. Some general exercise suggestions include:

Since individuals with PD are at risk for falling and freezing (becoming rigid), work out in a safe environment and, if possible, when someone is present. Avoid slippery floors, poor lighting, throw rugs, and other potential dangers (e.g. watch out for the pooch because he might want to join in the fun).  If you have difficulty balancing, exercise sitting down, lying on the bed or within reach of a grab bar or securely installed rail. Stop and rest if you feel tired during your exercise program since overexertion can make your PD symptoms worse.

Contributions: Janet Caputo, DPT, OCS,

NEXT MONDAY – Read Dr. Paul J. Mackarey “Health & Exercise Forum!” Next Week: Part II of II: Dance for Parkinson ’s Disease.

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

Lung Cancer is a deadly disease. Until recently, a chest X-ray, often used only after patients developed symptoms, discovered the disease when it was in its late stages. Over the past few years, however,  an effective and safe screening test has been developed and those who are at high risk for lung cancer can now be screened annually using low-dose spiral CT scans.

Lung Cancer Facts:

FACT 1: Each year over 250,000 people in the United States are newly diagnosed with lung cancer.

FACT 2:  90% of individuals who have lung cancer will eventually die of the disease, making lung cancer the most deadly cancer in the United States for both men and women. 

FACTS 3:  85% of all lung cancers are caused by smoking.

FACT 4:  According to the Pennsylvania Department of Health, 22% of people aged 18 years and older residing in Northeastern, PA smoke.  

FACT 5: The best prevention measures are; not smoking or using tobacco products, and avoid second-hand smoke or high air pollution environments.

One of the reasons for the high mortality rate in lung cancer is that the disease is often not discovered until it is advanced and treatment options are limited. Some of the most common signs and symptoms of lung cancer are easily mistaken either for a mild illness or for things such as “smoker’s cough”.  By the time many patients are diagnosed, their disease is advanced and may involve lymph nodes or other organs. 

For some cancers, there are established screening tests that help to identify these cancers at an earlier stage.  For example, routine screenings through colonoscopies, mammograms, and pap smears are well established and have saved thousands of lives.  Historically, lung cancer has not had such a screening test. This however, is about to change. This past summer, the United States Preventative Task Force (USPTF), an independent committee charged by congress to evaluate the most current data and make recommendations for disease screening, released a draft of a new proposal for a lung cancer screening test.

The USPTF now recommends that all persons who are at high risk for lung cancer should be screened annually using low-dose spiral CT scans.  High risk persons are identified as those who are between the ages of 55 and 79, who have a history of 30 pack years or more of smoking, and who are either still smoking or who have quit within the last 15 years.  A “pack year” is defined as smoking 1 pack of cigarettes a day for a year. For example, a person could have 30 pack years of smoking if they smoke 1 pack of cigarettes a day for 30 years.  Similarly, they could have a 30 pack year history by smoking 2 packs of cigarettes a day for 15 years.

CT, or computed tomography, scans are a form of three-dimensional imaging used by clinicians to visualize the organs and other anatomy of patients.  The scan can detect abnormalities on a patient’s lung with much earlier and with greater sensitivity than an x-ray.  Much like a mammogram, low-dose CT scans do not diagnose cancer but are a way to identify patients with abnormalities that need to be investigated further for the possibility of cancer.  This new screening test will allow physicians to see possibly cancerous abnormalities of the lung before the disease can spread and become impossible to cure.  The scan is non-invasive and generally considered very safe. Low-dose CT scans carry about 5 times less radiation than traditional high-dose CT scans and are equivalent to about 15 x-rays.

It is projected that this new screening practice will save the lives of between 15 and 20% of those diagnosed with lung cancer by detecting cancers before they can progress to the point that they are resistant to medical treatment.  The draft of the new proposal for lung cancer screening that the USPTF released this summer was based off of a landmark article in The New England Journal of Medicine in 2011. Once the final document is published, clinicians will be encouraged to adopt these screening practices and insurance companies will use these recommendations to adopt their policies regarding coverage for testing.

While this screening is a major step in the detection and treatment of lung cancer, it is not a substitute for quitting smoking.  The best proven methods to prevent lung cancer and its deadly consequences is to not smoke, use other tobacco products, and avoid exposure to second-hand smoke.

If you or a loved one need help quitting tobacco products, you may contact your physician or call 1-800-QUIT-NOW or visit www.lung.org.  For more information on the new lung cancer screening guidelines visit: www.cdc.gov

Signs and Symptoms of Lung Cancer:

NOTE: These signs and symptoms can be attributed to many different causes and are not exclusive to lung cancer. Always discuss your symptoms with your physician.

Who should be included in annual low-dose spiral CT screening for lung cancer?

