Introduction: (Dr. Paul Mackarey)

I have invited Gretchen Welby, PharmD, MHA to present the current wisdom on the very controversial topic of vaccination/immunization to raise awareness and dispel any myths and misunderstandings.

Scientific progress has rarely advanced by popular vote, and vaccination is no exception. While public sentiment deserves respect and thoughtful engagement, the evidence guiding immunization policy is built on decades of rigorous research, transparent testing and continuous review. These research processes are designed precisely to rise above fear, trend, politics or misinformation. Choosing to prioritize scientific findings over shifting opinion is not an act of dismissal, but of responsibility…it is a commitment to decisions that protect both individual lives and the collective good, even when those decisions challenge what feels comfortable or widely believed.

Vaccination Facts:

2024 marked the 50th anniversary of the World Health Organization’s Expanded Programme on Immunization (EPI).  An initiative to make life-saving vaccines available to all worldwide.  A modeling study done to mark the 50 years of EPI estimated that vaccination averted 154 million deaths, including 146 million deaths among children. Several additional studies on vaccine effectiveness show that vaccines improve infant safety, contribute to a healthy society, and even reduce cancer risk. Vaccines work for an individual and society.  The data show that many vaccines can reduce mortality by 99% or more. Unfortunately, global immunization has been a victim of its own success because people have forgotten how deadly and dangerous the diseases vaccines protect against can be.

Vaccine effectiveness is overshadowed today by misinformation about vaccine safety, changing vaccine administration timelines, and mixed public health messaging. What are the outcomes of the recent relaxed vaccine message? The number of measles cases has jumped.  Fifty-nine cases were reported in 2023.  In 2025, 2242 cases were reported.  For additional perspective, an article published in the 2007 edition of JAMA listed the number of deaths pre-vaccine release and the number of deaths post-vaccine release.  The findings are remarkable.

The recent Centers for Disease Control and Prevention (CDC) change to the childhood vaccine schedule reduces routine protection against 13 childhood diseases to 7, with shared decision-making now required for the remaining 6.  Diphtheria, tetanus, acellular pertussis (DTaP; Tdap), Haemophilus influenzae type b (Hib), Pneumococcal (PCV), Inactivated poliovirus (IPV), Measles, mumps, rubella (MMR), Varicella (VAR), and Human papillomavirus (HPV – changing from 2 doses to 1 dose) are now part of the routine vaccine schedule. 

Rotavirus, COVID-19, Influenza, Hepatitis A, Hepatitis B, Meningococcal ACWY, and Meningococcal B are now grouped in a shared-decision-making model. Traditionally, when changes are made to the vaccine schedule, they are made with much deliberation, study, and expert input from multiple agencies and governing bodies.  However, this recent change, however, did not follow the normal study path.  This is concerning because changes are proposed without proper study of the immediate and long-term consequences.

Vaccines have been shown to be safe, with most patients experiencing very minor side effects. Normal reactions from vaccinations include low-grade fever for 24-48 hours.  A low-grade fever and minor muscle aches signal the body's immune response.  Tenderness and redness at the injection site are other normal reactions from immunization and should last from 24-48 hours.  There is no proof that thimerosal (a preservative historically used in vaccines) causes adverse reactions.  Additionally, thimerosal has been removed from most vaccine preparations used today.  Vaccines do not overwhelm a child’s immune system.  Children are exposed to hundreds of antigens daily.  A WHOLE pediatric vaccination schedule exposes them to around 50 antigens.  There is NO evidence to support altering or delaying the American Academy of Pediatrics vaccination schedule. This does NOT increase safety; it DECREASES protection at a time when infants and children are most vulnerable.

How can consumers of healthcare information, in particular, vaccine information, find reliable, trustworthy, educated guidance? Since the June 2025 changes in CDC personnel have resulted in less qualified members of the Advisory Committee on Immunization Practices (ACIP), it is generally best to rely on non-governmental sources such as the American Academy of Pediatrics, American College of Gynecologists, the Infectious Disease Society of America, and the Vaccine Integrity Project for vaccine advice.  Additionally, discuss vaccine efficacy and safety with your doctor.

For More Information:

Contribution of vaccination to improved survival and health: modelling 50 years of the Expanded Programme on Immunization - The Lancet

Vaccination greatly reduces disease, disability, death and inequity worldwide - PMC

The New Federal Vaccine Schedule for Children: What Changed and What Are the Implications? | KFF

JAMA 2007; 298:2155-2162 

Visit your doctor regularly and listen to your body.     

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

EVERY SUNDAY in "The Sunday Times" - Read Dr. Paul J. Mackarey “Health & Exercise Forum!” in hard copy

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 in Scranton and Clarks Summit. Dr. Mackarey is in private practice and is an associate professor of clinical medicine at Geisinger Commonwealth School of Medicine. For all of Dr. Mackarey's articles, visit our exercise forum!

Part II of II

Patients often tell me that they would like to exercise but hesitate due to their knee or hip pain. They want to know what they should avoid, how to prevent and what is recommended to prevent or limit the progression of arthritis. Osteoarthritis (OA) is also known as degenerative arthritis. It is the most common form of arthritis in the knee. OA is usually a gradual, slow and progressive process of “wear and tear” to the cartilage in the joint which eventually wears down to the bony joint surface.

