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AFTER VACCINATION…MAINTAIN A HEALTHY IMMUNE SYSTEM

Every January, people make numerous resolutions related to health and wellness such as eating less and exercising more. As we enter our second new year living (or dying) with the COVID virus, it may be that the best health and wellness resolution is to GET FULLY VACCINATED!

The Omicron variant

The Omicron variant of SARS-CoV-2 is spreading throughout the United States like a wildfire. Consequently, a critically important New Year’s resolution is take action and seek the best protection possible. First and foremost, getting fully vaccinated offers the best protection considering the fact that the efficacy of the vaccination to prevent serious illness, hospitalizations and death is well-documented. Once vaccinated, taking care of your health and wellness is also important. The human body is designed to defend against some (but not all) foreign bodies such as germs, bacteria, and viruses. 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

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.

10 TIPS TO MAINTAIN A HEALTHY IMMUNE SYSTEM:

  1. GET FULLY VACCINATED!
  2. Don’t Smoke – it is obvious why this tip is critically important
  3. Eat a Mediterranean Diet – high in fruits and vegetables, fish/seafood, nuts, seeds, legumes, extra virgin olive oil and minimal amounts of red meat and Drink Plenty of Water … and drink alcohol in moderation
  4. Maintain a Healthy Body Weight – body mass index (BMI) between 18.5 and 24.9 is healthy. To calculate your BMI: www.nhlbi.nih.gov
  5. Get Adequate Sleep – 8 hours is a good goal but if not possible, supplement with a daytime nap
  6. Practice Good Hygiene – Avoid infection by washing hands often and thoroughly. Flossing and brushing your teeth is also important.
  7. Prepare Foods Properly - clean meat/fish cutting surfaces and cook food thoroughly
  8. Limit stress and Be Positive - make time to reflect and meditate and, when possible, avoid people who “suck the oxygen out of the room!” YouTube “Progressive Muscle Relaxation” for easy to use relaxation techniques
  9. Be Active – physically and mentally – keep your body and mind moving and when possible spend time outdoors and enjoy the natural beauty of NEPA
  10. Exercise – BUT DO NOT OVER EXERCISE! While exercise is an essential part of a healthy immune system, over exercise can weaken your immune system. In fact, many marathoners report a mild fever and flu-like symptoms after running the 26.2 mile race. 

Maintain a Healthy Immune System

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 in exercise you will be at greater risk for musculoskeletal injuries and may weaken your immune system. This is especially true for those who are newcomers. The goal is to gradually work into a fitness program and maintain it for life. 

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!

EVERY MONDAY – Read Dr. Paul J. Mackarey “Health & Exercise Forum!”

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

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: mackareyphysicaltherapy.com/forum

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/

I know that we are all tired of wearing masks. It can be hot, hard to breath and difficult to speak. People feel claustrophobic or confined behind them. Personally, I, too, feel exhausted after a full day in my mask. However, they continue to serve an important role in controlling the spread of COVID … even after we are vaccinated. Evidence has proven that wearing a mask reduces the risk of infection up to 89% and can block 70% of expelled droplets and particles (CDC.org).

Both Pfizer and Moderna vaccines have been released for public use. Many are fearful or wary of them for a variety of reasons. A main concern is that they were “rushed to market.” Last week’s article dispelled many of the myths and concerns the general public is having with the vaccines. The two vaccines have been put under rigorous testing and analysis, more than most vaccines on the market today. Concerns about the vaccines are understandable, but negative outcomes have been few and far between. However, due to the timely release of the vaccines and our inability to examine long-term effectiveness, several factors suggest that wearing a mask will continue to be vital in our fight against COVID-19. Therefore, we will not be shedding our masks anytime soon.

It may take months to distribute the vaccine to the general public

The distribution of the vaccine requires that each vial be frozen at very cold and constant temperatures. As they thaw, they lose effectiveness. Many facilities, especially in the rural parts of the country, do not have the capabilities to properly store the vaccines under the ideal conditions. It will take time to make these vaccine storage facilities safe for COVID vaccines. But fear not, as the details and logistics improve as you read this column, the vaccine will be available to the general public soon!

The amount of time we wear a mask depends on how many people get vaccinated

It is estimated that we need 80% of the population to get vaccinated for the infectious rate to swing in our favor. This means that we need the general public to unite and work as one to fight the spread of the virus. Yes, it is scary taking a new vaccine that has no long-term data, however, with over 1.5 million dead from COVID-19 it seems this is the best option. As a community, we have to band together, trust our science and act in the best interest of all.  

Immunity of vaccine does not happen immediately

Do not have a false sense of the security immediately following your vaccination! Pfizer reports that “it takes a few weeks” and Moderna reports 2 weeks for people to build up an immunity of 50% after the first vaccine. The timeline repeats again after the second vaccine resulting in 95% immunity. During that time, you are still able to contract and spread COVID-19. The use of masks during this time is necessary to keep yourself and others safe.

