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Back to school also means back to sports. Countless students are participating in tennis, soccer, cross country running, gymnastics, and other sports. These student athletes and others who engage in recreational sports and exercise can be vulnerable to excessive training for all the right and wrong reasons. Parents, family members, coaches, teachers, athletic trainers, friends and health providers must be aware of potential for exercise abuse…as part of the “fitspiration” movement.

It takes only a cursory glance through social media to become aware of the “fitspiration” movement. This catchy term may accompany posts of workout videos, pictures depicting physical activity, or pictures of individuals showing off the muscular bodies they obtained through dedication to rigorous exercise regimens. In a sense, exercise and fitness have become trendy in our society, with more strenuous exercise routines being perceived as more impressive. Cars boast bumper stickers with numbers such as “13.1,” “26.2,” or even “50,” referring to the distances so proudly conquered by runners. When we hear a friend has decided to commit to a rigid training schedule to complete a marathon, we are often in awe of their self-control and motivation, wishing we were that dedicated. But can exercise be a bad thing? The answer is complicated. Exercise is one of the best things we can do for our health. I have heard physicians say that if all the benefits of exercise could be bottled up into a pill; pharmaceutical companies would be fighting for the chance to sell it. However, it can get complicated when one’s reasons for exercising stem from a potentially destructive place, rather than a pursuit of health.

Exercise Bulimia/Anorexia Nervosa

Exercise bulimia is a term used to refer to the excessive use of exercise to burn calories or try to keep a low body weight. It is not a medical diagnosis in and of itself, but the notion of using exercise to make up for excessive calorie consumption or maintain an unhealthily low body weight can occur in both anorexia nervosa and bulimia nervosa. Moreover, when excessive exercise occurs in combination with a significantly low body weight, an intense fear of gaining weight, a disturbed body image, undue influence of body shape on self-worth, or a failure to recognize the seriousness of the condition, an individual would meet the criteria for anorexia nervosa.

Anorexia nervosa can cause serious complications in all body systems. Some examples include disrupted functioning of the heart, reduced lung capacity, hormonal imbalance, amenorrhea, (loss of the menstrual period in women), changes in brain structure, and in severe cases, difficulty with memory. The hormonal changes associated with amenorrhea, especially when coupled with extreme exercise, can lead to reduced bone density and can put women at high risk of stress fractures. Stress fractures are breaks in the bone that occur from overuse through large amounts of exercise rather than the traumatic bone breaks we typically think of where an obvious event results in a broken bone.

Warning Signs:

Because exercise bulimia can be a part of an eating disorder with potentially life-threatening consequences, it is important to be aware of the warning signs that someone’s exercise routine might be part of an eating disorder. Signs of exercise bulimia may include:

Not Clear Cut

While the definition of exercise bulimia implies a voluntary engagement in excessive exercise for weight loss, my experience from being on female track and cross country teams in high school and college has shown me that anorexia nervosa does not always fit the mental picture we may have of someone who refuses to eat at all or even of exercise bulimia where an individual compulsively engages in excessive exercise. During cross country, the mileage we ran likely would have been considered excessive by the average person. Our team often trained 7 days a week with run-length ranging from 5-12 miles. Most runs were at least 7 miles, and some of my teammates had long runs in excess of 12 miles. The men on our team ran even farther. In hindsight, one of my teammates may have met the criteria for a diagnosis of anorexia nervosa. Her weight was significantly below normal, she feared weight gain, did not eat sufficient calories to replenish what she burned on runs, and despite knowing she was thin, did not fully recognize the potential health consequences due to her low weight. However, it was not a clear cut problem. She was not an obvious candidate for an eating disorder because she was not pursuing the excessive exercise; she was simply following her coach’s training plan. If she did not exercise to the extent she did, the amount of food she ate would have been considered normal, so seeing her eating habits alone did not trigger any red flags. Finally, cross country runners are known for being lean, often even emaciated; it was a common side effect of the sport often not given a second thought. Thankfully, this runner never fell victim to the dangerous downward spiral that is sometimes seen in patients with anorexia nervosa. However, it is important to be aware of the unsuspecting ways in which an eating disorder can sometimes present.