It is most often found in middle-aged and older people and in weight bearing joints such as the hip, knee and ankle. It causes gradual onset of pain, swelling and stiffness in the joint involved, especially after increased activity. While diet and exercise help, some people are more likely to develop OA based on previous trauma or injury, labor intensive occupations and genetics. Either way, we all get OA to some degree but there are a few things you can do to limit wear and tear to your joints.

However, OA is not an excuse to avoid exercise, but it is important to be smart about it. Regular exercise is essential to maintain a normal lifestyle for those with OA. However, if you make poor lifestyle choices, do the wrong exercise, use poor technique, or are too aggressive, you could flare-up your joints and do more harm than good.

1. Don’t Burn the Candle at Both Ends
   • Poor sleep can affect your joints. One study found that people with arthritis felt more pain after restless nights. One theory is that when you don’t sleep well, it triggers inflammation in your body, which may lead toOA over time.
2. Don’t Slouch and Slump
   • Posture matters. Sit up straight. When you slump in your chair, it puts more stress on your muscles and joints and tires them out. Two good posture stretches are making a double chin by bringing your head over your shoulders and the second is pinching your shoulder blades together.
3. Don’t Ignore Pain
   • The exercise mantra “no pain, no gain” may be appropriate for a young healthy athlete, however, it may prove counterproductive for most of us. It’s true that some muscle soreness is OK, but not if it lasts for days or if your muscles are swollen or too sore to move or to touch. Joint pain isn’t normal, so pay attention to it. If you think you overdid it, ease up on your exercises. If the pain won’t go away, check with your doctor.
4. Don’t Overdo Computer Time
   • It can literally be a pain in your neck -- and your elbows, wrists, back, and shoulders. The problem isn’t just bad posture, but that you hold it for too long. That overworks your muscles. It also puts pressure on the discs in your back. Set up an ergonomic workstation. If you’re in a soft chair, prop up your arms with cushions to take the load off your shoulders and your neck. Be sure to get up and move every hour.
5. Don’t Get Rigid and Repetitive in Your Exercise Routine
   • If you perform the same exercise, sport or activity every day, you use the same muscles and joints repeatedly. Remember, overtraining problems commonly occur in single sport athletes. Mix in fun sports and activities to break the monotony by adding fun activities such as golf, swimming, biking, skiing, hiking or playing tennis. Avoid weight bearing exercises two days in a row. Run one day, walk, swim or bike the next. Use the elliptical instead of the treadmill on various days. Limit intensity – only work out intensely 2-3 times out of 5 days per week.
6. Don’t Squat
   • Avoid squatting…deep squatting is bad for your hips and knees. Even when gardening, use a kneeling pad instead of bending down and squatting.
7. Don’t Smoke and Chew Tobacco
   • Nicotine from cigarettes and chewing tobacco cuts down on blood flow to your bones and to the cushioning discs in your back. It limits how much bone-building calcium your body can take in. It also breaks down estrogen, a hormone you need for bone health. And it slows new growth that thickens bones…which can lead to OA and osteoporosis.

SOURCES: WebMD, University of Pennsylvania

Visit your family doctor regularly and listen to your body.

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

EVERY SUNDAY in "The Sunday Times" - Read Dr. Paul J. Mackarey “Health & Exercise Forum!” in hard copy

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 in Scranton and Clarks Summit. Dr. Mackarey is in private practice and is an associate professor of clinical medicine at Geisinger Commonwealth School of Medicine. For all of Dr. Mackarey's articles, visit our exercise forum!

It is no surprise that the most common New Year Resolution is to be healthier…eat less, exercise more, etc. However, health is multidimensional! To be truly healthy, one must have a healthy mind, body and spirit! It is well documented and established that exercise and diet contribute to your physical health, and mentally, the brain is healthier by avoiding toxins such as tobacco, drugs and alcohol, while the spirit is healthier by being mindful, spiritual and meditative. Unfortunately, less attention is paid to other critically important aspects of health: the unhealthy impact of negative visceral emotions such as hate, jealousy, and anger.

Considering our present divisive social and political climate in the United States and globally, I find myself in constant search to understand the pervasive hate and division which seems to be, not only prevalent, but acceptable. I have attempted to read books such as “The Science of Hate,” by Matthew Williams,  about the science of hate and survival, “Demon Copperhead,” by Barbara Kingsolver, about those marginalized and left behind, ”The Demon of Unrest,” by Erik Larson, about the history of our national political division preceding the Civil War and its relevance in the present, and watch TED Talks podcasts and television specials such as those presented by WVIA Public Media in a special series “We Stand Against Hate.”

All of this, to no avail! I failed in my effort to understand the unthinkable: We hate individuals whom we have NEVER even met. We hate groups of people through unfounded generalizations. We hate because of color, creed, stature, rank?!?! At the end of the day, I just don’t get it! Fortunately, I was not born with the “hate gene” and may never fully understand. But what I do understand is that HATE IS UNHEALTHY! So, if you want to be truly and completely healthy this new year, work on your hate!

What Is Hate? (Everydayhealth.com Laura Williams)

The word “hate” is thrown around more often than the actual emotion is felt. The statement “I hate broccoli” is rarely accompanied by the strong negative emotion of true hatred. Even strong feelings of anger or disgust are not the same as hate. According to Laura Williams, clinical psychologist “Hate is a profoundly intense and enduring dislike for someone or something. Hate can be tenacious, and often has roots in mistrust, fear, or (lack of) individual power, and vulnerability.”

It can be hard to distinguish hate from other powerful negative emotions that you may be feeling at the same time. Some psychologists say what makes hate different is that it’s directed toward who or what someone or something is, rather than what they’ve done.

