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Part 2 of 2

I have a vested interest in this column…I just had a big birthday! It is a BIG birthday because it is the one before I get health care insurance from Uncle Sam! Consequently, the “aging process” is very much on my mind!

In the book, “Being Mortal,” Atul Gawande discusses the role of medical care placing emphasis on “well-being” rather than survival, especially as it relates to end-of-life care. It is a “must read” for health care providers as well as the general public. The book also describes, in great detail, the process of aging; the physiology of bone and muscle mass loss, factors affecting balance and coordination, changes in mental acuity, memory, and mood. As depressing as it sounds (many of the changes begin as early as mid to late thirties), it is also a “call to arms!”

To prepare for the inevitable aging process one must be proactive, not reactive. From an early age, challenge yourself mentally by taking classes and learning things for which you may not have an interest. Try new physical activities and sports even if you feel unable to excel. Find balance in your diet by trying to eat fruits and vegetables that you don’t find appealing. Engage in daily exercise and physical activities even if you would rather be indoors playing video games. Lastly, get professional advice on matters beyond your scope. See your physician regularly for routine care and diagnostic tests, find a mental health professional if you are not at peace, consult with a physical therapist to help you design an exercise routine appropriate for your individual needs.

While it is never too late, remember, slowing down the aging process should not begin at 60, it begins at 30!

Memory Loss

Minor word or memory loss is a normal part of aging as the brain changes and affects how you remember things. Don’t hesitate to use technology or other tricks to assist you. For example, consider using alerts, reminders and lists on your smart phone. Also, you may want to organize certain items in a set location, use post it notes or a white board. However, these reminders are not a substitute for keeping your mind sharp. Studies show that being social, exercising regularly, eating well and learning a new skill can go a long way to maintain a healthy brain.

Weight Gain

According to several studies on aging, unfortunately, most people gain 1-2 pounds per year (10 to 20 pounds over 10 years). The aging body does not burn calories like you used to. But there are some simple steps you can implement to offset this pattern of weight gain. Obviously, eat less (less calories) and exercise more (stimulate your metabolism). Consider fruits, vegetables, and leaner protein instead of foods high in sugar/carbs and saturated fats and don’t forget portion control. Be active and take the stairs instead of the elevator.

Sexual Performance Challenges

Aging can also affect sexual performance. According to the Mayo Clinic, lower testosterone levels in men can lead to erectile dysfunction and hormonal changes in women can cause vaginal dryness. Stiff and painful joints add to the challenge. However, with a little effort, most healthy people can continue to be sexually active well into their 70’s and 80’s. Communication with your partner is important. Try new positions. Discuss hormone supplements and ED medications with your doctor. Try over-the-counter lubricants. Remember, exercise improves blood flow and stimulates sex hormones!

Urinary Frequency

Like the other muscles in your body, pelvic and bladder muscles also weaken with age. This problem can be worsened for men by an enlarged prostate and for women following multiple births. However, the muscles can be strengthened by performing specific exercises that target the area called Kegel exercises. These exercises involve squeezing the muscles that control urine flow. For example, while urinating try to stop midstream and hold your urine flow for a few seconds. Repeat 10 times and do this 3-5 times a day.  Other recommendations include eating foods high in fiber, avoiding carbonated drinks and limiting caffeine.

Boredom

People often fall into a rigid routine with age. While this predictable pattern often provides comfort, it can also lead to boredom. Try changing your routine or schedule. Learn a new skill (baking, painting, golf) or visit a new place (museums, libraries, community centers). Getting a part-time job or volunteering can be rewarding and stimulating.

Loneliness and Isolation

There are a number of reasons for one to feel lonely with age…children relocate, loss of a spouse, divorce. Experts say that it is important to take control by initiating contact with others. Call upon neighbors, friends, relatives, and former coworkers to chat or get together. Volunteer for a charity; join a book club or fitness group. Take classes at a local college and consider getting a pet.

