Special Feature “ Health & Exercise Forum” with Geisinger Commonwealth School Of Medicine – The third Monday of every month!
Guest Columnist: Kathryn Schmidt, MD
Personal Bio: Kathryn received her medical degree from Geisinger Commonwealth School of Medicine in 2019 and is now an Internal Medicine resident at University of Utah Health in Salt Lake City. She loves her program and her new city, both of which allow her to optimize her wellness, with easy access to skiing, hiking, and other outdoor activities. Prior to medical school, she attended the University of Wisconsin-Madison for her undergraduate studies and Northwestern University where she completed a post-baccalaureate pre-medical and health program. Throughout school, she worked as a research assistant, first with stem cell transplant recipients and women affected by gynecological cancers, and then with solid organ transplant patients. During medical school, she served as a volunteer at the Care and Concern Clinic, as well as at an organization called Pathstone, acting as a mentor to men and women who were transitioning back into the community after having spent time in prison. During her last year of medical school, she received a global health scholarship that allowed her to teach English in Thailand, with an emphasis on preventative health care topics. She has joined the global heath track within her residency program and hopes to continue to stay engaged in global healthcare throughout her career. When not working, she likes to kick-box, ski, hike, write, and be in the company of good friends or family, whether that be taking a weekend camping trip to a new place or just having a board game night. Something that makes her really happy is traveling… she has been to all 7 continents and is always ready for the next adventure!
Most people have heard the expression, “worried sick,” but did you know that you can worry enough to the point where it results in emotions that leave you physically ill? For the normal person, this isn’t good, but for the cancer patient, this is just downright dangerous. During my undergraduate education at the University of Wisconsin-Madison, I worked in a research lab that examined various predictors of recovery from cancer. Specifically, we examined the extent to which mood disturbance impacts cancer patients’ recovery following hematopoietic stem cell transplantation (HSCT), which is just a fancy term for a medical procedure in which a donor’s stem cells can be given to a patient suffering from certain cancers of the blood or bone marrow, like leukemia or multiple myeloma. Without getting into the complexity of the study, at the most basic level, we wanted to find out if patients who found meaning in their illness, didn’t avoid unwanted thoughts and emotions, and generally felt less depressed prior to transplant had more successful recoveries and stronger immune systems post-transplant.
Our study results echoed the conclusions of similar studies conducted prior to ours, demonstrating that there is indeed crosstalk between our psychological states and the neuroendocrine and immune systems, or in other words, our mental state can affect our physical state.
In patients undergoing HSCT, this is particularly salient, given the critical role of immune restoration in preventing recurrence of cancer, reducing complications, and ensuring survival. Distress, depression, and anxiety have been associated with a downregulation of immune responses relevant to tumor containment among cancer patients, and depressed mood has been linked to relapse and poorer survival following HSCT.1 So now that we know these things, if you are a cancer patient, fighting for your life, the importance of being happy is no longer just for your sanity, but is quite literally one way to increase your chances at a successful recovery. Interesting, right? But how does this apply to you? Well, you don’t have to have cancer for depression or other emotions to weaken your immune system. This basic concept is applicable to all of us in our everyday lives, and this link between the mind and body may be more powerful than you think…especially during this COVID-19 Crisis!
Here are just a few examples of what I’m talking about…
Most of us are going through a roller coaster of emotional states as this storm –called COVID-19 – continues to gain momentum, with global impact. Millions of people are experiencing major life changes. If this resonates with you, you are not alone. People have been self-quarantining or socially isolating for various amounts of time. With the cancellation of planned trips and weddings, the closing of schools and colleges, and mandated work-from-home arrangements, it is easy to be discouraged, especially given that we aren’t yet seeing the light at the end of the tunnel. While each person will respond differently to the challenges we are facing, fear and anxiety seem to be two feelings commonly cited during this difficult time.
While there is no perfect solution, there may be some helpful things you can do to feel more in control of your day-to-day emotions and general well-being. Different things work for different people, and there isn’t any single, correct way of doing things, so I would recommend getting rid of “should do’s” and expectations. Collectively, we need to cut ourselves some slack and realize that this is a process of trial and error. My hope is that we can feel a sense of togetherness and global solidarity despite physical isolation, understand how to continue living in this very unusual and weird time, and ultimately, find some peace among the chaos.