The negative physiological, physical health, mental and emotional effects of hate are well documented by many sources including the National Institutes of Health.

Physiological Effects of Hate:

• Hormonal Surge: Hate activates your stress response, releasing cortisol and adrenaline, which raise heart rate, blood pressure and blood sugar.
• Increased Inflammation: Chronic stress from hate causes widespread inflammation, damaging tissues and organs over time.
• Nervous System Overload: Hate overstimulates the nervous system, leading to restlessness and heightened states of alertness.

Physical Health Effects of Hate:

• Cardiovascular Problems: Higher blood pressure and chronic stress increase the risk of heart attacks and stroke.
• Digestive Issues: Inflammation and stress can lead to stomach pain, irritable bowel syndrome and other gut problems.
• Weakened Immune System: A suppressed immune system makes you more susceptible to infections and illnesses.
• Physical Tension: Involuntary clenching of the jaw, grinding teeth and tense muscles are common.

Mental & Emotional Effects of Hate:

• Anxiety & Depression: Hate is often rooted in fear and helplessness, which can fuel anxiety, depression and obsessive thoughts.
• Exhaustion/Fatigue: Maintaining hate is mentally taxing, draining energy and leading to a constant state of agitation.
• Behavioral Changes: Hate can manifest in angry outbursts, violence, or social withdrawal, which can negatively affect relationships.

Ultimately, hate creates an internal state of emergency which demands significant physical and mental resources and leads to wear-and-tear on your entire system. Letting go of hate is a form of self-care that promotes relaxation and long-term well-being.

Tips to Deal With Hatred: (PsychMatters, Joanna Kleovoulou, Clinical Psychologist)

• Acknowledge that you are full of hatred. Examine your prejudices. If you can admit that you are feeling hateful, then you can begin to deal with this emotion and find a solution to the problem.
• Understand why you are feeling hate. Look within yourself and ask why you are upset. Hatred usually comes from a place of fear, insecurity or mistrust.
• Try to catch yourself in your hatred. The mind in its ego state, will perpetuate it by saying confirming labelling statements such as “She’s really such a @*&?*.”
• Stop yourself - When you catch yourself in these phrases, words or actions, stop yourself, recognize that it just feeds your hatred and builds up more anger.
• Take a step back. In the heat of the moment, it can be hard to make wise decisions. Take a break, go for a walk or practice meditation until you have calmed down. Take deep breaths and allow yourself to relax. Once your mind is calm, you can and will be able to control your emotions in a more efficient manner, bringing perspective to your thoughts and feelings.

• Build connections with people outside your normal social group. Volunteer at a local soup kitchen or food bank.
• Deal with it. Instead of ignoring the issue, try to find a solution to the problem. If the situation is beyond your control, try to resolve it in your head by shifting your mindset. You may not be able to change a particular person or situation, but you can change how you think about them. Join “Emotions Anonymous” a 12-step recovery program. 
• Support victims of hate. Speak out within your personal network and through social media against acts of hate. Join support groups. VictimConnect Resource Center 1-855-4VICTIM; National Advocacy Groups such as Southern Poverty Law Center.
• Talk to someone you trust as talking to a close friend, family member or a psychologist about something painful can help to alleviate the negative feelings you are having. They can often offer valuable advice or guidance.

2026 is a great opportunity to be truly healthy…eat well, exercise more and rid yourself of hate!

Visit your family doctor regularly and listen to your body.     

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

EVERY SUNDAY in "The Sunday Times" - Read Dr. Paul J. Mackarey “Health & Exercise Forum!” in hard copy

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 in Scranton and Clarks Summit. Dr. Mackarey is in private practice and is an associate professor of clinical medicine at Geisinger Commonwealth School of Medicine. For all of Dr. Mackarey's articles, visit our exercise forum!

NEW YEAR’S RESOLUTION: GET A “RUNNER’S HIGH” ON LIFE!

The number one New Year’s Resolution in the United States is to lose weight. A close second is to gain control over one’s life. One of the best ways to lose weight is thought diet and exercise. It can also be a very effective method to begin taking control of one’s life. This is especially true for those suffering from stress, anxiety and depression. This year make your New Year’s Resolution to “Get a Runner’s High on Life!”        

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 – not to mention burn calories.

Physical activity, specifically aerobic exercise, while well known for its importance to one’s physical well-being has also been scientifically proven valuable for preventing and easing stress, anxiety and depression. Studies have found improvement in mental health for 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 group in counseling.

EXERCISE FOR PHYSICAL HEALTH:

• Loss or Maintained Body Weight
• Reduces LDL /Raises HDL Cholesterol
• Improves Circulation and Blood Pressure
• Reduces Risk of Heart Disease
• Prevents Bone Loss
• Reduces Stress/Muscle Tension
• Lowers Risk of Depression
• Improves Sleep Pattern
• Improves Strength and Flexibility
• Improves Balance/Reduces Risk of Falls
• Improves Immune System
• Improves Pain Threshold

EXERCISE FOR MENTAL HEALTH:

• Helps a person gain control over their lives
• Increases self-esteem
• Diverts attention away from worry, concern or guilt
• Improves mood – with visible signs of improvement in physique & body weight
• Increases sense of pleasure and satisfaction
• Anger management – release pent-up frustration, anger and hostility
• Increase in brain serotonin (natural mood elevator chemical in brain)
• Increase in beta-endorphins (natural mood, stress & pain control chemical in brain)
• Improvement in natural sleep patterns