Treatment

Treatment of eating disorders typically involves a multi-pronged approach with nutritional counseling, psychotherapy, and general medical care playing a role. The nutritional counseling aims to help the patient restore a healthy diet to attain a healthy weight, the psychotherapy aims at getting to the root of the issues that may have contributed to the onset of the eating disorder, and general medical care may be necessary to manage any complications from the eating disorder depending on its seriousness. Educational programs about eating disorders and risk factors have also been shown to be successful in helping to prevent eating disorders.

It can sometimes be a fine line between a healthy passion for exercising and eating well and the start of an eating disorder. Especially in athletes where extreme exercise is part of the sport and putting in extra training is rewarded, it is valuable to be aware of the signs and symptoms of exercise bulimia to help prevent a loved one from crossing over that line. Though serious health consequences are possible in the setting of an eating disorder, treatment and recovery are very possible.

For More Information: www.nationaleatingdisorders.org

GCSOM Guest Author: Mary Pelkowski, MD4 is a student in the Geisinger Commonwealth School of Medicine MD Class of 2022. She grew up in Sayre, PA and graduated from Notre Dame High School. She received her undergraduate degree in biology with a minor in chemistry from Saint John Fisher College in Rochester, NY.

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.

82 million adults spend an estimated 28 billion dollars on gym memberships each year! WHY? There are many reasons we exercise. Some people exercise to prevent illness such as cardiovascular disease or osteoporosis. Others exercise for mental health and as a stress release; others do it to improve strength, flexibility, and endurance to prepare for a sport. However, the number one reason people exercise is TO LOOSE WEIGHT!

When it comes to losing weight, patients have asked me a wide variety of questions over the years. However, certain questions are consistent. “What exercise is the best to burn calories?” “Even though I exercise 2-3 times per week, why can’t I lose weight?” “What is BMR?” “If I eat a Snickers bar, how much exercise do I need to do to burn it off?” “Are there any tools that I can use to help me track my calories and exercise output?”

Which Exercise is the best to burn calories?

Have you ever heard people say that they never felt better or burned more calories as they did when they ran? Well, they may be right! The following numbers are based on the average male weighing 150 pounds: running 6 miles per hour will burn 700+ calories (11-12 calories per minute); vigorously skipping with jump rope or fast cycling will do the same; vigorous walking at 4 miles per hour and moderate biking will burn 600+ calories (10 calories per minute). The 400-500 calorie club includes the following activities: slow jogging, swimming, football, basketball, baseball, tennis, skiing, and moderate walking (3.5 miles per hour).  Light gardening burns more calories than golfing using a cart (250 vs. 180).

Why you may not lose weight even though you exercise? What is BMR?

How many times have you heard people say, “It is hard for me to lose weight because I have a slow metabolism?” What does that mean? To explain this in detail you first must understand BMR. BMR is basic metabolic rate. It is the number of calories that your body requires to operate basic body functions that you don actively control, such as continuing to breathe, and keep your cells and organs working each day. The BMR is influenced by age, height, gender, body fat, and fitness level. BMR is inherently different (high or low) in each individual. While you can’t change your gender or height, you can influence some things to influence your BMR and burn more calories at rest. One, exercise for longer durations, with greater intensity and more frequently. Two, lower your body fat by eating less calories, especially fat and carbohydrates in your diet. Simply, eat less calories than you burn! Three, improve you muscle/fat ratio by weight training.

Basic Metabolic Index (BMI):

BMI:           < 18.5  = Underweight

BMI:   18.5 – 24.5  =  Normal Weight

BMI:    25.  -  29.9  =  Overweight

BMI:            >30.    =  Obestiy

For example, I am a 57 year old male, weighing 150 pounds at 5 feet 8 inches tall with a BMI of 22.8

*Calculate you BMI by entering you gender, height and weight and find how many calories per food item at:

www.calorie-counter.net

Are there any tools for tracking calories and exercise?