It is unknown if people who are vaccinated can still spread the disease

The clinical trials conducted on the vaccines did not examine if the participants should continue to wear masks. The study only investigated if the individual built up enough antibodies to become immune themselves. Therefore, we do not know if the participants could still be carriers of the virus and continue to infect others that were not vaccinated.

Anthony Fauci, MD, director of the National Institute for Allergy and Infectious Diseases and lead member of the COVID Task Force, recently reported that there is some evidence that the Moderna vaccine may provide a vaccinated individual protection against spreading the virus. However, more time and data are required to confirm these findings.

Not all are able to get vaccinated

It is important to remember that many immunosuppressed, autoimmune and pregnant individuals are not suitable for the vaccine. Until we are confident that vaccinated people are not “silent carriers” of the virus, the continued use of a mask is an important measure in protecting the most vulnerable people in our communities.

The duration of vaccine immunity is unknown

Until long-term data is available on the vaccines, we do not know how long our immune system will continue to produce antibodies. Antibodies protect us against the virus. This will be monitored as the distribution of the vaccine continues. The good news is, that we have observed individual’s immune system maintain antibodies up to six months in those who recovered from COVID-19. It is expected that the vaccine will at least mimic that immune system response.

2021 Is our year!

There is some light at the end of the tunnel … 2021 will be known as the year that the world took control of COVID-19! We will be shedding our face-protecting cloth companions soon enough. For now, we must wait, stay the course and continue to wear our mask, even after we are vaccinated. As time passes, we will know more about the vaccines and many of the uncertainties in this article will be answered. Until then, mask up, get vaccinated and be safe for yourself and others.

GUEST COLUMNIST: Paul Mackarey, Jr. DPT is clinic director at Mackarey & Mackarey Physical Therapy Consultants, LLC where he specializes in the prevention and treatment of neck and LBP.

NEXT MONDAY – Read Dr. Paul J. Mackarey “Health & Exercise Forum!” Next Week – LBP Part II of III

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

For all of Dr. Mackarey's articles visit our website: 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 in downtown Scranton and is an associate professor of clinical medicine at GCSOM.

Visit your doctor regularly and listen to your body.     

The New Year brings renewed energy in our collective efforts to win the race against a common foe. If we intend 2021 to be a year of joy and hope — we absolutely need to use all viable tools at our disposal and unite in our efforts to beat the coronavirus. One such tool is vaccines, considered one of the most important advances in modern medicine, and has been responsible for greatly improving our quality of life over centuries. Vaccines have allowed us to triumph over serious adverse diseases by reducing or eliminating many dangerous infectious diseases we don't even think about anymore.

Vaccination research and development has never stopped. Global partnerships have been formed to create faster, more efficient platforms and new technologies to help us against the onslaught of diseases like Ebola, Zika, and the coronavirus family — SARS (severe acute respiratory syndrome), MERS (Middle East respiratory syndrome), and now SARS-CoV-2 (severe acute respiratory syndrome coronavirus 2).

 The victory of vaccines, our most promising counter-pandemic measure, in our fight against a pathogen like SARS-CoV-2, the virus that causes Covid-19, relies on a critical mass of people becoming immune to the virus. This breaks the chain of transmission and, most importantly, protects the most vulnerable people in our community who cannot develop immunity through vaccination. This is called herd immunity — vaccines go beyond our individual benefit; it protects us as a community. Imagine this vaccinated community surrounding a pregnant mother who cannot get vaccinated now; she is protected through this invisible shield of the community blocking SARS-CoV-2 from reaching her.

Vaccine safety requirements are among the highest in the nation because they are widely distributed. Two vaccines (Pfizer/ BioNTech and Moderna) received U.S. emergency use approval (EUA) from the FDA. Nearly 2.8 million people in the U.S. have received a Covid-19 vaccine to date. Dr. Francis Collins, director of the U.S. National Institutes of Health, received the Moderna vaccine on December 22, 2020 — saying the two vaccines had been examined and put through more rigorous analysis than most vaccines to date. Nonetheless, some common myths are surrounding both vaccines:

Dispelling Myths About the COVID 19 Vaccine:

You can get COVID-19 from the vaccine.

Both approved U.S. vaccines contain no virus or viral particles. You are not injected with any part of a virus. The vaccines use synthetic messenger RNA (mRNA) that our cells can read to make a specific piece of the virus, which on its own cannot harm. This piece is the protein spikes on the outside of the virus, and it is what helps the virus dock onto a human cell and allows it to infect us. By allowing our cells to reproduce this spike temporarily, we teach our immune system what to look for in the face of a future coronavirus attack. This memory of what to look for provides us immunity and allows us to respond much faster.

Speed of development affected safety and efficacy.