Patients who fit all of the below criteria:

*A pack year is defined as 1 pack of cigarettes per day for a year

Medical Contributor: Sarah Bashaw, MD is a graduate of TCMC (presently GCSOM).

Medical Reviewer: Greg Cali, DO, Pulmonologist, Dunmore, PA

Read “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/forum/

What you eat, drink can affect meds

Most people know that some medicines don’t work well together. However, many may not be aware that what you eat and drink can have an effect on some drugs, too. Natural herbal supplements and other over the counter drugs can also have serious interactions with your prescribed medications. So, it might be wise to talk with your physician or pharmacist to see if there’s anything you should stay away from before you take a medication for the first time.

Grapefruit

This otherwise benign citrus fruit changes the way certain cells in your gut break down and metabolize medication through your body -- it can affect more than 50 drugs. It can make some, like fexofenadine (Allegra) for allergies, less effective and make others too strong, including ones that lower your cholesterol like atorvastatin (Lipitor).

Milk

Some dairy products, like milk, can make it harder for your body to process certain antibiotics. Minerals in milk like calcium and magnesium are part of the reason, along with the protein casein. If you’re taking antibiotics, ask your physician or pharmacist about the foods or beverages you should stay away from.

Licorice

Licorice is a popular herbal remedy for digestion and to flavor foods. But glycyrrhizin, a chemical in licorice, can weaken the effect of some drugs, including cyclosporine, used to keep people who’ve had transplants from rejecting their new organs.

Chocolate

According to sources at WebMD, dark chocolate can weaken the effects of drugs meant to calm you down or make you sleep, like zolpidem tartrate (Ambien). It also can boost the power of some stimulant drugs, like methylphenidate (Ritalin). And if you take an MAO inhibitor, used to treat depression, it can make your blood pressure dangerously high.

Alcohol

Alcohol can make certain drugs less effective or even useless, including some blood pressure and heart medicines. It also can make others stronger than they should be or cause dangerous side effects.  

Coffee

Coffee, while typically enjoyable and harmless, contains caffeine which can affect the levels of antipsychotic drugs like lithium and clozapine. It can also but boost the effects (and side effects) of other drugs such as: aspirin, epinephrine (used to treat serious allergic reactions), and albuterol (taken by inhaler for breathing problems). Additionally, it can make it harder for your body to take in and use iron.

Iron Supplement

Iron supplements can lower the effects of levothyroxine (Synthroid), a medicine that gives you thyroid hormone when your body doesn’t make enough (a condition called hypothyroidism). If you take this medication and a multivitamin, check to see if the vitamin has iron in it. If you need an iron supplement, ask your physician or pharmacist if you can take your medication at different times.   

Antihistamines

These drugs help with the sneezing and runny nose caused by allergies and are in most cases safe to use. However, when they are combined with other medications it can make blood pressure medications less effective and raise your heart rate. Talk to your physician or pharmacist about other ways to manage your allergies if you take blood pressure medicine safely and effectively.

Vitamin K

Vitamin K is the antidote to reverse anticoagulation. So, if you take the drug warfarin, (Coumadin) which is used to treat and prevent blood clots, be aware of how much vitamin K you take in. It can make the blood thinning drug less effective and put you at higher risk of a dangerous blood clot. Broccoli, Brussels sprouts, kale, parsley, and spinach are some of the most common foods high in vitamin K. Try to eat the same amount of these foods every day so the level of warfarin in your blood stays the same.

Ginseng

Ginseng, can also lower the effects of warfarin (Coumadin), putting you at risk for blood clots. And it can make you more likely to have internal bleeding, especially if you take antiplatelet medications (blood thinners) such as heparin or aspirin, as well as nonsteroidal anti-inflammatory drugs like ibuprofen or naproxen. For those who take MAO inhibitors, ginseng can cause headaches, sleep problems, hyperactivity, and nervousness.

St. John's Wort

While taken by many people with depression, this herbal remedy has not been a proven treatment for that, or any other health condition and it is not benign It increases the action of specific liver enzymes (things that boost certain chemical reactions in your body) that can weaken some medications. Those include cholesterol drugs (Lovastatin and Mevacor), the erectile dysfunction drug sildenafil (Viagra), and digoxin (Lanoxin), used to treat certain heart conditions. These are just a few of the many medications St. John’s Wort can affect.

Ginkgo Biloba

As with St. John’s Wort, while used by many to help with or prevent high blood pressure, dementia, ringing in the ears (tinnitus), and other conditions, there is no research that supports its value. It can weaken the effect of drugs used to control seizures, including carbamazepine (Tegretol), and valproic acid (Depakote). Ginkgo biloba also has natural blood thinning properties that can increase your risk of bleeding, especially if taken with other blood thinning medications such as aspirin, ibuprofen, warfarin (Coumadin) and clopidogrel (Plavix).