HOW TO BEGIN EXERCISE TO GET THE “RUNNER’S HIGH” ON LIFE:

• Consult your primary care physician. Be sure that your symptoms are not related to other health problems. Also, if you are using antidepressants or other medications discuss the impact it may have on your exercise program with your physician.
• Recognize and fight stress, anxiety and depression symptoms that are contrary to or prohibit physical activity such as: fatigue, lack of energy, slow motor skills. Work hard to recognize and overcome these symptoms to begin an exercise program. An aerobic exercise routine should eventually lessen these symptoms.
• Be realistic. Expect that aerobic exercise will take time to have a noticeable benefit. Do not get overly ambitious and set yourself up for failure.
• Begin with an aerobic exercise program that is practical and destined to succeed. For example: inactive and deconditioned people should begin walking 5 minutes per day, 3-5 days per week for 1 week. Then, add 3-5 minutes each week until you attain 30-45 minutes per walk 3-5 times per week. Younger and fitter people can begin to walk for 15 minutes and continue until they attain 45-60 minutes per walk, 3-5 times per week. Remember, what seems impossible today will be easier and become routine in 3-4 weeks so JUST DO IT!

• Find a pleasurable environment: a beautiful park (Nay Aug), a scenic lake (Lake Scranton), quiet countryside (rural farmlands of Dalton). Use a mall in inclement weather.
• Find a friendly, uplifting group or individual to walk, talk and exercise with. This may be more appropriate for people feeling isolated or withdrawn. Others may enjoy the peace and quiet of exercising and meditating alone.
• Be specific and compliant! Make a serious commitment. Keep a journal or exercise log. Mark a calendar. 30-45 minutes, 3-5 days per week – NO EXCUSES! Get and exercise buddy you can count on and help keep you compliant!
• Make it fun! Mix it up. Walk 3 days, swim or bike 1-2 days, some days alone, some days with a buddy.
• BE RELIGIOUS! Be religious about exercise BUT don’t get too compulsive!

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

EVERY SUNDAY in "The Sunday Times" - Read Dr. Paul J. Mackarey “Health & Exercise Forum!” in hard copy

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 in Scranton and Clarks Summit. Dr. Mackarey is in private practice and is an associate professor of clinical medicine at Geisinger Commonwealth School of Medicine. For all of Dr. Mackarey's articles, visit our exercise forum!

It will lead to a Healthy Mind, Body, Spirit!

Happy Holidays! Despite political divisions and war in the Middle East and Ukraine, it is at this time of year that we celebrate life with great hope and faith. People of many faiths take time to reflect, respect, and resolve. Christians celebrate Christmas, the miraculous birth of Christ, the Son of God, and the Messiah. Jews celebrate Chanukah, the miraculous festival of lights, when one night’s oil provided enough light and safety for 8 nights. Both major faiths promote healthy lifestyles for the mind, body and spirit. These faiths are grounded in hope, faith, love and peace. It is no surprise that studies repeatedly demonstrate that faithful and spiritual people live longer and healthier lives! At this turbulent time in the world, it is important to note that people of all faiths benefited equally!

I purport that to be truly healthy; one must have faith because complete health is multidimensional. Socrates preached this message to his students thousands of years before Christ. One must have a healthy mind, which requires intellectual stimulation with attainable goals related to education and intellect. One must have a healthy body by eating well, engaging in physical activity and having attainable goals related to his/her body. Likewise, one must have a healthy spirit with faith, hope, prayer and meditation, comrades and counsel, and set attainable spiritual goals.

5 Health Benefits of Religion and Being Spiritual….(health.com)

Being religious or spiritual has been shown to benefit your mind, body and spirit…

• Healthy Blood Pressure
  • High blood pressure (hypertension) can lead to heart disease and stroke, which are the leading causes of death in the United States, according to the Centers of Disease Control (CDC). It affects 1 in every 3 adults and only half of these people have their blood pressure under control. Well, religion and spiritually may help …
  • The health benefits of religion or spirituality are well documented.  One study conducted at Duke University Medical Center on 4,000 subjects, (older adults) who described themselves as religiously active were 40% less likely to have high blood pressure when compared to those less active. Moreover, they were surprised to find that those who described themselves as spiritual rather than religious also were less likely to develop high blood pressure.
• Greater Sense of Satisfaction
  • Research also indicates that religious people are more satisfied with their lives than those without faith. A sociology study determined that high satisfaction among church goers may be due to the strong social bonds that are developed within a religious congregation. Regular church attendees see the same people weekly and often more often, when participating in rewarding and gratifying church-related volunteer work.

• Greater Tolerance for Adversity
  • In an impressive study published in the Journal of the American Medical Association, researchers interviewed 345 late-stage cancer patients to assess their spirituality as it related to their illness. 88% stated that they were religious as it related to their coping mechanisms. It was determined that those using religion for coping demonstrated a 7.4% rate of resuscitation as compared to 1.8% for those not using religion as a coping mechanism.   
• Stronger Immune System
  • According to a Duke University study of 1,718 older adult participants, those described as “highly spiritual” were 50% less likely to have high levels of anti-inflammatory proteins that weaken the immune system and have been linked to some cancers, viral infections and autoimmune diseases. The outcome was similar for those who attend religious services at least once a week.  
• Greater Longevity
  • Those who attend religious services more than once per week are found to live an additional 7 years when compared to those who never attend services. Again, researchers feel that the social benefits of belonging to a strong religious community may be a large part of the associated longevity. Additionally, the lifestyle of religious people is often healthier: members of these communities rarely engage in risky and unhealthy behaviors such as smoking, excessive drinking, indiscriminate, unprotected sex, etc.