Take Care of Your Health

Most health problems associated with aging can be treated. Regular checkups and routine diagnostic tests (blood work, colonoscopy, cardiac tests) will assure that health issues do not get out of control. Be sure to organize your medications and take them as directed. Keep a health journal or use and app on your phone to list meds, allergies and record tests and doctor visits.

SOURCES: National Institutes of Health; Mayo Clinic, WebMD

NEXT MONDAY – Read Dr. Paul J. Mackarey “Health & Exercise Forum!”   This article is not intended as a substitute for medical treatment. If you have questions related to your medical condition, please contact your family physician.

For further inquires related to this topic email: drpmackarey@msn.com

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

Paul J. Mackarey PT, DHSc, OCS is a Doctor in Health Sciences specializing in orthopaedic and sports physical therapy. Dr. Mackarey is in private practice and is an associate professor of clinical medicine at GCSOM.

Part 1 of 2

I have a vested interest in this column…I just had a big birthday! It is a BIG birthday because it is the one before I get health care insurance from Uncle Sam! Consequently, the “aging process” is very much on my mind!

In the book, “Being Mortal,” Atul Gawande discusses the role of medical care placing emphasis on “well-being” rather than survival, especially as it relates to end-of-life care. It is a “must read” for health care providers as well as the general public. The book also describes, in great detail, the process of aging; the physiology of bone and muscle mass loss, factors affecting balance and coordination, changes in mental acuity, memory, and mood. As depressing as it sounds (many of the changes begin as early as mid to late thirties), it is also a “call to arms!”

To prepare for the inevitable aging process one must be proactive, not reactive. From an early age, challenge yourself mentally by taking classes and learning things for which you may not have an interest. Try new physical activities and sports even if you feel unable to excel. Find balance in your diet by trying to eat fruits and vegetables that you don’t find appealing. Engage in daily exercise and physical activities even if you would rather be indoors playing video games. Lastly, get professional advice on matters beyond your scope. See your physician regularly for routine care and diagnostic tests, find a mental health professional if you are not at peace, consult with a physical therapist to help you design an exercise routine appropriate for your individual needs.

While it is never too late, remember, slowing down the aging process should not begin at 60, it begins at 30!

Joint Aches and Pains

While aching joints are expected with age, inactivity is not the cure. Controlled movement, exercise and sport modification, supportive devices, and non-prescription supplements and medicines can go a long way.

Controlled movement may include lifting lighter weights or doing squats at ½ or ¾ through your available range of motion. Sport modification includes playing pickle ball instead of tennis or brisk walking or biking instead of running. Supportive devices can be wrist or knee supports or enlarging your racket or golf club grips to lessen the impact on your hands. Over-the-counter treatments include; hot and cold packs, paraffin wax, topical ointments or medications, and nonsteroidal anti-inflammatory drugs (NSAIDs). When all else fails, see a physical therapist for professional advice and treatment and discuss other more aggressive options with your family physician.

Wrinkles

Unfortunately, your skin also suffers from the aging process by getting thinner, drier, and less elastic. Avoid the things that can make them worse such as; smoking and ultraviolet rays from the sun or a tanning bed. Protect your skin from the sun, and if you smoke, quit. Consider skin products like moisturizers or prescription retinoids that might make wrinkles less noticeable over time. However, if it is really an issue for you, see a dermatologist.

Dry Skin

Aging also makes your skin more vulnerable to drying but there are some things you can do. Use sun screen and wear sun resistant clothing and quitting smoking will go a long way. Drink alcohol in moderation because it can dehydrate you. Also, keep showers or baths to less than 10 minutes and use warm water instead of hot followed by applying oil-based moisturizer.