There are several tools available for free online to help with tracking calories and exercise visit Prevention Magazine at: www.myfooddiary.com or try the App “Lose It”

BMI Calculator – to calculate your BMI

Calorie Burner – to calculate how many calories are burned with various activities

Daily Calorie Calculator – Find how many calories are in specific foods and what you need to do to loose or gain weight.

So remember, the number one reason we exercise is TO LOSE WEIGHT! But depending on exercise alone to lose weight is an exercise in futility. Losing weight is an intelligent and consistent combination of a balanced diet with portion control, proper nutrition, adequate exercise and activity grounded in lifestyle changes.

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.

Innumerable benefits for both mom and baby …

Including passing on vaccine-generated antibodies for COVID-19

A patient recently asked me if it is safe to take the Moderna, Pfizer-BioNTech, or J&J COVID-19 vaccine during pregnancy? While this is far outside my area of expertise, I took the opportunity to research the matter further and discuss the findings with local pediatricians, Dr Anders Nelson and Dr. Stanley Blondek. They are both strong supporters of vaccinating nursing mothers.   

COVID-19 Vaccine and Breastfeeding

According to the CDC, no safety concerns were found in animal studies: Studies in animals receiving a Moderna, Pfizer-BioNTech, or Johnson & Johnson (J&J)/Janssen COVID-19 vaccine before or during pregnancy found no safety concerns in pregnant animals or their babies. Human studies supported these findings.  In fact, in one study, vaccine-generated antibodies were also present in all umbilical cord blood and breast milk samples taken from the study, showing the transfer of antibodies from mothers to newborns.  

Moreover, in humans, in the largest study of its kind to date, researchers at Massachusetts General Hospital (MGH), Brigham and Women’s Hospital and the Ragon Institute of MGH, MIT and Harvard have found the new mRNA COVID-19 vaccines to be highly effective in producing antibodies against the SARS-CoV-2 virus in pregnant and lactating women. The study also demonstrated the vaccines confer protective immunity to newborns through breast milk and the placenta.

Multiple Benefits of Breastfeeding

Long before COVID-19, breastfeeding has always demonstrated many benefits for both mother and child. Expectant mothers typically do all they can to ensure their baby’s health. A wholesome diet, regular exercise and avoiding harmful habits like smoking are all important things a woman should do during pregnancy. However, there is something additional mothers can do AFTER their child’s birth that can be equally, if not more, important and has been around as long as human life itself… breastfeed! While far from new, it is has been rediscovered for it tremendous benefits and gaining popularity.

Nursing your baby immediately after birth helps solidify the bond between you and your baby. Moreover, the health benefits to baby begin right away. That’s because your breasts produce colostrum beginning during pregnancy and continuing through the early days of breastfeeding. Colostrum precedes breast milk and has plenty of antibodies to help keep your baby healthy. Colostrum is extremely easy to digest, and is therefore the perfect first food for your baby. Also, as the La Leche League (LLL) tells new mothers, “Colostrum has a laxative effect on the baby, helping him pass his early stools, which aids in the excretion of excess bilirubin and helps prevent jaundice.” Jaundice is common in newborns and is usually treated by placing the baby under special lights. LLL also points out that the concentration of immune factors is much higher in colostrum than in mature milk, which comes in after about two weeks.

The positive effects continue for both mother and baby as the child grows from newborn to infant. Breast-fed babies are, for example, less prone to sudden infant death syndrome (SIDS), an unexplained death of a healthy infant while sleeping. The peak incidence of SIDS occurs when a baby is about three months old. It is an unspeakable tragedy that affects entire families. While we must be very clear that breastfeeding is not a guarantee against SIDS, newer studies have shown that infants who were never breastfed may have two to three times the risk of dying of SIDS. Although the actual mechanism is unknown, some theories are that breastfeeding may provide defense against SIDS because it lowers a baby’s risk of infection through antibodies passed on by mom or because human milk is ideally equipped to nurture human brains -- and the brain controls sleep cycles.