Visit your doctor regularly and listen to your body.     

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

EVERY SUNDAY in "The Sunday Times" - Read Dr. Paul J. Mackarey “Health & Exercise Forum!” in hard copy

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 in Scranton and Clarks Summit. Dr. Mackarey is in private practice and is an associate professor of clinical medicine at Geisinger Commonwealth School of Medicine. For all of Dr. Mackarey's articles, visit our exercise forum!

Pediatricians and the American Academy of Pediatrics Recommend Parents Use Good Judgment

The American Academy of Pediatrics (AAP) cited studies suggesting that heavy use of electronic media may interfere with children’s speech and language development replace important playtime with parents and lead to obesity. Studies also have found that more than 90 percent of U.S. kids have used mobile devices and most started using them before age 1. The pediatricians’ group recommends no screen time for children up to age 2. Moreover, they recommend total screen time, including TV and computer; use should be less than one hour daily for ages 2 and older. Pediatricians don’t want parents to overreact. They understand that a little screen time on occasion is not likely to harm a child, especially if they are typically active and creative most of the day.

Dramatic increases in virtual education and toys powered by artificial intelligence (AI) make purchasing toys even more challenging. This may be the year to consider safe and appropriate gifts that promote physical activity. The academy’s website offers suggestions on ideal toys for young children, including balls, puzzles, coloring books and card games. Visit: AAP.org or HealthyChildren.org, the official parenting website of the AAP.

American Academy of Pediatricians Toy Recommendations:

Giving gifts to children is a favorite part of the holidays, whether they're wrapped under a tree or exchanged with the lighting of a candle. When choosing a toy for a child, the American Academy of Pediatrics recommends the toy be appropriate for the child's age and stage of development. This makes it more likely the toy will engage the child – and reduces the risk it could cause injury. Below are some additional tips from the AAP on toy selection and safety:

• Appropriate: Select toys to suit the age, abilities, skills and interest level of the intended child. Toys that are too advanced will frustrate your child and may pose safety hazards for younger children.
• Developmental: When choosing gifts for babies and toddlers, consider toys that will build developmental skills. Toys that can be manipulated, such as shape sorters, stacking blocks, and baby-safe puzzles, are great for developing fine motor, cognitive, and perceptual skills. For more tips on choosing toys for babies, visit HealthyChildren.org “toy selection.”
• Purpose: If you are considering a digital device for a child or teen, such as a tablet, smart phone or game system, think about the purpose of the device and the rules you want to set around its use. For more information, see these tips on HealthyChildren.org “mindful technology use” and “digital media use for young children.”
• Batteries/Magnets: Be cautious about toys containing button batteries or magnets. Children can have serious stomach, throat and intestinal problems – including death – after swallowing button batteries or magnets. In addition to toys, button batteries may be in musical greeting cards, remote controls, hearing aids, and other small electronics. Small, powerful magnets may be part of building toy sets. Keep button batteries and magnets away from young children and call your health care provider immediately if your child swallows one.

• Electrical: To prevent burns and electrical shocks, do not give children under age 10 a toy that must be plugged into an electrical outlet. Instead, buy toys that are battery-operated.
• Small Pieces: If you are buying a gift for a young child, look for toys without small pieces. Young children can choke on small parts contained in toys or games. Government regulations specify that toys for children under three cannot have parts less than 1 1/4 inches in diameter and 2 1/4 inches long. For more: HealthyChildren.org “how to buy safe toys.”
• Balloons: Children can choke or suffocate on broken or uninflated balloons. Do not allow children under age 8 to play with them.
• Ribbons/Strings: Remove tags, strings, and ribbons from toys before giving them to young children. Watch for pull toys with strings that are more than 12 inches long, because they could be a strangulation hazard for babies.
• Read the Label: When your child receives a gift, be sure to read the label and instructions. Warning labels give important information about how to use a toy and what is the appropriate age. Be sure to show your child how to use the toy.
• Storage: Parents should store toys in a designated location, such as on an open shelf or in a bin, and keep older kids' toys away from young children. If you use a toy box, choose one with no lid or a lightweight, non-locking lid and ventilation holes. Visit: HealthyChildren.org “toy box safety.”
• Artificial Intelligence: Toys powered by AI chatbots which interact with children are often inappropriate. For example, these chatbots can talk in depth about sexually explicit topics and inform listeners where to find knives and matches.

SOURCE: American Academy of Pediatrics (AAP); healthychildren.org

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

EVERY SUNDAY in "The Sunday Times" - Read Dr. Paul J. Mackarey “Health & Exercise Forum!” in hard copy

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 in Scranton and Clarks Summit. Dr. Mackarey is in private practice and is an associate professor of clinical medicine at Geisinger Commonwealth School of Medicine. For all of Dr. Mackarey's articles, visit our exercise forum!

The “First Thanksgiving” was in 1621 between the Pilgrims of Plymouth Colony and the Wampanoag tribe in present day Massachusetts to celebrate the harvest and other blessings of the previous year. In 1789, President George Washington, at the request of Congress, proclaimed Thursday, November 26, as a day of national thanksgiving. In 1863, Abraham Lincoln proclaimed the national holiday of Thanksgiving to be the last Thursday of November.