The development of the current vaccines did not start in January 2020. Science has been paying close attention to the coronavirus family for many years. Research into the messenger RNA technology used in the Pfizer/ BioNTech and Moderna vaccines has been in development for close to 15 years. The perceived speed in getting the vaccines to the public is partly due to unparalleled worldwide emergency cooperation, free sharing of information, and new faster technology platforms. Also aiding has been billions in private and public funding, allowing vaccine firms to run preclinical and phase I, II, and III trials in parallel instead of sequentially. The FDA completed a meticulous safety review, and the independent Advisory Committee on Immunization panel scrutinized safety and efficacy data from the clinical trials.

The Vaccine can alter your DNA.

Your cell's DNA is securely kept inside a nucleus in the cell. The snippet of mRNA that gets injected does not gain access to the nucleus and never comes in contact with your DNA. Your cell machinery translates the mRNA and manufactures the viral spike protein needed to present to your immune system. Once the instruction is read, human cells break down and get rid of the mRNA.

If I had COVID-19, I wouldn't need the vaccine.

Currently, we don't have enough information to definitively know how long after infection someone might be protected from getting reinfected with Covid-19. Early indications suggest this natural immunity may not last very long. The CDC recommends getting vaccinated. However, if you are currently infected with Covid-19, the recommendation is to delay vaccination until the illness has resolved.

You can stop wearing a mask after you're vaccinated.

According to Dr. Anthony Fauci, Director of the National Institute of Allergy and Infectious Diseases, getting rid of public health measures like wearing a mask is only possible once there are extremely low levels of circulating virus left. For this to happen, we need 75-95 percent of people to have immunity to the coronavirus.

COVID-19 vaccines are stored at extremely low temperatures because of preservatives in the vaccines.

Both Pfizer/ BioNTech and Moderna have reported that their vaccines contain no preservatives. The vaccines are created using a novel methodology to synthesize the mRNA, encapsulated for protection in a lipid or oily shell. This technology allows the vaccine to be free from materials of animal origin, egg, and without preservatives. However, mRNA is fragile and can break down easily. Storing vaccines in ultracold environments keeps them stable and safe. Vaccines are thawed before injection.

What are the risks?

Life and vaccines never present us with absolute safety in usage. We must acknowledge this — vaccines do carry some risks. Of the close to 2.8 million U.S. vaccines to date, very few recipients reported short-term mild or moderate symptoms that resolved without complication within a day or two. These included sore arms, redness at the injection site, headache, chills, fatigue, muscle pain, or fever — all expected indicators that your immune system is responding to the vaccine — and comparable to side effects seen with the shingles vaccine. As of December 23, 2020, the U.S. has seen 10 cases of anaphylaxis. Anaphylactic reactions can occur with any vaccine but are extremely rare. The cases occurred in people with a significant history of severe allergies and were safely managed with epinephrine, and the CDC has distributed safeguard protocols to vaccine sites.

 But, compare these calculated vaccination risks to that of the virus itself — which has infected more than 83 million people globally and killed approximately 1.8 million — including more than 350,000 deaths in the United States. Now add in the devastation caused to economies and health systems. Dr. Walter Orenstein, the former director of the United States' National Immunization Program, wrote that if vaccines are not administered to the persons they are recommended for, there is zero impact. In the current pandemic, time is lives. We need an estimated 80 percent of people vaccinated to reach herd immunity to have a fighting chance to stop this pandemic in its tracks — and we need to get it done now.

We face a collective threat — a pandemic, and a moral dilemma on choosing to be vaccinated. Concerns over the vaccines' safety are understandable, but reports on negative outcomes are few and far outweighed by the benefits. This quarantine year has taught me that we are intrinsically bound to our community, only truly to thrive through community involvement and participation. We need each other, and we have an obligation to take care of one another. Getting a Covid-19 vaccine is not just about you; it is protecting your grandmother who has diabetes, your neighbor who is immuno-compromised — it safeguards everyone who is medically unable to receive a vaccine and needs you as their human shield against coronavirus reaching them. Vaccinations save lives — when your eligibility phase comes up, be a solid citizen, loving caring child, sibling, parent, and spouse…GET IT!

This column is a monthly feature of “Health & Exercise Forum” in association with the students and faculty of Geisinger Commonwealth School of Medicine.

Author: Hendrik Marais, MD, MS

Hendrik Marais, MD, MS, received his Doctor of Medicine degree from Geisinger Commonwealth School of Medicine in 2015 and his Master of Science degree in Global Medicine from Keck School of Medicine at USC in 2019. He is passionate about creating positive and empowered patient health outcomes. He grew up in South Africa and currently calls Scranton, PA home – where he enjoys cycling, swimming, and discovering the beauty of NEPA. He is a member of the American Medical Association, American Public Health Association, and the International Society of Physical and Rehabilitation Medicine. He plans to pursue a clinical career in physiatry.