Conclusion

According to WebMD, only about 50% of medication is taken as it’s prescribed. People often take less than they need, take it at random times, or leave big gaps between doses -- all of which can weaken the effects. Make sure you understand your treatment plan and follow your physicians instructions. Moreover, the use of some supplements, as well as what you eat and drink, may have a serious impact on the safety and efficacy of your medications…when in doubt; ask your physician or pharmacist!

Sources: WebMD; National Institutes of Health

Guest Contributor: Dr. Carina Mackarey Pharm.D. is a doctor of pharmacy and clinical pharmacist at Wilkes-Barre VA and Primecare Pharmacy Services in Scranton.

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

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.

A routine visit to your primary care physician can be overwhelming. In addition to countless forms about insurance and privacy, endless questions about your medical history can be exhausting. A plethora of questions about your medical history is followed up by the health conditions of your closest relatives. While it may seem intrusive and laborious, the health conditions of your parents, grandparents, siblings, aunts and uncles can help them know what to be on the lookout for with you. For example, if your mother has high blood pressure, they might want to keep a closer eye on yours.  Both nature (your genes) and nurture (your family’s lifestyle) can have an effect on your health -- and you get both from your parents.

It is important to disclose any ongoing conditions (like diabetes or asthma) or serious illnesses (like cancer or a stroke) your parents, grandparents, and siblings have or had and how old they were when the health problem started. If any of them have passed away, let your doctor know their cause of death and how old they were when they died. They also may ask about things like your family’s lifestyle or diet, because relatives tend to have these in common.

Health Conditions That Run in Families

Just because a close relative had a certain condition or illness, that doesn’t necessarily mean you will have it. However, your chances are slightly higher than other people’s. Some health issues that can be passed down include:

Ethnicity and Health Conditions

Ethnicity refers to the cultures, customs and lifestyle choices of certain groups more than in the general population. Your doctor may ask about your race because people who have roots in certain parts of the world are more likely to have some conditions. For example, African-Americans have a higher chance of having sickle cell anemia and high blood pressure, Caucasians have a higher incidence of cystic fibrosis and Jewish people from Eastern Europe are more likely to carry the BRCA gene mutation and be born with Tay-Sachs disease.

Finding Your Health History

Many people do not know much about their family medical history for a variety of reasons.  If possible, ask your closest relatives about their health and the health of other family members such as; aunts, uncles, or cousins. If you’re lucky someone may have kept a family tree, baby books, or other keepsakes that could be of value. If that doesn’t work, there are other options in an internet age;

Help Online

The U.S. Surgeon General’s office has an easy way for you to collect this kind of information. It’s called My Family Health Portrait. It helps you make a kind of family medical tree that you can share with relatives and download to take to your doctor.

Getting Records

Information about your relatives can often be found in death certificates or medical records such as age at death, cause of death, and ethnic background. The rules are different for each state, but close family members are often allowed to order copies of these. Obituaries, which are often posted online, may also have some information. 

Ancestry Research

For those who don’t know much about your relatives and don’t have time to research it on your own, there are companies that can help fill out your family tree. Once you know the names of your relatives, you can try to contact them or find obituaries or death certificates.

Genetics

For some, it may be helpful or necessary to have genetic or DNA testing performed. A conversation with your primary care physician will help make an informed decision.

For Those Without a Detailed Medical History

Not everyone will be able to provide a thorough and comprehensive medical history for their physician. For example, adopted children or those who lost parents at an early age often lack access to a strong family history. Do your best to talk to your doctor about the information you do have or tell them that you don’t know much about your family health history. They can help you sort through it and maybe even tell you where else to look. Even if you’re missing some facts, any information you have can be useful.

SOURCES: WebMD; National Institutes of Health

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: 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 GCSOM

October is National Physical Therapy Month

October is National Physical Therapy Month. The American Physical Therapy Association (APTA) would like the nation to recognize the positive role physical therapy plays in your health and wellness. We are passionate about what we do! No, we don’t save lives, but we do save lifestyles and quality of life! PT’s are great people. We have a special gift to provide healthcare unique to our field. For example, while many different health care professionals treat back pain, PT’s are some of the very few working to rehabilitate stroke and head injury victims, amputees, children with cerebral palsy and other serious neurological and orthopedic disorders.

In honor of physical therapy month and the thousands of dedicated physical therapists working hard to keep you healthy and mobile, I would like to share some health and wellness pearls of wisdom.

Remember, we cannot control our gene pool or what happens to our bodies, however, we can control our lifestyles. Research suggests that lifestyle may play the biggest role on how healthy you are and how long you live. The food you eat, what you drink, if you smoke, how active you are and how you handle stress are critical factors that determine your longevity. Research also tells us that smoking, physical inactivity, and poor eating habits are the leading causes of death, in that order.