Americans and Canadians continue to celebrate this holiday as a time for family and friends to gather, feast, and reflect upon their many blessings. Like most, I am very grateful for the simple things, family, good friends, food, shelter, and health. I am also thankful for the dedicated scientists who develop vaccinations and medications so we can safely enjoy Thanksgiving with our families. It turns out that being grateful is not only reflective and cleansing; it is also good for your health!

Grateful people are more likely to behave in a prosocial manner, even when it is not reciprocated. A study by the University of Kentucky found those ranking higher on gratitude scales were less likely to retaliate against others, even when others were less kind. Emmons and McCullough conducted one of the most detailed studies on thankfulness. They monitored the happiness of a group of people after they performed the following exercise:

There are many things in our lives, both large and small, that we might be grateful about. Think back over the past week and write down on the lines below up to five things in your life that you are grateful or thankful for.” The study showed that people who are encouraged to think of things they’re grateful for are approximately 10% happier than those who are not.

7 Proven Health Benefits of Being Grateful:

1. Being Grateful is Contagious!
   • Studies show that something as simple as saying “thank you” to a stranger holding a door open for you or sending a co-worker a thank you note for helping you with a project makes them more likely to continue the relationship. Showing gratitude can improve your life by fostering solid friendships.
2. Being Grateful Improves Physical Health
   • Research has found that those who are grateful experience fewer aches and pains and tend to report that they feel healthier than most people. Moreover, grateful people are more likely to be health conscious and live healthier lifestyles.
3. Being Grateful Improves Psychological Health
   • Multiple studies have demonstrated that gratitude reduces many negative emotions. Grateful people have less anger, envy, resentment, frustration or regret. Gratitude increases happiness and reduces depression.
4. Being Grateful Fosters Empathy and Reduces Aggression
   • Participants in a study by the University of Kentucky found that those who scored higher on gratitude scales were less likely to retaliate against others and were more sensitive and empathetic when compared to low gratitude scorers.
5. Being Grateful Promotes Better Sleep
   • A study published in Applied Psychology, found that 15 minutes of writing down a gratitude list before bed led to better and longer sleep.
6. Being Grateful Improves Self-Esteem
   • When studying athletes, it was determined that those who scored high on gratitude scales demonstrated improved self-esteem which led to optimal performance. Conversely, those athletes who were not grateful and resented contemporaries making more money, for example, had lower self-esteem and negative performance outcomes.
7. Being Grateful Improves Mental Strength
   • Research has repeatedly shown that gratitude not only reduces stress, but also improves one’s ability to overcome trauma. For example, Vietnam veterans who scored higher on gratitude scales experienced lower incidences of post-traumatic stress disorder. Recognizing all you have to be thankful for, even during the worst times of your life, fosters resilience.

Conclusion:

Amy Morin, psychotherapist, mental health trainer and bestselling author offers this advice: “Developing an “attitude of gratitude” is one of the simplest ways to improve your satisfaction with life. We all have the ability and opportunity to cultivate gratitude. Simply take a few moments to focus on all that you have, rather than complain about all the things you think you deserve.” So…be grateful and have a happy Thanksgiving!

Source: NIH, Forbes, Amy Morin “13 Things Mentally Strong People Don’t Do.”

Visit your doctor regularly and listen to your body. Keep moving, eat healthy foods, exercise regularly, and live long and well!

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

EVERY SUNDAY in "The Sunday Times" - Read Dr. Paul J. Mackarey “Health & Exercise Forum!” in hard copy

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 in Scranton and Clarks Summit. Dr. Mackarey is in private practice and is an associate professor of clinical medicine at Geisinger Commonwealth School of Medicine. For all of Dr. Mackarey's articles, visit our exercise forum!

September is National Yoga Month - A Good Time to Begin!

 Healthy Mind, Body, and Spirit!

September is National Yoga Month! It is hard to believe that yoga, which is now a cultural mainstay, was once considered a foreign practice.  An ancient discipline that totes numerous health benefits, it is meant to cultivate inner peace, enlightenment, and a strong relaxed body. In the past, only major cities housed yoga studios but over time it has spread into small towns across the country.  Studios offer a variety of classes and each promotes their own unique philosophy. Whether you are looking for a new workout regime, compliment to your current program or simply to quiet your mind in a hectic world, yoga may be an option for you.

What is yoga?

Yoga is a discipline that developed over 5,000 years ago and is generally recognized as an ancient system for wellbeing. The word yoga, from the Sanskrit word “yuj”, literally means to yoke or to bind together.  The primary focus is to harmonize or unite the mind, body, and spirit through a combination of poses, breathing techniques, and meditation.

Where did it come from?

The specific origin of it is a topic of debate.  However, it is said to have originated in India and was brought to the Western world by gurus in the late 19^th and early 20^th centuries. The basis for most current practices is The Yoga Sutras of Patanjali.  In The Yoga Sutras, eight limbs of yoga are specified. The three most common limbs are meditation, pranayama or breathing exercises, and asana which are the physical poses.  Classes can vary greatly, however, most classes include a combination of meditation, breathing exercises, and physical postures.