NEXT MONDAY – Read Dr. Paul J. Mackarey “Health & Exercise Forum!”

Read all of Dr. Mackarey's articles at https://mackareyphysicaltherapy.com/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.

Exercise and be Happy!

Part II of II

Last week in Part I on Depression I discussed the importance of laughter for the prevention of depression. In this column, I will discuss one of the most understated benefits of exercise – mental health! Specifically, aerobic exercise (exercise that increases your heart rate for 30 minutes or more) such as walking, biking, running, swimming, hiking, elliptical & stepper machines to name a few, is the secret to “runner’s high.” This exercise euphoria is not limited to runners alone, but all who engage in aerobic exercise are more likely to experience high energy, positive attitude, and mental wellness.

Physical activity, specifically aerobic exercise, is a scientifically proven useful tool for preventing and easing depression symptoms. Studies in the British Journal of Medicine and the Journal of Exercise and Sports Science found that depression scores were significantly reduced in groups that engaged in aerobic running, jogging or walking programs, 30-45 minutes 3-5 days per week for 10-12 weeks, when compared to a control group and a psychotherapy counseling group.

Depression is the most common mental disorder and is twice as common among women as in men. Symptoms include: fatigue, sleeplessness, decreased appetite, decreased sexual interest, weight change, and constipation. Many of these symptoms are likely to bring an individual to their family physician. Unfortunately, depression is on the increase in the United States. According to the National Ambulatory Medical Care Survey, in the early 2000’s, 7 million visits to a primary care physician were for the treatment of depression. 10 years later the number doubled.

HOW EXERCISE REDUCES DEPRESSION

            According to research reported in The Physical and Sportsmedicine, exercise reduces depression in two ways, psychologically (mentally) and physiological (physically). 

Psychological or Mental Benefits of Exercise on Depression:

Physiological or Physical Benefits of Exercise on Depression:

HOW TO BEGIN EXERCISE FOR DEPRESSION

Work hard to recognize and overcome these symptoms to begin an exercise program. An aerobic exercise routine should eventually lessen these symptoms.

Read Dr. Mackarey’s Health & Exercise Forum – every Monday

Access all of Dr. Mackarey's articles in the Health and Exercise Forum at: https://mackareyphysicaltherapy.com/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 GCSOM.

Laugh and Walk Your Way to Happiness!

Part I of II

It has been 9 long months living with COVID 19! Most of us are weary and tired of social distancing, wearing masks, visiting with family from a distance or virtually. We miss the hugs and kisses of our family and friends. While it is critically important that we continue to stay vigilant, with no end in sight people are beginning to get “the COVID BLUES.” It only takes a few other problems like stress at work and health issues to put you over the edge…

Depression is the most common mental disorder and is twice as common among women as in men. It impacts life in many ways; family, friends, work, play and general health. Symptoms include: fatigue, sleeplessness, decreased appetite, decreased sexual interest, weight change, and constipation. Many of these symptoms are likely to bring an individual to their family physician. Unfortunately, depression is on the increase in the United States. According to the National Ambulatory Medical Care Survey, in the early 2000’s, 7 million visits to a primary care physician were for the treatment of depression. 10 years later the number doubled.

Recent research is very encouraging and supports the use of laughter and exercise to prevent and treat depression as a powerful adjunct to therapy and medication. While it is important to state that depression is no laughing matter, many mental health professionals support it as a method to confront an unpleasant situation and gain some level of control over it. One study showed that in elderly people who used humor on a regular basis, reported improved satisfaction in life as compared to their less humorous contemporaries.

4 Reasons Why Humor is Helpful in Battling Depression (based on recent studies)

1. Humor Demystifies Depression

Humor lets others know that you can be depressed and still be human…a productive and valuable member of society. For example, “I’m depressed but I am not a bad person and I can still be funny and fun to be around.”

2. Humor Improves Your Mood

Humor lightens temperament as it increases blood flow to the brain to release dopamine and endorphin, which are chemicals that improve mood.

3. Humor Relieves Stress

Humor increases chemicals in the brain that control the release of a stress release hormone called cortisol.

4. Humor Improves Self-Esteem

Telling a joke, being funny, and making others laugh, make YOU feel good about yourself…and feel more normal.

4 Tips to Improve Your Sense of Humor

1. Hang Around With Fun and Funny People

Whenever possible, try to associate with good people who “pick you up” and have good karma. Avoid people who are “downers” and tend to “such the oxygen” out of the room.

2. Listen to Jokes & Learn to Enjoy Them

While this may be difficult to do when your down, but it will go a long way to pick you up.

3. Learn to Tell a Joke

This is also not easy but very important to improve your sense of humor. It will help you rediscover your “inner child.” Ease into it and start slowly. Practice in front of a mirror in the privacy of your home. Begin using it on family and good friends.