Additional Benefits for Baby:

Additional Benefits for Mom:

Are there ever reasons why either mother or baby should not breastfeed? While extremely unusual, there are contraindications for breastfeeding. Mothers who must take certain medicines may be unable to nurse. There are also some conditions in newborns – some treatable – that may limit or prevent breastfeeding. Your physician (obstetrician/gynecologist or pediatrician) or midwife should be consulted before you take any medications, vitamins or herbals.

Conclusion

It is recommended that you exclusively breastfeed your baby for the first six months and continue for at least the first year. After that, it’s up to you. It’s also important to know that every baby is a unique individual. Don’t become alarmed if your child doesn’t seem to adhere to what the textbooks say. Instead, turn for support to some reliable and trustworthy: your physician, midwife and the La Leche League.

SOURCES: Le Leche League is an international nonprofit organization that distributes information on and promotes breastfeeding. www.lllusa.org; Centers for Disease Control (CDC); Harvard Gazette

Contributor:  Kathryn N Swatkowski, CNM …has been a Certified Nurse Midwife for 20 years, taking care of women throughout their life-span from adolescence through menopause

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 inquiries 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: https://mackareyphysicaltherapy.com/forum/

Tips on Low Back Pain

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. 

Prevention of Lower Back Pain

Maintain Fitness Level

As little as 10 extra pounds puts great stress on your lower back. It also makes it more difficult to maintain good posture. Eat well, exercise regularly and don’t smoke. Smokers have a much higher incidence of LBP and failure from lower back surgery.

Practice Good Posture & Body Mechanics

Good posture is critical for a healthy back. When sitting, standing or walking maintain a slight arch in your lower back, keep shoulders back, and head over your shoulders. In sitting, use a towel roll or small pillow in the small of the back.

Perform postural exercises throughout the day. Most of the day we sit, stand, and reaching forward and bend our spine. These exercises are designed to stretch your back in the opposite direction of flexion. Please perform slowly, hold for 3-5 seconds and repeat 6 times each 6 times per day.

Chin Tuck: Tuck your chin back to bring your head over shoulders.

Shoulder Blade Pinch: Pinch your shoulder blades together.

Standing Extension: While standing, put your hands behind back and extend lower back 10-20 degrees.

Good Body Mechanics and ergonomics are also important in the prevention of LBP. When lifting, think twice. Think about the weight, shape and size of the object. Think about where the object is going and the surface resistance of the floor. Does it require two people to lift? Can I safely lift that high or bend that low?

When bending to lift an object think about safety:

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/

“I was nervous and forgot to ask my doctor questions about my diagnosis!” “When the nurse asked me, I could not remember my medications!” These are two examples of the many frustrations patients have when visiting their physicians. Research shows, those who prepare in advance for their physician visits, have more satisfaction than those who just show up for their appointment. Moreover, for patients seeing multiple physicians, such as specialists, often communication is poor and your participation in the process can be invaluable. There are things you can do to prepare for your physician visits...

Make a Checklist

Medication List

Symptom List

Be Honest

Keep a Medical Journal

Bring a Family Member or Friend

Bring Your  Glasses and Hearing Aid

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

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

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 https://mackareyphysicaltherapy.com/forum/

As the country prepares to return to school and work this fall during a new wave of infections from the Delta variant of COVID-19, it is more important than ever to find healthy ways to control stress and anxiety. While exercise is important to trim our waistline or to speed up our metabolism, there may be more benefit to lacing up those sneakers than you’d think.  Recent studies have established a link between exercise, stress and cognition, making physical activity even more important.