Types:

There are numerous styles of yoga.  If you are a newcomer, deciding on a class may be difficult.  It is always a smart idea to call a studio before attending a class to gain information and have any questions answered.  Furthermore, if you have any health concerns you may want to consult your doctor prior to trying a new form of exercise.  Some common forms include but are not limited to:

• Hatha - Hatha yoga is a general broad-based term referring to any type of yoga that teaches physical postures. Typically, one will find Hatha classes to be slow and gentle and a great option for beginners.
• Vinyasa - This type of yoga focuses on the coordination of breath with movement. In Vinyassa classes, you can expect a continuous flow of movement from one posture to the next.  Classes can be fast paced and are often appealing to those looking for a more strenuous workout.
• Iyengar - Unlike Vinyassa, this type of yoga focuses on holding postures for a period of time to bring the body into it’s best alignment.  If you attend this type of yoga class you can expect to use props including yoga blocks, blankets, and straps.

• Ashtanga -  This type of yoga follows a specific sequencing of postures. This rigorous form of yoga always performs the same postures, in the same order at each class and is typically fast paced.
• Bikram - Typically performed in rooms heated to 105 degrees Fahrenheit and 40% humidity, the heat warms muscles and allows a deeper stretch. The difference between Bikram and Hot yoga is that Bikram follows a specific sequence of 26 poses from which hot yoga often deviates.
• Yin Yoga - This meditative practice is perfect for those who want to calm their mind. In this type of yoga, poses are held for 5 minutes or longer.  The purpose is to apply a deep stretch to the connective tissue (the tendons, fascia and ligaments) to improve flexibility.
• Restorative - Best for those who want to focus on relaxing and taking some time to slow down. Most restorative yoga classes will be slow moving with longer hold times to allow deep relaxation.  

Basic Poses:

Below you can find a few common poses or asanas that can be found in beginner classes.  These poses promote flexibility and strength and can be incorporated into your everyday workout routine. Remember, before you attempt the poses, begin by walking, biking or running to warm up. Don’t overstretch, perform slowly, and hold the position. You should feel  mild discomfort NOT pain.

Where to Practice:

There are a lot of options when it comes to where to start to practice. It is important that the studio you choose employs certified yoga instructors who have completed comprehensive training.  A good instructor can make all the difference in your experience. The studio should provide a clean environment and offer a variety of classes including beginner level if you are a newcomer.  The best way to get a feel for a studio is to stop in for more information.  You may want to ask about pricing as there are often discount introductory rates.  Ask about rentals if you do not own a yoga mat and request to see the space.  Some yoga studios have a strong sense of community while others are more like a gym. Try out a few different places until you find a fit for you.

Guest Columnist: Catherine Udomsak, PT, DPT | Model: Sarah Singer, PTA

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

EVERY SUNDAY in "The Sunday Times" - Read Dr. Paul J. Mackarey “Health & Exercise Forum!” in hard copy

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 in Scranton and Clarks Summit. Dr. Mackarey is in private practice and is an associate professor of clinical medicine at Geisinger Commonwealth School of Medicine. For all of Dr. Mackarey's articles, visit our exercise forum!

September is National Yoga Month - A Good Time to Begin!

Healthy Mind, Body, and Spirit!

Part I of II

September is National Yoga Month! It is hard to believe that yoga, which is now a cultural mainstay, was once considered a foreign practice.  An ancient discipline that totes numerous health benefits, yoga is meant to cultivate inner peace, enlightenment, and a strong relaxed body. In the past, only major cities housed yoga studios but over time yoga has spread into small towns across the country.  Studios offer a variety of classes and each promotes their own unique philosophy. Whether you are looking for a new workout regime, compliment to your current program or simply to quiet your mind in a hectic world, yoga may be an option for you.

What is yoga?

Yoga is a discipline that developed over 5,000 years ago and is generally recognized as an ancient system for well-being. The word yoga, from the Sanskrit word “yuj”, literally means to yoke or to bind together.  The primary focus of yoga is to harmonize or unite the mind, body, and spirit through a combination of poses, breathing techniques, and meditation.

Where did it come from?

The specific origin of yoga is a topic of debate.  However, it is said to have originated in India and was brought to the Western world by yoga gurus in the late 19^th and early 20^th centuries. The basis for most current yoga practices is The Yoga Sutras of Patanjali.  In The Yoga Sutras, eight limbs of yoga are specified. The three most common limbs are meditation, pranayama or breathing exercises, and asana which are the physical poses.  Yoga classes can vary greatly, however, most classes include a combination of meditation, breathing exercises, and physical postures.

Benefits of Yoga

So what is with all the hype?  Why has yoga become so popular?  Many would say it is due to its numerous mental and physical health benefits.  Research has shown that yoga, when practiced regularly, can reduces stress levels and even boost one’s immune system. Regular stretching releases tension in the body and the controlled breathing and mediation decrease anxiety. Studies show that those who practice yoga habitually can have decreased blood pressure and cholesterol making them less prone to heart disease. Other ailments which are shown to be positively impacted by yoga include insomnia, depression, and chronic pain including low back pain and headaches. Yoga is an excellent way to combat the negative effects of stress on the body and cope with anxiety and angst.

In addition to stress reduction, yoga has many physical benefits.  These include increased flexibility, strength, and balance. Those who practice yoga regularly are often less prone to injury, such as a muscle strain or tear, due to their increased flexibility. Furthermore, yoga can be an effective way to strengthen one’s core which is crucial to maintaining ideal posture and protecting the back.  For athletes, yoga can be a great way to challenge one’s balance and improve stability.  In the elderly, it is a safe way to improve overall body awareness and decrease the risk of falling.  Yoga has also been shown to improve respiration and many report an overall increase in energy when incorporating yoga into their lives.