4. Joke About Your Depression

It will be cathartic. For example, “oh my God, that would be so funny if I wasn’t depressed!” “Don’t tell my shrink I laughed so hard because he will take away my meds!” Don’t put yourself down, but laugh at yourself if you mess up telling a joke or trying to be funny. Then, try again.

Sources: LifeScript.com. If you or someone you know is in danger from depression contact the American Foundation For Suicide Prevention at 1-888-333-2377.

Read Dr. Mackarey’s Health & Exercise Forum – every Monday. Or view all of Dr. Mackarey's articles in out Health and Exercise Forum at: https://mackareyphysicaltherapy.com/forum/

Next Week, Part II of II - Exercise to Prevent Depression.

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 GCSOM.

A Pandemic Therapy

For most, walking can be the perfect pandemic activity. Walking is socially distanced, yet not isolated, while offering many health benefits.

Walking changes the world. Recently, when protesters demanding racial justice marched on Washington, they followed the footsteps of defiant walkers throughout history. From Mahatma Gandhi and the Indian independence movement to Martin Luther King, Jr., and the civil rights movement, walking and protest have been interrelated.

Walking is about more than walking, and always has been. Walking soothes. Walking inspires and sharpens the mind. The pandemic has taken away much... not only lives, livelihoods, but our need to feel free too. While there is much we can’t do, WE CAN WALK!

It might be said that with the right mindset, every walk is a pilgrimage. Many a breakthrough has been stumbled upon while putting one foot in front of the other. We run from problems. We walk toward solutions. While working on A Christmas Carol, Charles Dickens would walk 15 or 20 miles through the back streets of London, turning over the plot in his mind as the city slept. Beethoven found inspiration while ambling in the verdant Wienerwald outside Vienna.

Recent studies suggest that walking stimulates our creative mind is at its most creative at three miles per hour, the speed of a moderately paced stroll. Stanford University researchers divided participants into two groups: walkers and sitters. They then administered a test designed to measure creativity. They found that creative thinking was “consistently and significantly” higher for the walkers than the sitters. It didn’t take a lot of walking to boost creativity, either—anywhere from 5 to 16 minutes.

Studies have also shown that people who walk regularly are healthier and live longer than those who don’t. Surprisingly, you don’t have to walk very fast or far to enjoy this benefit. One recent study, published in JAMA Internal Medicine, put the 10,000-step myth to rest. It is an arbitrary number. People—older adults in particular—accrue health benefits by taking only a few thousand steps each day, and at a leisurely pace.

Benefits of Walking

In addition to stimulating creativity and reducing stress, walking has many benefits. “There’s no question that increasing exercise, even moderately, reduces the risks of many diseases, including coronary heart disease, breast and colon cancer, and Type 2 diabetes,” said Dr. Jennifer Joyce, MD, professor of family medicine at GCSOM. “Research has even shown that you could gain two hours of life for each hour that you exercise regularly.”

According to the American Heart Association, walking as little as 30 minutes a day can provide the following benefits:

Like everything, there is a right way of doing something, even walking. For efficiency and safety, walking with proper stride is important. A fitness stride requires good posture and purposeful movements. Ideally, here's how you'll look when you're walking:

Plan Ahead

Set Realistic Goals

Anything is better than nothing! However, for most healthy adults, the Department of Health and Human Services recommends at least 150 minutes of moderate aerobic activity or 75 minutes of vigorous aerobic activity, or an equivalent combination of moderate and vigorous aerobic activity. The guidelines suggest that you spread out this exercise during the course of a week. Also aim to do strength training exercises of all major muscle groups at least two times a week.

As a general goal, aim for at least 30 minutes of physical activity a day. If you can't set aside that much time, try several short sessions of activity throughout the day. Even small amounts of physical activity are helpful, and accumulated activity throughout the day adds up to provide health benefits.

Remember it's OK to start slowly — especially if you haven't been exercising regularly. You might start with five minutes a day the first week, and then increase your time by five minutes each week until you reach at least 30 minutes.

For even more health benefits, aim for at least 60 minutes of physical activity most days of the week.

Track Your Progress

Keeping a record of how many steps you take, the distance you walk and how long it takes can help you see where you started from and serve as a source of inspiration. Record these numbers in a walking journal or log them in a spreadsheet or a physical activity app. Another option is to use an electronic device such as a pedometer or fitness tracker to calculate steps and distance.

Sources: National Geographic; Mayo Clinic

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!”  

Read all of Dr. Mackarey's articles at: https://mackareyphysicaltherapy.com/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.

TRY A NEW APPROACH TO WEIGHT LOSS

MINDFUL EATING!