Exercise Improvements

Exercise has been shown to improve sleep and mood, decrease stress, and even increase libido.  It also can bolster our self-esteem and ability to problem-solve and to remember details.  In fact, strength training has even been shown to reverse cognitive decline to a degree in aging adults with mild impairment. Though the medical community is still trying to elucidate exactly how exercise boosts our brains physiologically, increased circulation to the brain and modulation of the hypothalamus-pituitary-adrenal axis that regulates the body’s response to stress have been implicated as the bearers of benefit. While exercise can be advantageous for everyone, it perhaps is even more valuable to those struggling with mood disorders.  Exercise can help combat anxiety and depression and quell the symptoms of Attention Deficit Hyperactivity Disorder and Post Traumatic Stress Disorder as it helps the brain to pump out neurotransmitters and pain-fighting endorphins. Exercise makes addiction management easier, as well, and has recently been shown to help alcoholics lessen consumption.

How Much To Exercise

So, how much exercise exactly is enough to illicit tangible cognitive benefit, you ask?  Any amount of weight lifting, running, walking, or yoga helps, but habitual activity helps the most.  Studies cite that a few consecutive weeks of participation in a fitness regimen yielded notable, positive results in subjects.  Try to make exercise part of your daily routine to encourage good fitness habits.  If you find the idea of adopting a strenuous new fitness program intimidating or off-putting, have no fear.  Moderate exercise is enough to do the trick.  The Mayo Clinic cites both brisk walking and mowing the lawn as examples of moderate activity, so an average fitness level is adequate for yielding positive mental results. 

How to Begin

If you’re thinking about beginning an exercise program for the first time, start gradually.  Begin with walking for 10 to 15 minutes twice daily, and add 1 or 2 minutes to your session every time you walk until you can walk continuously for 45 to 60 minutes.  The same principle can be used when beginning other fitness routines involving biking, swimming, running, etc.  Begin a weight training program to strengthen bones and tendons using 3 to 5 pound dumbbells, and increase the weight you use by a pound once you can easily perform 30 consecutive repetitions.  Be careful to pay close attention to posture and form. Contact your physical therapist or a personal trainer for assistance with designing an appropriate exercise program.  Don’t hesitate to contact your physician, either, if you have questions about whether a particular exercise program is safe and suitable for your age group or current fitness level.

Tips to Building Your Workout

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 Geisinger Commonwealth School of Medicine.

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

Part II of II

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 9, 2021, first day of acclimatization and August 16, 2021, first day of practice for fall sports according to PIAA), However, 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.

Prevention of Heatstroke:

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 in downtown Scranton and is an associate professor of clinical medicine at Geisinger Commonwealth School of Medicine.

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

Part I of II

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 9, 2021, first day of acclimatization and August 16, 2021, first day of practice for fall sports according to PIAA), However, 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.

Hot Temps and Exercise

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:

Signs of Heatstroke:

Treatment of Heatstroke:

NEXT MONDAY – Read Dr. Paul J. Mackarey “Health & Exercise Forum!” Next Week: “Heat Stroke 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 in downtown Scranton and is an associate professor of clinical medicine Geisinger Commonwealth School of Medicine.

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

According to the Centers of Disease Control (CDC), Hypertension (HTN), also known as high blood pressure (HBP), affects one in three adults (67 million people) in the USA. Unfortunately, only one-half of those with high blood pressure control the problem and, as a result, are at great risk for heart disease and stroke.

Blood pressure numbers represent the force against the walls of your arteries. Normal blood pressure (BP) is defined as a systolic pressure (the top number) of 120 mm Hg and a diastolic pressure (the bottom number) of 80 mm Hg (120/80). The Joint National Committee on Prevention, Detection, Evaluation, and Treatment of High Blood Pressure has classified blood pressure as follows:

Normal: lower than 120/80 mm Hg

Prehypertension: 120-139/ 80-89 mm Hg

Stage 1 Hypertension: 140-159/90-99 mm Hg

Stage 2 Hypertension: 160+/100+ mm Hg

Risk Factors for HBP*

  1. African American
  2. Obesity
  3. Stress and anxiety
  4. Excessive alcohol use – more than 1 drink/day for women, 2/day for men
  5. Excessive salt intake
  6. Family history of HBP
  7. Diabetes
  8. Smoker