We can’t control everything but we can try to control our psychological state and not allow negatively affect our physical health and immune systems, and if we are sick with something serious, we need to do everything in our power to give ourselves the best fighting chance at recovery. Just knowing that mood and psychological well-being affect our physical state is motivation in itself to decide that we are going to choose happiness. This is not to say that you can’t ever be in a bad mood… you can! We all have bad days, but we should work harder to not let our bad moods consume us.
NEXT WEEK: Part 2: Tips for Being Happy & Healthy During COVID-19 Crisis
Read Dr. Mackarey’s "Health & Exercise Forum" every Monday in the Scranton Times-Tribune.
This article is not intended as a substitute for medical treatment. If you have questions related to your medical condition, please contact your family physician. For further inquires related to this topic email: drpmackarey@msn.com
Paul J. Mackarey PT, DHSc, OCS is a Doctor in Health Sciences specializing in orthopaedic and sports physical therapy. Dr. Mackarey is in private practice and is an associate professor of clinical medicine at Geisinger Commonwealth School of Medicine.
This column is written at the request of Kathryn Sarrides, an exceptionally spry senior who lives happily in Green Ridge with her sage husband, Harry. They, like many their age, work hard to maintain their independence by engaging in physical activity and exercise as well as intellectual stimulation by playing bridge, reading books and staying socially active. Last week, Kathryn came to me with a very common problem among octogenarians and nonagenarians… she was concerned about her safety getting out of a chair, especially a chair that did NOT HAVE ARMS!
Falls are a leading cause of injury and death in seniors. Thirty percent of women and thirteen percent of men over the age of sixty-five will fall. Twenty to thirty percent of these individuals suffer moderate to severe injuries. While preventing falls is not an easy task, there are a few things to consider that may go a long way!
The National Institute of Health (NIH) recommends four areas of concentration for elderly persons to concentrate on in order to maintain safety and independence: strength, flexibility, balance and endurance. It will be the purpose of this column to recommend safe and practical tips to get out of a chair and exercises to keep you strong and limber enough to do it safely.
1. Scoot Your Butt to the edge of the chair
2. Tip Your Trunk Forward – over your bent knees
3. Push Off the Arms of the Chair – while leaning forward
4. IF THE CHAIR HAS NO ARMS – Place one hand on the chair seat and the other hand on your knee. Then push up with your arms (SEE PHOTO A)
5. Push From your Legs – at the same time you push with your arms
6. Stay Still Standing – for a few seconds after You get up …before you walk
Strength Exercises involve using the muscles to move the arms and legs against resistance such as a weighted object, dumbbells, resistance bands, and body weight against gravity. Strength is necessary to perform daily activities such as: getting out of a chair, walking, lifting a half-gallon of milk, transferring to/from a shower safely.
These exercises are performed while sitting in a chair with backrest, slowly, 5 -10 repetitions, and 3-5 times per week. No weight is used in the beginning, only the weight of the arm against gravity. In 1-2 weeks a light 1-2 pound weight and light resistance band may be added.
Do these exercises while sitting in a chair with a backrest:
Chair Push-Ups – While sitting in a chair with arm rests, perform a push-up by pushing off the arms while pushing with your legs (PHOTO B)
Shoulder Shrug – shrug top of shoulders up toward the ears
Row the Boat – pull both arms back at a 45 degree angle with bent elbows as if “rowing a boat”
Elbow Bend/Extend – bend and straighten elbows
Do these exercises while sitting in a chair with a backrest:
Hip Hike – lift hip up 2-4 inches as if “marching” (PHOTO C)
Hip Spread – with heels on the floor, spread knees apart
Hip Squeeze – with heels on the floor, squeeze knees together
Leg Kicks – extend knee as if kicking the foot forward and up
Heel Raise – raise heel up with toe on floor
Toe Raise – raise toes up with heel on floor
Do these exercises while Standing. Always hold onto a counter top or the back of a stable chair:
Standing Leg Curl – facing and holding onto the countertop (chair), bend the knee by bringing the foot back (PHOTO D)
Standing Hip Hike - facing and holding onto the countertop (chair), hike hip up as if marching (PHOTO E)
Standing Squat – facing and holding onto the countertop (chair), bend both knees to a 20-30 degree angle. Hold this position for 5-10 seconds.