There are many health issues associated with COVID 19 and gaining weight seems may be the most common of all. There are many reasons for weight gain during this stressful time and one of these is the psychology of eating. In the land of plenty, we eat mindlessly! Consider the facts. First, we blamed the food, thinking it was bad. But, when we chemically modify the food to remove or alter the fat or sugar and remove the calories, it fails to reduce our weight. In fact, it has been discovered that “fake sugar,” even though it does not have calories, can still increase blood glucose levels. Next, we decided that fat cells were the enemy, but when we removed fat cells from our body through liposuction, we failed to control weight gain. Then, we decided the problem was our digestive systems, so we placed bands or staples in the stomach or by-passed the small intestine. While these efforts helped many in the short run, long term, it failed as a long-term solution without a change in behavior. Many medical professionals have concluded that the problems people have with weight are not exclusively due to the food, fat cells, stomach or intestines, but rather, THE MIND! 

WHAT IS MINDFUL EATING?

Mindful eating, also referred to as intuitive eating, is based on Buddhist teachings which focus on the experience of eating, AND ENJOYING, our food. The concept was presented in a feature column in The New York Times written by Jeff Gordinier, based on his time spent in a Buddhist monastery. He learned that mindful eating practitioners eat in silence and chewed small pieces of food very slowly and deliberately to experience its taste, texture and smell. He discovered that it requires full attention to the experience of eating and drinking on the body and mind. It is often referred to as “the opposite of diets” because with mindful eating there is no right or wrong way to eat, but rather varying degrees of awareness about WHAT WE EAT AND WHY. The goal of this exercise is to teach our mind and body to connect and communicate while eating so one can learn important cues such as: what are my hunger signals? What does my stomach feel like when it is half, three-fourths and completely full?

THE RESEARCH

One study of 1,400 mindful eaters found that they enjoyed lower body weights, greater sense of well-being and suffered from fewer eating disorders. However, many feel the concept, while valuable, is very difficult to put in practice in the busy American family. Fortunately, research shows that the simple act of the family meal can have a powerful impact on mindfulness, health and wellness, even if it isn’t a picture-perfect meal.  

In a country that thrives on a fast pace with over-booked schedules, families struggle to balance work and school and after school sports and activities. Consequently, fast food, eat-and-go habits have become the norm. According to some studies, most find it difficult to sit and relax for a family meal even once a week. And often, when families do pull off a family meal, it is often overwrought with school drama, sibling rivalry, and parental discipline about school, homework or social activities, making the situation stressful. Even so, despite the family conflict, studies strongly support the health values of the family meal.

A recent study from Columbia University that received national attention found that children who participated in a family meal regularly were less likely to have problems with drugs or alcohol and more likely to excel in school. Moreover, those children eating with their families at least 5 times per week benefited most. Other studies have found that there is a significantly lower incidence of teens who smoke, use alcohol, have sex at a young age, fight, get suspended from school or commit suicide among those who have meals with their family on a regular basis. 

Tips for Mindful Eating

By Christopher Willard PsyD
Mindless EatingMindful Eating
1. Eating past full and ignoring your bodies signals1.Listen to your body and stopping when full
2. Eating when emotions tell us to eat2.Eating when our body tells us to eat
3. Eating alone and at random times and places3.Eating with others at set time and places
4. Eating food that is emotionally comforting4.Eating food that is nutritious and healthy
5. Eating and multitaking5.Eating and just eating
6. Considering a meal an end product6.Considering where food comes from

1 Let your body catch up to your brain

Eating rapidly past full and ignoring your body’s signals vs. slowing down and eating and stopping when your body says it’s full.

Willard suggests that slowing down the process of eating may be the best way to get our mind and body to communicate their nutritional needs. For example, it is well documented that there is a 20 minute delay from the stomach to the brain…which is why we continue to eat when we are full, only to feel overstuffed 20 minutes later. Eating mindfully involves: slowing down, sitting and relaxing, chewing our food 20 or more times, setting your fork down between bites, and practicing other table manners that promote slower eating and allows you to listen to the hunger/full signals from your body.

2. Know your body’s personal hunger signals

Are you responding to an emotional want or responding to your body’s needs?

It is important to distinguish between your unique hunger signals from your BODY (stomach growling, low energy, lightheadedness) as opposed to EMOTIONAL signals (stress, sadness, frustration, loneliness or boredom). Mindful eating requires listening intently to your body…knowing your body.

3. Develop healthy eating environments

Eating alone and randomly vs. eating with others at set times and places

Rummaging through kitchen cabinets in search of food and snacks and eating at random times and places are classic examples of eating mindlessly. Slow down, think about your hunger and how long it’s been since you have last eaten. Instead, plan a healthy snack or meal at set times and places. Plan you grocery list with this in mind. Keep a log or use a daily/weekly planner if necessary.

4.Eat food not comfort

Eating foods that are emotionally comforting vs. eating foods that are nutritionally healthy

Certain foods, many that contain sugars and fats, stimulate the pleasure centers of the brain and become the source of “cravings.” However, over time, we can retrain the brain to derive pleasure from healthier foods. Mindful eating involves thinking first, eating second, and choosing healthy options such as carrots, apples, grapes, oranges as a snack instead of cake, cookies, or chips.