Medical Conditions or Medications Contributing to HBP*

  1. Chronic kidney disease
  2. Adrenal gland disease
  3. Hyperactive Thyroid
  4. Pregnancy
  5. Renal artery stenosis (narrowing)
  6. Medications: birth control pills, diet pills, cold and migraine meds

*(National Institutes of Health, Medline Plus)

Symptoms of HBP

For most people with HBP, there are no obvious symptoms. HBP is usually detected at a health fair, or a routine visit with a physician. However, over time, HBP can cause problems with the heart and kidneys. Sometimes, a more serious condition can develop from very high blood pressure called malignant hypertension. Symptoms include severe headache, nausea and vomiting, confusion, vision changes and nosebleeds. Notify your physician immediately if you develop these symptoms.  

Diagnosis

Almost everyone has had their blood pressure checked with a standard or automatic blood pressure cuff. Sometimes, when a problem is detected, a home blood pressure unit is recommended to track BP throughout the day.

Treatment

  1. Eat Healthy – low salt, low fat diet which includes fish, fiber, grains, fruits and vegetables
  2. Drink Plenty of Water
  3. Do Not Smoke
  4. Limit Alcohol to 1/day for women and 2/day for men
  5. Maintain a Healthy Body Weight 
  6. Medication – not usually used for pre hypertension
  7. Limit Salt - less than 1,500 mg/day
  8. Limit Stress – consider meditation, tai chi, yoga
  9. Exercise – 30 – 45 minutes of aerobic exercise 4-5 days per week

Manage Stress

According to a recent long-term study, both men and women without a history of coronary artery disease or high blood pressure suffered from both diseases when they did not manage stress well. Those who allowed stress to upset them, (short fused and easily frustrated) had significant increases in cholesterol and blood pressure when compared with those who were more even-tempered and easygoing under stress.

Commit to Exercise

Exercise combats HBP and maintains a healthy body weight. The key to success when it comes to improving your life with exercise is to develop a regular, consistent program. A good program must include aerobic exercise (walking, jogging, biking) for 30 minutes (or  15 minutes twice a day) 4-5 days per week and mild/moderated weight training 2- 3 times per week.  

Diet Modifications

A low salt, low fat diet which includes fish, fiber, grains, fruits and vegetables is essential. Moreover, take care to avoid the “Seven Deadly Sins for High Blood Pressure” (Zee News):

Table Salt- Don’t add salt to your food because most foods have enough. Limit total salt consumption to 1,500mg per day.

Deli Meat – These foods are loaded with salt as an additional preservative.

Red Meat – In excess, the trans and saturated fats in red meat can also damage the blood vessels of the heart over time. Limit consumption to 1 -2 times per week.

Alcohol – It causes the blood pressure to rise and in excess, can damage the blood vessel walls. Limit intake to 12 oz of beer, 8 oz of red wine daily.

Whole Milk – similar to red meat, the high concentration of saturated fats can damage blood vessels over time. A low fat substitute is a better option.

Pickles – Just 3 of these tasty cucumbers have more than the 2,300mg of recommended sodium for an entire day.   

Coffee – Caffeine can cause a temporary spike in blood pressure and should be consumed in moderation, especially for those at risk or with high blood pressure.

In conclusion, while HBP is a potentially serious medical condition, for most it is a controllable and preventable problem. Lifestyle changes such as diet, exercise and stress reduction have been found to be most effective.

SOURCES: Centers For Disease Control (CDC); American Heart Association (AHA), University of Pittsburgh Medical Center (UPMC), National Institutes of Health (NIH), Medline Plus, Zee News

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 Geisinger Commonwealth School of Medicine.