Once you have mastered these exercises against gravity, then advance to using light weights or light resistance bands. Ankle weights are very inexpensive and can be purchased in 1 pound increments. Light resistance bands are available in yellow and red in colors.
Visit your doctor regularly and listen to your body.
Keep moving, eat healthy foods, exercise regularly, and live long and well!
Read Dr. Mackarey’s "Health & Exercise Forum" every Monday in the Scranton Times-Tribune.
This article is not intended as a substitute for medical treatment. If you have questions related to your medical condition, please contact your family physician. For further inquires related to this topic email: drpmackarey@msn.com
Paul J. Mackarey PT, DHSc, OCS is a Doctor in Health Sciences specializing in orthopaedic and sports physical therapy. Dr. Mackarey is in private practice and is an associate professor of clinical medicine at Geisinger Commonwealth School of Medicine.
A healthy immune system may be the difference between recovery from illness and dying. While you may not be able to improve an otherwise healthy immune system, you can take steps to maintain its health and integrity. Exercise is one of the best ways to maintain a healthy immune system.
With the closing of fitness centers, school gyms and exercise classes due to COVID-19, it may be a good time to begin a home exercise program that is quick and easy. For some, home exercises can be done before or after working from home to gain or maintain muscle tone. For others, home exercises may help maintain independence and safety performing daily activities around the house such as; climbing stairs, getting in and out of a shower, putting on shoes and socks, cooking, cleaning, and carrying groceries or laundry.
I have comprised 10 simple exercises including upper and lower body and balance and core. The only equipment you will need is a chair and resistance bands; yellow has the least resistance, black the most, red, green, blue in between. They can be purchased at any sporting goods or department store.
Remember, for most people it is more harmful not to exercise, so contact your physician to discuss whether independent exercise is appropriate for you. If you have special needs, you may need to consult with a physical therapist to get started. Good luck…I hope this helps you survive the COVID-19 quarantine!
These exercises are performed while sitting in a chair with a backrest, slowly. Hold the position for 3 seconds. Perform 5 -10 repetitions. Do these exercises 3-5 times per week. Begin with a yellow light resistance band.
Row the Boat (PHOTO 1)
Saw Wood (Photo 2)
Elbow Extension (Photo 3)
Hip Spread (Photo 4)
Hip Hike (Photo 5)
Leg Kicks (Photo 6)
Shoulder Shrug (Photo 7)
Elbow Bend (Photo 8)
Standing Leg Curl (Photo 9)
Standing Walk Aways - Backward (Photo 10)
Standing Walk Aways - Forward
Visit your doctor regularly and listen to your body.
Keep moving, eat healthy foods, exercise regularly, and live long and well!
Read Dr. Mackarey’s "Health & Exercise Forum" every Monday in the Scranton Times-Tribune.
This article is not intended as a substitute for medical treatment. If you have questions related to your medical condition, please contact your family physician. For further inquires related to this topic email: drpmackarey@msn.com
Paul J. Mackarey PT, DHSc, OCS is a Doctor in Health Sciences specializing in orthopaedic and sports physical therapy. Dr. Mackarey is in private practice and is an associate professor of clinical medicine at Geisinger Commonwealth School of Medicine.
The human body is designed to defend against foreign bodies such as germs, bacteria, and viruses, including COVID-19. A healthy immune system may foster a speedier recovery from illness. While you may not be able to improve an otherwise healthy immune system, you can take steps to maintain its health and integrity.
A healthy immune system protects us by creating a barrier that stops invaders or antigens, from entering the body. When an unwelcome invader slips through the barricade, the immune system responds by producing white blood cells and other chemicals and proteins that attack the foreign substances.
Is there a secret to a long and healthy life? Do genes control our destiny? How does lifestyle impact our health? 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.
To maintain a healthy immune system, physical activity is one of the most important factors in improving a lifestyle in a positive way. A minimum of 30 minutes of physical activity, 5 days per week can greatly contribute to longevity. Most experts agree that moderation is important. If you overindulge with exercise you will be at greater risk for musculoskeletal injuries. This is especially true for those who are newcomers. The goal is to gradually work into a fitness program and maintain it for life…now, during home confinement; it may be a good time to begin.
Researchers have found that the benefits of regular physical activity are numerous. Some of the more important benefits are:
Sources: WebMD.
Visit your doctor regularly and listen to your body.
Keep moving, eat healthy foods, exercise regularly, and live long and well!