5. Consider the life cycle of your food

Considering where food comes from vs. thinking of food as an end product

In hunter-gatherer cultures, people pay spiritual homage to those who provided the food and the plants and animals sacrificed in the process. Modern man/woman has been disconnected from their food and often eat without thought. Slowing down allows us to consider the farmer, butcher, baker, grocer, and those who prepare our food and bring it to the table. It can be both spiritual and thankful.

6. Attend to you plate

Distracted eating vs. just eating

Mindful eating avoids distraction. The classic example of eating the big bowl of popcorn at the movies and wondering at the end of the movie who ate it? When we are distracted we cannot listen to our body’s hunger/full signals and we overeat. Try single-task eating without phones, tablets, computers, or televisions. Instead, share some light conversation with a friend or family member.

EVERY MONDAY – Read Dr. Paul J. Mackarey “Health & Exercise Forum!”

Get all of Dr. Mackarey's articles at our website: https://mackareyphysicaltherapy.com/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.

Science:

A miniscule piece of single-stranded RNA virus has caused over 22 million cases and 776,000 deaths worldwide and is estimated to cost about 10% of the world’s total economic output ($8.8 trillion). The United States remains the most affected country alone with over 5 million confirmed cases. As millions remain jobless and no end in sight, we are all left to ask “What is the coronavirus and why is it so different?” The key aspect of the coronavirus (which is similar to other pandemics) is its novelty and easy human-to-human transfer. Being considered a “novel” virus refers to the fact of its original transfer from animal to humans who have never been in contact with this type of virus. As a result, our bodies have not developed immunity to this particular strain of virus and this allows for the rapid world-wide distribution of the infection that we are currently experiencing. Further, the ease of transmissibility of the coronavirus via the respiratory route (meaning that the virus can remain in mucous membranes of the nose and the mouth and can spread via droplets) from person-to-person further propagates the problem. Even simply talking in close distance can spread the virus. Additionally, the virus is enveloped (“corona meaning “crown” or “wreath” in Greek), which allows the virus to be adherent to surfaces for a couple of hours even after the original host has left.

Personal Impact:

I saw firsthand the extent of the medical problems this virus can cause as my mother, who works in an in-patient nursing unit, became positive for COVID-19. 10 weeks ago, she woke up feeling fatigued in the morning which she attributed to inadequate sleep. Approximately 3 hours into her shift, she was feeling unwell and feverish. Fortunately, she was able to get same-day testing at an urgent care and was told to quarantine for the next 2 weeks with over-the-counter medication of Advil, Tylenol, or Aspirin. After 4 days of stable symptoms and vitals, things took a turn for the worse as she started to experience severe headaches, increased fever, nausea, and vertigo, and weakness which prompted us to visit the emergency room. A week later, respiratory symptoms became much worse as she started experiencing sharp intermittent chest pain, productive cough, and her oxygen levels were 89% (normal is 99%). These symptoms occurred multiple times in the next couple weeks and led to more emergency room visits. Ultimately, she ended up developing pneumonia. From the initial onset to resolving of most, but not all of her symptoms, took a total time of 6 weeks. Her age, health care occupation, and underlying Type II diabetes played a role in the complicated and long course of her recovery and is still not 100%. 

Further complicating our problem was the fact that we did not have immediate confirmation COVID test. Further, our health care services refused to test other family members and did not recommend us being guaranteed until we showed symptoms, even though we had been in contact with my mom. However, we still self-guaranteed and got tested from MedExpress. It is important to remember that COVID does have an asymptomatic infectious period and it was important to us that we do not spread it to other people. 

Unfortunately, I have had other relatives who have also been positive for COVID and have not been as lucky as my mother. They have passed away. As a result of these personal experiences and my status as a medical student, I took the opportunity to research this problem in greater detail which has enlightened me about the proper management of this disease. I would like to share this information and recommend the following to the general public if you need to quarantine an exposed family member returning from college, travel or work:

Prevent Transmission

  1. Isolate: Find a room to isolate the infected person as well as a dedicated bathroom for the person
  2. Control Air Flow: Turn off outflow vents in the isolation room. Duct tape the vents shut to prevent any air circulation to the rest of the house
  3. Medications: Tylenol, Advil, Aspirin, anti nausa
  4. Medical Equipment: Volumetric Exerciser for breathing exercises (simple balloon can be substituted), pulse oximeter (to check oxygen levels), gloves, alcohol and thermometer.  
  5. Disinfectants: disinfectant sprays, towels, and bleach-based products, to clean door knobs, etc.
  6. Wedges/Pillows: to elevate the trunk and head if one develops difficulty breathing or pulse oximeter readings are low (below 95). Use 4/5 pillows when sleeping as oxygen levels can drop very low during nights as laying down flat makes it hard to breath.   
  7. Emergency Contact Numbers: If the need to go to emergency room, call ahead so they can get ready for your arrival to decrease any spread.
  8. Family Support: is essential. One of the best ways that family members can assist is to cook healthy foods, high in protein. My mom attributes most of her recovery to eating high protein foods such as boiled eggs and milk. She also felt that cooked vegetables and drinking warm water frequently was valuable.
  9. Clean Up: after infectious period is over, local disinfection services to disinfect the house may be helpful.