The following health and wellness tips can also serve you well…

One, to be truly healthy, one must have a health mind, body and spirit. A healthy mind requires education and intellectual stimulation. The body requires a good diet and physical activity while the spirit thrives on faith and hope. Strive to find balance and address all three elements of health and wellness.

Two, keep it simple. Should I walk, run, swim, or ride? Do I use free weights, barbells, rubber tubing or lifting machines at a gym? The answer is KEEP IT SIMPLE! You don’t need to join an expensive gym with a personal trainer to get in shape. Bands, light dumbbells, walking at the mall, and biking will all get you in shape. It must be convenient and consistent. 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 30-45 minutes of physical activity, 3-5 days per week will have many positive effects on your body. But, the studies also show that engaging in 10-15 minutes of activity 2-3 times per day, is also valuable to your health…even at work!

Three, be realistic. Expect that exercise will take time to have a noticeable benefit. Don’t get overly ambitious and set yourself up for failure.

Four, be religious. Be religious about exercise and diet but don’t get too compulsive. Studies show if you are too compulsive, you will probably not keep it up for life.

Five, ask a professional. There are a million misconceptions about health and fitness. For example, some people still think you can spot reduce! Ask a professional, (medical doctor, physical therapist, nutritionist, exercise physiologist), if you have a question about beginning a diet or exercise program. If you have health issues or concerns, see your primary care physician first.

Six, there is no secret to a long and healthy life. According to the National Institutes of Health (NIH), while genes play an important role, lifestyle plays the biggest role on how healthy you are and how long you live. The food you eat, what you drink, if you smoke, how active you are and how you handle stress are critical factors that determine your longevity. The NIH research has found that smoking, physical inactivity, and poor eating habits are the leading causes of death, in that order.

Seven, find a fitness mentor or role model. I have the good fortune of meeting many patients over the years that serve as my health & fitness role models. I continue to be inspired by those who overcome their disabilities and injuries through hard work and determination to regain health, wellness and function. Find someone who inspires you!

Eight, find a spiritual mentor or role model. Learn a lesson from “the greatest generation.” The WWII generation rarely complained, worked hard and placed great emphasis on God and responsibility to family. Try to associate with people whose “glass of water is always half full.”

Nine, do the right thing. When it comes to exercise, do the right thing. Get good advice, wear the appropriate clothing and shoes and eat and drink appropriately for the activity. Walk and run in running shoes, eat plenty of whole grains, fruits and vegetables with a good balance of protein and carbohydrates. Drink plenty of water before and during endurance activities. Make proper adjustments for different temperatures.

Ten, have FUN! A healthy lifestyle doesn’t have to be drudgery. There are plenty of good and flavorful healthy food choices. An occasional cheat is good. Also, there are plenty of fun activities and exercise options. Run, walk, swim, bike, hike a canyon, cross-country ski, downhill ski. Use the elliptical, recumbent bike, or stairmaster, recumbent stepper. Alternate routines, cross-train, or play a sport like tennis, golf (walk the course), racquetball or squash. Mix it up. IF YOU WANT TO EXERCISE FOR LIFE - YOU MUST HAVE FUN!

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

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

October is National Breast Cancer Awareness Month and there is good news to report!

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. I have discussed these findings with local physician, Dr. Christopher Peters of Northeast Radiation Oncology Center and he says that he regularly councils his patients about the value of exercise in the recovery from breast cancer. As found in the study, he recommends aerobic exercise such as walking and/or biking and mild resistance exercise. He also encourages patients to enroll in a formal rehabilitation program, especially to prevent a frozen shoulder if invasive surgery was performed.

Previous studies have shown many benefits of exercise for breast cancer patients including improving immune functioning and controlling depression. However, new research recently presented at the American Association for Cancer Research annual meeting was the first report to conclude that physical exercise may improve survival in breast cancer patients. Additional studies have shown other benefits of exercise. For example, a study conducted at Vanderbilt University found that women who had high activity levels throughout life were less likely to develop endometrial cancer. At the Hutchinson Cancer Research Center in Seattle, researchers found that exercise with moderate intensity can reduce serum markers of inflammation (C-reactive protein), which, when elevated, are associated with chronic disease and poor cancer survival.

In the current study, conducted at Harvard University, researchers compared survival rates in women with breast cancer with exercise levels in terms of metabolic equivalent (MET) hours per week. While women with high activity levels of exercise had the best outcomes, even women with moderate exercise benefited.

Benefits of exercise in women with breast cancer:

  • May increase breast cancer survival
  • Lessen risk of endometrial cancer
  • Improved C-reactive protein levels
  • Improve autoimmune function
  • Control Depression
  • Psycho-Social

In conclusion, current research supports the fact that exercise may improve breast cancer survival.  The following guidelines are proposed:

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