With all of the positive impacts yoga has on the body it is easy to see why it has become such a popular form of exercise.  There are classes to meet almost all needs and most poses can be modified based on ability. Yoga can be practiced by those of all ages and all fitness levels. Whether you’re looking for a way to loosen up tight muscles or you simply wish to quiet your mind for an hour, yoga is a tool to improve and maintain health. The only thing you need is a mat and an open mind. 

Is yoga right for me?

Yoga can be practiced by anyone. From children to adults to the elderly, there are classes for all ages and abilities.  It can be a form of cross training for athletes, especially runners who tend to have tight musculature.  It also promotes balance and core stability which may be beneficial to sportspersons including football players, soccer players, boxers, etc.  Furthermore, there are classes for the elderly which focus on balance and maintaining mobility. There are even prenatal yoga classes for pregnant women to promote deep breathing, flexibility and muscle tone. 

Next Week: Types of Yoga and Basic Poses

Guest Columnist: Catherine Udomsak, PT, DPT

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

STAY TUNED for Yoga: TYPES OF YOGA AND BASIC POSES: Part II of II!

EVERY SUNDAY in "The Sunday Times" - Read Dr. Paul J. Mackarey “Health & Exercise Forum!” in hard copy

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 in Scranton and Clarks Summit. Dr. Mackarey is in private practice and is an associate professor of clinical medicine at Geisinger Commonwealth School of Medicine. For all of Dr. Mackarey's articles, visit our exercise forum!

While I fully expect to be at the “butt end” of many comments for this column, I feel compelled to address this topic at the request of several patients. It seems that many geriatric physical therapists commonly encounter patients that suffer from constipation which limits their participation in rehabilitation. Ironically, research demonstrates that exercise and activity actually help relieve constipation. 

The National Digestive Diseases Information Clearinghouse (NDDIC) reports that 3.1 million people in the United States suffer from constipation. The NDDIC further reports that this problem leads to almost 400,000 hospitalizations, 1.4 million visits to emergency rooms, 1 million prescriptions and 121 deaths each year. Constipation is defined by the Ohio University College of Osteopathic Medicine as three or less bowel movements per week. It is also estimated that more than 27 percent of the elderly are affected.

Severe constipation can result in immediate medical attention in some cases due to intestinal obstruction. In addition to infrequent bowel movements, some symptoms include: feeling poorly, weight loss, loss of appetite, abdominal distention and/or pain, and vomiting.

Risk Factors for Constipation:

• Age
• Immobility
• Inadequate fluid and fiber consumption
• Recent Surgery
• Medications such as:
  • Antihistamines
  • Antidepressants
  • Psychotropic Meds
  • Opioids
  • Calcium Channel Blockers
  • Antacids

Prevention of Constipation:

• Exercise and Mobility
  • Physical activity is one of the most important factors in preventing constipation. A minimum of 30 minutes of physical activity, 5 days per week helps significantly. However, if age and poor health limit activity, then frequent, short bouts of mobility and exercise are recommended. It is critical for this population to work on transfers from chair or bed to stand to maintain strength and mobility.
• Diet Rich in Fiber
  • Fruits, vegetables, and bran are essential.
• Supplements
  • With a physician’s approval, supplements such as Metamucil or Citrucel can be helpful. Stool softeners, suppositories or enemas may also be worth discussing with your doctor.

Healthy people must continue to keep active. Get into good exercise habits at a young age and continue through life. Maintaining a consistent schedule of eating and exercise is also helpful. Some simple suggestions for beginning an exercise program for prevention of constipation in the healthy population are:

• Get your physicians approval
• Consult with a physical therapist to set up a program for your needs
• AEROBIC EXERCISE:
• Buy good running sneakers – not walking shoes
• Plan to exercise 3-5 times per week for 30-35 minutes
• Walk for aerobic fitness
• Begin 5-10 minutes and add 1-2 minutes each session
• Walk in a mall if it is too hot or too cold
• WEIGHT TRAINING:
• Use light dumbbells, sandbag weights and resisted bands
• Begin with 5-10 repetitions and add 1-2 reps each session
• Alternate weight training days with walking days

Depending on your general health and ambulatory status, these endurance exercises may be appropriate for you. Therefore, consider one or two of the following as a good starting point:

• Walk Around the House – Start walking around the house for 1-2 minutes nonstop.
  • Every 1-2 hours. Then, add 1-2 minutes every week.
• Static Marching – hold onto the countertop or back of chair and march in place for 30 seconds.
  • Rest 1-2 minutes and repeat. Do 5 cycles. Add 5-10 seconds every week.
• Climb the Steps – If you can do so safely, use the steps for exercise 1-2 times per day.
  •  Then, add 1-2 times per day.
• Walk the Mall/Treadmill – If you are able to get out of the house and can tolerate more extensive endurance exercises, get out and walk the malls or use a treadmill.
• Recumbent Bike – If balance is a problem, but you can tolerate more extensive endurance exercise, use a recumbent bike (a bike with a backrest)

IN CONCLUSION: KEEP MOVING YOUR BODY AND YOU WILL KEEP MOVING YOUR BOWELS!  

  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!” via Blog

EVERY SUNDAY in "The Sunday Times" - Read Dr. Paul J. Mackarey “Health & Exercise Forum!” in hard copy

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 in Scranton and Clarks Summit. Dr. Mackarey is in private practice and is an associate professor of clinical medicine at Geisinger Commonwealth School of Medicine. For all of Dr. Mackarey's articles, visit our exercise forum!