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

“Health & Exercise Forum” regularly promotes active lifestyles and outdoor activities. However, being one with nature is not without its risks and attracting ticks which can lead to Lyme disease is one of them. Over the last few years, I have been amazed by how many ticks I find on my clothing and skin after being outdoors…year round! Last winter, for example, we had an unexpected warm-up in February, and with temperatures ranging from 30 degrees in the morning to 60 degrees in the afternoon, I decided to ski in the morning and snow-shoe on the trails at Lackawanna State Park in the afternoon. Due to snow cover, I occasionally wandered off the trail and hiked through some brush. Later that evening, I discovered a tick on my neck, despite showering, wearing winter clothing and it being outdoors in FEBRUARY! It is no small wonder why some experts blame climate change on the dramatic increase in cases of Lyme disease…the research supports it! Later that summer, while I was not formally diagnosed with Lyme disease, I did suffer from symptoms associated with the disease for about 8 weeks. This experience has caused me to pause and take precautions when I garden, kayak, hike, mountain bike or engage in any outdoor activity that takes place near brush or wooded areas.     

The CDC

According to the Centers for Disease Control (CDC), approximately 300,000 cases of Lyme disease occur each year in the United States. Lyme disease is a bacterial infection caused by the bite of an infected deer tick and most prevalent in wooded and grassy areas of the New England, Mid-Atlantic and upper Midwest States. A heightened awareness and preventative measures are recommended for those who live, work, play, camp, hike, or bike in these areas.

BE AWARE – PROTECT AND PREVENT

Know Where the Ticks Live

Ticks thrive in moist and humid environments, especially in and near wooded and grassy areas. Wear long sleeve shirts and long pants with socks when spending extended periods of time in risky environments.

Stay on the Trails

When walking, hiking, or biking, stay in the middle of the trail and avoid the brush.

Use Repellent

The CDC recommends repellent containing 20% or more DEET, Picaridin, or IR3535 on exposed skin. Use products with 0.5% permethrin on clothing, boots, pants, socks, tents and other gear. Visit the Environmental Protection Agency (EPA) for more information about product safety. 

Control Ticks in Your Yard and Living Space

Keep your yard free of tall grasses and brush and use gravel or wood chips as a barrier. Mow the grass often and remove leaves quickly. Place playground equipment and toys in dry sunny area and away from brush and high grasses. Don’t feed or encourage deer to visit your living area. Chemical treatment for your yard and outdoor living space is available but should be used with caution and as a last resort.

Treat Your Pets

Use flea and tick treatments regularly on your pets such as Advantage IIR or Frontline PlusR and others. Ask your veterinarian for recommendations.

Perform Tick Checks

After being outdoors, perform a tick check. Use a mirror or family member to help you check hard to view areas. Also, carefully examine your clothing and pets for ticks before entering your home. Drying your clothing in the dryer on high heat will kill ticks.

The CDC recommends that you closely check these areas for ticks:

Remove Clothes and Shower

As soon as you enter your home (preferably through a mud room or basement), remove your clothes and take a shower.

Remove Ticks Immediately and Carefully

If you find an attached tick use a fine-tipped tweezers and carefully remove it as soon as possible. If a tick is attached to your skin for less than 24 hours, your chance of getting Lyme disease is very unlikely.

Be Alert For Signs or Symptoms

If you find a tick, keep an eye on the area for a few weeks. Look for signs or symptoms of Lyme disease such as rash or fever and contact a healthcare professional if you are suspicious.

 Know the Signs and Symptoms of Lyme Disease

Some or all of these symptoms can be associated with Lyme disease and you should contact your physician if you are suspicious: Skin Rash, Fever and Chills, Fatigue, Muscle and Joint Pain/Ache, Headache.

In conclusion, it is well-documented that Lyme disease is on the increase, due in part to warmer winters in the mid-Atlantic and northeast US. However, while experts are encouraging people in risky areas to take precautions during the spring and summer months, they are also encouraging parents not to limit outdoor activities for children and others. Keep in mind that spending too much time indoors is far worse for your health than the risk of contracting Lyme disease in the long run. And, even if you are bitten by a tick, you only have a 100 to 1000 chance of contracting the disease.     

SOURCES:

www.cdc.gov>lyme

www.epa.gov>insect-repellents

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 Geisinger Commonwealth School of Medicine.

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