Next Week: Learn some simple home exercises using Resistance Bands.
Read Dr. Mackarey’s "Health & Exercise Forum" every Monday in the Scranton Times-Tribune.
This article is not intended as a substitute for medical treatment. If you have questions related to your medical condition, please contact your family physician. For further inquires related to this topic email: drpmackarey@msn.com
Paul J. Mackarey PT, DHSc, OCS is a Doctor in Health Sciences specializing in orthopaedic and sports physical therapy. Dr. Mackarey is in private practice and is an associate professor of clinical medicine at Geisinger Commonwealth School of Medicine.
This column is a monthly feature of “Health & Exercise Forum” in association with the students and faculty of Geisinger Commonwealth School of Medicine (formerly The Commonwealth Medical College).
GCSOM Guest Author: Brendan Bormes, MD3
Brendan Bormes, MD3 graduated from GCSOM in May of 2019 and is presently a first year resident in Anesthesiology at Georgetown University Medical Center. A native of Clarks Summit and graduate of Scranton Preparatory School, he majored in biology and music at Bucknell University and received a masters degree in physiology and biophysics from Georgetown University.
It’s that time of year…after a long winter of nights that come early and last too long there is LIGHT at the end of the tunnel! In the fall and winter, especially this far north, many people start to feel the gloom of their surroundings creep into their psyche and spring cannot arrive too soon...Is this normal, or a sign of something more serious?
Seasonal affective disorder, or SAD, is at the far end of a spectrum of seasonal mood changes. The mildest of these, “seasonality”, is a normal response to cyclical changes in weather and light exposure. However, when symptoms like depressed mood, lack of motivation, or a shift to more vegetative daily habits become severe and debilitating, SAD may be the cause. In fact, one study found that SAD affects up to 10% of primary-care patients, and that those with a previous diagnosis of depression are even more at risk. Fortunately, though, there are well established therapies that can help those afflicted with SAD to get through the dark winter months. The American Psychiatric Association defines SAD as a subtype of either Major Depressive Disorder or Bipolar Disorder, depending on the symptoms. It can consist of episodes that onset during either fall/winter or spring/summer, or have symptoms characteristic of either “major depressive” or “manic” episodes. The vast majority of those with SAD, however, experience a persistent overall depressed mood during the shorter days of fall and winter.
In more serious cases:
If enough of these symptoms are present for a long enough time and onset in a seasonal pattern, that can mean Seasonal Affective Disorder. Most people with the disorder find themselves sleeping more and eating more (especially carbs), and report that their symptoms can even resolve with relocation to a sunnier environment. Along the spectrum of disease is a less severe form called “subsyndromal” SAD, which can still be effectively treated. Periods of SAD tend to resolve with the coming of spring, but they can be immensely distressing and always deserve medical intervention.
No one knows exactly why Seasonal Affective Disorder happens, but it appears to be associated with decreased exposure to natural light during the fall and winter months. One possible explanation is the “phase-shift” hypothesis. It states that your body’s circadian rhythms, which are regulated by hormones and the brain, become out-of-step with environmental sleep/wake cues as the days shorten. In other words, the light levels around you and your body’s internal clock are telling you two different things about when to sleep. This disruption of circadian rhythms, or “phase-delay”, likely contributes to the symptoms of SAD, although precisely how it induces changes in mood remains unclear. Another hypothesis for the mechanism underlying SAD involves abnormalities in the activity of serotonin, a neurotransmitter in the brain. Normally, serotonin regulates mood and attention. However, studies have found that people with SAD clear serotonin out of their brains faster, giving the hormone less of a chance to provide a boost in mood.
Current medical treatment of SAD targets the changes in both circadian rhythms and serotonin metabolism. This can be accomplished with light therapy, antidepressant medications or a combination of both.
Visit your doctor regularly and listen to your body.
Read Dr. Mackarey’s "Health & Exercise Forum" every Monday in the Scranton Times-Tribune.
This article is not intended as a substitute for medical treatment. If you have questions related to your medical condition, please contact your family physician. For further inquires related to this topic email: drpmackarey@msn.com
Paul J. Mackarey PT, DHSc, OCS is a Doctor in Health Sciences specializing in orthopaedic and sports physical therapy. Dr. Mackarey is in private practice and is an associate professor of clinical medicine at Geisinger Commonwealth School of Medicine.