10.) Prevention – without a doubt, the single best treatment for COVID-19 is PREVENTION! Wear a mask, wash your hands, and maintain at least 6 feet distance!

It is important to know that frontline workers who are placing themselves at risk in this pandemic such as nurses, physicians, and health care workers such as my mom are the backbone of our health systems. Keeping yourself healthy, keeps them healthy too!

Visit your doctor regularly and listen to your body.     

Keep moving, eat healthy foods, exercise regularly, and live long and well!

Vaibhav Sharma, MD3  is currently a third-year medical student at Geisinger Commonwealth School of Medicine. He completed his undergraduate studies at the University of Pittsburgh in the field of Neuroscience."

NEXT MONDAY – Read Dr. Paul J. Mackarey “Health & Exercise Forum!”  

Read all of Dr. Mackarey's articles at our website: https://mackareyphysicaltherapy.com/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.

Florida, Texas, and Arizona have recently reported the highest single-day totals of new COVID-19 cases. The data suggests that reopening too quickly, without adequate guidelines and restrictions is a documented failure. Consequently, Washington State is the latest state to delay its reopening plans. No matter how much we want to return to our normal lives, our lives before COVID-19, we must remain vigilant! The Director of the National Institute for Allergies and Infectious Diseases, Dr. Anthony Fauci, has repeatedly said, “You don’t make the timeline; the virus makes the timeline.”

The pandemic is not over and is not going away anytime soon. We can’t just go off to bars, sporting events, concerts, or summer camps and pretend all is well. Instead, we must learn to live with the virus for now. While feelings of frustration, confusion and even depression have become commonplace, we cannot let our guard down…whether your area is in red, yellow, green or phase 1, 2, or 3.

According to Aaron Hamilton, MD, Associate Chief Safety and Quality Officer at The Cleveland Clinic, “There’s still a lot of COVID-19 in our communities and in our hospitals. We’ve done a lot in society to flatten the curve, which kept people safe and helped healthcare manage the critically ill patients – but this isn’t going away over the course of the summer. The virus is not gone.”

As states and businesses open back up and life tries to carry on, it can be tricky to determine what activities and events are safe and what’s worth skipping. Dr. Hamilton feels that being aware of (and following!) the proper guidelines and safety measures can help you determine the risk level associated with a particular activity. There are actions we can all take that might not look or feel normal, but they can help protect us as we all learn to live in this new world. 

Consider time, space & people: These are the three main factors to consider attending an activity or event; time, space and people

Time

Less is better! Carefully weigh how much time you’ll be spending at the activity. Less time means limiting your risk of exposure to the virus.

Space

Where is the activity or event being held...outside or indoors? If it’s indoors, consider how enclosed or ventilated the space is. We know that it’s safer to be outside than inside (but that doesn’t mean the risk of catching the virus outdoors is zero). You should also consider if the space has a limit on how many people can be there at one time. This will clue you in to how easy or difficult it will be to maintain physical distance from others.

People

Are the people attending the activity or event outside of your direct household? Consider if they will be following and respecting safety guidelines, which include: 

Where on the spectrum does the activity fall?

“When thinking about the risk of an activity, I like to think of it as a spectrum,” explains Dr. Hamilton. “It’s less about safe vs. not safe, and more about layers of risk. Everybody will have to do a risk assessment for themselves and determine where they’re comfortable and what safety guidelines they’re going to follow.”

On one end of the spectrum, the absolute safest thing to do is to stay at home with your family. On the other end of the spectrum would be large, indoor gatherings. Certain activities will always carry a much higher risk than others. A large, indoor concert is going to be more dangerous than an outdoor picnic with a couple of friends who are following safety measures. How often you choose to partake in riskier activities and events matters as well.

The degree of safety depends on the degree to which you comply with the guidelines.

9 popular activities and events and what to consider when it comes to weighing the risk.

(Dr. Aaron Hamilton, The Cleveland Clinic)

As we all try to determine our new normal, remind yourself that the recommendations are there to keep COVID-19 in a place where we can manage it until we have treatments and vaccines available.

Source: Cleveland Clinic

EVERY MONDAY – Read Dr. Paul J. Mackarey “Health & Exercise Forum!”

Check out all of Dr. Mackarey's articles in our archives at: https://mackareyphysicaltherapy.com/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