Loss of Muscle Mass and Bone Density

Loss of strength and endurance is common in seniors. The loss of bone density in women (and men) is also expected. The aging process is only partially responsible. Lack of exercise and activity can also contribute to the problem. Make time to exercise daily (or every other day). Weight training for your arms and legs can be easily performed using light to medium dumbbells or resistance bands. Aerobic exercise can include biking, walking, or swimming, gardening, or swimming for at least 30 minutes a day (or 15-minutes twice a day).

Loss of Balance

The loss of balance and coordination with age is a serious matter because it can lead to falls that impact long term health and independence. Studies show that those who continue to challenge themselves by riding a bike, dancing, or engage in traditional exercise are much less likely to suffer from early balance problems and are less likely to fall…so get to it! If you can’t do these activities safely, try holding onto your countertop and walk forwards, backwards and sideways, preferably when someone is home with you. See your doctor to be sure that you don’t have a medical condition or taking a medication that contributes to this problem.

Sleep Problems

Sleep problems are part of aging in many ways; difficulty falling asleep, staying asleep, lack of deep sleep, waking up and not being able to return to sleep, etc. Sleep deprivation can have a negative impact on physical and mental performance. There are some things you can do to improve your sleep such as avoiding coffee and alcohol. Also, try to avoid napping during the day. Talk to your doctor to keep problems that can impact sleeping like high blood pressure or GERD, under control and ask about melatonin supplements.

SOURCES: National Institutes of Health; Mayo Clinic, WebMD

NEXT MONDAY – Read Dr. Paul J. Mackarey “Health & Exercise Forum!”   Next Week: Part 2 of 2 on Slowing the Aging Process. 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: http://www.mackareyphysicaltherapy.com/forum

Paul J. Mackarey PT, DHSc, OCS is a Doctor in Health Sciences specializing in orthopaedic and sports physical therapy. Dr. Mackarey is in private practice and is an associate professor of clinical medicine at GCSOM.

PART I OF II

You are never too old to exercise! A reader who described herself as “elderly” asked me if she was too old to exercise. Without knowing her age, I replied that she was not. I did qualify my response with the fact that exercise must be adjusted to meet the individual needs of a person based on age, health status and goals. Her question, however, led me to think of the many “elderly” who may be apprehensive to begin an exercise program for a variety of reasons. Fear of injury and lack of information may be two reasons. Another reason, according to this inquiry, is the fact that so many exercise programs featured in the media are geared to the young and healthy or baby boomers and few focuses on the needs of those over 75, home bound and weakened by age and inactivity. Those running, biking, skiing, golfing at 75 and over and do not fall into this category, please do not be offended, you are the exception. God bless you!

Why would someone 75 or 80 be interested in an exercise program? Well, one must maintain adequate flexibility, strength, balance and endurance to safely function in daily activities around the house. For example, the most common goals of elderly patients are: climbing stairs, getting in and out of a shower, putting on shoes and socks, walking safely for functional distances, tucking in a shirt or fastening a bra, cooking, cleaning, and carrying groceries or laundry.

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, practical and easy exercises that focus on each of these categories.

Remember, for most people it is more harmful not to exercise, so contact your physician to discuss whether independent exercise is appropriate for you. You may need to consult with a physical therapist to get started.

STRENGTH EXERCISES

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 walking, lifting a ½ gallon of milk, transferring to a shower or chair safely.

Examples of Strength Exercises for the Upper Body

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.

Examples of Strength Exercises for the Lower Body in Sitting

Examples of Strength Exercises for the Lower Body in Standing

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!

NEXT MONDAY – Read Dr. Paul J. Mackarey “Health & Exercise Forum!”  Next Week: Never To Old To Exercise – Part II of II

This article is not intended as a substitute for medical treatment. If you have questions related to your medical condition, please contact your family physician. For further inquires related to this topic email: drpmackarey@msn.com

Paul J. Mackarey PT, DHSc, OCS is a Doctor in Health Sciences specializing in orthopaedic and sports physical therapy. Dr. Mackarey is in private practice and is an associate profession of clinical medicine at Geisinger Commonwealth School of Medicine.

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